Training midlevels

[giddyup]

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I am SO TIRED of training midlevels. 15 years and I've had to train no less than 13. Worst nightmare happened. Most recent NP hired without appropriate vetting (not my call) and we had an insane amount of patient complaints about her attitude and she was warned multiple times and we got 2 more complaints this week so she was let go and will not be coming back next week. she had 80 patients scheduled next week. im on vacation. entire practice is switching EMRs week after that and it isnt very intuitive. anyone have any good cheat sheet resources for training midlevels? i know i should have made one by now but i havent prioritized it tbh.

 

[thecentral09]

Private or employed?

 

[callmeanesthesia]

Extend your vacation.

 

[giddyup]

Private or employed?

private

 

[mille125]

That is a nightmare...

 

[Agast]

Tell chat gpt what you want the training material to cover and then tweak the response to make sense

 

[Ducttape]

the best way to train them is to have them follow you around for a month and see how you work.

 

[SSdoc33]

accept that they only last a year or 2 then move on

id honestly just fix their mistakes rather than keep training them myself. not worth the hassle, b/c they always leave

vagabonds

 

[clubdeac]

You’re just training your future replacement. Between them and AI, private equity and hospital admin will have no use for us dinosaurs with actual MDs behind our name

 

[specepic]

Training is typically a combination of shadowing with me and shadowing with one of our existing APP's. This includes clinic and fluoroscopy suite so they really understand what the procedures look like and what the patient should be able to expect. We also have them rotate with orthopedics and our sports PM&R person as well as with the radiologist

We invest quite a bit in them, and they typically end up with their own panel of patients that they follow closely and we try to give them autonomy, but I certainly make myself available for questions especially when it comes to booking procedures and imaging interpretation

I suspect every region is a bit different and turn over can be a regional thing, that being said I think because of all the investment we make in them we tend to see less turnover overall

We also offer them quite a bit of schedule flexibility which seems to help with retention

Our interview process is pretty rigorous usually starting with a Zoom interview, an in-person visit which includes a half to a full day of shadowing in clinic, and they also meet with the executive team of the hospital very similar to a physician being hired.

The shadowing portion of the interview we found to be extremely helpful because you will find things out about them you would never know from a usual interview and you also get to see how they interact with patients and staff and get to pick their brain on their thinking process a little bit

 

[Ducttape]

ive had 3 NPs in the past 15 years. one lasted 6 months but wanted to move to warmer climes. the other 2 lasted 7 years each.

i know of 2 NPs that were at the location but different practices for 20+ years.

otoh, i see colleagues have APPs that last a year.

there definitely is more mobility for APPs than physicians.



its all about the right fit and making sure they have the appropriate training, support and interest in the field. can be hard to find.

 

[mdo1738]

Then don’t train them? I’ve never worked with one and I never plan to. You could probably pay a little bit more to get a burned out PCP who you could train in half the time to do 150 times better than any midlevel.

 

[clubdeac]

Here’s a new one

"I always want to prepare for [the worst]," she told CNBC Make It in 2023. "I've worked a lot of overtime hours just to make sure that I always have something extra."

Now, she sticks mostly to 40-hour workweeks with extra shifts here and there when her staff needs coverage. She could be making closer to $500,000 a year if she worked similar overtime hours to what she previously took on, but she doesn't feel pressured to, she says.

"I want to make more money, but I don't want to burn myself out along the way." Rodriguez says. "So now I've hit above the $300,000 mark, I feel good about that."

30-year-old makes over $300,000 a year in a hospital—without going to med school — CNBC

Chabely Rodriguez picked a lucrative career and quickly paid off her student debt when she started working. Now she's focused on investing for her future.

apple.news

 

[Ronin1]

Nothing new about the AA income train.
I have a friend making 300/ hr as an AA. Not bad for a 2 year program out of college. Better math than a lot of medicine from a strictly financial decision

Do the math 2 more years of tuition with med school. Let’s say 150k right there with living expenses. 4 years residency making 75k year. So a total after 6 year of 150k positive

AA school 6 years at 275k. 1,6500,000 or 1.5 M ahead. That would take a long time to make up. At least 7 years making anesthesia money.

 

[mille125]

Then don’t train them? I’ve never worked with one and I never plan to. You could probably pay a little bit more to get a burned out PCP who you could train in half the time to do 150 times better than any midlevel.

That is true......

 

[Ducttape]

Then don’t train them? I’ve never worked with one and I never plan to. You could probably pay a little bit more to get a burned out PCP who you could train in half the time to do 150 times better than any midlevel.

possibly, but because of how doctors are, you may find yourself in a contentious relationship where this burnt-out PCP has decided that he knows best and will decide to treat patients however he wants, not what you want.

 

[clubdeac]

Nothing new about the AA income train.
I have a friend making 300/ hr as an AA. Not bad for a 2 year program out of college. Better math than a lot of medicine from a strictly financial decision

Do the math 2 more years of tuition with med school. Let’s say 150k right there with living expenses. 4 years residency making 75k year. So a total after 6 year of 150k positive

AA school 6 years at 275k. 1,6500,000 or 1.5 M ahead. That would take a long time to make up. At least 7 years making anesthesia money.

I’m amazed at how much anesthesia has allowed very lucrative mid level creep. I mean what’s the purpose of an AA in comparison to a CRNA? Why even have this position?

I briefly dated a girl who was in AA school about 15 yrs ago when I was just starting out. I thought it was a made up job. When she’d get drunk she’d brag that after one more year she’d basically be at my level of training and make the same amount. I thought she was FOS but I guess I was wrong. I was making about $300k back then. Matches up. she was hot but arrogant as all get out. Needless to say, relationship didn’t last long

 

[CopaceticOne]

I’m amazed at how much anesthesia has allowed very lucrative mid level creep. I mean what’s the purpose of an AA in comparison to a CRNA? Why even have this position?

I briefly dated a girl who was in AA school about 15 yrs ago when I was just starting out. I thought it was a made up job. When she’d get drunk she’d brag that after one more year she’d basically be at my level of training and make the same amount. I thought she was FOS but I guess I was wrong. I was making about $300k back then. Matches up. she was hot but arrogant as all get out. Needless to say, relationship didn’t last long

Give it up already, you already got your answer in another forum.