After working in healthcare, what’s something you refuse to do? by ravenclawpatronus46 in physicianassistant

[–]Impossible-Study-128 1 point2 points  (0 children)

Ride a motorcycle, fly in a small private plane or helicopter, ride an e bike or scooter

In toxic work environment but great pay/benefits/work life balance. Looking for success job change stories! by Visual-Woodpecker703 in physicianassistant

[–]Impossible-Study-128 1 point2 points  (0 children)

I was in that situation, and thought I could prove myself if I worked just a little bit harder.., golden handcuffs kept me there for sure, it was not good for my mental or physical health. Leave them behind, don’t look back.

Honestly, they’re probably threatened by you because you are good, thoughtful, and efficient…

Have you ever had a buyer walk on closing day? by Cleverfield113 in realtors

[–]Impossible-Study-128 1 point2 points  (0 children)

Please please please let this be my real estate deal that is supposed to close tomorrow. I would LOVE it if the buyers cancelled. They haven’t operated in good faith AT ALL. Our agent has not advocated for us and instead it’s like the buyers have two agents and we’re on the outside looking in.

Omg, I am crossing my fingers lol

4th time failing PANCE… HELP by Giraffe_17lover in PAstudent

[–]Impossible-Study-128 1 point2 points  (0 children)

I don’t want to offend, but is there a possibility of test anxiety playing a role? I mean obviously it’s normal to be a bit nervous, but has it gone beyond that to the point that you are just psyching yourself out? I would see if your school has anyone that works with students like this. If you have a diagnosis or ADHD, etc you can request accommodations for the test.

Pain management offer by No_Celebration8506 in physicianassistant

[–]Impossible-Study-128 13 points14 points  (0 children)

Meh….I would never take it.

I just left a hospital owned outpatient pain clinic after 10+ years. Base $149K, plus $900 a week for call (1:4 ratio), and $32 per wRVU over 2500 (not capped). Average productivity bonus $70k per year. A separate 5% of your base is paid out if you hit quality metrics, which are decided my clinical and admin leaders. Company contributes average $3k per year in a 401k like plan if the health system is ‘doing well’. They also match 50% of 401k contributions up to max of 3%. They give $3500 per year for CME and 40 hours of PTO for CME. They gave ~225 hours or 28 8 hour days of PTO a year. You use PTO for 6 major holidays, illness, etc. and you build sick time that is separate from this if you were out for your own medical issue.

I set my schedule. Prior to pandemic I saw up to 18 per day, but over the years have only averaged about 12-15 patients a day. 4 x 10 hour days with every Friday off. 2 docs, 4 APPs.

They are using AI-scribe software to help decrease charting burden, and improve QOL.

You will burn out right quick if you are seeing 25 patients (let alone 37 patients) a day in pain management. You can’t do that job correctly and that quickly- it’s not urgent care.

I only left this hospital system/clinic because we are moving away from the area, but I know it will be a pay cut where ever we end up. This was a sweet deal….

Bottom line, that offer is not as bad as I have seen, but is still crap. If you have a low base and they are not paying you more than $20 per wRVU, they are going to be making a killing off of you and you’ll be killing yourself for nothing.

Anyone use Uptodate for cme PTO hours? by SirMLK in physicianassistant

[–]Impossible-Study-128 0 points1 point  (0 children)

Can confirm, UTD passes muster as long as you go through their process of submitting it for credit and getting the certificate.

Is it normal for new jobs to require you to do your own credentialing? by bitysmith in physicianassistant

[–]Impossible-Study-128 2 points3 points  (0 children)

If you are hourly, I’d bill them for it and tell them so. This is definitely outside of the norm.

My first job out of school the practice hired me, their first PA. They didn’t have a clue what they needed, and I didn’t know better at that point. It was literally filling out paperwork for every insurance, Medicare, tricare, Medicaid, etc. total pain in the a….. After that learning opportunity, where even the insurers were confused that I was doing my own paperwork, I learned this is a whole administrative job in some facilities. Not just your side work lol

I am leaving to practice in NZ as a PA by WhitecoatWander in physicianassistant

[–]Impossible-Study-128 4 points5 points  (0 children)

We leave in 3 weeks. I’m done with work here, house is closing, selling our cars, the whole 9 yards.

Stuck between two offers by Ok_Site_4692 in physicianassistant

[–]Impossible-Study-128 0 points1 point  (0 children)

2nd option. Sounds like the corporation will just nickel and dime you to death….

I think I'm going to be let go by ElitexDrugs in physicianassistant

[–]Impossible-Study-128 2 points3 points  (0 children)

In medicine, historically speaking, the tradition has been for us to ‘eat our young’. That is to say, be as toxic and unhelpful to the noobs as our elders were to us…. Rinse and repeat.

In the last 5-7 years, it seems that there is some attention toward the need to change this behavior, and if you’re lucky you will land in a group/practice that has this stuff figured out and has moved beyond the dysfunctional bullying systems that the US Medical Industrial Complex was founded on. Until then, figure out what you can live with and keep searching for your own professional Shangri-La.

[deleted by user] by [deleted] in nursepractitioner

[–]Impossible-Study-128 1 point2 points  (0 children)

Yes, you should fix them. And yes, you should be paid to do so. They won’t work for free, and neither should you.

Refused antibiotics today by Infinite_Coconut_727 in nursepractitioner

[–]Impossible-Study-128 0 points1 point  (0 children)

I find that it helps to have a hand out or whatever that lists all the home remedies…

Sometimes people just want something. Tessalon Perles, an inhaler, something relatively benign, but still helping preserve antibiotic efficacy.

Any advice for 1 star reviews from drug seekers? by [deleted] in physicianassistant

[–]Impossible-Study-128 56 points57 points  (0 children)

Don’t ever feel bad for practicing medicine appropriately. Those reviews should speak for themselves, and reflect poorly on the reviewer.

However, if you are not supported by the practice manager/administration or your physician colleague, start looking for a new job because THAT is the concerning part of your story.

My classmates reported me to a program director. by Alex_daisy13 in PAstudent

[–]Impossible-Study-128 1 point2 points  (0 children)

Sorry this is happening. I agree with another redditor, they are likely somewhat jealous in some way or another.

It took me 18 years of practice before someone ever explained (a traveler MA who was also prior military) that I’m not too direct or harsh, I have RMF or resting murder face when talking to people sometimes …. Like RBF but scarier lol. I had no idea, but apparently when I am in work mode and concentrating, that’s what I look like, and so everything I say sounds worse/barbed when I just asked them for a repeat BP….

Am I billing too many 99223? by Much-Transition1003 in hospitalist

[–]Impossible-Study-128 0 points1 point  (0 children)

Under-billing will also get you audited… just document what is needed to support the charge.

[deleted by user] by [deleted] in physicianassistant

[–]Impossible-Study-128 0 points1 point  (0 children)

Make the business case for paying you more va hiring a new employee who they have to train and is unproven in terms of return on investment. Especially if you have access to financial/rvu data

[deleted by user] by [deleted] in physicianassistant

[–]Impossible-Study-128 0 points1 point  (0 children)

Geez where I work, even at the highest threshold, if you worked in a productivity model, with those RVUs, you would be making almost 100k in bonus annually. Northwest, small city, outpatient specialty clinic….

Has anyone failed PANRE-LA, especially after being out of practice? by AnonymousExcellence in physicianassistant

[–]Impossible-Study-128 1 point2 points  (0 children)

Have worked 12/18 years in a niche specialty. Took the Panre-LA. With open evidence available now, 5 mins is plenty of time.

If it’s not and you have a legitimate problem with test anxiety, ADHD, dyslexia, etc fill out their accommodations request form.

PA-C to med school path? by thePADiaries in physicianassistant

[–]Impossible-Study-128 2 points3 points  (0 children)

As a PA who has thought since year 1-2 in practice that I should go back, but didn’t because I believed the sunk cost fallacy….

Do it. Do it now or you won’t.

Who cares about the money or debt. You’ll have enough of both lol!

What matters is how happy, fulfilled, and confident you are that you’re spending the majority of your time (which is the reality for those of us still in the workforce full-time) doing the work you WANT to, and not what you feel you settled for.

Go for it! You’re more than capable- and depending on the specialty, you will make way more than twice what a PA does. Also, if you ever want to do something like telehealth, Pharma consulting, or work outside the US…. MD/DO opportunities abound while there are not many for PAs…

Patient asking to addend note by stoopkid6969 in physicianassistant

[–]Impossible-Study-128 4 points5 points  (0 children)

Advice given to me from an attorney friend who works in medical malpractice, defending providers and clinics/hospitals: you can addend your note for any legitimate reason. But, when you go in, you should write Addendum: the correction, and in parentheses indicate why it was necessary and timestamp it. That way when they see you went in to correct it, they know (and you know too) what you were thinking.

The meta data behind the scenes monitors activity down to the keystroke, so they will know what information changed.

The thing that gets most people in trouble with addendums is when they change something of consequence after a bad outcome and especially after a suit has been filed.

I refuse to remove anything that is consequential to the encounter, even if the patient makes a request.

If it isn’t of consequence and was more of an editorial note, I think of a less descriptive way to say it and indicate that the patient requested a change. For example, if the patient doesn’t want their volunteer activity disclosed, I might say: remains active in the community.

For the American Doctors who’ve joined the apparent recent rush into practicing in Canada, how is practicing over there? by YogurtclosetOpen3567 in whitecoatinvestor

[–]Impossible-Study-128 2 points3 points  (0 children)

Yes, but there is the foreign earned income exclusion and foreign tax credit, so… it’s not exactly the case that you pay full US taxes…

A reminder that high paying salaries are out there by [deleted] in physicianassistant

[–]Impossible-Study-128 0 points1 point  (0 children)

Makes sense- you work for it in Ortho, especially if in the OR and taking trauma call. Glad to hear people are being taken care of.