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PAinPenna

I'm finally doing it (I think)

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Hi all, 

I've been working in Family Medicine my entire PA career. I consider myself a thoughtful, kind, and competent clinician. Problem is- I'm fried. I dread going in to work each day. I preview my schedule of 20-23 patients daily . It consists of the usual PC stuff- chronic disease management (but there's always the "oh-by the way" acute complaint OR positive Depression Screen  so even those visits are no longer no-brainers) . The rest is acute complaints - URI sx x 3 days with "patient demands to be seen" in the appointment note, or better yet- 88 yo patients who are "lightheaded" or "SOB" scheduled in a 20 minute acute visit.  Well Child visits , GYN complaints, Paps etc. (but of course, even a visit for Pap turns into "why am I always so tired?", etc etc)

Patient emails all day- "I have this chronic dizziness and blurred vision and numb left toe with a rash, please answer me back on what it could be"

Then, the endless stack of Forms - FMLA, school forms , Disability paperwork (I do not determine disability yet get forms all the time) work wellness forms (with complaints of "WHY was I billed for a BMP for my "Free Wellness Examination" when I am on Lisinopril for HTN ??!!"), Prior-Auths (yes our nurses try to help but the messages dump in )

Now- we are held to keeping our patients out of the ED. We all know about inappropriate ED use, but I have no idea how they expect us to prevent patients on our panel to NOT go to the ED when they have no copay, and the nearest UC is closed on Saturdays due to staffing problems. (True story)

So- I interviewed for PA position in Endocrinology, and was offered the job. I always liked Endocrine because I enjoy cognitive work over procedures. Awesome Docs and PA's. Awesome support staff. I do not have official offer yet. Probably will be decent $$ (which really isn't my motivating factor) and schedule (which IS. I asked for a 4-day work week)

The one reason I would NOT take the job = which may sound silly- is I am completely loyal to my current SP. He calls me his "partner" , is supportive , a fantastic mentor, and just all around great guy. HE is burnt out too- so we kind of bond over our bitching. But you know how this goes- I can change specialties as a PA, and he's stuck in IM. 

I get anxiety just thinking about resigning for the above reasons. 

 

So- Just looking for some moral support from any of you who have been in this position. 

Thanks! 

 

 

 

 

 

 

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it is nice that he calls you his "partner" but does he pay you like one?

do you get the $5000 CME and the many weeks of vacation like a partner would?

 

yup is is nice to have the respect, but the finances have to go along with it

 

you are finding why people leave PCP fields for specialty medicine

Did you know that a 99214 is paid HIGHER is specialty medicine?  This totally baffles me - an office visit is an office visit but somehow a specialist is worth more.... no wonder we have to many specialists....

 

jump ship if you need to 

 

give a nice long notice - be prepared for the counter offer from him - I would aim for the physician level compensation if he wants to keep you

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He doesn't own the practice. We're owned by a hospital system. Yeah, he'd push for a counter offer but again , money is not my motivator. Not dreading going to work every day and the insane amount of administrative burden that comes with it, is. 

I think I just talked myself into my decision huh 

 

 

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I work in a similar situation. My CP has become a good friend as well and he's very supportive but I have my fair share of scut like you. I only work 4 days (0.8FTE) but I still have all the crap you deal with and have looked into specially as well. I actually was approached by a few specialty dept heads, Spine, GI and OMM (we have a lot of DO's and have our own OMM dept) but I didn't want to do OR and rounds so turned down the spine job, GI gets a lit of crap (pardon the pun) as well and I wanted the OMM job but they didn't get the approval for me to switch and now they won't get an APP for a while b/c of budget issues.

 

I'm waiting for them to green light that and would love to do the OMM gig. Won't be able to do OMM but can do other things I can train in like FDM, TPI's etc. But I'm just wading in the water until something comes up. I'm always looking for opportunities to leave FM lol

 

I wouldn't feel too bad about leaving even though my CP and I are friends. We will always be that and I'm sure he would understand why I would want to go elsewhere. I sat get in where you fit in.

 

Sent from my SAMSUNG-SM-G891A using Tapatalk

 

 

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You just described why I would never work in a Primary Care practice! The only thing keeping you there is being too nice and not looking out for yourself!!

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Change jobs.  It just gets to be time.  I've done it several times throughout my 37 years of practice, am about to do it again, and have never looked back.  Well worth the time, effort and energy.  

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IMHO  Avoid corporate medicine at all cost!  You are a perfect example of what they do and what their prioriy is. $$$$  Same for your SP.  Enjoy your new life in Endo.

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23 hours ago, ventana said:

it is nice that he calls you his "partner" but does he pay you like one?

do you get the $5000 CME and the many weeks of vacation like a partner would?

 

yup is is nice to have the respect, but the finances have to go along with it

 

you are finding why people leave PCP fields for specialty medicine

Did you know that a 99214 is paid HIGHER is specialty medicine?  This totally baffles me - an office visit is an office visit but somehow a specialist is worth more.... no wonder we have to many specialists....

 

jump ship if you need to 

 

give a nice long notice - be prepared for the counter offer from him - I would aim for the physician level compensation if he wants to keep you

^^^

Such a good post.

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You can't live your life according to what's best for someone else, such as the physician you work with.  You have to do what works best for you.

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Thanks all. 

I was offered the job. They could not offer me the 4- day schedule so I declined. I won't go back to working 5 days- ever.

Also interviewing with Addiction medicine. No- I'm not crazy- I got my DEA Waiver and moonlight over there. Very rewarding work actually.  Now there's a full-time position available and I'm checking it out. 

 

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