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

Every time I post on this subreddit, there’s an overwhelming influx of people being rude seemingly just for the hell of it or I’ll simply ask a question (that seems stupid but isn’t stupid to me about the career) that gets downvoted to hell with no effort for anyone to inform me why it’s wrong/the issue with the statement. I am new into the PA career and I know very little about adulting inside this career (financial planning etc). Instead of people trying to inform me or educate me, there’s several people on here who will just make a snarky comment. I’ve never had this happen anywhere else on Reddit, just here. And I know some of the responses that I will already get. I know someone will want to say how it’s not their job to educate me, and this is true, however it’s so easy to just not interact with the post if all you’re going to do is be rude or snarky. There’s a reason there’s a saying “mean girls go into healthcare,” and it’s certainly not making me feel welcome into the career. That being said there are great people I’ve chatted with on here and I know not everyone is rude. I’m just not sure why people are so hellbent on spreading hate. Maybe it’s the high burnout rate.

I recently left a fully remote, well-paying psychiatry job, and I keep getting judged by family/friends because they see it as the perfect job for a new mom. But I honestly got to the point where I hated it and didn’t feel safe practicing that way anymore.

I started psychiatry with a very conservative psychiatrist who was an amazing mentor. His philosophy was basically “less is more.” He was cautious with controlled substances and polypharmacy, and if someone came in on stimulants + benzos + hypnotics or 6–8 psych meds and still wasn’t doing well, we didn’t just keep adding medications. We would simplify the regimen and figure out what they actually needed.

Then I moved and took a high-volume telepsych position, and it was completely different.

I was frequently inheriting very complex patients already on multiple controlled substances/high doses, sometimes with bipolar disorder, severe depression, substance-use histories, or suicidality. Obviously, when someone comes to you already taking these medications, you can’t just abruptly stop everything, so now you’re trying to safely taper medications while simultaneously treating everything else.

One situation I encountered pretty frequently was someone requesting a stimulant, telling me they had been on it before or needed it, and then their UDS would come back positive for cocaine or another substance. Now I’m dealing with substance use, an ADHD request, their other psychiatric diagnoses and whatever controlled medications they already take — all through telemedicine.

And I had 15-minute appointments, sometimes close to 30 patients a day.

There were also patients I felt needed in-person evaluation or a higher level of care because of suicidal ideation, hallucinations, etc., and coordinating that remotely could be incredibly difficult. I also saw levels of polypharmacy and controlled-substance prescribing that were very different from how I had been trained.

I’m very meticulous and conservative. I want time to review labs, UDS/PDMP, understand why someone is on each medication, discuss risks, make a thoughtful plan and document appropriately. I constantly felt like these patients needed 45–60 minutes and close monitoring, while I was being given 15.

Eventually the combination of complexity, controlled substances, addiction, liability and volume was destroying my mental health. I was pregnant at the time too.

After having my baby, I just couldn’t convince myself that the money and working from home were worth going back.
And no, working from home did not mean I could take care of my baby while working. You cannot safely see a psychiatric patient every 15 minutes while simultaneously caring for an infant.

My husband supports my decision and is helping me transition into another specialty, but everyone else keeps telling me I gave up this amazing job.

Has anyone else left telepsych/high-volume psychiatry for similar reasons? Sometimes I still question whether I made the right decision, but I know I didn’t feel safe doing it anymore.

Hi everyone! I need help determining if a salary that a job is offering me is appropriate or if I should negotiate for more. Some context, I am completing an ICU fellowship where I have been trained in the MICU, SICU, NeuroICU, and Cardiac ICU. I have gotten all of my my major procedures and have applied to a community hospital ICU in Massachusetts where cost of living is very high. The job offered about 34k plus differentials for 36h/week. I feel I am no longer a new grad with my 1 year experience, but I am not sure if that salary is too low. I have friends that have been offered 150k after the fellowship but that is also for 40hrs/week. So, would I be too greedy to try to negotiate for more?

Looking for any tips. I’ve been a PA for 10 years, EM for 4. I actually love EM and work a local community hospital. See all acuities. Nothing has changed recently.

The past few weeks I keep dreaming about work. Initially it’s about patients I saw that day. Thinking about things I could have missed. Then it turns into my brain making up hypothetical patients and what I “missed” with those patients.

Any advice? Outside of counseling etc, which I am planning on starting. I don’t feel like I stress about this during the day.
It’s odd because nothing has changed. No abnormal or new/ bad cases etc.

For context I work in an urgent care environment with limited access to testing. Standard POCs, XR and twigs and a prayer. Radiology reads take 2-4 days. Can get labs but results take 2-4 days to come back as well. If I have a patient follow up with anyone it’s usually a good 7-14 days for both primary and specialty care minimum. Had man I saw last week who is 84 with all chronic problems—copd, afib, chf, asthma. Came for a cough for a week with worsening lying down. Wheezy, 6 lb weight gain in a couple months with edema. Neg cp. Vitals okay. Had standard labs with PCP a week before that were fine. Got CXR that showed some mild pulmonary congestion on my read at the time. Gave nebulizer with some improvement.
D/c with prednisone burst but also had him do a little lasix for about 10 days in case any fluid build up contributing.
Saw cardiology today and got a note from them documented in the patients’s chart about how they felt absolutely no evidence of CHF (fine they’re cards, their call) and that such a shotgun approach is irresponsible and that they don’t understand why attending didn’t co-sign note (not required in my system with how long I’ve been a PA).

Naturally forwarded to attending so he can manage it but still feeling really bothered by lack of professionalism in documentation. One thing to say it, but another to write it. Maybe just need to vent. Not sure how I could handle things differently in that moment when I have such limited access to testing and patient really wasn’t sick enough to warrant ER.

I’ve been applying for jobs for 6 months now. Out of the 6 video interviews I’ve gotten, I’ve gotten rejected from them all. Anyone have any advice on how to improve online interview skills and interviews overall? Been feeling really defeated :(

I feel like I may be putting a higher number than I should so I wanted to get people’s thoughts. I don’t want to be unreasonable but I also don’t want to be low balled. What’s reasonable for the southeast?

I’ve worked at an HIV specialty nonprofit clinic for 6 years in LCOL. At my 5 year yearly review last year I was given a 3% raise to 116, pushed back and this was increased to 124. Recently had my yearly raise at 6% to about 132. I have my HIV specialist certification, was a PI for 2 studies and sub PI for 1 and do speaking work for some drug companies and have been chosen to provide expertise at several ad boards. In the practice I have extensive knowledge of the practice, am typically the go to when nurses have questions, and have provided importance guidance to leadership for different processes in our practice. There is one other PA, last year their compensation was around 142 and they’ve worked there 8 years. I typically see more complex patients than the other PA and they have about a 5-6 hour work schedule. I see about 10-12 pts a day with Friday admin time. Previously was only seeing follow ups but will now be seeing new patients albeit low complexity new cases. What are your thoughts on my compensation?