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dmdpac

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About dmdpac

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    Physician Associate

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  1. Most of us in my group wear either scrub tops or embroidered Nike golf shirts. Not many wear a white coat. A few old timers still wear them but that's it. We have one guy who, pre-COVID, wore a tie and a white coat every day. The white coat was always buttoned. He had a tie clip holding the tie in. I don't know how he managed. Since COVID hit, though, he's gone with just scrubs.
  2. Color me surprised not just that they responded but with the quality of the response. Nicely done, AAPA.
  3. So why not, for these community paramedicine programs involving PAs, bill based on diagnosis and treatment like would be done for patients we see in the ED? Is there anything in the billing regulations that would prohibit that kind of billing practice? I honestly don't know.
  4. I had this same conversation just recently with a colleague of mine who's also a former paramedic. I was the only paramedic in my class of 80+. A few people said they had "EMS experience" (EMT certification but very limited actual street time). I'd like to think my paramedic experience was the tipping point in getting me in to PA school. The group I work for also employs the state and local county EMS medical directors. In recent years they've brought up the idea for a community paramedicine program similar to the one described in the article about Austin. The same colleague I mentioned above and I have volunteered our assistance several times in trying to get things moving. Each time we bring it up we're shot down. No idea why.
  5. Keeping up with numbers, morbidity/mortality rates can be trying especially when things are changing as quickly as they seem to be. I did read this article today that countered some of the speculation that morbidity doesn't seem to be matching the increased positive testing numbers. The article also addressed concerns with increasing numbers of positive tests (indicating community spread faster than testing can track). Mortality lags so isn't a great indicator. What's more is that this isn't just an illness where we measure those who die compared to those who don't. There are increasing numbers of "Post COVID Syndrome" patients with lingering symptoms. Because it's still so new who knows how long that will last. Anecdotally, I've seen patients with this as well as talked to colleagues/coworkers who are dealing with lingering post-COVID issues.
  6. Over the summer, especially in the southern US, increases in young folks testing positive preceded increases in older folks testing positive. Sure, younger folks seem to do better. The older folks they give it to? They don't seem to do as well.
  7. Risking this after Rev's warning: Fact checking mail in voting: NYTimes. Back to COVID, I, too, am hoping that increased COVID social practices (e.g. masks) will reduce the impact of flu seasons. Given actions like Florida's Gov DeSantis, removing all COVID related restrictions on business, I'm not holding my breath that things will soon improve.
  8. Very well written and presented, Rev. MTA: ... and signed.
  9. Nice obit for Cpt Doug Hickock, NJANG PA who was the first military member to die from this. Probably the first PA, too? I haven't heard of others. Anyway, link.
  10. Agree with much of the above. Patient care is goal driven with a loose script for you to follow. You'll have questions to ask with a purpose behind them. There's little small talk. There's a defined end point (appointment time is over, results received and diagnosis made etc...). I find I'm less socially exhausted after a busy ER shift than I am after an hour in any other social-type situation. There is an adjustment to it. It'll be far easier an adjustment than you think. Introverts unite! Separately! In your own places of residence!
  11. Another paramedic here. I'm not working as a paramedic currently but so far I've managed to keep my NR current but on inactive status. (I'm having a hard time letting it go. That's another discussion.) Anyway. How old is too old? That depends on you. The oldest classmate I had was almost 50. There were a handful of us in our late 30's into 40's. If you want to go back to school age is but a number to be ignored. Go do it. I retook many of the prereq's at a local CC. It did not pose a problem for me when applying. If you're concerned about GPA it may be worth it to pad the transcript with some updated coursework. When I applied my GPA (without considering all the recent school work) was way worse than yours. I was able to turn my recent coursework, and subsequently vastly improved grades/GPA, into a positive talking point during my interview for school. Debt for grad school is certainly something to consider. Don't let it be a barrier for you, though. With smart budgeting and an aggressive payment schedule it can be managed pretty effectively. I graduated with >$150K in student loan debt. I was paid off and debt free four years to the day of starting loan repayments. Sure, those four years were focused on paying off the debt. Some sacrifices had to be made. But to this day I still think it was worth it. Ninety thousand a year in a few years sounds nice. Are you working a typical medic schedule with built in overtime to reach that? Depending on specialty you can make more than that working a "normal" 36-40 hours a week. Sure, specialty dependent (e.g. EM), you may still be working nights, holidays, weekends. But you'll still be home a lot more than the built in overtime schedule of working as a medic for less money. All the best in your decision. If you have other questions ask away.
  12. Or perhaps, in the proper environment, we could start having the discussion about how silly the idea of fire based EMS actually is. Yes, I know that separating them, no matter how justifiable it may be, would not solve the funding problem. At least not immediately. I agree with the rest of your comments. I have seen similar compensation discrepancies in my area, too. As much as I loathe to hold up ALS services in New Jersey as an example, they may be on to something. ALS is hospital based in NJ. With a hospital based system ALS services, community paramedicine, even the PA/NP/EMS services cited above could stand a reasonable chance of success once the nitty gritty of funding and economic sustainability are worked out. My NRP is current but on inactive status.
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