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Hi all!

I know the topic of non-clinical jobs has been discussed as nauseam on this site, so I do not want this post to reignite the discussion of what non-clinical jobs exist, where to find them, etc.

I am a little more than one year out of PA school. Started working in psychiatry, and frankly, it is the only specialty in which I have any interest. For the last several months I've been working in a sort of hybrid position that has me working from home doing overnight psych admissions for several area hospitals. I neither see not interact with patients. The intake and nursing teams call me when a new admission is ready, and we discuss the case before I place my admission orders. It's mostly just "getting patients through the night" before the attending can evaluate in the morning in person. It pays the same as clinical work with much less stress and administrative red tape. I miss seeing patients, but not at the volume of 25 a day, and the freedom I have now to be engaged in other areas of my life is priceless.

I don't want to hear about how my clinical skills will waste away and I'm only a year out of school, blah, blah, blah. I want to know from those of you working outside the direct patient care realm, do you have any regrets about leaving clinical practice? And on the flip side, are you happy you did?

I am truly happy to have time for my outside interests, family, and friends, but part of me feels guilty for not seeing patients, like I'm breaking the code of PAs or something. To be honest, after leaving the office, I have no desire to ever go back. If/when I tire of my current position, I'd love to move into remote insurance auth work as I've seen several PAs/NPs do. 

 

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If you don't like seeing patients one year out, wait until 26 years in lol.  On the bright side, you have time to build that non-clinical side of your career.  It's much easier to do it now then try and switch mid career.  

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18 minutes ago, Cideous said:

If you don't like seeing patients one year out, wait until 26 years in lol.  On the bright side, you have time to build that non-clinical side of your career.  It's much easier to do it now then try and switch mid career.  

I like seeing patients, just not 25/day five days a week lol. Maybe one or two days, sure, but the pattern now is unsustainable for even the most energetic and efficient among us.

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3 minutes ago, pa-wannabe said:

... but the pattern now is unsustainable for even the most energetic and efficient among us.

We sure are in agreement on that point!

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I like seeing patients, just not 25/day five days a week lol. Maybe one or two days, sure, but the pattern now is unsustainable for even the most energetic and efficient among us.

That seems to be the norm. I recently left a Primary Care job (well Primary care altogether actually) that had me seeing 21+/day. I am now in GI seeing 10-11/day 4 days per week. Sooooo much better. Just got back from a conference and ran into some old classmates and friends and they're seeing ~25 pts per day. Different specialties. One of them is in GI also and sees 25 per day... I'm like... Trick Dat! No thanks.

 

Sent from my SAMSUNG-SM-G891A using Tapatalk

 

 

 

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1 hour ago, Joelseff said:

That seems to be the norm. I recently left a Primary Care job (well Primary care altogether actually) that had me seeing 21+/day. I am now in GI seeing 10-11/day 4 days per week. Sooooo much better. Just got back from a conference and ran into some old classmates and friends and they're seeing ~25 pts per day. Different specialties. One of them is in GI also and sees 25 per day... I'm like... Trick Dat! No thanks.

 

Sent from my SAMSUNG-SM-G891A using Tapatalk

 

 

 

we as a profession, and NP and MD and DO need to stand up together against the admin types forcing this type of productivity

 

I am 'gasp' going back to private practice primary care - max booked is 16 in a 9 hour day

mostly 14/day

complex patient

 

 

the good jobs are out there.....

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3 hours ago, ventana said:

we as a profession, and NP and MD and DO need to stand up together against the admin types forcing this type of productivity

 

I am 'gasp' going back to private practice primary care - max booked is 16 in a 9 hour day

mostly 14/day

complex patient

 

 

the good jobs are out there.....

The funny thing is, the psychiatrist who worked down the hall from me at my old position refused to move from 40 minute visits to 20 minutes, and they just accommodated her because she's been there so long. So here's a person making more than twice my salary with half the workload. 

If providers could come together in our individual practices and advocate for more manageable schedules, it does stand a chance. Unfortunately, burnout seems to make most people focus only on their own scheduling needs.

 

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Left clinical practice 2 years ago for full time education.  Zero regrets.  Saved my sanity. Education is stressful, but it’s a different kind of stress and I actually feel like I am doing something that matters rather than catering to administrators.

I have occasionally had the worry that something will happen and I’ll have to go back to clinical practice and I won’t be able to get a job because I’ve been out for a while, and then after about 10 seconds the feeling passes because I remember that I’d rather sell my house and my car and take a major pay cut and go do something completely unrelated than return to the clinic, and I am totally ok with that. 

I hear the “you’ll lose your clinical skills” argument often, and it’s interesting...I find myself now, after having to study a lot in order to teach over the past 2 years, learning more new things and reviewing old cases, thinking about things I could have done differently, and I wonder if I would actually be a BETTER clinician now....doesn’t matter, couldn’t pay me enough to go back.  

If the job you have allows you to meet your needs in all areas of your life, you’ve hit the jackpot. Those don’t come along often.  As you said, that time is priceless. I’d have been super jealous of that job at that point in my career.  

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The best job for anyone is the one that fits their needs. It is about personal currency and that may shift over the years. For a long time I was all about the money. Now I am all about making enough money to max the quality of my time off which I want to be a lot.

It seems if you want to stay in psych what you are doing will require you to stay current. The patient contact could come back to you with a short ramp up if that is a direction you decided to go some day.

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8 hours ago, eighthnote24 said:

... I actually feel like I am doing something that matters rather than catering to administrators.

 

This. This is exactly what I'm talking about. I did extensive shadowing and worked in healthcare prior to PA school, but none of that prepared me for the red tape and paperwork we face from administrators. The time I had in outpatient was miserable not only because of the time constraints, but because of someone always breathing down my neck with billing, documentation, scheduling, etc. And that's the norm now, so changing practices would hardly have been a solution. 

I got into this field to do something that matters, and I can't help but feeling that I bought the lie I was sold. My fault entirely, but gosh it would be nice to feel like I'm doing something that matters again.

I'm so glad to hear education has been a good and solid shift for you. Gives me hope!

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Come to N. Texas and take my job.  No insurance/billing, practice medicine the way you want without being the PCP, no narcs/controlled substances, have extended holiday breaks, answer no calls/messages, and NEVER go home stressed.  

Edited by GetMeOuttaThisMess
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Telepsych is going to be very big in the future.  You might take a hit if you miss something and you have not seen/talked to the actual patient.  A brief telepsych link up with the patient after you get the case presentation by the nurses would protect you from this, let you keep up your clinical interviewing skills, and provide an interesting segue to the future in terms of experience with tele-psych.   Jails and prisons are big utilizers as well as rural hospitals.  Eventually, as the laws progress, you could set up your own business with a collaborating shrink.  

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3 hours ago, rpackelly said:

Telepsych is going to be very big in the future.  You might take a hit if you miss something and you have not seen/talked to the actual patient.  A brief telepsych link up with the patient after you get the case presentation by the nurses would protect you from this, let you keep up your clinical interviewing skills, and provide an interesting segue to the future in terms of experience with tele-psych.   Jails and prisons are big utilizers as well as rural hospitals.  Eventually, as the laws progress, you could set up your own business with a collaborating shrink.  

I've looked into telepsych extensively, as I think it would be the best of both worlds. At the moment, only psychiatrists and NPs are being considered for the organizations I've researched. Hoping that changes in the near future.

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53 minutes ago, pa-wannabe said:

. At the moment, only psychiatrists and NPs are being considered for the organizations I've researched. Hoping that changes in the near future.

 

Ugggh....

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On 8/15/2019 at 5:51 PM, pa-wannabe said:

The funny thing is, the psychiatrist who worked down the hall from me at my old position refused to move from 40 minute visits to 20 minutes, and they just accommodated her because she's been there so long. So here's a person making more than twice my salary with half the workload. 

Ha.. she was able to do that because you were tasked to work harder so they could accommodate her!

I think you have a sweet job. It provides for you, and lets you have the work life balance you like. You only owe yourself, not anyone else. Not patients (apart from being a competent provider), certainly not administration, and absolutely not that provider that got to keep her sweet workload at your expense. 

You’re providing an important service by performing admits and taking calls from nursing staff. You can go to sleep knowing that you are an important cog in the wheel. 

Telepsyche might be the future,  but I feel like it’s the kind of future that only an administrator would love. From what I’ve seen, it’s not quite lucrative enough for the provider to be a big draw away from in-person work. The rates are a bit low compared to the promises in the ads. But yeah, “independent provider” means you get in on the game.

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