New Grad PA

[PinchandBurn]

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I am an awesome nurse practitioner who never complains and is very dedicated to getting work done.

We just hired a physician assistant that is a new grad literally 2 months and. She is already talking about how she does not have any worklife balance, which we highlighted to her and healthcare is more like work life integration

She wants to get administrative time to do her notes. Currently we are paying her about $50 an hour. And she has literally no experience we have to teach her everything from scratch. I wanted to be somewhat fair so did give her about 2 hours of administrative time and additional 3 hours for doing notes.

She currently sees about 3 patients in 1 hr. how would you guys all do this because to most of us and even to my nurse practitioner completing notes is sort of just baked into the whole thing. Also I can see how she is probably overwhelmed now because she is in the learning phase but in a private practice setting I am not certain if it is feasible to pay her to do her notes.

Alternatively I was thinking about salary and her and paying her about $85,000 a year for 32 hours of clinical time. This way notes are done on her own time.

Any thoughts

 

[Ducttape]

8 to 4 job. last patient 3:20 (or 3 if you are generous). she has the last hour or so to do notes.



or tell her to get tough, and recount how you did 28 hour shifts for 3 months in a row before you got a weekend off but were still on call...

 

[PinchandBurn]

8 to 4 job. last patient 3:20 (or 3 if you are generous). she has the last hour or so to do notes.



or tell her to get tough, and recount how you did 28 hour shifts for 3 months in a row before you got a weeke

8 to 4 job. last patient 3:20 (or 3 if you are generous). she has the last hour or so to do notes.



or tell her to get tough, and recount how you did 28 hour shifts for 3 months in a row before you got a weekend off but were still on call...

agreed.

problem is she's like "its illegal" to do non paid work. As in doing notes and completing documentation.

Interestingly, most of us PP docs/NPs we all do notes at home. 9 to 5 or 8 to 3 is when we see patients. We try to do get some notes done, but we all think it's part of the job to get the notes/documentation done on "our own time". It's unthinkable any other way....

 

[eyeeye_captain]

I feel like the answer is obvious as a PP owner in another field.

Start looking for her replacement and then fire her as soon as you have a new hire. If she’s already causing this much trouble, and appears to be a bad fit on both sides, she’s probably going to quit on you within the next few months anyway. Then you’ll be behind the eight ball if you really need the help.

 

[callmeanesthesia]

agreed.

problem is she's like "its illegal" to do non paid work. As in doing notes and completing documentation.

Interestingly, most of us PP docs/NPs we all do notes at home. 9 to 5 or 8 to 3 is when we see patients. We try to do get some notes done, but we all think it's part of the job to get the notes/documentation done on "our own time". It's unthinkable any other way....

Unless she’s hourly (very unlikely), it’s not illegal and she needs to be educated on that asap.

 

[Ducttape]

there does seem to be a generational perspective also.

my gut impression is that Gen Zers are much more about maintaining that work-life balance ie keeping work at work in very defined time blocks, and i think her complaints are iin line this social more. i highly doubt you will ever get her to come in on her time off or that she will willingly see a patient during protected time.



please dont ignore your current NP by providing benefits to the new PA without appropriately showing appreciation to your NP. i suspect that in the end, it will be your NP and yourself left in the office.

 

[lobelsteve]

agreed.

problem is she's like "its illegal" to do non paid work. As in doing notes and completing documentation.

Interestingly, most of us PP docs/NPs we all do notes at home. 9 to 5 or 8 to 3 is when we see patients. We try to do get some notes done, but we all think it's part of the job to get the notes/documentation done on "our own time". It's unthinkable any other way....

I never do notes or anything clinical outside the office. I get in at 630 and leave at 330. Patients scheduled 730-315. Lunch is 1120-1230.

 

[Dr. Ice]

The generational perspective exists because according to Elon money is not going to matter eventually and neither will anyone’s 401ks…

 

[RoloTomassi]

You can't give her special treatment that your NP doesn't get. Can she spend some time with the NP so she can see how it's done, what's expected?

 

[MitchLevi]

This will not end up well.

She will have to be replaced.

Make sure you are documenting all of these conversations. When you fire her, which will happen at some point, you need the paper trail.

 

[SpineandWine]

Salary at $50/hour seems very low.
That’s less than 100k at 40 hours/week with 4 week vacations.

 

[Snowmen96]

So, just to make it clear, you hired a new graduate without any experience, and are paying her subpar hourly salary, and are expecting her to be at the level of your experienced NP without having to train this new graduate, and also want her to do charting, which is actual work, without even giving her the subpar hourly salary that you are paying her the rest of the time?

 

[PinchandBurn]

So, just to make it clear, you hired a new graduate without any experience, and are paying her subpar hourly salary, and are expecting her to be at the level of your experienced NP without having to train this new graduate, and also want her to do charting, which is actual work, without even giving her the subpar hourly salary that you are paying her the rest of the time?

Firstly we have trained her for 3months under direct supervision of me and my NP. Also i have been available all the time.

I have paid for her DEA, paid for various CME courses and controlled subs course. I have connected her with various reps to go to their courses and learn.

Listen I understand that she needs more training. I'm willing to do that. That's why she's $50/hr. Btw this is market for a new grad. She even said she didnt get a call from anyone else when she was applying. Most of the hospitals are saturated.

I think my biggest mistake was that I always assumed people just did their notes. When I was an employed doc I charted MINIMUM 10 hrs weekly "off the clock". If you didnt do that and wanted to mk sure all your notes were done in clinic, I would have been able to see less patients. That number is probably like 12 hrs now in PP.

Most NPs/Pas I have interacted with and who my colleagues have talked about all do this (do notes on their own time). Is that what most of your PAs/nps do? I genuinely dont want to screw her over. I also dont want to train someone else all over. In PP training someone is very time costly .

 

[Ducttape]

again, this has that feel of the generational gap, and i dont think you will be able to overcome it.


i wonder if there is another gap to consider.

i dont get the feeling that most new PAs get integrated into the classic healthcare model that occurs on the floors with inpatient hospitalized patients.

when taking care of hospitalized patients, no one gets "protected time to do notes". this PA may have gone through PA school without any exposure to note taking while on shift, unlike what every doctor and nurse would do (which is to write notes in between bites of food or after the shift is over).

 

[MitchLevi]

i wonder if there is another gap to consider.

LOL

 

[po_boy]

agreed.

problem is she's like "its illegal" to do non paid work. As in doing notes and completing documentation.

Interestingly, most of us PP docs/NPs we all do notes at home. 9 to 5 or 8 to 3 is when we see patients. We try to do get some notes done, but we all think it's part of the job to get the notes/documentation done on "our own time". It's unthinkable any other way....

If you have to do notes at home, you're doing it wrong.

 

[Baron S]

That PA is generating $300+/hr in revenue and getting paid $50/hr and you are complaining about her inefficiencies.

 

[clubdeac]

Maybe they need better training programs instead of superficial cursory training and licensure that allows them to bounce bw any specialty they desire while having to learn the specifics and intricacies on the job. Just an idea

 

[Drd105]

This sounds a lot like my current NP- I’m in PP currently looking for a replacement. This was my first mid-level hire and I was thinking maybe I need to switch it up to PA and new grad…however the generational issues seem very important to consider. My NP texted Tuesday afternoon (which she had off as pre-planned vaca) and said, “my car is in the shop and won’t be ready until tomorrow so I need to cancel the patients for tomorrow, thanks!” I said, “um you have 20 people on your schedule, take an uber and do your job and pick up the car end of patients (last patient 3:20).” She said, “I need to take care of ME, so NO I won’t be coming in.” She is Gen X with millennial/gen z spirit I guess?

 

[eyeeye_captain]

This sounds a lot like my current NP- I’m in PP currently looking for a replacement. This was my first mid-level hire and I was thinking maybe I need to switch it up to PA and new grad…however the generational issues seem very important to consider. My NP texted Tuesday afternoon (which she had off as pre-planned vaca) and said, “my car is in the shop and won’t be ready until tomorrow so I need to cancel the patients for tomorrow, thanks!” I said, “um you have 20 people on your schedule, take an uber and do your job and pick up the car end of patients (last patient 3:20).” She said, “I need to take care of ME, so NO I won’t be coming in.” She is Gen X with millennial/gen z spirit I guess?

Why would you need work ethic when you already have the heart of a nurse?

 

[po_boy]

This sounds a lot like my current NP- I’m in PP currently looking for a replacement. This was my first mid-level hire and I was thinking maybe I need to switch it up to PA and new grad…however the generational issues seem very important to consider. My NP texted Tuesday afternoon (which she had off as pre-planned vaca) and said, “my car is in the shop and won’t be ready until tomorrow so I need to cancel the patients for tomorrow, thanks!” I said, “um you have 20 people on your schedule, take an uber and do your job and pick up the car end of patients (last patient 3:20).” She said, “I need to take care of ME, so NO I won’t be coming in.” She is Gen X with millennial/gen z spirit I guess?

So you fired her right ?