Confused

[Yoga517]

Hello, all!

thank you in advance for reading. I have decided to present my situation here, as I feel like I have a better chance of hearing from unbiased parties. :) I have been a PA for about a year and a half, being at my first job for about a year. I work in a specialty, with nice hours and no weekends or holidays. (Very fortunate).  In our clinic, each of the physicians Work one day per week, and I am there full time so I help each doctor on their “day”. This includes some procedures, but mainly writing notes. I don’t see my own patients. I do see their patients if they are away, etc. it has been this way since I started. I was okay with it at first because I am new, however it is getting old. The dynamics are also tough. The supervisor for the clinic is an rn, and I have found that I am often the “middle man” between the nurses and doctors. I feel like I plug in holes (call backs, prescriptions, making decisions for care via phone when Dr isn’t available). I am afraid to bring this up because I guess I hope that there is a bigger future for me. We are supposed to be expanding in the next three years to a new space (we don’t have room for the drs there now, let alone me seeing my own patients ). The drs I work under love me and tell me how appreciative they are of my help regularly. They also take my advice on decision making for patient care, which is rewarding. But I can’t help feeling frustrated about the situation. Sometimes I wish I worked under one physician, and maybe I would have more independence if that makes sense. Am I expecting too much? Please be honest. 

[MT2PA]

So you're a glorified scribe/MA with the occasional chance to see patients only when they are out?  It sounds like you are the epitome of 'assistant' and not remotely a PA.  Not to be harsh, this isn't your fault, but if it were me, I would be looking for a new position.  The way you've been used and utilized to this point is not likely to lend itself to you finding autonomy or independence within this practice as they have grown accustomed to you doing the grunt work.

[Yoga517]

I was afraid someone would say that ?

[MCHAD]

Completely agree with the above statement.  The docs you work for are basically paying a ridiculous salary (if you’re being paid what PA’s should make) for an MA/Scribe.  I worked in a similar situation in oncology after working primarily independently in primary care for 4 years...I only lasted 10 months in oncology before I couldn’t take it any more.  

[jmj11]

Professional satisfaction for a PA is most experienced (surgery the exception) when you have your own patient panel, when YOU have a personal relationship with YOUR patients. It is only a matter of time before you will leave that job because the lack of professional satisfaction is not sustainable.

[EMEDPA]

satisfaction is based on autonomy with an appropriate scope of practice, respect from your peers and patients, and an appropriate salary. took me 20 years to find the right mix.

[Wish1pa]

I personally would not be happy in a position like this. I considered taking one very similar and decided against it because I knew I wanted to be more independent to be a happy PA. Some people may be happy doing this kind of job and thats fine but thats just me. If you're already not happy and they can't promise a change I would start looking for another job

[south]

I don't think this situation is unsalvageable; from your description it seems like a decent set of folks to work with.  I would voice your concerns and perhaps some changes can be made. 

You could point out that they can hire an MA or scribe for a few bucks an hour and free you up to bill for more actual PA work.  This generates a ton of money and makes you feel like you are progressing.  Win all around. 

If nothing changes within a few more months, then get your CV and your boogie shoes dusted off.

[GetMeOuttaThisMess]

I’m going to offer an opposite opinion. You’re a year and a half out and wrinkling in a non-specified specialty setting. I think the last part of the statement may be the source of your trouble. What’s the specialty? Is it possible that they are expecting you to pick up additional insight before turning you loose? Are you in a metro area where your docs are concerned about blowback from PCP folks when your following the pt as opposed to the specialist? I know one of my PCPs has this attitude since his statement is that he could have followed them himself. Just thinking about other possibilities. BTW, back in the early 80’s this WAS the typical specialty job description.

[jwells78]

If the group really "loves" you and are willing to help you realize your full potential, perhaps there is room for improvement.

 

Unfortunately, the situation sounds a lot like

1. They dont understand what they have in you being there (your scope/skillset)

or

2. They fully understand, and like it (want it) the way it is.

 

The RN manager likely has no idea what your scope could be, and who knows what gets whispered in the ear of the leadership in the office behind the seens (sorry, cynical eye).

 

If you like the specialty and the group, I would consult other PAs in your specialty /state and see what they are up to, procedures and pt load/such.

Then I would take your left foot and stick it as far as you can in the doorway, and start pushing your way into responsibility.

Go get it.

Take the initiative.  

If they push back, sit down with the Doc(s) and tell them you can be a much greater asset to them, "and here is how."

 

Drag that horse to water, as it were. 

[ALC0313]

You're definitely not expecting too much. I wonder, what made them decide to hire a PA to begin with? They're defnitiely not getting their money's worth out of you. If the doctor saw less patients on their "day" in clinic and you saw more, they would have time to do their own notes and you could gain some autonomy while continuing to learn. Maybe if you approach them with a solution to re-work the current arrangement it will help make some productive changes. If nothing else it will help you gauge how willing they are to work torwards expanding your scope... if they're not interested then I would start to look elsewhere.

Can you tell us which specialty?