A Scarlet Letter: Can a Great PA Have a Messy Past

In this episode, we're diving into the "scarlet letters" that can follow healthcare professionals. A youthful social media post. A misdemeanor from years ago. A board investigation. A license suspension that's since been reinstated. A termination. A messy divorce that's public. A career detour you wish you could erase.

How much should our past matter?

We explore the difficult balance between protecting patients and allowing room for redemption. Can someone who made a mistake become an exceptional provider? What should employers consider when reviewing an applicant's history? And how do you tell your story honestly without letting one chapter define your entire career?

Transcript

SPEAKER_00 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. Second chances.

SPEAKER_01 0:22

Yes, second chances or stories about. It is. Um, can a great PA have a messy past? The answer.

SPEAKER_00 0:31

Uh we think yes, but we're gonna go over it.

SPEAKER_01 0:34

Yeah, I think I think that in if you want longevity in this field, you can't expect perfection personally.

SPEAKER_00 0:44

You can't expect perfection for any person, any human, yeah, any aspect of life. So we're no different.

SPEAKER_01 0:51

If there's a blip, if there's a smudge on your record, not like criminal record, but like yeah, personal record, professional record, is that now your scarlet letter? Yeah, like will we ever move on and forget? Do we get a second chance, or is this just your defining thing? Yeah. It's like crying at work. Are you the crier? Like this just defines you forever.

SPEAKER_00 1:12

Um well, first, how was your week?

SPEAKER_01 1:14

Um, my week was good. Um last 24 hours have been a lot. Um, but no, my week was good. Um, clinic was good. I trained another PA this week, so I had my teaching hat on. So that was good. Um, that PA had to go home early and said, uh, that was a lot, but I will be back next time. Okay, that that was good. Yeah. Um yeah, so a lot of uh a lot of communication stuff this week. I did a review for another PA this week. Um, my patients uh I had a really good patient interaction this week where it, again, we see this all the time. She's having severe shoulder pain. She's been diagnosed with frozen shoulder. It's not frozen shoulder. It like is secondary to whatever something else going on. The MRI that she got, she's this massive cyst like front of her shoulder. And you know, it's one of those things like she's like, it hurts right here. And the radiologist mentioned nothing about it. Yeah, and you're like, Well, it could be. No, so I like aspirated it, and she wrote me this page in case she was like, That was it. That was it. Like doesn't that make you feel so good? You're like, it does, but then the you know, I thought it was gonna be a nice, easy exchange. It's like, thank you so much. And I'm like, You're welcome. And she wrote back, she was like, Why in healthcare does a radiologist not see that? And why did you see that? Are you a radiologist? I was like, No, but like I'm just better than I'm just better. But it was, you know, it led to like a 26 back and forth situation, you know what I mean? Yeah, um, but no, I had good patient interactions this week. Um, all my notes are done. That's good. Congrats. Um, I'm hiring I'm interviewing a couple medical assistants next week. So that'll be oh yeah, we'll see about that. Yeah. So life, life is transitioning and I'm here for it. Yes. So yeah, a lot of other per personal trials and tribulations that will occur next week as well. Yes. Yes. We'll see. What about you? How was your week?

SPEAKER_00 3:00

Uh, it was good. I, you know, I think I'm just trying to sometimes like things just get a lot and overwhelming, and you just have to step back and say, like, I'm just gonna focus on getting it done and doing the best that I can with what I have a visionable to me. Did you get it done? Uh last week, yeah. I mean, we semi-crushed last week. Um, I just had, I don't know if it's a summer thing, a lot of no shows in my schedule. Um, like five to ten a day. It's kind of crazy. It's a lot. Yeah. A lot of it is like urgent care follow-ups that just don't show up. But um, yeah, so that uh there's some other like administrative things going on that have affected my schedule. And so just not as full as usual, but we did 21 surgeries last week. That's insane. So that was a lot. That's pretty good. And it didn't even feel like never I feel like were we like that's insane. Shook by it. Yeah, that it just it just happened and it was good. That's good. So I like that. Um, but yeah, overall good, and you know, gonna make next week exactly the same, even better.

SPEAKER_01 4:09

Yeah, yeah. We're down a day next week, that Friday clinic, which affects affects you.

SPEAKER_00 4:14

Yeah, that's my big clinic day. So like our volume is gonna be lower next week, our surgical volume is lower next week too, because there's another day that we're close. So it's just it affects a lot of things. Yeah. I had a negative patient review this week, but not to go off on a tangent, but on the opposite ends, we always talk about the negative reviews. I'm like, why do we get that? Like so unfair. What about the ones that you get that you're like, that's justified?

SPEAKER_01 4:35

Like oh, when the patient's right.

SPEAKER_00 4:37

Yeah, when they're right. Yeah. Yeah.

SPEAKER_01 4:40

Was it wait, was this the one that you said you had to leave and come back?

SPEAKER_00 4:45

Did they like they came back, came back to haunt me? I thought enough time had passed that like they just didn't get the review thing to fill out because it's randomized. Um of course. No, no, I'm saying it's a good thing. Yeah, like they got, yeah, yeah. Of course they would. But let's listen, it doesn't go to everybody, but it went to that person. It went to that person. Of course it did. Um, and you know, those ones like they don't upset me as much. Like they upset me for myself because I'm like, do better, Hannah. Yeah. Um, but yeah, like I look at it and I'm like, But it also it also highlights what's wrong with the system.

SPEAKER_01 5:14

Like you can't be a high volume provider. Like if you are a high volume provider, if you are, yeah, when you're a high volume provider, if you don't have endless resources, like you don't have endless rooms, injections aren't drawn up for you. There's like an an available ultrasound every time you need one. Yeah. If there was, you would be on time all the time.

SPEAKER_00 5:32

Yeah, like if the system there's there's some system constraints to it, and some of it is pure just like sometimes there's human error and things too. Like I legitimately, in that scenario, was like I had a young child who was like screaming and inconsolable, and you know, we had to do this cast thing with them, and they were going freaking crazy. And in dealing with that, like mentally, yeah, that was all that was on my mind, and you know, as it should have been. And you know, I also recognize that we don't live in a world where people can sometimes just recognize, like, oh, things like that happen, like clearly they weren't intentionally trying to wrong.

SPEAKER_01 6:09

No, they they think no, they think you were in they were you were intentionally trying to wrong them.

SPEAKER_00 6:13

Yeah. Instead of being like, oh, like they're clearly very busy and things happen, but you know, whatever. I don't have that expectation of it. But otherwise, very good week. And next week I will not do that.

SPEAKER_01 6:25

Well, no, if nothing else though, like those crappy reviews make you self-aware. Yeah. You know, especially when you're like the patient was right, like I get it. And you know what? If that were me, I might have also said something. Maybe not like publicly in a review platform. Yeah, but maybe next time I would have been like, hey.

SPEAKER_00 6:40

Yeah, and you know, and that's the thing too. Like I talked to them after and I apologize to them in person. I'm like, why'd you feel the need to like do that? But whatever. Yeah. That was just it was easier for them. So yeah. But going into the uh the scarlet letter.

SPEAKER_01 6:56

Yeah, so the topic for today, I am going through application after application of new providers. And I've had not just recently, but like over the past 10 years, various applicants that have like small red flags, and then some that have big red flags, some that would would have things I wouldn't consider a red flag, but like those that I have to get permission from say that they are. So um the question of the week or the day, whatever you guys want to do here, is can you do something wrong professionally, personally in your past? And does that now define you going forward?

SPEAKER_00 7:37

I mean, from a moral standpoint, I like to say no. I I think that yes, you will always, you know, have that experience or carry that with you in some way, shape, or form, but should it prevent you from being able to move on? I think no.

SPEAKER_01 7:52

Well, again, healthcare, I mean, you're a person, I'm a person. We are people that decided to go to PA school and we learned all the things, but like we're also humans, you know, so we do things that sometimes are dumb. Yeah, not professionally necessarily, but sometimes in our lives. And you have to take, you have to separate the professional person, entity when they put on their white coat or scrubs or whatever, they hold a certain standard expectation, but then like you get to take that off. Yeah, like you take it off when you go home.

SPEAKER_00 8:23

Yeah at some point in your life. And so, like, you have to be given the grace that like this is yes, this is my job and this is my workplace self, but like outside of that, I'm still just the same.

SPEAKER_01 8:33

But like, what if it's not? What if you go to the grocery store and you like, I don't know, well, you do go to the grocery store, I do go to the curb sided. I do get curbsided, and like what if I get cut off and I want to flick somebody off? Then guess what? They're my patient. Like, I mean, I think about that stuff, you know what I mean?

SPEAKER_00 8:47

But like and you do. Yeah. Um, I will tie this to this is a weird way to tie it in, but like I was in a sorority in college, and um looking back, I mean, like, these are these are silly things, but in the grand scheme of it, I mean, this is a big life lesson. Um, one of the ways that the sorority board would explain to us every year, like how you conduct yourself, you're a representation of this organization and the bigger picture. So, like, yes, everybody's gonna party in college and have fun and like do things, but recognize that like other people who aren't in organizations or this organization, they can do whatever they want and look foolish, and that's on them. Now, if you do that thing, it's not only on you, it's on us too. Like you are representing us wherever you go, and so you are part of something bigger than just yourself, and it's a privilege, but it's also a responsibility. Yeah. So I do think that there is responsibility with certain careers that maybe others don't have. Like if I worked at Target, I don't think Target cares what I do on the weekend. Yeah. Arguably, I don't think here should care what I do on the weekend either, but you know.

SPEAKER_01 9:59

But I think like you're held to a certain standard because you you have to be there for your patients. Yeah. I get that. But like it is impossible to be on, quote, on 24-7 all the time, which is why you don't have a job where you work seven days a week. Like there are some days where you just unplug, yeah, take off, whatever. And again, like that doesn't mean that now all patients' needs like don't happen for the days that I feel like I'm not gonna do that. It's signing out to somebody else. Or like, you know, if I'm not reachable, this is why and this is who you can reach. But I don't know, I struggle with like I struggle with trying to represent who I am for all my patients and the practice, but also like I don't want to go to a soccer tournament with my kids and one of the moms is like, hey, can you check out my knee? Which by the way happens all the time. So like I'm not working now. Like, I, you know, of course I'm not gonna then make an enemy and say, absolutely not, here are my business hours, but like for the things where we judge people, what about if everybody wants to get drinks, right? Yeah. And then I'm the provider and I'm the provider who treated that person's kid. Yeah. Like now I have to think, like, okay, can I socially have a drink without that parent thinking that I'm going to drink and also treat their patient?

SPEAKER_00 11:21

Like you should be able to. Like, people have to be able to separate in their minds, like, this is your non-workplace self. Like, this doesn't mean that I get drunk before that I put pour some Bailey's in my coffee before OR days. Yeah.

SPEAKER_01 11:32

But also, like, you know, if I am in an adult soccer game and I rage out on someone on the other team, then next thing I know, I'm seeing them for knee pain. Like, what?

SPEAKER_00 11:42

And they're like, we but that's the same. Didn't you actually trip me? Yeah. But like that's like I did.

SPEAKER_01 11:48

And now I will help you. Now I will help you. But that's the thing. Like, I mean, we are we we have to be held to a certain standard, but also like we are human. So in professional PA career, like when when is it a mistake and when is it a pattern? Right. Like that's yeah, that's something that I would say when you did something one time versus this is what you do all the time, right? So that's something to consider, you know, what is normal behavior, what's not.

SPEAKER_00 12:14

Um and also like, does it affect your work and your job?

SPEAKER_01 12:18

Like, is this is there a professional repercussion for what you're doing? And this is a choice you made professionally, or this is a choice you made personally. Yeah. Like if I want to go hold up a picket sign and riot against, I don't know, PETA, whatever, can I do that if I'm wearing like my weekend clothes? You know what I mean?

SPEAKER_00 12:35

I would think yes. Like, you're are you not allowed to have opinions and things as a provider?

SPEAKER_01 12:41

But with that being said, I should be ready to be held accountable for questions with that. Should I be punished? No, but held accountable for that, I guess. But also like, I don't invite into the patient room people's opinions about my personal life. Yeah what I mean? Yeah, I'm there to treat them, you know, yeah, professionally. I don't need them to give me opinions about my life personally. Yeah. So it's hard. It's a really hard line. And when you live and treat in the community that you sorry, when you live in the community you treat in, how do you avoid it?

SPEAKER_00 13:15

You can't really. Especially like, and we're in, it's like a big community, but it's also very small town. Yeah. Still. Like you will see them at the grocery store and at the uh the local watering holes.

SPEAKER_01 13:26

You will. You will see them at the watering holes. But here's the thing we live in a world where your public image affects how people think your composite level is.

SPEAKER_00 13:37

So then let's dive into like social media stuff because like this is big and um, you know, there's a lot of a lot of providers representing themselves on social media these days.

SPEAKER_01 13:49

Okay. So when I was hired, all you had was the old resume, references. You call the references, maybe you don't, I don't know. And then maybe like hearsay, like, oh, let me talk to you who your supervising, you know, physician was for your rotations. That's it. Now, and I'm guilty of it. You can Facebook stalk people, you can Google search them, you can look at their Instagram. Yeah. Like now you look at all facets of their lives. Do I do that to see how good of a provider they are? No. But I do that. But no, but I also do that to see like what package they're bringing to the practice. Yeah.

SPEAKER_00 14:24

Like you said, like who are you as a person?

SPEAKER_01 14:26

Yeah. But they they represent your practice. So if you've got, I don't know, so judgy. Um, but if you've got someone who like is such a political social media presence, yeah. One, I guess, and I'm not saying like, you know, I'm gonna judge that and say, oh my God, I I can't have that, but like on the interview, hey, I see that you're very active socially in this regard. How do you draw the line when you're at work? Are you gonna bring that here? Are you gonna bring that here? Yeah. Or, you know, you have certain feelings about I don't know, anything.

SPEAKER_00 15:00

Yeah, yeah. Any of your personal views, are you going to bring that in? And if no, I don't think that's an issue.

SPEAKER_01 15:06

For example, our PTs, a lot of them give the parents their cell phone number, right? For because we have a lot of student athletes that are PTs tree. So to communicate, the PTs don't communicate directly with the kids because that's weird. Yeah, you give the parent your number, right? So the parent now has your number. Now they, you know, now their algorithm like populates you, whatever. We had a PT that was a bodybuilder, and all she had was pictures of her posted in like bikinis. It's like a little uncomfortable. Yeah, yeah. So, like, are you getting more patients because you're a legit PT or are you getting more patients because they like looking at your pictures?

SPEAKER_00 15:45

Yeah. And I mean that's sad stuff to think about too, because like my defense for this person, and again, because so like I I participate in social media. I post pictures of myself at the gym very frequently. Um, you know, again, like that's my personal life.

SPEAKER_01 16:04

But you also don't have an account that says Hannah the the the ortho PA. Well, it does. No, no, okay, hold on, hold on. Oh, okay. No, but I'm sorry. All identifying factors. Yes.

SPEAKER_00 16:18

Right. So like it's not about so my my social media account is not about my profession. It's my personal social media account. Um, do we have a and by we I mean like my team and my doc, do we have a somewhat professional social media account as well? Yes, but that one is purely like work-related things. Um, but I do think, like, yeah, if you're gonna have a personal account where you post those things great, obviously I wouldn't advertise myself with those things on it, like put bikini pictures on a professional account. Yeah. Um, but like, I don't know, like that's that's a hobby and a sport in itself, right? Like, what if you're a CrossFit competitor and you wear like I love those short CrossFit shorts?

SPEAKER_01 16:59

Like, what if I but it's confusing though because the social media accounts that promote professional, you know, networking like LinkedIn, that's a platform that it's advertising, like yes, post, post, post. And then you have to take that shift it, and then your personal stuff. So, like, you know, it's like you put on a hat of professionalism, and this is my professional profile, and then here's my non-professional profile, and God forbid someone sees that they are linked, yeah, and now it's confusing for them.

SPEAKER_00 17:28

Yeah. But also, I think it again, going back to the like, even though you have your personal life, it does come back and represent the greater picture of your company or your organization. You know, I think you should be able to post some things that are personal and fun and like you living your normal life within reason. Like, am I going to post a picture of myself in a bikini? Uh what is that called? The beer funnel? Doing doing a beer funnel. Probably not. Yeah, like I don't think that's a great choice. Should I get fired over it if it was posted? Probably not, but like, should you be posting it? Also no, like I wouldn't be surprised if I got a stern talking to like, hey, maybe you don't shouldn't do that. Yeah. Um, is it a firable offense? I I don't know. Maybe, maybe if you continue to do it after being uh told not to, or maybe you make your account private and make sure that nobody can see it except your personal friends.

SPEAKER_01 18:36

And they they can't see you anymore because they had no idea you had such strong religious beliefs. Or politically.

SPEAKER_00 18:42

Yeah. I was thinking politically too. Like that's such a big thing. And for me, not everybody feels that way, but it just blows my mind that like you can't have differing opinions and still like be friends with somebody or have them treat you professionally and it just be out of the picture of like yeah, what you care about. But I know for a fact that it does affect things, and I'm guilty of this. Do you ever find yourself like I mean, I never discuss like political things with anybody, but you shape shift a little shape shift a little bit when you talk to patients. Like, is your personality a little bit different in the room if Joe the farmer comes in and you're like, oh yeah, like the goats? Totally, yeah, totally talking about farming and sweet potatoes and I don't even know what. The tennis mom. Yeah. And are you like, oh my God, listen, like I totally get it. And my voice, I become valley girl.

SPEAKER_01 19:32

I'm valley girl in those conversations. Well, no, I think you are trying to be relatable because if I were to see a healthcare professional that was not relatable, I'm not going to disclose to them things that I maybe should. I don't know. And I'm not looking to be their best friend, but I if I saw my provider as perfect human, doesn't make any mistakes, I would have trouble relating to them. Or let's say, hey, did you do your home exercises? And I see the perfect person looking at me, I'd be like, Yes, I did. Yeah, I did. Yeah. But I don't want to disappoint them and tell them I didn't because they would have they would be disappointed because they're so perfect.

SPEAKER_00 20:10

Like, of course, you would do your home exercises.

SPEAKER_01 20:13

Right, exactly. But I don't know. I feel like it's just it's so tricky the professional persona and then the personal persona and keeping them separate and people get very confused between the two of them. And we are guilty of that. Yeah.

SPEAKER_00 20:26

Um, we're guilty of that. So question then. Would you rather, if you're interviewing or hiring, hire somebody who's a great PA, but they're all over social media and they like post a lot of stuff, um, or somebody who's maybe like not as great professionally, but they're not on social media and you have nothing to judge them based off of.

SPEAKER_01 20:49

Um, I would rather hire A because I would think B would be a murderer.

SPEAKER_00 20:52

Yeah.

SPEAKER_01 20:52

Right?

SPEAKER_00 20:53

Yeah, like why don't you have social media? Why don't you have social media? It's 2026.

SPEAKER_01 20:56

But also the relatability factor. Like, how are you going to be relatable if you have no social identity? I don't know. I don't know. You might get pushback from the city. But again, would I not management? I know, I know, but like would I would I exclude that person? I don't think so. It's just a very weird world that we live in because it's not so black and white and nothing's like this is paper and this is perfect and this is not. I mean, I I don't know. If someone does my husband doesn't have social media and he's not a murderer. I mean, I mean, I don't know.

SPEAKER_00 21:26

You've told me a story about I don't know what's his name again? Who? The snake. Mookie. Mookie.

SPEAKER_01 21:33

R.I.P. R.I.P. So maybe. Anyway, we don't so from a you know peer to peer standpoint with social media, we judge. Yeah. For better or for worse. Patients, I think. They judge, right? Hardcore. So let's talk about like hiring. Okay. So when we hire someone, and I'll give you three very distinct scenarios. Um, we hire someone I'm looking at where they went to school, where they previously worked at, very searchable, professionally searchable. And Google the you know Google the crap out of them. Um what I'm not looking at is the stuff that I have to work for. Like I'm not looking at criminal record for John Doe, right?

SPEAKER_02 22:16

Yeah.

SPEAKER_01 22:16

But my background check does. And that's not my job, but HR will do a background check. So scenario one years ago, I hired someone that had experience in ortho. Um, a resume was was solid, um, had worked for at least five years. She interviewed great, um, asked really good questions, background check came back, and there was this misdemeanor. I'm using like very soft words for something about leaving a kid in a car.

unknown 22:48

Okay.

SPEAKER_00 22:49

I don't laugh because that's acceptable. No, but like I don't even know what it is.

SPEAKER_01 22:53

Like it's a misdemeanor. And it comes up on a background check. So then I get the question from HR hey, this came up. Do you want to proceed? And I'm like, am okay, are you asking me if they're gonna leave patients in a car? Or in the room like I did last week? Or like hand, I mean, hands guilty, right? So, like that is something that came up. Who knows how many years ago it was. Now it's uncomfortable territory where now I have to talk about it with the person. So I did, and I felt like I felt like I was violating something. I don't know, because I don't care if we're being totally honest. Um and she gave she gave a story about what happened, how many years ago it was, and her mom was watching the kid and it wasn't her, and she was actually working three jobs, and long story short, yeah, she was guilty of what they said.

SPEAKER_00 23:40

So here's my thought with this too. Nobody who I, you know, I'm sure most 99% of people who leave their child in a car, it was a major accident, and I'm sure they feel worse about it than anybody who is judging them from the outside, and they're like, didn't mean to do it, and but can you imagine that?

SPEAKER_01 23:59

Like, one, were they even in healthcare at the time? Yeah. Okay. So what if they were 19? And what if five years later they went to school and they changed their life round? This now follows them, so that on a stupid interview for North Vedic practice, I'm asking this person, I'm like, who am I?

SPEAKER_00 24:17

Yeah, but also like that's basically saying that somebody who works in a certain job can't make a simple human mistake. I'm not saying that's a little mistake, but like you can still, like anybody can have a long day, probably us the inner.

SPEAKER_01 24:31

But here's the thing, okay? Like that is traceable. That's a legal thing. What about the town idiot that goes to the bar every Friday and gets hammered? And I have stories about that person, they apply for the job. There's nothing traceable. It's not like that. This is just here.

SPEAKER_00 24:50

No, no, no, no, no.

SPEAKER_01 24:51

So now on paper, based on our stupid standards, that person is better.

SPEAKER_00 24:56

Is better. Better fit.

SPEAKER_01 24:57

Better fit. Yeah. So like that, the background check dilemma. So when you now know, now we have to address scenario number two. Um, we had a provider that we had interviewed years ago, and this person had a very heavy presence in the um LGBTQ world. Yeah. Professionally.

SPEAKER_00 25:21

Professionally.

SPEAKER_01 25:22

They were the they they were the face of this professionally. Yeah.

SPEAKER_00 25:27

And everyone had a social media account, like living in this space as a provider, basically.

SPEAKER_01 25:34

Yes, yeah. And um felt very, very, very cert, very, very strong with we should make a movement in healthcare to get rid of pronouns altogether, like very much place their thoughts, and again, substitute this for religion, politics, everywhere, but very much professionally driven.

SPEAKER_02 25:52

Yeah.

SPEAKER_01 25:53

So did this come forward in the interview? No. Did I find this when I researched a person? Yes. So now having that person represent our company, now this lumps all that together. So now that is a face of us as a company feeling a certain way.

SPEAKER_00 26:11

Yeah, like you're basically deciding that you're gonna make a stance and nothing, you know, if that's the right or the wrong stance, but like you, you now own it.

SPEAKER_01 26:20

You now own it. So I had addressed it with this person, and this person was like, listen, this has nothing to do with this job. I don't even know why you're asking me. I was like, but it does though, because your identity is very much intertwined in what you're what you're doing here. And I'm not, I'm not saying I don't care about it, but like how do you separate that from your professional job? And they were like, I don't. I was like, Yeah, but I mean, who am I to say? Well, I need you when you put on your coat to feel a certain way, do a certain thing. It's not what I was saying, but it's just you can still be yourself, but like But it's like coming into it's like coming into work with like a Trump hat on every day. Yeah, like I'm gonna ask when you're here to maybe not put that hat on. And as soon as you leave, wear your hat. It's not saying that I don't support you. I just don't think you should bring that to a place where now you're being very forward with what you do and don't support you.

SPEAKER_00 27:11

And this is this is like because of a patient thing. Yeah. Like you are working in a role where you have to be neutrally serving all people, regardless of how they feel about what. And I'm not saying that like I I think it's wrong for patients to judge their provider based on how they see them, but it is gonna happen. Yeah. Um, and you know, you want to make everybody comfortable to an extent. Like if you're treating somebody who sees that you're wearing the Trump hat or whatever, now you and they don't feel that way. Well, they're now uncomfortable seeing you. Is that right? Is it wrong? I don't know.

SPEAKER_01 27:48

But it's but it's also addressing what is real. People, whether they want to or not, have a certain feeling about what you are portraying if you choose to portray a certain thing. Yeah. And they may not admit to it, we may not admit to it, but it that's it's what goes into what goes into it. Um, it's why we all wear scrubs. Like we don't wear our personal preference to work because we don't want to be seen for that. I want patients to come in and see us for what we are providing for them. Yeah. Um, scenario three. Uh going through resumes, talk to a provider, happen to Google the provider, which again I don't do, even though the past five minutes and sounds like I do it all the time. Yeah. Um, but I don't. This provider had their license revoked. Yeah, that's something we're gonna catch. Kind of during COVID. It was since reinstated. There are repercussions if your life license is revoked and then reinstated. There's a five-year contract that you sign that has certain terms and conditions. After those five years, there are no more repercussions. So this provider that I had talked to, great on the phone first. Now HR is telling me, uh, I don't know, you know, getting this person credentialed now that now they had they have this this smudge, this blip. But here's the thing like everybody makes mistakes. They did their thing. Yeah, they paid their time. Now, what was the thing? Does it matter?

unknown 29:18

I don't think so.

SPEAKER_01 29:19

Like, would I judge one way or another if it was, you know, worked a 24-hour shift and took Nycole in the car and fell asleep? I don't know. Yeah, like that makes sense. Right. Um smells like agreed Friday night. Was this someone who had a bachelor party and then got called into work two days later and blood alcohol level was still kind of high because he had a really good bachelor party? I don't know. Does that make it more acceptable? I don't know. You know, but anyway, so this person now has this smudge. So like, does it it's a mistake, okay? How long is it a mistake for? Like, is it acceptable that we forget after five years, ten years, 15 years? Is it never forgiven? Yeah. Is this person always gonna have this now follow them like a scarlet letter for the rest of their career?

SPEAKER_00 30:03

I hate that for them.

SPEAKER_01 30:04

I hate that for them.

SPEAKER_00 30:05

Yeah, like it especially you know, you've you've recognized it and done your time, like you said, so to speak.

SPEAKER_01 30:12

But even like but even like the whole DUI thing. What if they got a DUI at 17 before they even went to college or PA school? So can we judge a 17-year-old who now is a 35-year-old provider? No, but HR tells me I have to.

unknown 30:28

I hate that.

SPEAKER_01 30:29

It sucks because it also leaves like what's the redemption track? Like, is it can you ever come back from that? Yeah, you know, and do you always now have to explain yourself coming back from that? Yeah, and God forbid, if those of us who haven't had anything that's like questionable, now I'm always gonna be like in fear of that. Yeah, in fear of that.

SPEAKER_00 30:48

Yeah, and I hate that. Like, I I do get that, like, yes, those things are going to follow you, but like, gosh, can't we all just be a little more forgiving and yeah, understanding of everybody's past? I don't know. But I I also think that there's a difference between professional mistakes and personal mistakes and having to separate those two. Like, wouldn't you think it's a bigger deal per se to hire somebody who had made like a major medical error than had a DUI 10 years ago and no other criminal history sense?

SPEAKER_01 31:23

In uh North Carolina, the medical board decides when you get your license taken away and then they decide when you get it back. So, like, if that's the case, then punishment has been served.

SPEAKER_00 31:35

Yeah.

SPEAKER_01 31:35

So why are we then having any opinion?

SPEAKER_00 31:38

Why, why am why is my say more than the medical board? Like, shouldn't they be the one who's gonna be able to do that? That's why the medical board exists. Yeah, yeah, we're not the medical board.

SPEAKER_01 31:45

Yeah, it's like people get arrested and then they they're they're out in the wild. Now we fear them. I don't know.

SPEAKER_00 31:52

Jail has said that you've done your time. Yeah, jail says, jail says I guess you know, it maybe that's not always that's a little bit uh more um gray area, but the these are all gray areas. They all gray. They get to gray. It's very, very gray. This is not at all black and white.

SPEAKER_01 32:08

But I I think the the question here, and I don't think I don't think I have the answer, is the mistake forgiven? Or is it is it not forgiven? Sorry, is it forgiven, but just never forgotten? Like it's so sad to think about.

SPEAKER_00 32:21

Yeah. Forgiven and never forgotten, I think, is more acceptable than never forgiven, meaning like you can never come back from it and have a job again.

SPEAKER_01 32:29

Or so if this is a PA that we're talking to and they're listening and they're like, oh my god, this is like this is me. Like, do you just uproot and go to another state? Like, do you have to? Or do you just address it? Do you have to have like a five-minute spiel as to why and this is who I was then and this is why I'm not that person now? And here's my four letters of recommendation that show that.

SPEAKER_00 32:48

Yeah.

SPEAKER_01 32:48

Kind of, right? Yeah. I don't know.

SPEAKER_00 32:51

I hate that. Like, I mean, everybody makes mistakes. Yeah. And everybody should be allowed to be who they are outside of work. But I think that the take in live in my little happy.

SPEAKER_01 33:04

But the take end here is are you a good provider? Yeah. Do you have um a good character? Yeah. And outside of that, and there's like 10 deviations for the character part, but good character according to who, right? So are you a good provider? So does a good provider look at their mother-in-law's medical record because they just want to make sure everything was done okay? Technically, that's a violation.

SPEAKER_00 33:33

I never understood that one. I mean, I do, but like I don't.

SPEAKER_01 33:36

Yeah.

SPEAKER_00 33:37

Like, what's the problem?

SPEAKER_01 33:39

We worked with the physician, not with the physician, but the physician was at the same facility that we were at, and the mother needed foot surgery. And this physician, you can't. You are not allowed to operate on your family members. So this physician booked the case under his partner. When the um patient came back to the room, that physician came in and said, Hey, my partner's not available, I'll do the case. And the hospital was like, totally, totally planning on it. And the hospital was like, You can't do that. And he's like, Well, they're under anesthesia, and there is no provider, so I can.

SPEAKER_00 34:12

You know, like, oh, now I've made it some. I know, but like how, but how yeah, I mean, I get that. Like, that's that's you know, but crossing the line. Um, yeah, I mean, as far as like accessing charts and stuff, I mean But if I were to access my mother-in-law's chart, I don't know why I keep saying my mother-in-law, but here we are.

SPEAKER_01 34:31

If I were to access my mother-in-law's chart to see if she had an intramuscular tortol injection versus dexamethasone, technically, like, why am I looking at my mother-in-law?

SPEAKER_00 34:42

But like, what if they're asking you to, right? Is that a different thing? You know, what if what if my dad is like, hey, can you check and see like when the last time I got XYZ is like, what's the problem?

SPEAKER_01 34:54

Yeah, but if you're reading the note, yeah, that's that's not technically kosher. That's not kosher. Yeah, but we don't that that's not offensive, right? And like let's say that you know of, you know, a provider, like I said, that like you have a girlfriend and they're dating and they dated this provider, and you know that this, you know, that this provider they dated is kind of a douchebag. So now, like, does that go in their background check?

SPEAKER_00 35:20

You know, no, but it's in the back of your mind.

SPEAKER_01 35:22

It is in the back of your mind. But like again, technically, are they a good provider? Yeah. Maybe they're not a good boyfriend.

SPEAKER_00 35:28

Yeah.

SPEAKER_01 35:28

But are they a good provider?

SPEAKER_00 35:29

And should you hold it against them if you know things that, you know. Yeah. But I mean, it comes and part of this also comes down to like it's a small world, so you gotta be real careful about how you conduct yourself all the time because you never know who's watching or how it might come back to bite you.

SPEAKER_01 35:45

Yeah. So are we creating a culture of fear? I don't know. I'm kind of scared of this.

SPEAKER_00 35:51

Like, could you pull up my Instagram and like start deleting? Like, oh my God.

SPEAKER_01 35:55

No, I think you can learn from your mistakes because guess what? It's inevitable. You're gonna make mistakes. Um, be vulnerable. I hate that advice. But um, if you're too vulnerable, I know place they'll get eaten alive. But no, be vulnerable in so much as if someone's asking you about that, that can't be something you're not expecting. Yeah, right. I mean, you can't lie about it. But we we cannot create an environment where one mistake defines your career.

SPEAKER_00 36:21

We cannot. Yeah, I think that's wrong. I think, you know, does it work like that for I'd be curious, like for physicians as well.

SPEAKER_01 36:27

I but what this will lead to though is younger people knowing this and how like, you know, hard it is to navigate this world. Now you're running into a generation of people who are afraid to admit errors. Like I had someone who used to work for us that would always yes me and told me they did something. They didn't do it.

SPEAKER_00 36:47

Yeah.

SPEAKER_01 36:47

You know, they were afraid of, you know, I don't know, getting in trouble for something. But then again, now you are you're not admitting your errors, you know? And let's say someone notices that they are not mentally stable, yeah. You have to be clear that you need to, you need some, you need some help, right? Yeah. So you can't have a culture of fear where now you're making mistakes, but then you can't also have a culture where you're um judging people for needing to make mistakes.

SPEAKER_00 37:18

Yeah, like yeah, you have to be able to like, I I feel like this constant dichotomy of like the need to be perfect. I don't know why I use the word dichotomy. That's all right. I'm I what I'm trying to explain is I like I think about the urgent care providers having lived in that space for a while. You're hired with the expectation that you are going to be an independent thinker and independent decision maker and make and keep people happy and for lack of better words, serve the customer and and do what they want you to do, keep things flowing and keep that business like doing well. Yeah. But you are also expected to read the minds of all the physicians overseeing it and do exactly what they want to do. So I have encountered several instances where somebody has done something not necessarily wrong, like medically wrong, just different than what that other person would have done and been severely reprimanded for it. Yeah. And that sucks. Like the person didn't make a medical error. What they did was disagree. But disagreed with what you would have done. And they may not even have known like what that person wanted to do. And like, is the correct response? I think yes, for the provider. Because ultimately, like, yes, we can function independently, but are we independent providers? No, we work under the physician's licenses. So I would never intentionally go against what the physician wanted me to do if I knew they wanted me to do something different. But that comes down to them calmly addressing, like, hey, I actually prefer if you do things this way instead of like blowing up. Yeah. You know? Yeah. Like, gosh, people get scarlet lettered for some crazy things.

SPEAKER_01 39:08

Yeah. Telling you. But in regards to those that, you know, have had some mistake. And again, the DUI, the um, I don't know, the offense, the the hearsay, you know, Friday night drunk and whatever. Was anyone harmed? Yeah. Was it intentional? Was it isolated, or is it, or this is a pattern, or no, to test their character, what happened afterwards? Did you accept responsibility? Did you learn from this? Did you seek remediation? Did you demonstrate growth? Or do you continue to make excuses? That is that right there is going to determine whether that is a trustworthy person or not. Because we're not hiring perfect people, we're hiring those that are trustworthy, and you can't have trustworthiness without mistakes. Like, yeah, yeah. It's what someone does, someone does after that that determines what type of provider they're gonna be. Yeah. Right? I agree. Yeah.

SPEAKER_00 39:59

It was a good exit speech.

SPEAKER_01 40:02

It was a good exit speech. Damn it. But I mean, we can't, we cannot have providers that are fearful of making mistakes because it is a fine line. But if you are to get into this field, you have to understand what that comes with.

SPEAKER_00 40:16

You are representing something bigger than yourself.

SPEAKER_01 40:19

You're not working at Target.

SPEAKER_00 40:20

Yeah, you're not working at Target. You, I mean, you are it's somewhat of a well, I shouldn't say somewhat, that this is a privilege to work in this position and in these roles, people depend on you and trust you, and that you and you have to conduct yourself a certain way. Um, I can't make the comparisons that I want to make right now because they're a little bit too politically charged, but perfect. I'll keep those to myself um because that's not the space for this, remember? Uh but yeah.

SPEAKER_01 40:50

But it's interesting though, because we again we we have done many, many, many episodes thus far that have been like, you know, on the funnier side of stuff and whatever. But this is also really real too. Like unfortunately, these are all like things that we we deal with. So um hopefully that was educational. Very educational and just like a lateral epicondylatus talk would be or a distal biceps tendon rupture talk would be.

SPEAKER_00 41:13

Yeah, well, we'll we'll talk to one of those kinds of we'll do lateral epochondylatus and distal biceps, we'll do elbow pathology. We should do something um cut I hate when I say the word educational. It's all educational. It's all it's all educational. We'll do something clinical based. Um, I wanted to do soccer injuries too at some point. Yeah, like World Cup. Yes, yeah. I asked one of our foot and ankle. Do you see the Tibfib fracture? Yeah. Oh god, that just hurts my heart. Yeah, that was painful to look at, but it was. Yeah. All right, until next time. All right, bye.

SPEAKER_01 41:54

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.