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How did you leave your first job?


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I feel a good bit of loyalty to the practice that took me on straight out of school. The MD told me if I didn't like it to please speak up right away. They trained me for a good 3 months before i was out on my own. Initially i loved it - and i still have my moments. I am hospital based only. Do rounds and consults for a specialty service. I'm approaching my 2nd year mark and starting to feel burnt out. I'm not happy any more. I don't mind working hard but the practice is growing, the physicians are wanting to do less and less and I leave work feeling punched in the gut. The ER abuses us and gives us crappy consult after crappy consult. This morning for instance - i did rounds at two different hospitals with 9 consults thrown in the mix...all of this done between 7am-130pm...doc wants to keep going and for me to "dictate later" during all my free time i guess...once the md is gone - i start backtracking to finish orders, arrange transfers, do discharges, answer questions, dictate the consults/admissions we had done and basically clean up. I felt like i was drowning all day.

 

I'm ready for a lifestyle change but i dont know how to "turn in my notice" in a way that won't make them mad or burn a bridge. I'm slowly looking around at a similar specialty service near my home but haven't made any decision. Is two years long enough before leaving? They took a chance on me as a new graduate and spent a lot of money allowing me to shadow/learn. I keep getting positive comments from the docs but i'm still making crap for pay. They said there was a "freeze on raises" the first year...this is 2011 and now their excuse is that my review doesn't come up until the end of the year because that was my start date. However, they did give me an extra week of vacation at the beginning of the year...so obviously my compensation pkg came up but i was passed up for a raise. I am making the least out of everyone but i know i am one of the most efficient on the team. I've been told that many times but no one puts money where their mouth is. That would at least make things feel more worth it.

 

I don't know if i owe them more time or should just say its a lifestyle choice and i'll see ya later. I'm not even sure if a big raise would make me want to undergo that amount of stress.

 

Maybe i just need a vacation and reboot.

My very first job as a new-grad was in Cardiology in a moderately sized one hospital town.

The back door to this practice was literally 75ft from the hospital Emergency Room entrance.

 

When I started, there was 6 physicians and 1 PA (me).

We had 2 Nuc Cameras, 2 Treadmill rooms, 2 Echo Rooms and 20 exam rooms.

I rounded on Inpatients between 0600-0800 then started staffing the Diagnostic Testing rooms from 0900-1600.

I also seen Acute walk-ins between testing patients and handled any coag issues in the INR section in the basement.

I also had to see post-op CABG patients, co-chair the CHF clinic and see the scheduled patients of the physicians who were called away emergently to the Cath Lab.

 

Initially... I learned a LOT... and as a former Medic then CCRN, was in Heaven.

By yr 2.5... there was 13 physicians and 1 PA (me).

 

Shortly thereafter... with NO raises, bonuses, very little respect or appreciation I felt like I was on one of those damned treadmills and it became obvious that I was considered "ancillary staff"... it was definately time to move on...

 

Its not likely to get any better... and if it does... hopefully they won't resent you for addressing the issues and demanding a change.

 

It won't hurt to try for a better situation with this group... just be prepared to move quickly if it doesn't work out.

 

YMMV

 

Contrarian

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my first job treated me very well and gave me frequent raises and a great schedule( m-th 9-7, 3 day weekend every week, all the overtime I wanted at 1.5x, etc). it was a great learning experience. there was a residency program there and my sp was the residency director. he taught me a lot. after 2 yrs I felt like I had maxed out the learning potential there for the pa scope of practice at that place and took a transfer and an $8/hr salary cut to move within the organization to a place which let pa's see sicker folks. also my commute went from 63 miles 1 way to 3 miles one way. that wasn't the main reason I left. if the scope of practice grew with me I would have stayed longer.

they were disappointed that I was leaving but wrote me a glowing letter of rec.

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2 years is plenty to leave with your head held high.

 

VERY important to communicate with them your concerns - certainly figure out what you want in order to stay and present it also (i.e. yearly reviews with a COLA at 2%, and productivy pay ie based on receipts or on # of patients seen or some other measure, less hours, less call, more pay is the typical (and also what all the doc's want))

 

Very common for first job to be only a few years - many reasons for this - you grow and change a lot, an employer wanting to hire "cheap labor" is not likely going to want to start paying you what you are worth, your professional direction may change, life may change and a whole slew of other things. If you look around at the Doc's they are moving all the time (well some of them anyways)

 

 

I feel the single biggest issue is what someone else spoke of 'ancillary staff' status. This dooms you..... I have not had a job where i was able to change the employers minds about rather I was just ancillary staff or a revenue generator - seems to be defined long before I got there. I have realized the only one that is going to advocate for me is me - this has meant some harder job choices and changes since 2006 but it has been worth it in the long run. Also, docs and admin are always going to push push push for more productivity - has taken me a number of years to realize I need to slow down a little bit at a new job - I have always excelled and busted my ars at new jobs but I have found this only sets the bar higher then I can maintain in the long run. Set your and the employers expectations lower in the first 6m to a year and this will be something you can live with. I am not advocating to be a bum, but instead not be the hard charging PA (unless this is what you want to do all the time....)

 

 

By far the most important thing for you to do now is be a professional - work hard and demand to be paid what you are worth (figure out your receipts and billings and what you are actually getting paid). Give them plenty of lead time (I only had one employer pressure me to shorten my notice from a prior job and that was the first warning I got that they were a "less then stellar" organization to work for - only got worse from there - and I heald to my initial notice time) You literally can destroy the 2 years of hard work and effort is you act like a child and cry and stomp your feet, have temper fits, and in general act poorly - on the other hand if you are clear and concise and professional it "seals the deal" that you will get great references from them in the future (which is really all you care about if you are leaving them....)

 

 

course all of this is just my experiences so consider how much you paid for the advice.. ;-)

I just left my first PA job last Friday. I was there for 4 months but resigned after the first month. He had me under contract to stay 90 days or he threatened to sue me for breach of contract.

 

I am the 4th PA in ONE YEAR there and in my short time there, there has been SIX MA's go theough that place. No one in the place has stayed longer than 5 months except for the brown-nosing office manager who gets paid 90k which is WAY beyond her intelligence or qualifications. All she does is try to catch people doing things the doc and the wife (practice manager) dont like.

 

She kept hounding me on not clocking in even though I was salaried. One day she said "you haven't clocked in for a month" I retorted "Wow, really? I must'v\e not been here, i wonder who saw all the patients for 10 hours a day?" They made us work 4th of July and to be vindictive when I and another coworker objected, double booked my schedule.

 

I also took 24/7 Call with no extra pay for my cell phone bill and they have a cheap @$$ vm system that paged me EVERY time the vm came on so I spent most of my time fielding reschedule or cancellation calls. i once received a call at 1:05 am from someone who called to cx his appt the next morning then he calls back at 1:15am to say he actually CAN make it and nevermind his last message!! WTF??!?

 

They punished the MA's because a bunch of them took lunch together and they don't like that kind of camaraderie-for whatever reason is beyond me! They are very defensive people and think that everyone is out to rip them off.

 

I kept a stiff upper lip and killed them with kindness. The SP actually asked me to call him anytime if I ever want to come back and said that I was one of the best PA he has had come through and the patients love seeing me. Too bad he didnt reward that kind of work. I say good riddance but DON'T BURN BRIDGES!!!! (Not that I will ever go back there)

 

I started a NEW job monday that is like night and day!

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I kept a stiff upper lip and killed them with kindness. The SP actually asked me to call him anytime if I ever want to come back and said that I was one of the best PA he has had come through and the patients love seeing me. Too bad he didnt reward that kind of work. I say good riddance but DON'T BURN BRIDGES!!!! (Not that I will ever go back there)

 

!

 

 

probably the smartest thing you have ever done and a truly professional classy move! good job!

They are very defensive people and think that everyone is out to rip them off

 

Just curious, is this a common theme among physicians? I've seen similar comments like this made elsewhere.

Ventena said is better than I can. I am leaving after four years. 2 years is plenty. I really like my job and my boss, but I have reached the extent of what I am going to learn and what I am going to make. There is no hard feelings between us. I have found a better opportunity and I am moving on. A reasonable boss will understand that. An unreasonable boss makes you not care if they understand it or not. There is no reason to continue to do something you don't like just because you either feel bad or are to wimpy to leave. Look for a better job and when you find one be upfront with your current employer. good luck!

Just curious, is this a common theme among physicians? I've seen similar comments like this made elsewhere.

 

I have worked for/with SEVERAL MD's before I was a PA and NO, they are not all like that. The new place i am at now is awesome. They have such an easy going attitude about everything and all the MA's, ancillary staff, etc. have been there for years and i can immediately see why. Too bad I am only temporary here, but I am helping a doctor I know open up his own practice, well our own practice, in September. :D

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