Screw the Clinical Leadership Ladder, It’s a Jungle Gym in Healthcare Now

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Tracy Bingaman

I'm Tracy 

I'm a PA who burned out, big time, and now I teach PAs to negotiate effectively because every PA deserves a paycheck they are proud of and to feel valued at work. I love leopard print, skiing, and my morning routine. My mission? To help PAs stop feeling overworked, underpaid and overwhelmed and start feeling valued and earning what they deserve.

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We are about to debunk this myth that the one path to success and fulfillment in medicine is to climb the corporate ladder. This idea of a corporate ladder leaning against a building that is linear and that you climb one rung at a time is dead. time of death right now. 

No longer are careers in healthcare something where you start at the “bottom” and work your way up into leadership clinically and then eventually into administration. There is absolutely positively a way to find a career that compensates you generously where you are working clinically. 

If you have been considering a clinical leadership position, but you’re wondering if it’s right for you, Episode 214 of The PA Is In is for you. 

I want to take an opportunity to remind you that this journey through Healthcare as a human being is not linear. There will be twists and turns, job changes, specialty changes, and even shifts that you make inside of your current position to make it fit you better. 

According to a 2020 survey conducted by the Staffing firm at AMN healthcare, the average health care professional changes jobs approximately every 3 years. This idea of getting one job, staying there 30 years, and retiring with a pension is no longer the norm. 

I want you to think about that statistic for a moment. If you work clinically for 30 years and you change jobs approximately every 3 years or change positions within the same organization, you could hold an average of 10 different positions over the course of your career. 

Obviously this is variable and there will be seasons of your career where you leave jobs sooner or stay in positions longer. The reasons for leaving a position, an employer, or even a specific Health Care setting varies person to person. 

Interestingly in this 2020 study the AMN Staffing firm found that nurses and physical therapists tend to stay in their positions for longer periods of time. physicians, nurse practitioners, and Physician Associates make changes more often. 

People leave jobs for all sorts of reasons. They leave jobs for a better compensation package or schedule. We leave jobs for opportunities for career advancement. Change comes when we want to make a bigger impact and don’t feel we can do that where we are. And quite frankly we leave jobs when we are unhappy or dissatisfied with our current work environment. 

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It’s a Jungle Gym

I saw an article that declared the corporate ladder to be dead. This article gave this great illustration about how it is no longer a corporate ladder but rather a jungle gym. The path to success and fulfillment at work is no longer at one employer, one organization or even on one track.

Truly the best way to find a job that feels good, fits your life, fulfills and excites you, is to be agile and open to new opportunities. Whether that is a lateral move within your current company or climbing up, jumping over, sliding down and running back up to Circle back to another organization or somewhere that you have been before or a specialty that you have done in the past, it is not so straightforward as it used to be.

Making a Change

If you haven’t already taken a look at the decision framework downloadable guide which you can find at – It will help you to organize your thoughts and weigh the pros and cons both short-term and long-term about staying in a position versus seeking employment elsewhere. You can also use The Decision Framework to help you choose between two different positions if you have two job offers or if you are thinking where I’m at. 

Here’s what I have learned  in coaching and counseling people through these transitions as a part of their career as a healthcare provider. Your employer has become very used to seeing people who have made job changes. The average is a change in jobs every 3 years. That is, important to note, the average. That means that some people stay in jobs much longer than 3 years and some people will make a change sooner. 

There is no magic duration that is going to make a future employer think that you are “reliable”.  What they’re going to be looking for is a well-thought out answer to the question “why did you make a change at that time?”. This is something that you should think about in advance of an interview. 

Think about each of those changes and think about a way that you can phrase the reason for that change in a way that isn’t emotional or disparaging to your previous employers. 

All of this to say that there are real, valid reasons that you should leave a position. I’m going to cover five reasons that you should absolutely leave your position today.

It feels right to say that I don’t get to choose when you leave a job or not and these are not as black and white as it might sound. you don’t need anyone’s permission to give notice, start looking for a better job, and be open to opportunities. but in case any of those fears have kept you somewhere longer than you should have stayed, here are five clear reasons to leave your job. 

1 – Fraud or Unethical Practices

First and foremost the number one reason that you should leave your job: fraud or unethical business or medical practices. If you are aware of fraudulent billing, illegal activity, unethical practices when it comes to business, people practicing medicine that isn’t based on evidence, it’s time to leave.

 Then comes this question of knowing about fraudulent or unethical things happening, if you should report it. This is a very hard, emotionally charged, personal decision and you are really the only one that can decide.

No one wants to think about this happening but it is happening in practice. you are liable for fraud that is being built under your license. your reputation is closely intertwined with this practice or employer.

It’s one thing if things are happening accidentally and there was an oversight and something was done on mistake and when it was realized it was addressed and corrected. What I’m talking about here is  an employer that is knowingly committing fraud or breaking the law who is unwilling or unable to stop doing that.

Every day that you stay in a practice like that, you are condoning what they are doing.

2 – A Toxic Work Environment

The second reason to leave a job is a toxic work environment. A toxic work environment is defined as an environment in which the behavior, attitudes, or actions of individuals create a hostile, unhealthy, or otherwise negative atmosphere.

 Working in a toxic environment can negatively impact the well-being, mental health, productivity and morale of team members working there.

 There are so many behaviors inside of healthcare as a whole that lead to toxic work environments. Healthcare is an area that is fraught with trauma and toxicity. Want to hear more about culture and how we can improve the culture in our healthcare systems at large? Harrison Reed and I cover that in this post. We experienced this as a part of training, as new graduates, and in our careers as a whole.

 Things that can lead to a toxic work environment include but are not limited to bullying, harassment, excessive workload, lack of communication, unrealistic expectations, poor or non-existent feedback, gossip, favoritism, micromanagement and also lack of opportunities for growth or advancement.

The bottom line here is that if you dread going to work because the environment is toxic, it could be time to leave your job. 

3 – Non-Existent Work-Life Balance

You probably already know that I think work life balance is bullshit. I think that this idea of balance as a snapshot in time where everything is perfectly weighted half and half, that giving your work as much weight in your life as you give to the rest of your life is too much credit for work.

 Life is too short to work at a job that takes every last drop of knowledge, creativity, and goodness inside of you. Patient care is a worthy pursuit but it should not be draining you 100%.

 If enough clinical employees share that the workload and expectations are unreasonable, sometimes you can get another position approved. Sometimes you can get increased administrative time. Sometimes you can distribute the work differently. However, if none of those things are happening, non-existent work-life balance is a wonderful reason to leave your job.

4 – Poor Compensation

Whether it’s the benefits package, the schedule, your actual paycheck or you simply feel like you are not valued at work, all of those are reasons to consider moving on.

Part of this is quantifiable, numbers things like salary, retirement matching, Health insurance, paid time off and CME budget. Part of this is qualitative. How does working there make you feel?

 Do you feel like a valued member of the team that has a vote? Does the administration understand what it is like to work at the bedside in the capacity that you are? Are your physician and nurse practitioner colleagues treated fairly, better than, or worse than you? Does your job realize that you have specific revenue generating value but that also you are valuable simply because you are a person?

 You deserve absolutely positively without a doubt to feel valued at work. you deserve to be compensated fairly and generously for your knowledge, skills, and ability. Your paycheck as a PA should be something that you are proud of. 

If your paycheck doesn’t make you proud, book a Negotiation Consult here. It’s an hour-long consultation where we review your current compensation and I offer you feedback on what you can ask for and how to ask this in a way that is gracious and effective.

 If you are not valued at work and you don’t feel valued based on your compensation, it may be time to move on.

5 – You Don’t Like It

Yep, that is the entire reason. That is reason enough. 

If you simply don’t enjoy what you are doing anymore, look to make a change. Now if you simply don’t like the content of what you are doing but you love certain aspects about your job, take the time to make a note of what you do enjoy. 

How can you find a position within your current organization or department or specialty or outside of it where you get to do the things you love most about your job? 

If you can objectively zoom out and look at your job and say these are the aspects that I enjoy the patient interaction the time spent doing this procedure and identify what you do enjoy, this will give you a leg up when you start to look for a new position.

 Sometimes you have grown. Outgrowing your job from a skill standpoint is okay. Outgrowing your position from an ambition standpoint is perfectly normal. Deciding that it is time to move on simply because you don’t enjoy the place that you are working, the patients that you are taking care of, or even the specialty that you are in is okay. 

Use The Decision Framework to help you decide if it’s time to stay or go or head on back to episode 123 How to Know If It’s Time to Quit Your Job for me to walk you through using your mind or your gut to decide if it’s time to stay or go. 

If I could go back and tell myself anything earlier in my career, one of the pieces of advice I would relay would be to be more proactive about my job changes. It doesn’t feel good to wait until you are so frustrated and unhappy you cannot imagine working another day in your life at the place you are leaving.

Be agile. Be proactive. Be looking for opportunities for what’s next for you in your career! 

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I'm Tracy Bingaman

It's so nice to meet you... I’m a PA Mom life coach, self-care promoter, curly haired achiever, mom and dog mom, and a margarita drinking badass.

I burned out working as a PA... BIG TIME. I quit my job, doubled my hourly income earned, work half as much and learned to build a life around the things that I value instead of a schedule set by someone else and now I get to share all that I've learned with you. 

oh hey!

Now I teach PAs to do the same.

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