Is it true Kaiser rotates physician assistants through different specialties?

[place123]

I can't seem to remember where I heard this from so I am trying to confirm.  PAs here in socal who work at kaiser make big big bucks.  I heard that they will rotate their PA's through different specialties.

Or is my imagination running wild?

[EMEDPA]

they have regular and float positions. if you are a regular cardiology pa , you will work in cardiology. if you are in a float pool they will send you anywhere there is a hole in the schedule.

[place123]

interesting, I am guessing that only PAs will do this?  One of the reasons I am becoming a PA is due to the flexibility with specializing.

[AbeTheBabe]

They have specific job postings like ortho, urgent care, etc.

[EMEDPA]

2 hours ago, AbeTheBabe said:

They have specific job postings like ortho, urgent care, etc.

yes, but they ALSO post float positions in many areas where you cover multiple sites and/or functions. the multiple functions tend to be closely related however, like urgent care and family medicine walk in clinic. you are not doing cardiology one day and ortho another. I was a KP employee for 13 years (8 full time and 5 per diem).

also , in regards to the "big bucks" statement above- a lot of this comes from differentials for nights/weekends/holidays/overtime. there are 2 reasons to work for KP: job security and their pension after 5 years. you will notice I did not mention autonomy and broad scope of practice. They tend to think of PAs/NPs as interchangeable widgets with a new grad being interchangeable with someone with 10+ years of experience. they use a lot of PAs. that is not the same as saying they are PA friendly. often the roles are fairly limited in the specialties, like an entire panel of patients with Hep C if you work in GI, or all you do is wound checks if you work in surgery, etc. It is a good place to start out, but hard to stay the 5 years due to scope of practice restrictions and the attitudes of many physicians there towards PAs.

[AbeTheBabe]

1 hour ago, EMEDPA said:

yes, but they ALSO post float positions in many areas where you cover multiple sites and/or functions. the multiple functions tend to be closely related however, like urgent care and family medicine walk in clinic. you are not doing cardiology one day and ortho another. I was a KP employee for 13 years (8 full time and 5 per diem).

also , in regards to the "big bucks" statement above- a lot of this comes from differentials for nights/weekends/holidays/overtime. there are 2 reasons to work for KP: job security and their pension after 5 years. you will notice I did not mention autonomy and broad scope of practice. They tend to think of PAs/NPs as interchangeable widgets with a new grad being interchangeable with someone with 10+ years of experience. they use a lot of PAs. that is not the same as saying they are PA friendly. often the roles are fairly limited in the specialties, like an entire panel of patients with Hep C if you work in GI, or all you do is wound checks if you work in surgery, etc. It is a good place to start out, but hard to stay the 5 years due to scope of practice restrictions and the attitudes of many physicians there towards PAs.

Really? That's sad to hear. I've actually considered going over to Kaiser because I've heard they have good pay and great benefits. In what field and area of the country did you work in? I'm in ortho in Los Angeles.

[EMEDPA]

they do have good pay and great benefits. they have to in order to treat PAs the way they do.

My first job in urgent care right out of school was in CA working for KP in urgent care. they treated me well, but there was definitely a culture of "this is PA work and this is MD work".

My next job was with KP in Oregon working in EM. I had transferred into the position from CA. Better scope of practice, but many specialists refused to talk to PAs on the phone, our scope of adv skills was limited, and they called at 0630 EVERY SINGLE DAY I was off asking me if I wanted to fill open shifts, even if I had just gotten off at 0200.

The pay and benefits are awesome, that is for certain. I had KP insurance when my kid was born. difficult labor and delivery, NICU time, etc. total bill? $5.

If I was still there I would be at the top of the pay scale(step 20) and close to making $100/hr on night shifts with differentials, but would want to kill myself after each and every shift.

The final straw that made me leave was when they took the code cart out of the PA area and wanted to make a new grad fp doc my SP. when I said I should work with an EM doc they said" it doesn't matter, you are just a physician'S assistant". I handed them my pager and walked out that day. best professional choice I ever made. had a new job the next day at a level 1 trauma ctr.

[AbeTheBabe]

Wow, didn't know that, something to think about I guess. How long ago was this? The ortho PAs I've talked to who work at Kaiser seemed to enjoy it.

[EMEDPA]

I left KP 7 years ago. If you have low expectations to scope of practice and autonomy and are ok with being an "assistant" and just punching the clock for 20 years it is a great job.

[BruceBanner]

Recent Kaiser PA here. I was in Colorado.

I agree with much of what EMED stated. Three primary reasons to work at KP: job security, progressive pay, and amazing benefits.

Kaiser PAs are part of the local 7 union. As such, your job is pretty protected (you have to do something really egregious or be a major problem to get fired), the pay scale is progressive (2 guaranteed raises per year), and you get union benefits, which are excellent. Healthcare for me and my wife was essentially FREE---as in no cost to me. She had tens of thousands of dollars of office procedures done and our bill was never more than a $10 copay.

There are lots of shift differentials if you are in EM or UC. OT after 8 hours in a day, etc.

All that said, Kaiser drove me out. They are very much a commercial entity and a large bureaucracy at the same time. You will have little autonomy.  Everyone is a "chief" of something and there is a top-down physician culture there, where docs are the heartbeat of Kaiser and PAs/NPs are sort of lumped into the same labor pool. 

Kaiser is constantly forcing their "patient access" agenda down your throat. See more patients, make them happy. See more patients, make them happy. That is the refrain you will hear over and over at all the mandatory meetings they make you go to.

Getting time off was a nightmare, and their PTO offering was insulting. Sure, we got the typical week of CME, we got 2 weeks sick time, but actually using your 10 days PTO for things like, you know, time off?? Near impossible due to their patient access religion and union seniority rules.

Just food for thought. I heard similar warnings before I was hired, and they were mostly true.

 

[EMEDPA]

huh, I guess PTO has changed, it used to be awesome:

3 weeks to start, 5 weeks at yr 3, 7 weeks at year 5, etc I was at 12 weeks PTO and a week of cme when I left. had something like 400 unused pto hrs that they paid out as salary. relandscaped my whole property for that, put in a hot tub, etc.

[BruceBanner]

Wow, yeah things have changed. It could just be our regional union too.

We got 1 week CME, 2 weeks sick time, 10 days vacation, and like 2 or 3 "float holidays" which were essentially vacation days. Normal standard paid holidays.

All time off had to be requested in February of each year during the bidding period, and requests were granted by seniority. After that, you got time off approved on the basis of "organizational need", which means clinic staffing minimums.

Of course the non-union docs would take 2 weeks off every summer and scattered weeks throughout the year They also got profit sharing to the tune of ~$20-30k each December.

[cbrsmurf]

I've been at KP for 4 months now, head and neck surgery.  I and the other PA's here do ENT only.  I was hired 20 hrs minimum but work 40 hrs/wk in head and neck.  I know the EM PA's/NPs were recently switched to UC's only.

Benefits are great, but years 1-5 you only get 10 days PTO + 5 days flex time off.  One extra week of PTO every 5 years I believe.  Actually using PTO isn't terrible, but they may because I work in a specialty with normal business hours.

Coming from small practices, definitely feels like being a small cog in a giant machine.  The docs and staff have been friendly and helpful, but I hear that can vary between specialties and locations.  Patient load is reasonable.  Normal +/- of working in a small company vs a giant corporation.

[EMEDPA]

KP gets a new philosophy every 5 years every time they get a new regional medical director. If the new guy or gal likes PAs/NPs they hire tons and let them do a lot. Then the next one comes in and says PAs/NPs should only work in primary care or in very limited roles in specialties. I have seen it go back and forth 4 or 5 times. For a while they were talking about PA solo coverage of smaller ERs and urgent cares, now they are back to PAs in urgent care only. stick around and it will change again in a few years.

[Z PA-C]

9 hours ago, EMEDPA said:

KP gets a new philosophy every 5 years every time they get a new regional medical director. If the new guy or gal likes PAs/NPs they hire tons and let them do a lot. Then the next one comes in and says PAs/NPs should only work in primary care or in very limited roles in specialties. I have seen it go back and forth 4 or 5 times. For a while they were talking about PA solo coverage of smaller ERs and urgent cares, now they are back to PAs in urgent care only. stick around and it will change again in a few years.

Very true. During my rotation at Kaiser there was a surgery PA who had been an ER PA for 10 or so years but then the new regional med director decided PAs shouldn't be in ER and they had to reshuffle them around. She ended up in the gen surgery department but was doing outpatient only because the surgeons didn't want an ER PA doing first assist and don't have the time to train her.