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No support staff?


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I'm a new grad and starting training for my first job. I was super pumped about it and everything was great. Pay was good, speciality I wanted, perfect location, got a lot great with the doctor in the interview, etc.

 

In EMR training with a couple of other PAs and medical assistants the training office manager was talking about workflow and all that so I asked what exactly was my role since we were all together.

 

I was told that PAs are supposed to function completely on their own. Cool right? Well it turns out that this means I have to go to the waiting room and call back all my own patients, triage them with all the PMH/allergies/etc., scan all of their paperwork, take them to x-ray if needed, do the full H&P and dictate the whole thing, order an MRI and scan it in and set it up for scheduling, scan in PT orders, draw up all my own injections and set up for the procedure, schedule the patients follow up appointment, print out their clinical summary, complete their checkout, and then clean the room and bring back the next patient. I also have to make sure the rooms are stocked. The MD has a couple of MAs and the training manager said if I'm really nice the MAs might help me here and there. I'll also have to give some of the injections for the physicians patients but I get a productivity bonus so I doubt I'll get credit for giving those injections.

 

I'm a new grad so I know I'm kind of low on the totem pole but is this normal? I'm trying to be optimistic but am feeling pretty frustrated about this. I'm supposed to make a bonus for productivity but I just don't see how I'll be able to see many patients if I have to scan, clean, stock, schedule, etc. on top of seeing and documenting on all my patients. Anybody have any advice?

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Run, do not walk, from a position like that. PAs should not be doing 60% of the things you described. You are a board certified clinician and should be working in that capacity. Your workflow should directly mimic that of the physician. If he's not turning over rooms and taking blood pressures/scheduling patients, neither should you.

 

If they didn't hire me a MA to do the things you've described, I would look elsewhere for my first gig.

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Yeah I'm pretty disappointed.  The bonus was a big part of the package too and every PA has gotten it.  Evidently this new workflow was implemented in the past year or so and are trying to get it to catch on.  It was made by an office manager that was a CMA...

 

Every PA I've spoken to that works there/has worked there said there bonus was great...like higher than their base salary good.  I'm just frustrated.  I'm hoping once I start I'll be able to speak with the doctor and hopefully he agrees with me and sees where I'm coming from but who knows.  

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I completely agree. I have a family I need to support though so I can't just be unemployed for a couple of months waiting to find/start a new job

 

And this isn't at every office. Evidently this was one managers idea and they are trying to implement it in a couple of offices. The last PA switched offices so I wonder if that was one of the reasons. Not even every PA at the office I'll be working at has it. It's like they want to start it and use that model going forward. It makes no sense. It honestly kind of felt like it was just animosity from a couple of the CMA turned managers towards PAs for some reason. I have yet to even work in the office and when I asked about support staff in the interview they didn't say anything like this. Part of me is hoping it's just this new manager that isn't even the manager at my office just hoping that's how it goes.

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I'm hoping once I start I'll be able to speak with the doctor and hopefully he agrees with me and sees where I'm coming from but who knows.  

What do you think the doctor can do about it? He's an employee just like you!

 

If you insist on going to work, just sit there until your patient is roomed.  Don't lift a finger to room, take vitals, clean your rooms, or act as patient transporter.

 

There's a difference between pitching in when there's an emergency, and consenting to ingrained stupidity.  The reason MAs are there to do those things is that they get paid 1/4 or less of what a provider does.

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That's true. Like stated above I haven't even been to the actual office I'll be working in. It seems to be very physician driven as far as "teams". In terms of the Doc X team has three MAs for him and the PA and uses these forms and does things this way. Doc Y has two MAs that cover between both of you and does things this way etc. idk, I'm gonna look for other stuff but can't just be unemployed for months

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I completely agree. I have a family I need to support though so I can't just be unemployed for a couple of months waiting to find/start a new job

 

And this isn't at every office. Evidently this was one managers idea and they are trying to implement it in a couple of offices. The last PA switched offices so I wonder if that was one of the reasons. Not even every PA at the office I'll be working at has it. It's like they want to start it and use that model going forward. It makes no sense. It honestly kind of felt like it was just animosity from a couple of the CMA turned managers towards PAs for some reason. I have yet to even work in the office and when I asked about support staff in the interview they didn't say anything like this. Part of me is hoping it's just this new manager that isn't even the manager at my office just hoping that's how it goes.

I honestly can't believe you're willing to accept this and start working under the terms you've listed. How do you think your patients are going to feel when they're being taken care of by the MA, oops, I mean PA? C'mon, seriously think about this. You've trained to practice medicine and treat patients. How are you supposed to be doing that if you're too busy scanning in papers and all the other MA tasks?

 

Do not do those things. I hope you haven't already agreed and said that you will. Insist that you get an MA. You are doing yourself and your training a disservice if you work as an MA 75% of the time and a PA 25% of the other time.

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I honestly can't believe you're willing to accept this and start working under the terms you've listed. How do you think your patients are going to feel when they're being taken care of by the MA, oops, I mean PA? C'mon, seriously think about this. You've trained to practice medicine and treat patients. How are you supposed to be doing that if you're too busy scanning in papers and all the other MA tasks?

 

Do not do those things. I hope you haven't already agreed and said that you will. Insist that you get an MA. You are doing yourself and your training a disservice if you work as an MA 75% of the time and a PA 25% of the other time.

I agree and we understand that you have to have a job to make money, but this is not a "job" or good for the outlook of your training (being a new grad.). You need good training for at least the first year (NOT doing MA task). Also, I have said it before, but you are screwing ALL the other PAs/NPs/ that come after you. You can find another job relatively easily. We are PAs and are in HIGH demand. I hope you already started looking for a new job. 

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I've started looking already. The manager that said that isn't he manager at the office so I'm hoping it isn't the actual case. I'm looking though, and have a pregnant wife and a daughter so unless someone is going to create a go fund me page while I'm unemployed I have to stay. Resumes are being sent out tho

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I've started looking already. The manager that said that isn't he manager at the office so I'm hoping it isn't the actual case. I'm looking though, and have a pregnant wife and a daughter so unless someone is going to create a go fund me page while I'm unemployed I have to stay. Resumes are being sent out tho

Congrats! We are having our 2nd baby in 3 weeks. I know where you are coming from, but you can get travel jobs/PRN jobs/etc. You have a great degree, but cannot have it all (specialty/location/pay), gotta pick 2 of the 3. If there is a will then there is a way. I literally was in the same boat you were in several years ago and everything worked out fine. Please do feel like we are bashing you, but trying to give you advice that we have all went through. There are valuable resources from everyone's words/wisdom on this forum, take it in and keeping your head high! Good luck!

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Thanks. I definitely appreciate all the advice. That's pretty much what I was thinking but wanted some experienced PAs to give their insight as well. It's really frustrating because this is a very large company with over 20 offices and it seems like this office is the one that's trying it. I'm sending out resumes and texted all my preceptors so their keeping their ears open.

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I've started looking already. The manager that said that isn't he manager at the office so I'm hoping it isn't the actual case. I'm looking though, and have a pregnant wife and a daughter so unless someone is going to create a go fund me page while I'm unemployed I have to stay. Resumes are being sent out tho

I literally cannot stop recruiters from contacting me for immediate-start Locums jobs, despite telling them I am not interested for the past 3 years. You could work at one of those while searching for long-term work. There's a good chance one of the jobs could turn into FT. Get in touch with a recruiter. Do not accept being walked over.

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Is locum work really a smart move for a new grad?

 

I honestly think this whole things is a miscommunication. I would personally send out a very stern email to whoever your contact is asking for clarity in this matter. This just seems ridiculous--like lack of common sense ridiculous--to not have an MA paired with a provider. On top of that, how can the docs have 3/2 MAs and you have none? Just doesn't make any sense.

 

I bet if you do indeed start here, you will find it was just a big miscommunication. But in the meantime, ask!

 

If you do start here, and it turns out to be true, you need to really show that this is not a smart, and sustainable workflow. Really, its just plain stupid! You are a money making provider and the more patients you see the more they make, when your faxing papers, and doing this and that, the company you are working for is LOSING money! Just tell them that and they will see the light.

 

Good luck

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Thanks again for all of the advice I really value it and I didn't willingly take this job knowing that was the case as I specifically asked about support staff in my interview.

 

As far as a mini update. I talked with the manager that actually interviewed me, not the CMA manager that told me the stuff that made me write the post.

 

She said that for a brand new PA, you won't have have your own MA because you're training with the new doc and will be in the same pod as him and working with his MAs as a whole pod team. She said the point of all the extra computer training we are doing now is so we just know the whole system in case we need to just scan something in real quick or do something because the MA is busy. She said that once your seeing your own clinic after the physician and everyone is comfortable ill obviously have help. She said the reason this new thing is even being discussed is because there are PAs in the company that are only seeing like 6 patients a day for some reason and business wise it's hard to justify a PA that's been here for several years only seeing 6-10 patients a day paying their salary plus an additional MA. She said that was the exception and with the doc I'm with and location I'm in me being busy will not be a problem at all. Then she said plus, you'll be a lot for knowledgeable about the MAs role so you can have a better working relationship with them. She said it's about seeing patients and obviously ill be way more productive with an MA.

 

So that was an additional explanation so I don't know if that is more true.

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THAT sounds very reasonable and makes sense.  In my first job there were 3 MAs to 2 MDs and a PA, and "my" MA was the one my SP had just had, who knew how he liked things done, so she was working closely with me while my SP "broke in" a new MA at the same time.  MUCH much different than not giving the new grad any support.

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I can't agree that any professional office put a licensed PA in this position.

 

It is a set up for failure, burn out and mistakes.

 

I am not an MA or an RN and I do not know how to RN. I can take vitals and take a history.

 

I cannot be productive if someone is not helping me. 

 

A friend and former student got put in this position in a specialty clinic after having had an MA for months. He was told it was a budget thing and he had to make it work.

 

He lasted a few months and quite literally walked out. They didn't adjust his production or the expectations. He has phone calls, lab results, refills, rooming patients and then actually seeing them and doing notes same day. 

 

It was insulting and a complete failure. They still haven't filled his position and it has been over a year. Word travels fast about a bad set up.

 

I would go back to them and tell them you need the RIGHT set up from the get go and this is not standard practice for a medical provider.

 

If they don't like the PAs seeing 6-10 patients a day - FIRE THEM. Not your fault that others don't do well.

 

This is not a good precedent for any PA/NP/MD/DO. 

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