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Urgent care: do you enjoy it?


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I'm considering an urgent care job, was in pediatrics for the last 13 months and ortho before that for 2 years. I did enjoy casting/splinting and such in ortho, and I like being hands on. I just wanted to hear from some urgent care PAs and find out of and why you like what you do. I want my next job to be something I can stay in for awhile. Only thing is it is kind of a big company with 25+ locations and I don't want to feel like I work in a factory but there seems to be a lot of support for PAs there and I think I would like the variety. So why do you like it? Cons?

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I dig it. It may not be as mentally taxing as other positions, but I have treatments that can be effective for patient's ailments. Also, I'm hands on and really enjoy the ortho stuff and laceration repairs. I've previously worked other fields (Neuro and Spine Surgery), but I've been really happy with my work in the UC setting.

 

Pros:

  • Hours. I do 36 hours a week broken up into 3 shifts
  • No call
  • Shifts generally go by pretty quickly
  • I work for a hospital so I'm treated well (respect, autonomy, benefits).
  • I see a wide variety of cases. Just recently went to AAPA conference and I was impressed with how much general medicine and board friendly info I've retained simply from seeing it day to day or reading up on things in my free time

 

Cons:

  • Occasional drug seeker (I rely heavily on prescription monitoring programs and rarely use opiate narcotics even if their PMP comes back completely clear)
  • No continuity with the cases unless they're seen within my hospital system
  • Have to work occasional weekends and holidays (although at time and a half so this can also be placed in teh pros column)
  • Some days I'm on autopilot and have to force myself to dig deep so I don't miss the potential serious case (GERD showing as MI, stroke rather than migraine, retained foreign body, etc)
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Beattie228 hit on most of the points I would have but I'll add a few.

 

Pros:

- when you are off, you are off.  All charts are finished same day, on the clock.

- no dealing with prior auths, pre-approvals, paperwork nightmares

- in general you can often trade shifts to work out a long weekend off, etc

- my clinic is pretty good about firing folks such as drug seekers if they act out, lie to us, etc.

- no chronic pain, anxiety, etc treated

 

Cons:

- work a lot weekends and a lot of holidays

- patient volume (I'm at a high volume clinic)

- no continuity of care is a big thing (this was really hard when I was a new grad, hard to learn this way)

- burnout

- high turn over of support staff can sometimes make it difficult

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I've worked in a variety of urgent care settings.

 

1 - Was just me and an MA/Xray tech.  Worked 10 hour shift and was able to run out and do errands if someone came in the MA would text me.  Was able to nap in the exam rooms.  Pretty did whatever I wanted and very low volume patients.  Never thought about the place off the clock.

 

2 - large volume urgent care with 3-4 MAs and front desk staff and another provider or two on duty.  0 hour shift that always turned into 11-11.5.  Would see 100 patients sometimes between just two of us.  The owners of the clinic wanted us to see every patient that walked in the door even if at 8:59pm.  Wouldn't ever send us help if were getting slammed and then screwed my on my percentage of productivity bonus.  They also handled work comp and DMV physicals.  I didn't stay long here at all. 

 

3 - Low volume urgent care.  8  hour shift with one front desk and one MA or LPN.  No onsite xray.  Very management volume about one per hour if that.  Part of a large health system, but feel as though it is my own little walk in clinic. 

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  • 3 years later...

I did UC on a PT basis for about 2 years to supplement my ED FT job.  It was a fairly high volume relatively low acuity site.  I found that I really preferred the higher acuity and more mentally challenging ED environment.  I also found that the procedures I did in the UC were trivial compared to what I got to do in the ED.  I'm glad I did it - it helped my learn symptomatic management for low acuity complaints.  Still, I got tired of the number of times per shift I had to give the "your URI is almost certainly viral and you don't need an antibiotic" speach.

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