Successful PA and Supervising Physician relationship

[Colorado Joe]

I am graduating in a few months and will likely be working in an emergency department with several supervising physicians.  I have a type A, extroverted personality and have a great deal of patience, however, I tend to question authority in appropriate situations which can come across as argumentative/combative if not well-phrased.  Does anyone have advice or a good resource to prepare me to navigate the PA-MD relationship?  I certainly do not want to come across as argumentative, but also need to learn how to be assertive when appropriate.  Thanks

 

Joe

[newton9686]

Yeah, I'm pretty much the same so I look forward to the advice of the experienced PAs on this board. I did however see this piece of advice that I really liked. Supervising Docs can tell you what not to do, but not what to do. So if you don't agree, dont do it.

[beattie228]

A lot of that relationship comes with building a rapport with the doc's you're working with. This can be a bit tricky in the shift work gigs like UC and ED early on just because there's so many moving pieces, but it'll happen in time. I think it's helpful to keep a few things in mind when you're getting critiqued or receiving advice from a supervising physician:

• Often times, the critique you're receiving is coming from a good place, i.e. good patient care. Their name is going to be on the chart (usually in ED setting), so they want to make sure good medicine is being practiced
• There is often more than one correct way to go about something. The markings of a good PA is someone who can navigate themselves through subtle nuances. i.e. Doctor X prefers Ibuprofen 800 TID for their go-to anti-inflammatory whereas Doctor Y prefers EC Naprosyn BID.
• I find it helpful to remind myself how much additional training they've undergone. A highly trained, competent physician is a wealth of knowledge. Tap into that, and create an atmosphere where the physician isn't timid to chat with you about a case

The above advice about the Supervising doc not being able to tell you what to do is entirely false. You want to build a relationship of trust with your supervising physicians so that they give you more slack, but at the end of the day, it's their show. That's the nature of the PA profession, in my opinion. If you want to be head coach on the floor, you need to go to medical school for a few more initials after your last name or scope out a rural ED gig later on down the line once you've got some experience under your belt.

 

At the end of the day, don't over think it. Be cordial, know your stuff, and be an advocate for the PA profession by creating a harmonious relationship between the PAs and Supervising Physicians.

[Colorado Joe]

@beattie228Excellent comments, thanks for posting!  I am fully ready to be under a supervisory role as I value the mentorship and learning opportunities from those more experienced than me and look forward to the career ahead of me.

Joe

[Wellness]

On 5/2/2017 at 9:30 AM, beattie228 said:

A lot of that relationship comes with building a rapport with the doc's you're working with. This can be a bit tricky in the shift work gigs like UC and ED early on just because there's so many moving pieces, but it'll happen in time. I think it's helpful to keep a few things in mind when you're getting critiqued or receiving advice from a supervising physician:

• Often times, the critique you're receiving is coming from a good place, i.e. good patient care. Their name is going to be on the chart (usually in ED setting), so they want to make sure good medicine is being practiced
• There is often more than one correct way to go about something. The markings of a good PA is someone who can navigate themselves through subtle nuances. i.e. Doctor X prefers Ibuprofen 800 TID for their go-to anti-inflammatory whereas Doctor Y prefers EC Naprosyn BID.
• I find it helpful to remind myself how much additional training they've undergone. A highly trained, competent physician is a wealth of knowledge. Tap into that, and create an atmosphere where the physician isn't timid to chat with you about a case

The above advice about the Supervising doc not being able to tell you what to do is entirely false. You want to build a relationship of trust with your supervising physicians so that they give you more slack, but at the end of the day, it's their show. That's the nature of the PA profession, in my opinion. If you want to be head coach on the floor, you need to go to medical school for a few more initials after your last name or scope out a rural ED gig later on down the line once you've got some experience under your belt.

 

At the end of the day, don't over think it. Be cordial, know your stuff, and be an advocate for the PA profession by creating a harmonious relationship between the PAs and Supervising Physicians.

Now you've added confusion to my understanding of a PA... You make it seem like I will always have to tailor my care to the standards of my SP, even with something that can be so minute as NSAID Rx. Now I know as a new grad there is very strict supervision, as there should be, and I am hoping that is the place from where you're speaking. Forgive me, but I do not want to be a ten year practicing PA trying to decide between NSAID's because I forgot which my SP prefers.  

[beattie228]

Nah, you're definitely not tailoring your care at each step of the way. Well, depending on what area of medicine you practie and your relationship with your SP. The NSAID example was just me trying to point out being flexible about how your SP practices can help that PA/SP relationship flourish. As you gain confidence and experience, you practice with more and more autonomy. At least that's how it has been with my own career.

[Wellness]

2 hours ago, beattie228 said:

Nah, you're definitely not tailoring your care at each step of the way. Well, depending on what area of medicine you practie and your relationship with your SP. The NSAID example was just me trying to point out being flexible about how your SP practices can help that PA/SP relationship flourish. As you gain confidence and experience, you practice with more and more autonomy. At least that's how it has been with my own career.

Thank you for clarifying! You had me a tad concerned.