I am a glorified scribe, not a PA

[Guest AA2526]

Just looking for some professional input on this issue...I am currently working as a certified physician assistant in a dermatology clinic, I have been here for over 8 months now. I work solely with my attending dermatologist, there are no other providers in the clinic. I am his first PA that he has had in the clinic and we discussed my expectations and role as a PA extensively before I accepted the position. For the past 8 months I have been following him into rooms, scribing for him (writing notes, sending in the patient's prescriptions, dealing with insurance, etc), I do not interact with the patients otherwise. I have maybe an average of 4 of my own patients per day on my schedule, otherwise I am following him around, I solely see established acne patients and rash follow ups. I have 2 years of emergency medicine experience where I was very autonomous. I was excited for the opportunity to join the dermatology realm however I am so very disappointed in my experience. I have spoken to him about it several times and he is always very open to allowing me to do more including biopsies, skin tag removals, wart freezing, etc. however he never actually allows me to do it when it comes time. He was very adamant about me never doing routine skin checks. I'm not sure why I should stay here at this job at this point - I get no benefits other then basic health insurance, we work federal holidays, and I just don't feel respected in my profession. It's very upsetting to me and honestly demeaning. I wanted to see what input/ideas other PAs have on the issue. Thanks in advance! 

[bepst5]

You should quit.  That's not what you went to school for.

[Reality Check 2]

Run, time to go.

 

[rev ronin]

If you're getting paid six figures to be a glorified scribe, it could be a lot worse. You're dealing with a self actualization crisis, not threats to patient health or your licensure.  That's not to say it's a good situation... but there are degrees of badness.

[MSPAC2]

Start looking for another position now but chances are that the local dermatologists in your area know each other so I would tread lightly. If you’re getting paid nicely, stay at least one year. 

[CAAdmission]

If someone wanted to pay me a ton to do basically nothing and have no liability, I'm not sure I'd walk. Get a side gig in an ER to practice real medicine. 

[Patho]

I was over worked and underpaid in hospital medicine. And I would pick up some PRN shifts until it truly becomes unbearable. But I’ve also gotten to the point where I’m ok with certain things from burn out so maybe this is not the best advice. 

[Mayamom]

21 hours ago, CAAdmission said:

f someone wanted to pay me a ton to do basically nothing and have no liability, I'm not sure I'd walk. Get a side gig in an ER to practice real medicine

This or even an urgent care.   

[SedRate]

On 2/9/2023 at 2:12 PM, AA2526 said:

Just looking for some professional input on this issue...I am currently working as a certified physician assistant in a dermatology clinic, I have been here for over 8 months now. I work solely with my attending dermatologist, there are no other providers in the clinic. I am his first PA that he has had in the clinic and we discussed my expectations and role as a PA extensively before I accepted the position. For the past 8 months I have been following him into rooms, scribing for him (writing notes, sending in the patient's prescriptions, dealing with insurance, etc), I do not interact with the patients otherwise. I have maybe an average of 4 of my own patients per day on my schedule, otherwise I am following him around, I solely see established acne patients and rash follow ups. I have 2 years of emergency medicine experience where I was very autonomous. I was excited for the opportunity to join the dermatology realm however I am so very disappointed in my experience. I have spoken to him about it several times and he is always very open to allowing me to do more including biopsies, skin tag removals, wart freezing, etc. however he never actually allows me to do it when it comes time. He was very adamant about me never doing routine skin checks. I'm not sure why I should stay here at this job at this point - I get no benefits other then basic health insurance, we work federal holidays, and I just don't feel respected in my profession. It's very upsetting to me and honestly demeaning. I wanted to see what input/ideas other PAs have on the issue. Thanks in advance! 

Good ol bait and switch. Had something vaguely similar happen when I switched fields. Sorry this happened to you.

Before you take action, I encourage you to sit down with him and ask him why he hired a PA. See what he says. Go into the conversation with an open, curious mind. And then ask him what it would take for you to be able to practice at the top of your license within his practice. Perhaps there's more to it such as he envisions a long ramp-up period and wants to make sure it's a good fit before entrusting you with more responsibilities. Perhaps he's heard horror stories and there are things you can do to show him your abilities. 

Like others said, there's worse things out there. Personally for me, money only makes up for so much so I would leave a situation like this if there was no real hope to do what I signed up to do. Maybe stay if I was at the tail-end of my career, didn't care about losing my clinical skills, and wanted something super easy. However, the schedule and benefits don't really seem great either. 

[bike mike]

I had this bait and switch once. Was told I'd be managing ECMO and LVAD patients and when I showed up for my first day (after moving across the country) was told the job description had changed. Worked as a scribe and changed driveline dressings. I lasted 6 weeks before leaving in a way I'm sure has me black listed at the organization but I couldn't give a rats ass.