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Does anyone else have to room their own patients?


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I was just wondering if there are any other PAs out there that have to room their own patients and take their own vitals? Sometimes this even involves having to clean exam rooms in between patients.We have medical assistants available to assist the physicians but the physicians feel I should be "more independent".

I'm feeling abused and disrespected. Am I overreacting? Is this normal?

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What specialty are you in? This can vary widely. But in general, no, PA's do not generally room all patients. But, a good "boss" is one that would never assign a duty to someone that you wouldn't do yourself. So, when my nurse is busy doing an EKG or ear wash, I will room a pt and have them take vitals later after I do an assessment.

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I was just wondering if there are any other PAs out there that have to room their own patients and take their own vitals? Sometimes this even involves having to clean exam rooms in between patients.We have medical assistants available to assist the physicians but the physicians feel I should be "more independent".

I'm feeling abused and disrespected. Am I overreacting? Is this normal?

 

You're a student, right? I see it as a good thing to get some experience taking vitals, and getting a feel for what the MAs do. And if I could tell you the number of rooms I've cleaned in my 2000 volunteer hours ... you wouldn't be complaining.

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Meg, your status shows you as a student hence the assumption.

 

Is the fact you having to room/vital your patients the only reason you feel abused and disrespected or is it just yet another matter in the whole situation that is deeper than just rooming? Do you feel rooming your own patients slow you down enough that you lose some appointment slots, thus cutting into the billing? Does it extend your hours worked per day to the point where your hourly wage dips below that of your peers? (assuming salary wage remaining steady despite hours worked) Perhaps if you can show how the practice will benefit (seeing more patients thus billing more money)from you having assistance may help convince the physicians to kick an MA your way.

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My supervising physician told me that he has never worked in a practice where the PAs had an MA helping them. He does not feel that PAs in general should have medical assistants help them. Of course it slows me down tremendously.

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I am the only PA in the practice. All of the other surgeons have support from the MA staff. I am thinking of leaving but just wanted to see if this is really as common as my SP claims.

 

Hmmm. I have my own MA, and would never, ever be treated the way you're stating. If I were, I'd leave. To tell you the truth, it sounds ridiculous.

 

Change your profile status ... and then change your job.

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My supervising physician told me that he has never worked in a practice where the PAs had an MA helping them. He does not feel that PAs in general should have medical assistants help them. Of course it slows me down tremendously.

 

This sucks! I often have to "help out" my MA's since the turnover at my office is so FREEKIN FREQUENT my MA's are always NEW!!! I have only been there 3 mos BTW. My SP utilizes the MA's more than i do. For instance, when doing intra-articular injections, he often pulls in a MA to hold the bottle as he draws up the solution. :rollseyes: I always do it on my own unless its a female pt then I pull in a chaperon. But I digress....Your situation kinda stinks. in all the practices I was a MA at, our PA's had their own MA, as it should be. Your doc sounds like an elitist.

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I am the only PA in the practice. All of the other surgeons have support from the MA staff. I am thinking of leaving but just wanted to see if this is really as common as my SP claims.

 

I'm sure it's not doing anything to help the confusion some patients have about PA vs. MA. It sounds like your SP wants to keep you much lower on the totem pole.

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in my last job (private prctice, pretty laid back bariatric surgery), I turned over the room but it was no big deal as all I had to do was change the paper. it was my own room with my own desk, and I had 1/2 hr slots (usually, sometimes 15 mins but usually 30) for each pt. I asked for this so I would have the time to see the pt's without rushing (bariatric surgery = lots of pt issues), do their band adjustment, and write my note. changing the paper on the exam table took 2 seconds so I didn't mind. I would also re-stock my drawer out of consideration for the person using the room the next day (I was part time). there was an MA and if she wasn't checking pts in she would come in and change the paper. she also did all the autoclaving of instrucments and ordering of supplies. I really didn't mind keeping my exam room tidy. and we didn't do vitals! (one of the reasons I don't work there anymore -- it was a very sloppy practice, and a little too laid-back in terms of pt care).

 

HOWEVER...my job before that (also bariatric surgery), we had MAs and they supported me and the surgeon equally. they roomed the pts, got a brief hx and supplies ready in the room based on what the pt was coming in for, weighed the pts, calced BMI, and took vitals. it was HUGELY helpful, but also I was seeing 4 pts an hour which didn't even leave me time for documenting. it was nuts. the snotty receptionist tried to push me into rooming pts and doing what the MAs were doing, but she had issues and I basically told her to shove it (she's a receptionist!!).

 

if I had to stay later to complete documenting, I billed OT (which was in my contract).

 

I think PAs should get exactly the same support as the docs/surgs they're working for. anything less is disrespectful and an attempt to keep you lower down the totem pole. unacceptable.

 

ps I even get leery of that whole "team player" mentality which shames (us) into doing way more than we should so we never have a minute to breath, eat, etc. it's like we can never stop proving how valuable we are! I tend to say "no" when I am pressured into things outside of my job description b/c it sets a precedent for the practice to allow it more and more and move that line further and further until you're barely able to function. SORRY! if I'm being pressured to do things that are really outside of the initial hire agreement/job description/etc, I usually just say, "well, we can discuss these added duties (call, etc), but I think it will also require a new job description and an adjustment in my pay". shuts them up pretty quick, or gets you a raise. :)

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Meg,

 

It sounds to me as if your concern is not that you have to room your own patients, but that the physicians are not expected to do so as well. I am in a family medicien practice where the MAs are expected to room the patients for both my SP and for me. My SP has three exam rooms and I have two; he has a higher patient volume than I do. Despite the clear expectation that the MAs room both of our patients, I find that I often have to ask for an MA to get a patient of mine from the waiting room, and my SP has never had to ask; his rooms are always full of patients waiting to be seen, with vitals entered in the electronic record. I definitely feel a double standard; even thought the MAs are supposed to treat us similarly in preparing our patients to be seen, I have to ask - often several times per day - for my waiting patients to be roomed. And yes, on many occasions, I have simply roomed the patients myself so that I don;t get too far behind schedule. It's not that the MAs are too busy; they are simply less attentive to my needs. And this concept of overtime for medical documentation is intriguing. I estimate I spend no less than eight hours per week, and often more, completing patient documentation from home on the practice's tablet. It is currently a source of contention for me, over which I have expressed the intention to transition by the end of the year if a more equitable solution cannot be found.

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Guest Swennerb

I completely agree w the above. If the MA's are busy and you have the time to help out and room a pt or 2, that's one thing- but to completely single you out as the PA and that you don't need an MA is disrespectful. it would really bother me, in fact my good friend just left her job and that was one of the reasons why. It's our responsibilty to set the standard for ourselves and those who will enter the field in the future, we have to do what's right- even if it means walking.

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And this concept of overtime for medical documentation is intriguing. I estimate I spend no less than eight hours per week, and often more, completing patient documentation from home on the practice's tablet. It is currently a source of contention for me, over which I have expressed the intention to transition by the end of the year if a more equitable solution cannot be found.

 

my take on it is, "if I work (for you), you pay me". so if a practice wants me to see so many patients per hour that I can't properly document, I get paid for the time I stay longer to document (at OT rate if it's over the expected # of hours/per day). I was offered that load of crap (with a big smile to boot!) with them saying, "oh you can take the computer/tablet home and finish your notes there!". as if that's a GOOD thing! why would I want to do that? why would I use my OFF time, my personal time, my HOME time...working? as if being home makes it not work. no thank you. I'll stay an extra hour or two and finish my notes. and bill for it.

 

...but I did have that part in the agreement from the get-go -- it's a good one to ask for when negotiating terms. you could easily ask for that -- just say that the hours you're working exceed the original terms of your employment, and you'd like to have a salary/OT change to reflect that. if they so no, and you don't like much else about the job, screw them.

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I work for a small IHS and in my family practice clinic I have never roomed my own patients. It was brought up once by an administrator as a way to "streamline" some processes and my nurses and MAs actually backed me up and said it made no sense for me to room my own patients. This varies throughout our health network, however. I once went to the IM practice to "help out" when they were desperate for someone to cover some acute care. I had never even been in their building, didn't know where anything was and was expected to room & vital my patients and clean exam rooms. I didn't know where anything was and it sucked. I had to do a pelvic and finally begged the staff to set it up for me because I just couldn't find anything. It was ridiculous and I have found excuses not to help again, so now they don't ask. This was VERY physician specific. Our docs treat us as relative equals in the practice (other than in pay of course). I work primarily in our busy walk-in clinic in which shifts are rotated through the entire practice and we all get the same support: 2 MAs and one RN, all dedicated for that provider, whether it be MD,DO,PA or NP (we have all). I am acutely aware that this is not the norm in our network, and perhaps in most of PA practice, so while I am sure I could get a job elsewhere if the need arises, I would be very reluctant to leave my current position. The respect and support I receive is outstanding.

 

It clearly depends on your practice requirements. PAs function very differently in different specialties or in the same specialty but in different offices. It sounds like it would be worth looking at other opportunities and now that you have more experience, be sure to ask what kind of ancillary support you would have. Good luck.

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I know what you are saying and it would be frustrating and I would feel the say way. But I have to say, right now I'm rooming my own patients, taking out the garbage, vacuuming the floors . . . and if the toilets were in our suite, I would be cleaning them too. The odd thing is, I'm loving every minute of it. But that's the difference that you feel when you control the corporate check book.

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I know what you are saying and it would be frustrating and I would feel the say way. But I have to say, right now I'm rooming my own patients, taking out the garbage, vacuuming the floors . . . and if the toilets were in our suite, I would be cleaning them too. The odd thing is, I'm loving every minute of it. But that's the difference that you feel when you control the corporate check book.

 

what a skinflint lol

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Thirty years ago, when the practice nurses (who were LPNs) pulled this on me, my attending called them out and said “provider time is scarce and getting scarcer. Treat her as you would me”. The only time I did this was when I was starting a solo satellite practice and seeing about 5 people a day for the first month or so.

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