Attitude in the workplace

[maybemedicine]

Where do I start? I work in a high volume outpatient clinic (UC/occ med). I am constantly being interrupted by staff for signatures, clearance etc. things that can wait until end of business day or mid day when I get a chance to take care of it. 

I even got a rack so papers aren’t sprawled in my desk and discussed a process of leaving the paperwork, I will get to it every time I sit down I will address it, if not at the end of day. I have made that abundantly clear and have never gone back on my word. Still there are interruptions.

The staff will come to me vs any other provider for emergencies etc but also paperwork. I mean, I understand I’m readily available and obviously will help in a medical emergency. But the incessant disruption throughout the day becomes redundant and bothersome.

I have been told by staff that I have been rude or short with them. I personally do not feel that, rather I am being direct with the staff with clear instructions, because otherwise, when given vague instructions things don’t get done right or there are a billion other questions that are asked. I even reached out to my supervisor on how to address this and his answer was “you take charge and are more direct that the other providers”. He did not answer my question. He did understand the issue I had with the constant interruption, again no feedback, other than “you’re doing the right thing”. 

I feel like I have to walk on eggshells at work. I not only have to watch what I say, but how I say something and who I say something too. I feel like I shouldn’t even speak to anyone, in fact most days I don’t. Obviously, if I completely stop talking that will then be another issue.

I noticed that my efficiency with seeing patients have dwindled. Not in the quality of care but the quantity. I am still a nice person, or at least feel that way (and told I’m pleasant by the patients). I wish there was a magic pill or wand to change my attitude.

I have been journaling, meditating. I just find that at the workplace I am still pleasant (atleast from my point of view). I was out for a week on vacation, not sure if I magically changed in a week and became a different person (especially after vacation). Shouldn’t someone come back more relaxed?  

I even have little reminders in my desk to be positive (I’m not negative or complain), I guess it’s just the tone in delivery. But some other staff say nothing is wrong, and just how I speak. But that’s how I speak and it hasn’t affected the other staff. 

Given the mask update this week too. I have  chosen to stay masked, not only because I have only practiced medicine with a mask (first job in 2020) And that’s all I know, but I don’t trust my facial expressions at work, and I don’t want to add another “attitude or behavior” reason for the staff to complain about.

I will take suggestions on how to bring a positive attitude each and every day to the work place. Also, like I stop and think of my response but should I flick a rubber and in my wrist before I respond to someone to remind myself to keep it short and simple? Or will being short and simple also be an issue? Do I remain the quiet person and does that reflect that I have a new found attitude? Any help is appreciated. 

[rev ronin]

Have you made formal complaints about staff interrupting you for non-emergency matters? Someone obviously told them it was reasonable to do so.

Consider accepting their paperwork, walking to your desk, putting it in the inbox/basket, and returning to your work.

I totally get the "we need this now!" bit of occ med... but their emergencies are not mine. Of course, if something is overdue because I spaced it, I definitely care and will get that done ASAP, but most of the time people just want to get their tasks handled, no matter who they have to interrupt to do it. As long as you incentivize their behavior, it will continue.

[cinntsp]

Staff are like that in any setting.  We get a lot of that on the inpatient side as well.  You are an a-hole if you are direct with the nurses, case managers, etc.

[sas5814]

You hurt my feelings!

Happens everywhere these days because people who are easily offended think they have a right to never be offended.

I, sort of, solved the problem at work by simply saying "no" with no explanation after suffering the same issues you describe. Because I get things done, and  because the physicians in the clinic (I am the only PA) are somewhere between abusive and just whiney every time any staff member brings them a problem I became everyone's "go to" guy. So now I do what I think needs to be done when it needs to be done and draw some hard lines otherwise.

[Reality Check 2]

If men are direct and succinct, they are often seen as Managerial.

Women use direct, clear communication and I just get called b**chy.

I had never seen the show Bones (huge fan of the books which are POLAR different) - a few people told me I was like Bones.

Turns out, I am.

I do not apologize. I work in a stressful environment and expect people to do their jobs - the way their jobs are intended to be done. 

Evidently that is mean.

I do not call people names, I do not throw things, I do not raise my voice. I do communicate the clear need of what needs to be done.

If that is B**chy - I can't help it. No coddling. Momma is not going to guide you to your desk and teach you to do your job.

Somehow we have raised a generation of hypersensitive oversensitive folks who can't separate professionalism from anything else.

I do say please and thank you

[SedRate]

You've received good advice and insight thus far. 

 

13 hours ago, maybemedicine said:

I have  chosen to stay masked, not only because I have only practiced medicine with a mask (first job in 2020) And that’s all I know, but I don’t trust my facial expressions at work, and I don’t want to add another “attitude or behavior” reason for the staff to complain about.

I'd argue that seeing your facial expressions would actually help others. Nonverbal communication is huge and there's more to it than what can be provided by the forehead and eyes. 

[Reality Check 2]

Masks cannot hide my eyes rolling................

I have had to adapt my body language a lot. 

Long story - growing up in violent household - I get defensive pretty quick.

Had to learn to adapt my presence to be firm but not threatening. Hard when used to defending oneself.

Folks needs to know what their job IS and then be held to actually DOING THEIR JOBS.

Too many scripted responses in life "I am sorry for any inconvenience this may have caused you". No, you are not, you just read that.

Let's be real and get Sh*t done, please. Cut the niceties and platitudes..........

Yep, it's a cranky day

[CAAdmission]

3 hours ago, sas5814 said:

Because I get things done, and  because the physicians in the clinic (I am the only PA) are somewhere between abusive and just whiney every time any staff member brings them a problem I became everyone's "go to" guy. 

That was my problem - I was a the only non a-hole in the group. 

For self-defense, I have now become an a-hole. It works. 

 

[ventana]

15 hours ago, rev ronin said:

Have you made formal complaints about staff interrupting you for non-emergency matters? Someone obviously told them it was reasonable to do so.

Consider accepting their paperwork, walking to your desk, putting it in the inbox/basket, and returning to your work.

I totally get the "we need this now!" bit of occ med... but their emergencies are not mine. Of course, if something is overdue because I spaced it, I definitely care and will get that done ASAP, but most of the time people just want to get their tasks handled, no matter who they have to interrupt to do it. As long as you incentivize their behavior, it will continue.

Excellent advice. 
re read it

 

 

you are a bit burned out. 
 

not uncommon 

 

step one is always be nice to your coworkers.   
step two.  Stop doing their emergency.  Simple state you would love to help but am just right now.   Then suggest they put it on your desk.  
step three.  Let admin this is going on.  Bring up that multitasking is dangerous (this is a known accepted fact and if they say differently it is a bad omen).  Our brains are linear.  
simply stop doing them. 
 

 

last year I got told I was grumpy at work.  Fact of the matter is I was in a similar position and stood up for myself.  People try to take the easiest way out and for some reason handing everything to the PA becomes how staff clean their own desk.  Point this out.   Correct people kindly that they need to prep their very thing for you.  Then do it on your time.  Heck put it on your desk and let it sit for a few days and magically they stop asking.    Be careful though if you are not producing RVU.  
 

good luck.  Organized medicine sucks right now.    Start your own clinic!!

[TWR]

You have been practicing for 2 years in a specialty that can be quite stressful for even a seasoned PA.  You haven't yet developed the "seasoned" PA crust yet so you are reacting to each situation, and they sense that you are not in control.  You may be the best, smartest PA on earth but you will need to set guidelines for the people you work with if you are to succeed in your present setting.  Maybe step outside of your role as the clinician and do something for your PA. As Reality Check stated above, "please and thank you" let people know you care.  Just me venting.

[Mayamom]

5 hours ago, ventana said:

and for some reason handing everything to the PA

This is how is was for 30 years for me.  Everything gets dumped on the PA.   It's frustrating and exhausting. 

[sas5814]

12 hours ago, Mayamom said:

This is how is was for 30 years for me.  Everything gets dumped on the PA.   It's frustrating and exhausting. 

33 years in and I only , in the last couple of years, figure out I could just say no or "I'm not doing that" and the world didn't burst into flames. It like a super power I didn't know I had.

 

[SedRate]

2 hours ago, sas5814 said:

33 years in and I only , in the last couple of years, figure out I could just say no or "I'm not doing that" and the world didn't burst into flames. It like a super power I didn't know I had.

 

Thankfully, I learned this from y'all on this forum. Unfortunately, I'm still figuring out how to say no without causing problems for myself. Lol

[EMEDPA]

Yup to all of the above. I recently stopped following up on other people's non-urgent messes at the job that sends me the most as a member of the pool. I found a way to not have them come to my email, so now they don't even exist for me...lalalalalalalalalalalalalala

[Reality Check 2]

I am in no way condoning the dumping behavior in offices or hospitals.

After thinking about this, it struck me though.

In some cases, the staff/crew/team trusts the PA to do what is right for the patient.

It has affected my career in negative ways when the patient especially expresses more trust in me or likes me better, frankly, than the docs I work with.

The ortho surgeon I worked for (not with, for - in his mind) got physically agitated when a patient made an appt with me instead of him and told him to his face that I explained things better and took more time. His face got all red and he stormed off. 

Nurses come to me with problems they have with other providers - whatever they are NP/PA/Physician. The admin crew comes to me with their issues. It tends to get me in trouble with higher "leadership" when I help translate or relate issues or needs.

Perhaps PAs - most of us - are cut from different cloth. We care, we listen, we teach, we explain.

That does NOT mean we are the doers of all and the fixers of all - but maybe it speaks to a quality we have over others that shows through more brightly.

I am going to sincerely try to harness that energy and redirect politely, help where I can and take some pride in knowing that something about me, as a PA, might make people trust me to do what is right.

Enough sappy, I have to go back to being logical now...................

[ventana]

34 minutes ago, Reality Check 2 said:

I am in no way condoning the dumping behavior in offices or hospitals.

After thinking about this, it struck me though.

In some cases, the staff/crew/team trusts the PA to do what is right for the patient.

It has affected my career in negative ways when the patient especially expresses more trust in me or likes me better, frankly, than the docs I work with.

The ortho surgeon I worked for (not with, for - in his mind) got physically agitated when a patient made an appt with me instead of him and told him to his face that I explained things better and took more time. His face got all red and he stormed off. 

Nurses come to me with problems they have with other providers - whatever they are NP/PA/Physician. The admin crew comes to me with their issues. It tends to get me in trouble with higher "leadership" when I help translate or relate issues or needs.

Perhaps PAs - most of us - are cut from different cloth. We care, we listen, we teach, we explain.

That does NOT mean we are the doers of all and the fixers of all - but maybe it speaks to a quality we have over others that shows through more brightly.

I am going to sincerely try to harness that energy and redirect politely, help where I can and take some pride in knowing that something about me, as a PA, might make people trust me to do what is right.

Enough sappy, I have to go back to being logical now...................

then by god they have to pay use more then 20-50% of the doc pay.... period....

[thinkertdm]

7 hours ago, Reality Check 2 said:

I am in no way condoning the dumping behavior in offices or hospitals.

After thinking about this, it struck me though.

In some cases, the staff/crew/team trusts the PA to do what is right for the patient.

It has affected my career in negative ways when the patient especially expresses more trust in me or likes me better, frankly, than the docs I work with.

The ortho surgeon I worked for (not with, for - in his mind) got physically agitated when a patient made an appt with me instead of him and told him to his face that I explained things better and took more time. His face got all red and he stormed off. 

Nurses come to me with problems they have with other providers - whatever they are NP/PA/Physician. The admin crew comes to me with their issues. It tends to get me in trouble with higher "leadership" when I help translate or relate issues or needs.

Perhaps PAs - most of us - are cut from different cloth. We care, we listen, we teach, we explain.

That does NOT mean we are the doers of all and the fixers of all - but maybe it speaks to a quality we have over others that shows through more brightly.

I am going to sincerely try to harness that energy and redirect politely, help where I can and take some pride in knowing that something about me, as a PA, might make people trust me to do what is right.

Enough sappy, I have to go back to being logical now...................

PAs combine science and humanity to be, you know, what physicians strives to be, before hubris took over.  

[rev ronin]

8 hours ago, Reality Check 2 said:

Perhaps PAs - most of us - are cut from different cloth. We care, we listen, we teach, we explain.

We really need to make a "Why PAs are better than physicians" publication. This would be right up top.

[Reality Check 2]

I would not campaign against anyone but promote the good in PAs.

PAs are an excellent choice for healthcare. We care, we listen, we educate, we explain. 

[iconic]

Learned the hard way not to care about the practice more than the physician does. They will be making all of the money off of your hard work and you will see none of it. A lot of PAs go way beyond of what is required of them to take care of patients. If a practice is poorly run, it is not your job to fix it.. 

[rev ronin]

1 hour ago, Reality Check 2 said:

I would not campaign against anyone but promote the good in PAs.

PAs are an excellent choice for healthcare. We care, we listen, we educate, we explain. 

Saying we're better than physicians at patient care isn't putting anyone else down, just stating the basic facts. It's no more pejorative than saying that MDs are better than PAs at treating undifferentiated illness. Fact is, PAs who have more life experience are far better at communicating with patients than those who never held a real job until residency. Obviously, generalizations abound, but there's a reason PAs aren't just "physician extenders" but bring real distinct value to the healthcare team.

[CAAdmission]

The path to a career as a physician tends to either generate or select out terrible people. You always have to be comparing yourself to others and climbing over them to get into med school. The cycle repeats again when you vie for a residency slot.

Many enter med school because they are narcissists or they seek some combination of wealth, prestige, and power. Many of the rest wind up like this by virtue of daily contact with terrible people. It's hard to blame them. The system is practically designed to manufacture egomaniacal jerks. 

[sas5814]

One of the best docs I ever worked with said "everyone in med school takes Arrogance 101. Some people go on to the graduate program."

[ventana]

17 hours ago, iconic said:

Learned the hard way not to care about the practice more than the physician does. They will be making all of the money off of your hard work and you will see none of it. A lot of PAs go way beyond of what is required of them to take care of patients. If a practice is poorly run, it is not your job to fix it.. 

yup - took me a good 4 times to learn this - I was there to make them money. period

7 hours ago, CAAdmission said:

The path to a career as a physician tends to either generate or select out terrible people. You always have to be comparing yourself to others and climbing over them to get into med school. The cycle repeats again when you vie for a residency slot.

Many enter med school because they are narcissists or they seek some combination of wealth, prestige, and power. Many of the rest wind up like this by virtue of daily contact with terrible people. It's hard to blame them. The system is practically designed to manufacture egomaniacal jerks. 

If they are not that way before entry, after 3-8 years of 80-100 hr work weeks they are pretty much all burnt crispy......

[rev ronin]

1 hour ago, ventana said:

If they are not that way before entry, after 3-8 years of 80-100 hr work weeks they are pretty much all burnt crispy......

I tell my patients that surgical training beats the milk of human kindness out of people, so to not expect much bedside manner from surgeons--come to me for that.  As much as I may come across as abrupt or matter-of-fact sometimes here... all y'all are PAs or want to be. Patients have the excuse of not having signed up for this life or to learn the jargon.