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I have been a  PA for over 10 years now and worked at my current practice for over 5 1/2 years.  I've worked with the same two very supportive supervising physicians this whole time and believe I have more than proved myself competent.  It's family practice, so I see my own schedule of patients and don't hesitate to ask my SPs for advice or present a case for their opinions.  Last week I was presenting a rather complicated case to one of my SPs and he started pimping me.  Now, I will be the first to admit that I don't know everything and always have room for learning and improvement, but I was very annoyed about it.  It was condescending and made me feel like I was back to being a PA student!  In general this guys is pretty supportive but he does apparently have a side to him that needed to feel superior.  Annoyed, I shrugged it off ....but I'm wondering peoples thoughts on this--do you get pimped by your SPs after years of practice?!

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No.  I hardly see him.  If I do have a question, I'll ask one of the docs, but they are too professional and busy to waste my time and theirs.

If you've worked with these clowns for five years and they feel the need to assert their dominance by humiliating you, consider finding a position elsewhere.

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Shrug it off unless you think he was intentionally trying to belittle you. My last SP used to gently pimp me and I  had 20+ years in. If I didn't know..I didn't know and I'd learn something. I didn't see any malice in it and I think as my SP he was entitled to probe my understanding sometimes. No blood...no foul.

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Honestly I like pimping. I work in surgery and obviously it is very common in our field but I also see it in other specialties. I think I have learned the most from physicians (and other PAs) who would ask me a lot of questions about anatomy, post op cares and complications, even basic physiology. 

I have never been in a situation where pimping was used to humiliate. I think feeling embarrassed after not knowing an answer to a question is normal and it should drive us to keep improving on the things we don’t know. It keeps me humble for sure. I also think that being able to adequately answer questions or even show your thought process and give an educated guess helps your SP build trust in you. If they blindly trust you... and you make a mistake down the road... it makes you look even worse in their eyes. 

I would also caution the attitude  of “Ive been a PA for ______ (fill in the blank) years, I don’t see why they are questioning my knowledge.” Dunning-Kruger effect and feeling superior in your abilities, especially in the early to mid years of your career is ridiculously dangerous. I have seen this attitude out of several APPs at my institution and it honestly makes me mad. 

 

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I think the intention is the key - I've had several who have pimped me from a place of instruction, NOT to belittle me or show superior.  In fact, the ones who pimped me would ask me questions on occasion due to some of my experiences they have not had.

 

As for an interview I had where the doc started pimping and was obvious from the idea of - "I know more than you...know your place..." - yeah, politely declined the rest of the day of interviews.

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Don't put me on the spot and expect me to pull answers out of my ass.  If you are teaching, or even want to educate a fine point, then tell me.  I don't appreciate these little games.  I mean, for crying out loud, I know obscure details too, but it all amounts to guessing what the pimpor is thinking.  

Here's a classic example of pimping:

"What have I got in my pocket?" he said aloud. He was talking to himself, but Gollum thought it was a riddle, and he was frightfully upset.
"Not fair! not fair!" he hissed. "It isn't fair, my precious, is it, to ask us what it's got in it's nassty little pocketsess?"

In the original post, a complex topic was brought to the sp.  Instead of "this sounds a lot like blah blah, you have the such and such; check x,y,z in a week, if no better then do d,e,f" you have to play a riddle game.

I've had excellent mentors who taught me lessons I'll never forget, one of which was the adjuvant effect of Tylenol with tramadol, and she didn't resort to this nonsense.  Just basically laid it out.

Lastly, I don't think we'll under pressure.  Not someone having chest pain, u can handle that.  I'm talking someone quizzing me on minutiae...my hands get clammy, I stammer...not a reflection of my clinical skills or knowledge.

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I think there is definite benefit in the Socratic method to teaching.  I personally benefit from being asked questions to help guide me along the process, be it the pathophys of the disease, pharmacokinetics/dynamics of the treatment, why guidelines are what they are etc.

When it comes from a position of superiority and is designed to belittle you then yes, definitely nonconstructive and shouldn't be tolerated.  Unfortunate that you've had such a good relationship with this individual up until this point, not having participated in the conversation I'm tempted top play devil's advocate and wonder if he wasn't just falling back on the standard approach to teaching that most medical professionals undergo in their early careers.

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I have found pimping to be used in 2 different ways - one is the formal/informal way of gauging knowledge in a definite teaching environment (with the added "benefit" of education through humiliation 🙄) , the other is to draw out what you do actually know when confronted with something that's truly perplexing, such might also be so obvious that you're not seeing it.  In the OP's case, they might have been pimping them to draw out stuff so that "AH HAH!" moment happens - kind of guiding your thought process as it were.

However, not having been there and not heard the tone of voice involved, I'm only guessing.

$0.02 CD

SK

 

Edited by sk732
spelling oopie
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It seems I'm in the distinct minority, probably having been the victim of abusive pimping - by a group of PAs no less.  99% of the time when I ask my preceptor a question, I know the answer; I either want some real life input from their experience, or I'm torn between two equally worthwhile decisions.  In all cases, there is a patient waiting, because, you know, work- and I don't have time for this crap.

I completely understand the "teaching" technique; I just think it's crap.  Especially if you mean pimping to be shotgunning obscure and tangentially related questions, otherwise it would just be an informative discussion.

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I frown on pimping fully licensed colleagues. Talking out a case, comparing historical experiences and sharing knowledge of a workplace and how to get things done - yep, count me in.

Students - I am not the type to rattle off questions in a game show fashion or to instill fear or degrading.

Our ER attending as a student would come in for morning rounds and case review. He asked you to present your case and then would only say things like "and....", "next step...." but would unfortunately let you walk down the primrose path right into a rabbit hole and flounder. Then he would make the game show buzzer noise that you were wrong. It wasn't helpful to anyone. The thought process got off on the wrong foot and he just let you keep going. I would have appreciated gentle direction or interjection along the way - such as "well, that might work but is not as accurate as xxx" or "that could work but not in this case due to renal fxn or whatever". 

I am super strong in a lot of things but simply hate kidneys - nephrology - not my strong suit. If I need help and ask questions - please don't pimp me - I am already asking for help. 

If a physician colleague needs to assert some sort of superiority - Nope, can't handle that. We work together or I go elsewhere.

 

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I frown on pimping fully licensed colleagues. Talking out a case, comparing historical experiences and sharing knowledge of a workplace and how to get things done - yep, count me in.
Students - I am not the type to rattle off questions in a game show fashion or to instill fear or degrading.
Our ER attending as a student would come in for morning rounds and case review. He asked you to present your case and then would only say things like "and....", "next step...." but would unfortunately let you walk down the primrose path right into a rabbit hole and flounder. Then he would make the game show buzzer noise that you were wrong. It wasn't helpful to anyone. The thought process got off on the wrong foot and he just let you keep going. I would have appreciated gentle direction or interjection along the way - such as "well, that might work but is not as accurate as xxx" or "that could work but not in this case due to renal fxn or whatever". 
I am super strong in a lot of things but simply hate kidneys - nephrology - not my strong suit. If I need help and ask questions - please don't pimp me - I am already asking for help. 
If a physician colleague needs to assert some sort of superiority - Nope, can't handle that. We work together or I go elsewhere.
 
It depends on your definition of pimping. Most of the attending I work work I dont think of colleagues, some of them are my best friends.

Our pimping usually starts as , "Did you know yaddy yadda."

But with real term, the hospital administration pimps us. We are the street walkers of the ER. Lol.

Sent from my SM-N950U using Tapatalk

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On 5/17/2019 at 4:06 PM, Reality Check 2 said:

I frown on pimping fully licensed colleagues. Talking out a case, comparing historical experiences and sharing knowledge of a workplace and how to get things done - yep, count me in.

Students - I am not the type to rattle off questions in a game show fashion or to instill fear or degrading.

Our ER attending as a student would come in for morning rounds and case review. He asked you to present your case and then would only say things like "and....", "next step...." but would unfortunately let you walk down the primrose path right into a rabbit hole and flounder. Then he would make the game show buzzer noise that you were wrong. It wasn't helpful to anyone. The thought process got off on the wrong foot and he just let you keep going. I would have appreciated gentle direction or interjection along the way - such as "well, that might work but is not as accurate as xxx" or "that could work but not in this case due to renal fxn or whatever". 

I am super strong in a lot of things but simply hate kidneys - nephrology - not my strong suit. If I need help and ask questions - please don't pimp me - I am already asking for help. 

If a physician colleague needs to assert some sort of superiority - Nope, can't handle that. We work together or I go elsewhere.

 

I haven't had any students yet, but I've been trying to think, buzzing noise or just ridicule?  Difficult to choose.  

I always think there are two ways to train a dog.  The first (and, unfortunately, more common) is the beat down, ridicule, teasing.  They will learn, but become sullen, bitter, and eager to pay it forward.

The second is through compassion, humor, and friendship.  They will learn, and love you forever.

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I do have standards for teaching though that I am a stickler on.

If I teach how to present then I expect proper presentation. If you start out your presentation incorrectly, sloppy, lazy or just BAD - I will stop and ask the student to restart.

Somehow "I have this guy with a headache....." isn't going to cut it with me.

I have stopped a student twice (it was an NP student but that is another soap box) who REFUSED to present correctly or accurately. I told her she couldn't see patients anymore and would just be a shadow. She made no effort to improve and I failed her rotation. 

So, pimping aside - there are standards.

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On 5/16/2019 at 7:01 PM, JDayBFL said:

I would also caution the attitude  of “Ive been a PA for ______ (fill in the blank) years, I don’t see why they are questioning my knowledge.” Dunning-Kruger effect and feeling superior in your abilities, especially in the early to mid years of your career is ridiculously dangerous. I have seen this attitude out of several APPs at my institution and it honestly makes me mad. 

 

+1, It seems like you are fully aware that you don't know everything, you know you can improve, but the second you revert back to being a student and being eager to learn again it's uncomfortable to you. I think it would be best to check your ego and keep learning. Aspire so next time he tries to pimp you, you can answer adequately, and possibly even come back with some questions he might not know.  

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