u/AdventurousDish2051

I just need to vent I think. I've been a PA for 10 years and I've been working in cardiology up until now. I recently switched to family medicine and urgent care. I've been working this new job for about a month. I'm so used to patients getting diagnosed with heart disease that I think I became a bit numb to it, hence the change.
Well today I had a guy come in with vague complaints and he was clearly jaundiced. After stat labs and a very concerning stat RUQ US I sent him to the ED and he has pancreatic cancer likely with Mets to the liver. This is the first time in years I have felt pain in my gut over a patient's diagnosis. He is so kind and was so grateful for my help and I just feel awful for him and his family. With heart disease I felt I had some control in helping my patients, but today I feel defeated because it's likely too late to truly help him. This sucks

So I'm leaving cardiology after 10 years and I absolutely CANNOT WAIT to no longer have to treat or work up POTs anymore! Those patients are so draining.
So I was wondering for anybody else that has left a specialty, what disease process were they happy to leave behind? I'm sure we all have that chief complaint that makes our head hurt before we even go in the room.

This is meant for PAs that need to vent, if you're coming here to be negative and say that we're terrible providers, this is not the sub for you

hey guys! My eight year-old Australian Shepherd has been having loose stools for about a week. We brought him to his vet yesterday. He was tested for Giardia and other infections. He does not have any. They gave us the Purina pro gastroenteric food and a probiotic. Problem is my husband took the dog to the vet not me so the instructions are very vague.
We only have one can of the Purina pro gastroenteric food left and he's still having loose stools, even though they are better than they were.
He's otherwise fine eating drinking playing as normal.
Since it's the weekend, I can't get in touch with my vet, so I'm trying to figure out what I should feed him when I run out of this special food if he's still having loose stool. From what I understand the Purina pro gastroenteric is a prescription.

Thank you for the advice!

I wanted to come back and thank everyone who responded to my post about approaching my boss about my salary. A lot of you really opened my eyes to my situation.
What I didn’t mention in my original post was that my cardiologist employer wasn’t just severely underpaying me — he also doesn’t provide benefits to his employees, including no healthcare. I had just reached my three-year mark with the practice, and per my contract, I was supposed to start receiving a 401(k) match at that point.
My office manager had actually confided in me that one of her biggest frustrations was that he was unwilling to cut into his own salary to properly compensate his employees. This cardiologist only sees patients two days a week, no longer does procedures, and spends most of his time at his home in another city 2 hours away. He does read all of our studies. Myself, another practitioner, and the office manager are the ones primarily running the clinic, and I also handle hospital consults while he is away.
After reading everyone’s comments, I decided to set up a meeting with my office manager about my contract and compensation. I showed her my research, including the AAPA salary report, as well as current job listings in my area and what they were offering even entry-level PAs. Based on my experience and responsibilities, I was actually making below the 25th percentile for PAs in my area. She completely supported me and told me she 100% agreed.
The problem was my cardiologist had recently made a rule that my manager could no longer give raises without going through him, so I scheduled a meeting directly with him.
The meeting went about as well as I expected. I showed him the numbers, explained what I felt was fair compensation, and brought up that I realistically needed some type of healthcare stipend. I also reminded him that I was supposed to start receiving my 401(k) match.
First, he immediately declined any type of healthcare stipend. His reasoning was that if he did it for one employee, he would have to do it for everyone, and because we are a small practice, we can’t work with an insurance company.
He told me he would think about my salary and get back to me within 15 days.
Then came the part that really upset me. He told me we were changing brokerage companies and that I actually would not be receiving my 3% 401(k) match until 2027. I was extremely frustrated because I was never informed of this, and I felt like this was a breach of my contract.
So I did what many of you recommended — I started applying for other positions.
Within a week, I had two offers. Both offered about 20% more than what I was currently making, plus benefits and 401(k) contributions starting within the first 60 days.
At that point, I honestly wasn’t even concerned about what my boss was going to counter with. He did eventually come back with a 5% raise, but I gave him my four-week notice.
He tried to ask me to stay for 60 days because that was in my contract, but I reminded him that he had already breached the contract by not providing my 401(k) match, and he was lucky I was giving four weeks.
I just want to say thank you to everyone who encouraged me. I don’t know why I let myself stay in that situation for so long. I think I was scared to leave a specialty I had been in for 10 years.
I’m so glad I made this change. I’m moving to a practice with no call, no weekends, no holidays, every other Friday off, and it’s also 20 minutes closer to my house.
I truly couldn’t be more excited for this next chapter. Thank you all for the advice and encouragement

I'm a current PA, seriously considering a specialty change and going into ortho specialty. I'm up for a job in the coastal region with emerge ortho. It does require periodic call for a surgical specialty, but the hospital is be on call for is not a trauma center and does not get many emergent cases. I also know this is true about it the hospital because I currently work at the hospital just a different specialty. Emerge ortho is a huge company. I'm wondering if anybody on here works for them specifically in this region? Can you tell me a little bit about your work life balance? I'm not opposed to taking call here and there, but I've never had a job where I've had to actually go in during college. It's always been at home on the phone. I am very intrigued though by the compensation model and the ability to make pretty significant productivity bonus yearly.
I am also wondering about how their productivity bonus works. I was told the APPs have control of their schedule to an extent? I was basically told I can work as hard as I want or not hard depending on my lifestyle and my priorities. I have an interview in person this week obviously I'm going to ask these questions, but I'm curious if I'll get more candid responses here.

Hey guys, i've been a PA for 10 years now. I've been posting a lot on this sub recently about potentially finding a new career so thank you for tolerating me. I'm in the process of interviewing with sports medicine orthopedic surgery. I'm really excited about the possibility of this job. It will be a completely new specialty for me however, being a former college athlete this is something I'm really interested in. One of the reasons I'm looking to switch jobs is because I'm burnt out. I work in cardiology right now and I am so tired of the amount of insurance, denial and peer to peers and constantly fighting with insurance telling patients. They can't get medications or procedures that we want to order because of insurance reasons. It's honestly exhausting. I'm wondering if there's anyone that works in orthopedics that can give some insight to how much of this you deal with during your day to day?

I had posted a couple weeks ago about how to approach my boss about my salary, or lack there of.
I took a lot of the advice that was given and I have started to apply to other jobs in the event my current employer is unable to properly compensate me.
I have 10 years experience in cardiology. While I know I can do other specialties it does intimidate me a bit to make the switch. I think I'm looking for moral support if anything! I've applied to orthopedics, urgent care and vascular surgery so far. If I took the vascular job that wouldn't be a huge change but urgent care and ortho would be a bigger learning curve.
I'm excited to see what's out there but also nervous I dedicated too much time to one speciality and that I'll be like I'm a new grad all over again.

So I have been fighting Humana over the most ridiculous denial for a nuclear stress test for a patient and I seriously have no idea how it keeps getting denied and I've just kept pushing so they have offered me to do something called an administrative law judge hearing. I am 100% doing it.
I've never even heard of this until today. I was told I'm going to speak to a judge who will determine if the service should be approved.
I think it's crazy that I'm speaking to a judge about this and not a physician. I was denied a peer to peer on multiple occasions.

Has anyone ever actually done one of these? What should I expect?

I am a physician assistant, I specialize in cardiology. I have been in cardiology for 10 years now. I used to work for a big corporation in Virginia and when I moved to NC I got a job with a private practice cardiologist. When I first moved here he matched my salary from my old job, but since then I have not seen much of a raise. I've been with this practice 3 years now and I just looked at the AAPA salary report, I'm making 10-15K less than the national and state average for my specialty with my experience.
I am trying to figure out how to best approach the topic of a raise. It is honestly making me lose sleep. It's different with private practice because it is all so personal. I know finances sometimes run tight. With a big cooperation it's much easier in my opinion to approach these conversations because you don't have any relationship with the HR people. I'm concerned I'm going to sound greedy and be told they can't afford it.
I love this job, but honestly, I struggle monthly with finances, and I'm a newly single Mom, I don't think I can continue with my current salary. It would really kill me if I had to change jobs.

Hey guys! I work in a private practice that specializes in cardiology and sleep medicine. We've had several incidents recently that has led me to realize We need to do some more training with our staff on how to react to emergency situations. There are all CPR certified, but I'm thinking more along the lines of - how do you recognize a stroke and what immediate steps do you need to take if a patient walks in having a stroke?
A lot of this will be targeted for the front desk staff. front desk are the first people to see these patients and I feel it is very important that they know what to do in these situations. Obviously they always call for help, but I want them to know what to do while waiting for help.
I'm posting to ask if you guys have any ideas on what to train on? This is what I have got so far.

1. Recognizing suspected stroke
2. Recognizing suspected heart attack
3. What to do if a patient passes out
4. What to do if a patient has a seizure
5. What to do if a patient is belligerent or threatening
6. Protocol when the lab calls with a critical lab result

Please share insight and let me know what else I should add! Even though we are a specialty practice, as I'm sure you guys know we have all sorts of things that have happened so it does not have to be specific to cardiology or sleep medicine. I appreciate the help!