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Need experienced PA's advice!!


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Hi All!!!

 

 

New grad here.  What is rounding for cardio and GI patients like?  Is this difficult for a new grad?  I have interviewed for cardio and GI where this would be a part of my day.  Also, I have interviewed for ER fast track-there are no benefits- well, you can pay $1500 for your insurance which to me is the same as no insurance.  There is no PTO whatsoever, no time off for CME and no $$$ for licensing or CME whatsoever.  Pay is $55/hr.  Thoughts?  Just trying to get my head around these choices.  Please let me know why one might be better than the other regarding practice, life balance, experience, etc.  I realized I don't have a lot of details to give you, but lets assume GI/Cardio pays well and has great benefits.  Which would you pick out of the three choices and why?

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Agree, pass on the $55/hr offer. They are just trying to take advantage of you.

 

You'll find in your career that there are no shortage of employers out there who just want to use you for your license, prescriptive authority, or to turn a profit. 

 

As a general rule, if someone is paying you NO benefits whatsoever, your wage should be 25-50% higher than it would be for a benefited position.

 

So, as a 1099: Conservatively add at least 33% to your required salary. Don't get used.

 

As a non-benefited W2, you may add a little less because you aren't paying self-employment tax, but in my opinion you should never take a W2 position with no benefits.

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I round at several hospitals in cards. It goes like this:

 

- Consult (first day we see)

  - check tele

  - Read the H&P and the order that called for you

  - see the patient to get HPI, cardiac background, physical exam (quick; much will be in the H&P)

  -Create the first part of the consult (HPI, PMHx, PSgHx, SHx, FHx, allergies, meds)

  -Examine labs, testing, vitals

  -Develop the assessment and Plan

  -Write orders

  -Get tests from outside hospitals

 

 

- follow-up visits

  - Tele

  - Short patient visit

  - Review labs, tests, vitals

  -Write progress note

  - Write orders

 

When you start out, it probably takes about 30-45 min for a consult and 15 minutes to do an established pt visit, including the note. This varies based on the severity of the patient and what's happened since you saw him or her last. You get faster with time. In the beginning, it might be helpful to write out your consult. As times goes by, you will get more comfortable dictating it as you do, which is faster but requires more organization on your part.

 

The big issue for a new grad is access to someone who can help, be it your SP or a more experienced PA (or NP) than you are. In the beginning, you will have lots of questions. Less as you go along, but still something new will always come up. You need to know your antihypertensives, antiarrhythmics, and pressors well.

 

Hope this helps.

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