Part two of your virtual shadowing day in dermatology.

In part one I walked you through the flow of a clinic day. Here I get into what I actually like about derm and what's harder than people assume.

The best part is that you can see it work. Somebody comes in with acne that's wrecking their confidence, and a few months later they're a different person. You don't get that kind of visible, fast feedback in a lot of specialties.

I also break down the difference between medical, surgical, and cosmetic dermatology, because they're very different jobs and the practice you join determines what your days look like. And I talk about patient expectations and how often I still explain what a PA is and what I'm qualified to do.

What I cover:

• What makes dermatology satisfying to practice
• Treating acne and seeing visible results
• Medical vs. surgical vs. cosmetic derm practices
• How practice type shapes your daily work
• Managing patient expectations
• Explaining the PA role to patients

Resources:

Free Application Timeline: https://www.thepaplatform.com/services/free-application-timeline

Free Resume Download: https://www.thepaplatform.com/services/free-resume-download

Pre-PA Counseling: https://www.thepaplatform.com/services/pre-pa-counseling

Pre-PA Academy: https://prepaclub.thepaplatform.com/landing/academy

Mentioned in this episode:

CapYear Training

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Alright, we're back with part two of talking about being a Dermatology PA with Archana.

I hope you enjoy this and stay tuned for an announcement about our next day in the Life series.

Welcome to the Pre PA Club Podcast.

If you want to learn how to become a physician assistant, you're in the right place.

I'm your host, Savannah Perry.

Let's get to it.

I want to thank mypa Resource and PA School Prep for sponsoring the Pre PA Club podcast.

So mypa Resource is a personal statement editing service that edits only PA school essays, only edited by PAs and most of us have admissions experience, so I am one of the editors.

Definitely check them out if you need help with your content grammar flow, making sure that you are on track for turning in your application and you can use the Code futurepa for a discount on any of their service options.

PA School Prep is an online course that focuses on the anatomy, physiology and med terms that you'll need for PA school to make sure you feel confident going into that first semester and that you are able to handle what PA school throws at you.

So check that [email protected] and also use the code futurepa for a discount there.

All right y', all, thanks for listening.

So the first part of today's episode actually posted back in August on August 7th, so if you didn't listen to that, you may want to go back and take a listen.

But just answering more questions today about my job as a Dermatology PA and I'm really excited because the next Day in a Life event will be on October 1st.

I not I'll be posting on social media exactly who is doing that because I'm recording this ahead of time.

But be on the lookout for that and make sure you're signed up and all of these Day in the Life events are added to a course.

If you go to prepacourses.com it's free.

You can sign up and watch kind of the replays of that there and we'll be adding them to the podcast as well.

So however you like to watch or listen, we try to make it as easy as possible for you.

But thank you so much for listening to the podcast.

At this point we I can't believe we're over three years now.

How I guess we'll keep it going but I'm so happy to have this great community.

If you're not in our Pre PA Club on Facebook, check it out.

We also have the forum on the PA platform.com now so if you have Any questions that you want to post anonymously, you can always post them there.

And then, of course, you can always reach out to me or on social media or wherever you like to hang out.

So.

All right, we'll get into this quickly today so you can hear all about the rest of my job as a derm PA and then I hope to see you guys on October 1st.

All right.

How do procedures work with your schedule?

Do you have set days and times, or does it mix in?

I prefer set time.

So, like I think I said earlier, like, the end of the morning into the afternoon.

But then if I have to mix in, in or, you know, switch it up, it's not a big deal.

But we have someone in my office now that's, like, dedicated to scheduling, so if I ever have a conflict or something, I just let her know and she'll, you know, switch around things or open up procedures.

You mentioned your clinic deals with medical, surgical, and cosmetic cases.

Is this common in most dermatology clinics?

It really depends.

We have some offices here who don't do any cosmetics.

We have some that are primarily cosmetics.

One of my best friends from PA school used to work in an office in Texas that was strictly surgical and only did Mohs.

There's a ton of variation there.

Why did you decide to do PA instead of md?

A few reasons.

I think I went into college, not sure as a bio major, which kind of puts you on that pre med track.

I never felt strongly about medical school.

Like, I just never felt like, oh, my gosh, I need to be a doctor, I want to go to medical school.

It was more like, healthcare is interesting, medicine's interesting.

I think I'd like to do that.

And so I think I just kind of researched everything, looked at it.

I knew about the PA profession after freshman year is when I really did shadowed.

And I shadowed a doctor and a PA who worked together.

So I got to see, like, them work separately and together.

And I just.

I very much saw myself in the PA role.

Like, we were very similar types of people.

I really like the teamwork component.

I like kind of that collaboration.

And I'm also someone who just.

I like to work, and I like things to happen quickly.

And so the idea of, like, medical school and residency and not being able to, like, 100 choose the area I wanted to go into because that's mostly decided by a test score that just really stressed me out.

And I was already having anxiety from chemistry, and so it just was better for me to go the PA route.

And I.

Once I decided I was like at complete peace with that.

I never looked back, never felt like I needed to go to med school or anything.

Okay, what is the most rewarding part of being a derm?

PA or PA in general?

I mean, derm is nice because it is one of the areas of medicine that's somewhat like instant gratification.

Maybe not completely instant, but you can see it and your patients can see it.

So.

So if someone comes in with a rash or a spot, I can make that go away.

And so when they see it go away and they come back for follow up, they're so happy because either they're not itchy or their rash is gone.

And so that's a very rewarding part of the profession versus if you fix someone's high cholesterol, they probably aren't really going to be able to tell and may not be as appreciative.

So I really, I like, I like treating acne patients especially.

I think just like you didn't see a difference in their confidence and that's really cool.

Challenges as a pa, like, this is hard because I really don't feel like that many challenges as a pa.

I mean, yeah, sometimes patients don't know what we do.

That's true.

Or don't want to see us, but that doesn't really bother me.

In Georgia, pas pretty much.

I mean, are well respected.

We have what I would call like good autonomy.

And so, I mean, I think, yeah, I don't really, I don't see it as a challenging profession.

But most people would say, like the PAs, I would say for us, like,.

It, it just depends on where you practice.

Like Hawaii doesn't, like, they just opened their first PA program.

So, like, the profession is not well known in Hawaii.

Nurse practitioners are kind of saturating the advanced practice provider realm here.

That is probably going to change with this PA program coming in.

But that was a challenge that I faced here is kind of explaining and educating what the role of a PA is.

Like I said in my sleep practice, there was no other option.

You either see me or you have to go to another sleep center.

That was it.

And I think that really helps because the thing is, like, I'm one, I'm one of those people that, like, I do my best to educate my patients on the role of a PA in healthcare, my role in their care.

I try to involve patients in their own care because living in Hawaii, there's a lot of cultural background too.

There's a lot of culture here.

And with culture comes traditions, including things that people eat so like you said, Samantha, like something as simple as cholesterol, right?

I mean, I can say, yeah, you shouldn't be eating this, but I'm not going to tell somebody who's culturally got this.

This is like a staple in their diet.

It's part of their culture.

You know, you try to meet them halfway and that's involving them in their care.

Okay, I don't want you to eat this, but if we can, let's just like cut back to half.

So those are challenges.

Like, there's also cultural challenges in that sense to get people to be compliant to then better their health here.

And then it's just the lack of education, I think.

And.

And if people want to see a physician, if I've educated you and you're still adamant that you want to see a physician because you're just more comfortable, you can see a physician because at the end of the day, I want you to take care of whatever your issue is.

Like, I wanted to be seen and I want it to be addressed and I want you to come out better health wise.

So it doesn't bother me if they would like to see the physician, But I do definitely try to educate them and say, hey, like, I can do the same thing.

And if I need my physician, I also can contact my physician.

So, you know, if it'll make you feel comfortable, and I will, I will call my physician with those patients, you.

Know, so every once in a while I have one.

I guess a couple weeks I had one that was like, so am I seeing the doctor?

And I was like, I was done.

Like, I'd already done everything.

And I was like, well, not today.

You're not scheduled with her.

But, you know, if you want to see her in the future, that's perfectly fine.

They're like, no, no, that's fine.

I was like, well, honestly, like, you don't want me to have to get the doctor.

If I have to get the doctor, that means you have something really weird going on.

And he was like, oh, yeah, don't get the doctor.

But it was funny.

Like, it was just like a routine skin check.

Like, he was totally fine.

But yeah, and that's what I mean.

Like, I think patient compliance.

And she's asking me issue in healthcare, like, no matter what, what role you're in.

But like in Georgia, PAs and MPS are essentially the same.

Like, we are identical.

And especially where I'm at, like, the PA program is so well established that PAs are preferred for sure.

Hold on.

What I do do, I think there may be PA job saturation in the future.

Maybe some.

But like, I think, I think it just depends on where you want to work.

Like it.

I.

Like I said, I stayed in like a suburban area and none of my classmates in this area had trouble getting jobs.

And a lot of us have switched jobs, never had trouble finding one.

People who went to like Atlanta, they had trouble finding jobs because it is more saturated, especially with experienced pa.

So like, you may have to work somewhere, like compromise on your location to get the experience, but then move to where you want to be to get the job you want.

Pros and cons of PA residencies.

I actually have like a whole podcast episode on this where I talk to two different ER people, one that did a residency and one who didn't.

And they kind of like compare this exact question.

So if you Google like the PA platform, podcast residency, it should pop right up.

Or if you message me on Instagram, I'll send it to you.

Let's get the like, pre PA questions for now.

Interesting cases.

Let me think.

Erosive pustular dermatosis.

One was interesting.

Contact reactions are interesting.

So when people come in and usually it's like tiny blisters in a certain area.

I had one recently that was like on her face and hands because that is like a mystery.

Like we have to try to figure out what they're coming in contact with that's making them break out in these certain areas.

So I mean, it can be.

I had one girl, she was in college and it kept happening to her and we figured out it was her roommate burning a candle.

Like, literally the, like fragrance from the candle was becoming airborne and making her have this reaction and so trying to figure out that.

So it's really interesting.

What else have I had that's interesting.

Cases I've had disseminated hsv.

So somebody came in and who had her herpetic vesicles on their entire body, like scalp, everywhere.

It was wild.

We had to send him into the hospital.

I had a melanoma patient who had these black dots come up right here in her scalp and onto her forehead.

That was.

She actually didn't have any mets, which was good.

But like, that was a crazy one.

That was one that I walked in the room and I was like, this is not good.

And I walked out to get my physician.

I mean, like it.

I knew right away that it was, yeah, like a really bad melanoma.

I've had melanoma in a 27 year old.

That was actually my very first melanoma.

I found it was on her back.

But yeah, really different.

All kinds of things.

Never know I'm gonna get ways to stand out for dermatology.

I think if you can get some experience, like at least on an elective or shadowing, it's helpful just like confirm that you know you want to do it.

Other than that, it's all gonna really just be personality and like getting to the interview and being able to kind of, you know, make a good impression and also get along well with your supervising physician.

That's.

That's ultimately why I was hired.

Like, we got along very well.

How did you get into derm?

So kind of like that.

Like, my preceptor, I knew a job was opening.

I guess I haven't really covered this.

I knew a job was opening and I told my surgery preceptor that I was interested in getting into derm.

And so he.

I hope he saw the Internet, but he made the call to get me, like, put in a recommendation for me and I'd send in my resume.

And so then I went and interviewed and then I did a day of shadowing and then I was offered the job.

Besides new patients, do the follow ups get assigned to you in a specific way?

Yes, some.

So, like, I'll see some of either the physician or the PA's follow ups, especially if they aren't there that day or they need to come in.

I don't know if it's done a specific way.

I don't honestly, like, pay attention to that.

But yeah, I do see some other people swallow ups.

How did I practice biopsies on very willing patients.

And I mean, we would always ask them.

And a lot of patients are perfectly fine with me doing a biopsy, but I mean, I had the basic skills to do one.

Like a shave.

Biopsy isn't very difficult to punch biopsy.

I knew how to suture.

And.

And that's the main thing you need to know how to do.

What's the process of changing specialties that would be if you.

I mean, you just have to find somewhere that wants to train you.

So, like, I would.

If I wanted to go into cardiology, I would get a job as a cardiology pa. And then did I go away or did you just go away?

You went away.

Okay.

I still can't.

I can't hear you, but I can see, you know, but yeah.

You hear me now?

Yeah, yeah.

I was like, maybe I'm frozen, but I'm just gonna keep talking never.

But yeah, so then you.

They would just train me, like, as A. I would have to do a lot of review, but I could potentially do that.

Um, as far as pay, like, so the average, just in general, of the average salary of a new grad PA is like 80,000.

I think the range is like 75 to 85,000.

There's a lot of controversy about pay in dermatology because some practice practices will want you to come on.

On a training salary that's a little bit lower until you get established.

And so, yeah, there's a lot of controversy about that.

But eventually most derm PAs do also get, like, a production bonus since we are very procedural based generally.

Do I feel like PAs are underpaid?

Not if they're good at negotiating and willing to walk away from jobs that they should walk away from.

I'm like a very big proponent about, like, strong negotiations and knowing your worth.

Yeah, yeah.

It's uncomfortable, but, like, it has to be done.

Oh, this is a good one.

What are the characteristics of a bad pa?

So, I don't know.

I think.

Like, like I think of a PA who wants to be a doctor.

Like, and they're out there, like, they should have gone to med school because that's what they wanted do.

And so, you know, I've heard of and known of PAs who like, won't introduce themselves as a PA and won't correct someone if they, like, call them a doctor.

Like, don't clarify their credentials.

And I don't think that's right.

Yeah, and I like not knowing the limits of your knowledge.

I mean, I've definitely had referrals or again, heard stories of and I've seen actually firsthand PAs who think they can handle things they can't and they should have asked for help.

Even doctor, like, a good doctor knows when to ask for help.

And so, like, that's just actually being a good human and a good healthcare provider.

And so I think just being arrogant in that sense and thinking you can handle stuff you can't other than that.

I mean, like, there's always gonna be good.

Good ones and bad ones.

Yeah, I think that.

I think the whole, like introducing, you know, or not introducing yourself, but like, somebody calls you a doctor, so and so, and you don't correct it.

I think that's just as.

I mean, I, I agree with you.

I. I feel like, you know, you're.

You're a pa. Like, be proud of your profession.

Like, you didn't, you didn't get into this to be a doctor, right?

If you did, you're in the wrong profession.

So you should and, and again, this is why this, this is only contributing to the fact that people aren't educated about PAs because you're just allowing people to call you doctor and willy nilly and you're not a physician, but you are very, very capable of doing many of the things that physicians physician does.

Definitely with the education.

Although they do have those like newer programs out there that are like the doctorate of medical sciences, which is geared towards PAs that want to go into education.

There it's made by PAS for pas.

I feel like that's going to get into like a controversial, you know, topic of discussion too once there's more of them out there.

But technically they've earned your doctorate, you know.

But again, you have to educate and still need to explain that you are a physician assistant.

Well, that's right.

So like in Georgia it's illegal even if you have have your doctorate to refer to yourself as doctor.

Yeah.

So like my teachers that had like their doctorate could not in a clinical setting be doctor.

So and so and like.

And I'll so I mean and to be honest, like I'll correct a patient once like if they.

Because some of them, they just like don't listen or they.

Yeah, so like if they're like, well, doctor, doctor, like, whatever.

I'm like, no, I'm, I'm Savannah, I'm the pa. And then if they're still like, you're a great doctor.

I'm like not a doctor, but thanks.

Like, yeah,.

I will talk about sleep med after, after Savannah's done.

Yeah.

And telemedicine.

I did some telemedicine for a while.

We stopped.

There are definitely technical challenges.

Kind of like tonight, I don't know.

Like also it's just very funny.

Like being in Durham.

Like people will show.

Will still like show you anything and it's really funny.

Like yeah, very interesting during telemedicine and dermatology.

But for me, I think telemed for me was being in sleep was actually good.

Like in Durham I could see it because you, you for sleep, the physical exam doesn't really change if you're going to order a study or not.

Everybody gets a study.

So.

Yeah, I can see the challenges with that too.

I know it like urgent care and even our family, our PCP was doing telemed.

And thing is you lose the, you know, you lose the physical exam part.

So for specialties that require a good physical exam to direct therapy or work up or treatment.

Yeah, I mean telemedicine definitely limits and even for you students, right?

Like anyone that's allowing you guys to shadow via telemed.

You're missing out on like learning the physical exam, really learning the interaction between the provider and the patient, bedside manner, things like that.

So definitely limitations.

How to tell pointers on how to tell if a job is worth pursuing.

As a pa, I think shadowing, if you can, is great.

Like I interviewed at three different jobs and I spent at least half a day shadowing at all of them.

And so I think that, you know, helps you to see how you're going to get along with everyone, see the flow.

If a PA has worked there before that you can talk to, I think that's great.

To get their insights, they're gonna, they're gonna be honest with you or you're gonna be able to tell if they, there were any red flags that they are maybe indicating how did you get your second derm job?

Were they hired at the time or did they create a position for you?

They did create a position for me.

So I, I started knowing I was going to put in my resignation.

I started kind of putting out some feelers.

And one of my friends who had been a local jar MPA had been there previously, but she moved.

And so I just texted her and was like, hey, hey, do you think that this doctor would want a part time pa?

And she was like, let me ask.

And so she got in touch with her and she was like, she absolutely wants you, she's going to contact you, blah, blah.

And so then she got in touch.

I went the next day and it was funny.

She was like, can you come this afternoon?

And I like, wasn't ready at all.

I got ready real quick and went over there and so we talked and she was like, yeah, I think, you know, we have space here.

We've had someone part time in the past and she works and my doctor works Mondays half a day because in the afternoon she goes and works at the prison doing dermatology there, which is really interesting.

She's there all day Tuesdays and then she switches off every other Wednesday and Friday and then the other PA is there Monday through Thursday and I'm there right now Mondays and Tuesdays.

But yeah, they, they created a spot for me and I am so, so thankful that they did.

It was.

Yeah, it's been really, really good.

Do I still feel imposter syndrome sometimes?

Not really anymore.

Like, I do, I do feel confident and I think I said before, like, like what I know and what I don't know.

So I wouldn't say.

Yeah, I wouldn't Say I feel like that much in my derm job.

Like, in life in general.

Yeah, but not so much there.

What's your favorite part of your job?

Being a pa Free sunscreen.

No, I'm just kidding.

Kind of.

But no, I. I really do like treating acne patients.

I would say that's my favorite.

Sometimes they can be difficult.

Like, teenagers don't want to talk to me.

But, like, some of them are really, really cool.

So I really.

I do like, treating.

Treating acne and just seeing the improvement there.

But it is actually, like, one of the perks of my job is I have not bought sunscreen, face wash, moisturizer, like, any of that since I started in dermatology.

Like, I get a lot of samples and get to try some stuff, so that's nice.

And I get, like, discounts on skincare stuff.

I get free Botox.

Everyone always asks that if I get free Botox, and the answer is yes.

So what do patients call you?

They call me Savannah.

And, like, I've heard of PAs who go by, like, Pa Perry or whatever, but that's weird to me.

You're like, PA Savannah.

Like, no, they just call me Savannah.

We had a freeze.

Think it's bad.

Have I ever felt uncomfortable asking your supervisor for help or, like, your questions or concerns were not welcome?

No.

I mean, I can tell they're busy sometimes, so.

And I tell the patients.

I'm like, listen, like, I'll try to get so and so in here, but, like, maybe they're gone for the day or they're in a procedure.

And then I'll tell them that, and I'll, you know, tell them I'll talk to them and we'll get back to the patient.

But, yeah, I mean, I. I don't have any trouble.

Like, I mean, I'll just go and be like, hey, I have a patient.

If you could pop in with me, that would be great.

Like, you can see your next one or finish what you're doing.

But, like, both of the doctors I've worked with are both literally, like, no, I'm coming.

Like, it's fine.

Which is really cool.

What's your favorite procedure to perform and why?

I probably.

I like doing all of them.

I like suturing, like, just in general, but I really like doing.

We have this V beam or candela laser.

It was actually my old office.

We have a different one here.

But that laser is really cool because it targets vessels of the face and, like, red spots.

So if you have, like, a cherry mangioma on you, so with the vessels, like ones that people get around their nose, it makes them instantly go away, and it's like the coolest thing.

So it's like I line it up and I zap it, and then the line just goes away.

And I just always thought that was so cool.

So I like that.

Have you ever had a patient with trichotillomania?

Yes.

Usually children, sometimes adults.

How often are you coordinating with other specialties for your patients?

Occasionally, not a ton.

So we'll have some rheumatology referrals, but we handle a lot of that on our own.

Sometimes patients will want to go to allergy, but allergy referrals are actually not very helpful in derm at all.

We do work with a mohs surgeon, and so that's where the majority of our referrals go.

Mohs or plastic surgery.

But yeah, occasionally we have to work with other specialties.

If I have like an accutane patient, sometimes I have to get with their primary care pediatrician about stuff too.

So you can kind of talk to different people.

Have I come across any Canadians in u. S. Programs?

I think so.

How do you tell someone really bad news without getting too emotional and tips?

So in general, I'm not a super emotional person, so I wouldn't say that.

Like, I struggle with this.

And I mean, and like, that's not to say I don't care, but, like, I just, I. I don't get super emotional about things.

I think this is, like, probably the opposite of what happens.

Like how since having a child, like, I'm like, less emotional about other stuff.

And so, like, I mean, I think just being there for the patient.

Also in my surgery rotation, since I was dealing with a lot of breast cancer patients, I learned a ton about delivering bad news.

And I think if you can do like a cancer focused rotation, you.

You'll learn a lot there and just kind of being there for the patient, you know, answering their questions, being positive and while still presenting the facts and being realistic about things too.

And so, yeah, it just takes practice, too, of being able to kind of separate yourself from situations and not take things home with you.

Too much too.

Typical day.

I don't know if I answered this, but I get to work around 8 if I'm on time.

Do my pathology start seeing patients from 8 to around 11 30, 12.

Bless you.

And then I always get a lunch break, usually 12 to 1.

And then sometimes we'll have rep spring lunch, but sometimes not.

Sometimes I go home for lunch and then see patients from 1 to.

I think my last patients at 3:50.

So usually I'm walking out the door by 4:30 and getting home.

So, thoughts on traveling PAs?

I think probably best to have some experience to do that.

Let's see.

Oh, this one.

Okay, non Durham question.

Since both of you are married to men in medicine, were you single during PA school or the application process?

I've heard that the majority of PA school students are single, so I'm wondering what your experience has been.

So I was, I was engaged.

Yeah.

When I started PA school, I got married in between the first and second year of PA school.

And then a lot of my friends, I guess a lot of my friends at the beginning were single.

But then they like got engaged or started dating during PA school and got married like afterwards.

I don't know if that answers your question, but hey, you're muted.

Oh.

Oh yeah.

I was saying, I feel like for me, what really helped was I was similarly like I was engaged when PA school started and then I got married like three months before graduation, which was a horrible decision because you had like eor and like what was the thing?

I don't even know the osce.

Yeah, I think it was just a lot of stuff going on like right before graduation.

And my school is also on the quarter system, so it was the second to last quarter.

So anyway, a lot of exams and I think the one thing that was really nice about having a spouse and I don't know where your husband was in his training.

Savannah.

But like mine was in residency in Hawaii, so we also had the long distance thing, which makes it hard.

I mean, generally long distance relationships are harder.

But the thing is, you're so busy in PA school that like, you really don't have time and you lean on your classmates.

Like, my class was super close.

I was in a class of 24.

Everybody was really, really close.

I always, like, I'm a big supporter of getting involved in PA school.

Like I was class president.

Definitely don't have to be president.

I'm not gonna lie.

It.

It's a lot of work.

But it was nice because there's a distraction outside of school that also like keeps you away from remembering that your significant other is really far away.

But my husband, because he was in residency, he understood the rigors of school, like in, like in, you know, medical training.

So that was nice because he wasn't nearly as needy.

Like he wasn't needy at all during PA school, whereas I was really needy when he was in med school.

I didn't get it.

I didn't understand it.

You know, like, so I do think there's benefit of being with someone who understands, you know, that's all.

Sometimes our conversations now, though, like, we have to, like, tell ourselves we're not talking about medicine because that's the other thing.

I don't know if that happens with you guys, Savannah.

But like, like, you know, we're both like, excited about, you know, to talk about this one, like, crazy thing we saw during the day, but we have to, like, backtrack away from talking about medicine.

Yeah, it's nice to like, debrief and like, understand where each other's coming from.

But yeah, we were on like, completely parallel paths.

So, like, we started at the exact same time, Pennsylvania med school.

So, like that first year where we were engaged and both in our first year, like, we didn't see each other, like, maybe once a week we'd like, grab lunch or go study in the library.

But it wasn't.

I mean, like, we.

Because I lived at home and he lived with roommates.

So like, we just didn't see each other and it was fine.

Just plan a date in May to get married and that was it.

All right.

How do you negotiate or even ask for a raise?

I. I mean, so like, like, I.

Number one, I'm a proponent of like, trying to have a built in negotiation aviation time or like, review.

Like, so when I was at my yearly review that we would bring this up, but also like just doing research.

I mean, I found like Durham specific resources as like, salary and talked to other PAs and kind of came in with my ideal setup.

And I was fairly firm in that.

Like, I, you know, and even to the point where at one point I had to say, like, if this is what y' all are offering and the best that you can do, I'm not gonna be able to continue working here knowing that that might mean I had to leave.

And.

And I think my office quickly learned that I don't.

Like, I'm not playing when I say those things.

Like, I really mean them.

And so I just think you have to kind of have confidence in what you're worth.

Like Archa said earlier, Preference Working inpatient vs. Outpatient?

Private clinic or hospital?

Or is it all opportunity based?

So, I mean, in Durham it's pretty much all private clinics, so I don't necessarily have a preference.

I never actually.

I only had one inpatient rotation and it was psych, which a psych inpatient rotation was rough, so not my preference.

The rare diagnosis, it was erosive pustular dermatosis.

I Think that's the one I was talking about.

Do you have to have good skin to be a derm pa?

I've actually like gotten this question before and.

No, I mean, like, I still break out.

I don't think I have that great of skin.

I think it's gotten better since I've started working in derm, but like, I definitely don't have perfect skin.

I've also gotten the question, like, do you feel doing cosmetic stuff that you have to like, look put together and like, look better when you go into work?

And again, no.

I mean, I like.

I mean, I try to look presentable, but like, I also, I don't know, don't feel like that matters that much.

So anyway, yeah.

Do you see children at the office often?

Yep, we see lots of kids with senior on 20 to 25 patients a day.

How do you manage your time but also ensure giving patients quality care?

So I do a couple things.

I mean, so I have my ma and she goes in and kind of gets a history and review of systems.

So when I come in, it's, it's like go time.

Like I don't have to do any of that.

So it's, you know, this is what you're here for and we get straight to it.

But like, I always, I always make the point of asking the patient, like every single one, I'm like, do you have anything, any other skin questions, anything else going on with your skin, any other spots?

Just to give them that opportunity to kind of think of anything else that they want to make sure that we're covering.

But like, skin is fairly straightforward.

I mean, there's just.

There are things that are not straightforward, but for the most part it is straightforward.

If somebody wants to know what a spot is, I tell them what it is.

If I don't know what it is, it's probably gain a biopsy.

And so it's not.

There's not a ton of like, I won't say, like explanation like medicines.

Obviously I'm explaining what to do and how to do it, but it really just balances out with the people who don't need a lot of explaining versus the ones who have a more extensive something going on.

So, yeah, I mean, I don't think, like, I guess I don't equate necessarily like spending more time with a patient as giving them better quality care because I respect their time and I know they probably have things going on too.

But if I have someone who just needs to talk about something, that's fine, we'll talk about it, but I try to be really respectful of that.

How often do you try to travel or take vacations during the year?

So I only work, like I said, Mondays and Tuesdays.

And my husband is off every other week.

And so we have like a vacation every other week, but we just stay home.

But, like, I mean, we'll go to the beach.

My office actually doesn't track vacation days.

Like, they don't camp care how many vacation days I take, which is nice, but I haven't.

I don't even know if I've taken one yet.

Maybe one day.

Yeah.

And then, like, I get Christmas off and like, all.

All the big holidays, I still get off.

Yeah.

See?

Did you.

I had school.

I. I had my.

My child after school when I was working.

I talked about a few cases.

Something I wish this may be a good one to end on.

Something I wish I'd been taught in.

I feel like I talked about this recently.

I don't remember where though, but I feel like what you.

And it's just.

I don't know that you could teach this.

But something that I wish I knew from PA school is that you're not going to make everyone happy.

Like, all of your patients.

That was something that pretty early on, like, the first couple months, like, I remember I had a patient who the mom was like, freaking out, which I like, I did everything appropriately.

It was more like on the patient and patient mom side, which you kind of learned with working with pediatric patients, how that can be.

But.

But I was very stressed out thinking that I did something wrong and that, like, I wasn't a good PA and all this stuff.

And both my husband and my supervising physician were like, you need to chill.

You did everything correctly.

Like, if anything, learn to explain this differently or learn that, like, no matter how you explain it, someone's gonna freak out.

Like, it is not your fault.

It is fine.

And so it was nice to have someone tell me that, but, like, it wasn't fun to go through feeling that way.

And so I think just.

I always try to tell people like, you, I'm not gonna say you're gonna mess up.

You will mess up.

But, like, you're also just not going to always do everything perfectly or make everyone happy with what you do.

And so you have to also, like, get to the point where you kind of accept that to a degree too.

Okay.

A couple more questions came in.

I am on my husband's health insurance, and my old office, they paid half of it.

It for just me.

But then I. I've pretty much always been on my husband's.

Do you get the same benefits as a part time pa?

I don't.

I didn't even ask for benefits cuz again, like I'm on my husband's pretty much everything, so.

And then I don't know if.

I don't even know if they offer retirement.

Like I didn't.

I don't even think I asked.

All right, so I guess that's all the questions for me.

Yeah.

Thanks for putting this together so quickly, Savannah.

It was nice.

Sorry about the crazy weather and difficulty.

It happens.

It happens.

No, I'll.

I'll stick around for like general questions.

I'll answer the ones that were perfect that pertain to me or the private message ones.

If you guys have anything else, I will answer those questions too.

You guys know where to reach Savannah?

She's at the PA platform, of course.

She's on Instagram.

She has a website.

She offers some really great services regarding, like pre pa, like mentoring and giving you guidance as far as getting into PA school.

So definitely reach out to her if you have questions.