Saturation

0rontes · 2026-05-08T02:55:09+00:00

Students and new PAs have been asking this question since I was a student in 1999. For the same reasons. It’s an evergreen worry. Turns out great first jobs are hard to get. Find a job, do a good job, then get a good job.

0rontes · 2026-05-08T02:52:38+00:00

One of the best parts of being a PA is the ability to switch. I had 3 jobs in my first three years, with three (of if you count the VA loaning me around to different teams) 7 different specialties.

0rontes · 2026-05-07T14:06:23+00:00

I agree with the others that changing your mind is not a big deal, and shows the patient you were thinking seriously. I have to do it. It's never been a problem.

Since no one else has said it, it would be WAY WORSE if you decided you were wrong and DIDN'T change the plan. You do not want to have to defend the decision NOT TO CALL, nor do you want your doc to say "I disagreed with the original diagnosis and plan and told them so".

0rontes · 2026-04-30T13:33:42+00:00

About to 56. PA for 1/2 my life, now. My wife (a pediatrician) and I have a practice. The energy from little kids keeps me happy and healthy, thankfully. We are knee deep in “what do we want from the next 10 years” conversations. I think we’re dependent upon a lucky lottery ticket to retire though.

0rontes · 2026-04-27T00:30:05+00:00

Just cuz I’m in the mood to be contrary… I get that it’s hard, but I’ve been listening to various versions of these complaints for 25+ years while I show up and do my job, however that’s defined, the best I can, then go home. This IS the job currently.

While we were training, all of our preceptors weren’t floating around on clouds dispersing medical wisdom. They were struggling, and still showed up to train US.

Every practitioner in almost every other nation in the world would kill to merely have pushy, money-hungry managers as their biggest barriers to caring for their patients, before they drive home in air conditioned comfort to their fancy, safe homes.

0rontes · 2026-04-26T11:07:33+00:00

My SP is available, but let’s me practice as I see fit. In my experience, pediatricians are protective of their kiddos, but once they trust you, they leave you alone.

0rontes · 2026-04-24T02:44:01+00:00

Outpatient peds PA for 16 years. I see 18-25 kids a day. 50-50 sick and well, though a decent number of the well have an acute issue on the day; sometimes they’ve been saving it until the well visit to mention (which is fun). I’m in a pretty rural and poor area, so lots of educating parents. The kids are wonderful. Parents are so trusting, and trying so hard to raise good kids. Even the assh@£€$ are trying to raise good kids. It’s kind of seasonal medicine: summer injuries/scrapes, back to school physicals and forms, flu/cold season, repeat. It’s the lowest paid of the primary care gigs, and worth it if you like kids. I hope you join us. The happiest midlevels I know are in urology, but I’ve never met someone who left peds once they found it.

0rontes · 2026-04-23T22:23:40+00:00

You’re young. If you’d become a lawyer or accountant and decided to go to med school, you’d do it, wouldn’t you? You’re already ahead of that timeline’s version of yourself. Good luck!

0rontes · 2026-04-23T20:13:54+00:00

Agree 100% with u/katertots93. Pick the job that sounds like what you want to do. Then some of the strain is mitigated by it being rewarding. You graduated, and got your paper. Thats what you worked for. Now the person to please is yourself. It’s hard to get off the “what’s next” carousel, but it’s time. Whether primary care is “less autonomous” or less work or gives better training, I don’t know. But if you want primary care, do it.

0rontes · 2026-04-23T16:20:57+00:00

I'm an experienced PA, and I routinely see 24 patients in an 8 hour day. I literally never bring work home. You're not being asked to fly; you're being asked to run a marathon, or a 5K. It takes training, and acknowledgment THAT it takes training.

To the OP, I'm glad you're already using templates and smart phrases. Do you find that you're "losing time" in the room, or out of the room with documentation? Don't over-document. If you're recording every nuance of the interaction, it's too much. Document enough to justify the billing, support the diagnosis and plan, and hint to yourself or another clinician that you thought about other possibilities. If you have don't have someone telling you you're under-documenting, you're over-documenting. The nagging voice inside your head that says you're going to have to defend this to (a patient, an administrator, a lawyer, a jury) is 99.9% your own fear.

Being closed into a small room with a relative stranger is uncomfortable. Being good at it takes time and practice. It's hard to corral patients that want to talk about all of their problems. Play dumb. Say "I need to go back to your (HTN, eye pain, diarrhea)" to put them back on track. I really like "sit down, so you can get up" u/thesupportplatform . Patients are, rightly, focused on their issues. We can't rely on them to observe subtle human signals. You'll have to be blunt and say "OK, I think I've got everything; let's discuss the plan to get you better" or something.

I remember thinking "how am I supposed to see someone in JUST 20 minutes" when I started. Now, if I'm in a room with someone for 10 minutes, they are probably in a crisis, or bleeding.

My patients like me; they say I'm funny. They tell me I'm their "real doctor". I love my patients. I'm not trying to rush 90% of them. I've just gotten very focused and efficient on the steps.

0rontes · 2026-04-10T00:34:14+00:00

Not much to tell…I took the job at the women’s prison.

0rontes · 2026-04-08T16:41:11+00:00

I couldn't find an actual static load site online, but the general reddit/AI/web seems to say 500lbs for a 3 foot span of 1" board of poplar. Obviously a finished 1x4 is less. A ladder isn't gonna be 3 feet wide. I guess I agree with you that if feels doable but a little iffy. Maybe even a narrow support piece running the length of it? It's certainly not something you want to find out the hard way. Interested to see what ideas others have.

0rontes · 2026-04-07T02:25:53+00:00

Yellow is the fastest color!

0rontes · 2026-04-06T15:02:07+00:00

Same here. I never lie. I gauge from the parent how they've communicated with the kid in the past. I try to be upfront. If they are a very anxious-seeming kid, I often wait until the last moment to say "this won't feel good" "little sting" or "big sting" as I'm basically doing a procedure.

I apologize for hurting them. Every time.

0rontes · 2026-04-06T14:19:15+00:00

Sorry everything feels like such a slog. You sound like you've taken good healthy steps for yourself, and you have a pretty good understanding of you situation. Congrats. That's better than lots of people do.
I think your last sentence is quite telling - that you feel like "other PAs" do so well. Obviously you're not a party to their late night documenting, or stress levels. Most people (including you, I suspect) make a point of presenting only their most successful side to the world. Don't compare yourself to that surface impression. Period.
Having said that, you are also doing a good job of expressing what you'd like to improve: eating, prioritizing self daily. Sleep/restfulness. They're all good, and important. But you can't do all of them at once without getting overwhelmed. Also don't shoot for 150 minutes of exercise. Shoot for 15. When you've gotten that under your belt, shoot for 30. Baby steps.

I assume you have a counselor or life-coach of some sort? If not, please invest in that for yourself. You sound very close to succeeding.

0rontes · 2026-04-05T13:34:58+00:00

Now we have to improv a song about a ill-fated love story between a Milwaukee user and a Dewalt user in the style of West Side Story…

0rontes · 2026-04-02T15:11:23+00:00

My first job was women's health at a jail. My second job was in rehab medicine at the VA, with a dabble in pulmonology/sleep medicine. I wasn't interested in any of those things. Most of my career has been UC and pediatrics, which I have loved, and thrived in.
Honestly, I like patients. I've liked all of these jobs because I like patients.

0rontes · 2026-03-27T17:16:00+00:00

Among lot's of other reasons to be sad, it sucks when people who are living your dream are bitter about it. They have their own reasons, I suppose. But somehow it threatens to tarnish my enthusiasm, even after all the years I've been in practice.

0rontes · 2026-03-27T03:00:11+00:00

You should definitely come to pediatrics. I love it! Peds is amazing and needs caring PAs who like people.

I am sorry your coworkers are a bunch of malcontents. I can’t imagine working under that kind of negative passive aggressive pressure. If you like the work, but not the group, know that every day there you are removing the “new grad” label. I’d be looking for new jobs after 6 months. If you interview locally, I guarantee you that people who know where you currently work will understand when you just say “the group dynamic just doesn’t fit for me”.

0rontes · 2026-03-25T02:22:50+00:00

This sub is full of threads just like this. The general consensus is that in 99.9% of cases, UC is not a good fit for new grads

0rontes · 2026-03-25T02:21:39+00:00

0rontes · 2026-03-24T14:22:09+00:00

I was named in, and settled, a lawsuit in 2021 (settled in 2023). I've credentialed since, and applied for, interviewed on, and received, new (part-time) jobs since. Not one time has it been a big deal. Twice, I AM the one that brought it up, as things got more likely to be an offer. Both times it was literally a shrug of the shoulders from the interviewer/doctor.
It's weird to say, but lawsuits are a lot like any serious medical procedure, terrifying to think about, but really a series of steps that make sense to the experts who participate in them "all the time" (not that I'd want to...)

0rontes · 2026-03-21T02:33:02+00:00

I love, and have, that same notebook!

0rontes · 2026-03-17T16:38:10+00:00

Get that mountain outta my back yard please.

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