latinxpac Posted October 16, 2021 Share Posted October 16, 2021 FYI this will be a long post to explain my situation, I appreciate all advice! I am 9 months into a primary care position as a New Grad PA, at a FQHC and that the experience has been "turbulent" can say the least. This position, I specifically sought out because I wanted to work with the specific patient population: refugees, migrant workers, and new immigrants majority from Spanish-speaking countries. I proud to be the first female Latinx Spanish-speaking provider the practice has ever had. I have quickly built up my panel of patients and can see the impact I am able to make with my patients. Right now the driving force for me showing up to work everyday is only my patients. Otherwise, work has been draining mentally and physically, and I have realized my SP and some of the other physicians do not respect or understand the role of a PA-C. When interviewed and started this position there seemed to be a clear training model, and the FQHC put on a facade that all the employees are happy with a great work culture. However, in the 9 months I have been there I have seen 3 docs, and 2 APPs leave due to burn out. I have also seen >15 MAs and LPNs leave due to low morale. I have brought to the attention of my supervisor that the working conditions on the floor and the load which is up to 25 or greater patients a day is causing burn out. We do not get any administrative time and are expected to see "everyone" while completing all tasks. My SP seems to indicate that the load is reasonable, and I should be able to handle some of the most complex patients, that I did not get much experience with in PA school. One of the other new grad PAs recently had a mental breakdown at work, and needed. During my meetings with my supervisor she will often compare my inadequacies and say things like, "I notice the PAs struggle more than the NPs." I am good friends with one of the NPs at my job and she struggles just as much as me. I often feel like my SP uses reverse psychology on me, to push me or make me work harder, but this is only breaking me. The only thing I have going for me are my numbers, I have currently the highest show rate of all of the providers and I attribute this to being able to relate and speak the language of my patients. My show rate is 85%-100%, while other providers are getting 50%. Work for me three months ago was becoming a revolving door due to having an untrained MA, who was not documenting correctly in my charts. I was constantly working and constantly on my computer in the AM at home, at work, and then again in the PM at home. My SP did not seem to care/help me turn this off. When I pushed back and said that I needed my MA to be trained or an administrative day to fix the errors I was given a PIP, to improve my charts, about one month ago, which led me to finally apply to a new job. Other incidents that have happened over the course of my work life at this company have also led me to apply to a new job: 1) One of the MAs, was repeatedly called "Little Girl" by one of the MDs, never her real name. HR did nothing to take care of this and she ended up walking out, and never returned. 2) LPNs were bullying another new LPN, calling her names and saying vulgarities to her face, she left. 3) Another MA walked out who had worked there for >7 years, b/c things had gotten "so bad". 4) A new MA had come into work seeming like she was having a panic attack and disclosed to a provider that she is an alcoholic. Two MAs got their personal benzo's to give to her to come down, and this ended up being a big HR mess, in which no one was terminated ( I was not involved only heard about this). 5) This same employee eventually came back to work, was working drunk while running me. I reported this to her supervisor, supervisor agreed, told HR. HR tried to force me to tell her the process of blood testing, and what would happen to her since it was suspected she was under the influence. I refused since I wanted to remain anonymous, however they kept pushing me. I continued to refuse, but they disclosed my name to the drunk MA that I was the whistle-blower. She was fired for having a 0.3% BAL at work. From this experience, I learned I cannot trust HR. I found in police records this MA has been charged with 2 DUIs and resisting arrests already since the incident. 6) Incessant gossip among the nursing staff that never turns off in Spanish or English. 7) This month a MA disclosed to me and others that she has been chatting with a 17 year-old online through video games, and that she plans to go meet him. She said his mother was upset when she found out, but she is "in love", she is 30 years old, and maybe she can wait for him. She also has sent him "naked photos of herself". Long story short, I ended up filing a report with our state's child abuse program, and had to report this to her supervisor, and my job is taking steps to discuss this with her, but I am not sure what these will be. Since these incidents, I have since interviewed at the new job, and have gotten a positive response from the team that I will probably be hired. I am looking to shadow first, to ensure this job is a good fit. At the job where I currently work, things have gotten slightly better this month because my MA left, but I fluctuate with good weeks and difficult weeks. For the first time, I have sought out mental health services, and I attribute this due to the stress at the job. What kills me each patient visit, is my patients often ask, "how long are you staying." Looking at their charts they have gone through >10 PCPs. I realized at the end of the day the person most affected is going to be the patient. Do I want to stay at this job for them, YES, but I don't think I can take it anymore since the leadership won't change anything. If anyone has had a similar situation please give me some advice. I have a two year contract so far, but will likely have to break it. I have never broken a contract, so not sure what the repercussions are going to be. I have been trained with some great procedures, but the training and learning are not enough to stay over the value of my mental health and my fear pt safety is not being respected. I love primary care, I love educating and I could not imagine working with any other patients. At FQHCs is there any unionization or if you do not trust the leadership to help you is there a greater organization you can contact/complain? Thank you so much for the help and support, any advice helps about my situation, and thank you for reading this. Stay safe and be well to all! 2 Quote Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted October 16, 2021 Administrator Share Posted October 16, 2021 When the patients OR the staff ask "how long are you staying?" that's a red flag that you should not plan on staying. FQHCs, like most nonprofits, are run by incompetents, who are at times well-meaning, but generally ineffective. Of all the messes you mentioned and assuming for the sake of anonymous internet advice that you're telling the whole story, I believe that HR disclosing your name to the alcohol-abusing employee is the best cause for you to walk away, and in fact probably sue, this employer. If this were a sane employer, they would be bending over backwards to keep you. Rest assured that while many FQHCs have stupid, inexcusable problems like this, there are other avenues for you to help this very needy population. I recommend you get out of there and find a new place from which you can help them. You're going to want an employment law lawyer, and while they may seem expensive, I believe that is a good investment in your career viability in the long run. 5 Quote Link to comment Share on other sites More sharing options...
latinxpac Posted October 17, 2021 Author Share Posted October 17, 2021 Thank you, I really appreciate this advice a lot. I have begun the process of talking to a lawyer and hope to be able to get of this contract freely and cleanly. Will post and update about this. I've talked to a good friend about this and they have told me, "I know (me) the best answer to this." Meaning it is time to walk away from this whole experience and move on. Again, thank you for taking the time to respond...we shall see what the next chapter will be. Quote Link to comment Share on other sites More sharing options...
sas5814 Posted October 18, 2021 Share Posted October 18, 2021 I had a 3 year contract with a FQHC and left at 2 years. it was nothing like the snake pit you are describing but, as Rev said, they are often run by well meaning morons. Our CEO started out as the CEOs secretary and had no formal training or education in between those 2 positions that would qualify her. We had a well meaning board made up of lay-people who basically rubber stamped everything. I too was often asked how long I would be there. The last PA got fired for writing crazy amounts of benzos and narcs for a staff member. Protect yourself and be gone from this place as soon as you have a place to go. You are well intentioned in your desire to help the patients but you will destroy yourself eventually and be no good to them or yourself. You didn't create this mess. You can't fix this mess. 3 Quote Link to comment Share on other sites More sharing options...
latinxpac Posted October 19, 2021 Author Share Posted October 19, 2021 Your are right, and I really appreciate this advice, thank you! Quote Link to comment Share on other sites More sharing options...
CAAdmission Posted October 19, 2021 Share Posted October 19, 2021 21 hours ago, sas5814 said: they are often run by well meaning morons. There's also a risk that some are run by evil morons. 1 1 1 Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted October 19, 2021 Moderator Share Posted October 19, 2021 I really wonder when a corporate structure will be sued fir bad policy that in fact is practicing medicine with out a license??? 1 Quote Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted October 19, 2021 Administrator Share Posted October 19, 2021 6 hours ago, CAAdmission said: There's also a risk that some are run by evil morons. Evil morons tend to gravitate to high-volume, low-oversight things like "low T" clinics. Or elected office. 1 4 2 Quote Link to comment Share on other sites More sharing options...
iconic Posted October 20, 2021 Share Posted October 20, 2021 (edited) You are not the first provider who left before their contract was up. You would think that these ppl would get a clue that employees are no longer putting up with abusive work conditions. PAs unfortunately do seem to put up longer than many others Edited October 20, 2021 by iconic 1 Quote Link to comment Share on other sites More sharing options...
trazodone Posted October 21, 2021 Share Posted October 21, 2021 As someone who has endured toxic and abusive work place for years before finally standing up for myself, you are doing the right thing. I would look at your contract and see if there are any ramifications (i.e. paying loans back, etc). The best thing that you can do for yourself is to step in and say "It's okay for me to put myself first". I did not realize this for years and then knew it in the back of my mind for years and did nothing about it until finally we had a significant safety issue that went ignored and I decided it was time. I would recommend documentation thoroughly of all e-mails you have regarding the above incidents in case you need them in the future so that you can document the WHY behind your decision if it were to become an issue with the contract, although I do not think that it will. Quote Link to comment Share on other sites More sharing options...
SCAR123 Posted October 23, 2021 Share Posted October 23, 2021 I was in a somewhat similar situation for a FQHC. I lasted a year and we had higher than 100% turnover of providers during that period. We hired people, they lasted 2 months, one day just never showed back up because it was so poorly ran. Incompetence from the board to the CEO to the front desk to the MAs. my advice: apply to new jobs, tell them why you are leaving (remember to keep it objective), get accepted, leave current job. The chance of your current employer being competent enough to pursue holding you to your contract is astronomically low. They have almost no benefit and will spend lots of time/headache to pursue compensation from you leaving. It’s not worth it to them. Take care of yourself and leave just like every smart person before you has done. Quote Link to comment Share on other sites More sharing options...
cinntsp Posted October 26, 2021 Share Posted October 26, 2021 Places like that are generally run poorly and chew through providers quickly. It's not worth your mental health. Quote Link to comment Share on other sites More sharing options...
latinxpac Posted December 13, 2021 Author Share Posted December 13, 2021 Providing an update, I will be resigning soon and already obtained a new job at a health system that is not a FQHC. Looking back on what happened, my SP often gaslit me, and made me feel less than than the provider I was. Advice to all, never let anyone do that to you. And do not be afraid to walk away. Thanks to all who commented and helped me. This was a tough decision to make on behalf of my patients, but the best one. 1 1 2 Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted December 13, 2021 Moderator Share Posted December 13, 2021 5 minutes ago, latinxpac said: Providing an update, I will be resigning soon and already obtained a new job at a health system that is not a FQHC. Looking back on what happened, my SP often gaslit me, and made me feel less than than the provider I was. Advice to all, never let anyone do that to you. And do not be afraid to walk away. Thanks to all who commented and helped me. This was a tough decision to make on behalf of my patients, but the best one. Nice job. 1 Quote Link to comment Share on other sites More sharing options...
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