The Ortho PA Archetypes

Are you the golden retriever PA? The procedure goblin? The apex predator? Or the one one minor inconvenience away from overload? 👀

This week we’re spinning the wheel of PA archetypes and calling out every ortho personality type we’ve worked with (and maybe which ones we are). From the over-explainers and boundary kings/queens to the “Dr. PA” vs “MA PA” dichotomy… no one is safe.

Funny, mildly unhinged, and maybe a little too accurate. 

Transcript

SPEAKER_02 0:00

Welcome to Joint Effort PAs, where two orthopedic surgery PAs get real about life in medicine. From tips and tricks to professional growth, work-life balance, and everything in between. We're here to share what we've learned and what we're still figuring out. Let's get into it. We're live. We're live. Um, weekly wins this week, weekly recap.

SPEAKER_01 0:28

I'll start.

SPEAKER_02 0:29

You have to start. I will start. I want to hear your uh success of the week again.

SPEAKER_01 0:33

Yeah. So a lot of um my non-medical friends, my friends who don't, you know, honestly who don't work, let's be honest. They call this time of year May Sember because it's like December, but in May. It's like the end of school stuff, the end of sports stuff. Everybody's got a banquet, everybody has like a thing. It's playoffs for sports, you got to get teacher gifts, like all the things, right? Um, so anyway, so this Friday, my daughter had her little school graduation and it was perfectly in workable hours. It was 9 a.m. on a Friday. So I knew about it. I wasn't gonna take the day off. In fact, I wasn't even gonna take the morning off. I was just gonna make it work. So I coordinated my whole surgery day to like make this work. And of course, whatever, you know, higher beings intercepted. And I had one assistable case that I was with first. My goal was during turnover to literally run up the road to the school, see my daughter walk across the graduation stage thing, have her see me, eye contact, check the box over, and then leave. That's like all I needed to do.

SPEAKER_02 1:33

For the first time in your life, pray for a long turnover.

SPEAKER_01 1:35

Pray for a long turnover. Yeah. So I assistable case first. I moved a questionable assistable case second that required a lot of setup, x ray, whatever. So I thought I built in 20 to 30 minute turnover and then 20 minutes. So I was like, I got a good 45 minutes. So the other room that we were not going to use, cases got canceled. So the staff was like, Oh, cool, we'll flip you. And I was like, Why? Any other day, any other day? I would be like, Yes, no. So um they did that. I rolled the dice, you know, got in my car, drive too fast up the road, and I saw my daughter. That's it. And I took a little video, she saw me, I saw her.

SPEAKER_02 2:12

Yeah, as long as she makes eye contact with you and doesn't have the memory that you weren't there at her graduation.

SPEAKER_01 2:17

So, yeah, so she has a memory. I was there, I have pictures, I was there. Um, but it's amazing. The repercussions if I wasn't going to make it.

SPEAKER_02 2:25

I'm thinking of like, did you ever watch the movie Jingle All the Way with Arnold Schwarzenegger? Yeah.

SPEAKER_01 2:30

But like that, this type of stuff, this is what I stay up at night worrying about. Like, was I there enough? Like, I don't know. But this is one of those things that it ended up just working out, which is amazing.

SPEAKER_02 2:40

Yeah.

SPEAKER_01 2:40

Absolutely amazing.

SPEAKER_02 2:41

Sometimes it does, sometimes it doesn't.

SPEAKER_01 2:42

Yeah, yeah.

SPEAKER_02 2:43

So this one um this time it was a win.

SPEAKER_01 2:45

This one did. So that was that was my heartfelt feel good story of the week. What about you?

SPEAKER_02 2:51

What did you have any negatives for the week?

SPEAKER_01 2:55

I had a bunch of I had a bunch of pitfalls. Okay. Um, I I had a lot of staffing things this week. Um, again, a lot of administrative stuff that just is uh not going well this week.

SPEAKER_02 3:09

Or for the foreseeable future. Yeah, no.

SPEAKER_01 3:11

Um, but we're doing a lot of really good stuff on the clinic side. Um, saw a lot of patients, had some really good discussions. I had a couple of really good phone calls with patients yesterday. So clinically, I felt really good about the care that I delivered this week.

SPEAKER_02 3:24

Yeah, I think it was like a clinically good week. Now I hit my hundred mark finally. Yes. Yeah. Got the push. Those two weeks in a row of 99. I was like, what is wrong with me? Like, what's wrong with me?

SPEAKER_01 3:34

Yeah.

SPEAKER_02 3:34

Yeah. 105. So I broke the mold.

SPEAKER_01 3:37

You did break the mold. So now every week has to be that. Like, will you be disappointed?

SPEAKER_02 3:42

Or what is your new Well, first of all, this week, Memorial Week. So, like, that's a Monday's a big clinic day for me. So, like, you know, this week's a loss. I think I'm not going to go as crazy out of my way to force it into existence, but I think it did show me that I can at my baseline for like my pre-existing clinics, probably have them a little bit higher. Yeah. Like almost like an airplane to accommodate for the cancellations. So, like, you know, have overbook yourself with the expection. So I I feel like I can handle the higher Friday. I have myself booked for 43. So we'll see. Oh my gosh. I didn't realize what I had done until I looked at it and I was like, ooh, can I give you questionable?

SPEAKER_01 4:24

Can I give you some advice? Yeah. Okay. We talked last week, maybe the week before, I'm not sure. You have your limit of like, what is my, you know, what's my template for the day? 35. I hit it, great, I don't, great. You can overbook yourself to like 37, 38, 39, okay. Once you get past 40, 40 is the bad place. Each patient after 40 feels like four. I also have 40 on Wednesday. And I just know, like, I and and again, Wednesday is our first clinic day after the long weekend. So there will be add-ons. Like it's just they will. They'll find spaces to put people in. That's gonna that's gonna stick with you for a little bit.

SPEAKER_02 5:01

Yeah. I'm gonna, I'm gonna be in mourning or some sort of state next week after this.

SPEAKER_01 5:07

My advice is 40.

SPEAKER_02 5:09

Yeah.

SPEAKER_01 5:10

So anyway, we'll see how that goes.

SPEAKER_02 5:11

We'll see how it goes. Um, but yeah, we had cool cases this week. It was uh yeah, clinically a good week, obviously, patient volume-wise, a good week.

SPEAKER_01 5:20

Um yeah, we I had um I had two patient encounters this week that I was dreading for two weeks. Do you ever have those?

SPEAKER_02 5:28

Oh, yeah. Okay, yeah.

SPEAKER_01 5:30

I had two that I was reading. So I saw a kid who's 15 two weeks ago, and it was a 315 appointment. I think the front desk didn't check him in. It was 345. I asked where he was. The medical assistant was like, oh, he's been in the room for 20 minutes, but didn't have his his paper anywhere, so there's no way of me knowing. So I was like a little flustered going into the visit. There's an MRI follow-up from like an urgent care thing. He tore his ACL, he tore his MCL, he tore his supposed to a lot of corn, he tore everything, right? So I go in the room and I am mostly sure we talked about the ACL. My note said we did, but I focused so much on the MCL because this was a distal evulsion. Like the kid's 15, might it heal? Probably won't. So I tried to talk to him about we need to see if this will heal first before we talk about any type of surgery. And of course, the patient and mother directed the conversation to like, but what about football? And I never like at the first visit to throw in, oh, that's completely out of the question because I'm gonna lose them after that.

SPEAKER_02 6:28

Yeah, yeah, they'll go somewhere else immediately.

SPEAKER_01 6:30

Multiple ligament injury. This kid also, like, you know, grew six inches in the past however many months. So he's got a bilateral knee, even though it's a good one, 15 degree contracture. So I'm in my head, I'm like, this kid is going to be a nightmare to rehab. So I said, All right, let's do, you know, let's do two weeks of um physical therapy, let's see if his quad can work, swelling down, gait, restoration, whatever. So I sent him to therapy, to one of the therapists that doesn't see a lot of them. And he he texted me and he said, Hey, I said uh ACL, and both the mom and the kid looked at me like, Whoa, are ACLs torn? I had like, no idea. So I was kind of like, you know, then I start doubting myself. I'm like, did we talk about the ACL?

SPEAKER_02 7:07

Also, like you you've had so many of those encounters in life, you know, like you so doubt yourself you're like, okay, patients just hear what they want to hear.

SPEAKER_01 7:15

Yeah, anyway, so but again, if you're a 15-year-old and I say ACL, MCL, L C L, which I did, and ALL, like you get lost in the alphabet soup of it, right? Yeah. So um I was like, okay, uh, you know, I'm just gonna call. And the the therapist who saw these, this patient, I don't know they did a great job. Yeah, collaborating with me. Yeah, I think they could supporting. Yeah, I I question it, let's put it that way. So I'm thinking to myself, all right, I'll I'm gonna call the mom. So I wait till the next day. I call the mom, but the dad picks up. Now the dad wasn't at the visit, right?

SPEAKER_02 7:48

Uh yeah.

SPEAKER_01 7:49

I have a very good conversation with the dad.

SPEAKER_02 7:51

Yeah.

SPEAKER_01 7:52

And um, you know, told him that yes, the ACL is 100%, it's a full thing, it's 100% torn. Yeah. But the problem is the MCL, but also this kid has such a terrible gait pattern. Like doing surgery on him now or even in the next month is gonna be, he's gonna struggle. Like this will be a year recovery for him, regardless. So I said, let's just see how he does. Let's see him back in two weeks. So again, it's 315 again. So I'm like waiting all day, waiting all day, waiting all day. So I see that uh patient comes back. Um, dad is with the patient. So I was like, of course, when the medical system is back, I'm like, who's in the room? Dad and patient. Great. Dad has the note printed out from last time about what you guys discussed, which by the way was all the things, and he's reading it and diagnosis, assessment, full thing. He's ACL. I don't like it either. And he says, I'm sorry, I don't see ACL on here anywhere.

SPEAKER_02 8:40

I'm like, but it's right, it's like it's like you're taking the paper and you're like circling it, highlighting.

SPEAKER_01 8:44

I'm like, did he print it before I close the note? Like, you know, then I'm asking all these weird questions. Then then I'm like, all right, I think I can do this with the dad and the kid, because the dad and I were on the same page, so I thought. So then by the time I get in there, medical assistant's like, hey, the mom just got here. I know. And I'm coming behind the curtain. Sweating. Yeah. I'm like, okay. And I thought about it for two weeks, like how I'm gonna have this conversation. And then now at this point, I'm 60% sure I mentioned the ACL. Yeah. Like now I'm even doubting myself. So I'm like, you know, water those like going down, yeah, yeah. You know, I'm like, you know, splash, splash, water and face in the mirror, like get shit together. So I go in the room and I decide, I like almost like temporarily black out because everything I wanted to do, I didn't do. Oh my god. So I come in with my computer, I was gonna show them the you know the images like we did the last time. You start stumbling over your word like no, I didn't. I didn't. And I walked in and I was like, I said, Hey, I was like, I'm glad we have everybody here. And I just go, I think we need to start over. Yeah. And then the mom and the dad were like, oh my God, thank you. Yes, let's go back to the beginning. And we did, we had a really, really good visit. But like, I kid you not, I feel like I like blacked out. I know I did a great job, but everything I prepared for for two weeks, out the window.

SPEAKER_02 9:56

Yeah. Out the window. But you started over. I started over and I felt great about it.

SPEAKER_01 10:01

They actually gave me a good review, but I was like, Amazing, the amount of time I spent not sleeping over that one.

SPEAKER_02 10:06

Yeah, yeah. You know, it keeps you up at night. You wake up at 2 a.m. and you're like replaying the conversation.

SPEAKER_01 10:12

I did. I kept his name kept like flowing through in my head all week. But anyway, um, so anyway, so that that happened. Uh, and those those happen infrequently, but that one's frequently, but frequently enough to make you lose sleep. No, I know, but like again, Hannah, as you are entering your 43 patients, that's what happens when you get up to high volume.

SPEAKER_02 10:30

It's gonna be like it is I know they're gonna be like, what did you just say? Anywho, but there's there's two ways, I think, from a little bit of a tangent that that can be handled on the therapist back side too, to help you out. There, the two ways are, oh, well, like, yes, Beth went over all of these things with you, but right now focused on this part because this drives how we're gonna deal with the rest of it. So that's like why we're focusing on this. And so that like makes them reassured and they're like, oh, it makes sense, like why that was more of the focus of the visit. Or, oh, they didn't tell you this. Well, like I'm telling you the thing.

SPEAKER_01 11:09

I think it was a little bit of that, but I think the therapist also went to, I don't know what I'm talking about. And when you do that, now you have a question of trust on the clinic side, and now with the therapist. So I was like, God, why did you make it worse? Yeah. So spoiler alert, we're gonna have a physical therapist on to talk about these issues in a couple weeks. Yes. Uh and this, that I think that interaction spawned me wanting to do that, but anyway, um at the end of the day, like it ended up being okay. Um, but he'll be a tough rehab. Yeah.

SPEAKER_02 11:37

So yeah. Those are the ones too that like you have to, if you don't save yourself, that's gonna become somebody who's like, I never want to see the only want to see the doctor. I only need to see the doctor because I had this like weird interaction interaction.

SPEAKER_01 11:50

And I will tell you, I looked to see if they requested their records. Yeah, because that happened. It made me feel when when the therapist talked to me, it made me feel like that. When I talked to the dad, I was like, oh my god, we're we're totally fine. I don't know, it just made me feel like that.

SPEAKER_02 12:05

And then you're like, did I lose somebody for us for the city?

SPEAKER_01 12:08

Yeah, but it also makes me think like that one I was very like in tune with yeah, like I don't know, did I, didn't I, whatever? All the other ones I think I did. Like, how many people leave? And they're like, what the hell was that? Yeah, I hope that's not the case.

SPEAKER_02 12:21

Who the hell made you overthink it?

SPEAKER_01 12:22

Made me overthink it. Now I'm stuck in this weird place. But anyway, shifting gears, hopefully a little bit to uh something more transition into what we're gonna talk about. We had a new PA at our practice start this week, and we just finished with the student last week or the week before that. So having experienced providers, having new providers, we have decided, much like with surgeons, there are different PA archetypes that exist. There are. We're gonna dissect it today.

SPEAKER_02 12:51

There are personality traits, and um, in going over this, I realize that I, you, all of us, we probably are a combination of all of these things, but we fit more into certain categories than others.

SPEAKER_01 13:04

Yes.

SPEAKER_02 13:05

It has been requested to not reveal our identities. We will not reveal our identities at the end, or you can decide for yourself.

SPEAKER_01 13:12

Well, but that's the thing, those who know us, those who don't know us. We apparently now are getting fan mail.

SPEAKER_02 13:16

So if you want to write in, write in and what do you think we are, and then what you are, or if we've missed the bill and you're something very different, and you are this arc type that we don't know about.

SPEAKER_01 13:28

Yeah, this new species we don't know about.

SPEAKER_02 13:32

Yes. Okay. Well, let's start with uh with number one, um, which I deemed the over-explainer.

SPEAKER_01 13:40

Yes.

SPEAKER_02 13:41

So this is somebody that takes a a long time with patients.

SPEAKER_01 13:44

Yeah, their patient encounters are they're over. They're running late usually.

SPEAKER_02 13:49

They're running late. They are taking like 30 to 45 minutes full time. Yeah.

SPEAKER_01 13:55

And on every visit, on a new one, on someone who just is here for a shot.

SPEAKER_02 13:59

Yeah. Yeah.

SPEAKER_01 14:00

This is the one also whose notes have risk benefits and alternatives, and then there's a paragraph of all the things that they probably didn't need to talk about in the depth that they did.

SPEAKER_02 14:10

And the differential is like so wide, you're like you just listed every possible pathology that could happen in the knee. Yeah. So it almost becomes destructive because you're not like specifically, yeah, you're not clear on anything. Um, you're trying to cover all of your bases, yeah, but that to me also exudes a little bit of lack of confidence.

SPEAKER_01 14:32

Yes. Now their patient reviews are glowing for uh they they explained everything well, um, they answered all my questions. Their reviews are also negative with I waited in the waiting room for an hour and a half.

SPEAKER_02 14:47

Yeah, yeah. Yeah, and I think like from a follow-up perspective, these people can kind of sometimes burn you a little bit because they got so much time on the front end with this other person and they expect it, and now they have that expectation, or they explain to them like the 20 possible things that could be going on and like held their hand during it. And when you tell them, like, actually, I don't think this is bro, this isn't broken, and they're like, But the other person, like, yeah, they they gave me this splint and I feel good in it, and it hurt me. They said I didn't have to go to work broken, and they took me out of work and they cared so much about me, and you just took my splint off and told me to move my fingers and go back to the room. You're evil. Yeah, I hate you.

SPEAKER_01 15:30

No, yeah, no. So uh I think the over explainer cares a lot about the patient, but also is a rule follower as far as education. Yeah. Like if the patient leaves and they're not educated, I didn't do my job. And I'm not saying there are certain circumstances where you need to not educate, it's just that that can be done more concisely.

SPEAKER_02 15:52

Yeah. And I mean, you have to base this on what type of clinic you're running and what type of schedule you have because you will be forever behind. Um, and I mean, you don't have to over-explain yourself. Explain yourself, but don't over-explain yourself.

SPEAKER_01 16:07

Do you think the over-explainer cares more about patient satisfaction or wants to hear himself talk or herself?

SPEAKER_02 16:14

I think it possibly could depend on the person, but I think they care more about patient satisfaction. I think they're like worried about not doing a good job.

SPEAKER_01 16:21

So is this also a little bit of a subtype of someone who's afraid to make a mistake?

SPEAKER_02 16:26

Yeah. Yeah. Yeah. They're afraid to make a mistake. They don't want the person to leave feeling unheard. Yeah. Well, like they don't have answers.

SPEAKER_01 16:37

So and I like this breakdown, the over-explainer, when stressed, their response is to explain more.

SPEAKER_02 16:45

Yeah, yeah. Do you ever find yourself doing this though? Because I like I'm not an over-explainer typically, but if somebody, you ever have that like patient interaction where they're kind of pushing you a little bit, where maybe it feels like they're questioning your knowledge base and you get into overexplaining mode.

SPEAKER_00 17:01

Yeah, I well, no, I will do that to show them.

SPEAKER_01 17:04

Like again, if you have the pay, the patient who's looking at you, I did a pre-op the other day, and this woman was constantly looking at my badge, like to make sure I was credentialed the way that I should have been. And then I started changing what I was saying to literally show her. Yeah. You know what I mean? No words. Yeah, but I didn't do it in more words. I did it in words that she maybe thought were impressive.

SPEAKER_02 17:26

People like my drawings. That tends to be a hit. I I do like to draw on. Yeah. Um, yeah, I do a lot of drawings, they've gotten better over the years. Yeah. I feel like sometimes my medical assistants will see it. They're like, what is this? Yeah.

SPEAKER_01 17:41

So the over-explainer, when you do their review, by the way, that also takes a long time. Because they need to explain with negative criticism why they did what they did. Which again, there's not always a window that I need you to talk.

SPEAKER_02 17:54

Yeah. So like Do they want also the negative criticism? Like you tell them the positive things and they're like, please tell me what I'm doing wrong. Like you need to know.

SPEAKER_01 18:02

Yeah, but they also don't have a problem. They don't refute the negative things, they just need you to know why they chose to do that. Yeah. But are very receptive to please tell me, please make me better.

SPEAKER_02 18:14

Criticism, open to constructive criticism, all the things. And usually this person is very pleasant to be around. Very pleasant to be around.

SPEAKER_01 18:20

Yeah. Everybody likes the overexplainer. Like, like um especially patients. Staff. Yeah. Staff patients.

SPEAKER_02 18:25

Now, other than when they're running an hour behind and the staff is like, okay.

SPEAKER_01 18:29

Yeah, no, that the front desk likes them the least because they're they have to tell the patients why the weight is still happening. Yeah, yeah. All right. But would we employ the overexplainer? Yeah. I mean, yes. You need one.

SPEAKER_02 18:41

But but possibly in a role that maybe being um an hour and a half behind isn't going to be detrimental. Yeah. Lesser volume. Yeah. Yeah.

unknown 18:50

Okay.

SPEAKER_02 18:51

Um, they might work really well in a primary care setting.

SPEAKER_01 18:53

They would work well in a primary care setting. Yeah. Yeah.

SPEAKER_02 18:56

With a low patient volume. That is true. Yes. Yes. Uh, number two. Who's number two?

SPEAKER_01 19:03

Number two is the apex predator PA.

SPEAKER_02 19:06

It sounds terrifying.

SPEAKER_01 19:07

It's terrifying. Yeah. Um, so this is the PA that thrives with autonomy, chaotic situations, and difficult cases. High stress. Yeah. Right.

SPEAKER_02 19:19

Very efficient. They're thinking ahead. Yeah. And about what happened last week at the same time. It's just all happening. It's all simultaneously, and they've got it under control. So like teetering on like a little when you have like those plates stacked on the little stick. Yes. And they're like falling off.

SPEAKER_01 19:39

Yeah. They're they're falling off. But they're not falling. They're not. And there's food on them. Yeah. Yeah. Um catchphrases. It's fine. Already handled it. It's already been done. Yeah.

SPEAKER_02 19:50

Yeah.

SPEAKER_01 19:50

Um, I don't need your help.

SPEAKER_02 19:52

Yeah. Nope. Don't worry about it. Don't worry about it. Yeah. Um, unintentionally intimidating when people meet this person, they might be like, I'm a little scared. Yeah, yeah. But again, that's that's more the person, not the PA. It's not, yeah. It is because they haven't met the person, they don't know the person yet, but they are just so taken back by the Apex Predator demeanor.

SPEAKER_01 20:18

Um But this one also like, again, you have the schedule for the day. Although things are chaotic, somehow they've got everything lined up. They know what's going on, they know what happened last time, they know what the next step is.

SPEAKER_02 20:32

Um people are a little bit afraid of this one. And by people, I mean not only their colleagues, but possibly surgeons, physicians alike. Possibly nervously to disappoint said people. Um because yeah, it's unintentional intimidation. I mean, it's just a lack of wanting to disappoint somebody at that high level. Like you don't want to see them juggling their plates and drop your own fucking plate and like see their eyes glaring at you.

SPEAKER_01 21:05

Yeah, because they're somehow disappointed in you.

SPEAKER_02 21:07

Yes, yeah, yeah. Um, so you know, the this person is very necessary to the everyday processes. They're handling things that maybe three or four people should be handling, but in one person.

SPEAKER_01 21:22

That is true. Um probably probably fit for a leadership role.

SPEAKER_02 21:26

Fit for a leadership role. They're also not wanting you don't want to disappoint them because you can't you can't afford to lose this person. Can't afford to lose that person. That person is pivotal in every way.

SPEAKER_01 21:38

Now, is the ape and we're just spitballing here. Spitballing. Is the apex predator human?

SPEAKER_02 21:44

Or are they are they a robot? They are a subtype of both, meshed into one. Um I I don't want to say I don't think robotic. Robotic makes it sound like cold. Yeah, cold and like everything is just black and white. That's not

SPEAKER_01 22:00

Do patients like the apex predator?

SPEAKER_02 22:02

Patients do like the apex predator.

SPEAKER_01 22:03

Do patients recognize they are the apex predator, or does it only exist in the work setting?

SPEAKER_02 22:08

I think that that patients do recognize the apex predator. And I think that patients like the apex predator because they feel protected by it. Like the apex predator is, I don't know, like the lion, and the patients are the cubs and they're like doing all the things to like circle them and protect and like they trust the lion. They trust the lion to, you know, devour everybody else. Devour everybody, provide sufficient care. The uh the other lions in the um, what is it, a pack, a pride of lions. The rest of the pride is like depending on this lion to uh to make sure that things go the way they need to go.

SPEAKER_01 22:46

So the stress response, right? So when the apex predator is under stress or you know something's not right, they respond by doing more. Doing more, doing more, becoming more efficient.

SPEAKER_02 22:58

Something else on at another project. Um so we know that this person is very efficient, that they are very reliable and they're always three steps ahead of everybody else. What might be the weaknesses of somebody like this? Um, a little intimidating and possibly forgetting and not being able to accept that others aren't operating at the same speed. That is true. That is true. I don't I don't personally find that a negative though. I think that those people should be operating in the same speed.

SPEAKER_01 23:30

I think sometimes some people should have higher standards for themselves. Yeah.

SPEAKER_02 23:34

And the apex predator is just manifesting that trying to get you to meet those standards, realize you're helping them try to realize their potential.

SPEAKER_01 23:40

Can the apex predator take criticism?

SPEAKER_02 23:43

Yes.

SPEAKER_01 23:44

Yeah. Yeah. Will the apex predator take criticism from those inferior to them?

SPEAKER_02 23:52

I think so. I think so too. Because I think the apex predator like wants to be great, and if there's something that somebody else has noticed, regardless of their level above or like they're they want to fix that.

SPEAKER_01 24:04

That's true.

SPEAKER_02 24:05

So I don't know. Apex predator pivotal role. Pivotal role. Does exist. It does exist. They're the unicorn in a way. I don't know. Do do any other places have an apex predator? I'd love to know. Yeah, I'd love to know who the other apex predators are.

SPEAKER_01 24:22

Can there be two or more apex predators?

SPEAKER_02 24:26

Will they fight each other like two beta male beta fish in a tank? Yeah, that's kind of what I'm thinking. Yeah, I'm thinking that too. They'd have to be separated by a wall of glass.

SPEAKER_01 24:36

Or an ocean.

SPEAKER_02 24:37

Or an ocean. Um I mean, so potentially. Yeah, theoretically. They could theoretically, but they had there has to be a level of separation. I think two apex predators can have their own territory of predation. Is that a word? Yeah, it is. No, yeah. So they're hunting in their own territory. It's like the Lion King, right? Yeah. So like Mufasa had his territory and then Scar, he was in charge of the Darkland. So as long as like one is Scarlet's Mufasa.

SPEAKER_01 25:06

Scar like literally killed Mufasa. So I do not know if it's gonna be survival of the fittest. That's true. I'm here for it.

SPEAKER_02 25:12

But if Scar he was dealt a really tough hand in life, so that's true. Um okay, yes. So in number three, we have the golden retriever. Who doesn't love a golden retriever? Yeah, golden retrievers, they are the best. They're the best, they're adorable. Um, and just they're always in the family pictures, they're always there, they're just there. Yeah, they are constantly there. When you get home from work, they're in your face, like trying to make you happy. You uh you feel good around the golden retriever.

SPEAKER_01 25:48

Yes, the golden retriever PA wants the forever relationship with the surgeon. Yeah. They want to right off into the sunset because they have this thriving team environment. Yeah. Um, and nothing is more rewarding than that. Yeah. They want to they want to know that they have a bowl of water at the end of the day. It's always there.

SPEAKER_02 26:08

So when I was reading this, I was like, I don't know, like, does this sound like a bad or a good thing? The golden retriever just like they thrive on like what be like a pat on the head at the end of the day?

SPEAKER_01 26:19

No, well, I will break that down. They thrive on positive reinforcements. Yes, yes, they do. And if there is negative reinforcement, they will move mountains to fix that with their tail tucked between their legs. Their tail tucked between their legs. Yes, yes.

SPEAKER_02 26:34

So thriving on the teamwork, morale boosting, the surgeon partnership. They want to be loved by everybody.

SPEAKER_01 26:42

But they are loved by everybody. They're not like they don't try too hard. They just because they do so much and they are always recognized for what they do, they are loved by patients and staff. Right? Yes, that is so um weaknesses of the golden retriever.

SPEAKER_02 27:00

The golden retriever has no boundaries because they live to please everybody. That's true. Like dogs don't, you know, live for themselves. No, they want they want to satisfy everybody else's needs. That's true. So no boundaries overextends.

SPEAKER_01 27:15

No boundaries. They overextend, they say yes to everything. They are always there. Um, you know, and you're not gonna know about it because they just do it because that is what is expected or I don't say asked of them. That's what expect is expected of them to have a successful day.

SPEAKER_02 27:30

Yeah, and it's not even like they just they want to, they want things to be ex successful so that they continue to get that positive reinforcement, that treat at the end of the day. A little treat.

SPEAKER_01 27:42

But they're also the ones, and it's almost like what the St. Bernard's or whatever that are the sled dogs, that they're just like carrying the sled, and they're like, it's fine, and then they and then they like die of a heart attack.

SPEAKER_02 27:54

They're carrying it for so long, carrying the load, and just you know, they're still happy and they're wagging their tail and panting, and there's no indication, then just all of a sudden they just pass out. They just pass out.

SPEAKER_01 28:06

Oh my god. But their their again weaknesses is um no boundary, so a lot a little bit of self-sacrifice. Um, but they can handle it because the balance is that jobs get done and the team says thank you, and patients are happy. Um, but their stress response.

SPEAKER_02 28:25

Wait, are you mad at me? Are you mad at me? Are you mad at me?

SPEAKER_01 28:29

Um, and then the catchphrase, you will, you know, they will respond to stress and what they will say is just add it on. Just add it on. Yeah, just on. I'll just open a weekend clinic.

unknown 28:38

Yeah, why not?

SPEAKER_01 28:39

Just give it to me.

SPEAKER_02 28:42

I love it. I love the golden retriever.

SPEAKER_01 28:43

No, I think the golden retriever PA is super helpful. That's a great part of a team, specifically when you have a surgeon who is very task oriented, or the surgeon who can kind of fire and say, We need this done, then you know that it's gonna get done. Yeah. Okay.

SPEAKER_02 28:59

Yeah, you have your golden retriever there.

SPEAKER_01 29:01

You have your golden retriever there. They're gonna fetch the ball. Yeah, they'll bring it back.

SPEAKER_02 29:04

And they're happy about it.

SPEAKER_01 29:05

They are happy until they keel over and die, until they have a heart attack. Or they're a purebred, so they die of cancer. But oh my god.

SPEAKER_02 29:14

Um okay, moving on, the boundary queen slash king. Yeah, because this is it could be either or this is a not gender discriminatory.

SPEAKER_01 29:24

This is not gender discriminatory, but it is generationally common. I think we see a lot of our new grads that are the boundary king and queens. And again, uh, I don't necessarily think this is a bad thing. And I think some people have more of this than others, but whenever there is a situation, I feel like this is the predominant thing. Like, like, hey, can you, you know, we recently uh released like a self-scheduling. Hey, can you self-schedule? Um if the email was sent saying, hey, I released this self-schedule on a day they weren't working, they won't respond with, thank you, you know, um, thank you. I will, you know, I will do this on Monday. They will say, I just want to let you know I received this email on my day off. Yeah.

SPEAKER_02 30:10

Or just no response and the the automated like, I'm out of the office. Yeah.

SPEAKER_01 30:15

Yeah. So they thrive on work-life balance, not work, still health recognition. They're the ones that are in the health and wellness um committees at work.

SPEAKER_02 30:28

Yeah, they they have plans after work and they can't be missed if their patients 15 minutes, 16 minutes, I should say. If they're 16 minutes late, they're like, well, I'm already out the door because I've got uh dinner with my family after my reformer Pilates class.

SPEAKER_01 30:44

And if the patient is walking in and they are infected and have a fever, it doesn't matter because they're not working anymore. Pilates class. They're Pilates because Pilates class.

SPEAKER_02 30:54

Weekends, like, oh, we had to add on an emergent case over the weekend. I don't work on weekends like somebody else that's not right.

SPEAKER_01 31:03

Like but there's not even any communication, it's just a year in their head where if there is stuff added on the weekends, they just say, huh, I wonder who's going to do that. Moving on, right?

SPEAKER_02 31:13

Yeah, yeah. And they don't they don't stress about it.

SPEAKER_01 31:14

No, they do not stress about it. They probably have perfect skin. They have perfect skin.

SPEAKER_02 31:18

Like, I don't know, like, what is this? I think I'm developing psoriasis. That that is a form of psoriasis. I just noticed it yesterday. I was like, why is the side of my face really scaly? But no, I think I'm developing psoriasis.

SPEAKER_01 31:34

No, I think what you're developing, I think you're developing a tick. Like when you're stressed, you just literally rub the skin off the side of your face.

SPEAKER_02 31:42

Well, I tell you, what would make me stressed is having boundaries to the point that I was questioning who else was helping wash out an infection of my own patient over the weekend. I can't handle that. Yeah.

SPEAKER_01 31:55

So um yeah, their weaknesses besides not necessarily being seen as a team player, is that their coworkers, their managers just for uh see them as less dedicated.

SPEAKER_02 32:10

Yeah, yeah.

SPEAKER_01 32:11

Like you're not here for you're not investing.

SPEAKER_02 32:13

But they don't care though. They don't worry about it. Like they're that's off their radar. They don't think that anybody thinks that about them. Yeah. Because the people who are thinking that about them are hyperfixated on work and they're not, so it's just not even registering. But did you see? Do you watch the pit?

SPEAKER_01 32:27

No. Oh, okay. There was this episode. You should. There was this episode where there's this um, you know, intern and the shift is over, but they lost power during the shift, so everybody has to go back and take their paper charts and upload them. And she literally looks at the clock and is like, My shift is over. Like I'm done. I'm I'm gonna go now. And everyone's like, but these aren't gonna upload themselves. And she's like, That's that's not my problem. And was very happy to walk out. Yeah. That's just how they it's just like how they live. Yeah. Whereas the other ones were there till Lord knows when, you know, doing all the documentation.

SPEAKER_02 32:58

But um what do you think it's like working with this person from like an MA perspective and their surgeon's perspective?

SPEAKER_01 33:06

Um, from a surgeon's perspective, I think the surgeon has to do way more.

SPEAKER_02 33:12

Yeah.

SPEAKER_01 33:12

I had a medical assistant that was a boundary king, and I would send him stuff at like 450, and he would say, Thank you very much. I will take care of this first thing tomorrow. And I'm like, Oh my god, like if I wanted you to do it tomorrow, I would have sent it to you tomorrow.

SPEAKER_02 33:28

Yeah, like it was urged urgent enough that it urged it. Urgent enough that I sent it today. Yeah.

SPEAKER_01 33:33

So um, I think they're relatively black and white. I think for you know, those working around them, there's no question what they're doing or not doing. Yeah, you just everybody's not doing anything. They're not doing anything. Yeah. I I assume um from a surgeon's perspective, I would find that very hard to work with.

SPEAKER_02 33:52

I think it depends on the surgeon too, and what their expectation, like if the surgeon is very um, you know, wants to take care of everything themselves anyway, this person's probably fine. They're just a body and an extra set of hands. And if that's all they need and want and expect, yeah, then this person fulfills that role. From an MA's perspective, I almost think this person might be um like a lot more well-liked because if they have that life balance, the MAs and everybody are gonna also feel that balance and not be bothered after hours.

SPEAKER_01 34:22

But I guess yes and no. Like if the if the boundary king or queen is not doing their things, then it falls on the next person. So again, I think the MA secretly hates them. Yeah. Unless you have an MA who is like way overdriven and is like, yes, somebody else has to, yeah. Yeah. Someone has to pick up their slack. Yeah, there has to be a balance of who wants to be that person. Yeah. But their stress response when they they're hit their limit, which I don't know how, um, is they take a vacation.

SPEAKER_02 34:51

Yeah. Yeah. They're like, huh, I feel like I'm burning out. Should I take a long weekend? Mental health day, yeah. And not take my phone with me.

SPEAKER_01 34:59

So the boundary king and queen will call out. Oh, yeah. They will call out. Yeah. Apex predator, no. Golden Retriever Predator never.

SPEAKER_02 35:07

The apex predator would never call out, even if they were pill vomiting.

SPEAKER_01 35:12

It's true. And the golden retriever, if they lost their voice, they are still speaking the same amount throughout the day. Everybody's just gonna hear the scratchiness.

SPEAKER_00 35:22

Stop talking.

SPEAKER_01 35:23

No, but um, the boundary king or queen, their catchphrase is um my PTO was a notification. Like I have already booked the trip.

SPEAKER_02 35:31

I'm gone.

SPEAKER_01 35:32

Yeah, I'm not, yeah. I I'm not waiting for your approval. I've I'm doing it regardless of what you say.

SPEAKER_02 35:38

I judge this person too. I judge this person too, but like, is it because I'm a little jealous of them? I don't know. Oh no, no. Like, do I wish I had maybe 10% of their balance? Yeah, I don't know.

SPEAKER_01 35:52

I'm gonna change this. The catchphrase for the boundary king or queen is I don't feel comfortable with that. That is that is and I've heard that way too often. Way too often. So I don't know. I don't think the boundary king or queen, if they're so inflexible, they're not gonna last in orthopedics. Yeah, just not gonna last in orthopedics.

SPEAKER_02 36:10

You know, there is there's something else out there for you that's much better suited. That is true. Yeah, maybe you should do aesthetics and injectables. Yeah, not a bad idea. After plans. All right, now we have the procedure goblin. Yeah, and when I was asking Chad GBT to help create these archetypes, uh, he was making the procedure goblin out to be like an only positive thing. Like, ooh, this person's very technically proficient, does all the things, and and those types of procedure goblins do exist out there. Um we all strive to be that type of procedure goblin. I feel that sometimes I try to be that type of procedure goblin, but I'm talking about the negative aspects of it too.

SPEAKER_01 36:54

Well, okay, to be fair, we have both encountered this person when they are looking for procedures that don't necessarily need to be procedures. Right. There's also the flip side where we used to have a mid-level provider that was in the OR all the time. Yeah. They were just great with their hands, assist, that kind of procedure. I know. And so that person, when you recognize that you are very good with your hands and procedures and you can use that power for good, that's a great ORPA.

SPEAKER_02 37:26

Yeah.

SPEAKER_01 37:26

Like that's someone who you, you know, you get on medley or whatever, and you just pick up shifts in the OR. Yeah. Super happy. Yeah. Yeah. The procedure goblin is someone who, and again, I picture like I picture Smeagol from like Lord of the Reach. Yeah. Yeah. I picture like a quasimodo with like forceps in their hand, right? They are looking someone down. Exactly. So they're looking for, you know, a minimally displaced fracture they must reduce, right?

SPEAKER_02 37:51

I mean, like on the post-reduction films, and you're like, did something change? I don't think so. Yeah, no.

SPEAKER_01 37:57

Um, someone who's got to put a splint on everything, someone who's looking to inject everything, you know, must aspirate every knee before we inject.

SPEAKER_02 38:07

So there's something in there I must probe out.

SPEAKER_01 38:10

So again, thrives on injections, laceration repair, suturing procedures, but I think unfortunately doesn't see all the other things, right? Um they're enthusiastic and again, fearless. They're never the one that's going to tell you I don't feel comfortable with that. Never, never, never, never, never. Um and uh their weakness is that their confidence and their enthusiasm for wanting to do things uh overpowers judgment.

SPEAKER_02 38:39

Yes, yeah. It doesn't quite match maybe the the proficiency that they um feel versus what actually exists. There's a mismatch.

SPEAKER_01 38:47

Yes, and their their decision making is clouded by their desire to get their hands dirty. Yeah. You know. Um so that that that we don't love. You need a little bit of that, you know, technical person that you know if someone comes in for something, you know it can be handled because you know this person's gonna do it, but it's also the person when they have 20 people in the waiting room and there comes in a risk reduction, they're not walking down the hall to get Hannah to help.

SPEAKER_02 39:14

Yeah.

SPEAKER_01 39:14

Well, they should.

SPEAKER_02 39:15

Yeah, yeah. Yeah, like there's yeah, you need to triage yourself appropriately too and not let yourself go behind. Yeah. I caught myself in this situation this week, actually. I was covering urgent care in one of our facilities, and I had a very light schedule myself, so I had nothing else ready to do. And somebody checked in who had a foreign body in their leg somewhere from a fish fin. And I was like, uh, they asked like the other doc who was there or whatever, and they were like, oh. And I was like, I'll do it. I'll do it. I got my ultrasound because the other dog was like, Oh, well, you'll have to like look for it with ultrasound, see if it's superficial enough, blah, blah, blah, blah, blah. So he was telling the check-in person, like, I don't know. And I was like, I got my ultrasound in my backpack, like, I'm gonna do it. Like, I actually was ready for this all day today. So I got everything set up, like, numb them up. I see it on ultrasound, like it's pretty superficial. I can feel it. Um, and it's like very adherent to everything around. Yeah, I was probing for like far too long, enough so that I was like, I know other people are ready now. Like I've put myself in this place and I'm not backing out now. Yeah, but then my staff started coming in. Oh, yeah. So you know that's your people were sent in to come get me, and it was like like almost like a little like slap. I was like, oh yeah. I've hit that point where people are like, Are you okay? Do you need any help? I'm like, get out. No, I don't need help. Thank you. Yeah, um, it yeah, I did find it. It came out. So all was well in the end, and then I was a little bit behind. Yeah, but whatever.

SPEAKER_01 40:51

But again, an experienced provider who is going to take on a an unplanned procedure, right? Um that's someone who can manage their time and know their own limits. Let's put it that way. Right. If you were someone who didn't have an ultrasound, who just, you know, numbed it up, made an incision and just fished around and doesn't know anything about anatomy. Like we we've we've worked with some of those, you know. Um, and that's that's always a difficult conversation. Um, because, you know, hey, I think you do a great job, and I love that you're willing to take on new things, but everybody else waited three hours. Yeah, everybody else waited three hours. Um, but anyway, so that's the procedure goblin for better or for worse.

SPEAKER_02 41:28

For better or for worse. And then next up we have the easily overstimulated PA. I don't know if this is the right title for it, but there's the the archetype explains itself. Um they they can't have the chaos.

SPEAKER_01 41:42

So I think we've talked about this before. Like some people just don't have the limit that other people have. I think some people's threshold is a little bit lower than others. This is that person.

SPEAKER_02 41:54

Yeah, some people need to sit during clinic.

SPEAKER_01 41:56

Oh my god, don't even get me. So why does that bother me so much? I when I see someone sitting during clinic, it disgusts me. Like, I don't even know how else to say it.

SPEAKER_02 42:08

Like, I don't even know how else to say it. Like you're the clinic you work in, there's no sitting to be had.

SPEAKER_01 42:13

No. And if I'm sitting, actually, well, I did one, like I was doing like a webinar thing. I was doing somebody's review and I was on a meeting one time during lunch, and I was sitting and someone was like, Are are you? And you like you got up and you were like, uh, no. No, I like but I remember being like, I think I'm gonna sit down. It felt so weird too. Yeah. No, but the overstimulated. It is a sign of weakness when you don't sit. So the overstimulated PA can only handle a certain amount of volume, needs things to be predictable. Yeah. Um one patient at a time, you add on one patient or ask them one thing that's like out of while in the middle of something else, and it's a complete breakdown after that. So um anal, what is it? Paralysis by analysis, right? If they see something they don't understand and they have to look it up, if that throws them off, now it like exponentially ruins their day. Like the next thing becomes harder, and then the next thing becomes harder because there was a challenging thing that was thrown in there that they weren't expecting. Yeah, the overstimulated PA cries a lot. Yeah. Break down. They break down. Um, they sometimes lock themselves in a room.

SPEAKER_02 43:19

Yeah.

SPEAKER_01 43:20

Um they might leave and never come back. Yeah, yeah. Um their catchphrase is I'm trying. And it's and it sounds like that. Trying my best. Shaky voice. Shaky voice, yeah. So um I always feel like this provider needs mentoring. Like I want to just like help them.

SPEAKER_00 43:40

They're there, you know, wrap them up a little bit.

SPEAKER_01 43:42

Yeah, like wrap them up a little bit, try to make things like safe for them. But at the same time, you know, a little hard love.

SPEAKER_02 43:49

Like you gotta you can't be safe all the time. You gotta be like put out into the elements. Yeah, this sound for yourself.

SPEAKER_01 43:56

This provider, like if a patient comes in and they yell at them, oh my god. Yeah, they cannot get a bad review because if they do, like they'll quit, right? Um, they are compassionate, they're empathetic, right? So if someone comes in crying, they know how to handle that, but they don't deal with aggressiveness, they don't like confrontation, um, they don't like not being heard.

SPEAKER_02 44:18

Yeah.

SPEAKER_01 44:18

Um, but also a little bit like on the border of like collapse every time you see them. Yeah.

SPEAKER_02 44:24

You know, yeah, you're worried you feel like you need to protect everything around them and their environment to keep them exhausting for those around them.

SPEAKER_01 44:31

Yeah. My catchphrase for them is are you okay? Are you okay? And they're not. They're not okay. Yeah. Um, they will say sorry. Yeah. Yeah. So I have a provider right now that says, Hey, um, can I ask you something? I'm sorry. Yeah. Or hey, I'm calling, I'm sorry.

SPEAKER_02 44:44

I'm sorry that I am bothering you.

SPEAKER_01 44:45

I cannot, like, cannot not say sorry. Um, that they say that way too much. Um Yeah. Yeah. Yeah. They they worry about them. I worry about them, but they do look like when they're stressed, they literally age. Like they look disheveled. You know what I mean? Like they wear it. Yeah. They wear their stress on their face.

SPEAKER_02 45:05

In the form of psoriasis.

SPEAKER_01 45:08

In the form of dry patches.

SPEAKER_02 45:09

Yeah. Um, and then this last one we have like a a double-edged sword to it. It's a dichotomy. You can be either or on one end of the spectrum. So we have the the PA that thinks they're basically a doctor, and the PA that's not much more than an assistant. Yeah. And and our goal is to live somewhere always in the middle and practice at the highest potential of our uh our whatever you call it. But um, you don't want to be too much on the on the end either.

SPEAKER_01 45:42

So the the doctor PA thinks they're a doctor. They won't tell you that, but they will also never correct a patient when they call them doctor.

SPEAKER_00 45:50

You know what I mean?

SPEAKER_01 45:51

Yeah. Um they uh they they like I don't say they're arrogant and they are though, right? Like a little arrogant.

SPEAKER_02 46:00

Um they got a little complex about it.

SPEAKER_01 46:02

They do. They're decisive, they want to be productive, they want everyone to recognize in when they walk in the room, they generally have an ego.

SPEAKER_02 46:09

Um they want to be treated like the provider.

SPEAKER_01 46:13

But they will do things too that will undermine others because they want to rise to the top, but not in the way of like they'll climb over you to get there. They will, they will shove you under to get there, trampled, step on you to get there, right? So they're the ones that want to be recognized, but they don't do it in the right way. They just they want the power of that title. Yeah. So I've worked with those to rise to the top. Yeah, I've worked with those, and it they do not rise based on merit. They they are the ones that want to schmooze with the doc. They're the ones that call the doc by the first name. Mm-hmm. Mm-hmm. They do.

SPEAKER_02 46:48

Yeah. Calling a doctor by their first name, I'm not saying you can't. I'm not saying you can't because like, yes, you know, maybe like outside of the site, but I still don't do that. Like, do you do that?

SPEAKER_01 47:02

I do not do that. And I don't do it, I don't do it in front of other people in a professional setting. Correct.

SPEAKER_02 47:08

Like, perhaps if you were in a non-professional setting and I don't know, you have that type of relationship, great, but like I I wouldn't do it in a work setting. Yeah, for sure.

SPEAKER_01 47:21

Yeah. So weakness is if you point it out, they become more arrogant, more defensive, and I think they are terrible teamwork. Yeah, they're terrible teammates. Yeah. Terrible teammates. No. So I think um they're also the ones that come in with zero experience and demand a salary because they did their research and have nothing to back it up.

SPEAKER_02 47:43

Like, I need an MA immediately. I need a salary. And like I would like my coffee brought to me.

SPEAKER_01 47:50

They never get coffee for anybody else. Never. They also don't pack lunch, like they eat out all the time.

SPEAKER_02 47:56

Yeah, they do eat out all the time, and but they also expect that like it will be provided for them, maybe. Yeah.

SPEAKER_01 48:02

Definitely.

SPEAKER_02 48:02

Where it's in my lounge access.

SPEAKER_01 48:04

Yeah, they're never helping move the patient in the OR. Yeah. They're never in the room getting getting ready with the OR staff because they're above that. I mean, they don't need that.

SPEAKER_02 48:12

Yeah, no, they they just come in when the doc comes in because that's that is their role.

SPEAKER_01 48:15

Their notes are always open. Yeah. Because they don't have time, you know, they have time to spend. Somebody'll do it for me. Somebody'll do it for me.

SPEAKER_02 48:20

Yeah. That's not that's not part of my job, is it? Like closing the notes. Crazy.

SPEAKER_01 48:25

Yeah. No, these are emotionally exhausting people to work with in a different way than than the overstimulated PA.

SPEAKER_02 48:32

Do you think the doc likes working with these people?

SPEAKER_01 48:34

I think some docs like working with these people because it it these people are mirrors for the docs.

SPEAKER_02 48:42

Yeah. Like they can be their buddy.

SPEAKER_01 48:44

Yeah. Yeah. Yeah. They're they're their hype man. So in an orthopedic world, you will have certain personalities that thrive off of that personality. And again, not because they're great clinically, but because they continue to positively reinforce the doc. Like oh they brow out. Yeah. Yeah. Yeah. But at the end of the day, when you look at their numbers, like mediocre. Yeah.

SPEAKER_02 49:07

You know, like you guys are not, you're not thriving as much as you think you are. Yeah.

SPEAKER_01 49:12

They will interrupt in a presentation and say, well, actually.

SPEAKER_02 49:15

Yeah. Yeah.

SPEAKER_01 49:17

Yeah. Yeah. We don't love, we don't love them. But they exist.

SPEAKER_02 49:20

They they definitely exist out there. And then by uh the dichotomy to that is the one who doesn't operate anywhere near the top of their uh their standards.

SPEAKER_01 49:31

The other one is the one that went to PA school because they thought they should, yeah. And sounded fun. Sounded fun and they have always done the bare minimum. Yeah. They never make a decision for themselves. Any they're very good following algorithmic protocols, but as soon as something is outside of something's complicated, yeah, they they toss it off to the doc. Yeah, they're not. So they don't take on extra tasks. They're never the ones that are going to be um, you know, how can I help you with this? Let me see what else I can do. They're not looking to grow in their career. Um, just very happy coasting.

SPEAKER_02 50:09

Yeah. They're like, I'm just happy to see every, you know, two-week post-op patient. Yes. Nothing, nothing new or complex. I don't want to like have to be the one to figure out new things. Um, maybe they're the person that wants to run a like simultaneous clinic where they're seeing patients together and they're basically scribing for their doctor.

SPEAKER_01 50:29

Well, yeah, they are presenting to their doctor, the doctor tells them what to do, and then they just do it.

SPEAKER_02 50:33

They just do it.

SPEAKER_01 50:34

This is the one where the anesthesiologist says, Hey, you ordered ANSAF, they're allergic to penicillin. Do you want to do clindamycin? And they're like, I don't know. Let me go check with the doc.

SPEAKER_02 50:43

Let me ask the doc. And then they go ask them, and then they report back, and you're like, Are you basically like the middleman? Yeah. Yeah. Yeah. The little pigeon carrier pigeon. Yeah. And again, parent sitting on their shoulder.

SPEAKER_01 50:55

Some situations, some roles. I mean, this is what you need. If you have a surgeon that is super type A, super controlling, doesn't let you do anything anyway. I've worked with that before. Yeah, you're not going to be happy in that role. But if you were the MAPA, very happy in that role. Yes. Yeah.

SPEAKER_02 51:12

And sometimes you have to break yourself out of that. Cause I think that can be where a lot of people start out, maybe especially with docs who have never had APA before. Um, and they don't know like what to do with this person. So their expectation level isn't much. It's like, oh, you're just going to do the things I tell you to do, right? And like be there and assist me in the ways that I verbally tell you I need to be assisted and not, you know, think ahead or think for yourself. So if you are stuck in that and needing to break free of it, I mean, your goal is to one, push yourself and two, kind of push them away, so to speak. Like you learn the things that they want to do and the way they like to do it, and then you just you do it on your own and you stop asking. Yeah. Maybe they're very textbook savvy. Yeah. And that's part of what is their detriment too, because it's all got to be black and white. Yes. And, you know, this person has numbness and tingling, but it is in their whole hand and not just the first three fingers and half of the fourth, and therefore it can't possibly still just be carpal tunnel syndrome. Yeah.

SPEAKER_01 52:17

Because they'll miss things because they're so they're just so black and white. Again, they're so algorithmic. If something comes in a little bit uh, you know, askew, they just can't, they can't adapt. Yeah. Um, this is also the person where you ask them, hey, I'm gonna go see a patient. Can you do an injection? And they would rather do the administrative phone calls and calling the patients. Yeah, they just don't look too much.

SPEAKER_02 52:39

Do you think they're just like not comfortable with those things too? Going back to ooh, that doesn't make you comfortable.

SPEAKER_01 52:43

I don't think they'd ever say it doesn't make you comfortable, but I think they're like, Well, I've never done it, therefore I can't. And there's no, yeah, there's no like. Why don't you teach me? Yeah. Um, yeah, those are interesting. Yeah. But I've seen both the doctor PA and then the M A P A. And again, in orthopedics, I think you'll see more of the former, less of the latter. Yeah. But I what we we've seen both.

SPEAKER_02 53:04

We have seen both. We've seen both. And we strive to be somewhere in the middle of that.

SPEAKER_01 53:08

We do. Um, dare I ask you what you think you are, or we'll just leave that, we'll just leave that out there.

SPEAKER_02 53:14

I think, I think we can. I think um, well, uh, you know what? I'll reveal yours. Beth is the apex predator.

SPEAKER_01 53:21

I am you guys. Yeah, I am. Yeah. I don't know how else to.

SPEAKER_02 53:25

I mean, we were all a little bit scared of Beth when we first met her. Not in like a I'm scared of her. She sounds and looks like a mean person way, but like you don't want to disappoint Beth a little bit. Yeah, yeah.

SPEAKER_01 53:36

Like no, I think um, yeah, I don't think I was always I don't think I've always been that way necessarily, but um, I I am.

SPEAKER_02 53:44

Yeah, the Apex Predator isn't born the Apex Predator, they they rise to the occasion, they see the need and they fill the role. Yeah. Um, 100% that is Beth.

SPEAKER_01 53:55

Yeah. Hannah, on the other hand, Hannah is not to a T, but mostly Golden Retriever. Mostly the Golden Retriever. Mostly Golden Retriever, yeah. Yeah. And again, uh not in a bad way, but in a very, very good way. You do have, you do have some flavors of Apex Predator. You do.

SPEAKER_02 54:16

I have some flavors of, I think we all have a little bit of some flavors of everything, you know? Yeah. Um, I I can get emotionally overstimulated at times. I can I can have my fair share of breakdowns in times where like my morale doesn't match what a golden retriever's energy should. But um, but yeah, I'd say 80%.

SPEAKER_01 54:37

Yeah. I've gotten myself, maybe I've gotten myself stuck in the again, like you said, with the foreign body and those procedures. It's like, oh, this is easy. This should no problem. And again, nine times out of 10, it is no problem. It is easy, but I've gotten myself in a situation where I'm like, God damn.

unknown 54:51

Yeah.

SPEAKER_01 54:52

Now you know, now there's like yeah, did I really need to do this type thing? Putting a pick line in a overstepped my uh my boundaries here a little bit. Yeah.

SPEAKER_02 55:00

Um, but I'm riding that golden retriever, St. Bernard. Yes.

SPEAKER_01 55:03

Yes. Bernie's mouth dog with your heart monitor on top.

SPEAKER_02 55:08

Yeah, just to make sure. I love it. Um, but yeah, we we've all uh met and worked with one of each of these on said list.

SPEAKER_01 55:17

So if we missed any, please let us know. Yeah, there's gotta be some out there.

SPEAKER_02 55:21

There's gotta be some out there that we don't know of. Yeah. All right, guys. Till next time. Bye.

SPEAKER_01 55:36

Thanks for tuning in to Joint Effort PAs. If you enjoyed this episode, be sure to subscribe, leave a review, and share it with a fellow PA or med minded friend. You can also follow us on Instagram at Joint EffortPAs for updates and extra content. See you next time.