sas5814

Contracted physicians, assistants at Ascension St. John go on strike (detroitnews.com) My entire life I have been anti-union. I have had to change my mind because of the way giant corporations and organizations act.

Just finished this quarter. Still passing but had a bad round. There are WAY too many "what would you do first" questions when 3 or 4 or 5 are all correct things and would likely be done all at once. Many have "what would you do" questions where the correct answer is highly subjective and 2 or 3 of them would all be fine choices and not wrong at all. One mentioned an intensivist. I do not have an intensivist. I have never met an intensivist. The only way to get to an intensivist is after an ER evaluation (generally). I have never worked in a hospital and spent most of my career in primary care in under served areas. The answer to the question is "send them to the ER." Not a choice. It is clear to me many of these questions are being written by people who work in large academic centers or work in specialty care and their idea of "common knowledge" is horribly distorted.

I was thinking more like anal probe. How bad you want it?

All true. However without a human to interpret the non verbal cues it won't take a hot second for people to figure out how to manipulate the process to get what they want or think they need.

Mental health chatbots powered by artificial intelligence developed as a therapy support tool - CBS News I have followed a couple of threads in different places about WHO is going to be replaced by AI and when. Most of what I have followed has been in a "residency" forum on Reddit. They are all tired and cranky so most of them are hoping "midlevels" will all be replaced by AI. Some think AI will enable "midlevels" to do more and more pushing the docs out. Of course nobody really knows but I found this article to be interesting.

Well everyone knows that is caused by low Oxycodone titers.....

OH! I got got.

We can't get out of our own way in this country. The whole point was to draw people into hard to fill jobs they might not otherwise take. Oy.

I learned it transcribes cuss words pretty well....

I think we all know virtual visits are just a fact of life these days for many reasons. There are opportunities for expansion of services where it is totally appropriate and can really improve access to care. There are also manifest abuses to make a buck and/or create a shiny looking metric. I am interested in some solid, well constructed data about the effectiveness of VV in terms of quality of car in addition to access to care. I can find hundreds of opinion pieces but not much in the "real" data category. Quick read of NIH and Mayo on the subject suggests specialty consults virtually seem to have equal outcomes as live visits with some variation by specialty. However the data on primary care is murky and the more complicated the patient the murkier it gets.

Yea you have to be careful with Google to make sure the info they send you to is credible. There is a way to only "scholarly" articles but I don't remember how.

Because the questions cover such a broad expanse of medicine its really tough to pick a reference (or 2) that would be good study guides. Its likely you'll spend a lot of time reading things that won't be in a question. When I start my questions I have UpToDate and Google and Medscape open on another screen. If I need a clue I start searching. About 90% of the time I find at least something that points me in the right direction.

I think "better" is a response to years of complaints. It is more reasonable and easier. I like that to my abuser confining themselves to slaps after punching me for years. Its better.

There is a bigger question... does this test improve outcomes or make anyone a better provider? There is so much passive "that's the way it is". I rode the NCCPA like a rented mule for 10 years and challenged them to justify their existence over and over. I invited Dawn Morton-Rias to my podcast when I was president of PAFT and offered to provide the questions ahead of time and promised I wouldn't deviate from them. Hard questions like "can you prove this improves outcomes?" Nope... the pretty much exact response was "there's no upside to answering these questions." I am retiring in less than 2 years and I work for an org that doesn't require continued certification. I am still taking the PANRE-LA just because I'll probably want to do something after retirement and I'm hedging my bets. I am still frustrated I have to spend my money and my time doing this worthless test. Question everything. Get the NCCPA's foot off your neck.

The NCCPA has zero evidence recertification does anything to improve the quality of care or make any of us a better provider. The sad truth is they have this entire profession by the short-and-curlies and there is nothing anyone can do about it.