Joint Effort PAs
We're two orthopedic surgery physician assistants discussing PA school, life as a PA, cases and topics related to orthopedics, and much more!
Joint Effort PAs
Are You in the Right Specialty? Part 2
Use Left/Right to seek, Home/End to jump to start or end. Hold shift to jump forward or backward.
We’re back for Part 2 of “Am I in the Right Specialty?” — because apparently choosing a career based on vibes, caffeine tolerance, and how personally offended you get by a clinic running 45 minutes behind is completely reasonable.
This week, we finish our throwback magazine-style specialty quiz and find out where your PA personality really belongs. More questions, more questionable logic, and more opportunities to realize that your specialty may have chosen you long before you chose it.
Grab a pen, keep track of your answers, and play along with us. Your specialty fate awaits.
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. And we love the chaos. So let's see how this goes. Okay. All right. What is your ideal workday? 20 to 30 patients, moving all day, always doing something, or OR all day, one patient at a time, intense focus. 10 to 15 complicated patients. Uh, this is the third one now. Um, like you get to slow down and think about each one. D is a half day of clinic, half day of procedures. Um, E is a predictable schedule with manageable volume and minimal surprises. I take that as the cop-out answer, whatever. Who is gonna choose that? Well, a lot of people are gonna choose that.
SPEAKER_01Like that is what a lot of people just go to like get a job. Get a job for the predictability of it. Anyway, whatever. Yeah, whatever. Um, I am I'm gonna say D because it's half clinic, half procedures, which is literally my week. It's I like A, which is 20, 30 patients, let's move. I like B, which is OR all day, but I like the merging of the both. So D, final answer.
SPEAKER_00Yeah, because I I mean, and we actually have some days, those are gonna be my favorite days. Tuesdays are our OR slash evening, afternoon, evening clinic day. So we get to do a little bit of both. Um, I like the variety. I mean, you can't really have OR all day without 20 to 30 clinic patients spread throughout the week, or you won't have anybody to operate on. Um, I will add a caveat into that because in we we don't get to do this as much as we would like to, but flipping rooms in the OR, that is like I love those days. Yeah, because that is like it's like the move, move, move chaos of 20 to 30 patients, but it's in the OR and our quase cases are quick. So it is like you're on fire. Yeah.
SPEAKER_01Yeah, yeah. That ideal day is when you actually are like, wow, my feet hurt and I have no idea what time it is. That's a nice thing.
SPEAKER_00I haven't eaten or drank, and like we finish, I take my hat off, and I'm like, that was amazing.
SPEAKER_01So again, if you think about that, and again, notice that in none of those questions did it say anything about a specialty, but people awful often confuse liking a subject or liking a specialty with liking the workflow of that specialty. Like I like Ray's anatomy, but I don't want to do general surgery. Come on. Yeah, you know, I can like it, but doesn't mean I like the fact that they're, you know, in bowels all day long. I like watching it, it's not like doing it. Yeah.
SPEAKER_00Well, they're in more than bowels all day long. True. Do you know what I mean? Anyway. Um, all right. Uh okay, so end of the day, 4 45 p.m. and a complicated patient gets added to your schedule. What is your response?
SPEAKER_01Oh my God. I'm gonna I'm just gonna tell you guys it's B. I'm annoyed for a split second, and then I'm very interested. Some of my best visits have come with the five o'clock patient that really had an appointment at 3 30.
SPEAKER_00Yeah.
SPEAKER_01So I I'm I'm not uh as even healed to be like, oh my god, it's fine. Just check him in. Yeah, because it's there's so many other variables. No, I do. I get annoyed for a couple, you know, 10 seconds, and I'm like, the answer is always check them in. Yeah, yeah.
SPEAKER_00I agree. I'm gonna like ask like it inconveniences me, but I'm gonna like really.
SPEAKER_01Yeah. Um and I know I can spend time with them because there's nobody after them.
SPEAKER_00Number seven, we kind of touched on before, but I'll ask you. Yes, this is my question. Yeah.
SPEAKER_01Yeah. So this one is like my um what I was telling Hannah that I ask some patients. So you have four things happening at the same time. Let's say, like, the medical assistant needs an order, patient's waiting at the door, looking at their clock, saying I've been in here for 20 minutes, you know, they have a radiologist on the phone that needs to speak with a physician or a PA about an MRI, and then your doc's like, hey, I need you to admit a patient. So how you would handle that, I think um, you know, defines what specialty you would be would be good at. So um again, let's break this down for a second. If you were the people pleaser, you would take your physician first, right? Yeah. Okay. If you did what was the easiest thing to do, do the things that are, you know, no no-brainer. Just tell a medical assistant, whatever it is, fine. Yeah. Get the physician on the phone, that's okay. But if you want to work in an emergency, urgent care, you go with the the highly the you triage it. Yeah. Everyone's most important first. A patient waiting, staring at you is highly annoying, but that's not that's not the most important thing. Yeah. The radius on the phone, probably also not the most important thing because guess what? If they want to talk to you, they're they're gonna wait.
SPEAKER_00Oh, wait on hold. Yeah, yeah.
SPEAKER_01Um, admitting the patient, I guess, would be first.
SPEAKER_00Yeah, yeah.
SPEAKER_01Anyway, yeah, multitasking. That's interesting how people answer that.
SPEAKER_00Um, responding to actual emergencies. God, I don't know. I don't really have a lot of emergencies I respond to. I probably would turn the other way.
SPEAKER_01Well, okay, that's one of the answers.
SPEAKER_00One of the answers is uh you look through your phone get amputated, or is it an actual emergency because my response is going to be different?
SPEAKER_01I know. Well, okay. Would you look the other way? Would you question your life choices like why am I even in medicine? Uh, would you nervously say, How can I help you? And then follow whatever algorithms in your head, or adrenaline kicks in, you're like, I got this. Um, or is it even calmer than it would be if you had a confrontational conversation with like a family member? Oh my god.
SPEAKER_00Um, yeah, I mean, for the most part, like I'm probably just gonna turn the other way. Are you talking like an airplane situation here? You know, you're at the middle of something and like you're out of concert. Somebody somebody passes out, like I'm not gonna be the one. I don't have an ego about this. I'm not gonna be like, oh my god, guys, I'm a PA. I yeah, like I have training. Give me a pen and let's hollow it out and shove it in the ribs. No, I am not qualified.
SPEAKER_01I mean, I guess I am, but um I I I am weirdly calm and stuff like that. I feel like I'm a very good person in an emergency because I can kind of like very clearly what's going on, let me help you figure out how to get that done. Maybe it's not me.
SPEAKER_00Yeah, yeah, right. Like I I'm not like panicky, I'm not gonna freak out if somebody's like bleeding out. I'm okay, like let's call 911 and somebody who can help. But my level of response is not like oh, I'm the one that is there a doctor on board, yeah.
SPEAKER_01No, right, no, yeah. If we're on the airplane, my earbuds are in and I'm literally sleepy.
SPEAKER_00So yeah. Is there anybody with any medical training? And if somebody is like a, I don't know, a DMT tech or something. Yeah, like yeah, that those are the people that should handle it. So all right, round three. Um, this one is about the people.
SPEAKER_01Yeah, we could lump probably all these together. I think this is um trying to differentiate if you are built for primary care or if you're built for subspecialty. And uh are you you know, are you built for high volume visits or are you built for long duration talk?
SPEAKER_00Yeah. No, thank you.
SPEAKER_01Okay, so yeah, the first one. So your patient has a laundry list of complaints. Your response to that is this is my personal hell, get me out of here. Which I mean, like that is an initial response. I'm already 40 minutes behind. Um, I'm intrigued. Maybe they're all connected, meaning let's dive into it. You say the patient, let's work through it, or which two are we gonna talk about today?
SPEAKER_00I'm gonna hope that the medical assistant has already gotten through the which two are we gonna talk about today? Um, but probably not. They're probably gonna bring it up anyway, even if they were told that. But uh yeah, I'm annoyed because I really can't. Like now I'm gonna be 45 minutes behind for everything else. Um if if it seems all interconnected, hopefully I can like pick up on that and like you know, be the one who comes up with the final, like they've been waiting 10 years and nobody has ever diagnosed them correctly. And oh my God, how did you just figure that out? That's all connected. I would I would love to be that person. More often than not, it's not the case. Yeah.
SPEAKER_01We've we have um some primary care students that will rotate with our sports med doc. He's non-operative, and sometimes I'll get them um when he's out or something like that. And I recall when they go in and do an HPI and it's like a follow-up for shoulder pain. They come out and they're like blah, blah, blah, blah, blah. History of diabetes. They did have surgery on their right foot two years ago, and I was like, say less, stop, stop talking.
SPEAKER_00Like the primary is their foot attached to their shoulder now?
SPEAKER_01Yeah, the primary care focused people want to go through all the things, want to connect all the things. Functional medicine, holistic, want to go through all the things, connect all the things. Again, it's very important to know that about yourself. Can you pinpoint, go right to it? Because that's exactly what our specialty is most of the time.
SPEAKER_00And I'm not saying those aren't important, but like, you know, know when certain things are important versus aren't important. Like, I'm not saying there couldn't be some sort of relevant connection, like, oh, maybe they had surgery on their foot two years ago, and it's important to note that like they're an uncontrolled diabetic and they had some crazy postoperative wound healing complication from that procedure, and that is now going to affect my decision making for what we do for this. But um, but no, you gotta get it, gotta get to the point, or you won't be able to see your 30 patients a day. You'll never get to 104 a week at that rate.
SPEAKER_01Oh boy. Um patient doesn't follow any of your recommendations and returns saying they're no better. Now, again, I've seen this firsthand with providers at our practice, how they handle it a little bit differently. Um, and again, this is your internal response. Internal response and external. Okay. Okay, let's reset. B, why didn't you do what we discussed? And again, saying that a little bit aggressively internally. C, maybe I didn't explain it effectively enough. D, I am generally frustrated with you. And why are you here today? Or E, this type of interaction traits my soul.
SPEAKER_00E, for sure. It is soul draining because I go through all of those. Um, I go through the frustration and then I'm like, why did this person not do it? And then I have to reset myself now to talk to them and go in the room because I'm not the type of person that's gonna go in there and say, hey, what the fuck? Like, dude, why didn't you, why didn't you go to therapy? Why are you bothering coming back here? Yeah, why are you if you didn't do what I said? Yeah, like I just go somewhere else. Like, I'm not gonna do that. They're gonna tell me, like, oh, like I never got a call, or oh, is the copies really expensive, or oh, like I just did therapy for something else, I just don't really feel like therapy is helpful. And I'm gonna have to like, okay, like I understand where you're coming from. Like, let me look at let's talk about other options or why I think that that is still super important.
SPEAKER_01And again, this gets down to uh figuring out if you want to go into a specialty that requires an enormous amount of patience. And also, what is your reaction to that? I've had um again, providers where they hear that and the providers are like, well, then I guess we have nothing to discuss here. Again, like, no patience. Yeah.
SPEAKER_00I do say that out loud sometimes prior to going in the room. Yeah.
SPEAKER_01Well, again, internal.
SPEAKER_00Um, okay, so let's talk about like injections. You probably deal with this a lot with new providers and urgent care and like certain types of procedures that they have never been exposed to and never done before, and their comfort level with um the whole see one, do one, teach one scenario and doing things independently and um unobserved. So somebody hands you a needle and said, You've seen me do this twice, you know, we we've talked about this, like your turn, go get it. Um so some personality types might say, A, finally, B, sure, but a little hesitant. Um, C, can you watch me do it just once? D, I'd rather practice first. Like, how on me? Exactly. Um and E, why are we rushing this?
SPEAKER_01Okay, and F, when I had one provider say, are you sure this is OSHA approved?
SPEAKER_00Like, why are you in a state of the case? Are you basically asking, is it am I qualified to do this?
SPEAKER_01No, I think it looked so dangerous to them. There's no way that, like, I know which situation you're talking about. Yeah. Yeah. So why why are what does management yes, danger? Does management know we're doing this? I literally have had someone say that to me before. Um, but do not get yourself into a field that is procedure heavy and you know, maybe doesn't require a lot of supervision once you're comfortable with that. If that is the first thing that you say, you should not be in a procedural field.
SPEAKER_00I'm gonna go with sure. I feel like sure is like I mean, I finally I'm like Yeah, that sounds like you're like annoyed you had to wait so long.
SPEAKER_01Yeah, yeah.
SPEAKER_00Like a little overconfident, basically. Um, can you watch me once? I won't say there's anything wrong with that. Like, no, I think that's that's perfectly fine. Yes. Um, rather practice first. Well, that's a little bit, I mean, isn't that the same as watch me once? That's the same as normal. Yeah. All right. What gives you the biggest dopamine hit? I feel like this is a good, this is a good one. A reducing a fracture and it looks good after. Yeah.
SPEAKER_01Because if it doesn't well, it's the race over to X-ray. Yeah. So that your eyes can see what you think they're supposed to see. Yeah.
SPEAKER_00Yes, yes. Um, solving a difficult diagnosis. That's also a good one. C, stabilizing somebody who's critically ill. Oh God. Um, D, a patient telling me they're finally feeling better, and E completing a perfectly organized day on time.
SPEAKER_01That's tricky.
SPEAKER_00Definitely A, but yeah, A for sure. A for sure.
SPEAKER_01E close second.
SPEAKER_00Dislocated shoulder. Sign me up.
SPEAKER_01Yeah.
SPEAKER_00About a month ago, I was literally at home. I think I had just walked into my apartment and they were doing a sports physical night, and somebody texted me. Yes. My medical one of our medical assistants texted me and was like, there's a dislocated shoulder in urgent care. You're like, I'm already in my car. I was like, Yeah, you know, I'm I'm I'll be there in two minutes. Yeah. Okay. So came back. I was in an outfit similar to this. I was in like shorts and a t-shirt. I walked in the room. The guy didn't speak any English. Perfect. I was our one medical assistant that speaks Spanish in the practice. She came in to help. I'm in my shorts and t-shirt over there. I'm like, we're doing this right now.
SPEAKER_01Like uh I have left my house. I don't think I was asked. I was like, do you want me to come in? It was literally me saying that for a shoulder dislocation, a distal radius reduction, an aspiration of an infected knee and some type of laceration. Those things will get me out of bed, no problem. Yeah. Oh, yeah. Yeah.
SPEAKER_00Like I will turn my car around for almost anything procedurally. 100%. I did a couple weeks ago to go aspirate a knee in the ER. I was like, Yeah, you don't have to ask twice.
SPEAKER_01I've done that at midnight, and I picked up a ride-along one time. I picked up someone who was my student at the time. I called her at midnight and I was like, hey, do you want to go to this ER with me? And she was like, Yes. I'm like, that's amazing. She was great. Um, but anyway, yeah, so that that pretty much sums up our um our quiz. So let's go to the what's the interpretation of this? Yeah. So um again, the chaos questions. If you can multitask naturally, you can make decisions quickly, you can tolerate interruptions, and they actually don't sidetrack your day, they can kind of make you perform better. That is an ERPA, trauma, urgent care, critical care. Yep. Um the you know, caveat here though is the adrenaline and what you love about that can disguise your your burnout. So if you go 100 miles an hour all the time, sometimes the engine fails. Right. So again, that's something you need to know about yourself. If you figure out ways to fix your engine. Figure out ways to fix your engine. Um, the fixer. So again, when you see something and you're like, I I can fix this, I need an identifiable problem that has a tangible solution, very procedure heavy. You like the autonomy, you like to see results like this is broken and displaced, now this is non-displaced, you would do very well, ortho, general surgery, ENT, any type of like interventional radiology. So uh if you like interesting.
SPEAKER_00Yeah.
SPEAKER_01I mean, if you like fixing tangible problems, that is that is your that is your go-to. Now the detective, and again, I feel like not that you can't be the detective in ortho, um, but this is, I feel like those that want Ortho to be this. I'm not saying it's not, but if you love ambiguity and the labs excite you and they you want to dive into like the root of the problem and you don't mind saying like, hey, this doesn't quite fit. Let me have you come back and I'll order this lab and come back and let's get this MRI to quote, see what's going on. That they just don't fit well in ortho because it, I mean, like at least in our world, people come in, what is the problem and how can you get me to fixing it? Yeah, exactly. And um, the PAs that come into ortho that shouldn't be in ortho end up going into some type of internal medicine because your brain works that way and you thrive that way. Yeah. And I'm not saying ortho's not like that, but in a surgical specialty, it it it's not like you have to be able to be the detective while you're doing the other things too. So, but my urgent care people they they and I use this word all the time, it's paralysis by analysis. You like are paralyzed because you can't you can't quite like get to that. Like for instance, um, I had a um patient that came into urgent care, diabetic neuropathy, uh, on a Saturday, fell, you know, did something their foot. They went to the ER, the ER diagnosed with cellulitis, uh, x-ray was taken, x-ray was not read yet, so they discharged him. He quote, walked, literally, walked in urgent care. I should show you the x-ray because it's that impressive. It was a Lis Frank fracture dislocation and also the fourth and the fifth metatarsals. Oh my god. And the picture of the foot, it looked like a club foot, it was beefy red, and there's blisters all over the place. Oh my god. So the provider was like, Well, what how do I like what what do I put them in? How do I treat this? I was like, for what? Like the cellulitis. I'm like, dude, that's a that's a fracture blisters. The guy walked in here. Yeah. Well, I know, but our foot and ankle person's like out of town, so I mean, they're also diabetic, and like I don't know if they just like, are we sure this is from the fall? Uh I mean 100% sure it's from the fall.
SPEAKER_00Yeah, like you think you just that you think immediately like developed cellulitis right after you.
SPEAKER_01I mean, this conversation that like went on and on and on, and I was like, they said, All right, I'm just gonna put them in a boot. I'm like, no, no, the skin's gonna literally stuff off. Yeah, no, like bulky Jones dressing. They're like, well, but I'm gonna send them to the ER, so I don't want to go through all that because they're gonna take it off. So I think I'm just gonna throw them in a boot. And I'm like, no, like you know what I told them to do? Bulky wrap it with like a web roll, throw them in a post-op shoe because they're gonna walk out of here and drive themselves to the ER and let them figure it out there. They're like, what about the cellulatis, like IV antibiotics? I'm like, yeah, but we don't do Ivy. We don't do antibiotics, but like also a secondary problem. But anyway, it's like it's just the way that some people's brains are wired, don't thrive in certain specialties.
SPEAKER_00Yeah, yeah. You have to just be able to come up with immediate solutions. Um, with the relationship PA, somebody who just wants to get to know you personally. Yeah. You want to have like your patient, your low patient base, and you know them all and you treat their mom and their grandma. Yeah, guess what?
SPEAKER_01Women's health, family medicine. Yeah, yeah, yeah.
SPEAKER_00You guys can you can chat. Yeah. Yep. Time for chatting. Orthopedics, we embody all of it. We're just perfect. And like we're we have to do all these things at the same time. So, like, top of the food chain. Yeah. That's what I'm gathering right now.
SPEAKER_01Yeah, we need our whiteboard out so we can literally draw the overlap of all of these and where Ortho is or where we are.
SPEAKER_00Did you ever watch um It's always sunny in Philadelphia? Have you seen that meme where he's like got the things that try? Yeah, that's what I feel like.
SPEAKER_01Yeah, I think we can publish this.
SPEAKER_00Yes, yeah. No, this is gonna be a real thing. No, on the gram, you should put these questions up.
SPEAKER_01Yeah. I'm not kidding. Yeah. And also tell us what specialty you're in.
SPEAKER_00Yeah, we want to know. We want to know what you scored on the quiz, and then one day this quiz will be published. Actually, every PA student should be forced to take this quiz.
SPEAKER_01Yes. I love it.
SPEAKER_00Maybe make people take this when they interview here.
SPEAKER_01But it's so funny though, because well, there's a couple questions here which we didn't talk about, which I'm just gonna go over really quickly. Um, the questions that they don't really teach you in PA school, again, this is stuff that like I will ask indirectly on an interview how important is schedule predictability for you? And some people are like, whatever, I'll work whatever. Somewhat, it's really important, it's extremely important. I need to know exactly when I'm leaving. Like that we've talked about that. Yes. If you are that type of person, I don't know that certain specialties are gonna bend for you, right? Um, and then this is a really good one. Like, how much emotional energy can you carry home? Right. So A, I compartmentalize extremely well. Yeah. Some, but I recover. Um, I think about patients afterwards. Difficult cases stay with me for a long time, or I absorb everyone's emotions like a human sponge. Right. Like if that is the case, shouldn't work in the ICU. Right. Um, but that's another really good question to ask yourself. Like, if you work with like say cancer patients, if you can't leave that at work and you take them all home and now everyone you know in your life now you know you project on them or something, right? Like now everyone has cancer and everyone's gonna die and this is gonna be terrible, then maybe that's not, you know, psychiatry is not the best for you. Oncology is not the best for you. But yeah, those I ask indirectly on interviews.
SPEAKER_00You made the wrong call.
SPEAKER_01You were wrong. Oh yeah, these ones were bad too. Yeah. If you yeah, this one again, if you made the wrong call, nothing catastrophic, but it's just you like you didn't kill somebody.
SPEAKER_00You just like how do you handle that? You just put the cases in the wrong order for the day or something. Yeah.
SPEAKER_01But no, how do you handle that? Do you remember it unexpectedly while you sleep until you die? Um, do you think about it for three days and then move on? Do you have to talk it out? Do you review exactly why you missed it, or do you fix it, learn, and move on? Like those are those are those are hard questions. I talk about it right here. I know. Talk about on join FRPA. But anyway, yeah, we'd love to hear from you guys, see if that hit uh hit home at all. But um, yeah, I could diagnose some of our current providers and tell them if they're in the right field or not.
SPEAKER_00I think that would be healthy for them.
SPEAKER_01I do too.
SPEAKER_00All right, until next time.
SPEAKER_01All right, bye. 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.