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ALTERNATIVES TO CLINICAL MEDICINE FOR A PA

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I've been doing ER medicine for 14 years. I'm at a point where its become so stressful dealing with over worked hospitalists, lack of quality nursing staff, arrogant specialists and the bullshit hospital bureaucracy , I need a change. Looking to transition into a non clinical role. Any suggestions would be greatly appreciated.

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Well, I can't tell you where to look, but I can tell you where not to look. I was interested in transitioning out of clinical side, and got a Master's in Health Administration. After 2 years of looking for a position that is not a $70k reduction in salary, I can say that if you don't know someone or have a ton of admin experience already, you are wasting your time and money. At least, in my experience.

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I don't think there's a whole lot for a PA in a non clinical arena. I was thinking of this a few years ago. I remember posting here on it. Only thing I found was PA program Professor but the pay was such a big step back. It was about 50-70k less. The plus side was, at the time, there more than a few positions as PA programs were popping up all over the place.

 

My solution was changing specialties... Will let you know how that goes. I start in April lol

 

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True. When I was at a CAH we had a medical staff of 6. Me and the docs and PAs from the local practice. We were full voting members of the med staff. Volume was low. Acuity varied wildly but bad stuff was transferred to bigger facilities elsewhere. COL was low too. 

We were about an hour or so out of Dallas so it was easy to get our big city fix most anytime.

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CAH, or just consider looking at a different hospital in general.  I've been in my ED for 16 years (big academic hospital); love 99% of the nurses, generally good interactions with specialists, and no problems with our hospitalists because the ED determines who gets admitted without their input.  Bureaucracy is everywhere, but there are definitely always better places out there. 

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I can set my watch by this type of thread every 2 months LOL.  The answer is......jack squat unless you want to teach.  Some have been able to go into a business position/admin or write test questions etc, but as far as a real viable profession that use the Physician Assistant degree?  

 

...."Swing and a miss!".

 

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It's interesting that this forum always seems so pessimistic about this topic, but the truth is there are options out there that don't require a huge pay cut. Here is an article discussing non clinical side hustles, but it could just as well be applicable to full time careers, too
https://modernmeded.com/non-clinical-side-hustles-part-ii/

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1. pharm reps

2. teaching

3. PA school administration 

4. Practice manager 

5. Small practice rural area PA 😉 

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22 hours ago, medic25 said:

CAH, or just consider looking at a different hospital in general.  I've been in my ED for 16 years (big academic hospital); love 99% of the nurses, generally good interactions with specialists, and no problems with our hospitalists because the ED determines who gets admitted without their input.  Bureaucracy is everywhere, but there are definitely always better places out there. 

I love this. I have only worked at 1 place that did this. it was also a big level 1. all the admits were done by IM residents. the discussions went like this: "Mrs smith in bed 3 needs to be admitted. she has pneumonia. thanks. "

I work at 3 CAH EDs now. they all have hospitalists (FP) who generally are not overworked, so the only time they refuse an admission is if they feel the pt needs something we can't get quickly(procedure, consult, etc). really feels like more of a team thing. I know all of them well and we socialize outside of work. at some big places, the only goal of the hospitalist is to avoid work until shift change so they give you this list of extra tests to get before they will accept. by the time the tests are back, they are off shift. At 2 of the 3 CAHs the docs are on 24/7 call from home for 7 days and generally round every morning, so there is no reason to put off an admit for 2 hrs for silly tests. At the slightly busier CAH, it is a small group and they know they are screwing their partners if they put off an admit, so they accept anything within 30 min of shift change. 

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9 hours ago, EMEDPA said:

I love this. I have only worked at 1 place that did this. it was also a big level 1. all the admits were done by IM residents. the discussions went like this: "Mrs smith in bed 3 needs to be admitted. she has pneumonia. thanks. "

It's hard to explain how great a help this is to your mental health until you work in  a system where you decide who gets admitted and who doesn't.  You've got a little old lady feeling weak who looks good on paper but something just feels a little off to you?  Then you keep her in the hospital for observation, and don't lose sleep over sending someone home who might have a bad outcome.  We even stopped having discussions with the admitting teams years ago; the only time I make a phone call is for an ICU/stepdown unit admission.  Otherwise we just enter the admission order and make sure that our note is written, and the admitting team gets the story from the chart. 

I've had this conversation more than once with students and new grads; don't just look at the salary, look at the ED resources and how the system works.  Sometimes it's worth giving up a little salary to work in a shop with systems in place that help to keep you sane.  

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If you have a loose definition of clinical....

I have a friend who does VA disability physicals through a government contractor

Another friend who stated a company and does only firefighter and law enforcement qualification physicals

A couple of buddies who do online reviews of workman's compensation claims

The UC I just left in Washington state hired a couple of PAs as regional medical directors...spoke with an NP who interviewed for one of the positions and it would have been a pay cut for her so she passed. Only required 1-2 days of clinic per week I think

If you have a Masters you could teach at a community college

If you have a Doctoral degree you could teach as most colleges with a PA program (some will take masters, better salary with doctoral however)

The Army is looking for a TCCC (traumatic combat casualty care) instructor at Fort Sam Houston (or was recently) however this requires military experience in a combat zone setting as a PA or senior medic.

Most military posts hire contract PAs to perform pre and post deployment reviews...the extent of your physical exam might be listening to heart in lungs but is mostly chart review and asking questions.

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