It is super easy for new physician assistants to become overwhelmed. You feel like you are expected to know everything. Unfortunately for most, as soon as you step foot in the door of your first patient’s room imposter syndrome can take over. I have found this was a common sentiment among my peers.
Once you fight through imposter syndrome then you have another obstacle. You may be in the same boat I was where you were taking your work home every night and felt like I didn’t have a life outside work. I would spend hours upon hours working after I left the office. I was constantly studying and documenting at home because I didn’t feel I could do it between patients.
Regardless of if you read the rest of this article, I promise things will get better with time. This will happen naturally as you gain more experience and become more efficient on your own. In the hope that it will speed up the process for you, I am going to discuss 5 tips I wish I had been told when I first started as a PA. After you read this article you will have actionable takeaways that you can start incorporating tomorrow at your job. My hope is that an increase in efficiency will not only benefit you monetarily but also will prevent burnout in the long run.
Recommended: 4 Self-Care Practices I Do to Prevent Burnout As a Physician Assistant
New physician assistants should see fewer patients
Hopefully, this is an option for you. I started off seeing very few patients per day. This continued until both my collaborating physician and I were comfortable with me seeing more. This was extremely beneficial as it allowed me time to study. I was also able to focus on ensuring I learned the EMR system.
I spent a lot of time shadowing other providers in the office in between seeing the patients on my schedule. This allowed me the opportunity to observe how different providers approached disorders. I could then decide for myself what type of approach I wanted to take.
If you are in a position where your office is expecting you to see a full load of patients right off the bat then they are setting you up for failure. New physician assistants need to be made aware of this. I would highly recommend talking to either the physician who hired you or whoever else is in charge and saying that you would prefer to start with a lower volume. Then you can slowly increase patient volume in the months that follow or how you see fit.
Finish documenting patients before leaving work
This was something I did not do for the first 6 months or so after I had a busy schedule. It was overwhelming, to say the least. I started my career with an excessively long commute (1.5 hours). I would get home and spend what little time I had before bed charting. Most of the time I would leave it until the weekend. It would take me even longer to chart on the weekends because I would have to remember everything from several days prior.
After several tiring months, I finally made up my mind that I wasn’t leaving work until I had finished charting. That’s when life started to get a little easier. I made sure to always pack a lunch and would work through lunch if necessary. I would prefer spending that hour I was already at work charting. That way I didn’t work during the limited time I had in the evenings.
This adjustment alone is a game-changer! You may have to stay late for a few weeks or maybe months. You will be able to focus so much better at work than at home, I promise that. Over time you will become more and more efficient with your charting. Then you’ll get to a point where you may just be staying for about 15-30 minutes after work every day.
Schedule a set time every week to study at home
Who said you were done studying when you graduated? As a recent graduate, you know the basics but you haven’t really learned the specialty. I will argue that you should absolutely be studying regularly for at the very minimum the first year after graduating.
I was very fortunate that the physician who hired me was more than willing to teach. For the first 6 months, we both read chapters from a dermatology textbook. Then we discussed the chapters once every other week in the morning before seeing patients. This allowed me the opportunity to ask her questions about complex disorders. She would give me patient anecdotes that filled in any knowledge gaps I had after studying.
I also completed an online dermatology fellowship through the Society of Dermatology Physician Assistants website to augment my studying with the dermatologist. I am extremely grateful I took advantage of the time I had during my first year, when I was seeing fewer patients, to do the necessary studying.
Three years in, I see up to 40 patients a day and couldn’t imagine adding on textbook reading. Instead, I do my required CMEs and read any new studies that come out that are relevant to my patient population.
Get to work early and complete any necessary administrative work
You may be thinking, great I should stay late and finish charting but what about everything else that is required of me? It would be nice if our jobs were as simple as seeing patients and charting, but there is typically much more involved. There is busy paperwork, prescription refill requests, interpreting lab and imaging results, etc. All of this can take up a lot of your time, especially for new physician assistants.
I used to get to work early to get any necessary paperwork completed prior to seeing patients. This way I was starting with a clear plate every morning and didn’t have to worry about anything besides the patients I was seeing that day. I would recommend recent graduates do this as well.
If you have a nurse or medical assistant helping you, try to delegate the more tedious tasks to them whether that’s filling out a prior authorization for a specific medication or calling a patient back about a simple question. It is necessary to make certain phone calls yourself. For example, I always call my patients who have biopsy results positive for melanoma so they have the opportunity to ask me questions. Sometimes you may not be able to reach them on the first phone call and then you’ll need to make time in between patients, during lunch, or at the end of the day to call again.
Schedule times to meet with your collaborating physician
As I mentioned previously, I met with my collaborating physician every other week for several months after first starting work for the purpose of studying complex dermatologic disorders. I also used the time to ask questions unrelated to medical diagnoses and to discuss my goals and progress as a new medical provider.
If you can set up goals for yourself whether that is how many patients you are comfortably seeing per day or the types of patients you are seeing then you’ll have objective ways to measure your progress. If you don’t have the option to schedule every other week or monthly meetings with your collaborating physician, then at the very least ask to meet with them once a quarter for your first year.
It is vital for new physician assistants to know if they are doing things correctly. If you are not billing or charting correctly for the first year it may not only be difficult to change your ways but you will be discouraged that you wasted time and potentially money doing things incorrectly for so long.
Final thoughts on increasing efficiency at work for new physician assistants
Increasing your efficiency at work can be instrumental in decreasing your patients’ wait times and also for your personal financial and mental health. I highly recommend setting up systems as early as possible in your career. One tip I did not mention in this article, a bonus tip if you will, is to really learn your EMR system so you can use it to create shortcuts when you chart patient visits. Also, don’t be afraid to delegate certain tasks if you have the option to do so.
I have all the faith that incorporating these 5 (or 6) tips over the next few months will greatly improve your time at work and also likely your time at home as well. If you have any questions regarding ideas to overcome problems with your specific work environment do not be afraid to email me or comment below with your question!
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