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Wow ctalbot, no offense but you seem like a defeatist, perhaps a career in theater would suit you well.  I agree this is likely a troll.

Ways to work as a physician assistant without "giving medical advice"

-  Do PHA's for the military (periodic health assessments) go through screening questions and flag those charts who need further evaluation/treatment.

-  Do physical examinations for insurance companies.  Are you comfortable interpreting basic labs, and listening to someone's heart and lungs?

-  Go work in one of these new fad weight loss clinics.  Sell nutrition bars, shakes, supplements and encourage people to exercise. 

 

Seriously, did you get yelled at by another clinician or something?  I have never met a second year out of school PA-C who "knows everything..." sounds like you went into the completely wrong field... Amazing you didn't realize it sooner.

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Ok up date, if you actually care lol Existential crisis averted. Basically just focusing on helping patients rather the idiocracy that flows around me on a daily basis (psychiatrist of 20 something ye

Don't make some of us go Army/Navy/FMF all over you and tell you to stop the self pity stuff - glass half full says you passed your certification exam, so therefore can't be (a) stupid and (b) unknowl

Confidence comes from one of 2 places. Hubris or experience. The first gets people killed. The second comes only with time in the trenches. Experience and learning from it never ends and anyone who te

I’m going to play devils advocate again (my specialty).  Maybe the OP is a smooth talker and was able to sell them self well to get into school and can memorize like nobody’s business, but like many I have run across, can’t apply what they’ve learned to real life situations.  My wife sees it as a professor for a dental hygiene program all the time.  Every year I wonder how such and such whom she talks about made it in to their esteemed program.

Bottom line, to answer your question, there are other options, many of which won’t pay as well.  Field agent for the ME.  Teach a college level/high school science class.  Do insurance review work for major insurers in-house.  Med sales.  Sell health insurance.  Go back to school and become an actuary.  Mortuary work.

i don’t particularly blame you for not liking the work.  People are a PITA.  The science is interesting but the people part can be a killer, especially for a type A.  Out of curiosity, male or female?

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Caveat: didn't read all the above responses

My Response: stop the pity party, I've been told by more than 1 physician I work with that it takes 5 years to fully get comfortable in medicine - and most primary care residencies are 3 years...so physicians finish residency and still don't feel fully comfortable for another 2 years!  You are only 2 years in and don't feel comfortable...GOOD!  Now you have a choice to make, get out of providing medical care and do something else or work you butt off and gain confidence.

If you decide not to provide medical care because you lack confidence, knowledge, etc. then PA education should not be the answer.  Is there a behind the scenes job for a PA that doesn't involve patient care, no idea.  If it were me, if I'm getting out of patient care I'm sprinting from healthcare entirely - so look for a new career path.  Get an MBA or something.

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CTALBOT,  I read somewhere that it takes 5 years to be proficient in what you do.  That refers to all occupations.  I retired after 31 years of practice and almost everyday learned something I didn't know.  That is what medicine is about and kept my interest for 31 years.  It is ever changing.  The only thing that doesn't change and caused me to pull the plug on my career are the doctors and the bureaucracy that we are forced to work in.  My advice to you is to to talk to a senior PA that you can share your concerns with before doing anything rash.

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Confidence comes from one of 2 places. Hubris or experience. The first gets people killed. The second comes only with time in the trenches. Experience and learning from it never ends and anyone who tells you they haven't had a "miss" in their career is kidding themselves.

I have been at this about 30 years and have fairly broad experience. The other day mom brought a baby in because "he just isn't right" and "he seems sleepy" and "the babysitter says he took a 3 hour nap and he never does that." I went over this kid with a fine tooth comb...twice. He was sleepy but aroused and fussed at me when I pestered him.Vitals were perfect. Exam was benign. I told mom to watch him for a couple of hours and see what happened. If he popped back great. If he didn't or anything worsened in any way go to the ER. The next morning I checked and they had gone to the ER. Benzo overdose. The babysitter drugged the kid so she wouldn't have to watch him. Never crossed my mind. It was a hard miss and I'm smarter for it and the kid is going to be fine.

It shook me but it didn't break me. Hang in there a while longer and you may find confidence will come to you with more time and experience.

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38 minutes ago, sas5814 said:

The next morning I checked and they had gone to the ER. Benzo overdose. The babysitter drugged the kid so she wouldn't have to watch him. Never crossed my mind. It was a hard miss and I'm smarter for it and the kid is going to be fine.

It shook me but it didn't break me. Hang in there a while longer and you may find confidence will come to you with more time and experience.

As a parent of a toddler, this makes me feel murderous... and might give me nightmares. What is wrong with people!?

This actually happened on the show Shameless and I didn’t think it was funny and worried me that stupid, horrible people might get ideas from it. :(

Did they do a tox screen when the baby came back? How did they figure out the sitter did it? 

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Tox screen in the ER was positive for benzos. Neither Mom nor Dad had an RX for anything similar and there was none in the house and no known drug use and they had been gone from the home for 4 hours when the baby started acting "sleepy.". Prelim investigation showed sitter has RX for benzo. The investigation continues but that is the preliminary opinion based on what is known at this time. 

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On 10/16/2017 at 9:51 AM, SERENITY NOW said:

So you don't enjoy being a PA because you're not confident in your abilities and medical decision making?  I'm 2 years out and still don't know a ton as well, and I'd agree that not knowing things and feeling inadequate does lead to stress and burnout.  However, the takeaway I get from that realization is that I need to learn more, to study more, to find mentors to continue helping me grow, etc .... not to give up!  I'm sure you knew that learning medicine wouldn't be a walk in the park... its incredibly challenging, but that makes it all the more fulfilling once things finally start to click after all of that hard work.   

I Agree with this post. "Impostor Syndrome" is a real issue with not just PAs but Docs too. It is often cited as a major reason for provider burnout. We've all been there I am sure.  

OP, you are only 2 years out. You are still in your "informal residency" in my opinion. Find jobs and Docs who will mentor you and provide an environment to learn more. The answer to ignorance is education not surrender.  

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I'll be frank. It's possible you're bad at your job, but I think it's less likely if you have the insight to doubt your own decision making. It's more likely that you just hate the uncertainty that comes with this job and are burned out, which pretty much everyone who is a provider has experienced.

The worst providers I've met all think they're fantastic. In reality they're dumb as fucking rocks. Lack of self confidence is not the same as incompetence, you need to make sure you're not shorting yourself.

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4 hours ago, sas5814 said:

Tox screen in the ER was positive for benzos. Neither Mom nor Dad had an RX for anything similar and there was none in the house and no known drug use and they had been gone from the home for 4 hours when the baby started acting "sleepy.". Prelim investigation showed sitter has RX for benzo. The investigation continues but that is the preliminary opinion based on what is known at this time. 

That is evil. I hope that babysitter gets sued and imprisoned and karma comes after her. I’m so glad the baby was okay. I would be pretty shaken up by that case, too. 

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To address the OP issue, I wonder if you could use some counseling and/or an SSRI because it sounds like you’re in kind of a dark place. I have a friend who went through a horrible time at his physical therapy job in an inpatient rehab center that led him to question his career and also caused some pretty serious hypochondria and paranoia about his health. He switched to an outpatient, sports rehab type job and started Zoloft and it’s been like night and day. He loves being a PT now and hasn’t had any more ER visits or MRIs for anxiety that he thought was MS, cauda equina, stroke, etc (the hypochondria got pretty bad and really expensive). 

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If you want to be blunt, think of it this way: somewhere out there is someone who graduated the same year as you, maybe even someone from your program, who is WAY more stupid and unprepared than you are.

And yet, this hypothetical person isn't tying him- or herself in knots and questioning everything. He/she is sailing along, doing their best, learning as they go, and gradually getting better. 

The question is, do you want to give up, and let this chucklehead actually become smarter and better than you, or do you want to figure out how to proceed? The impostor syndrome is real, and nobody is perfectly able to identify where they're at on the Dunning-Kruger curve. The fact that you're worried is probably good, but worrying isn't all that helpful. Talk to a mentor, and if you don't have one, please get one. Get a bunch, if you can. 

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Ctalbot, a few months ago I was fired for making a couple minor mistakes when I was 38 weeks pregnant. it really shook my confidence because, only a sh*tty provider would get fired when pregnant (I thought). And I have a been a pa for 4 years. But I remembered that I did well in pa school, I passed the boards by a decent amount and that practicing medicine is not supposed to be easy. But I love it so I keep going and now I have a job that I am thriving in. I have always had somewhat of a confidence problem but I compensate for it by working hard and studying. If you got into this profession for the right reasons and not because its "cool" or pays well, then you can overcome this

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On 10/19/2017 at 10:30 AM, Wish1pa said:

Ctalbot, a few months ago I was fired for making a couple minor mistakes when I was 38 weeks pregnant. it really shook my confidence because, only a sh*tty provider would get fired when pregnant (I thought). And I have a been a pa for 4 years. But I remembered that I did well in pa school, I passed the boards by a decent amount and that practicing medicine is not supposed to be easy. But I love it so I keep going and now I have a job that I am thriving in. I have always had somewhat of a confidence problem but I compensate for it by working hard and studying. If you got into this profession for the right reasons and not because its "cool" or pays well, then you can overcome this

Did they fire you for your mistakes, or were they looking for a way to get rid of you without having to pay for you (and your bennies) for maternity leave? sounds like they were daring you to file a discrimination suit. 

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1 hour ago, boli said:

Did they fire you for your mistakes, or were they looking for a way to get rid of you without having to pay for you (and your bennies) for maternity leave? sounds like they were daring you to file a discrimination suit. 

Good question..hard to say for sure but after reflecting on it and many many many people telling me my mistakes were not fireable offenses, Im thinking the latter...but at the time it really shook me up!

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What about attending a conference specific to the field you work in? Sometimes sitting in a classroom with others as excited as you (and others willing to learn) is refreshing! I have many times I feel similar, but then I attend a lecture or read an article or something and am re-energized, mostly because I love the field I am working in. I am 1.5 years in, but considered leaving my job (but not the career!) because I felt similar and no one I worked with wanted to train or teach me. Luckily, one of the docs took a special interest in my education and now I don't dread going to work. Maybe you just aren't working with the right people?

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you could also go into surgery... which can be anything, cardiothoracic, ortho, plastics,etc......you just assist the doc in procedures and when you’re doing clinic your just checking wound sites... that doesn’t require too much diagnosing.. per say.. or you can do EP cardiology just round on patients and get h&ps on patients who need ablations, ppm, or ICD’s there’s limitless possibilities as a PA that’s one reason being a PA is soo appealing. :) Hope you find your passion!


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OP first of all:  Do you want to improve and get more proficient and become a competent and confident clinician?  Or do you want an exit out to pasture where you just punch a clock and get a check with as little medicine or effort as possible?

If it's the former, then that's on you to study and learn, and ask for help.  No one is going to serve it to you on a platter, like your education thus far might have.  The rest of your life is in your control; the days of having an instructor/mentor/professor are pretty much over. You are going to have to pull out the adult britches and join the fight.  Are you studying during your time off?

The latter is a narrower choice but there are options.  Many have been posted here.  There are "retirement in place" gigs and an aggressive job search will turn them up.  

Here's how I know that:  I got myself in a but of a situation and posted a thread asking whether I should take a job at a chiropractic/wellness/rehab clinic doing nothing but dozens of "trigger point" and the occasional B12 injection, over and over all day every day.  Career wise, a dead end, but it pays pretty well.  Chiros in my state can't give injections.  There are about 6 or 7 of these jobs currently on the boards (mostly Indeed).  

I also agree with those suggesting you consider seeing a counselor or other mental health professional for an evaluation.  There's no downside and it may help. 

Best of luck and let us know what happens.

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Separately, I feel the need to respond to a couple of things.

I join the response to EMEDPA's post about residencies/fellowships.  These have been a lot more competitive than most people think, especially in the last couple of years.  I know this for an absolute fact with my own fairly significant "n" value, and I think I should probably leave it at that.  I did pass by the blatant slave labor and/or three-year contract at half pay BS, but even the ones with a long reputation of being very disorganized and a bit of a "last resort" got 65 applications last cycle.  This has come as a bit of a surprise to everyone, based on the language in the rejection letters.   

Also re: surgical jobs.  For some reason, I wound up in this field, and believe me when I say that nearly everyone, especially surgeons, want a position where they happily skip from case to case without any yucky rounding or clinic.   These positions probably exist, but I've yet to find one.  Patients need to be seen and managed by the surgical team pre- and post-op, and if they are admitted to you, then congratulations, you are managing their pain/diabetes/adrenal insufficiency/decubitus ulcers.  This means that there are a lot of surgeons and surgical PAs that spend most of their time rounding and in clinic, which they think is a waste of time or beneath them.  And some won't shut up about it.  

Just a few comments from my brain.

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