Share your experience of the first day!

[camoman1234]

Just now, jmj11 said:

I stayed about 10 months, fighting the system, only because I had just moved my family there and we had starting building a house. My SP "caught me" seeing his patient and then had the hospital move me to tiny office, separate from his, where I could not touch a patient. Why would they hire a PA? By going from a regular clinic to a RHC (moved a few hundred years outside the city limit and hired a PA) they would make several hundred thousand dollars a year more as a practice.

So weird they would do that and piss their money away. I can't believe you stayed that long! :) 

[Nycpac33]

On 3/21/2018 at 11:06 AM, jmj11 said:

I stayed about 10 months, fighting the system, only because I had just moved my family there and we had starting building a house. My SP "caught me" seeing his patient and then had the hospital move me to tiny office, separate from his, where I could not touch a patient. Why would they hire a PA? By going from a regular clinic to a RHC (moved a few hundred years outside the city limit and hired a PA) they would make several hundred thousand dollars a year more as a practice.

Omg... so sorry about ur horrific experiece! Thank god its not like this anymore although ive ran into a few butt hurt attendings who gave the stink eye when witnessing a PA run shit... ??‍♀️ #buildabridgeandgetoverit

[camoman1234]

On 3/20/2018 at 10:47 PM, jmj11 said:

It is too complicated to try and to explain. I was heavily recruited by a hospital CEO and Medical Director. I went in under the pretense that the medical director (a decent man) was going to be my SP. I made many trips to the area, asked all the right questions and was lied to each time. It was a plan all along to create a fake Rural Health Clinic (which required a PA). After I signed the contract, and after I moved my family to the area, they then informed me that Dr. X would be my SP, the one who hated PAs but loved Rural Health Care money. In the end, we went to court as I sued them. They settled out of court.

What money is Dr. X speaking of from RHCs? I work in a RHC and we get paid about 70 cents on the dollar. Definitely could make more money elsewhere or NOT being a RHC. Now, prior to taking over this practice, it was a pill factory and the patients were told you get your script monthly and that is it. You must come back for other issues. Now you can make good money that way. Here is what this clinic was doing, 300 schedule I scripts per month x $80/patient and you spend about 30 seconds to 1 minute per "refill" per month, plus you have sick patients, etc... That is a guaranteed $288K per year and you are in the room about 1 minute...Maybe that was his thought...? 

[sas5814]

RHCs get cost based reimbursement from Medicaid. It is significantly more than if you aren't a RHC. The numbers have, of course, changed since I was in one but we got $87 per Medicaid visit. If we weren't a RHC we would have gotten $18. It really only makes money in Medicaid heavy areas.

[TheDude]

My first day in CV Surgery goes like this.

Showed up at 0545 to round-this was after credentialing was approved and sat around my house for about 4 weeks so this was truly day 1 besides computer training and all.  First patient to see was a pre-op for a thoracotomy.  Reviewed all the notes, looked at his films, reviewed the consent.  Time was about 0630 and went in to talk to him about the surgery,  Had a somewhat altered mentation, and as a former flight paramedic I wasn't a total idiot, but had a bad gut feeling about this fella.  Didn't feel comfortable signing his consent for the surgeon or marking the patient, walked out in the hall and another PA with the CV Surgery service was there.  Asked her opinion on the matter, and was met with "not my patient, not my problem, you should know the basics before coming in on day 1.  Good luck." and was said very snidely I must add.  Long story short, the guy was having a brain bleed.  I called my surgeon and told him, he told me he didn't care and to "sign the fucking thing."

Went to OR with another PA (who to this day is still a mentor in my eyes and close friend) and his Surgeon and took vein for the first time, and felt a sense of accomplishment when I managed to have the senior Surgeon compliment me.

Ran into the fist PA who was a B to me earlier in the morning, and she proceeded to berate me because my surgeon had to call her to go see a consult because I was in the OR.  "I don't care if you were in the OR, you need answer your pages when called."  I didn't have a pager yet and no missed calls or texts from my attending or anyone else

Rest of the day was me sitting in an office overlooking the helipad and wondering if I made the right choice 

I stayed with this shit show for over a year and half and when I made the move to another practice in the same specialty, I made a vow to not being a d-bag to someone on their first day.    

[Audra1111]

On 3/22/2018 at 8:54 PM, TheDude said:

My first day in CV Surgery goes like this.

Showed up at 0545 to round-this was after credentialing was approved and sat around my house for about 4 weeks so this was truly day 1 besides computer training and all.  First patient to see was a pre-op for a thoracotomy.  Reviewed all the notes, looked at his films, reviewed the consent.  Time was about 0630 and went in to talk to him about the surgery,  Had a somewhat altered mentation, and as a former flight paramedic I wasn't a total idiot, but had a bad gut feeling about this fella.  Didn't feel comfortable signing his consent for the surgeon or marking the patient, walked out in the hall and another PA with the CV Surgery service was there.  Asked her opinion on the matter, and was met with "not my patient, not my problem, you should know the basics before coming in on day 1.  Good luck." and was said very snidely I must add.  Long story short, the guy was having a brain bleed.  I called my surgeon and told him, he told me he didn't care and to "sign the fucking thing."

Went to OR with another PA (who to this day is still a mentor in my eyes and close friend) and his Surgeon and took vein for the first time, and felt a sense of accomplishment when I managed to have the senior Surgeon compliment me.

Ran into the fist PA who was a B to me earlier in the morning, and she proceeded to berate me because my surgeon had to call her to go see a consult because I was in the OR.  "I don't care if you were in the OR, you need answer your pages when called."  I didn't have a pager yet and no missed calls or texts from my attending or anyone else

Rest of the day was me sitting in an office overlooking the helipad and wondering if I made the right choice 

I stayed with this shit show for over a year and half and when I made the move to another practice in the same specialty, I made a vow to not being a d-bag to someone on their first day.    

I am starting my first job in surgery in less than two weeks and this is exactly what I am afraid of. Except there's no way I will let another PA talk to me that way. I would have definitely said something to that her for sure. What exactly did she mean "know the basics"? What was there to know on day one besides show up and learn? You should not have been doing the consent or explaining any surgery if you were brand new. Shame on them for that! Your job the first month even is to learn the basics she so rudely spoke of. WTF is wrong with her?!

In regard to the surgeon, that was unsafe practice so he shouldn't even be practicing after what you just wrote.