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Should I leave?

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Alright, I really need to vent some. I am in practice with 2 docs. The main guy I have been with almost 6 years. I was very busy seeing patients and surgery assisting with the main SP before the newer guy came in almost 2 years ago. The practice consists of 50% work comp and the rest medicare, hmo, and private patients. It seems that I am seeing a lot less patients and doing less in general since the arrival of the new guy. The main SP has had a few lawsuits in the past year (nothing involving me) and is paranoid that everyone is out to sue doctors because of the economy. The lawsuits were nothing that he was at fault for and 2 were dropped. So now, he is not letting me see any pre-ops anymore and overall see less patients. I am doing more paperwork than anything else. On top of that, since we do a lot of work comp, some insurance carriers for these companies don't want a orthopedic PA seeing their patients which makes things worse. He doesn't really back me up with these carriers because he says he doesn't want to lose the accounts. He doesn't want to let me go because of my help in the surgeries. I really want to go to a hospital ortho position, such as kaiser. My salary is pretty good, but I feel I will not grow either with this guy since I'm doing less in the office. My last raise was 2 1/2 years ago. Any thoughts? Should I leave or just wait it out?

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Im not there yet, but I sure as hell would be moving on. You have a paranoid doc and a pretty poor employment relationship now, for whatever reasons. Your development is definately being halted, and that aint good for you long term. And there are many other ortho docs looking for your services. He's obviously afraid his practice is gonna tank, I would just let the two docs have at it, sounds like it's gonna be awhile before he is comfortable letting things "be normal again".

 

Maybe you interviewing and coming to him with your notice to leave will change his tune, but Im gonna guess not.

 

This is what happens when the clinic takes on all that work comp, there's a lot of pissed off people involved.

 

Onward and upward I say.

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I'm not worried about job security with him. He has time and time again stated that I'll always have a job with him, and he did pay for my PA schooling, but I've done more than my share of repaying that back to him. He hasn't cut my salary nor does he intend to, but it's the long term that I'm worried about. He cut the staffs' salaries by 10% all around but not mine about 2 years ago and he hasn't given them a raise either. I have gotten steady increases up until now and things aren't getting cheaper in Southern California. The odd thing is the younger doc isn't that busy either and is planning on leaving probably in a year or so, once he passes the boards and once his wife finishes her cardiology fellowship.

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Move on... but keep in touch.

Maybe in a few yrs... when he and his new pal divorce... he will ask/beg you to return and you can if the price and scope of practice is right.

Move on... but keep in touch.

 

Contrarian

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Thanks for the feedback. I'm really hoping to get into a kaiser gig around here somewhere, but no luck yet. As soon as something pans out, I'm not going to look back. A few years back I had the opportunity to go there but I had to stay loyal because of him paying for school. At this point though, I'm looking for the right opportunity which may mean a pay-cut ,but hopefully, I can work my way up again. Hopefully, I don't burn my bridges with him.

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True, you want to leave on a good note, but that may/may not happen. You say he hasn't given you a pay cut but the cost of living always goes up and your salary hasn't gone up with it. Maybe leaving will be good for both of you. You can extend your skills and he will recognize what he lost...it's up to you. Ball is in your court.

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He doesn't really back me up with these carriers because he says he doesn't want to lose the accounts. He doesn't want to let me go because of my help in the surgeries. I really want to go to a hospital ortho position, such as kaiser. My salary is pretty good, but I feel I will not grow either with this guy since I'm doing less in the office. My last raise was 2 1/2 years ago. Any thoughts? Should I leave or just wait it out?

 

In the perfect PA/SP world there would be a honest conversation about your role and your need to have growth as a professional within this practice. In reality it's been my experience that when the feeling of being under utilized hits, it's time to brush up the resume and be proactive in your own professional advancement. IMO putting you professional advancement on hold until the other doc leaves really isn't a good idea....1 year or so is an awfully long time to be pushing papers without any guarantee about your role.

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Since he paid for your schooling and has appeared to respect you quite a bit up to this point, I would definitely give him the benefit of the doubt once you have a job offer in hand. That would be the time to approach him with your concerns and have that "honest conversation." If he can't/won't oblige, then he should understand at that point, you need to move on and when things change on his end, he will have your contact information, should he want you back, and you want to go back.

 

But have that conversation with him, he seems to deserve that IMO, just have that job offer beforehand, should he get rubbed the wrong way.

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Move on... but keep in touch.

Maybe in a few yrs... when he and his new pal divorce... he will ask/beg you to return and you can if the price and scope of practice is right.

Move on... but keep in touch.

 

Contrarian

 

Yup that's the way to go!

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I've never heard anything good about kaiser.

 

I have talked to a couple of PA's here and they seem pretty happy. Both have been there for several years. I guess it depends on which one you go to.

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He paid for your schooling?

 

Wow!

 

Not really that astonishing when you consider in-state community college/certificate program tuition rates at that time and that we generally bring in 3-4x our employee burden...

 

There were about 5-6 people in my class who's job was paying their tuition so they didn't need loans. At the time in-state tuition was only ~ $1500/qtr (5 qtrs) so several of my class mates who were hospital nurses had their full tuition paid for with employer tuition reimbursement.

 

My tuition was only ~$25k so if I was being paid $70k/yr and billed $250k/yr ...

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Not really that astonishing when you consider in-state community college/certificate program tuition rates at that time and that we generally bring in 3-4x our employee burden...

 

There were about 5-6 people in my class who's job was paying their tuition so they didn't need loans. At the time in-state tuition was only ~ $1500/qtr (5 qtrs) so several of my class mates who were hospital nurses had their full tuition paid for with employer tuition reimbursement.

 

My tuition was only ~$25k so if I was being paid $70k/yr and billed $250k/yr ...

 

 

Yeah, you're right. If I remember right, my tuition was roughly a little above $30k for the whole program, not counting that I paid for all the books and supplies. I had enough nerve, I guess, to ask him if he would do it back then, and he did. He knew me pretty well when I was a OR tech and I used scrub on all his cases back then. For someone who has been an orthopedic surgeon for over 20 years, $30k is a drop in the bucket, believe me. Money is the last of his worries, even though he will constantly complain about not making enough.

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do you guys sign a contract or something? what prevented you from running off and going somewhere else after PANCE?

 

 

No, I did not sign any contract with him, but I didn't want to walk out on him either since he did pay for my schooling.

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A good sp is hard to find. If you have a good rapport, get respect, you have to decide if it's worth it. You could move on, hook up with another doc that could make your PA life terrible even though you're getting paid more. You would literally dread going to work everyday.

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Well, the time has come today where I will be telling my SP the good (bad for him) news that I'm leaving. I got the dream job that I wanted (Group of 4 docs and 1 PA, 10 minutes from home, better pay with production bonus, matching 401k, etc, etc) after searching and interviewing for a few months. Just kinda nervous about telling him. Have a feeling he might throw a fit.

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Hi all, although I have had this account for some time now I am very new with forums in general, so please take it easy with me... I have a similar situation with my current employer I need to vent too, I think I can probably get some advise here as well. here is some background about me, I graduated and started working mid 2009. I have experience with ortho (private practice with surgeries done in hospital and sx center) and some internal medicine. I am currently working as ortho PA for a trauma hospital. I am the only PA of the orthopedic team, there are five residents and 4-5 attendings in the team. I have been working for the hospital now for a year.

When I interviewed for the job I was promised to have fair amount of OR first assist hours, but as soon as I was employed and had left my other job the chairman told me that this is MD/DO residency program he has to keep the residents happy as "the residents are the bread and butter of orthopedics" "They have to learn" etc, so I don't get to scrub in unless the residents are not around. I have to carry the orthopedic pager which is not a quite pager every single day and respond to pages that come in from ED, FT, Trauma Bay, Floors, and 2 nursing homes. In addition to do all regular floor work, seeing and following patients in clinic, ambulatory pre-op, post-op etc.

I officially work for 37.5hrs/wk for $37/hr, although I am not salary based, and supposed to get paid hourly and OT, I have not even had an hour of OT this past year despite my many many Over Time stays to cover residents on most of days, and when I say OT stays, I'm not talking about 10-15 or 20 minutes, there had been days that I stayed 4-5 hours after my working hours had finished and still no OT pay. Despite this and the fact that I work during my one hour break time that is subtracted from my total hours, I have to admit I love my job and the orthopedic field, reducing of fractures, locating the dislocated joints, splinting, castings, pre-op/post-op evaluations, treatment plans, etc, etc, however my issues is that I get to be "forced" a lot by the residents that come and go every 2-3 months, and one attending that is always there to do things that are not necessarily my responsibility or dumped on me, eg. pt transfers (literally pushing the wheelchair or the stretcher), social work issues, all phlebotomy and EKG work that for some weird reason no nurse or tech or phlebotomist would do (since the resident on call at night did not order,...), paper work that no one else wants to do etc. In short I get to do a lot of scot work, and cleaning behind every one else in addition to my regular duties.

I need your advise, is this what a regular ortho PAs does? is this normal? should I quit/leave? ps this is a 1199 union position and I am just afraid if I approach the union, worried about thing becoming very messy. I would appreciate your kind advise.

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