r/physicianassistant

I am in severe, crippling burnout and I am only 3 years in.

My first job was inpatient general surgery - I worked very close with my attendings and felt very supported, but had to leave after 1 year as I moved across the country.

Cue the worst 2 years of my life. About 2 years ago now, I started an outpatient gastroenterology job in New Mexico. It is extremely independent. I feel like I have no support. The clinic is 2 full time PAs (me included), and 1 part time PA. There is an amazing locums PA who has been in and out but is currently out. I did not get much training. No structure to it. Thrown to the wolves if you will. For all of us PAs, we only have one supervising physician. He is in the office for half of the day, 2 days of the week. The rest of the time, he's scoping. We can call him for questions, but often he's unable to answer, and he is also drowning as well. I feel like OpenEvidence and Doximity have been my attending. I have had to teach myself and I feel so lost all of the time - these patients are so complex and it takes my entire soul in order to make sure they are taken care of to the best of my ability - I don't have any "me" left when I get home. The patient population here is incredibly difficult. I am in so far over my head. I am becoming a shell of myself, angry at the world. The patient population is extremely socioeconomically disadvantaged - I have to bear witness to people who don't have running water and can't do their colonoscopies because of it, and can't pay for a hotel in town. Extremely low health literacy. Language and cultural barriers. People who we lose contact with because they get different phone numbers or don't have a phone. Insurance issues. Constant paperwork. Constant inbox - results, documents, messages. It never ends. I am drowning and I can't do it anymore.

I am moving to New Zealand in 2 months. I do not know if I am going to continue working clinically. This experience has made me genuinely question the PA profession altogether. I don't believe in it anymore. At all, unfortunately. I just don't think that getting 2 years of medical education and then practicing independently is safe.

I refuse to continue to endure the chronic levels of stress I have been under the past 2 years. It feels inhumane. The demands are too much. I was wondering if anyone else has felt or feels similar. I feel very alone in all of this.

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

Hi everyone. Im a new grad considering positions currently and I went through the process of clearence with Hospital A and would start probably within a few weeks. I just got accepted to Hospital B which with clearence would be 3 months for now for a start date. im having trouble deciding to just stick with Hospital A or resign my offer now and wait three more months to start. For reference I haven't started working anywhere and its been about 7 months since I graduated. Below are more details of each hospital choices. I would greatly appreciate any insight!!

Hospital A: OBGYN/ City hospital in Queens. = $148,625.57 yearly

~1199 position, mostly clinic with the potential for L&D depending on department needs.
~ M-F 8-4:30pm,
~ 20 vacation days and 12 sick days, Pension through union, 403b retirement plan but no employer contribution

~CME = 5 days and $750

~Commute: 45 min two busses

Hospital B: Internal Medicine/ NYP Manhatten = $161,000 rotating shifts 3 months days,3 months nights with 10% differential 3- 12.5 hour shifts.

~ CME= 1,000

~ 4 weeks vacation time/ 12 sick days per year / 3 personal holidays

~ perfect attendance can award you two extra vacation days

~ After one year the hospital contributes 5% to my annual salary and it increases with time.

~Commute: About an hour +/-10 mins taking two trains into the City.

** If you made it this far thank you! I keep going back and fourth with both the pros and cons. I do see myself in both specialties, with OBGYN as a perference but would love a 3- 12 work week in an inpatient unit rather than a clinic job. Internal Medicine can def. help solidify medicine esp as a new grad. HOWEVER, if I CHOOSE HOSPITAL B, I would wait another 3 months to start. I dont think its 'correct' to start Hospital A and then leave within 3months till the other job starts? Or just stay with Hospital A?

If anyone has any insight or advice. Id greatly appreciate it.

I have two jobs in the looking at both are ER.
JOB 1: 120/HR, nights 12 hr shifts, about 10 shifts a month. Total driving 100 miles there is an hour 30 and back is 50 min. 2500cme
Job 2: 100/hr, day shift 10 hr shifts, 12-13 shifts a month. Total drive time is about 10 min total both ways. 2000 cme

Have a question for Derm PAs!!

I am a PA without derm experience, and have been wanting to break into Derm for a long time. Most places won’t take me without experience. One practice I applied to is willing to take me on but suggested that I keep my current PA job and come train with them one day a week being paid as an MA/scribe but in “training” then after 1-2 years I would transition to being a provider.

Any thoughts on the 2 years MA/in training? It seems to be a common thing.

What’s the coolest physician lounge or hospital/place of work perk you’ve seen?
I’m curious to hear what’s out there! What has been the best physician lounge you’ve experienced at a hospital or place of work, and what made it stand out?
Did it have great food or insane complimentary snacks, comfortable spaces to relax between shifts, massage chairs, nap rooms, or something completely unexpected?
I’m also curious about other cool amenities your place of work has offered its employees, such as a nice fitness center, or other unique perks!
I’m interested to see what’s out there beyond the typical break room or typical perks to see if others are living my dream 😊

Would you rather work with a supportive supervising physician or group of APPs?

Currently deciding between jobs and the team is definitely something that is important to me. Would y’all rather have a supportive group of APPs at work with attendings who more or less dont care about APPs, or have an attending who cares and loves to teach with a team of APPs who are nice but arent as close with?

Edit: i forgot to add that I’m asking bc I’m a new grad

What was your next move and were you happier?

Now I don’t mean fun as a joyful, yay I’m so giddy type thing but does it get repetitive and boring?
Last year in Japan, my mom got some type of temporary cosmetic surgery, which really interested me that I sort of researching on it and I wanted to be a derm pa so I could eventually switch to aesthetics, but I wasn’t sure if that was a very good option.
I would prefer preferably like the practices done in East Asia to research about during college or even my career or just have a stable job to go in my free time and observe.
I know PA school is very hard and that’s what I’m most cautious about because I’m already having a B in chemistry as a sophomore which sucks cause if I’m going into healthcare, I feel like I should do better.
Is the job itself alright? Is the job growth gonna go up? I have a lot of questions lol

I’m a new grad PA and could really use some outside perspective.
About a month ago, I verbally accepted a position in a large academic ED that I was genuinely excited about. The only thing was it was lower compensation than I’d liked but it’s an academic hospital.

Since accepting, I’ve already been through about a month of credentialing/onboarding. I submitted my references, my references completed all the required forms, and the hospital has invested significant time into credentialing/privileging me.

Then this week I received the official formal offer from the ER position the same day I unexpectedly received an offer from a Neuro ICU at another major hospital system. The interview process at the ICU begun before I had an ER offer, but I continued through the process after the verbal offer just to see if they would offer me a job and what the compensation/ benefits would be.

ED offer:
$102K base + ~$5K value-based bonus, I don’t know if there is night shift shift diff
1,680 hours/year
Mix of 8- and 12-hour shifts
~2 weekends/month
1 week off each quarter + 5 vacation days
Start in December

Neuro ICU offer:
$130K days / $150K nights ($10/ hr shift diff)
1,612 hours/year
175 shifts/year
Split between two hospitals
about the same weekend commitment, but more flexible

I really like EM, but I’m also am okay with critical care and could see myself liking Neuro ICU, although neurocritical care wasn’t originally my main career goal. What I wanted to do with the ED is just work there for a couple years and figure out what I like then switch to a higher paying job.

I’m also struggling with the fact that I already committed to the ED job and they’ve invested a month of time into credentialing me and I submitted so many references for credentialing that already filled out the forms. I would hate to have to explain to my references and make them fill out more forms.

I’m also wondering if it would be reasonable to tell the ED about the Neuro ICU offer and ask whether there’s any flexibility in my starting salary, given that I already accepted about a month ago.

I guess I’m just asking how much weight should I put on accepting a verbal offer and working through credentialing. How bad would it look if I bailed and what would my references think? And would it look bad to negotiate pay after accepting a verbal offer a month ago (they never gave me much of a chance to negotiate to begin with)?

I am about 9 months into my first job in outpatient neuro. I do not have a caseload I am lucky if I have 1-2 patients in a day. Otherwise I help the doctor with his patients and his notes. Red flag considering the amount of time I’ve been here?

So, I work in a fast paced UC. I had relatively normal visit w a male pt, except towards the end, pt started over sharing about home life/trauma. I empathized, but quickly discharged and didn't really continue the convo. I didn't think twice about it tbh-if you work in UC, you know...you encounter all kinds of people. Anyway, next day, he has friend requested me on FB. I already have privacy on to where only friend of a friend can request me, and we have one mutual friend. I feel really WEIRD about this. Am I over reacting? Should I tell my boss?

I currently work at an urgent care and have for almost four years. I have never practiced family medicine. My urgent care clinic does occupational medicine along with your typical urgent care complaints. Now they are wanting to add primary care.

For those who transitioned to UC to Family medicine, how was it? Any review courses you would recommend? My clinic says they won't force me to do primary care, but the writing is on the wall, and I don't want to lose my job.