Not enjoying medicine, wanting out

[BruceBanner]

I'll be honest---I do not like being a PA or healthcare in general most days. 

 

A little background: I'm in my early 30's, been practicing for a little over 2 years. First gig was in Ortho Spine---hated it---current gig is in Occ Med and disability evals. It's tolerable but in no way do I love it, and many days I hate it.

 

I did well in school, but there were no rotations that I really liked. That's when it first hit me that I may not enjoy medicine as much as I thought.

 

What I LIKE about medicine:

 

-Using my skills to help someone who TRULY needs it, i.e. injured or ill through no fault of their own.

-Diagnostics and decision-making

-The money

 

What I DON'T like about medicine:

 

-The patients: Malingerers, factitious pts, somatosizers, whiners, non-English speakers, drug seekers

-The chaos of a walk-in clinic

-Sick visits

-Mundane tasks like physicals, charting, etc

-Treating people who don't need or don't appreciate care

-Insurance dictating my scope of care

-The list goes on

 

None of this is to whine---I made the choice to get into medicine and that's a choice I have to deal with. 110% my own doing and it makes no difference if I didn't know what I was getting into. Still my fault. Sure, I could change jobs, but at this point I'm not convinced the grass is going to be greener in another specialty or in another practice. I've considered nonclinical jobs, but those are easier said than done to come by. With the immensity of student debt I have I've essentially backed myself into a corner where I need to make $80k + a year just to stay afloat. So as much as I'd love to go be a park ranger, it's not financially feasible.

 

I feel lucky to have good-paying, stable work in a respectable and competitive field; but I find myself living more and more for my days off and hating the time I'm actually at work.

 

I really don't think I'm going to get any advice I haven't already heard or thought of on my own, I just want to know if there are other PAs out there who have been through this or feel this way, and how you are dealing with it.

[PACdan]

What I DON'T like about medicine:

 

-The patients: Malingerers, factitious pts, somatosizers, whiners, non-English speakers, drug seekers

 

Your first reason says a lot.

 

Go work with kids. Cancer kids. Kids don't wanna be sick, they don't want drugs and they don't want to be there any more than you do. They're also brutally honest and that is usually funny to boot.

But you if help them, make them feel better and smile, the reward is 1,000 fold.

 

Or, remote wilderness medicine. Since you mention Park Ranger.

[winterallsummer]

Ortho spine and occ med - yeah that may be the reason why.  As the above poster said find somewhere that you will find your niche.  Don't give up so early, both those fields can be extremely draining (with some exceptions).

[cinntsp]

I wonder how much of your issue is due to the fields you have worked in.  Those are prime specialties to deal with malingerers and folks that just don't get better.  Your dislike for "sick visits" is a harder one to tackle since medicine is essentially aiding the sick. Hem/onc was a good suggestion.  None of those patients want to be patients and really appreciate you trying to give them more life or quality of life.  Work at a large institution and then you won't have to worry so much about insurance issues.

[Guest Paula]

You could volunteer your time on a medical mission trip or find a job in an underserved medically needy country that will accept PAs.  You then will be the IMG to them with skills  their medical professionals have left their country to come here for. 

[Guest Paula]

^^^^^ It makes me really sad when a PA is not happy with their job.  I love mine..... even the boring aspects of it.  The variety is good in FP.  Try a reservation job and you will never be at a loss for interesting cases. 

[Will352ns]

CIA......really.

[LKPAC]

What was your medical experience prior to becoming a PA?  Did you not know what you were getting into?

[gleannfia]

I will second some of the suggestions here. Heme/onc definitely. Wonderful patient population. Plus, a very dynamic field where you are never bored. I worked in it hope to get back in it. And, as Paula suggested, Indian health. I did an assignment with Native Americans early in my career in Oklahoma. Fascinating pathology exposure. I recall one challenging case where a 50-something woman came in with intractable headache. She had seen 2 ER docs and a community PCP, all who diagnosed migraine and gave her Demerol. An optometrist and I figured out that she had undiagnosed double angle closure glaucoma. She would have lost her sight. No one had bothered to figure out that women in their 50s do not usually develop migraines.

 

Also, I would ask if you are content in your personal life. I went through period where I absolutely hated being a P A. But I was also unfulfilled in my personal situation

 

Now, I am very grateful to have fulfilling work that pays well when so many people are under or unemployed.

[whoRyou]

Something tells me there are more people like you than we know. As you know this forum only serves only so many who know about it and participate. I hope you find some solace in perhaps another profession. But it does bring up a question, are PAs really the saints they are made out to be if they aren't truly happy?

[BruceBanner]

Thanks everyone for the replies. In response to some of the questions, prior to PA school I was a ski patrol EMT. I knew about as much as I could know about clinical medicine from that...but obviously there is a world of difference. My interests were mainly in science and diagnostics, not so much patient care.

 

My personal life is honestly great. Lots of hobbies, great girl, great family. I'm usually quite happy outside of work.

 

I never considered heme/onc or peds for that matter. I don't want kids myself but I can relate to them. They're honest. I always thought ID would be cool but there doesn't seem to be a preponderance of PAs in that area.

 

It would take something REALLY compelling to get me to give up this early. I'm no quitter by any means...but a "way out" has been crossing my mind a lot.

 

The CIA would be badass!! But I think I've enjoyed too many discretions to qualify ;)

 

Sent from my XT1028 using Tapatalk

 

[Guest Paula]

None of us are saints.

[whoRyou]

None of us are saints.

I concur Paula, but if you are someone who has had NO prior healthcare experience and has had NO real life experiences and then reads this No. 1 Best Master's Degree For Jobs: Physician Assistant Studies. People will assume we are ... Because we have this 'easy' lifestyle and making all this dough when they don't realize all the hard work that went into it - before, during and definitely after

[True Anomaly]

IN addition to the above suggestions, maybe something more procedure-based?  Being an IR PA would be pretty nice- the one at my old hospital (who worked in the ED with us for a while before transitioning to IR) only works M-F 8-5, and basically has his choice of procedures.

[UGoLong]

Changing jobs -- and even careers -- is not particularly unique. Many PAs try several positions before they find one that they like. Having changed careers in a major way several times in my life, I’ve learned some lessons that I’d like to share with you:

 

1. A bad gig colors everything bad; even the sky looks gray when you drive to work! It's important to deconstruct your job in your mind and really understand what parts of it you don’t like. 

 

You have had two PA jobs, both of which involve patients who often have chronic pain and some of whom are mainly trying to get disabilities approved. You might want to try a different type of practice. For example, I’m in cardiology, where I am mostly on my own with patients who just want to be able to live normal lives and who generally appreciate our services. And the diagnostics, procedures, and meds are interesting. Life isn't easy and the job has all of the annoying aspects of jobs everywhere. On the other hand, several times each day, I am reminded of exactly why I'm here. It's enough to keep me working when many of my cohorts are retired.

 

Or maybe you’ve just had two bad physicians in a row. Whatever. Try to figure out what’s good and what’s bad.

 

2. To do something new, you have to leave room for it to grow. This I believe with all of my heart. When you are in a difficult situation with lots of demands on your time, there is little room to think, let alone try something new. Take a walk every day, track down some of your old classmates and shadow them at work, whatever. I’m a PA today because I took a hospital tour 30 years ago and later -- on an absolute whim -- decided to take a basic EMT course. It is amazing to think about all that has happened as a result and just how different my life is today than if I had stayed on my original path.

 

3. If you’re thinking about being something other than a PA, go for it. Just take a small step in a direction of interest and see how it feels. You don’t have to leap off a cliff to make a change. Each small step either reaffirms your goal or gently directs you to a new course. 

 

I was an engineer, a manager, and a management consultant full-time for 20 years while simultaneously helping to raise three kids, working nights as a volunteer and part-time paid EMT (and later paramedic), and taking night classes before I left to go to PA school. And I was 10 years along this path before I even knew what a PA was!  

 

4. Finally, it’s OK not to know where you’re headed. Try new things if only to see how they make you feel. Dissatisfaction is not a bad guide that you’re at least somewhat off-course. Don’t curse the emotion; it can lead you in new directions. Just take it slow and see what turns up.

 

Good luck!

[physasst]

Think about Sports Med.....Patients generally want to get better, and are pretty honest. In fact, the hardest part is often getting them to slow down because they all try to speed up their recovery.

 

Mike

[SocialMedicine]

Not sure I agree a physical is mundane 

 

A private practice setting w/ private insurance and NOT in occ med or ortho would likely cut down on alot of those patient experiences you dislike. 

 

Why not try for position in health administration or consulting. Or maybe some kind of adventurous medical position like the CIA. Although my guess the CIA PA is just doing primary care in a not so desirable location rather than treating traumatic injuries in a secret spy station while dangling from a rope in an elevator shaft. 

 

You can ALWAYS find a position per diem as a PA, esp if you are willing to take a clinical salary hit to keep up your skills and experience while experimenting elsewhere. 

[GetMeOuttaThisMess]

Short response, you are not alone, and I'm right there with you. I don't know how many times I've modified this response so I'll just leave it as is.

[BruceBanner]

Thanks again for the above replies. They are encouraging.

 

Some of you may indeed be right that I am just in the wrong specialty. To be completely honest I HATE seeing most patients. I am so fast and curt just so I can get the visit over with. I'd say maybe 1 out of every 30 or 40 patient encounters is rewarding to me on some level. Usually it's a legit injury like a bad lac or an amputation. The rest of the time, though....80% of my pts are non-English speaking, almost none of them are educated, many are malingering or embellishing, and there is very little personal accountability in their own care, nor do many of them even want to get better. They have no clue what specialist they saw, what he did, what meds they are taking, etc. At first I took it in stride and made lots of jokes with colleagues, but now I cant stand them. It has killed my compassion.

 

The main reasons I have stayed with my current 2 jobs are stability and lifestyle. I work 4 days a week, never on call, never work a weekend. I need a stable gig on my CV after my first blunder in spine. My area is tough on PAs; there are jobs but they are mostly primary care gigs in overworked community clinics and workhorse jobs like neurosurg and ortho. The few appealing gigs that pop up all require 3-5 years experience in that particular specialty. So it is tough.

 

Like I said, I'm not giving up. It could be I just haven't found my niche. But right now I hate medicine.

[dmdpac]

I'd like to say thanks to the OP and everyone who responded so far.  This has been a pretty honest and thought provoking discussion so far. 

 

It seems like this may be a pretty common feeling among many especially early on in their career.  I wonder how much of this is related to still being relatively new and trying to settle in as a PA versus legitimate "I hate what I'm doing".  That could be an interesting sociological study for any PA student out there looking for a grad project.

 

I'm still trying to put my thoughts  on this particular subject in order and I haven't been able to clearly articulate them... at least to myself.  So I'll just reiterate my thanks for the honesty in the thread and leave it at that for now.

[Joelseff]

Ortho spine and occ med - yeah that may be the reason why.  As the above poster said find somewhere that you will find your niche.  Don't give up so early, both those fields can be extremely draining (with some exceptions).

 

This^^^

 

My first gig was in Spine and a lot of WC pts....I broke the hell out of there! I went into GI/Hep after and really liked it. I did a GI/HEP Tx rotation in school and felt really comfortable. I am currently in HIV and FP and love my job most days. I actually took a paycut to work here from GI and I make substantially less than what I made at spine but I am so much happier.

 

Do I get the malingerers, worried well and the whiners...of course ever hear of ACA??? I still love my job though. I knew though that i wanted FP/IM/PC even before school because most of my HCE was in in PC.

 

My advice is to switch specialties. Occ med and spine are magnets for malingerers and whiners. I used to do and document many a positive Waddell's signs.

 

Wish you the best. Get out of your current specialty!

[ventana]

Occ health and spine surgery....

 

yeah I would HATE that too, But I LOVE being a PA

 

PA is amazing in that you can use it a million different ways..... BUT you choose two of the fields with some of the most challenging, entitled, deceptive patients out there (IMHO)

 

half your patients were probably trying in some way to work the system......   they are negative engery vortexes 

 

 

Try a specialty that you think might be fun....... everyone discounts primary care, not very glorious, but man is it fun and you really get to help people.....  and you control who they see for other providers, so if you think it is surgical you send to a surgeon and get a surgical correction, if you think it is endo you send to endo...... and so on and so forth.  Due to this i think you influence the patients health  more then any other field.....

 

 

Reflect on what you like, then find the field that deliver it....

[TWR]

Bruce, Ithink your first sentence sums up your feelings. You do not like being a PA. I don't think, given your dislike list which I agree with all but the "sick visits" will change your feelings about what we do and the patient population. Medicine has changed radically, IMHO, over the last 2 decades. Beauracracy runs medicine not the clinician be it an MD, PA or NP. We have lost control and patients know this. Many are masters at working the system. After practicing for 28 years, I have come full circle and am just about ready to give up clinical medicine and do consulting to clinicians regarding the contracts and salaries they are being offered. I have owned my own practice in NYC for many years before relocating to TX. I am just not having "fun" anymore and I suspect there are many of us that feel likewise even those not practicing for decades. I love working with (most) patients but not the system we practice in. Let's face it, today it is all about the money and NOTHING else. Yes outcomes are important but the more tests and procedures you order the better!!!!!!!!! Good luck Bruce.

[GetMeOuttaThisMess]

^^^

[KMD16]

^^ I second that!