wendyfrancis Posted March 22, 2013 Share Posted March 22, 2013 I'm hoping to get some input from PAs that enjoy their jobs and may have some recommendations for me as to a career change. Since I've been a PA, I've worked in Orthopedics (6 years in Sports/Medicine). I don't think I've worked less than 48-50 hours during a work week since I've started. Now, I'm just exhausted and burnt out. I took a different job (still Ortho), in a different city, 1.5 years ago for a better work life balance. This came with a $30K/year paycut. I even stated in the interview that "once I hit 52 hours I become grouchy and in general-just an unhappy person and that if I was consitently working 50 hours I would leave". Of course they said NO, No, No. Our PAs never work past 5pm, never more than 40 hours, blah, blah, blah. Now, I'm making ridiculously less money, working the same hours, ruining my shoulders and hands, and constantly having to cancel plans because "I'm stuck in the OR". I am so down on the PA profession right now, that I'm wanting to get out alltogether. I guess I would just love to hear from some PAs that love their job/field, because I honestly haven't worked with anyone in my field that feels differently. We are all so burnt out. Anyone... please give me some inspiration and let me know what jobs/fields you are in. If you are happy and how many hours you are putting in per week. Link to comment Share on other sites More sharing options...
physasst Posted March 23, 2013 Share Posted March 23, 2013 I left Ortho for some of the same reasons...went into ER, but got completely burnt out on that, even though the hours were less. NOW, I am in PM&R spine care, and loving life. 35-40 hours per week. Protected admin and research time....and 1 hour time slots. I see on average 6-8 patients per day. 3-5 new patients and 2-3 returns. Life is good and I am surrounded by great providers. Link to comment Share on other sites More sharing options...
treejay Posted March 23, 2013 Share Posted March 23, 2013 i guess they don't call it "plenty of money and relaxation" for nothing Link to comment Share on other sites More sharing options...
winterallsummer Posted March 23, 2013 Share Posted March 23, 2013 What do you think about ER or urgent care? Link to comment Share on other sites More sharing options...
Guest Paula Posted March 23, 2013 Share Posted March 23, 2013 I have worked family practice in rural area for almost 6 years now and in between the two different reservations I was on I worked 3 years in UC/ER. ER/UC burned me out just because of the 12 hour days and I worked about 18 days a month or more at a few different sites, via locums and employment. So, now back in FP, good hours 8-4 every day, 1 hour off for lunch, 12 federal holidays (I call them 12 psychiatric days) plus 4 weeks vacation, 2 weeks paid CME, best salary of all the jobs I've had, every weekend off, and love my job. Still don't like the hour commute each way that is over the river and through the woods, but no job is perfect. My SP no longer signs any of my charts and I have a pretty stable autonomous practice with an SP who trusts me. Still no EHR so the paper charts get pretty heavy and cumbersome and I suffer a few paper cuts each week, but none have killed me with an overwhelming infection. So, life is good. Try something completely new and get out of the surgery field, look for a job that respects your time. Challenge yourself. Actually you might like an UC job. SOme are 3 days a week, 12 hours and then you get 4 off. Not bad, actually. Good luck and I hope you can get rejuvenated. Link to comment Share on other sites More sharing options...
Contrarian Posted March 23, 2013 Share Posted March 23, 2013 Psychiatry... $100k+/yr Average 6-10 patients per day 30 min follow ups and 90 min new patient visits. Sit and listen /ask questions /don't even have to touch them. Link to comment Share on other sites More sharing options...
treejay Posted March 23, 2013 Share Posted March 23, 2013 ^^^^^^^^^^^ awsome ^^^^^^ Link to comment Share on other sites More sharing options...
zepoPA Posted March 23, 2013 Share Posted March 23, 2013 Family Practice with some UC patients. M-F 8-5 one hour lunch (outside of the office 95% of the time) $130K, weekends OFF. I get to go to gym for an hour daily before work. Rarely stay at work past 5pm. I worked Trauma many years ago but my sons were babies and the call schedule was tough, so I made a monumental switch to FP and never looked back. I can work Sat. If I choose to cover a shift. I went to most of my sons football and basketball games AND practices. Sons are grown now but I'm staying in FP. I cook dinner nightly and that is PRICELESS. Link to comment Share on other sites More sharing options...
discogenic Posted March 23, 2013 Share Posted March 23, 2013 Are there many ortho jobs out there that are primarily or even completely in clinic with no OR time? Link to comment Share on other sites More sharing options...
CornellSPA Posted March 23, 2013 Share Posted March 23, 2013 Agree with above! Consider working for a hospital where you do shift work (3 12's, 4 10's etc). Many anesthesia PAs have set hours, make great $, and are allowed to sit down all day! Link to comment Share on other sites More sharing options...
winterallsummer Posted March 23, 2013 Share Posted March 23, 2013 130K in FP? What state do you work in zeroPA? Link to comment Share on other sites More sharing options...
medman2007 Posted March 23, 2013 Share Posted March 23, 2013 130K in FP? What state do you work in zeroPA? I know the statisitics reveal that avg salary in FP (or primary care in general) is significantly less than other specialties; however, I'm finding more and more that some PAs/NPs are finding pretty good gigs in FP these days. Also, the UC component probably adds a lot to total salary. Seems many of the FP jobs these days are no longer strictly FP, but with UC duties added as well. Link to comment Share on other sites More sharing options...
JC30 Posted March 23, 2013 Share Posted March 23, 2013 My first job after PA school was in Ortho. It lasted all of 7 weeks. I had a similar experience. I got the "you'll be out of here by 5pm every day" speech too. In reality I was working 55-60 hours/week + call. Salary? Not enough for 55+ hours/week. There are new grads in FP working 40hr/wks making what I was earning in Ortho. Link to comment Share on other sites More sharing options...
Moderator ventana Posted March 24, 2013 Moderator Share Posted March 24, 2013 The fact of the matter is that man doc's when PAs first come in view them more as quality of life improvers then providers People accept jobs that are silly hours for not enough money - and maybe get sold a bill of goods by HR and the hiring people then they get into the job and get abused/overworked/taken advantage of I think a lot of this deals with the maturing of the PA profession - young grads think this is fine, then as you age you realize it is not worth it, then you leave, after a few cycles of this some employers will realize they are loosing great PAs because they are burning them out.... I think?? that FP and IM is starting to change to treat us more like revenue generation centers - ie providers, and therefor we are no longer an after thought, but instead built into the productivity of the practice - but not sure I think one thing that might force the issue is the huge numbers of doc's in IM and FP that are going to retire in the next 10-15 years - their simply is not enough doc's to replace them, and therefor the PA and NP are going to be thrust into a higher level of performance and pay (on average) just thoughts though.... Link to comment Share on other sites More sharing options...
Cideous Posted March 24, 2013 Share Posted March 24, 2013 Urgent Care FTW! Link to comment Share on other sites More sharing options...
discogenic Posted March 24, 2013 Share Posted March 24, 2013 Psychiatry... $100k+/yr Average 6-10 patients per day 30 min follow ups and 90 min new patient visits. Sit and listen /ask questions /don't even have to touch them. Where does psychiatry stand as far as Obamacare and the evolution of healthcare goes? Is it positioned any better or worse than anything else in healthcare? Link to comment Share on other sites More sharing options...
Contrarian Posted March 24, 2013 Share Posted March 24, 2013 Due to the recent rash of high profile shootings... Mental Health Parity Coming, President Says By David Pittman, Washington Correspondent, MedPage TodayPublished: January 16, 2013 WASHINGTON -- President Obama promised Wednesday that his administration would issue final rules implementing a 2008 law that requires insurers to cover mental health services on a par with physical care, but the President gave no time frame for doing so. The law -- the Mental Health Parity and Addiction Equity Act -- states that if a group health plan covers the treatment of mental illness or drug or alcohol abuse, it cannot charge higher copayments, deductibles, and out-of-pocket expenses for those services than for treatment of physical illnesses. Companies with fewer than 50 employees in their group insurance plans are excluded from the law. Groups that pushed for the law have been waiting for the remaining rules holding up its final implementation. Although the Obama administration issued an interim final rule in February 2010 on some quantitative metrics health plans can use to ensure parity between mental health and physical health services -- such as caps on out-of-pocket costs -- it stopped short of specifying nonquantitative treatment limits. The American Psychiatric Association (APA) praised the inclusion of the parity rules in Obama's proposals to stem gun violence. "We strongly urge the administration to close loopholes involving so-called 'nonquantitative treatment limits' and to ensure that health plans deliver a full scope of mental health services in order to comply with the law," APA President Dilip Jeste, MD, said in a statement. "Such action will best ensure that Americans get the full range of mental health services we believe they are intended to receive under federal law." Mental health advocates, including the National Alliance on Mental Illness (NAMI) in Arlington, Va., also said they were pleased the promise was included in the broader gun control proposals. "That's more than we've had," Andrew Sperling, director of federal legislative advocacy for NAMI, told MedPage Today Wednesday. The 2010 interim final rule spelled out quantifiable limits such as out-of-pocket caps on mental healthcare, copays, deductibles, and caps on inpatient and outpatient stays. "They've helped enormously in people who are likely to run up on those caps in their plans," Sperling said. But some areas were still undefined, such as which mental health services are comparable to medical care. For example, insurers don't know where therapy falls in relation to physical healthcare. Also, health plans are unsure which mental healthcare services should be deemed medically necessary, since such services are often less clearly defined compared with traditional medicine. "But we're really hoping that the final rule will fill in some of the holes," Sarah Steverman, director of state policy for Mental Health America in Alexandria, Va., told MedPage Today. Until insurers know which mental health services are comparable, "you really can't enforce parity at all," Steverman said. Sperling said he is "generally confident" that if the Obama administration puts a promise in writing that it will come, despite the fact that advocates have been waiting for almost 3 years for such a rule. Once rules are issued as Obama has promised, advocacy groups will work to ensure health insurers comply with the law and consumers are aware of their rights. Steverman cited a survey 2 years ago that found more than 90% of the public was unaware they had a new right to mental health services. "We know there's a lot of education for the public" that still needs to be done, she said. While not part of the 2008 law, Obama noted the Affordable Care Act (ACA) includes provisions to help mental health coverage parity. Mental health and substance abuse services are part of the 10 essential health benefits all new small group and individual plans must cover under the ACA. "The administration intends to issue next month the final rule defining these essential health benefits and implementing requirements for these plans to cover mental health benefits at parity with medical and surgical benefits," the White House wrote in a proposal issued Wednesday containing a number of steps to curb gun violence. Link to comment Share on other sites More sharing options...
jdtpac Posted March 25, 2013 Share Posted March 25, 2013 I've enjoyed reading the original post & all the posts in this thread.this conversation truly supports the beauty of our profession in that if we do get burned out in a particular specialty, unlike our supervising physicians, we have the flexibility to move fairly easily into another specialty. This in great part is do to the demand for our services and current supply. as long as the demand for PA's is greater then supply moving between specialties is much easier than you might realize. The Academy has a very good position paper on maintaining flexibility within our profession. My concern however, is that there is a growing number of individuals in our profession who want to see specialty exams for recertification. The path that NCCPA is taking in addressing specialty PA concerning to me. I'm afraid some of the things that they are developing may just be the start of "pigeon-holing" PAs into specialties decreasing our flexibility. I be interested in hearing others opinions on this subject. It may be a little off subject but I think it also is in line with the basic tenents of this thread concerning burnout. Link to comment Share on other sites More sharing options...
zepoPA Posted March 25, 2013 Share Posted March 25, 2013 130K in FP? What state do you work in zeroPA? California. After working FP 15+ years we learn a lot from the patients. There is a level of trust between patient and provider that becomes invaluable to the practice. The SP is aware that many ESTABLISHED patients chose to come to the clinic because of the PA. And patients recommend their family and friends to see you. And when the PA is experienced in different areas, the SP is happy to see the practice grow with MOST IMPORTANTLY: well established patients that continue to come back regardless of insurance coverage. In other words, REVENUE to his practice. Minor procedures, as in UC like someone mentioned. Patients don't want to wait hours in the ED, or pay ED fees for procedures and testing that can easily be done at a well equipped FP-IM practice. It is not unusual to see the following scenario: drain the Grandpa's abscess; examine Grandma's HTN, review her EKG and change meds, do the Mom's PAP Smear and treat her cystitis, refill son's allergy and asthma Tx , order and review an Xray right then and there for the daughter's sprained ankle and perform Dad's DMV physical all in one morning. Not a moment of boredom in FP. But the real bonus is that you know their entire medical Hx well because they have come to you for years. It works for me. Link to comment Share on other sites More sharing options...
lang Posted March 25, 2013 Share Posted March 25, 2013 I've enjoyed reading the original post & all the posts in this thread.this conversation truly supports the beauty of our profession in that if we do get burned out in a particular specialty, unlike our supervising physicians, we have the flexibility to move fairly easily into another specialty. This in great part is do to the demand for our services and current supply. as long as the demand for PA's is greater then supply moving between specialties is much easier than you might realize. The Academy has a very good position paper on maintaining flexibility within our profession. My concern however, is that there is a growing number of individuals in our profession who want to see specialty exams for recertification. The path that NCCPA is taking in addressing specialty PA concerning to me. I'm afraid some of the things that they are developing may just be the start of "pigeon-holing" PAs into specialties decreasing our flexibility. I be interested in hearing others opinions on this subject. It may be a little off subject but I think it also is in line with the basic tenents of this thread concerning burnout. I know that one of the MAJOR reasons I chose the PA route is the flexibility in specialty. I really don't want to see that ability disappear! But I have a friend working in derm and facing her first PANRE. She's really nervous about it because so much of her past training isn't utilized in this specialty. I understand that she has been stuck in the derm world bubble and a primary care PANRE will require A LOT of reviewing. But she thinks derm is the only specialty she will ever want. She could be right but she could be wrong... Possibly you could declare a specialty and do a recertification in that specialty with the understanding that you are relinquishing your lateral mobility. PA's that want to maintain that ability must continue to re-certify using the primary care PANRE. This could be a totally dumb idea. IDK. :=D: Link to comment Share on other sites More sharing options...
lang Posted March 25, 2013 Share Posted March 25, 2013 I've enjoyed reading the original post & all the posts in this thread.this conversation truly supports the beauty of our profession in that if we do get burned out in a particular specialty, unlike our supervising physicians, we have the flexibility to move fairly easily into another specialty. This in great part is do to the demand for our services and current supply. as long as the demand for PA's is greater then supply moving between specialties is much easier than you might realize. The Academy has a very good position paper on maintaining flexibility within our profession. My concern however, is that there is a growing number of individuals in our profession who want to see specialty exams for recertification. The path that NCCPA is taking in addressing specialty PA concerning to me. I'm afraid some of the things that they are developing may just be the start of "pigeon-holing" PAs into specialties decreasing our flexibility. I be interested in hearing others opinions on this subject. It may be a little off subject but I think it also is in line with the basic tenents of this thread concerning burnout. I know that one of the MAJOR reasons I chose the PA route is the flexibility in specialty. I really don't want to see that ability disappear! But I have a friend working in derm and facing her first PANRE. She's really nervous about it because so much of her past training isn't utilized in this specialty. I understand that she has been stuck in the derm world bubble and a primary care PANRE will require A LOT of reviewing. But she thinks derm is the only specialty she will ever want. She could be right but she could be wrong... Possibly you could declare a specialty and do a recertification in that specialty with the understanding that you are relinquishing your lateral mobility. PA's that want to maintain that ability must continue to re-certify using the primary care PANRE. This could be a totally dumb idea. IDK. :=D: Link to comment Share on other sites More sharing options...
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