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Seeking some words of wisdom...

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I've been a practicing PA for 13 years in family practice, largely in the community health/underserved patient setting.  The clinic I've been established at for a decade began having some administrative politics over the last few years (COVID precipitated, like many places, but the issues were already existent pre-COVID) which contributed to a toxic work environment, and gradually developed to a point where the dynamics became inhibitory to one's ability to do their job (not withstanding the resilience to mental health, and going back to face another day). Factor in, I'd also been commuting an hour and 15 minutes each way to work for the last 10 years,

Thus, I reluctantly--and on on good terms (none of the issues impacting the clinic involved me personally, but trying to float above, and focus on the job with my immediate support staff became increasingly fatiguing)--resigned my permanent position at the end of last August.  Because the clinic was so short-staffed, I left it up to them if they wished to arrange some sort of per-diem coverage with me, until they could on-board the newly hired advanced practice provider over 3-6mos.  The arrangement was mutually beneficial, as it left me some breathing room to recoop my mental health, while still bringing in something of a paycheck, kept me in a clinic setting on a much more preferred limited basis, and they had a ready-made coverage person who could fill-in as needed, who already knew their staff, EMR, and patient population. 

So, while I loved this per-diem thing, the reality is, you still need bennies, and some sort of retirement plan at some point.  I'm blessed to be in a situation where my partner works from home, and we have the financial cushion for me to drop down to the per-diem status over the last 8mos or so (I'm on his health insurance).  Because I'm vested in the state pension system, and am looking to retire potentially in the next 10-12 years, I'd had my eye out for another position which shares in the same pension contribution--mostly via another community health/local health department.  I have a BSN as well (worked as a nurse for about 5 years prior to PA school), which I've kept active, and decided to take a plunge--and a break from the primary care provider role/advanced practice provider clinical setting for a time.

I accepted a position at a local health dept much closer to our home (commute is now 20-25min), as a public health nurse; though, the actual role is the Infectious Disease/Communicable Disease Coordinator--meaning, tracking, following up/investigating on STDs/vaccine preventable outbreaks/food-born/and vector borne goodies.  It's a learning curve in another direction, not so much with the disease-management, but definitely with the various levels of coordination, data-collection, reporting, and contact follow-up, and occasionally site investigation for the entire county in which I'm situated. So, it's the break from an active clinic role I think I was seeking, while still keeping me involved in some aspect of healthcare.

Okay, TL:DR-with the above, what I'm getting at is: I'm wondering if anyone ever stepped away from their actual PA role as a clinician for a time, to take on a position still involved with healthcare/medicine, but not doing active patient management? And then, was worried about being away from the clinic role for too long? I don't miss the stress, and constant worry that never seems to quite alleviate when managing chronically complex patients, and skew-ball acute visits, etc, but I also appreciated the (always changing) clinical acumen I've acquired over the years (and I do miss some of my patients with whom I'd developed the kind of bond that happens over a decade of managing them). I guess I'm having a bit of an identity crisis right now. This job is 5 days a week, and makes it difficulty to offer the same per-diem availability to my old clinic. I intend to keep my PA MOC up-to-date, or course (the nice thing is, this new position offers AMPLE free CME, AMA credits--lots of learning with it in the epidemiology-case definition CDC way, and clinical management still...), and depending on how this position fleshes out over the next 6-12 mos, I'd probably continue to keep this as my primary job, while still hopefully finding something per-diem as a PA.  I just don't have a lot of time right now, amid the orientation with this new role, and not a lot of mental energy left-over by the end of a work-day, or weekend. But the idea of being out of active clinical practice for even 6 months straight sort of freaks me out, and makes me get anxiety about being out-of-touch for too long.  How long is too long to be away from an active clinic role as a PA, while still working another position involved with healthcare/medicine? What "advices", or words of wisdom, might one offer if they ever shared a similar "break" from active practice to pursue another (albeit, still related to medicine/healthcare) career-path?

Sorry for the length, and the identity-crisis a the moment--and thanks for any insights or 'wisdoms' offered. 

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That would have been a dream job for me.    Enjoy it while it lasts.   I stepped away 4 years ago.  Transitioned back to the lab.   Still keep my NCCPA stuff current; malpractice current.    Now have some serious medical problems so never going back to patient care again.    Best of luck.   You will figure it out as time goes along. 

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Good for you for stepping away and offering to cover. 

I didn't step away from active pt management but stepped away from toxic work environments and unreasonable workload expectations and dropped down to per diem and short-term FTE assignments. It is great.

I don't plan on ever going back to a job that won't give me enough time to pick up some per diem work outside or be able to take care of my normal responsibilities. Unfortunately, that eliminates most M-F 9-5. Have you considered switching to a four-day workweek to allow for some flexibility? That helped me when I worked M-F.

As for stepping away from active pt management (I have stepped away from certain specialties and then gone back), I noticed that after even as little as 3-4 weeks, I started to forget little things. So keeping per diem assignments has really helped and forced me to keep up. I keep notebooks/folders for each specialty and review my notes as needed to refresh my memory which is very helpful.

Although carrying a per diem job can be a bit difficult with a FTE, there are lots of jobs out there that might fit the bill. Get creative with your current job and see what is possible. 

Edited by SedRate
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