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PAsoldier

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  1. I work in an addiction clinic. The majority of our patients are on Suboxone (or another form of buprenorphine), but we also have many on Vivitrol. While typically everyone that is a part of our program gets a Rx, there is an extensive screening process that includes H&P, lab work, urinalysis, etc. We assess for appropriateness of treatment. Some people don't meet the "addiction" criteria for one reason or another. Some people require a higher level of care than we ware capable of providing. Some people have HCV or HIV that requires treatment before they can safely take medication for their addiction. We are a specialty clinic and don't actively treat the co-morbidities, but we do ensure that they have a PCP and are addressing other issues. Counseling is also a mandatory part of the treatment plan. Addiction is a complicated brain disease and it can't be treated by simply throwing medication at it. I believe that MAT (Medication Assisted Therapy) is a vital, life-saving, adjunct to a well-rounded, comprehensive addiction treatment plan that is tailored to the specific patient. We operate on a BioPsychoSocial model and try to address all aspects of a patients life. We assist them with obtaining transportation, housing, education, child care, etc. I actually really enjoy working with these patients and find the work extremely satisfying. It's a great thing to help someone go from daily IV heroin use to Recovery.
  2. I made the change from Ortho Trauma to Addiction Medicine last August. I love it. It can be challenging, at times, but very rewarding. There are several different settings that offer opportunities for PAs wanting to practice in this field. I currently work in an Office-Based Opioid Treatment clinic but there are providers in inpatient settings, intensive outpatient therapy, family medicine offices, comprehensive rehab centers, etc. Now that PAs and NPs are able to apply for/obtain an XDEA waiver and write for Suboxone, there are likely to be more opportunities than ever!
  3. Yes...PAs and NPs are now authorized to write for Buprenorphine for addiction. HOWEVER, lets make sure not to mislead anyone on this. BEFORE being able to write for this, we must complete an approved 24 hour CME course, then apply for the XDEA number. Then, it can still take up to 45 days for SAMHSA to review your application.
  4. armymedicchris...I think you might be right. Things at IPAP do change frequently, however. Regarding state funding, that might have changed, as well. I'm pretty sure when I started IPAP in 2012, funding came from NGB. Therefore, I don't really owe my particular state for school, but the National Guard as a whole. What you are saying does some familiar so that might have changed in the last couple years.
  5. Thanks everyone for the input. I hope this discussion keeps going because I'm enjoying seeing the different points of view. I will be sticking it out until I find something else and then I'm gone.
  6. I do love ortho. That new gig sounds like just what I want. I don't want my own panel either. I agree that I probably doesn't work well in a specialty practice. Maybe, maybe, in a general ortho or sports medicine practice. We are trauma, and particularly pelvis and acetabulum. Most of them need surgery and get scheduled for it after the initial visit. There has to be a better way to utilize a PA than what he has in mind, though.
  7. LTJGonealPAC, I agree. We are switching to a new EMR on Monday and I was told I need to learn it fast because he won't and I will need to be able to walk him through it and finish what he can't.
  8. Walkoffshot, I feel ya man. I basically function as an assistant to the medical assistant in clinic. I follow him into the next room and get their job started so they can finish what they are doing. Then I stand there and try to take notes on anything new I hear. It's sad, really. Anybody have suggestions for the best area of medicine to look into? Where are PAs being utilized like we should, in general? I realize that each job is different and each SP is different. Just looking for general suggestions. I'm thinking maybe Family Medicine.
  9. Thanks Delco714. I'm learning that these problems are quite common. I agree that it is wrong. As much as I love Ortho and the OR, I'm thinking it just might not be the best fit for me and what I need. Thanks for your input!
  10. Thanks man! Good to know I'm not alone. I feel you on the 9-10 hour days without a lunch. I guess that comes with the territory but I know it sucks. I have been at it for about 8 months and I've about had all I can take, so I'll be looking for another gig. I do get to do injections (like you said "whoopty do!") but that's about the only "PA thing" I do during clinic. He never discusses cases with me prior to surgery and I'm constantly having to say "I'm not sure what his plans are". Even if I ask him, I don't get much of a response. The pay is not good but the bonus structure is not bad...50% after I bring in what he pays me. However, I am constantly "on call" because trauma doesn't follow a schedule. No call pay. All that would be fine if I felt like he appreciated what I bring to the table. Anyway, thanks for the reply and hopefully you can move on to where you are happy!
  11. Not sure if this helps...I'm a recent IPAP grad (October 2014, Class 2-12). I applied through the Guard and there were 10 slots per class for Guard, 10 for Reserves, and the rest of the Army slots were AD. I believe those numbers might have change since then. I think we had about 10 AF people, 5 Coast Guard, and no Navy (I wanna say the Navy didn't send to every class...maybe every other class?). Anyway, when I started, you could apply for an AD seat as a Guard member. That changed while I was in school and Guard no longer had the option to go AD. You had to apply for a Guard seat. I do know of some people who went AD after finishing and getting back to their state. A soldier from my unit was a year ahead of me at IPAP and she got in really easily. There were only 7 qualified applicants for the 10 slots for that class. At the time, Guard soldiers applied individually for each class. I think that has changed to be like the AD guys and it all goes into a big applicant pool and they select once a year and then tell you what class you will be in. Things change constantly with IPAP, though, so your AMEDD recruiter might know. If not, contact the schoolhouse directly. They might be able to provide you with the latest guidance or at leas point you in the right direction. Also, try the IPAP Facebook page. It is full of IPAP staff, students, and graduates. A little advice, though...do a quick scroll to see if your question has already been asked. They tend to get a little pissy about the same questions being asked over and over. Like people have time to scroll through years of posts! lol Anyway, my AMEDD recruiter called me today to have me talk to a potential applicant and he told me IPAP is about to switch to an online application. Not sure if that's a good thing or a bad thing. I think putting together that damn application was harder than the school itself! Hope this helped a little!
  12. Yeah, I basically had made up my mind to at least start looking for other opportunities the first time he told me I should have went to med school if I wanted to do more. He solidified his position today by actually putting that in writing in my performance review. I don't want to make any spur of the moment decisions and I wanted to get as much feedback (positive or negative) as I could before I made a final decision. Thanks for your input!
  13. Hello Fellow PAs! I need some advice... How important is a somewhat structured training environment to you? I am all for "trial by fire", but I am also a firm believer in the "see one, do one, teach one" method. That's how I learn the best. My SP is not so good at training a new PA. I have been in Ortho Trauma since December (my first job) and I was hired to basically replace the Trauma Fellows he had in the past. It was discussed, at length, before I accepted the job, that I would require a different level of training (a lower level, admittedly) than someone who had completed med school and an orthopedic residency already. I was assured that that would not be an issue and he loved to teach. He was the head of Orthopedics at several medical schools in the past. However, it turns out the people he loved to teach are the ones who are already at an advanced level in their training. As the head of the department, he didn't really deal with training the med students, interns, or lower level residents. That was handled by the senior residents, apparently. SO, it has been a REAL struggle to learn and perform at the level he is expecting. I have no doubt that I will get there. I just don't know that I want to stick around at a job where I'm basically teaching myself. He doesn't show much interest in my development as a clinician. Actually, he doesn't really see me as a clinician. He sees me as his assistant. Not that I have a huge problem with functioning in that role as I get started in my career. My big problem is that he constantly tells me my job is to "make his life easier" and that I'm a PA, not an MD. I'm not trying to be an MD! I just want to function as a PA and not an overpaid medical assistant or as only a surgical assistant. The previous statement that my job is to make his life easier really bothers me. While it's true, to an extent, that seems to expose an underlying contempt for my profession. It seems he doesn't see PAs as teammates but as truly assistants. I try hard and I have, in my own opinion, come a long way since starting. I still have a long way to go but I know my experience and knowledge has grown exponentially, even if it has been by my own studying or by other people besides my SP. I just can't shake the feeling that I (or any PA, for that matter) will always be seen as an assistant and can only do the things he delegates. I have tried to get him to let me see patients in clinic but all he wants me to do is go into the room before he does and remove sutures, etc. Like I said, an overpaid MA. I do get to see a few patients in clinic when they want to come in and he isn't available. This amounts to about 4 patients a MONTH. He says "my patients are here to see me, not my PA". While that is true for many patients (after all, he IS the super specialized acetabular surgeon), many patients are perfectly fine with seeing "his PA" for follow-up visits or for other things the MD isn't necessary for. He just doesn't want that. So, anyway, my main question is...should I stay and hope it gets better? Or should I start exploring other options? I honestly don't see his opinion about PAs changing and I'm just not sure I will adjust to the role he wants me to play. IDK...maybe surgery isn't the place for me. I love the OR, but if that's all I wanted to do I would have gone to Surgical Assistant school...not PA school. I live in a large city and there are plenty of other PA jobs out there. I know the grass isn't always greener on the other side and, usually, it's just as wilted. I just don't want to continue on at a job where the SP doesn't really get what a PA can offer and seems to not really respect me as a clinician. I apologize for the long rant and I'm sure it seems like a huge gripe session. I just wanted you guys to get a feel for my frustration. Any advice or experience with something like this would be greatly appreciated!! Thanks!!
  14. This must be a new regulation. I am ARNG and currently a Senior at IPAP. I didn't make it on my first board, then my packet got automatically resubmitted for the very next board and I was picked up. Wouldn't surprise me if they changed things up, though. Things seem to change by the minute around here.
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