Rbnz Posted January 7, 2016 Share Posted January 7, 2016 I am a new grad who has been working as a surgery PA for the past 4 months. I first assist 4 different surgeons (ortho, ob/gyn, and general). I have 2 colleagues that are physician assistants as well. We had a meeting with our CEO at the hospital about 2 weeks ago and he said that if we are not busy doing surgeries he wants us working in the family practice clinic seeing walk in patients. Prior to this meeting if I was not helping in the OR I would have been helping in the surgery clinic, learning how to work and see patents on the floor, and learning wound care at a wound care center. The CEO says that all the surgeons are not busy enough to have a PA help them in clinic. So his solution was to put us in family practice clinic seeing patients. It has come to the point that they are micro managing us BIG TIME!! They have started calling and texting daily to find out if we are done with surgeries and if we can come see patients in family practice. They also call the pre-op nurses and PACU nurses to see what we are doing. It is getting out of hand... I don't have a huge problem with doing family medicine. There is only one DR and he is there 2 days out of the week and on days when he is not there he is available by phone. The patient load can vary from 10-25 patients per day, with a lot of those being new patients. The majority of these patients are over 60 with chronic medical problems and poly-pharmacy. CEO states that in order to learn you have to be thrown in and learn as you go. His argument is that almost all new grad PAs are seeing their own patients in 2 weeks right out of school. This makes me very nervous!!! Especially since I have been doing surgery only for the past 4 months. I was hired to be a surgical PA, not a family practice PA. I am fine with doing the work but am curious if I should argue for more money or RVUs due to this new change. What are your thoughts. I signed a 3 year contract, if I break it I have to pay back 10K (sign on bonus). I really don't want to leave this job as it gives me a great opportunity to see and learn a lot of medicine. But I can't be micromanaged like this and worked harder than I already am. I would feel justified if they payed me more for this work I am now being forced to do. I currently work about 50-60 hours a week. Get paid 46 an hour. And split surgery call 50/50 with another PA, so I typically have over 100 hours of on call time every 2 weeks. Link to comment Share on other sites More sharing options...
Boatswain2PA Posted January 7, 2016 Share Posted January 7, 2016 You were hired to be a surgical PA. If you WANT to be a surgical PA, then refuse to do the fam practice job. Spend any "down time" improving yourself so you can be an even better surgical PA, and provide better value to the organization. If you were hired to be surgical PA, but you want to do family practice, then use this as a means of shifting specialties. I am an emergency medicine PA. Every once in a great while I will help out the FP docs by doing urgent care clinic, but I hate it and will only do it as a favor to the docs I work with. Want me to manage your chronic HTN? I'll refer you to FP specialist. Want me to manage your insulin dosages? I'll refer you to FP specialist. Want me to intubate you as your airway is swelling due to your anaphylaxia? Got it. Want me to sedate you and reduce your trimalleolar fracture? Got it. That's what I do. Decide what you want to do, and then do it. Don't let some overpaid bureaucrat drive your career. $46/hour? Really? That sounds terrible. Where are you at?? Link to comment Share on other sites More sharing options...
Sunnyn Posted January 7, 2016 Share Posted January 7, 2016 Wow! Is this allowed? Isn't there a contract that states what your duties will or not include? Link to comment Share on other sites More sharing options...
LKPAC Posted January 7, 2016 Share Posted January 7, 2016 I'm a FP PA and I sometimes help out in the OR. (I'm a former surgery tech with plenty of first assist experience.) But seriously, I see your point. Link to comment Share on other sites More sharing options...
Rbnz Posted January 7, 2016 Author Share Posted January 7, 2016 Small town in Arizona. I tried negotiating for more money but they would not budge and it was more than any other offer I had. As far as it being allowed?? I don't know. When they had me sign papers when I was hired on, they had listed all the surgeons and the family practice doctor as being a SP for me. Link to comment Share on other sites More sharing options...
Boatswain2PA Posted January 7, 2016 Share Posted January 7, 2016 I'm a FP PA and I sometimes help out in the OR. (I'm a former surgery tech with plenty of first assist experience.) But seriously, I see your point. Teamwork is important. But do they ask you to help in the OR? Or do they tell you that you are going to... Link to comment Share on other sites More sharing options...
LKPAC Posted January 7, 2016 Share Posted January 7, 2016 Teamwork is important. But do they ask you to help in the OR? Or do they tell you that you are going to... Good point. I am asked, not told. Usually, it is an emergent situation and we all pitch in to do what is needed. Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted January 7, 2016 Moderator Share Posted January 7, 2016 One thing- What are you actually CREDENTIALED to do? If there is nothing in your credentialing that mentions primary care, then the hospital actually hasn't authorized you to practice family medicine. The contract I have with my physician group, as well as my credentialing packet through the hospitals I work at, only authorize me to do emergency medicine. And what sort of medical training does this CEO have? I realize you can't tell someone like this off if they have no medical training, but there's no place for a non-medical person to tell you when you're able to see pts on your own in a new specialty Link to comment Share on other sites More sharing options...
Boatswain2PA Posted January 7, 2016 Share Posted January 7, 2016 Another option - if you can't fix this, or walk, then you maybe just be square with the patients who come see you in clinic. "Doc, I have this rash....""Well, I am a surgical specialist, so I am going to refer you back to see your primary care provider. Have a nice day!" <moves on to next patient> Link to comment Share on other sites More sharing options...
MT2PA Posted January 7, 2016 Share Posted January 7, 2016 "Other duties as assigned" is my least favorite phrase and it probably exists in most job descriptions regardless of the field of work. If the FP doc is listed as an SP, you're probably on the hook. OP - if it were me, the micro managing would be my biggest issue. If you don't have surgeries, aren't prepping or following up on a procedure, and you aren't needed in the surgical areas....I understand the hospital's logic of putting you to work vs having you doing nothing. I've left jobs previously due to micro managing. If your options are 1. more work but no more money (if your current job won't budge) or 2. find a new job but lose your bonus, then I'd say maybe start looking for other employers. You have the potential to either negotiate a higher pay or another sign on bonus that would compensate for paying back the 10k. At the very least, it can't hurt to know what else is out there. Link to comment Share on other sites More sharing options...
electric130 Posted January 7, 2016 Share Posted January 7, 2016 If you don't mind doing the FP and as long as you have someone that you can ask questions then I would think of it as a learning experience. It will make you a more well rounded PA. I think the spirit in which you were thrown into it sucks. Sounds like they just said you will be doing this without asking or giving you any options. I doubt they would treat an MD in that way and just shows that the people "managing" groups these days are just pushing us for more numbers without thought to the employee or what is best for patients. Another issue is how many hours you are working. You better believe I would say something about being paid for 46 hours and working 10-15 more per week. Keep your time working documented and bring that to their attention. If it is in your contract you work 46 hours then they need to figure your hourly rate and pay you for anything over that. PAs will be taken advantage of if we allow it. I have seen it so many times, especially with newer PAs that are afraid to speak up. Link to comment Share on other sites More sharing options...
Rbnz Posted January 8, 2016 Author Share Posted January 8, 2016 I really appreciate everyones advice. He is listed as a SP for me, along with all the surgeons. There is no certain number of hours stated on my contract that I can work. CEO does not have any medical training. It really comes down to the way they are going about this. If they would have approached us and said this is what we are thinking, what are your ideas/thoughts, it would have been totally different. Also, would it be unreasonable to ask for RVUs instead of a pay increase? Link to comment Share on other sites More sharing options...
delco714 Posted January 8, 2016 Share Posted January 8, 2016 Another option - if you can't fix this, or walk, then you maybe just be square with the patients who come see you in clinic. "Doc, I have this rash...." "Well, I am a surgical specialist, so I am going to refer you back to see your primary care provider. Have a nice day!" <moves on to next patient> When did we get so spiteful. The patients deserve better than that, come on. Two options, accept this and do your best, or leave. I don't think you'll win any arguments here by the sound of it Link to comment Share on other sites More sharing options...
Boatswain2PA Posted January 8, 2016 Share Posted January 8, 2016 I should've put that post in the sarcastic font to make it more clear... :-) Link to comment Share on other sites More sharing options...
BruceBanner Posted January 8, 2016 Share Posted January 8, 2016 Not to be captain redundant here but you are being taken advantage of, OP. It sounds to me that in this situation you are the egg and they are the rock. Whether you throw yourself against them or they come down on you, you are going to break. I agree the micromanaging is out of hand---you are a professional and deserve some space---but you may have to face the binary decision of cutting your losses and leaving (not now, probably closer to 1 year), or sucking it up and paying your dues. The only potential solution here is to get all the PAs together and state your case as a group. Link to comment Share on other sites More sharing options...
delco714 Posted January 8, 2016 Share Posted January 8, 2016 I should've put that post in the sarcastic font to make it more clear... :-)Oh thank god hahaha Link to comment Share on other sites More sharing options...
Reality Check 2 Posted January 8, 2016 Share Posted January 8, 2016 On the old Carol Burnett Show, Tim Conway had a character in a train station or a factory. There were 3 windows on the wall. Carol walked up to one and posed her question - in one of his famous accents - Tim Conway would say that wasn't his department and refer her on to the next window. She would go to the next window, Tim would open the slide and put on a new hat and ask her what she wanted............... Only funny on TV, by the way. The non-profit I worked for briefly in a rural setting fully expected me to see patients in a building with no power on, no heat and no expected time that the power would be restored. The inner rooms had NO WINDOWS and the otoscopes, etc were electricity dependent. The female CEO actually expected me to continue to see a full day of patients with no power, no phones, no lights, no heat and seriously do a pap smear and physical. She wasn't kidding. I told her without hesitation that it wasn't medically ethical nor appropriate and we would not be seeing patients as long as the power was out. She then sent me 40 miles to the next clinic where they had no rooms or nursing staff for me and expected patients to be seen. My stay with this clinic and their psycho CEO was short - needless to say. This CEO sounds desperate and uninformed. Unless you are a super rural hospital in the middle of nowhere - this is dumb. The patients aren't dumb - they will (or should) notice the inner machine workings of the establishment and realize that they are short handed and the staff is less than happy. It shows - trust me. Personally, I would find an attorney to take your contract apart with tweezers and see how this works - is it technically legal or not. Have the attorney communicate questions or comments about the contract directly to the head of HR or the CEO and only bring you in when time to negotiate changes. I could not stay in that position. If you don't want to do any FP or UC - DON'T - not fair to you or the patients. I doubt you will be able to fight a CEO single handedly but stay true to your ethics and professionalism. Move on. Corporate medicine sucks................................ My very old 2 cents Link to comment Share on other sites More sharing options...
LKPAC Posted January 8, 2016 Share Posted January 8, 2016 I've been thinking about this thread, here's my thought: Would an MD surgeon be expected to work FP clinic in his "downtime?" If the answer is no, then neither should the surgical PA. I can't imagine any surgeon doing this. Link to comment Share on other sites More sharing options...
Sunnyn Posted January 8, 2016 Share Posted January 8, 2016 Just a thought....Not sure if it is correct. Can the surgeon in any way step in and maybe speak up for you, and just say that he/she needs you to do other things. And also say....that it would be not right to take advantage of someone....and not lean towards doing some cost effective analysis? Link to comment Share on other sites More sharing options...
afarmboy Posted January 12, 2016 Share Posted January 12, 2016 Bite the bullet and hire an attorney as Reality Check 2 stated. Make sure this is an attorney that has experience with employment contracts, healthcare contracts, and ideally PA employment contracts. Are you a member of your state's PA association? They should have a recommendation for legal counsel for you. No wonder they wanted a 3 year contract. If an employer that you're unfamiliar with is legit and not worried about turnover, they should be willing to let you sign a 1 year contract, at least for the first go-round. Best of luck, and keep us posted. Link to comment Share on other sites More sharing options...
cbrsmurf Posted January 12, 2016 Share Posted January 12, 2016 I've been thinking about this thread, here's my thought: Would an MD surgeon be expected to work FP clinic in his "downtime?" If the answer is no, then neither should the surgical PA. I can't imagine any surgeon doing this. But the surgeon would not be qualified/certified to practice FP. They might force the surgeon to do more in-office procedures or do more clinic that is under his specialty. As a PA, you are legally able to practice in any specialty that your SP is certified in. If I were CEO of a hospital, I'd want everyone of my employees to maximize profit/revenue. From a financial standpoint, if OP can make the company more money, it makes sense. It doesn't make sense to me, if you are working 55 hr weeks, to pay someone overtime to do more work. Link to comment Share on other sites More sharing options...
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