jmj11 Posted October 4, 2012 Share Posted October 4, 2012 :;-d::;-d::;-d: either way there is a fishy odor..... Link to comment Share on other sites More sharing options...
tigerlily Posted October 4, 2012 Share Posted October 4, 2012 OMG, I am 5'2". I guess I should start my MMA instantly...since I am still a Pre-PA I should have plenty of time. MMA is a good idea, especially since big gold chains won't help my super intimidating appearance. Link to comment Share on other sites More sharing options...
Moderator ventana Posted October 5, 2012 Moderator Share Posted October 5, 2012 don't get this much any more but when I do this is the response all very quickly in the visit - about 1 min I am a PA - explain my qualifications and over a decade of experience blah blah blah offer again to treat them - if not explain that I can rebook with doc and tell them I will let them think about it (if they have continued to say no) and walk out of the room walk downstairs, grab a coffee, chat, maybe see a different patient...... then go back in and get answer I KNOW that they are told that they are seeing a PA so it is ultra manipulative of them refuse to see me. - if they continue to decline I will get them booked with a doc - usually some 1-2 months away and have the MA escort them out is passive agressive, but it works - people and staff know that I am the option if they book with me - if they want someone else they need to book with them Link to comment Share on other sites More sharing options...
PACProvider Posted October 5, 2012 Author Share Posted October 5, 2012 Thank you for the excellent suggestions. I really like the suggestion about having a patient sign a statement that spells out who this will be seeing and obtaining their consent. There is a lot of merit in that approach. I also like the remark from someone who says basically that the rager goes or the PA leaves. I believe in working things out with reasonable approaches among reasonable people. If that doesn't work, it's time to look elsewhere. Link to comment Share on other sites More sharing options...
Dobbyrocks Posted October 5, 2012 Share Posted October 5, 2012 I have been at the same practice for 10 years so I seem to get less and less of this (thank goodness). I usually will say something like "I'm sorry if there was a misunderstanding, but you were on my schedule today. I'd be happy to get started with you now or you can wait to see the doctor." That's it. If they say they'll wait, then I make sure they do (wait, that is. In our office we probably wouldn't reschedule them but you can bet they'll be cooling their heals in that exam room for quite some time before I get a chance to let my SP know that they only want to see him). I used to try to convice, cajole, smile, impress, catch more flies with honey, that sort of thing. Now, for the most part, I just get the hell out of the room. The thing to remember, it's not about you...it's about them. Usually these patients are either (1) outrageously self important or (2) uneducated. Their request to see the doctor has nothing to do with your skill, training, competance or personality. So don't take it personally. Avoid the bullet that's about to hit you and get the hell out of the room! Let it go, and go see the next patient. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted October 5, 2012 Moderator Share Posted October 5, 2012 also as you age and look more "doctorish" you will get less and less of this. as a fresh faced new grad with no wedding ring I used to get it a lot more often than I do now looking older than many of my attendings... professional dress helps too. lab coats look professional and I try to always wear one. sure, it's a prop but one folks know and trust. Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted October 6, 2012 Administrator Share Posted October 6, 2012 also as you age and look more "doctorish" you will get less and less of this. as a fresh faced new grad with no wedding ring I used to get it a lot more often than I do now looking older than many of my attendings...professional dress helps too. lab coats look professional and I try to always wear one. sure, it's a prop but one folks know and trust. Yep, finished my third week here at my first practice, not one patient has refused to see "the PA" yet. But then, I've got the lab coat, tie, and graying temples, so I don't really look much like the new grad I am. Link to comment Share on other sites More sharing options...
Contrarian Posted October 6, 2012 Share Posted October 6, 2012 Yep, finished my third week here at my first practice, not one patient has refused to see "the PA" yet. But then, I've got the lab coat, tie, and graying temples, so I don't really look much like the new grad I am. What...!!! No septum rings, Nose, Eyebrow, lip, cheek, tongue piercings....??? NO neck and facial tattoos...??? Not even a few "teardrops"...??? DAwg... you slackin and ain't "keepin it real" by "expressin yo self".... Link to comment Share on other sites More sharing options...
physasst Posted October 6, 2012 Share Posted October 6, 2012 I do remember how it was when I worked at a "world famous clinic" where people came from far away. They would react just has you described sometimes. I hated to try and see someone who started the visit in anger. However our department had a policy that you see who you see and you can't switch providers. This pertained to MDs. I was the first PA in the department. The head of our (70 physician) department wanted me to say when I walked in the room, "Hi, I'm so and so the PA. You have the right to see an MD and I will help you make that arrangement if you wish." (sort of like the Miranda rights). However, when my boss (the boss of our sub group of 6 providers) heard this, he was livid. He, btw, was an extremely good SP, about the best I ever had. His view was that the policy about physicians should apply to me. If I gave the patient the option of seeing someone else, so he reasoned, then it would imply that the quality of care varied among providers. He rejected that notion. So if a patient refused to see me, and they did about once every few months, they were treated the same way as if they rejected seeing one of the neurologists ( and sometimes they did for stupid, prejudicial reasons like the neurologist was foreign born, a woman, a person of "color") their appointment was cancelled and they were put in the back of the line. That meant they had to reapply and see, if they were one of the 10% chosen to come the next time the lottery is spun. Then if they do come back, it would be months later and they would be randomly assigned to the expert in that area . . . which could be the same person they were scheduled with the first time. BTW, Patty Atkinson remembered you. As for me, it doesn't occur often, but occasionally. I tell them that they have 2 choices. 1. They can see me today, and I will manage their condition. 2. They can talk to the desk and re-schedule with a physician. We are booked about 2-3 months out for most of our providers. They have that choice. If their spinal condition or pain is severe enough that they needed an appointment, they can decide if they would like to wait again, or see me. I haven't had one patient take option 2. Usually I hear..."Uh, okay, yeah, I guess it's okay, we'll just go ahead today". Not to mention that every patient I see is referred to the center, and when an internal physician/provider (90% of our referrals) orders a "Spine Center Consult", there is a box which asks "Okay for Spine Center Midlevel Provider (PA/NP)?" with a yes/no response required. This means, that theoretically, the patient should know that they are seeing a PA. Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted October 6, 2012 Administrator Share Posted October 6, 2012 What...!!!No septum rings, Nose, Eyebrow, lip, cheek, tongue piercings....??? NO neck and facial tattoos...??? Not even a few "teardrops"...??? DAwg... you slackin and ain't "keepin it real" by "expressin yo self".... No piercings, tats, or other body modifications whatsoever. I am indeed boring. Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted October 6, 2012 Moderator Share Posted October 6, 2012 No piercings, tats, or other body modifications whatsoever. I am indeed boring. Not having piercings or tats is the new having piercings or tats. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted October 6, 2012 Moderator Share Posted October 6, 2012 not having piercings or tats is the new having piercings or tats. finally i'm cool....are vintage watches the new trendy iphone equivalent? If so i am so getting some.... Link to comment Share on other sites More sharing options...
d2305 Posted October 6, 2012 Share Posted October 6, 2012 I never wore professional attire in the ER, just scrubs and a lab coat. Link to comment Share on other sites More sharing options...
jen0508 Posted October 7, 2012 Share Posted October 7, 2012 ditto... none of the 10 PAs in our group even wear a lab coat. less than half the docs wear one. Link to comment Share on other sites More sharing options...
d2305 Posted October 7, 2012 Share Posted October 7, 2012 EMEDPA did you see what the students and residents are spending on attire on the SDN. I have never spent over $200 for a shirt, and $5000 on a suit. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted October 7, 2012 Moderator Share Posted October 7, 2012 YUP, saw that...and no love for my suggestion of vintage watches.... Link to comment Share on other sites More sharing options...
Guest JMPA Posted October 8, 2012 Share Posted October 8, 2012 I have been at the same practice for 10 years so I seem to get less and less of this (thank goodness). I usually will say something like "I'm sorry if there was a misunderstanding, but you were on my schedule today. I'd be happy to get started with you now or you can wait to see the doctor." That's it. If they say they'll wait, then I make sure they do (wait, that is. In our office we probably wouldn't reschedule them but you can bet they'll be cooling their heals in that exam room for quite some time before I get a chance to let my SP know that they only want to see him). I used to try to convice, cajole, smile, impress, catch more flies with honey, that sort of thing. Now, for the most part, I just get the hell out of the room. The thing to remember, it's not about you...it's about them. Usually these patients are either (1) outrageously self important or (2) uneducated. Their request to see the doctor has nothing to do with your skill, training, competance or personality. So don't take it personally. Avoid the bullet that's about to hit you and get the hell out of the room! Let it go, and go see the next patient. Totally agree with you, I will not waste my time with a stupid, arrogant ****. It is their loss. I usually just say my name is so an so and im a physician assistant and am here to see you today. The second they notion they want to only see an MD i just walk out. Link to comment Share on other sites More sharing options...
Contrarian Posted October 8, 2012 Share Posted October 8, 2012 ^^ Yep ^^ Its rare and only happens now once every few yrs, but when it did/does... I spend NO time trying to convince them to allow me to attempt to solve THEIR problems... and I do nothing to try to obstruct or expedite them seeing a physician. Since I fully respect one's right for "Patient Autonomy"... I simply smile, escort them back to the waiting room and move on to the next patient. Sometimes after their attempts at the front desk to see a physician has resulted in them getting a appointment weeks to months later, they then send staff back to say that they have changed their mind a will let me see them. At this point... the schedualed/alloted time for them to see me has past... and I'm on to other patients and things so no... I still don't see them. Link to comment Share on other sites More sharing options...
jsfelder0417 Posted October 8, 2012 Share Posted October 8, 2012 The table clocks are only cool if you mount them on a chain and hang them from your neck a la Flava Flav Link to comment Share on other sites More sharing options...
Joelseff Posted October 8, 2012 Share Posted October 8, 2012 finally i'm cool....are vintage watches the new trendy iphone equivalent? If so i am so getting some.... Haven't you amassed quite a collection of these in the past few months??? Link to comment Share on other sites More sharing options...
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