Burnout

[taecson]

I don't really comfortable speaking this frankly to my colleagues. None of my close friends or family are in the medical field so they don't truly understand.  I am still a somewhat new PA and I am already considering a new career path. I went to PA school 2 years after graduating college, so I don't have any experience in any other fields besides healthcare. But I've been having serious thoughts about quitting my job and quitting the medical field altogether. A little background about me, I am in my late 20s and I have been a practicing PA for about 4 years. During this time I have been at the same practice, a specialty and internal medicine office. There are several physicians, but I am employed by one. I see patients in the clinic, in several acute care hospitals, and at nursing homes. Although I like the variety and the types of patients I see are very interesting to me, there are downsides to the job that just become more apparent every day. I work M-F 9-5 and 2 weekends per month. I have to take round at the hospitals and take calls on those 2 weekends, plus take calls 3 weekdays out of the week. I often work 3 weekends a month, and occasionally even 4 when my contract technically says 2. 

My supervising physician is retirement age and he refuses to retire and instead delegates more and more tasks to me. For example, sometimes if he is too tired / lazy he will tell the staff to just transfer patient appointments to my schedule. Patients are understandably upset when they made an appointment with the doctor they've known for years and get switched to the schedule of a PA they don't know. I feel like "as the PA", and an employee of the doctor, I pretty much get saddled with all the grunt work and undesirable tasks that he doesn't want to do. I know in other settings PAs are treated with a little more respect and not just given the busy work to do. There are some upsides, I do like my SP, we work well together, and I feel like I can honestly and freely discuss patients with him without judgment. I also know that he may retire in a few years so this job won't be permanent either. I don't know if getting a new job will help.

I applied for two separate jobs that I did not get. One was a family practice M-F with no call/weekends and the other was an allergy practice M-F with no call/weekends. Getting rejected for both of those jobs really discouraged me and made me feel trapped at this job. It won't be easy to find a new position.

I get frustrated with patients too. It just feels like there are so many patients who are med seeking. Some providers in my area were recently sentenced to prison time for overprescribing narcotics. They were reckless with their prescribing and I am quite careful, but the fact that jail time is in the realm of possibility for our profession constantly looms over my head. 

Patients also often want to be on disability when they clearly do not need to. There are so many patients wanting DMV disability placards and getting irate when I tell them they don't qualify. In addition, patients whose licenses get revoked want me to sign off on them being safe to drive when there was a clear reason the licenses were revoked. Again, I am on the receiving end of the brunt of their frustration and anger when I say they need a specialist clearance. There is just so much liability in our career field and so much stress involved. Liability is always there medically too. YOUR decision can affect whether a patient LIVES or DIES and it's so much stress that I have actually developed my own health issues secondary to the stress. 

I have had a patient stalk me and become obsessed with me. He wrote me unhinged letters and made many calls to the office describing my car, etc. We had to get the police involved and I considered filing a legal restraining order. I know this is possible in any profession, but it feels like healthcare can be personal and intimate and patients can get the wrong idea. I again contemplated quitting the profession at this time.

I have looked into other careers such as being a pharmaceutical representative, working in research, being an accountant, ANYTHING other than this. I have contemplated quitting and just living off my savings until I figure it out. I have talked to some colleagues to an extent, many are much older and have been PAs longer than me. I sometimes question if I'm just being an entitled millennial who wants life-work balance early on in their career until I realize that it's not normal or common to work 24-25 days in a row. It's not normal to only get 4 days off a month (if that. Some days I would get 2 days off a month.) I actually finally told my SP I was considering leaving because I was too burnt out. He trivialized my concerns and said "Why are you burnt out? You're young. I have been doing this for 40 years." Which is true, but this wasn't the life I envisioned for myself. After talking, he did acknowledge my concerns, and he hired an NP who can help me with the workload and guaranteed that I will only have to work the 2 weekends a month as outlined in my contract and I did get a raise. (I still feel like I'm underpaid which is a whole separate story.)

Sorry for the essay, I just really needed somewhere to air out my frustrations with other people in my career field. Thanks in advance for reading.

[mgriffiths]

Saw this on your reddit post as well...or at least I assume you are the same person.

But, the reality is that you have worked 1 job.  During this time you have allowed yourself to be abused.  This is a perfect example of "moral injury" - NOT burnout (google zdoggmd and burnout).  Your SP is abusing you...whether he realizes it is without regard.  Ok, so he has hired a NP to "help" - what does that actually mean?  Honestly from an outside perspective this is what I see:

• You told your SP your intention of leaving.
• He hired a NP to "help."
• What stops him from just getting this NP trained and prepped to takeover your job in full and in a short period terminate you because you are no longer needed?
• NOTHING!  You are relying on the goodwill of an individual who has been abusing you for 4 years!
• You need to continue looking for a new job ASAP so that you are able to leave your current employer on your terms.

When looking for a new job you MUST remember there are 3 options and you generally only get 2...but depending on the area may only get 1: location, specialty, salary

 

Since you have experience you are in a better boat than a new grad, but my recommendation is that you need to start expanding your search for employment.  Also, you need to make sure you have a "good twist" on how to explain to prospective employers why you are looking to change jobs.  It never looks good to just say, "My current SP sucks and abuses me.  I only get 2 days off per month!!!"  Not saying you are doing that, but just mentioning in case.

[Cideous]

A lot of your issues can be fixed or at least improved with a job change.  However, that really depends on where you live.  Opportunity where I live is very thin, even in a big city.  Do you have a family?  Kids?  If no, you are in a 100% better situation then most when it comes to moving.

[surgblumm]

You are obviously of the female gender which is not meant to sound chauvinistic. There are not to many men being abused by the patient you described. I would take legal recourse. As far as being charged in a sting relating to writing for narcotics, the answer is simple, don't write for them. Your practice seems to be built up of many undesirable types of patients who are trying to intimidate you and they have less than desirable moral fabric. The answer to this is to simply change locations. One job experience is certainly not enough to erase your years of hard work and education. Internal Medicine of Family Practice can be rewarding and most have little to no weekends. Yeah, you can be a pharmaceutical representative but will that be fulfilling. Corporate jobs seem glamorous but really stink. You are female, you are single, you have no kids to worry about, what hinders you? And don't be afraid of being transparent with your colleagues as most of us are really interested in helping each other.

[sas5814]

There is a lot to unpack there and I won't presume to try and give you an answer to all of it. I will, however, try to give you one huge tool.

Stop feeling bad about anyone who gets mad at you for doing the right thing. This is a skill you will have to learn and it takes active effort and practice and it is HARD. However I found it to be the single biggest tool that changed my attitude about people. Once mastered it will give you a great calm in uncomfortable circumstances.

People who seek drugs, want disability they aren't entitled to, want handicapped placards they don't need, or otherwise want to game the system USING YOUR NAME AND PROFESSIONAL TITLE aren't worthy of your concern and stress. They are simply wrong. Stop giving them space in your head. Politely say no and move on to someone you may actually be able to help.

You are being mistreated on so many levels. It isn't your fault. Fix what you can. Learn to cope with the rest. Change your circumstances when possible.

Best of luck.

[SedRate]

4 minutes ago, sas5814 said:

There is a lot to unpack there and I won't presume to try and give you an answer to all of it. I will, however, try to give you one huge tool.

Stop feeling bad about anyone who gets mad at you for doing the right thing. This is a skill you will have to learn and it takes active effort and practice and it is HARD. However I found it to be the single biggest tool that changed my attitude about people. Once mastered it will give you a great calm in uncomfortable circumstances.

People who seek drugs, want disability they aren't entitled to, want handicapped placards they don't need, or otherwise want to game the system USING YOUR NAME AND PROFESSIONAL TITLE aren't worthy of your concern and stress. They are simply wrong. Stop giving them space in your head. Politely say no and move on to someone you may actually be able to help.

You are being mistreated on so many levels. It isn't your fault. Fix what you can. Learn to cope with the rest. Change your circumstances when possible.

Best of luck.

This.

Expand your job search criteria. Something will come up. It will take time, so in the meantime, fix what you can and cope with the rest. 

[jcash]

Keep your head up. I know how you feel. I’ve worked a short time in pain management and it was soul sucking. Yes expand your search. Search for an SP that will support you and teach you. Do NOT continue to take the current abuse at your job.

I’ve contemplated another role outside the clinic, teaching or admin. There are other roles out there for us. But I think you need to explore other offices first. Apply to many jobs and interview with an open mind. Stand up for yourself and make them stick to the contract!

What state are you in?


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