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Showing content with the highest reputation since 02/24/2019 in Posts

  1. 10 points
    Well after spending the day in the ER and having a family member admitted I noticed one thing.... The first 5 seconds of your visit are the most important for raport building.... and to put someone at ease. Lots of people coming in and out of the room, only one actually stopped, fully introduced themselves and explained their roll in the delivery of care. That one was received the best by the patient and myself (I was there as family, no name tag, keeping quiet in the corner so no one knew my position/education/title) Those first 5 seconds are critical and so many people waste them by just jumping into history, or even worse exam (way to fast!) So stop outside the door take a deep breath knock, ask if okay to come in walk in slowly, close the door behind you - hospitals are noisy places introduce yourself, your title, and your role ie I am the hospitalist provider Shake a hand or make and effort to touch the patient is a gentle introductory way - if received well indeed shake the hand, if not received well just stop looking for contact Pause briefly and let the patient and family absorb who you are, what you are, and what you are likely doing there.... Max 5-10 seconds and yet it sets the stage for a successful interaction...
  2. 9 points
    Long story short, the hospital I work for in Virginia has decided to move towards only interviewing/hiring NPs. The rationale: NPs don't require supervision or co-signature. State law says PAs need 5% of their charts co-signed, hospital policy is 100% and have in turn used that policy to change the status quo. Cautionary tale comes in two forms, the first being the obvious that the time for a name change is upon us. As long as the name assistant is associated with our profession, this will continue to happen across the country. The second cautionary tale is the need for a pile of 'F-U money' on hand. When I precept soon-to-be PA graduates, I tell them to tuck away $10,000 in a high yield savings account and never touch it. Start this with your very first paycheck. This is your "hell no, I'm not doing that" fund for piece of mind that you can leave any toxic position without worry because you'll likely be able to find another gig while you live off of that money. Fortunately I practice what I preach and had the flexibility to walk away without being forced to stay with a team heading in a direction I don’t agree with.
  3. 9 points
    ...No one knows. You're receiving moderately-educated guesses at best, and wild shots in the dark from internet strangers at worst. Even an adcom member can't give you a 100% reliable "chance" because each school is different. Your experiences, personal statement, school list, timing, and "fit" all play a role. Even then, adcoms make surprising decisions. It's not uncommon to be accepted to reach programs and rejected from "safety" schools. Instead of risking false confidence or misplaced defeat, ask yourself these questions instead: Are my GPAs, both science and cumulative, competitive compared to this school's accepted student profile? If not, is the reason compellingly discussed in my personal statement? Does my transcript show that I have grasped the fundamental knowledge to succeed with intense, graduate-level medical science coursework? If there are weak areas of knowledge on my transcript, have I put in the work to turn those weaknesses into strengths? Do I meet all the prerequisite requirements for each school on my list? If I have a questionable course, have I asked for clarification from the schools that require it? Is my PCE (hours and type) competitive compared to this school's accepted student profiles? If my GPAs are below the accepted average, does my PCE surpass the average? If my PCE is below the accepted average, does my GPA surpass it? Have I spent time making sure my experience descriptions are comprehensive and accurately convey what I've learned? Have I scored at least 300 on the GRE (if I'm choosing to take it)? Do my other activities show deeper layers of my personality and interests? Have I taken on increasing responsibility as I've grown? If I've stated an interest in a specific area (for example, underserved or rural care), do my experiences show my passion for that area is genuine? Have at least three people agreed to write me an excellent letter? Do my references meet each school's requirements? Does my personal narrative have an introduction that grabs the reader's interest? Do I "show" the qualities that will make me an outstanding PA, instead of just listing them? Do I show understanding of a PA's role? Does the conclusion convince the reader I'm ready for PA school? Have others read and enjoyed my narrative? Is it grammatically flawless? Do I have an overarching passion or theme that ties my application together? Are my future goals guided by my experiences? Am I a good "fit" at each school on my list? If an interviewer asks me why I applied to each school, what will I say? Do I have a game plan for applying? Have I set myself up for success by planning to apply early? Have I thought beyond the finish line of getting a seat to the logistics, pressures, and potential loneliness of devoting the next 2-3 years to school? Am I in a financial position to fund CASPA costs, interview expenses, seat deposits, and relocation expenses? Am I in a financial position to afford PA school? How is my credit score? Do I have significant undergrad loans, car payments, mortgage payments, or other financial constraints? Does my family truly understand the time investment of PA school? Will my partner move with me if I relocate, or will we have a long-distance relationship? Are we both on the same page about these plans? Can I confidently say I'm ready, not just for PA school, but for life as a PA? Gratuitous link to my blog: https://emttopac.wordpress.com
  4. 9 points
    Got my call of acceptance 2/12 and am so excited! Just wanted to let my future classmates know I’m a local, grew up & have lived in Whittier forever lol so if anyone has questions about moving here or about the area feel free to reach out to me! Hope I can help make this transition a little easier, especially for the ~50% of the cohort coming from out of state
  5. 7 points
    This is not meant to be self edifying... Have a new patient - 45yr old male, hx of Hodkins lymphoma many years ago - something like 15 I am not overly familiar with this, and read uptodate on it - (I know what I don't know) Says that they are at increased risk for colon CA and should have colonoscopy early I talked to him, explained - NO ONE not his PCP or Onc doc had ever mentioned this to him, so off to colonoscopy he goes - turns out precancerous polyps seen and removed... PCP is not about knowing it all, PCP is about reading, educating, and communicating to the patient what you have learned - it is not degree specific (to Boarded Doc's had NEVER mentioned this to him.....)
  6. 7 points
    “Pigman, an emergency room physician, offered a 153-page amendment to the measure that added physician assistants to the bill, a move that made doctors, and some lawmakers, more uncomfortable with the measure.” Representative Pigman who introduced the bill and got it out of committee, and is also an EM physician, added us on. We should all write him a thank you letter.
  7. 7 points
    I am not usually on PA Forum so forgive me if this was already covered. A friend sent me this story. What are people supposed to think when we call ourselves Assistants and tell people daily that we require supervision? BTW, the new Virgina law is collaborative for PAs so you could have pointed that out. We use words like "delegate", assistant" and "supervision" or supervising as part of our normal language and then are astonished when people throw those same words back at us. Words matter. Definitions matter. What do you refer to your SP as? My partner? My supervisor? My colleague? How do we all define our profession? You need a 60-second elevator speech that defines us the way we want to be defined (and is still legally accurate). That's why the AAPA has a title change investigation going on now. It's vitally important we look closely and do it right. That's why we have OTP as POLICY of our profession and hope eventually all state laws adopt its principles. That's why we are looking to the future with hope for real change, but you have to join the AAPA now (it's not the AAPA of years ago) and join your state organization. We won't have too many chances. If I had 10 or more years left to practice (BTW, I have none) I would be involved in some way forwarding us all. I am not saying this because I drank the Cool-Aid, I am saying it because it's the only way we can change the landscape so stories like this do not become the norm. Your support gives us the support we need to change the landscape. Let's work together. Dave Mittman, PA, DFAAPA.
  8. 7 points
    We need OTP and name change SIMULTANEOUSLY. Both are holding us back. We are seen as inferior. I was humiliated in front of touring nurses today with the assumption that NP's are superior to PA's because they dont need to be supervised
  9. 6 points
    There is a lot of discussion about burnout, stress, too many patients, unrealistic expectations etc. Many of the rules and systems that create this type environment put provider and patient at risk. This has led to a "water cooler" conversation that I think bears exploration. What if, when law suit or board complaint gets dropped on a provider, he/she sues the administrators who created the policy? not the organization but the individual administrators who created and implemented the policy? Would this "sharing" of risk and liability provoke a change in attitude among the policy makers? How many cases would it take before it became national news and was known throughout all of admin country wide? I used to direct every disgruntled patient about wait times etc to the VP of clinical services who created our staffing model and thought 50 a day per provider in the UC was a great idea. I was told to stop doing that. My answer was...you don't get to create bad policy and then hide from the results. What if that concept was elevated to include legal liability?
  10. 6 points
    The AAPA could also make a statement like" from this day forward the term x and PA shall be considered equivalent" and then folks could start using the new term and billing under PA until it was formalized in each state. Nametags could read(for example) John Smith, MP/PA to meet requirements that certain states have that PA be listed. I am really surprised this has not been done already actually. the chiropractors, naturopaths, and several other professions did overnight changes like this.
  11. 6 points
    My favorite is a base salary and productivity. What form this might take is only limited by your imagination. The beauty of some productivity is when you are busy everyone is happy and profitable. There is so much variability by state and region as to typical salary that I can't really give you anything specific.If you haven't seen the AAPA salary report I'd recommend you use it as a basis for your bargaining. Be creative. Be open to ideas that make money for everyone. 70k? pass. remember you can always negotiate down. You can never negotiate up. Be prepared to walk away if the terms just don't fit you. Employers can smell desperation like sweat.
  12. 6 points
    A friend and fellow PA just sent this to me. It embodies everything so many of us are experiencing. it's E-VER-Y-WHERE
  13. 6 points
    I don't think the "assistant" in physician assistant ever, ever meant "stand there until I ask for something" or "get me coffee, Moneypenny". Today I did not hold a single retractor, kiss any surgeons ass, run around in my scrubs looking flustered while the surgeon strolled in. I met with my team, made clinical decisions on 15 patients, advised one on life sustaining measures, refilled numerous prescriptions, but had to review the chart to make sure they were still needed and appropriate until the next appointment; and dealt with one pompous asshat DDS who did not understand how the VA deals with prescriptions from non VA providers. I did hold the door for one of my patients, so maybe that makes me an assistant.
  14. 6 points
    Hi guys! I’m Jaleesa from Western U’s class of 2020! I know you all are excited about interviews and acceptances! It’s nerve racking to wait until mid-March for that letter but your patience will pay off. We are currently SUPER busy with all sorts of tests and assignments but we are setting up a Facebook page for your class and I will send you the info for that soon. We will need a picture of your acceptance letter and an photo ID sent to the email that I will provide later! Until then, sit back and enjoy this peace you have because PA schooo is going to be the fun but crazy ride!
  15. 6 points
    I just got my call of acceptance and I interviewed January 12th... I am so beyond excited to meet all of you and for whoever is waiting to hear back- hang in tight! I will be praying for you Good luck!!!
  16. 6 points
    At this point late is all we have. A conscious decision was made years ago to tie ourselves firmly to the physicians because they would always control medicine and they would reward our loyalty. Things changed and we were very slow to change in response. Recriminations aside....we need to move forward as fast as we can and all of us need to stop bitching and start working on these issues. It makes me pull my hair when someone complains about a bunch of stuff and then says "someone should fix this." YOU....YOU should help fix it speaker! Death By A Thousand Cuts
  17. 5 points
    I am not a CAPA member but am sharing this to get more people to participate in moving OTP forward! If you are a California PA or know one share this link. It is a petition for supervising physicians to complete to help advance OTP in California. CAPA needs thousands of signed petitions! CAPA Petition
  18. 5 points
    it doesn't make a difference with docs, it makes a difference to the HR administrator who sees one person with a doctorate and one without and decides to go for the non-physician with the higher degree because it is a higher degree
  19. 5 points
    IMHO: Agree with above. "Take a break is common advice" and I took it, but knowing what I do now, I wouldn't have. Anything you can study that is concrete will help. In my experience: Anatomy was mind blowing, every class I had taken before (4, at 3 different institutions) barely scratched the surface. My advice would be "Acland Academy" videos, they are real cadaver videos, broken up into short sections for viewing. 100% worth the fee. I would have told myself to watch every single one at least once just to get my bearings. <- my #1 advice without question. Physiology was also very in-depth, and some of my UG, had prepared me well for some of it, but not all. I found the YouTube channel NinjaNerdScience EXTREMELY helpful. They are concise and hit all the key points with adequate but not excessive info (very tricky to find, most are either too much or too little). The people who make it are current PA students, so they are right on target, and I have not noticed any errors in their videos. Also it should give you a very good taste of "what you're in for." <- #2 advice, no question. If you are unfamiliar with EKGs, there are many concise books out there that are reasonably priced. I really liked "The Only EKG Book You'll Ever Need" but the others I've seen are also good. The big thing is knowing your way around a rhythm strip, and how the leads relate to the anatomy and how the axis works; if you know the mechanics, learning all the abnormalities will be a breeze. Once you start, DirtyUSMLE (on YouTube) is good for hitting the key points of a lot of stuff. Made for med students but as a study guide, so the depth of info is not over the top. Probably not very helpful until you have background info, just "keep it in mind." Osmosis and SmartyPANCE are also popular online programs. Probably better for when you start as supplemental info to go along with whatever you are learning. They are not cheap, but SmartyPANCE has been pretty helpful (it's just the one I went with; have heard good things about Osmosis too). The big thing for me was the massive volume of information, and the terminology. My medical terminology UG class was a joke (think a children's book about cars when you're trying to train a mechanic). If you can at least have your bearings in the aforementioned info, that will help. But "having your bearings" is probably a lot more than you think right now, it was for me (and I'm a BS Biology major). I haven't had any "conceptual" challenges, but I hammered upper level bio classes pretty hard. For me it has been more like "memorize this whole dictionary, in two weeks; then you'll have a new one to memorize, rinse and repeat." Pharm is an outlier. Programs are very different, and even how to study it is... "complicated." You'll see when you get there. Every rule has exceptions and there are 10 ways to do the same thing, but "which one is "best," is a common theme. I listened to an audio book "Memorizing Pharmacology: A Relaxed Approach," and it definitely helped, but was not "high yield" information. TLDR: 1 - Purchase the Acland videos and watch every single one (only the hands and feet exceeded what we had to know for exams, and not by a lot). 2 - If you're still game, start plugging away at the NinjaNerdScience videos on YouTube. 3 - If you're still wanting more, get a "condensed" EKG book and focus on the mechanics more than the diseases.
  20. 5 points
    I was accepted!!!!! And they also got their accreditation!!
  21. 5 points
    I get it. When I left the Army I was so weirded out about the possibility of being unemployed I took the first job someone offered me and canceled 3 other interviews I had lined up. A wise man learns from his mistakes. A genius learns from someone else's.
  22. 5 points
    Been there done that too! I hear this tripe from many NPs and their lackeys with management titles far too often!! I invite them to step into my solo remote care practice site 700-1000 miles from a physician or hospital and somehow I don't get any takers!!! Nurses spend their careers trying to validate the chip on their shoulders and compensate for not being physicians and the "PA Profession" spends too much time trying to be liked and make others happy!!! I just do my job as best I can and to hell with the game players no matter their title or station!!
  23. 5 points
    I love being a PA. I didn’t want to be a nurse. I hate our title and stagnant leadership that sits by and does little no nothing to promote our profession. I work in primary care right now (trying to do ER, hopefully soon). I have little interaction with my SPs. Once I am in that room with my white coat on, Im the provider. I’m often called doctor. I always introduce myself as a PA. I had to fight for my job because “they only hire NPs because we have to supervise PAs and sign off on their charts.” I had to find the laws and correct them. I got my job. I have people ask me in the community. “What do you do?” “I’m a PA.” “What is a PA?” [emoji849]”I’m a physician assistant. I diagnose and treat patients. I write prescriptions.” “Huh?” “Kind of like a nurse practitioner.” [emoji362] “Ohhhhhhhhhh!” Which I get is part of the problem, but do I really have time to explain everything in every interaction? The public knows what an NP is. They think I’m a “medical assistant.” Meanwhile commercials are running all the time here about nurse practitioners and independent practice and how wonderful NPs are. We have no effective lobby. We have no effective public education measures. Our title is not reflective of our training, of our practice, of what we are. We are getting demolished.
  24. 5 points
    I too am wherever the doc isn't, but I can see that that may not be the case for a PA in surgery. The point is, if we are one profession, we would benefit from a title that describes us better than just someone who waits for orders from a supervisor. In my case, I have a more knowledgeable colleague (the doc) whom I can call and discuss a complex case with if necessary, and whom I try to keep up to date on our hospital cases in case he gets a call when I'm off.
  25. 5 points
    Accepted off the pending-open seat list today!
  26. 5 points
    Just an update guys, I spoke to Trina this morning and she said the class is still not fully seated. They hope to fill it within the next couple of months! Hold on to hope. I am praying for you all.
  27. 5 points
    "My pain...it's like getting shot...in the head..." Me: "have you ever been shot in the head?" "Well, no. It's what I imagine getting shot would feel like". Me: "so, instead of MAKING shit up, take the worst pain you have ever felt. Then compare this to that. It's easy. Hell, just make up a number that's realistic, I just need it so I can bill you higher, and ain't no one is gonna believe ten out of ten, shot in the head pain while you sip your Starbucks". After a pause: "I'm going to write president trump" Me: "fine. Make sure you spell my name right- it's I-m-a D-u-m-a-s-s. Don't let the door hit it on the way out." "What about my viagra?" Me, a little exasperated by now: "Dude, you got shot in the head pain AND a letter to write. You ain't got time for that. Buy her chocolates. You're still not getting methadone for your dental pain, I don't care who prescribed it in the past" Him: "but it huuuuurts" "Yes. I know. Like a bullet. In your head. You were here for antibiotics just last week!" Him: "it's the other tooth. The antibiotics only worked on the first one, the other one still hur..." "For crying out loud, I know!"
  28. 5 points
    These clowns are just as bad as the moron that said I could keep my health plan if I liked it.
  29. 5 points
    Hey guys, I'm currently in didactic year at CSOM pa program, my interview last year was one relaxed 2 on 1 interview with program faculty that lasted about 20 minutes. First, they sat around 30 of us in a class room, gave us an essay question to write about (ethical question I don't remember what it was, sorry!), and then we waited as they called names for interviews. I got asked very typical questions like "why do you want to be a PA?" and "what is a difficult decision you've made and how did you overcome it?". The best advice I can give you is to remind you guys to have a lot of energy and excitement, be genuine with your responses, and highlight why you are a good fit by incorporating the mission of the program into your responses. Standard mock interview questions are great practice. However, do not sound robotic!! I got my acceptance email the first week of April. I hope this helps and puts some of your nerves at ease. Good luck guys!!!
  30. 5 points
    I got the phone call for acceptance a few weeks ago, but I just got the call for my #1 school so I will be retracting my offer. I hope that changes a life for someone! Good luck to all!
  31. 4 points
    @corpsman89: OTP. WI has tried its best to get all parts of OTP. Still working out details. The Hospital Association has lots of power and we are in the process of getting our last discussion with them. It's been a battle. 3 years in to the legislation process and are on draft #10 which should be the final one. They didn't like collaboration.....they wanted cooperative agreement (meaning the PA WILL COOPERATE) with them and requested that our legislation be written such that we are supervised, physicians totally responsible for the care of the patient and that they must be available immediately to the PA. (They want us to codify CMS language in our legislation....ahhh...NO!) We did not bend to that request and had to hire a special health care attorney to come to our defense. Disclaimer: My personal view is that PAs should be independent and has been my view since the beginning of my career in 2004. We seem to have support from all the legislators we have been meeting with since June 2018. They all get the common sense OTP points. So, PA FORUM colleagues: Wish us well, pray for us, send us positive thoughts, and help us get to the finish line. Thanks!!!
  32. 4 points
    The problem is we keep talking about respecting or physician partners. 1) They have no respect for us except when they control us and 2) They aren't our partners. They never will be. They oppose everything we do so why do we continue to worry about their feelings? What else can they do to us? We don't have to be antagonistic but we need to keep them informed and then proceed regardless of what they think or how they feel.
  33. 4 points
    I agree and have stated similar feelings on occasion. I am endlessly frustrated with appeasing physicians. however, like it or not, they swing a big political stick. We shouldn't be hat in hand when dealing with them as stakeholders but there is no profit in being antagonistic either. Polite, persistent forward movement. How do you eat an elephant? One bite at a time.
  34. 4 points
    Go interview. Consider it information gathering. You may hate it, you may love it. Worst case scenario you're right where you're at now but at least you won't be wondering based on hypotheticals.
  35. 4 points
    post it here so I know where to join.
  36. 4 points
    Hell no to 70K. Truly rural gigs tend to require management of complex co-morbid patients who, in a higher population location, would be co-managed by "specialty" care. Remember that in rural medicine there is often: a) no specialist access within reasonable travel distance for your patients, or, b): the specialists within reasonable distance are so far and few between that the wait to be seen is 3+ months. You may be largely responsible for managing all of this. e.g, think: psychiatry, nephro, cards, neuro, GI, etc etc. It can be incredibly stressful. If you are going to have to significantly manage patients in these areas that alone should bump your pay up significantly, easily over 100K. Find out from this practice how this type of thing is handled. Good luck!
  37. 4 points
    I got in!! I'm so excited to meet everyone. If anyone would like some tips or any help I can give please feel free to message me and I'll be as detailed as possible! I know what it feels like to want help and I'm so grateful for those that have helped me. So I'd be honored to pay it forward.
  38. 4 points
    "Evening Mr. Smith, my name is MediMike, one of the PAs with the pulmonary critical care team " *Ventilator sounds/gurgles/screams*
  39. 4 points
    I’d say definitely not in the personal statement. That being said, the personal statement should answer the question “why PA” specifically, so your essay should be tailored to why the PA profession (and not include any cliches/generalities about healthcare that applies to MDs/RNs/NPs/DOs.) With that said, I was asked the question “have you ever considered any other profession in healthcare besides deciding on PA” in multiple interviews, and I straight up told them I wanted to become a doctor in undergrad but outlined the many events since that time which made me reconsider the MD/DO profession and decide on PA. I eventually got accepted to all of these programs so I think they appreciate your honesty and your ability to reason and rationalize your decision to pursue the PA route. I would say that it is not necessary to bring it up if they do not ask that question specifically. Hope that helps answer your question!
  40. 4 points
    This is probably the most important point in this whole thread. Far too many PAs are content to gripe continuously about nothing getting done and complain about the leadership, but they make no effort to actually work with their professional organizations (either AAPA, your state CO or your specialty organization). The PAs running these organizations aren't appointed from Mount Olympus; they are other PAs who cared enough to volunteer their time and effort to try and make a difference, typically at personal expense. We would have a lot more lobbying power if more of us got involved in advocating for our profession. OK, getting off my soapbox now....
  41. 4 points
    You're over thinking it. Thank you cards aren't necessary, and if the coordinator isn't emailing you back, just let it go. No, that would not be a reason for a program to not accept you. Just be patient and wait to hear from them.
  42. 4 points
    Gawd I hope that don't try and dig up that old ghost, Physician Associate.... All to try and maintain some form of "PA" initials. Weak. I'm not a Physician and I am not an associate. I practice medicine. I am a practitioner of medicine. A Medical Practioner. MP.
  43. 4 points
    I think there may be a difference in perception for PAs who work in surgical specialties because they...for the most part...are in fact assistants. They assist in surgery and follow post op protocols set by the surgeon. No matter how well paid and skilled they may be, they do not tend to have the level of autonomy enjoyed by primary urgent and emergent care PAs. Foods for thoughts...
  44. 4 points
    full time hourly x 22 years at multiple locations in 3 states. . salary is an invitation to be abused. salary would have to be very well spelled out with a discussion of overtime, for example 75/hr for 144 hrs/month. any hrs above 144 at 1.5x base rate of pay. I know folks working open ended salary arrangements who are paid for 160 hrs and required to work much more to meet the needs of their departments. that is not ok. If I work extra, I get paid to work extra. end of story.
  45. 4 points
    I will advocate people to dissolve AAPA and form a new group if this happens
  46. 4 points
    Avoid applying to this troll's program.
  47. 4 points
    The fact that we NEED to have some physicians supervising us but NP's do not, makes us seem less reliable and skilled to most administrators and public. Like it or not perception is reality. What I hear often is, well why don't NP's need to have physicians go over their pt encounters and notes but y'all PA's do? Is it because PA's are less trained and reliable and hence need closer supervision? We can try to convince them all we want how our education and training is superior to NP's and so on, but we get quickly squashed as mere "ASSISTANTS" acting better than what we actually are It pisses me off seeing so many PA's get disrespected like this in the hospitals. and they just shrug it off. This is really sad
  48. 4 points
    at my regular job today. CRNA comes up to me and says" hey, it looks slow in the ED today, wanna do a difficult tube in the OR with me in 20 minutes". yes, yes I do. new pointer for big tongues: much smaller blade than you think you need so you have room for your tube in their mouth. easy peesy.
  49. 4 points
    cannabinoid hyperemesis syndrome...."it's not the weed, man". this is getting so common. it is almost every shift now....haldol is the remedy...drug em until you like em....
  50. 4 points
    In California nurses seem to have all of the political support. As a former Paramedic and now PA I was trained in the medical model. PA's should be the ones in the pre hospital setting.


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