PAstudentCanada Posted August 23, 2012 Author Share Posted August 23, 2012 Bob, I am a new grad. Just finished school last week. What did you mean by "doing this for a few years?" Link to comment Share on other sites More sharing options...
PAstudentCanada Posted August 24, 2012 Author Share Posted August 24, 2012 I spoke with my SP today about some of the issues that bothered me. He also kept introducing me to people today as "my assistant" which kind of rubbed me the wrong way so-to-speak. I told him that. He apologised and said it is hard for him to not think of me as a student since I was a student under him for 3 months. He said he will try harder and told me having me there is stressful for him because he is not used to it. We shall see how things progress. Link to comment Share on other sites More sharing options...
andersenpa Posted August 24, 2012 Share Posted August 24, 2012 I spoke with my SP today about some of the issues that bothered me. He also kept introducing me to people today as "my assistant" which kind of rubbed me the wrong way so-to-speak. I told him that. He apologised and said it is hard for him to not think of me as a student since I was a student under him for 3 months. He said he will try harder and told me having me there is stressful for him because he is not used to it. We shall see how things progress. Ouch. You may have to cut the apron strings on this place. Sent from my DROID RAZR using Tapatalk 2 Link to comment Share on other sites More sharing options...
PAstudentCanada Posted August 24, 2012 Author Share Posted August 24, 2012 I had to look up what "cut the apron strings" mean and, after reading the definition, I still don't get what you mean. What do you mean, andersenpa? Ouch. You may have to cut the apron strings on this place. Sent from my DROID RAZR using Tapatalk 2 Link to comment Share on other sites More sharing options...
andersenpa Posted August 24, 2012 Share Posted August 24, 2012 I had to look up what "cut the apron strings" mean and, after reading the definition, I still don't get what you mean. What do you mean, andersenpa? Doc's got you on a short leash. Sent from my DROID RAZR using Tapatalk 2 Link to comment Share on other sites More sharing options...
PAstudentCanada Posted August 24, 2012 Author Share Posted August 24, 2012 Doc's got you on a short leash. Sent from my DROID RAZR using Tapatalk 2 Isn't that how it should be on my 4th day in practice? Link to comment Share on other sites More sharing options...
Joelseff Posted August 24, 2012 Share Posted August 24, 2012 I can see, that since you are new, presenting to your SP on every case as reasonable FOR THE FIRST MONTH OR SO. After that it would be ridiculous. Also It's problematic to present in front of the pt. As a student sure, being pimped in front of pts is a rite of passage but now that u r a PRACTITIONER, its ridiculous and serves to undermine your credibility with the pt as a PRACTITIONER. I would suggest presenting your A & P to him in his or your office or heck the hallway but in front of the pt makes u look incompetent and unready to practice (in the eyes of the pt). Btw how do u see 15 pts per 4 hours if u have to present every Freakin case? Sent from my myTouch_4G_Slide using Tapatalk Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted August 24, 2012 Moderator Share Posted August 24, 2012 Isn't that how it should be on my 4th day in practice? My 4th day in practice I presented probably 25% of my cases to my sp in his office and reviewed all xrays with him. I shared an office with a senior pa and he was my consult most of the time for the first yr. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted August 24, 2012 Moderator Share Posted August 24, 2012 I guess Canadian medicine is different than southern medicine (should be a specialty in its own right LOL).... it's the same as american medicine but they put gravy on everything. Link to comment Share on other sites More sharing options...
PAstudentCanada Posted August 24, 2012 Author Share Posted August 24, 2012 I said this to him, about not presenting in front of the pt, but he disagrees. Also, the Ontario College of Physicians and Surgeons is advising him that to bill the Ontario Health Insurance Plan for my work he has to personally see and be involved with each patient. He is taking this very literally (other SPs are not and are still getting paid their billings just fine). Any advice on what, if anything, I should say to him? I can see, that since you are new, presenting to your SP on every case as reasonable FOR THE FIRST MONTH OR SO. After that it would be ridiculous. Also It's problematic to present in front of the pt. As a student sure, being pimped in front of pts is a rite of passage but now that u r a PRACTITIONER, its ridiculous and serves to undermine your credibility with the pt as a PRACTITIONER. I would suggest presenting your A & P to him in his or your office or heck the hallway but in front of the pt makes u look incompetent and unready to practice (in the eyes of the pt). Btw how do u see 15 pts per 4 hours if u have to present every Freakin case? Sent from my myTouch_4G_Slide using Tapatalk Link to comment Share on other sites More sharing options...
PAstudentCanada Posted August 24, 2012 Author Share Posted August 24, 2012 it's the same as american medicine but they put gravy on everything. That's true, eh. We also live in igloos :P Link to comment Share on other sites More sharing options...
PAstudentCanada Posted August 24, 2012 Author Share Posted August 24, 2012 My SP says that PGY1s in FM all have to review every case in real time so I should too. Link to comment Share on other sites More sharing options...
Joelseff Posted August 24, 2012 Share Posted August 24, 2012 I said this to him, about not presenting in front of the pt, but he disagrees. Also, the Ontario College of Physicians and Surgeons is advising him that to bill the Ontario Health Insurance Plan for my work he has to personally see and be involved with each patient. He is taking this very literally (other SPs are not and are still getting paid their billings just fine). Any advice on what, if anything, I should say to him? If he never plans on you seeing pts on your own or if he insists on seeing the pt after you see the pt or heck if he insists on having you present on front of the pt like a student, I don't know how you can really grow there? Sounds like you are expected to be a perpetual PA-S. I don't know the regs there in Canada. Maybe they are really restrictive re: PA practice but I would do like Andersen says and say "peace out" Maybe find you a SP that is more conducive to your career growth. Sent from my myTouch_4G_Slide using Tapatalk Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted August 24, 2012 Moderator Share Posted August 24, 2012 that's true, eh.We also live in igloos :p yeah, what's that abooot? Link to comment Share on other sites More sharing options...
PAstudentCanada Posted August 24, 2012 Author Share Posted August 24, 2012 He says he does plan on not reviewing in real time eventually. I think this will all work itself out. He means well, he is just new to all this. If he never plans on you seeing pts on your own or if he insists on seeing the pt after you see the pt or heck if he insists on having you present on front of the pt like a student, I don't know how you can really grow there? Sounds like you are expected to be a perpetual PA-S. I don't know the regs there in Canada. Maybe they are really restrictive re: PA practice but I would do like Andersen says and say "peace out"Maybe find you a SP that is more conducive to your career growth. Sent from my myTouch_4G_Slide using Tapatalk Link to comment Share on other sites More sharing options...
Beorp Posted August 24, 2012 Share Posted August 24, 2012 I don't claim to know all of the licensing stuff with PAs in Ontario, but aren't they still not a regulated health profession? Might getting a college (which is obviously going to happen in the not too distant future), make it easier for your SP to take a step back? Link to comment Share on other sites More sharing options...
Joelseff Posted August 24, 2012 Share Posted August 24, 2012 He says he does plan on not reviewing in real time eventually. I think this will all work itself out. He means well, he is just new to all this. I hear ya. I would say give it a few months and see. I would really discuss with him about the presenting in front of pts though. The diff between you and a PGY1 is that a,PGY1 is still a trainee. You are supposed to be a practitioner for the office and it serves the practice well to have its patients completely comfortable with seeing a non physician provider. My SP is new to being an SP also and he was an attending at county before going into private practice. he and I set out from the beginning to define my role and how we are going to foster that in our practice. I remember when i first started with him I presented almost every case for about a week then he said "Joe, you are doing great I fully trust you." Then after that I only bounce stuff off of him when i am unsure or need another opinion but ultimately its my decision. It made me more comfortable but also more diligent about being as accurate as possible b/c I don't want to harm that trust. This is totally different from my very first SP who treated me like a true noob (i was new but but was far from incompetent) it didn't get better after 5 months so I kicked rocks. I am at a good environment now and love my job. I say put your SP on a short leash and give it screw months but start networking just in case this job tanks. Good luck! Joe Sent from my myTouch_4G_Slide using Tapatalk Link to comment Share on other sites More sharing options...
Joelseff Posted August 24, 2012 Share Posted August 24, 2012 I hear ya. I would say give it a few months and see. I would really discuss with him about the presenting in front of pts though. The diff between you and a PGY1 is that a,PGY1 is still a trainee. You are supposed to be a practitioner for the office and it serves the practice well to have its patients completely comfortable with seeing a non physician provider. My SP is new to being an SP also and he was an attending at county before going into private practice. he and I set out from the beginning to define my role and how we are going to foster that in our practice. I remember when i first started with him I presented almost every case for about a week then he said "Joe, you are doing great I fully trust you." Then after that I only bounce stuff off of him when i am unsure or need another opinion but ultimately its my decision. It made me more comfortable but also more diligent about being as accurate as possible b/c I don't want to harm that trust. This is totally different from my very first SP who treated me like a true noob (i was new but but was far from incompetent) it didn't get better after 5 months so I kicked rocks. I found a much better SP who remains one of my good friends up till now. I left there because I wanted FP and HIV. I am at a good environment now and love my job. I say put your SP on a short leash and give it screw months but start networking just in case this job tanks. Good luck! Joe Sent from my myTouch_4G_Slide using Tapatalk Sent from my myTouch_4G_Slide using Tapatalk Link to comment Share on other sites More sharing options...
Joelseff Posted August 24, 2012 Share Posted August 24, 2012 Sent from my myTouch_4G_Slide using Tapatalk Triple post...arrrgghhh Sent from my myTouch_4G_Slide using Tapatalk Link to comment Share on other sites More sharing options...
PAstudentCanada Posted August 24, 2012 Author Share Posted August 24, 2012 I don't claim to know all of the licensing stuff with PAs in Ontario, but aren't they still not a regulated health profession? Might getting a college (which is obviously going to happen in the not too distant future), make it easier for your SP to take a step back? Correct, we currently work under medical directives (and he did create a full and complete set of medical directives for me). We are all waiting on this http://www.hprac.org/en/projects/physicianassistants.asp just a few more days now! Link to comment Share on other sites More sharing options...
PAstudentCanada Posted August 24, 2012 Author Share Posted August 24, 2012 Thanks for the advice :) I hear ya. I would say give it a few months and see. I would really discuss with him about the presenting in front of pts though. The diff between you and a PGY1 is that a,PGY1 is still a trainee. You are supposed to be a practitioner for the office and it serves the practice well to have its patients completely comfortable with seeing a non physician provider. My SP is new to being an SP also and he was an attending at county before going into private practice. he and I set out from the beginning to define my role and how we are going to foster that in our practice. I remember when i first started with him I presented almost every case for about a week then he said "Joe, you are doing great I fully trust you." Then after that I only bounce stuff off of him when i am unsure or need another opinion but ultimately its my decision. It made me more comfortable but also more diligent about being as accurate as possible b/c I don't want to harm that trust. This is totally different from my very first SP who treated me like a true noob (i was new but but was far from incompetent) it didn't get better after 5 months so I kicked rocks. I am at a good environment now and love my job. I say put your SP on a short leash and give it screw months but start networking just in case this job tanks. Good luck! Joe Sent from my myTouch_4G_Slide using Tapatalk Link to comment Share on other sites More sharing options...
primadonna22274 Posted August 24, 2012 Share Posted August 24, 2012 Agree with Joe's advice to wait it out and see how things go over the next few months. Keep in mind that since PAs in Canada are so new you are a trailblazer and really lucky to have a job. I have many PA mentors who tell me they worked FOR FREE for the first 6 mos of their careers just to prove to folks what they could do (early 80s in Oregon before PAs really caught on). Try to be humble and learn something from every patient. I agree that after a few months it would be counter-productive to present more than a fraction of your patients. Trust comes with time. Give your SP some credit for sharing his knowledge and helping start your career. IMO it speaks volumes that you were ABLE to tell him how you feel, and that he listened and said he would try. The new PA-SP relationship is vital to the success of your practice and will go a long way to promote excellent patient care. After a few years you should be autonomous, but nobody should expect complete autonomy right out of PA school, particularly in primary care which is vast. I've said before that anyone who thinks primary care is easy has never done it. Good luck and do your best, and keep the communication open. Lisa Link to comment Share on other sites More sharing options...
PAstudentCanada Posted August 24, 2012 Author Share Posted August 24, 2012 Thanks!, Lisa. :) Agree with Joe's advice to wait it out and see how things go over the next few months.Keep in mind that since PAs in Canada are so new you are a trailblazer and really lucky to have a job. I have many PA mentors who tell me they worked FOR FREE for the first 6 mos of their careers just to prove to folks what they could do (early 80s in Oregon before PAs really caught on). Try to be humble and learn something from every patient. I agree that after a few months it would be counter-productive to present more than a fraction of your patients. Trust comes with time. Give your SP some credit for sharing his knowledge and helping start your career. IMO it speaks volumes that you were ABLE to tell him how you feel, and that he listened and said he would try. The new PA-SP relationship is vital to the success of your practice and will go a long way to promote excellent patient care. After a few years you should be autonomous, but nobody should expect complete autonomy right out of PA school, particularly in primary care which is vast. I've said before that anyone who thinks primary care is easy has never done it. Good luck and do your best, and keep the communication open. Lisa Link to comment Share on other sites More sharing options...
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