New Grad Job Concerns

[bjs0127]

Hello all,

I started a new job as a new grad three weeks ago. I was hired on several months ago. When I was interviewing I had a great feeling about the place. The doctor I was going to work with stated that he has worked with multiple mid-levels, PAs who were new grads, and would be there to help me all the way and that I would not be alone.

Well, in my first week, I learned that he was leaving the facility to move away, and his last day is 9/20. The move is such that it has been planned for a while. It was not disclosed to me at all during the time I was waiting to start, and it has left a bad taste in my mouth. I also learned they wanted me to be under a doctor of another specialty than the one I was hired for, which in my state, technically will not work as it will limit me to what the new supervising doc does. I went to a PA rep on the medical board of my state (NC) and managed to get her on a conference call with people in admin, which got that situation straightened out.

Unfortunately, although they are trying to find a new doc, they are scrambling to do it because the geographical area I am in is not desirable to live or work in. I was informed today that the doctor who is moving away will be mine and the other providers from literally across the country, and that locum docs in our specialty will start next week and be on site.

I understand that they are working on fixing the situation, however I am scared to see what happens. I don’t feel like it is a safe environment for a new graduate, and if I had known what all was going on, I probably would have backed out. I have been seeing patients, and now that my SP has been changed back to the original doc I feel better as far as legal matters go, but he’s about to be gone. I’m honestly very uneasy. Some of this fear is coming from the uncertainty of what will happen, on top of being a new grad taking care of patients.

I have a 2 month introductory period where the employer or I can terminate the working relationship no harm no foul per my employee manual. I’m trying to figure out what I need to do to protect myself and the patients, even if it means I leave. I have an interview next week and plan to see how it goes and if it is right for me, I want to accept it if I am offered a position. It would be in the ER and the onboarding process sounds promising with 3 months of orientation, where here I’m being pushed in kind of quickly and not really shadowing or seeing patients with anyone.

I gave a written notice of my terms and needs to stay, which includes on site direct supervision for at least 6 months, and they are trying to fulfill that with the locum doctors but I still feel very hesitant. That makes me feel guilty about looking for another position. Am I right to want to leave? The other NPs keep telling me to run, classmates too, and my poor husband just wants me to be happy. I don’t know if I should give them a chance or jump ship if I have the opportunity.

If anyone took the time to read this and/or has words of wisdom, it is greatly appreciated!

[MT2PA]

It's encouraging that they have apparently been receptive to your concerns especially regarding the legal matters.  Frankly you aren't wrong to walk away given the circumstances and no one would fault you for that.  Only you can decide if their efforts to remedy the situation are going to be adequate and leave you comfortable as a new grad.

 

[seekingtruths]

I’m sorry you’re in this situation. Sounds very stressful. I encourage you to listen to yourself. It is wise to have reasonable expectations for your employer. As a PA, those expectations include a basic framework to allow you to practice legally, including an agreement with a suitable collaborating physician. Also, I think it’s reasonable to expect a certain level of support as a new grad, including physicians and PA/NPs that are committed to showing you the ropes. It sounds like these admins are rather clueless and flying by the seat of their pants. You have concrete reasons to be alarmed - this employer has demonstrated that they are unprepared and do not care about onboarding you the right way. Decisive action now may save you problems down the road. It’s much cleaner to end it sooner rather than later.

Locums doctors are not committed to the practice and do not have a strong incentive to develop you as a PA. You’ve got a lot of learning to do as a new grad and the early years are critical to build good clinical foundation and skills. Trust your gut. 

[ventana]

ask for an extension of the trial period where EITHER of you can walk away

 

Explain that with all the dynamics going on you want to land in a good place and hope it is this place, but if not you want to be able to leave on a good note 

 

be professional.....

[bjs0127]

Thank you all for your responses!

I think what I will do is see how this job interview goes. If the atmosphere is better, all of my questions are answered with good answers, and I have a general good vibe about the place and I get an offer, I’ll take it. Then I’ll figure out what to do about putting in an appropriate notice (although the manual says that no notice needs to be given in the first 60 days, but I’ll do it because it is the professional thing to do). If that doesn’t pan out I’ll look into making the introductory period longer while still looking for other options.

They are aware of my concerns and I think they are aware that I am likely looking for other jobs now. I have not said one thing or another to admin about if I will be staying, but the document I gave them included a clause from my contract stating that if the terms of the contract were broken then it is considered terminated. There had to be a written notice given. The term in this case being that the employer will provide appropriate support personnel. My bases are completely covered. Now I just need something lined up so I have an exit strategy, and figure out what in the heck they want as far as a leaving notice.

Edit: Also, I have been appropriate and professional in all of my dealings, and have gained a lot of respect from my co-workers for how I have handled this situation. It has been a nightmare but they have all been supportive.

Edited September 19, 2019 by bjs0127
Addition of details.

[sas5814]

I'm sorry you are in such a spot but it sounds like you have a pretty good handle on it. The only thing I would add is the word "quit" should only be used the day you do. I'm sure you know  that but I have dealt with a lot of folks over the years who thoguht the threat to quit was some kind of powerful bargaining tool.

Let us know how things go

Edited September 23, 2019 by sas5814

[bjs0127]

Hi all, just an update for you.

They brought in a locum doctor who is 4 months out of residency to be our primary supervising physician. She is very nice and open to questions, but she will have a full schedule soon and not have as much time to mentor. I have gone up to two patients an hour and I pray for no-shows so I can stay on top of everything and have time to research and formulate plans for patients.

I had the interview with the ER, and what they have available is part-time. I really need a full time job, but I am keeping it as an option for the moment. It could turn into full time during the time I am credentialed. One of my friends had a bad run-in with the company that staffs the ER (she wound up terminating her contract before she even started her job), so that makes me slightly hesitant. However, the scenarios in the two different ERs are not the same and everyone handles things differently.

A little background on my loan agreement if I did not mention it in a prior post: I have to serve the area I work in for 5 years in order for my loans to be forgiven. It is not PSLF but a private grant. My loan agreement with the local hospital involves the VP of HR at the hospital along with the physician recruiter. I have contacted them and informed them of what is going on. They were concerned for me, and understand that I want to leave the job as soon as possible. I am so thankful that they understand that a new grad should not be in this situation. They are willing to give me a 60-90 day grace period to search for and get a job in the area, and even after that time period if I do not find anything, the loan will not default. Instead, we would meet to discuss other placement options before I have to pay the money back. They are also searching around the area for placement for me.

I did have a conversation with someone who is high up in an urgent care chain where there is one in the town I am supposed to work in. The position involves an externship working with another seasoned provider for at least six months as a new grad, in which I am being paid full salary. It sounds wonderful. Unfortunately, the loan repayment deal has thrown a bit of a wrench in it, as he is unsure if it could take place in the town I am committed to. He is working with the scheduler to see if they can do that before he extends an official interview. I have my fingers crossed and am hoping and praying for this; the schedule would be better (for me) and the externship sounds like a dream for a new grad like me. I believe if there is a position available, chances are fairly good that I'll get an offer. The person I spoke with knows one of my classmates and her husband along with one of my PA school professors.

In light of my conversation with the hospital, I have decided to go ahead and resign. I am going to wait a couple of days to see if I do hear back from the urgent care company for an interview, but if I do not, I'm going to turn in my notice well before my 60 days. I'm planning on giving them until November 1st as of right now, which will get me through two more pay periods and give them a decent amount of time. If things get worse in the next couple of days, I may shorten it. The last NP that was let go is apparently being sought after for abandoning her patients, although from what I have been told, the business doesn't have a leg to stand on with those charges. I have already decided to prepare letters for my patients to "discharge" them from my services to the other providers at the facility so they won't be able to say that about me. I'm making sure to dot my i's and cross my t's for everything, in addition to staying as professional and polite as possible. I'm just ready for this nightmare to be over.

[Lightspeed]

7 hours ago, bjs0127 said:

The last NP that was let go is apparently being sought after for abandoning her patients, although from what I have been told, the business doesn't have a leg to stand on with those charges. I have already decided to prepare letters for my patients to "discharge" them from my services to the other providers at the facility so they won't be able to say that about me. I'm making sure to dot my i's and cross my t's for everything, in addition to staying as professional and polite as possible. I'm just ready for this nightmare to be over.

The NP was “let go”, and then they went after the NP for patient abandonment? Even if she quit, how much time would they want for it not to constitute abandoning the company’s patients? 
 

That sounds like the organization wants to try to punish people who leave. You probably are already keeping all your correspondence, but be careful to email copies to your personal email, and print those suckers each day. You want to make sure that you can show that you told them well ahead of time you were leaving. 
 

The patient abandonment issue to me is BS in most cases. Would it be patient abandonment if you got hit by a car and couldn’t return to work? Would the world fall apart of someone didn’t show up to work one day? It probably wouldn’t be convenient for the clinic, but would it be the same as leaving in the middle of surgery, and then having to close without finishing the case. Would it be worthy of a lawsuit for breaking contract? Sure. Should a license be pursued because the company couldn’t appeal to anyone to come out and work out there? No way.
 

It seems like the smaller the city, the more greedy the bosses are, until you get to places that are so hard up for providers that they begin to appreciate them. Is your city like between 40,000 and 70,000 people? That’s where I’ve seen the most people insisting on non competes, and threatening that kind of repercussions for providers that want to transition out. 
 

Be very, very wary. They are populating your office with new providers for a reason. They are losing providers for a reason. 

 

[bjs0127]

Oh, the town I'm in is even smaller than that. Think very rural yet citified. My non-compete is for 30 miles for the specialty I'm in. They tried to say it was for all medical specialties, but it is not worded that way so even if they tried to enforce it I could just not do family medicine. I'm starting to think it's not for me anyway but that could just be the situation I'm in. I'm questioning being a PA altogether and I hope that it's just my situation and not how I really feel.

For anonymity, I can't tell the whole story about the NP being "let go", but let's just say the provider had already put in her notice and had a specific obligation that they knew about that she had to miss work for. She missed work and they told her she was being terminated since she could not have a day off during her notice. Then it got turned around that she was abandoning her patients.

I know it is possible that retribution may happen. I am just aiming to keep it professional and not personal (although messing with my license is VERY personal) and keep it to the facts in addition to covering my own butt. I had a verbal conversation about my comfort with locums and I told them I didn't know as I have never worked under them before, so now I"m just going to add that to the written list of reasons why I'm leaving. Everything I have is ironclad and I'm keeping EVERY thing. I'm a bit uncomfortable leaving without another job in place, but my husband and I can live on just his income for a little while. We'll still have a roof over our heads and food on the table. Plus, I'm still waiting to hear from the urgent care position and the people involved in my loan repayment are looking at positions for me as well.

Either way they shake it, from the document I turned in, my contract is breached and I could walk away now with no notice, but I'm going to do the right thing. 

[sas5814]

Interesting. I'm glad things, while painful, are going to work out  eventually and you are wiser for the experience.

The patient abandonment thing is pretty interesting. One of the sad advantages of being in Texas, where physician's ride us like a rented mule, is we can't abandon patients by leaving a practice because they aren't really ours because we aren't physicians. It makes my head hurt to say that but there it is.

Edited October 6, 2019 by sas5814