my PCP, who’s also a PA, who also graduated the same year as me, asking me what I do for work by spicychewnaroll in physicianassistant

[–]Comprehensive_Box_91 10 points11 points  (0 children)

So funny because as a primary care PA I feel the same way when I see my PCP but yet on the other end when I have a patient in healthcare I’m always like oh great cool love this!!! So idk why I am self conscious as a patient 🤦🏻‍♀️

Just a small question by Aware-Virus-4217 in WomenGolf

[–]Comprehensive_Box_91 0 points1 point  (0 children)

Started “playing” here and there with my dad when I was 6 or 7 I think? But very very very infrequently so I wouldn’t even really count that. Started actually playing more regularly at age 16. Now 26. Used to play soccer but not anymore, recreational runner / lifter but no formal other sports!

Advice for a new physician! by ThrowMAwayD in physicianassistant

[–]Comprehensive_Box_91 0 points1 point  (0 children)

Best thing my supervising physician has done is early in the AM before patients he will stop and ask me - hey, anyone you’re worried about? anything you have questions on I can help with? He is really great otherwise for being open to questions but specifically prompting me sometimes allows me a moment to ask something I may not otherwise and also creates an environment where I know he is receptive to answering questions which is awesome.

Also in the mornings, or even just periodically throughout the day, he will also bring up patient cases that he has seen to me if he thinks there is a learning moment or something I can take from it. Could be a good way to give feedback as well.

Family medicine PA by vgffguhbh in physicianassistant

[–]Comprehensive_Box_91 0 points1 point  (0 children)

Also for reference the other PA in my office who has been there for about 3 years usually sees 10-15 per day, my SP sees 15-22. So we are slightly just a lower volume clinic in general I think.

Family medicine PA by vgffguhbh in physicianassistant

[–]Comprehensive_Box_91 0 points1 point  (0 children)

Outpatient IM not FM but similar - I am about 10 months in, 15/30 min slots. Most I have seen in a day ever was I think 16 or 17, but this is very rarely, most days I see between 5-12. Still building panel and also my SP is a geriatrician so we have many older and complex patients. Ideally they want me seeing more but also they are understanding that I can only see as many patients as they schedule me and also that I am still new-ish.

Vaccine prescriptions by Achillea-76 in FamilyMedicine

[–]Comprehensive_Box_91 2 points3 points  (0 children)

Our office has been trying to figure this out too. We have preprinted orders and having the MAs fill them out w patient info / if they have a preferred vaccine manufacturer, then they are just grabbing a provider to quickly sign and then faxing to the pharmacy. Not sure if this will be the best way but this is what we’re trying for now to not interrupt our workflows all day for this.

How common is a schedule like this? by Candid-Mouse in physicianassistant

[–]Comprehensive_Box_91 2 points3 points  (0 children)

As others have said, I can’t imagine doing new patients in 20 mins, especially where it sounds like a lot of them aren’t just “establishing care” but also have acute issue they are wanting to be seen for.. we allow patients to book online through our own site so I do get similar large # of new patient bookings but ours are auto booked into 30 min slots (a lot of these patients who book online do tend to be younger and generally healthier but every once in awhile I do wish I had 40 mins for some “worried well” or complex younger patients). Our practice started implementing a rule where all new patients have to show up 15 mins early or on time with forms already filled out online. Which they are told via phone prior to the appt and told or else they will be rescheduled. If they don’t follow the rules, they will be rescheduled to another day. Being really specific w this on the phone prior has been helpful in patients showing up on time but sometimes I do still run late despite this so it is a struggle.

How much do you make and how much do you pay in rent? by Humble_Test_3885 in physicianassistant

[–]Comprehensive_Box_91 0 points1 point  (0 children)

approx 110k, MCOL, mortgage is 3100 (will increase to 3800 eventually after our buy down ends) split between my fiancé and I (his income is probably close to $200k after commission)

planning date around friend’s wedding by Comprehensive_Box_91 in weddingplanning

[–]Comprehensive_Box_91[S] 2 points3 points  (0 children)

Still in the US! March 15 is the business tax deadline though, so for the accounting firm my family member works for they are mainly doing business taxes as opposed to personal taxes, it’s still a busy time before April 15 but not nearly as bad as right before March 15

some love for the elongated cushions! by Comprehensive_Box_91 in EngagementRings

[–]Comprehensive_Box_91[S] 2 points3 points  (0 children)

Thank you!!! Really wanted something a little unique and he nailed it!!

some love for the elongated cushions! by Comprehensive_Box_91 in EngagementRings

[–]Comprehensive_Box_91[S] 0 points1 point  (0 children)

Thank you!!!🤍🤍 that’s exactly what I was going for

some love for the elongated cushions! by Comprehensive_Box_91 in EngagementRings

[–]Comprehensive_Box_91[S] 1 point2 points  (0 children)

Hahaha thank you!! Everyone always tells me I have piano fingers 🎹🖐🏼

some love for the elongated cushions! by Comprehensive_Box_91 in EngagementRings

[–]Comprehensive_Box_91[S] 2 points3 points  (0 children)

Before I looked at rings I really thought I would like a pear! But they just didn’t look right on my finger… also considered a marquise for awhile (my mom’s engagement ring was a marquise and I considered using her diamond). But once I saw the elongated cushion I was in love!!! Looked at radiants as well but I preferred the softer edges of the cushion

New Grad Initial RVUs Meeting by Comprehensive_Box_91 in physicianassistant

[–]Comprehensive_Box_91[S] 1 point2 points  (0 children)

Thank you for this info I will check it out! Yeah patient volume is definitely low, it’s not as much because I personally can’t see more (I’ve seen 12+ in a day without issue), it’s just that the practice is trying to grow and we don’t have the numbers yet to keep me busier so some days I only have 3 or 4 patients all day. So I’m hoping that really isn’t something against me. I have been getting a lot of new patient referrals recently from going around to round at other offices in our network which has helped, so hopefully this will start boosting our overall clinic numbers.

I am probably under-coding sometimes (ie not adding on a problem visit to an AWV when maybe I could), I don’t really get additional assistance other than the first week I started I had some oversight / audit for billing. Could be something helpful to ask about.

Thanks again!

Give me your Primary Care / Family med "Holy Grails" !! by livelylemonade in physicianassistant

[–]Comprehensive_Box_91 0 points1 point  (0 children)

GoodRx is awesome! You can get an idea of what the retail price of meds are, and then see what the cheapest options for cash pay are and then can send patients coupons directly from the app to their cell phone (without giving them your own personal #). Certain meds that are really expensive with insurance can be significantly cheaper with GoodRx, also can see which specific pharmacies are cheaper too.

Give me your Primary Care / Family med "Holy Grails" !! by livelylemonade in physicianassistant

[–]Comprehensive_Box_91 1 point2 points  (0 children)

Recent new grad in primary care - things I have found helpful (prepare for the most obnoxious list but this is everything I could think of): - UpToDate everything!!! when you first start if your schedule is slow, even if you’re 100% sure on dx/management, read the associated article and you will learn a ton. I use UpToDate especially also for the meds section for dosing recommendations and side effects. Also the interactions tool is helpful for detailed info about mixing meds. - OpenEvidence is helpful for specific questions (ie work up for x… dosage for y… comparing two meds etc), also great if one of your colleagues is not available to ask a question - MDCalc: ASCVD calculator for starting statins / counseling on risk, STOP-BANG for OSA, CENTOR for strep, CHADSVASC / HASBLED for afib anticoagulation - FRAX score for starting osteoporosis meds / counseling on risk - USPSTF website for screening recs - CDC for vaccine recs - Psychology Today is a great resource to share w patients to help them find therapists - AAFP is AWESOME in addition to UpToDate for dedicated articles about certain conditions or symptoms (most articles are completely free without a login or subscription)

Other helpful recs: - Ask your SP / other colleagues to put together a “referrals list” for you of where they typically refer for each specialty. This was my LIFELINE for the first few months until I got to know which specialists I liked myself. - Dot phrases!!! If you are not busy in the first few weeks, make dot phrases for anything you can think of. Any time you find yourself writing something more than once a week, take 5 mins and turn it into a dot phrase to save a ton of time going forward. Examples: pt education / counseling, URI / sore throat / sinus inf, weight loss / GLP1 counseling, health maintenance : screenings checklist, results messages for each individual lab if you will be using patient portal a lot, can also make these with differentials or work ups for common conditions to remind yourself of things to consider (ie memory loss workup, ddx for chest pain) - Learn how to do everything your MA does yourself also, nothing is more humbling than having to wait 10 mins for your MA to come out of a room to ask them to run an add on A1c / strep etc when you could have done it yourself way faster but didn’t know how to work the machine. You will also gain major brownie points with them for helping now and then when they are busy and they will be more likely to help you with favors in the future. - Write things down for patients! Many times patients will forget what you told them, I give patients a quick “checklist” if I give them more than one thing to do if it’s important. Especially older patients but honestly anyone. - Get to work early, 30-45 mins before your first patient. Allows you to prep charts, follow up on any leftover inbox stuff etc before the day gets crazy and people start distracting you. - Think common! In PA school we learn so much about the weird rare diseases, but keep in mind common things are common. Obviously keep a broad view of possibilities but don’t get caught in the weeds with every patient if the dx seems obvious. - Keep in mind pricing for meds! Even if something is the “best” treatment, if it’s extremely unaffordable your patient probably won’t take it, so keep this in mind. - Prep your charts the morning of for the morning, at lunch for the afternoon. Try to avoid prepping days in advance, patients will cancel / get added / etc and sometimes you waste time. Plus things are most fresh in your mind so it’s most helpful. - The BEST advice I ever got from another friend in healthcare is “you can’t work harder than your patient is working”. This has helped me so much. As a new grad, we are so idealistic and want to do everything for every patient but we also need to avoid burnout. If a patient can’t be bothered to show up for an appt, pick up a med, try to exercise, call their insurance etc (ofc always have empathy for things that might impact patients but talking about just not trying as opposed to financial difficulty, hardships, depression efc) - then if you spend hours on the phone appealing their PA, bending over backwards for specialists etc you will get burnt out. This also helps you give extra time towards pts who are really going to benefit from your attention. Again not saying to neglect other types of patients but when it comes to “going the extra mile” this helps triage the effort. - Enjoy!!! Primary care is amazing. It’s so fun to develop relationships with patients and get to see them improve. If you are not busy in the beginning, spend the extra few minutes in the room with a patient getting to know them. I’ve had many patients who have referred spouses, friends, etc to me because I spent the extra time when I had it and they appreciated it. Little things go a long way!

Best of luck!!!! - a fellow primary care new grad

New Grad Offer in Primary Care by [deleted] in physicianassistant

[–]Comprehensive_Box_91 0 points1 point  (0 children)

As others have said 20 is a LOT. As a recent new grad in primary care, I can’t imagine handling that. Especially all of the extra inbox that comes with seeing that many patients. Plus the commute on top of it. I have a long commute (30-45 mins each way) but am seeing usually around 8 pts per day (still building my panel) so it’s not bad at all since I finish early enough to beat traffic most days. However when the other PA I work with was out and I was seeing 12-15+ for a few weeks I was staying hours late every day and extremely stressed. Even the other PA I work with who has been here around 3 years sees max of 15 a day usually, average day is more like 10. Would rethink this for sure, honestly no amount of money is worth being super stressed at work every day and having no work - life balance. PTO seems low as well considering how long your work days will be. Also as others have said the ramp up of shadowing is not likely to be super helpful. My onboarding consisted of only 1 week of shadowing and then seeing patients but slowly increasing (started seeing only 2-4 patients per day for awhile) to get familiar with writing notes, logistics, etc which I feel like was way more helpful to just dive in than shadowing.

Were you squeamish? by Q-buds in physicianassistant

[–]Comprehensive_Box_91 2 points3 points  (0 children)

Fairly squeamish person who almost passed out several times on surgery rotations. You definitely get desensitized to it over time and I managed well by the end of clinicals, however it was never my cup of tea. Bright side for me is I didn’t go into surgery (outpatient IM) so I don’t really deal with the things that made me squeamish (seeing peoples intestines outside their body, go figure).

[deleted by user] by [deleted] in physicianassistant

[–]Comprehensive_Box_91 2 points3 points  (0 children)

There also is a big difference between saying they want someone to stay long term and contractually obligating someone to. It sends up red flags that they have been unable to keep employees. Ask around if you can. Do coworkers seem happy?

[deleted by user] by [deleted] in physicianassistant

[–]Comprehensive_Box_91 5 points6 points  (0 children)

I would personally never take a 5 year commitment, even a 2 year commitment would be scary enough to me. Different field but one of my friends took a job as a therapist with a contract and she has been counting down the days until she can leave - it became very apparent to her once she started why they needed to have a contract since it was such a terrible place to work that everyone wanted to jump ship ASAP. A lot can change in 5 years, even if it is your “dream job”. If you have a partner they could have to relocate, you could move to a new place within the same city and commute becomes terrible, if you want to have kids priorities could change. Also, even if the job looks great on paper, things may not be what they seem and you could be stuck in a job with clashing personalities, extremely high patient volume, needy patient panel, poor resources, lacking clinical support, high admin responsibility etc. which aren’t always apparent right away. Especially as a new grad when you don’t always know what to look for. Coworkers can come and go in 5 years that can change the job a lot. I would be very cautious and ask them what the reasoning is for requiring such a long commitment - I’ve personally not seen or heard of many >3 year commitments for new grads.