Houstonian Posted August 31, 2013 Share Posted August 31, 2013 Working 4 days a week can help enormously with burnout-- especially if Wednesday is your day off. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted August 31, 2013 Moderator Share Posted August 31, 2013 Working 4 days a week can help enormously with burnout-- especially if Wednesday is your day off. 4 tens is a very nice schedule. I did that for 2 years at my first job. m-th, every weekend a 3 day weekend. once you start working longer shifts then this at a busy place though it gets tough. I did 3 12.5 hr shifts/week at one job and it was brutal. after the 3rd day we all talked about recovery days. currently do 24s at another place which is much slower and it's not a problem. it's a very precise dance to balance shift length vs volume. at a really busy place sometimes it makes sense to have no shifts longer than 8 hrs. if slow 24 or even 48 hrs is doable if you have a call room to take a nap. Link to comment Share on other sites More sharing options...
jwells78 Posted August 31, 2013 Share Posted August 31, 2013 Bless the FP PA; you guys have it rough- and I mean that. I did a 4 month stint as a student in a FP/Urgent Care and I couldn't get out of there fast enough. One nice thing about EM- treat and street, and MOST of the time you don't see them again... Perhaps that makes me anti-social... Either way, I'm sorry for your burn out- wanted to let you know you are appreciated. Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted September 1, 2013 Moderator Share Posted September 1, 2013 Bless the FP PA; you guys have it rough- and I mean that. I did a 4 month stint as a student in a FP/Urgent Care and I couldn't get out of there fast enough. One nice thing about EM- treat and street, and MOST of the time you don't see them again... Perhaps that makes me anti-social... Either way, I'm sorry for your burn out- wanted to let you know you are appreciated. Agreed....I've never done family medicine, and I really didn't like my FM rotations either. But I seriously appreciate those of you who do it. Link to comment Share on other sites More sharing options...
Guest Paula Posted September 1, 2013 Share Posted September 1, 2013 ^^^^^^^^^ Hey, thanks it's nice to be appreciated. I hated my surgical rotation. There was no way to communicate with an anesthetized patient either before or after the surgery. Before they were so nervous, during they are out cold, and afterwards they have no idea what you just said to them as they were vomiting. LOL! Link to comment Share on other sites More sharing options...
Joelseff Posted September 1, 2013 Share Posted September 1, 2013 Agree with Paula. Mrs. PAC - you are being taken advantage of. Start looking for a different position asap and when you find one and have an offer in hand - IF and only IF you really want to stay where you are currently working - then go to the doc and present what salary and hours you think is fair. If you really do not want to stay - then give your 2 weeks or 4 weeks (max) and say thank you very much for the experience. No, you do not have to train the new employee - but if you do, I would sit this new person down and tell them the facts about the job and what they are getting into. FWIW - I have started a few bitter threads this week. But, all in all, I love my job and my patients. I am in small town KY and this is truly a family practice. In many cases, I see the husband/wife/children/grandparents/aunts/uncles/cousins - you name it. I know exactly what is going on in the family dynamics so when I have a patient coming in for depression symptoms, most likely I know the cause. I attend birthday parties, weddings, cookouts, and funerals. I cannot walk down the street without patients waving hello from their vehicles or as in the case yesterday when I went to the local courthouse - a patient opens her office window to yell hello from across the street. The people in this town are my extended family and I make sure they know it and I try to treat them as such. I am sure it would be different in a bigger city. The reasons you state above are why I love FP as well. I think we get a bad rap because FP is not sexy like EM or Surgery. Our victories with our pt's are smaller in scale as say a corrective surgery or emergency intervention. It's in the drop from a 17 A1C to an 11 in that obese diabetic who was motivated to get her numbers down or that middle aged grandpa who wanted to see their grandchild graduate high school so he worked hard on his diet and complied with meds. Little things like that get me up in the morning. I just wish it paid better lol :p Sent from my myTouch_4G_Slide using Tapatalk 2 Link to comment Share on other sites More sharing options...
matrix Posted September 5, 2013 Share Posted September 5, 2013 I am not in family medicine but agree that you deserve more pay and recognition. No one will ever thank you for preventing the stroke they never had :heheh:.. Link to comment Share on other sites More sharing options...
akjean Posted March 17, 2014 Share Posted March 17, 2014 I've been in FM for 2.5 years (first job out of PA school) seeing patients who are working but uninsured. I'm at the burnout point too. It's actually kind of nice to read this and see I'm not alone, but it's a little sad/embarrassing to be feeling this way so early on in my career. Our patient population is unique in that we are their ONLY stop for healthcare. They can't be referred out unless it's sort of critical. I feel like I am carrying the weight of my many patients on me whenever I am in the office. It wasn't this way at first, but as my patient load has increased, my stress has gone way up. My solution: I'm switching to a specialty. I thought it was a coop-out move to switch, but I've realized it's the best thing I can do for myself and my sanity. I know a lot of it has to do with the practice where I work, but I have to do something. Hope all of you have a successful transition OUT of burnout. Thankful for this community. Link to comment Share on other sites More sharing options...
primadonna22274 Posted March 17, 2014 Share Posted March 17, 2014 I too felt burned out after six years in FM. I sold my house, moved cross-country, took an EM job. More burnout a year and a half later. Changed jobs again. Taught for a couple years. About 8 years into my PA career I figured out the cure for (my own) burnout: being diversely employed. I really like being in different places on different days and having a fair bit of control over my schedule. Teaching helps, as does the validation one receives from grateful staff at "locums" locations. Keeping interested in hobbies outside of one's job helps too. Ultimately I got fed up with being taken advantage of by greedy docs and never being fairly compensated for it, and on top of that I was frustrated with the glass ceiling of being a PA, so I went back to medical school. Ironically I will most likely match in FM (my first love really). At the moment the only burnout I feel is a really bad case of senioritis and a terrible need to get paid again :) Good luck to you. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted March 17, 2014 Moderator Share Posted March 17, 2014 Agree with Prima. variety is key. my current schedule looks like this: 10 night shifts/mo at solo inner city dept, often with pa students 2-4 shifts/mo at rural ER in vacation destination site 0-4 shifts/mo at rural critical access hospital, solo coverage. high acuity, low volume. when done with my doctorate I hope to teach at a local program a few days/mo and work less at full time job. Link to comment Share on other sites More sharing options...
KMD16 Posted March 18, 2014 Share Posted March 18, 2014 I agreed w/ both of you. Variety is the way to go. Switching from nonsurgical to surgical specialty has it downside and often times not the best approach. Link to comment Share on other sites More sharing options...
SocialMedicine Posted March 18, 2014 Share Posted March 18, 2014 1) I ask all patients to mention the issues of the day at the start of visit. If they say chest pain, discuss alopecia mgmt., questions about genetic counseling etc ... I quickly say we are going to focus on the chest pain since that is life threatening. 2) I do not see drug reps. If they want to discuss their wares they can pay you to listen or take you out to an expensive dinner. 3) If a patient spends more than a 2-3 minutes talking friendly, especially if they have health issues, I redirect things and say "lets focus on your healthy we only have a limited period" "or Id rather see you health than discuss my vacation" you can be friendly and make it into a joke. 4) How will he make it difficult to leave ? Do you have a contract ? Especially since he can just see the patients himself it does not sound like you need to give him more than a month notice. It does not sound like he manages the practice well. If you like the patients so much make him an offer ... 20 patient a day max. If he does not like it walk out. Link to comment Share on other sites More sharing options...
Moderator ventana Posted March 18, 2014 Moderator Share Posted March 18, 2014 Very easy is a primary care with uninsured patients to feel like you have the weight of the world on you. You still have the ability to refer, and should. Anyone of these patients that you do not refer trying to be nice could in fact turn around and sue because you limited their care without discussion. I learned the hard way that no matter what the financial situation is of the patient you follow the same standard of care. Yes they will not be able to attend but at least you've provided the option to them. Does tend to destress you as well. Overall, and it sounds cold, stop putting so much of yourself and your job. In order to be a good provider you yourself have to be healthy and if you are letting it affect you negatively that doesn't help. I agree on the above suggestions, no drug reps, try to stay on time( less stressful), regular exercise, don't be afraid to schedule follow-ups when people come in with long lists are they just present too much information. All else fails, start your own practice( yeah that's lower stress) Link to comment Share on other sites More sharing options...
BruceBanner Posted March 25, 2014 Share Posted March 25, 2014 Old thread but lots of good responses. I too have recently been struggling with burnout. I've notice that when we have slow days, I'm fine, and being a PA ain't so bad, lol. But when we are slammed for days or weeks on end, I get irritated, short with patients, and I freaking hate being a PA. I'm also working 2 jobs so that adds to the burnout. One skill I've learned in Occ Med is cutting people off and getting to the chief complaint. If you give people too much talking space they will go on and on and you'll never get anything done. You just cant feel bad about it. You aren't their counselor, and you aren't their "everything" specialist. I start with "what brings you in today?", and if they start rambling or going down rabbit trails, I just interrupt them and say "tell me where you are hurting the most right now." I treat the chief complaint, and if I'm in doubt, I refer. Done. I agree with the others that variety and if possible part-time scheduling are key. FM, Occ Med, and ED/UC have the highest burnout rates mainly because of the volume of work and the ignorant, demanding, whiny patient population. It sucks to say but we all know it's true. Unless you LOVE your main job, I personally think working 2 or 3 part-time jobs is the way to go. You get variety and don't really get enough exposure to get burned out on any one job. Plus the pay is often better than one job alone. Link to comment Share on other sites More sharing options...
shani26 Posted March 26, 2014 Share Posted March 26, 2014 New grad: just started a job in FM with the underserved. Was definitely unprepared for the amount of BS that I would encounter. Also the amount of extremely sick and non compliant patients. I have been there 5 mos- and although I do work with a great SP ( although I only see her 2 half days a week)- worrying if I haven't done enough, whether or not I ordered the right lab, did I ask the right questions, etc. I know its really about confidence and time: sometimes I feel like I should have specialized. Some of the other PA and NP's that I worked with wished that they hadn't taken the NIH grant- which is probably why I wont. Link to comment Share on other sites More sharing options...
Febrifuge Posted March 26, 2014 Share Posted March 26, 2014 Shani: even in my Urgent Care, I see non-compliant patients. I work in the building where about half of the people who come to see me have their PCP... or at least, that's where they are supposed to come see a PCP. We also have EMR, so I know perfectly well how long it's been since their last checkup, routine labs, A1C, or whatever. When I see people who need to be more involved in their own care, I say so. I take care of whatever brought them to the UC first, but I don't skip the speech about how important it is to have someone who knows you, watches you over time, and can tell with one look at you that something isn't right. Urgent Care is a lousy substitute for primary care, and I straight-up say that. On the other hand, you can't get blood from a turnip, and people are gonna do what they are gonna do. If I were a PCP I would frame it more like "well, I have lots of education and training on the subject, plus a few really good ideas about how I would help you to be more healthy. But I'm not magic, and the effort really has to come from you. When you get serious about doing your part of it, let me know." Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted March 26, 2014 Share Posted March 26, 2014 Feb, are you in an UC that is operated by a group of PCP's, or several within the building? In other words, is the UC clinic only for the patients of that practice(s), or open to anyone? Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted March 26, 2014 Moderator Share Posted March 26, 2014 . If I were a PCP I would frame it more like "well, I have lots of education and training on the subject, plus a few really good ideas about how I would help you to be more healthy. But I'm not magic, and the effort really has to come from you. When you get serious about doing your part of it, let me know." "I just want a pill. I don't want to do any exercise or change my diet, I just want a pill to fix everything. oh, and I want it on the 5 dollar list at walmart or I won't be able to afford my cigarettes, tattoos, 60 inch flat screen, new mustang, and budweiser". Link to comment Share on other sites More sharing options...
jmj11 Posted March 26, 2014 Share Posted March 26, 2014 Having worked 7 days a week, 10-12 hour days for three years, I see burn out so far in the rear view mirror that it is over the horizon. I didn't know that the human psyche was so invincible. I thought surely by now I would have . . . did you see the movie "Falling Down?" And if I told you my compensation you would be in disbelief . . . on the low side. However, in my case, I've been offered a couple of positions lately that would double my salary and reduce my work load by 30%. Yet I declined. I think a quote by our own Michael (on his FB link) said it best. An entrepreneur is someone willing to work 80 hours per week to avoid a 40 hour week. Link to comment Share on other sites More sharing options...
whoRyou Posted March 26, 2014 Share Posted March 26, 2014 ... I think a quote by our own Michael (on his FB link) said it best. An entrepreneur is someone willing to work 80 hours per week to avoid a 40 hour week. First part, yes. Second part, unlikely ;-) Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted March 26, 2014 Share Posted March 26, 2014 Having worked 7 days a week, 10-12 hour days for three years, I see burn out so far in the rear view mirror that it is over the horizon. I didn't know that the human psyche was so invincible. I thought surely by now I would have . . . did you see the movie "Falling Down?" And if I told you my compensation you would be in disbelief . . . on the low side. However, in my case, I've been offered a couple of positions lately that would double my salary and reduce my work load by 30%. Yet I declined. I think a quote by our own Michael (on his FB link) said it best. An entrepreneur is someone willing to work 80 hours per week to avoid a 40 hour week. God bless you. I wish I were of that mindset...well, I guess I could be with skyblu in our beachside cabana with EMEDPA pulling Mai-tai duty while the happy clientele wait. :-). All kidding aside, I'm amazed (meant as a positive) at your mindset and that of others who are able to excel in such an environment. I don't mind working, I just don't want to do it as the primary purpose in my life. On second thought, THEY can provide care and I'LL tend to the Mai-tai's! Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted March 26, 2014 Moderator Share Posted March 26, 2014 On second thought, THEY can provide care and I'LL tend to the Mai-tai's! the ma-tais ARE the care we provide.... Link to comment Share on other sites More sharing options...
whoRyou Posted March 26, 2014 Share Posted March 26, 2014 the ma-tais ARE the care we provide.... Let's NOT ignore the famous margarita Especially since some of us just got back from Texas! Link to comment Share on other sites More sharing options...
Febrifuge Posted March 26, 2014 Share Posted March 26, 2014 Feb, are you in an UC that is operated by a group of PCP's, or several within the building? In other words, is the UC clinic only for the patients of that practice(s), or open to anyone? Open to anyone. Part of a large multi-specialty group/ an HMO, PPO, whatever we are. I don't recall. In Minnesota, it's been like this for decades. My clinic takes people who are members of our plan, all the others in the area, public assistance, or even no coverage/ self-pay. Also the occasional business traveler staying at one of the nearby hotels, or the out of town relative of someone who has a PCP in the building. Link to comment Share on other sites More sharing options...
Febrifuge Posted March 26, 2014 Share Posted March 26, 2014 "I just want a pill. I don't want to do any exercise or change my diet, I just want a pill to fix everything. oh, and I want it on the 5 dollar list at walmart or I won't be able to afford my cigarettes, tattoos, 60 inch flat screen, new mustang, and budweiser". "Welp, I'm not your PCP, I'm just the urgent care dude. I don't do that. Have a nice day." Link to comment Share on other sites More sharing options...
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