On a scale of 1-10, how much do you like working in Occ Med?

[lamontPA]

I just finished my first week of my first PA job (in occ med) and I really enjoyed it. I work with a solo doc, seeing 25-30 patients/day between the two of us. I love the fact that i get to perform so many procedures and it is exciting to know that any kind of gnarly acute injury could come at a moment's notice. The only possible downfall of working in occ med is all of the worker's comp paperwork and administrative stuff.

 

My questions are:

1. How would you rate working in occ med on a scale of 1-10

2. What are the pros and cons of your day!

 

Thanks,

lamontpa

Acute Occ Med, California

[EMEDPA]

Unfortunately a lot of occmed is folks seeking permanent disability or narcotics so it's a bit of a downer. some practices could be different but I rate it somewhere after corrections medicine, pain clinic, and addiction medicine in terms of desireability....maybe 3 on a 10 scale.....

but hey if you like endless paperwork and pts who lie to you about chronic pain then go for it!

if you like" gnarly acute injuries" occmed is not the place to be....that would be the emergency dept.....:D

[Guest zulu62]

Somebody's gotta do it :p

[NoClinic4Me]

I was bored stiff in occ med, did it for two years. I always felt I was treating the same thing, over and over again. Also, there are a lot of alterior motives going on for "injured" workers. Also, you cannot really be a patient advocate when you are kissing the a%^ of the employers and insurance carriers.

 

Glad you like it!

 

Pat

[Guest TimErick]

I love my job in physiatry/OM! Nice variety of people, time to spend with them where I don't feel rushed, and I walk out the door at 5pm with all my charting already done, so I can start fresh the next morning. I also have an excellent supervising MD, and a great ancillary staff, and am being paid quite well. No complaints here!

 

--Tim--

 

P.S. With 4 years' experience working in drug rehab, I don't get bothered too much by the drug-seeking behavior some exhibit. I understand it really drives some people crazy.

[BlocDoc]

I rate it somewhere after corrections medicine, pain clinic, and addiction medicine in terms of desireability....:D

 

Hey, I'm reading thus stuff!!!

[Marlene G]

Awwww, c'mon. I love working with addicts. You do get those who want to stay clean and they are a pleasure.

;)

[Guest zulu62]

Addicts are the small minority of the population that actually know what it takes to make them happy in life..... another Rx.

 

 

Awwww, c'mon. I love working with addicts. You do get those who want to stay clean and they are a pleasure.

;)

[Lightfoot]

Over-all, I'd say a "9".

 

Now, having said that, one must understand there are different types of occupational medicine. Some happen to be the "doc-in-the-box" urgent care clinics who happen to care for any injuries generated in local companies. In those settings, you will see the malingerers, drug seekers, etc. That's not fun.

 

Other settings will do the full array of occupational medicine services, including specialty exams and certifications, work site visits and evaluations, work suitability evaluations, case management, behavior health aspects, injury tretment, evaluation of exposures, etc. That's the type of operation I am in, and while most of my day is consumed with the mundane exams and certifications, there are enough other challenges thrown at me through the course of the week to keep my pucker factor alive (such as the chest pain in a 40 year old female who was on the treadmill for her work conditioning due to an occupational illness).

 

Keep in mind that some occupational medicine is captive to a particular company with unique problems or concerns and needs. I happen to work at a DOE site with very complicated programs, a half dozen prime contrators and up to 2,000 other assorted companies, sub-contractors and subs to subs. It can make you head spin. However, the plus is we don't have to navigate all the state inustrial claims paperwork (we have enough of our own!).

 

So, in some respects, and judging from the opinions and biased comments expressed this far, understand that there are apples and oranges when talking about "occupational medicine." Some are terrible to work in and others are great.

[Guest yvonne]

I am very interested in physiatry/physical rehabilitation medicine and trying to decide between the PA or MD approach to this field, but need some insight into how these career paths are like. Would anyone here be willing to chat on the phone with me to discuss your experiences as a PA? I was a patient for a long time under a wonderful physiatrist, but she has a very small private practice and was not familiar with the job function as it pertains to PAs. My case is a bit complicated because I am a bit older (27) and making a career change into medicine. Therefore I'm trying to make an educated decision (based on age, time, debt, career fulfillment) whether to accept my post bac acceptances for this Fall, or start the PA pre-reqs this Summer. I know shadowing a PA in PM&R would be the ideal method, but I only recently discovered the PA track after having already applied to the post bacs and have not been able to find one in my area to talk to/shadow. Thanks!

[zzz]

Hi Pat L,

 

I saw you are a RN as well. How is RN job like compared to PA? I though about doing RN after passed the board too but then it costs time in school and then the NCLEX exam then renewal for PANRE after 6th.

 

Also, how do PA-C find jobs in the first place?

[zzz]

Hi Marlene,

 

Your job sound amazing. I would like to be able to do what you do but I don't know where to start. Pretty much all clinic or hospitals do not accept new grad. So lost!!!!!!

[Patrick13]

I had a less than positive view of occ med coming out of school but no experience to back it up. I am a "new" grad and got my start in occ med. I frankly couldn't find a job anywhere else in this part of the state. I work in a dedicated occ med clinic in a semi-rural setting. I do DOT physicals, fit-for-work physicals, urgent care, new injuries and follow-up. I see a lot of shoulders and hands as we have a large beef processing plant nearby. My first week I saw three forklift v. foot. I re-attached a partially amputated finger a few weeks ago. I can do a very thorough physical in 5-7 minutes now. I have a few malingers and few patients that are not much fun to deal with. Very rarely do I prescribe narcs and never more than percocet. We work to get people better and back to work as soon as possible, which is why the employer's here use us. I work 8-5 weekdays with no weekends/nights/call and see 12-20 patients a day, usually around 18 lately. I started in the mid 80's plus bonus, 3 weeks vacation, 1 week sick, 1 week CME + costs and they paid for my state and dea license. I am learning to be OK with the lumbar and cervical strains which are my "bread and butter" lately. I still like the other stuff better and I am getting really good at ortho and neuro. Every specialty has its' "bread and butter" and you have to be OK with whatever that is. If were working in the ED I'd see a ton of painers, Ortho/sports patients are high maintenance, any surgery specialty would force me to work with surgeons. Family med and peds are a nightmare in during flu season. And unlike occ med, many patients can't afford their basic treatments/diagnostics/imaging and are as a result non-compliant to some degree. My patients get what they need when they need it. For me, at this point I am as happy as I could expect to be with my job in occ med.

[marilynpac]

@Patrick...good for you! Look at it this way, you do procedures, maybe simple casting, can do a quick exam. IF you ever get tired of occmed, there isn't really anything that you don't qualify for(ok maybe not CT surg) but the door is open in many other areas for you...

[kittryn]

@Patrick...good for you! Look at it this way, you do procedures, maybe simple casting, can do a quick exam. IF you ever get tired of occmed, there isn't really anything that you don't qualify for(ok maybe not CT surg) but the door is open in many other areas for you...

 

(and who would want to go into CT surgery anyway? it's a f&cking nightmare!)

[Febrifuge]

This is an old thread, but what the heck. Waste not, want not.

 

After a couple of months of doing OEM in a fill-in basis, one shift a week pretty much, I'm loving the contrast to my main UC job.

 

If we get a little workplace injury that's actually an injury, suddenly I'm "the Trauma guy," which is amusing. Otherwise, I'm just enjoying the ability to look at the schedule for the day, and have some semblance of an idea of what kind of day it's going to be. I love acute care and walk-ins, and it's never the same day twice when I'm at the clinic in the evenings rocking the UC, but when somebody strolls in at 10 minutes to closing time and requires 30 minutes of clinic time and another 15 of documenting time, it's a bad day. And I don't want to work more shifts in UC, and have more of those.

 

There's a cool mental shift in perspective, too. The clinician/patient relationship is different (and sometimes doesn't actually exist) in OEM, for one thing. For another, if I see a young healthy person here for a pre-placement exam, it's a GOOD thing, not a "so why did you even come in today?" kind of thing.

 

Anyone feeling a bit burned out on a specialty they used to love might do well to consider the greener pastures of Occ Med, at least for a bit. It requires a really nice general knowledge base, and if you have good docs and support staff, the workflow is in some ways easier than anyplace where you have to do 100% of the documenting by yourself. It's a common complaint about all the paperwork, but compared to my lengthy UC notes for people who haven't seen a PCP in years and come in with slight worsening of a 6-month problem, it's cake. "See printed chart and scanned history form for complete history." "Exam normal. See scanned form for full details." Bam, done, out the door at 5:00. Peace.

[RealityCheck]

Alright, I'll give up a bit about myself. I work in Occ Med in the Pacific Northwest. This is not my first Rodeo. I did Occ Med in Texas.

Each state is different. Texas can direct care and contracts with specific clinics for all services. Other states cannot direct care and it is all up to the patient.

My clinic knows workers comp inside and out and we are a specialty but are laughed at by other services because they don't get it or understand you can actually be a board certified doc in OM.

Anyway, back pain gets old but the work is not that hard.

Trying to advocate for patients can be tough in a state where the average turnover of state claim managers is 50% yearly and none of them know squat about medicine much less spell radiculopathy.

I get frustrated by trying to convince a claim manager with a HS diploma or a GED that the back sprain dx'ed in the ED is actually radiculopathy and they need an MRI and probable ESIs or a spine consult.

Somehow, my licensure and experience should not have to deal with a mother-may-I system run by non medicals.

I do enjoy the lacerations, burns and eye injuries - a decent variety and I love to sew - years and years in surgery - only now the patients can have a conversation with me.

Lots of decent hard working folks out there who need their boo-boo fixed. 

We don't do chronic pain so saying no to narcotics is actually pretty easy. I can pick out the ulterior motives pretty quickly and usually just bluntly shut them down.

I have figured out who I would never want me or my family to work for based on how they treat their employees and it has directed some of my consumer activities as well.

It is decent if you have past experience with ED/Urgent Care or Ortho. 

DOT is interesting. My favorite is still - wow, you weigh 457 lbs and you are completely sure you don't have sleep apnea?…...

I have a weak doctor with way less experience and zero leadership skills. Makes my life difficult when I sew better and know more and she really isn't into learning from others' experiences. 

Corporate medicine does NOT value PAs regardless of abilities and experience. We are somewhat disposable.

It is good work in the right setting.

 

25 yr PA

been there, done that