Respected, Not Feared: A Female PAs Guide to Leadership and Difficult Conversations

Why does it sometimes feel like nobody listens when you're calm—but suddenly everyone pays attention once you're angry, overwhelmed, or at your breaking point?

For many women in medicine, authority can feel like an impossible balancing act. Be too accommodating and your concerns get overlooked. Speak up too forcefully and you're labeled "difficult." Somewhere along the way, many of us start wondering:

• Why do I have to raise my voice to be heard?
• Why do I have to be visibly upset before people take me seriously?
• Can I be respected without becoming someone I'm not?

Whether you're a new graduate or years into practice, this episode is about learning how to become the kind of leader whose words carry weight—not because they're the loudest in the room, but because they're trusted.

High standards. No emotional explosions required. 💜🎙️🦴

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 have to start. We have to start somewhere. I mean, I guess we start now is as good of time of any as now is as good of a time as any to start this week's podcast.

SPEAKER_01 0:37

Yes.

SPEAKER_02 0:38

This is some heavy topics. How do we lighten the mood initially? Before if I get into this and not the right mindset, then I'm gonna sound really depressed talking about this.

SPEAKER_01 0:48

No, no, no.

SPEAKER_02 0:48

We will not allow that. Okay. How's that? Perfect. How was your week leading up?

SPEAKER_01 0:55

Um, my week was okay.

SPEAKER_02 0:57

Um, a lot recently.

SPEAKER_01 0:59

I know, I know. Um, I have a lot of stressful things like professionally going on. So I did something very like grown up this week, right? I had a conversation that I knew I felt a certain way about something, and I was like, listen, I can't do what you're asking me to do because I have feelings about it. I'm just not ready to have that conversation. So when I'm over that, we'll talk. Well, do you want to talk about it? I was like, I don't want to talk about it. I'm just gonna like process my feelings, and when I'm done, then we'll have that conversation. But I know that's how I'm I'm reacting right now.

SPEAKER_02 1:30

Did you have the conversation yet?

SPEAKER_01 1:32

I did, yeah.

SPEAKER_02 1:32

Okay, good. Yeah. Do you feel better now?

SPEAKER_01 1:35

Yeah, I still I still think I'm doing the right thing, but I'm not doing it because I feel a certain way. I'm doing the right thing. Yeah, it's not an emotional response. Yeah. So that I thought was fairly grown up.

SPEAKER_02 1:43

It is. Yeah. It's a hard thing to do.

SPEAKER_01 1:45

Yeah, but I also had another conversation this week where I refuse to apologize for my actions. Yeah. I mean Which again is one of the underlying themes of our topic today. But um, yeah, I had another conversation where I refuse to um apologize for my actions. Like when you are in a stressful situation, you respond a certain way. I don't respond outwardly toward anybody. Like I don't like rage out.

SPEAKER_02 2:12

Yeah.

SPEAKER_01 2:12

I internally kind of like really focus and get quiet and just do the job. Apparently, that makes other people uncomfortable. And my response was, well, fucking deal with it. If that's not, if that is my response and it makes you uncomfortable when I do that, but I'm getting the job done for the sake of the patients. Like that's the fucking reality. Buckle up, it's gonna happen again.

SPEAKER_02 2:33

Like, sorry.

SPEAKER_01 2:34

Would you rather I lash out?

SPEAKER_02 2:36

Yeah. Yeah. I mean, you're you're living in a form of discomfort too. We're all in a form of discomfort. Yeah. So I mean, but see if you can do anything to ease my discomfort would be nice.

SPEAKER_01 2:48

No, surgical cases were really good this week. Um clinic volume and and you know what variability and what I saw was really good. Um, I did a lot of scheduling things this week. I had a lot of other like interdepartmental conversations this week. Um, I had to defend myself to other departments this week. That was another uncomfortable conversation. Um, but again, we'll talk about that. Yeah, a little bit too. What about you?

SPEAKER_02 3:15

Um, overall good. You know, I feel like it was a little bit later of a week. I feel like I was having such a heavy volume, and then all of a sudden the summer has kind of dropped things off a little bit. So we only did six cases this week because I only had one OR day. Well, okay, I take that back. Yeah. One OR day with my team. Um, and then walkabouts. I had a I had a long walkabout uh this week, actually two walkabout days. And I scrubbed with our podiatrist um for one day this week, and it was actually really cool. Yeah. Got to do a lot of stuff. It was very uh very enlightening. Um, and just like got to practice different skills that I don't normally get to. It was fun. Yeah.

SPEAKER_01 3:59

That's that's always refreshing. That's taking a walk on the other side of the street for a minute.

SPEAKER_02 4:03

Yeah, and it's like I feel like those are are good. Like, do I want to continuously walk down that street? No. Is that the path that I am going to take every single day? No, but once a year, not bad.

SPEAKER_01 4:16

Perhaps. Yeah.

SPEAKER_02 4:16

I think that's a once a year kind of thing, just to kind of refresh one's mindset.

SPEAKER_01 4:21

Yeah.

SPEAKER_02 4:21

So like a palate cleanser, if you will.

SPEAKER_01 4:23

Yeah, it's called it's walkabout. You go see what else is out there.

SPEAKER_02 4:26

Yeah. But you always come home.

SPEAKER_01 4:29

You always come home. It's just you're going for just a stroll. That's all.

SPEAKER_02 4:32

Yeah. Yeah. Like an unleashed dog that knows its way home always, but you know, it's gotta get its exercise.

SPEAKER_01 4:39

The go the golden retriever always finding its way back now.

SPEAKER_02 4:43

I mean, a good loyal golden retriever doesn't need to be leashed or fenced in. Yeah. Because it will always come back. I never I'm just I'm digging myself a hole here. All right. But uh to go back, yeah. So we have multiple themes for this week that are all centered around the idea of how to be a good leader and how to manage and balance your emotions and difficult conversations. And we have several examples of recent occurrences that have prompted this.

SPEAKER_01 5:12

We do. Um, so in the world that we live in, which is orthopedics, um and in most line of medicine, maybe not like OB or Durham. I don't know why I'm making those generalizations, but whatever. I think a lot of places the administration are female, right?

SPEAKER_02 5:32

Yeah, yeah.

SPEAKER_01 5:33

The docs generally are male. For OB, you think too? I think just I'm generalizing. I think I'm talking more ortho. I think the exceptions are OB, right? Yeah, yeah. Maybe Durham, I don't know. Um, and then you have the management team, which is like a little bit of both of everything. So, like for our audience, how can you be a female PA in somewhat of a broy field, right? And be respected for your decisions, be respected for what you do, and when you disagree, how do you not, you know, how do you not emotionally escalate your feelings? How do you regulate? How are you respected without doing what most male surgeons do, which is just use their words and blow up and instill fear in those around them?

SPEAKER_02 6:27

Yeah. Right? Yeah.

SPEAKER_01 6:28

Their presence or their words.

SPEAKER_02 6:30

But it doesn't work. Like we can't, we don't have that cap capability.

SPEAKER_01 6:34

Well, it doesn't work. It doesn't work because there's there is an association between uh a female, and I won't even say PA, but just in general, a female that has a lot of power who has no real fear, they're kind of a bitch. Yeah. Right? Like that's just what it is. Yeah. So how can you be that respected leader that people fear in a healthy way? Yeah, healthy fear. Without being called, you know, emotional crazy off or meds. You know what I mean? Like I just I don't know. I feel like I feel like that's that's something that I teeter with a lot. And I've had a lot of.

SPEAKER_02 7:11

I was not.

SPEAKER_01 7:12

I'm like very, I'm very not much, I'm not on or off. No, but um, I just feel like whenever there's conversations, for example, okay, got a lot of stuff going on on on my team. I have a PA that's leaving, I have a medical assistant that's leaving. I've got a lot of other departments where there's just a lot of turnover and it's a lot of staff that have been here a long time. They're just making moves in their career. It's inevitable. Like when you take a job, you don't marry it. Like I get it. I know it's coming. But um I needed to just kind of like from a 10,000-foot view, just like think about strategizing and whatever. So I sat outside during quote lunch, which was me closing notes. I had like six documents open, and everybody who walked by was like, Are you okay? Oh my god, are you okay? Are you okay? Like I was literally removing myself to just like get my thought centered. And that appeared that I was like sulking.

SPEAKER_02 8:05

Yeah. No, that hurts to me too. Like I go on, like, well, to be fair, I do call them my mental health walks, but I don't say that out loud to people. But um, some days I'm just like really overwhelmed by things, and and I'm probably not in a good mood to be honest, but I'm not like choosing to make outward expressions of that. But yeah, I go off and I find a little corner to live in. And yeah, that's generally taken as sulking.

SPEAKER_01 8:34

Yeah. Sometimes it is. It it is sometimes like if I'm alienating myself, maybe it's because I don't know.

SPEAKER_02 8:40

I want to alienate myself.

SPEAKER_01 8:41

I want to alienate myself, not to like cry or like look internally, but just because I don't want anybody talking to me.

SPEAKER_02 8:46

Yeah, like it's just too much right now.

SPEAKER_01 8:48

Yeah. So um, but anyway, so uh where do we start?

SPEAKER_02 8:53

I don't know. I don't know where to start. So I mean, we you kind of broke this up into some seg segments. Um the some like mistakes that you can make as a you said new female PA or you know, establish. We can all make these mistakes.

SPEAKER_01 9:08

Yeah. So again, like things that are running through my head, right? Um when I want to be heard in the workplace, sometimes at home too. Yeah. Why do I have to raise my voice? Why do I have to swear? Yeah. Like if I feel like, hey, can I hey, can you guys get the ultrasound ready? Because I have like three patients. Versus, can somebody fucking get the ultrasound? Like which one makes my assistant move? Yeah. Faster.

SPEAKER_02 9:32

Yeah.

SPEAKER_01 9:32

Right? Like, why do I have to say it that way as opposed to say it the right way and be taken seriously? Like why um why do I have to walk away and remove myself before something realize somebody realizes that I'm like annoyed? Yeah, yeah. Um does it take that? Yeah. Um, can I still be respected being myself, or do I have to put on this whole persona of being like the hard ass bitch to get respected? Yeah, like those are like those are questions, right?

SPEAKER_02 10:00

Yeah, no, I think like I I feel like a lot of females probably struggle with that. Yeah, do you have to act a different way? Because if you're too friendly and and too nice, are people gonna just walk all over you? Oftentimes the answer is yes, or it feels like yes.

SPEAKER_01 10:13

Yeah, and I think where we're going with this is how do you develop a good positive uh professional influence as a as a female PA or just as a PA in general?

SPEAKER_02 10:27

Yeah.

SPEAKER_01 10:28

How do you do that?

SPEAKER_02 10:28

I think you have to be assertive, like you have to be confident and stand your ground on on everything that you do, your clinical decisions and your administrative decisions, and people need to know that like you feel solidly about the things, the decisions that you've made. Um, not wishy-washy, like I'll do what whatever, you know. Cause I think if you come into a role or a situation where you're just willing to accept however things are, um, you know, if it's running too slow for you, people don't seem like they respect you, and you just accept it, you're gonna fester within. Yeah. And like you're gonna get very frustrated very quickly. Yeah. But you don't want to come in too hot either, like the crazy person who's mean and too assertive and you know acts like they're above everybody, and that's not gonna be taken well either, and you'll probably get treated poorly because of that.

SPEAKER_01 11:29

For the PAs that have come into this practice that have earned my respect, um, let's talk about that. So I've seen PAs and Ps come into the ortho world and they think that by chatting it up with everybody, being super social, like if everybody likes me, then I'll get respect. Or you go the opposite way, if I work hard enough, if I'm helpful enough, if I never complain, if I always say yes, then I'll get respect. Like, what do you think about that?

SPEAKER_02 11:57

Do you think that's I think that I fall victim to that very often. I think that that I don't know if I associate those things with respect per se, but it, you know, just wanting to be well liked because I hope that that will serve me well in some capacity.

SPEAKER_01 12:13

So I don't, I'm not deterring all that. I think if you do all that, you are super liked, super helpful, you build a reputation for that at your expense, right? Then you're completely overwhelmed. So in your career, I think instead of saying, you know, always yes to everything, be available. Like again, I will contrast that being unavailable. Uh, we have some PAs that are never available. Not for every ask. Sorry, not for some asks, for every single ask. And they now have the reputation of don't even ask them because they're gonna say no. Yeah, being agreeable. And again, not every time, but most times. Hey, can you do me a favor? And again, I would never ask someone necessarily that I think I was putting out, but if I if I'm really desperate, hey, can you help me with this? Yeah, and they're agreeable, that clicks and raises them up a level in my head. Yeah. Um and I think being a person who always says yes when it's appropriate. Yeah, you know, but here's the difference like, hey, I lost my retainer. Can you go look in the trash for me? Yeah, yeah, yeah. Like that's not gaining my respect. Like, no, I'm not gonna do good surviving for the right. I've got, hey, I've got a couple injections in my clinic, but I really need to go through this this hard discussion visit. Do you think you can do me a solid and just hit these three knee injections? Sure, no problem. Great, yeah, great. I think that that's the yes person. That's not someone who's doing something that's totally out of their realm just so people will notice them. And I think I've seen that. Like I've seen PAs come in and say yes to all the wrong things. You know what I mean? Like it's yes to every single social event. Yeah, like I'll hang out afterwards.

SPEAKER_02 13:51

Yeah, like it's it's yeah, it's gonna be helpful within. Um, but yeah, no, I I agree. I think like the the PAs that I have grown to respect are the ones that are very communicative and are willing to say yes and help out. And I know I would never try to take advantage of any of that, but like there's certain people that I would never really think of asking to help round on a patient, and then there's some people that I will ask for that because I know that there's some strings attached on.

SPEAKER_01 14:19

But there's they're reliable. You know that if you ask them to do it, it'll get done. Yeah, you know that they're competent because they've demonstrated that through, you know, whatever they do, and you know they're professional. I feel like that's the difference, you know.

SPEAKER_02 14:32

Yeah. Now, going back to what you said about like asking for help and things like that, um, that kind of hits our themes. Do you do you struggle with that ever? Like asking for help if you're overwhelmed and busy. Um, well uh or do you just like do you just like run yourself ragged and like a little final?

SPEAKER_01 14:53

No, a little bit of both, a little bit of both. So I think like you, I think I want to demonstrate that I can handle challenging things. Yeah. And a challenging thing is when you have a hundred things going on. And if I can handle those things and I feel like I'm doing a good job and I have, you know, my attention where it needs to be, no, I will not ask for help. But if I see it's getting out of control, then I will ask for help. But I guess like the real like advice piece here, or I want you guys to understand the red flag goes up when a professional way to ask for help is say, hey, I've got four patients back here. I have four in the waiting room. I gotta stop right now. Let's strategize how we're gonna get all these people back. Yeah. Versus you see the patients, you see that this one's waiting 20 minutes, now it's 25, now it's 30, and then you're like, guys, I'm helping in its shaky voice, and now you're crying.

SPEAKER_02 15:44

You don't have like an actionable step for somebody else to do to help you.

SPEAKER_01 15:48

But nobody's reacting to you because you're asking strategically, they're reacting to you because you're fucking breaking down. Yeah, yeah. You know, like that's the difference. Like, and there now goes your reputation of they're a crier.

SPEAKER_00 16:00

I know.

SPEAKER_01 16:01

Every time they get overwhelmed, they cry. So let's now help this person to avoid the uncomfortableness of the crying, versus I think if it's done in a professional way, um, you know, where you're asking, again, not over nice, like, hey, but just like, hey, I, you know, this is we really need to buckle down, we really need to do this. I think that that's the better way to go. Yeah.

SPEAKER_02 16:23

I had a situation this week where I like, you know, in debriefing about it, but uh, it was it wasn't even a busy day. That was what was like so disappointing to me. It was like not a high volume day, but it was just like a stent where you know, six people or whatever come in all at the same time, and I had like four or five rooms filled, like I think four. Yeah. Um, and it was I mean, you know, these types of situations, like one person talked for a lot too long. Too long. The next person, I was already, you know, behind, and I have four people now waiting behind. The next person I go to see was an urgent care follow-up who fell and hurt both of her wrists, but both of them hurt everywhere, and there was nothing on x-rays, and like everything I touched hurt, and it was just a really lengthy discussion, and I was feeling rushed during it, but also like there was nothing more I could do do in the situation that was gonna make this better. Um, finish that visit and like strategizing in my mind where do I go next and what do I do? So I go see an MRI discussion and decide to do an injection while my medical assistant is casting the one I just came out of. But then I have this patient waiting for like 45 minutes that's literally just been like transitioned from a splint to a cast, and I just need to look at the x-rays and put the cast on. So then I'm like, I'm just gonna do this before I do the injection. So I go in there to do that, and they talked for a little longer than I expected. Then my other medical assistant had to get the cast stuff ready, but I had to go in and mold the cast. And then I had a pre-op visit of somebody waiting for a long time, and I was like, this should be quick, it's a pre-op. And before I knew it, like I go do the cast, and then the kid's screaming and they can't get x-rays on him. My freaking patient that I was gonna do the injection on for the MRI discussion, at this point, I've been out of the room for like probably an hour. I know, that's it was yeah, they had to, you know, come out and they were like, Oh, it's time. I was like, so many things going on at once. And um, yeah, at the end of the day, my doc was like, Why didn't you ask for help? And I'm like, I mean, like, I should have. You're right. But in the moment, like, I didn't even I didn't even know I needed the help or what help I needed as I'm but so here's the thing, and that's on to the next point.

SPEAKER_01 18:31

In a stressful situation, you can't, you have to understand how your emotions affect your ability to communicate, right? So you cannot effectively communicate if you're in fight or flight.

SPEAKER_02 18:43

Yeah. It's not even a thought. I was never even thinking about the time on the clock or like what's happening.

SPEAKER_01 18:48

And that's that is um that is something that as you continue to do this more and more, you will recognize. You'll recognize when you're like it's falling apart. It's falling apart. You'll recognize when it's falling apart. And that's when you stop, you take a second, you communicate what you need, and then you keep going, right? Yeah. I mean, that that is hard to do. And that they don't teach that in PA school. Like they just don't, yeah. You know? Um, because what's the risk, right? Yeah. The risk of stopping what you're doing is admitting you can't do it all. Yeah. That sucks. Yeah. Um, or it's asking for help and then being still annoyed at the people helping you that they don't recognize that you're running around with a chicken with your head cut off. Like that's annoying too. Yeah. So then you have to deal with your feelings about that. Yeah. You know? Yeah. Um, stopping to ask for help. And I will say this all the time, like in our urgent care, when they get slammed, right? When we talk about this at leadership meetings, like, why did nobody call to ask for help? Because they were busy seeing people. We were busy seeing patients. Like, you know, when you go in the fight or flight mode, it's not second nature to stop and say, How can I do this more effectively?

SPEAKER_02 19:53

At this point, I'm not looking at my computer even. I am grabbing the papers, hoping what's written down is accurate. And I am going room to room, you know, just going off of that.

SPEAKER_01 20:04

Yeah. I think if, and you feel it, and I don't know what your like set off is. Mine is my ears get really red, or like I'll start to like people can see. No, or like I know, but I still say to myself, okay, it's like it's my visceral response to like shit's shit's hitting the fan, right? That's when I'll stop and I'll say, I need like I need this. And if you stop and you can communicate, it's far better received than if you're doing it emotionally, which again will be something like, um, you know, oh, did you need some help? No, I'll just do it myself. Like, yeah, it becomes something. Have you ever said that? No, uh, no, I mean, my God, in life, yes, I probably are probably. But um, but that's those are pitfalls. And that's that's not yeah, that's not good.

SPEAKER_02 20:46

Yeah, recognizing those those moments. Yeah. Um, so good learning experiences. Yeah. Well, what about crying at work? Let's talk about crying at work.

SPEAKER_01 20:58

Um, I don't think in the past 10 years I've cried at work. False. I did one time. I did one time. Oh my god. I remember yes, we were at the hospital and there was this super inappropriate tech. Yes. And every time I came in the room, he would say something to me, like very inappropriate. Okay. And it would always be like under his breath or like right before the doc came in. I remember talking to my doc about it. Not like I was like, you know, reporting it, but I was like, this guy's such a dirtbag. And I and then I'm like, I can handle myself right. Yeah, like someone, and I know who it was to this day, even though they didn't admit it, someone said something to HR at the hospital. That he was saying something. I got pulled out of a case, marched down to HR, and they told me, Hey, this was reported. So and so said that this tech was, you know, sexually harassing you. Can you tell us about that? And I started. Like angry crying. I was like, I cannot believe that I am forced in this situation right now because of something somebody said. Like you literally pulled me out of what I was doing. Yeah. And someone went behind my back to say something. Something I was talking about, like you know, reporting it or whatever. I was so mad. Oh my God. And that I think I was so I can I can't even tell you how mad I was. And I came out as like it was it was not even like it was crying. I was bad.

SPEAKER_02 22:27

I mean, angry crying, I think that's like that is what tends to get the best of me. Like I have never sad cried at work, like where or stress cried. I've never been so stressed that I've been. It wasn't unhinged crying. Yeah. But angry crying, I have. Or it's frustrated crying, I guess.

SPEAKER_01 22:43

I was like, I was like, I do not need to be here. I did not ask to be here. Yeah. You cannot do this to me. I don't give a shit about what happens to that guy. Do not involve me in that. I don't want to be involved. I don't want to be involved. I'm not the one reporting him, and you're making it about me, and I'm not.

SPEAKER_02 23:00

So you think that person thought they were doing you a favor? Yes. Yeah.

SPEAKER_01 23:03

Yes, I do. And um then I had to go back to the OR and pretend like nothing happened. Oh my god, and your eyes were all red. Yes. Oh my god, it was so embarrassing. Do you guys want to do anything? No, I don't want to talk about it. No. I mean, look at me.

SPEAKER_02 23:16

Like, stop, look the other way. No, so uh you're like, oh my God.

SPEAKER_01 23:21

It was so mad. Um but again, like my you know, you're when when crying happens, now imagine the person receiving that, right? They're like, Yeah, oh my god, are you okay? This obviously is bothering you. I know it almost makes it worse because they're like, wait, you know, because listen, the crying to all the criers out there, the crying changes the entire conversation because the conversation is now not about the issue, it's about your emotional state. You know, yeah, yeah. But the double standard is if you go the other way and you're angry and you're throwing shit, it's not also about your emotional state. It is, but it's not the same stigma. Yeah, you know.

SPEAKER_02 24:02

But it almost is the same thing because I feel like the angry doc who rips a cabinet off the wall. Yeah, that may or may not have happened at one point in the history of the city.

SPEAKER_01 24:12

No, I know, but nobody's asking that one if they're okay. Everybody just is like, but everybody is a little bit more scared of that person. People also fear the crier, but in a very different way.

SPEAKER_02 24:21

Yeah, but they they go back and laugh about the oh, they're they're recruiting. The cabinet off, yeah, it's crazy. Yeah. And the crier, they're just like, oh, they just can't handle it. Like, they definitely can't handle it. Yeah, yeah. And that is always my fear. When I get when I break down, I'm like, this is gonna look like I can't handle it. And like, I can, but just my emotions are coming up. Like there's just like this is just how I'm expressing it. Yeah. I had, I thank you for normalizing crying at work, by the way.

SPEAKER_01 24:49

Yeah. Oh, did I did my traumatic story normalized for you?

SPEAKER_02 24:53

Yeah, I had to make sure you also had one experience before you can share yours.

SPEAKER_01 24:57

And did you have one? No, no, no. No, you didn't know I didn't either.

SPEAKER_02 25:01

No, I actually told Beth about it like immediately after it happened. I think I went on a little walk and I was like, Well, this just happened. I know, I know. No, no, I made you define it.

SPEAKER_01 25:11

I was like, wait. So like eyes watering or like crying. But you said it was like a hybrid.

SPEAKER_02 25:18

It was, it was no. I mean, like I that like that didn't happen. Are you sure you weren't sick? I might have been, I don't know. It's like heaving. Yeah. Um, but it did. Like I compared it to to being sick because in the moment I was just so frustrated, yeah, and like so high emotion about everything going on. And I went to talk and respond and like, you know, you know, like I was about to throw up, but it was just it was it was crying that was gonna come out. And I knew that I wasn't gonna do that in the hallway, so I ran away.

SPEAKER_01 25:55

Well, but here's the thing but here's the thing do people cry at work? Yes. Do successful professional females cry at work? Yes, I'll say yes, they do. Yeah, they do clearly. But the difference is, and what you did, remove yourself when you can see it happening and then revisit it later and talk about it.

SPEAKER_02 26:15

After that, and you know, I honestly think for whatever men and women are different and like just process emotions. I sometimes need to get that out so that I can have a regular conversation and not be shaky voiced on that.

SPEAKER_01 26:31

Yeah, well, again, because I think that that garners respect. I think when you're, you know, you have to pause and remove yourself and like let's talk about this later. Yeah, I think when you're like, listen, I'm not in any state to talk about that. Like I did this week. I was like, listen, I have an issue. I can't even talk about it yet because I'm like processing how I feel about it. Yeah. So let's talk about it at the end of the day or something like that. Yeah. And I was able to do that. Yeah. Or anyway. Now the opposite end of that, swearing. Does swearing equal authority?

SPEAKER_02 27:01

I don't know. It's confusing for me, and I'll tell you why.

SPEAKER_01 27:04

It is like my parents, right? When I was younger, you know, I grew up like Irish, Italian Catholic, right? My dad swore. The whole time, but never at me. When he did, it was serious. It was serious and got my attention. So like I'm somewhat programmed that when I hear that, I'm like straightening up. Like, what I do, what I do, what's going on, what's going on? Like it yet, it gets my attention. Yeah. Crying gets my attention, but in a very different way.

SPEAKER_02 27:31

I think it's also it really just depends on the person because it's sometimes part of someone's vocabulary. I don't know. It's just like how but do you hear though?

SPEAKER_01 27:41

Because like today, I mean, if I counted on one hand how many times for those around me, right? Yeah in the OR setting, it was a lot, right? So orthopedics, and I can't speak because I don't know. Orthopedics can be colorful. The language can be colorful. Yeah. Okay. When you're working in a high stress situation in the OR and things aren't going your way, sometimes language is colorful. Yeah. Right.

SPEAKER_02 28:02

Um But I also think that's how I communicate when I'm not when things are funny and like if I'm having a good time or a bad time.

SPEAKER_01 28:09

Like Yeah. So when the surgeon I work with or the surgeon that works in the other room, when they swear, people notice. Like you notice. It gets your attention. Um so that makes again, not me, because I feel like I'm very confident in my role, but that can make female P female PA feel like maybe I should be louder, maybe I should be tougher, maybe I need to curse more. So, like, what are your feelings with that? Is that a way to gain authority?

SPEAKER_02 28:37

I don't know if it's a good way to gain authority. Do I still do it? Does it still happen? Yeah. Yeah. I mean, I think it's just it's second nature though. If something is really bothering me, something happens shocking, like I'm not gonna say, wow, guys, like that sucks. No, are you fucking kidding me right now? Yeah.

SPEAKER_01 28:58

So again, okay, and I'll I'll break that down. When I say something like that, yeah, which I probably said a hundred times today. Yeah, uh, I don't think that that it it gets people's attention as to the way that you feel about something. Yeah. Uh clearly.

SPEAKER_02 29:13

Yeah, it's just it's very clear. There's no what do you call it? Like w explanation mark uh posture, it's like a fucking exclamatory? I don't know. It's a it's a thing. It's like, I don't know, adjective. It's not. It's not an adjective. I can't think of the word.

SPEAKER_01 29:30

Anyway, but if you say it, there's no mixing words. You know exactly how I feel about it. Whereas if you say this, you know, this process is so dumb because of this. Like if you say something that has a little bit more uh beef to it, like you know, uh the turnovers, right? Punctuation was the word I was making. Oh my god. We had we had a turnover last week that was 16 minutes, right? And it's bad. It's great. Yeah. 16-minute turnover for like a big shoulder case. Oh my god.

SPEAKER_02 30:04

It was it was great. Like beach chair to beach chair?

SPEAKER_01 30:06

Yeah, okay. So um the doc I work with was like, this is amazing. And then the next turnover, so of course, you know that's the expectation now. Well, it is. The next turnover was like 46 minutes, okay, to which we all responded, This is fucking ridiculous. What is the variable, right? Yeah. So how that could have been handled better, right? Is listen, we had a 60-minute turnover. These are the people that were in the room. Why don't we set up some standard based on what they do? Right. That should be the why did you make it work? That should be the standard, right? I mean, that that I think garners more respect than this is fucking ridiculous or whatever. So, you know, the response that's emotional is that the response that's authoritative is, you know, let's let's make a process, let's make a standard based off of what we just saw, which was awesome. So I don't think you need volume to be authoritative. Um you need you need to speak, you just it needs to be clear. This fucking sucks is clear, right? But yeah, it's very clear. I don't think that that needs to come like that at a high volume for people to understand how you feel. Yeah.

SPEAKER_02 31:12

And I think like the the note of you know, being tougher, being louder, being more abrasive, that's gonna wear on you over time too, because that's not actually how you're feeling inside. You're like putting on that as a way to try to compensate for the fact that like you're not happy about something or you're overwhelmed and you're stressed. Yeah, you're still gonna be all those things. Now you're just yelling at everybody. And now people are angry at you and not liking you, and you're still overwhelmed and stressed, and it's just a negative compounding effect.

SPEAKER_01 31:45

So, okay, here's like the next thing. So, next level, and again, this I swear to God, this is not about the doc I work with, but this just so happened to be a very good example of this today.

unknown 31:55

Okay.

SPEAKER_02 31:56

Okay, so just have to throw that out there.

SPEAKER_01 31:58

Just have to disclaimer, right? Why do people finally listen when you're almost about to lose your shit?

SPEAKER_02 32:05

Yeah.

SPEAKER_01 32:05

Like what why is that?

SPEAKER_02 32:07

So do you think that you do a good job at like leading up to letting people know that things are minor issues, like so women in general. Yeah, like do you wait until it is the breaking point? Did do I? Okay.

SPEAKER_01 32:24

Well, I will use a very specific example today. Um, there were so many little things today in the OR that were just not right. Like certain things, like there's the way that the surgeon I work with like certain things, there's the uh just everything. It's everything about the room, everything about the cases, everything about the text, everything. And everything was like a little bit off, right? So it finally got to the point that it was in, I think, our third case or something, where there was not enough room for him to drill. The reason was is because the table we were using is a table we never use. So now that we're 20 minutes into the case, the case is set up, the patient's under anesthesia. You can't change a table. Yeah, right. But he realizes in the middle of that that the table's not right, and he just lost it. He was like, Why do I have to? Like, you know, we do the same thing. I've been this surgery center's been open for so many years. I've operated the same group of people in this room. Like, why do I have to double check these things? Why do you want me to yell? Do you want me to degrade everybody in this room to get my point across? Like, why do I have to do that? Why can't you guys just just do your job? Like, I don't understand. And I mean, we were all like, like it was a very effective way to communicate. It was more colorful than that. I'm not sure. Yeah, yeah. Um, but he even said he's like, why? Like all the little things. And he did say stuff after the little things, but they completely got like, yeah, you know what I mean? Yeah. And he even said, he's like, I'm just, I'm just, I feel it, like I'm getting annoyed, I'm getting annoyed, I'm getting annoyed. And then finally had like the the communication, and he's like, Why do we all feel like that? Why do I have to lose my shit for you guys to respond? Why? Yeah. Whereas women, I think in general, like I would not go from zero to a hundred. I don't think I do, but I would like slowly hint something, then I would suggest it, then I would like say it a little bit stronger, and it will go for weeks and months, and then finally it get to the point, well, then I'll explode. Like I feel like my wick is very long. And then and then finally, and it doesn't come out, it doesn't come out productive at all. It doesn't come out with like, hey guys, I think we should strategize. It comes out with like, guys, I'm fucking dying. Like, I why don't you see that? You know what I mean? And then it's it's just not really, I don't know. And then once I have that final blow up, then we can fix things. But like, why do I do that? I think it's just females do that. I'm telling you, men do not do that.

SPEAKER_02 34:50

Females do that. Yeah, I don't know. I think I like to try to pretend that I don't care for a long time until I finally do it.

SPEAKER_01 34:57

But that's the same thing. Ignore, ignore, ignore, ignore. Suppress, suppress. But I know it's suppress, suppress, suppress, and then finally it's not even the thing, right? Like let's say you had the front desk didn't check in your patient. It's not that that made you lose your shit. It's that and the 100 things before.

SPEAKER_02 35:14

Yeah, the 100 things before that. Like, so each time now they're after is going to be a bigger deal. And you know, I worry sometimes after I lose my shit about those things. I'm like, did I overreact? Like, was I being dramatic? Then I'm like, fuck, no, I wasn't being dramatic. Like, I deserve things to be done decently. I deserve like some decent, you know.

SPEAKER_01 35:34

Yeah. Yeah. Um, so I guess like, you know, all these things, which again, thus far, I mean, these are all very real things, like all these topical authority, crying at work, happened, trying to be too nice to build your reputation. Like, where can we advise our our listeners?

SPEAKER_02 35:55

Yeah.

SPEAKER_01 35:56

I what do you think some really good advice um falls for our listeners?

SPEAKER_02 36:04

Well, I'm clearly not a hundred percent there yet, but I will give advice based on my own shortcomings that it is better to voice small things assertively and calm. And as they come up, even if it seems like you're making a deal of something that shouldn't be a big deal, yeah. That's my worry. Like if I'm in the middle of a clinic and you know, somebody doesn't, you know, help get a patient in the right way or order a set of x-rays, I'm like, well, whatever, mistakes happen. Like, I get it, things get over. Um, there's oversight, forget to pull the x-ray flag, this doesn't get done, and I asked this to get done. This email wasn't answered. Individually, I can understand all of those things happening. And then I get to a certain point where enough of them have happened that I'm like, this is the final straw. Yeah. I think you just have to individually address those things, whereas I don't.

SPEAKER_01 36:59

Yeah, I think it all comes down to learning really good communication skills as a PA. Yeah. And again, after we're done with our uh three-day wilderness retreat for CMEs that we're gonna do eventually, we will also do a practical communication skills course.

SPEAKER_02 37:16

Practical communication, emotional regulation.

SPEAKER_01 37:19

Practical communication skills, every female PA should learn.

SPEAKER_02 37:22

Yeah.

SPEAKER_01 37:22

Like I could write a book.

SPEAKER_02 37:23

Yeah. And not over apologizing.

SPEAKER_01 37:26

So, number one, do not apologize for existing. Do not come up to me and say, hey, sorry, sorry to bother you, but do not say that.

SPEAKER_02 37:33

Yeah.

SPEAKER_01 37:33

Like if you want me to respect you professionally, do not apologize before you ask whatever it is needed to ask. Yeah. Right. Another way to say that would be, do you have a minute?

SPEAKER_02 37:41

Yeah.

SPEAKER_01 37:42

Right? That's a very good way of saying I need your attention versus like, sorry, sorry, sorry, sorry, right? Um, don't beat around the bush. Don't give me the runaround where you start to feel the emotion building up, just tell me what the issue is. Just say it, right? Because the runaround and the buildup will make you more emotional too. It will. And if you think that my email to Hannah is, hey Hannah, can you cover our rural office tomorrow? Whoops, I forgot to tell you. I don't want the delay, delay, delay, delay, delay. And then the response simply, I was not given us enough notice and I cannot do that. Okay, cool. Yeah. That works for me. Yeah. As opposed to whatever. Yeah. Um learn professional disagreement. So instead of crying and emotionally responding to something, voice that you disagree in a way that is respectful, right? Or respected.

SPEAKER_02 38:34

So and why you disagree.

SPEAKER_01 38:36

Why you're disagreeing, or I don't see it that way. Um, my concern with this is um, can we discuss another option? Something like that. So just because you're disagreeing doesn't mean that you're disrespecting, but a professional way to communicate something that you don't agree with.

SPEAKER_02 38:51

And I think like, you know, say this is with within your team or communicating with your doc or something, and something's not there's some system breaking down, something that's not going well, right? I think coming in with sometimes it is good to ask, like, okay, what what do you want me to do differently and what can I change? Yeah, yeah.

SPEAKER_01 39:12

You've said that I've heard you I've heard you say that so many times.

SPEAKER_02 39:15

Yeah, I will definitely ask that, but I also think um coming in with your own suggestions to show like your initiative and thoughtfulness in it, like, hey, do you think that doing this differently this way would help my situation or help this situation? Yeah. Um, yeah, yeah. And definitely uh not getting overly aggressive and acting like somebody's been off their meds.

SPEAKER_01 39:42

Yeah, but that's the thing. Confidence is different from aggressiveness. And I think when you communicate something clearly without emotion, which again, that is such a hard skill. But when you do that, instead of like reactive and emotional and you're sweating, your hair's all out of place. Like, I think it is way more respectful to do that in a very clear, calm way. And then lastly, like to be a successful PA female in an orthopedic field where you can feel intimidated, you can feel like you have to brow out, you can feel like you need to do things because you try to mimic behaviors that you see. Yeah, build your reputation on your own. So build it before you need it. And again, Hannah did this, you did a really good job doing that. Like you were reliable, you were always available. Like that speaks for itself. If you are out of town and you need a PA to cover for you, you know you're gonna go with the reliable ones. They already have the reputation of that.

SPEAKER_02 40:41

Be the reliable one, yeah. And also be the one willing to admit when they need help and make a mistake, and when things are not working for them.

SPEAKER_01 40:55

Yeah. I hate that that's a toughie. That is a toughie. Um, but yeah, crying at work. Ugh. Can't believe I cried at work. I mean, that was a long time ago. It was a long time ago, but I was like so mad. I cannot even tell you how mad I was. Who's so mad? I have become, I've gotten to that level of mad, but my reaction is not like that. I don't know when that switches.

SPEAKER_02 41:17

I feel like just the being taken out, like being singled out, like it's get getting called to the principal's office, right?

SPEAKER_01 41:24

Completely ambushed. It felt like I got called to the principal's office.

SPEAKER_02 41:27

So I was like in front of like what is happening? What am I doing?

SPEAKER_01 41:30

I literally went down a hall. I'm like, where does this all lead to? Like, yeah, am I getting fired? And then when it turned into that, it like exploded out of me.

SPEAKER_02 41:36

Yeah.

SPEAKER_01 41:36

Like in all ways. It was bad.

SPEAKER_02 41:38

Yeah, and it's like it just catches you off guard. Like, and it's an uncomfortable thing to talk about anyway. So it was bad. I don't know. Yeah. But look, we've normalized it. So if you've cried at work, us too.

SPEAKER_01 41:52

Tell us your tell us your story. We'll tell you if that was okay or not. Yeah, yeah.

SPEAKER_02 41:56

We'll have 100 follow-up questions. Yeah. I need to to further assess it to determine if it was worthy of crying at work. I agree or not. Yeah. So all right. Well, until next time. Bye.

SPEAKER_00 42:19

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.