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I forgot to post this last week. " The Next Step in your Carreer."


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The Next Step in your Career

Robert M. Blumm, MA, PA, DFAAPA, PA-C Emeritus

A multitude of PAs and NPs are on professional social media sites requesting information on how they can apprehend that first job. In contrast, I see very few requests relating to how to disengage from a current job, with the exception of those who thought that they were being victimized or underpaid. As a senior resource for PAs and NPs, I am often contacted with privileged information that many cannot openly discuss on the public forums. I thought that, as a service to you, I would undertake discussion of this type of problem with some reasonable suggestions.

Working as a PA or an NP can be akin to being a co-pilot: when you lack confidence in the pilot, their decision-making process, their inconsistent results or their visual limitations. When you begin to doubt the integrity of those that stand across the table in the OR, when the pilot has problems with truth and reality. When, as my plastic surgeon associate of 46 years asserted, “When it stops being fun, Bobby… it’s time to quit.” Perhaps it is useful to remember that a fighter jet has an ejection system that is fast to react at the touch of a finger.

What can happen if you fail to recognize that the future is looking bleak and that the aircraft will not land safely? What will happen to the two hundred souls on the aircraft or the one patient who has placed their confidence and truth in you and your profession? What if you fail to recognize the signs and then fail to hit the ejection switch or hit it too late? The answer is imminent disaster for you personally and for the patient with whom you share a sacred trust. Their assurance is your integrity. The choice we must make to eject into the unknown skies with strong winds is small when compared to being involved in a tragic medical error.

If the aforementioned conditions exist, you are on an unsure journey that could possibly end in disaster. Our very foundation is built on the iconic pledge “Do no harm.” The risks in patient care are great.  The risks of practicing medicine and nursing and caring for patients is greater if you do not have a personal liability insurance policy. Why even mention this in an article that calls for a decision to eject? Because many clinicians are unaware of their liability. They are unaware of the fact that the aircraft or the practice has ceased to be safe. They have failed to do a “walk around” and to do an intensive search of their practice situation. They have slowly been desensitized to the inadequacies of their contractual relationships with supervising or collaborative physicians. There are also those who feel a sense of obligation because they have been in a practice for a lengthy time and leaving would feel like a betrayal. These emotions spell an imminent disaster. Having thirty thousand miles in your aircraft or thirty years in practice can make you a conformist. Now is the time to be adequately insured and represented and your lifeline can be a call to CM&F and the purchase of A++Best Superior rated policy. This decision is as important as your decision to eject from your practice as it gives you the freedom to think clearly.

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