How to Be a Better PA Part 2: Medical Staff, Administrators, and Supervisors

This is part two of a special three-part podcast series by Joe Gilboy PA-C on becoming a better PA.

Part one was all about building better relationships with our nurses and ancillary staff.

In part two we cover essential strategies on how to stay off the medical staff radar and get the medical staff, administrators, and supervisors on your side.

Let's jump right into this special episode of The Audio PANCE and PANRE Podcast.

You can listen to the podcast below and read the summarized (and edited version) of the transcript or listen in your podcast player of choice.

The Audio PANE/PANRE Podcast Episode 88: How to be a Better PA (Part 2 of 3)

You can also click here to listen to or download this episode.

Episode Transcript and Summary

This episode was recorded by Joe Gilboy PA-C and edited for clarity and readability by Stephen Pasquini PA-C.

Welcome, everybody. This is Joe Gilboy, and this is a podcast to have a series of three podcasts on how to become a better PA.

Today, we're going to talk about medical staff, our administrators, and our supervisors, whether a nursing supervisor, PA supervisor, or possibly physician supervisor.

What I will be teaching you here in this podcast is how to interact with them and how to deal with them. And most importantly, how to have you make a better reputation for yourself and how to make you a better PA.

• First, we're going to talk about the medical staff, which is a big group of people.
• Second, we need to learn how to deal with administrators. These can also be the office managers at the clinics where you work.
• And then your supervisors, these are the people above you, whether a nurse, a PA, or a doc.
• Lastly, we will covering how to deal with (or leave) a toxic job

So, let's talk about all these three people we're going to have to interact with.

How to be a Better PA with Medical Staff

Let me explain who medical staff really are, not whom you think there are, but I'm going to show you who they really are.

I've been a physician assistant in the emergency room for 35 years. You would think that after 35 years, I've developed some tough skin. But there's one group of people that I fear the most, and you will begin to fear them as well. Who are they? The medical staff!

Everybody has a boss. For example, you have a boss, and your boss has a boss, they have a boss, everybody has a boss. But there's one person who's at the very top of this pyramid. That's medical staff.

So, when medical staff asked for something, when do you get it done? Now? Yes, right now, like yesterday was too late.

So, the medical staff has asked for your ACLs card, PALS card, NCCPA card, or DEA number. They want a TB test, a flu shot, or they want your antibody titer for chickenpox.

When are we getting it done?

Now! No, literally right now. Because you see, the last people you want to be on the radar is medical staff.

Let me share with you who medical staff really is.

What's their job?

Are you ready for this? I hope you're sitting down?

Their job is to fire you.

Yeah, you heard me. They want to find a problem. That's their job.

So, when they start asking for things, they're looking for a problem. So, let's just say a young physician assistant is working in urgent care that we will call Betty.

So, here's Betty, the new PA working at the urgent care. Medical staff wants something, and she's like, well, you know, I'll get to it tomorrow. I have a birthday party to go to this weekend. And you know, and then it's my parents, wedding anniversary, I'm going to have that. And then my boyfriend's taking me to this. And you know, I'll get back to it when I get back in town. And as this time has gone by, Tick-tock, tick-tock. She's getting these new emails in her inbox from the medical staff. They've sent one, they've sent two, they sent three. Now they send one to her, and they're saying, hey, if you don't get this done in 10 days, you're on suspension!

Guess who gets the seat in that email? Your boss.

Let me explain to you how this plays itself out. You see, at the end of the year, when you're up there for that yearly evaluation, they're going to say, "Hey, so how's our new physician assistant? How's she doing?"

Well, they're going to talk to a group of people. They're going to talk to the nurses. They're going to talk to the physicians. And guess who else they are going to talk to, folks? That's right, the medical staff.

"Are there any dings with this person? Have they no gotten things done on time?"

Now think about what I'm saying hard.

So, imagine you're the boss. And there's these two PAs that show up. One PA gets everything done on time, and the medical staff doesn't even know they exist.

They're like, yeah, this person gets his TB test and flu shot and antibody titers done on time.

There's this other PA. Well, we had him on suspension for a week because he wouldn't get a TB test. And you're the boss, and it's time for her yearly evaluation. Whom do you want to give the raise to?

Yeah, let that bounce around in your head for a second.

Whom do you want to give the raise to? The person that medical staff has no idea that even exists in the department because they're getting everything done on time or a PA that they had to put on suspension for ten days?

Now, do you get it, guys?

You see, I hate to say this, but getting along with the medical staff is not only the way to preserve your job. But it's also the way to make more money.

Because when it's time for that yearly evaluation, your boss is going to look at you like, "Hey, you show up to work on time, you get along with the nurses, and you get along with the medical staff." They want to keep you.

That's when you can turn the screw and say, okay, well, to keep me, I would like $10 more an hour, or more vacation time or whatever it is that you're trying to angle at. That's how this works, folks.

I get these new grads who get out of school. They tell their supervising physician that they want to make $80 an hour, right? And let's just say the going rate is $65. And the doc will say, well, wait a sec, you know, I start new PAs off at $65. They're going to go well; I'm a recent grad, and I deserve this. I deserve that. Or I went to some fancy, dancy school.

Now, can you understand that at the end of the day, your boss does not care where you went to school? It means absolutely nothing. That's just a piece of paper. What's going to mean everything to your boss?

Can you see 20 patients, not kill anybody, get along with the nurses, get along with the staff? And most importantly, doesn't get on the medical staff's radar.

This is about your reputation.

You want to be the PA that medical staff doesn't even know exist.

You're like, so when does this girl get her TB or guy get a TB test, always on time, gets his flu shot on time gets his antibodies done on time. I don't even know his DEA numbers expire because he turns it in on time. That's who you want to be.

So never, ever, ever get on medical staff's radar.

I am going to give you a little inside story. I got an email. This was about nine o'clock in the morning. I got an email from medical staff, and they wanted antibody titers. They're like, "you know, hey, Joe, we need your antibody titer, Hep B titer, measles titer, and chickenpox titer."

So that was nine o'clock in the morning. I was in the walk-in clinic at noon, getting my antibodies, titer tests. And then the lady looked at goes I said, Yeah, there's something about a DPT shot, and she goes, you know, our records down, we can't pick them up. I said, just give them to give it to me. And lo and behold, they did my antibody titer. And they gave me a DPT shot. And believe it or not, guess who got two DPT shots last year? Yeah, that's me.

The medical staff emailed me back that afternoon. I emailed them back within four hours. Everything's been done. And they emailed me back saying, "Hey, thank you for getting things done so expeditiously."

Does everybody understand my boss is looking at me like the medical staff doesn't even know you exist? They're kind of worried because you got two DPT shots. I'm like, you know, I got twice the amount of antibodies. I’m not really worried about it.

So now, at the end of the day, this is what I want to share with you. Don't ever get on the radar. They want something – you get it done. Right. Now, if you do that, guys, he'll do great.

How to be a Better PA with Administrators

So now the next group we need people we need to talk about is the administrators.

So, when the administrators come downstairs to your hospital, urgent care, walk-in clinics, surgery center, wherever it is, be polite, and be cordial. Be respectful to them. Say hey, it's great to see you, how have you been you know, it's you know, I hope all is well with you and sounds great.

So, if you're cordial and polite with them and respectful, they'll remember you. And then when that yearly evaluation comes up, the administrator can go to your boss (who's your boss's boss), and they go, hey, you know, I met one of your PAs the day ago, great guy. Very nice. He was very polite and very cordial, and very respectful to me. You've got a good kid on board.

And now your boss is going to go, "wait a second. I need to keep this new grad, maybe young pa, on board. That's what you want to do.

So, in other words, be polite, be cordial. Be respectful to your administrators, and remember, they're the ones that make policies.

I think it is kind of funny that everyone argues so much about who's in charge of making policies. At the end of the day, guys, it all boils down to policies. That's what you must play under.

These are the rules. They're not the referees. You must play by these rules. You can get mad at the referee, but he's just enforcing the rule.

So, think of administrators as the person who is just enforcing the policy. So, when you see the administrators, be polite, be cordial, be respectful.

How to be a Better PA with Supervisors

The last group of people that we need to be aware of is our supervisors. So, whether this is a nursing supervisor, PA supervisor, or physician supervisor, they are your supervisor. And I keep telling everybody this again: be respectful, kind, cordial, and very workable.

You want to be the PA that everyone wants to work with. You want to be the PA that when you walk into the OR suite, or you walk into the clinic, or you walk into the surgery center or walk into, you know, medical office or you walk into the ER, you're going to be that PA.

"Oh my gosh, it's going to be a great day. Look who's here." So, when the nursing supervisor comes up and asks you a question, again, be polite, cordial, and respectful. The same thing with your peers. Most people have a PA supervisor, right?

Just be polite and cordial with them. Your MD supervisors, you want to be that pa that does everything?

No, listen to me. You see, you want to be the PA that the MD is like, oh, god, this person's work with me today!

I know they'll pick up the extra patients. They'll pick up the pace. They'll do better in the OR. They're much more respectful. They're much more cordial. This is the person I want to work with, that guy or that like that girl, that's who I want to work with, it's them.

And this is what you need. Because you see at the end of the day, guys, what I'm really trying to share with you. And I'm trying to tie this all in with you. This is about reputation.

You see, guys, at the end of the day, no one cares where you went to school. I mean, I know it's a congratulation from whatever university or PA program you graduate from. Congratulations.

Okay. But no one cares. No one will care about your GPA. No one will care about your PANCE or your PANRE score. They'll mean absolutely zero.

What will mean everything, your reputation?

What kind of person is this individual like to work with? Are they good? Are they bad? Do they get along with the staff? Do they get along with medical staff? Do they get along with the administrators? Do they get along with the supervisors?

That's what's going to count, folks. Because at the end of the day, let's just say you leave your job and go to the next job. Who do you think they're going to call?

Yeah, they're going to call one of your supervisors. And what are they going to say? They're not going to say where you went to school. They are not going to say what your GPA was, your PANCE or PANRE score was?

They're going to say what kind of person you are to work with, which is based upon your reputation.

This is what I keep trying to hammer home is. So how does everyone understand where I'm trying to with this

In other words, the medical staff wants something. When am I getting it done? Now?

How am I going to be to the administrators when they come downstairs? I'm not going to be afraid of them. I'll walk up to them and shake their hand. I'm polite cordial respectful.

My supervisors, what am I going to be? Polite, cordial, and respectful.

I'm going to be that workable PA? Hey, can you go see these extra four patients? Do you mind staying an hour later? I'd love to. I'd love to stay 10 hours later. Thank you. Can I have another?

That's who you want to be. Not the person who is like, "well, I need to leave a half-hour early, and can I get my hour lunch? No, I want a two-hour lunch. You know, I just don't feel like coming in today because I just I'm not feeling it. You know, my chakra's not in line. You know, I'm just not feeling it."

Yeah, this is not who you want to be. This is not who they want to hire.

They want the person they can rely upon. They want the person that they can trust the reputation on, and this is what I'm trying to share with you.

The Toxic Job

One other little piece here because I know many of you guys are going to ask this question. Hey, Joe. I've got this really toxic supervisor. I got this toxic nursing supervisor, I've got this toxic PA supervisor, or I got this toxic physician supervisor, so just say you've got a toxic person in your crew, right?

And trust me, I've been here, guys; I have Pandora's box full of bad memories here. I just want to keep this box closed. So, I'm on your side here.

So, what do you do with the toxic nursing supervisor?

Two things. So, whether it be a toxic nursing supervisor toxic, physician assistant supervisor, toxic physician supervisor? So what do I do?

Okay, so this is the way you get out of this. This is how you thread the needle.

One, you go up to them directly. So, let's just say you have a toxic nursing supervisor, right? So, you go up to whoever this nursing supervisor is and say, "listen, I find some of the things you inappropriate, I don't find this working for the best interest of the department."

And remember, that's a buzz word, best interests of the department or the office, the surgery center, or the ER, this isn't serving the best interests of our department.

"So, if you don't mind, I would appreciate it, if you change your policy or attitude towards me or to the group of people."

So, the first thing you do is you confront you lay down your complaint.

You also followed it up with an email.

Dear nurse supervisor or PA supervisor, or MD supervisor. The other day, we spoke about (x,y,x). Thank you for your time consideration. Sincerely, Joe.

You have verbally stated this to them. And now you have an email, which is very important.

Now, let's say that they continue to be toxic. Now, what do you do?

Everybody has a boss. Now, you go to their boss's boss, except this time, you've got documentation.

And you say, "so, I presented this to my nursing or physician supervisor, and this is what I presented to them, and they continue this behavior."

I've been at some toxic jobs. I just look back, and I find it amazing that I ever survived. So, what do I recommend when people are in a toxic job?

You've completed the steps above. You've politely confronted them and verbalized this in an email, and you went to a higher source, and nothing got done.

So, when you leave this toxic job, how do you do it?

You be polite, be respectful, be cordial.

"This is my two-month resignation. Thank you for your time consideration.

You don't even bring it up. You just exit.

Okay. So, can we all agree that most of us sleep 6-8 hours a day, which means we're awake for 16, right? Eight to 10 hours is going to be at work.

My wife's a writer. So, she's off doing her writer stuff, right? I might see her for a couple of hours. I don't see her that much.

But my nurses, are you kidding me? I see them eight to 10 hours a day. So, you see, the people you work with are your family. You're going to spend more time with these people than your own family.

If you have a miserable family at work, you will take home a miserable attitude and then take it out against the people you love the most.

So, these toxic jobs that you sometimes get yourself into. Get out. Get out as soon as you can!

This will literally ruin your soul. And then you'll take it home to the people you love the most.

"But I'm making so much money."

I see this all the time; I hear this from all my students all the time.

"But Joe I was making such good money."

One of the things you learn about life as you get older, it's not always about money. I agree that money helps. It helps pay off your student loan, mortgage, car payments, bills, etc. I get it, I've got the same things.

But at the end of the day, I'm happy with the family I have in my ER. I get along great with everybody. I get along with the medical staff. I get along with the administrators, and I get along to supervisor. I get along with almost everybody. It's my family.

And so now, when I come home, I'm not in a bad mood. I don't have any toxic stew on me. So, I can spend time with my wife and my daughter, and my dogs. And I'm just Joe. Nothing came home with me.

Your Reputation Matters

And this is what I keep trying to share with you guys. This is how you develop a good, healthy reputation as a PA.

And now if you go to the next job, what's your boss going to say?

Oh, this guy is great. Or this girl is great. I don't want to give her up. She gets along with everybody. You're the luckiest person in the world to get her. Get him.

That's what you want to do.

So, listen, guys, it's been enjoyable. I hope this podcast has helped you out. And this is podcast two or three. The third and the final podcast is getting ready to come up. And at that podcast. We're going to wrap the first two podcasts up. And what are we going to talk about? Your reputation.

Take care, guys.

Joe Gilboy PA-C