krisephillips Posted November 18, 2016 Share Posted November 18, 2016 We have an express care clinic in our multi specialty building. We met with them today to discuss patient care, splinting, follow up as we have had some issues with patient care recently. A young express care PA interrupted the ortho attending discussing knee injury protocols to say "if the problem can't be seen on x-ray, then i don't know what is wrong!" Ugh......sigh Link to comment Share on other sites More sharing options...
Reality Check 2 Posted November 18, 2016 Share Posted November 18, 2016 Deep Sigh of Utter Embarrassment. Hopefully someone can take this young PA and re-instruct in an actual knee exam. Or lock in him a room with 2 knee immobilizers on and a locked hinged shoulder brace on each side...... Some of us actual examined knees before MRIs and still managed to figure out what was wrong with the knee. I feel your pain................................ Link to comment Share on other sites More sharing options...
DiggySRNA Posted November 18, 2016 Share Posted November 18, 2016 lord. This is why PCE is required. Link to comment Share on other sites More sharing options...
sk732 Posted November 18, 2016 Share Posted November 18, 2016 lord. This is why PCE is required. I would have to say it's more why BME - Basic Medical Education - is required, along with people getting failing grades in their classes/rotations for lack of critical thinking and physical exam skills if this is how they go about their daily work/life. SK Link to comment Share on other sites More sharing options...
Moderator ventana Posted November 20, 2016 Moderator Share Posted November 20, 2016 that is why we should eat our young, drill them to ashes, pounce on them and all that..... yikes (not) Seriously though.... I see this a lot - UC and ER's hire new grads with literally no experience, and short of some amazing HCE (highly unlikely) these are crappy providers..... Had one that told me non-traumatic hip pain in a 74 year old female with known osteopenia did not need anything besides plain films to r/o fracture. After explaining to him - why on gods earth he did not know this from the history is beyond me, that 20+ years of prednisone taken for PMR/seronegative RA (Rheum just doesn't want to confirm) with osteopenia and non-traumatic hip pain that radiates to almost vaginal area MUST have a CT to R/O and maybe an MRI if persists..... Deer in headlight look - and his response was "let me go talk to my attending", came back a few quick minutes later and said CT would be ordered. honestly these new PAs are doing the best they can, but man they should not be turned loose like this...... Residency or some type of supervised year for all new PAs As well in the UC or ER setting I truly believe the first 6 months should require 100% case presentation to a more experienced provider cause triage is not always right! (BTW the very first thing the Ortho did in F/U was order a STAT MRI- thankfully negative on this patient) Link to comment Share on other sites More sharing options...
SedRate Posted December 10, 2016 Share Posted December 10, 2016 I agree that the first 6 months be supervised or at least require 100% case presentation... that is why we should eat our young, drill them to ashes, pounce on them and all that..... yikes (not) Seriously though.... I see this a lot - UC and ER's hire new grads with literally no experience, and short of some amazing HCE (highly unlikely) these are crappy providers..... Had one that told me non-traumatic hip pain in a 74 year old female with known osteopenia did not need anything besides plain films to r/o fracture. After explaining to him - why on gods earth he did not know this from the history is beyond me, that 20+ years of prednisone taken for PMR/seronegative RA (Rheum just doesn't want to confirm) with osteopenia and non-traumatic hip pain that radiates to almost vaginal area MUST have a CT to R/O and maybe an MRI if persists..... Deer in headlight look - and his response was "let me go talk to my attending", came back a few quick minutes later and said CT would be ordered. honestly these new PAs are doing the best they can, but man they should not be turned loose like this...... Residency or some type of supervised year for all new PAs As well in the UC or ER setting I truly believe the first 6 months should require 100% case presentation to a more experienced provider cause triage is not always right! (BTW the very first thing the Ortho did in F/U was order a STAT MRI- thankfully negative on this patient) Link to comment Share on other sites More sharing options...
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