Are You in the Right Specialty? Part 1

Ever wonder if you picked the right corner of medicine—or if you’ve just been in too deep for too long? Is your soul longing for an unmatched specialty? 

We think there should be a quiz a la pre teen magazine that matches you to your perfect fit

Play along and see if your current specialty is actually your perfect match… or if it’s time to reconsider everything.

We broke this episode into two parts so come back next week for the rest!

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. Am I where I should be? Am I even doing what I should be doing? These are questions we're asking ourselves. These are questions. This is an introspective episode. Yeah. Are you built for what you're doing? Are you built for orthopedics specifically? Yeah. Or what am I built for? If you don't know, I think um we're gonna talk about it this time. Kind of like what sport you're built for, right? Like you look at somebody and you can tell like they're a swimmer because of their broad shoulders. Or like, ooh, you look like you run ultra marathons because there's not much single ounce of fat on you.

SPEAKER_01 0:54

Yeah, yeah. Um, yeah. So this this topic this week, we're gonna talk about how do you know what specialty you're actually built for? And again, to be clear, that is sometimes different from what you want to do.

SPEAKER_00 1:06

I know. Well, yeah, it's same thing as with sports, right? Like maybe I wanted to be on the basketball team, but I was five foot and they were like, mm.

SPEAKER_01 1:16

Well, it's not that you know you can't, it's just that maybe your talents will be used better elsewhere. Yeah, it's not what you were made. Built for do you have a story of how you got into ortho?

SPEAKER_00 1:27

Of how I got into ortho? Um, I guess like the athletic training segue with it. Uh honestly, like I didn't have a lot of interest in high school. I wasn't like have a really a place, and I wasn't really on any sports teams. So I joined the sports medicine club. Okay. And to be part of a team. To be part of a team. Like that was my team. And I just like went fucking crazy with it. Like I started to go insane and became like the president of the not honor society and doing all this shit for it. And perfect. Yeah. And so became obsessed with it. And then when I went to college, I was like, that's not really like I want to uh actually I wanted to be a marine biology major and I wanted to train killer whales. Like, who doesn't? Let's do it. I know, like it I thought it would be great. Like you could swim with dolphins and stuff, and I would like pet them and be on the beach every day, and that's not really the case. So I was like, well, I guess I'll go back to the only thing I knew, the only thing I've ever done, which is sports medicine. And then I did that. Plus, like I was introduced to our practice from a from a young age. I was picked from the tree early.

SPEAKER_01 2:40

You were picked from the tree early. But I I also think when you are around this, like you rotated here in high school, right? That was your like internship class.

SPEAKER_00 2:49

Yeah.

SPEAKER_01 2:49

And then um ATC program here, and then hired as a medical assistant. Like, I think if you grow up here, there's also like some desire to come back.

SPEAKER_00 2:59

Yeah, it was more like a this was my team, also. It's a homecoming. Yeah, it was my homecoming.

SPEAKER_01 3:04

But it's not like you have the typical story of like you were a diehard athlete, and then it had to be ortho for you because you had to fix people like they fixed you.

SPEAKER_00 3:13

Yeah, I broke my elbow, and some PA out there helped me get back to doing whatever, and I wanted to do that.

SPEAKER_01 3:20

But that's very I and again, I say it like that because it's kind of typical. Like I've heard that story a hundred times, right? And that makes sense. Like I get that your desire to help that population is there because there's some pull of it, you know, there's some pull, and I get that. But I guess what we're talking about today is um I've also had that exact person who said, I broke my elbow, it was super traumatic, and this PA helped me through it, and I want to be like them. And then I see them here in their hands, and I'm like, oh my God, no.

SPEAKER_00 3:53

You're not like them.

SPEAKER_01 3:54

You're not like them. Yeah. I know you want to be, and your story and your essay says you should be. Yeah, but no, you know. So we're going to today try to give you guys some footprint so that you know when you look in the mirror what the mirror is saying back to you.

SPEAKER_00 4:13

You just look internally. You you, you know, maybe you wish you were this certain person and you're not, but you would thrive as the other version.

SPEAKER_01 4:27

Um, all right. Well, before we get into that, because I'm ready, how was your week?

SPEAKER_00 4:32

My week was it was pretty good actually. It was another little short week. My doc was out for a little bit towards the end of the week, so we tried to smush a bunch of our cases into the front end of the week, and it actually went pretty well. We did two distal biceps, we did a um radial and ulnar shaft and scaphoid in the same case. Yeah. So that was fun. That x-ray. Yeah, yeah. And then uh we did our 10th thumb implant, our 10th biopro. It was a huge deal. I almost had a breakdown because well, okay. Fortunately, we were scheduled for 10 and 11. Okay. We only made it to 10. Yeah, yeah. Thank God we're doing. I knew where this was going. Okay. I got a cake made, I got these stickers made. You saw the stickers. Oh, like if we had not done 10 and I had like set all that stuff up that morning, like I probably would have sat in the corner and cried for half of the day. I would have been a little bit more. Um, but yeah, oh, it was a terrible situation too. Like it just the things that can happen in communication breakdowns, and like um, so like everything that can't could go wrong did go wrong. The patient um had a pre-op visit with me, but none of like the labs were done before the pre-op visit. So they were not ordered, I guess for for whatever reason. And uh anyway, long story short, the day before the case, the nurse mess like, hey, the patient is on a GLP one. So we typically like, you know, they go through that.

SPEAKER_01 6:15

So it depends where you're at as far as what the rules are, but right, or like if you take it for diabetes versus weight loss.

SPEAKER_00 6:22

Um this point, it wasn't even in this person's chart that they took it. Of course not. So it was never added in. But anyway, besides the point, they um she's on the GLP one. It's the day before the nurse catches it and says it's okay though, because I told her to do a clear liquid diet all day. So I'm like, okay, like I'm glad that we caught this. This is fine. It's handled. Like, I wish we had handled it different on the front end, but it'll be fine. She's also they need a metabolic panel. Um, and I'm like, why was that never ordered at pre-op? Whatever. Like, I'm gonna put in the order, somebody call her and have her go get it real quick today. So she does. Um the this is all between me and the medical assistant. And then later that day, and Benoit's to I, a result comes back that her blood glucose is very low, and it was a like critical low value, i.e., makes sense because she didn't eat all day, which is fine, like you're not gonna die from that. But um, so somebody reaches out to the doc and is like, hey, what do I tell this person to do? And he's like, Tell them to eat. Um not gonna do that. No, no, no, he did because he didn't know about the GLP one or the fasting situation or anything. So we actually our team, but separate people collectively had told her to stop eating and then to eat. Yeah. And then she arrives and eats because you guys told me I should eat yesterday because in fact you didn't advise me, you instructed me to eat.

SPEAKER_01 8:06

You instructed me to eat.

SPEAKER_00 8:06

I was like, oh my god, like I'm about to lose my mind. So stuff like that happens, and I'm like, God, like I sometimes I just don't know what more to do to make things go right. Like you feel like you're doing all the right things, and yet still somehow perhaps it's a sign. I don't know. But whatever, it's rescheduled, it'll be fine, I suppose. So that would have been 11. It would have been 11. Okay. However, we still did 10, so we still ate the cake. Yeah, the cake was right, and I still celebrated just as happily. And I revived the Instagram account. I don't know if you saw. I did. I saw that. I was gonna say something actually.

SPEAKER_01 8:42

Yeah. I saw that post. Yeah, it makes me it it makes me feel like a little spark of creativity. Yeah. It's like reignited. It's the fire you think out. No, no, it's actually.

SPEAKER_00 8:51

You're like, wait, that is that's a fun thing to see.

SPEAKER_01 8:53

It's still burning.

SPEAKER_00 8:54

Oh, that's good. How was yours?

SPEAKER_01 8:56

It was good. Um, this was the last week that the provider that's been working with me for about five years had. So it was, you know, it was good, it was bad, it was, it was the end. It's also the beginning. Uh, I don't know. There's a lot of feelings this week. But um uh clinic-wise, we had we had a great week. We did another Misha. Um, that was cool. We did um an instability repair, which we're doing a lot of new things with instability repairs. This one was kind of run-in-the-mill, but it got me excited for like things to come. Um, but the highlight was Friday we did a revision ACL, PCL, primary MCL repair, revision ALL, all in the same patient. It's a lot of things. It is a lot of things. So the order of things was removal of hardware and then re-establishing tunnels, which it wasn't as hard as it could have been. The primary procedure was 10 years ago, then uh drill for PCL, then drill for ACL, hold places with sutures for that, then pass everything, don't tighten everything, then open up, do the MCL, and then tighten that, then tighten everything, then go to the ALL. So it was like Oh my gosh. Yeah. And it was mentally, I mean, and again, I was the assist, it was not the primary surgeon. Mentally, it was like everything has to go right. I'm on the back table doing two graphs, got to keep them separate, the length, the sizes, and you know, make sure everything's okay. And it went relatively smoothly. I did go into the room beforehand and I was like, everybody, listen up. The entire rest of this day relies on the success of this case.

SPEAKER_00 10:30

I said, Do you want a good day? This has to go. That's what I said.

SPEAKER_01 10:32

I was like, everybody, this is this is it right now. If you're like, hey, what, what's the case? This one, this one's the case. Um so that that was that was it was good. It was it was successful. And we've done, I haven't done a revision before in that case, but the last, because these are so infrequent when you do like a whole ACL, PCL, I then recall the last two that we did, um, which, you know, were not that smooth. So I have lived worst case scenario, and then we just lived best case scenario.

SPEAKER_00 11:00

I love that. Yeah. Learn from the past. Yeah.

SPEAKER_01 11:03

No, but that was um, that was like four surgeries in one. That was really, really, really cool. So um, but yeah, so next week, um, next week I've got a locums PA starting. That's uncharted territory. Hopefully, maybe we'll talk about that next week. I have a ton of uh content for next week. So um locums roles, hospital roles. Yeah, so little, little little bittersweet week, but um also my kids went back to school, so it was like a monumental week in a lot of different ways.

SPEAKER_00 11:32

It's a lot happening in your life right now. Even just today.

SPEAKER_01 11:37

There is, but going back to what we want to talk about today, I interviewed a PA, okay, and this is the backstory, because it's always a backstory. I interviewed a PA this week for a total joint position. The guy came in with um a non-ortho history, non-healthcare history is a second career for him, um, history and kinesiology, and really in that world um of like personal training, defined himself at such a high level and treated elite athletes. Went back to school. Um, ortho makes sense, but the things he was talking about and the side projects he wants to do, I'm like, bro, you're a sports med guy. You are you're a sports med guy, or you're a project manager.

SPEAKER_00 12:15

You're like, that role's already been taken here.

SPEAKER_01 12:17

No, I know. I'm like, and I'm not looking for someone on my team, which is weird because I just said I was, but it's already been filled. But like he's brand new at that, but also was speaking from someone who's had life experience because it's a second career for him. So he was actually like, you know, asking higher level questions. But I looked at him and he asked me questions like, you work at a private practice, you guys see high volume, like what do you do to protect your PAs? Like, how do you get people to work here when they go to the hospital and see 15 patients a day, make the same paycheck and go home? And I'm like, bro, thank you for asking me that, but I'm gonna turn it right back to you if that's the life you're looking for.

SPEAKER_00 12:53

Why didn't you interview there?

SPEAKER_01 12:54

Interview there. Yeah, why are you still looking for a job? Yeah, you know? So I just I had this realization of like, how did this guy end up here? And how did nobody tell him total joint world is not your world?

SPEAKER_00 13:06

Yeah.

SPEAKER_01 13:06

Like he'd probably be okay, but he's is the what he's going to want to impart on patients and what will be done in his life to make himself happy and successful is not that.

SPEAKER_00 13:15

Yeah, you have to know yourself. And I feel like that it and sometimes it takes a little bit of time. Like I first starting wasn't really sure what my role in life would be. I. The urgent care was perfect, but I did know very quickly that hand upper extremity was that was it for me. Like once I got a taste of it, I was like, this is this is where I want to be. Yeah. And I had some opportunities for like the spine team, which like would have been arguably at the time, like it was a much more predictable opportunity. Yeah. It would have been more lucrative, financially more lucrative at the time. Yeah, definitely. Um, but I just knew I was like, this is not, I am not that person who is gonna not like I want to do injections and I want to be doing evals on like multiple kinds, and this is not me saying spine is not complex. I actually do think spine is very complex and I don't understand it most of the time. But like, but anyway, but it's like you know, you're doing the same couple of procedures over and over and over again. You get so good at them, that's total joint. And total joints, it's the same thing. I that that's not me.

SPEAKER_01 14:19

Um, and you know that and you move on, and you you focus on what is well, but then you can seek out opportunities that you know one you'll be good at and two will be fulfilling for you. Yeah, we had another guy that we used to work with, and he he really wanted to be an ortho. He had the history of like, I broke my elbow, and I, you know, this guy fixed it, and man, he got in here, and there's nothing ortho about this guy. Yeah. His intentions were great, yeah, but he needs to be an internal med hospitalist. And I'll tell you what, I got a call after, spoiler alert, he doesn't work here anymore. I got a call from someone who was like, hey, you know, um, you put your name down as a reference, and I'm you know, just wondering this guy's gone from job to job. I'm like, well, because he came to us from another ortho job. And he told me because I don't know why I didn't work out, and he did get let go. It was like a circumstantial thing. And that's what we did. We let him go. Um, and I said to them, I was like, you know what? I never do this, but this guy is not an ortho guy. Yeah, great guy, yes, man. You can count on him, but just not, he's not in the right field. Yeah. And the other PA was like, I really appreciate that.

SPEAKER_00 15:25

Gosh, but yeah, I tell him that. Who needs to tell him that? Like, not my job to tell him that, but um, but you just like subtly email him job postings for internal medicine positions. He saw this and thought of you.

SPEAKER_01 15:36

But I will tell you what, I had a PA that worked here also, that was not really happy with the physician that she was paired up with. Um, it was kind of a circumstantial thing on paper. She was, she was great. She had 10 years experience, was going to take this new surgeon and build his practice up, and they just didn't get along. I saw it, I know she saw it. Yeah. And I pulled her aside and I was like, listen, I have this job opportunity for you in spine. And she came from neuro, right? Okay. In spine. This physician's asking about you. They want to meet you.

SPEAKER_00 16:09

Yeah.

SPEAKER_01 16:10

I will clean up all the ties here, just do yourself a favor and just seek another relationship that might be more fulfilling. And she was like, No, I'm just gonna see this out. And long, you know, short story short, we let her go. Like it just didn't fit, you know. You guess where she works now? In neuro in like pain management. So I don't know. It's just it's one of those things. So, how do you know? Hannah and I are gonna tell you today.

SPEAKER_00 16:33

Yeah, yeah. How do you know? So for that, that kind of covers, you know, the wrong. Yeah. And it can go wrong.

SPEAKER_01 16:40

Yeah.

SPEAKER_00 16:40

So what are the ways that like what things predict do you think what your personality or what things predict what your specialty would be?

SPEAKER_01 16:51

I think it's it's a lot of personality, it's a lot of how you communicate, it's a lot of what type of chaos that you thrive in. And if you don't know that about yourself, you're gonna get stuck in the wrong specialty. Um, and it sucks because like I I wanted to go into neuro. Like I love everything about neuro and the brain and interactions with various medications and whatever. I I could teach a class on that. But I remember, I mean, like, it wouldn't be a good class, but but I remember in PA school, I was like, this is my path. I'm going to go into neuro, if not like psychiatry. Like, I'm I'm totally gonna do this. And then um I interviewed post-undergrad, not for PA school, where I was like, I'm doing I'm gonna get my PhD in in neurology. And I went on two interviews and talked to current students, and they told me, you know, the lab and they're like, Listen, you need to like, you can't, you you need to be the type of person that can't wait to see what your rats are doing in the morning. You want to look at those lab values. And I was like, oh my God, like somebody kill me, somebody kill me, get me out of here. I don't want to do this. Yeah. But like, what do I do now? I can't wait to look. Like, if I know someone's getting an MRI, I can't wait to see what it looks like the next day. Like that, like that, you know. Oh, I know.

SPEAKER_00 18:04

Like I stay up all night sometimes and I'm like, has the report come back? Because I want to see if it if the radiologist matches what I reads come back. Yeah, I want to look at those first on my own, and then I want to see if it's a lot of different things.

SPEAKER_01 18:16

I have one of those that I saw a patient, and then someone else saw the patient, and someone else got the MRI Arthur Ram, and I was like, there's gonna be nothing wrong, and there wasn't. And I was like, boom, boom. Like I that's what I like, yeah, you know, can't sleep about. But anyway, um, I think it's you gotta know the stuff about yourself. So this hopefully one day will make its way into the AAPA monthly magazine. Yeah. As far as what specialty should you be? Yeah. We're going to trademark it, join F for PA's quiz. Your 17 magazine. Yes, yeah. Like, yeah, I got my, you know, what what is my color wheel? You ever take those quizzes? Or like, what is what is like your color palette? My color, my color palette. Yeah. This is kind of the same thing.

SPEAKER_00 18:51

I love that.

SPEAKER_01 18:51

Yeah. Perfect. Okay. So we're gonna clump these together. Um, so this first one is your natural operating system. These are questions that um you will answer based on how you function.

SPEAKER_00 19:05

Okay. So we'll give you the question and all the answers, and then we'll answer it ourselves, I suppose. Okay. So round one, um, your clinic, question one, your clinic is 45 minutes behind what starts happening to you internally. A, unacceptable. Try to start figuring out where the bottleneck is. B, fine, we'll get through it eventually. C, I'm stressed, but I'm gonna make sure every patient still feels heard, give them time, and I'll just be behind and internally stressed. D, secretly, I kind of like the adrenaline. And E, I begin questioning every decision that led me to healthcare. So, um, yeah. Hannah, how would you answer that?

SPEAKER_01 19:48

So I know I know exactly how you're gonna answer this.

SPEAKER_00 19:52

Really? Are you? Are you sure? Um I mean, I feel like D. Okay. But I mean, there are there are subsets of the other answers. I'm gonna go with D because like I don't know if this is just me being I'm the martyr or whatever, but like I like the adrenaline and I yeah. But I don't like that patients are waiting for 45 minutes because now I'm gonna get two star reviews. Yeah. So I need to find out how to fix it.

SPEAKER_01 20:16

Okay, this is how I thought you were gonna answer it, because this is how I'm gonna answer it. First, I'm gonna say A. Yeah. Then I go immediately to B. Then I go to C, then I go to D, and then it's E. Like I go through all of those. You, yeah, you can't even pick one. No, I cannot pick one because my I immediately gun to my head, A. Yeah, unacceptable. I need someone to figure out where the issue is. Well, that's how I verbalize it. Well, throw every patient back, steal everybody's rooms, and then and then I'm like, guys, guys, also collectively, guys, it's fine. We're gonna be fine. And then in my head, I'm like, let's fucking knock this out. Yeah, like this is awesome. And then I'm like, why am I sweating? And then I'm like, why don't? Yeah, what was that all for? No, but it's it's funny because in certain specialties, and again, this is a little teaser for where this all ends up. In certain specialties, uh, if it's unacceptable and you go immediately to like, I need to correct this problem versus like, hey, it's cool, patients will understand. Like, that is not that doesn't flow in certain specialties. It's certain specialties where there's built-in time for each patient can talk to you about 26 things, then yeah, take your time, man. Take your time. You probably have a buffer built in your schedule somewhere.

SPEAKER_00 21:28

All right. Run through these like quicker by just asking the questions. And I think what we should do is post them on the gram. Perfect. And then people can take their quiz and we'll at the end of the week put the results.

SPEAKER_01 21:40

But I will tell you that that first question, that I use as an interview question. Yeah? I do. It's a slightly different. But I want to see how people I want to see how people will answer it. And I will say, um, uh, you well, I guess this is more for the chaos one, but um, you have three patients checking in, the phone rings, you're in the middle. Of a splint, two people are standing at the door asking how much longer it's gonna take. Like, how do you deal with that and in what order?

SPEAKER_00 22:05

Mm-hmm.

SPEAKER_01 22:06

Yeah.

SPEAKER_00 22:07

I love that. Yeah. Anyway. Give me my pen and paper.

SPEAKER_01 22:10

Question two.

SPEAKER_00 22:10

Um, question two. How do you feel about making a decision with incomplete information?

SPEAKER_01 22:15

Uh yeah. Give me what you have and I'll just figure it out. Yeah. Yeah. I will quickly research if I need to know, right? Like if I don't know beyond what I feel comfortable with, yeah. I will look stuff up real quick. Um, I will discuss it afterwards. Yeah. Especially when it's like in real time. Cause if you stop and you're paralyzed by having to discuss everything, that does not work in certain specialties with certain volume.

SPEAKER_00 22:37

Yeah. I I mean, I do I will make the call that I can at the time. So I guess be comfortable as long as I can change my course later. I'm just honest. I'm like, hey, I'm working with what I have, but if there's more that comes to me, then you're great. I'm gonna change it. You're an A and a B. See, that's what I struggled with the first one.

SPEAKER_01 22:54

Yeah. A, A, and B. Okay. So anyway, decisiveness versus recklessness. So that's what you guys need to think about for question two.

SPEAKER_00 23:01

Okay. Question three. Um, someone interrupts you, maybe not the same person. You're interrupted six times while writing a note. How does that make you feel? Um, B, annoyed but manageable. Yeah. Um, mine is E. I'm documenting on the wrong patient now.

unknown 23:19

Okay.

SPEAKER_01 23:20

Or alternatives include I need everyone to stop talking to me immediately. I can handle it, but eventually I'll miss something. That's super chill. That's chill guy. Yeah. Um, or no problem. What are we talking about? Unfazed. Yeah. The answer to this question may separate emergency med, urgent care specialties from those requiring a prolonged concentration.

SPEAKER_00 23:39

Yeah, I don't my attention span isn't good enough for that. So um, okay, number four. I like this one. Your supervising physician says, do whatever you think. Or I will say in direct quotes, because I get this at least seven times a week, do whatever you want.

SPEAKER_01 23:58

There's such a subtle difference. I want to do a whole podcast on that statement.

SPEAKER_00 24:02

On the statement, do whatever you want. I think we I think we should unpack that because for multiple reasons, but yeah. Do you get that too?

SPEAKER_01 24:12

Is that just me? I get the, well, I'll say, hey, what do you want to do? And I'll get the just figure it out and tell me what you decided.

SPEAKER_00 24:20

Yeah. I mean, the do whatever you want is akin to that. Um there's like a snorky undertone there. Or did I just hear it that way? I I don't know. Maybe there is. Yeah. Maybe there is. The golden retriever is still wagging its tail, like, okay.

SPEAKER_01 24:35

But it said, like, I heard when you said that, like, do whatever you want, like, you're not gonna listen to me anyway. Like, I heard that.

SPEAKER_00 24:40

No, the do whatever you want also comes with like the caveat that do whatever you want, however, do what I want.

SPEAKER_01 24:49

Oh, you know, I see that's a passive aggressive, do whatever I want.

SPEAKER_00 24:52

I don't know. It's not passive aggressive, it's more like I think the intent is there. Do whatever you want to give me the control, but like it's so hard to relinquish that ultimately God, it's so layered. It's so it's there's a lot to unpack there. That's why it needs its whole episode. All right, so my emotion with that, do whatever you think. Uh mine's not on here, and my emotion is apathy or melancholy because it's just so indifference, thank you. Because it's just a run-of-the-mill, like, yeah, that's used to it.

SPEAKER_01 25:24

This is important because it defines how much autonomy you actually want. And again, I've had people I interview that say the words like, I want to, you know, I love the independence. And then when it comes down to it, they cannot make a decision. No, they want somebody to tell them what to do. They want someone to tell them what to do, they want to carry it out. Yeah, um, I like the freedom of it. I feel like that is um, yeah, I'm like 98% freedom and 2%. Are you sure? You know?

SPEAKER_00 25:45

Yeah, yeah. Well, I love the freedom until the consequences of my freedom come into play. And I like the moment before I start to question it. We've talked about this. Like you, you know, plan this whole surgery based on your exam and your interpretation of things. And then you get to the morning of and you're like, what if the biceps is not actually torn? Yeah. Like, did I read the right MRI? Like, did I look at the right thing? I have so much imposter syndrome with that. It's insane. Like the other day I went back and I swear, this this like fracture that we did that was all three of them, I must have looked like 20 times at the x-rays. Like, is it both of them? Like, think about it. I knew it was and I would pull it up at like 10 o'clock at night, and I'm like, oh, okay, oh yeah, let's see. Okay. Oh my god. I know it's a that's a problem. Um, so yeah, I I want the autonomy.

SPEAKER_01 26:49

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.