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dmdpac

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  1. Thanks, all, for your thoughts. I'm currently fortunate to work for a group that currently offers a lot of PTO (along with an overall nice benefits package). I'm currently at six weeks a year not including time for CME. Sadly, there are local politics at play threatening the future of the group. (It's not if the group is dissolved... it's when.) I'm attempting to avoid being caught flat footed when it all falls apart. I haven't had to look for a job in ten years. The changes between then and now in terms of benefits offered is... disheartening. It's not just PTO. It's also health insurance, retirement plans (matching vs profit sharing vs you're on your own) among others. I'm willing to accept, however, especially based on some of the other comments here, that I was just really damn lucky to fall into this group when I did.
  2. After almost ten years with my current EM group, a group with generous paid time off (PTO) benefits, I've been looking for a change. One thing I'm encountering among other EM groups is that PTO doesn't seem to be an offered benefit to employees anymore. Is this really a thing? For those of you with no PTO benefits how do you manage time off? Front and back load your schedule to balance the shifts you need to work and the time you need off? Or do you just take the financial hit in taking a week off? If the former, are your schedulers willing to work with your to make sure you get the time you need both to work and not work? I'll admit to being caught off guard and surprised by this trend. I'm not entirely sure what to make of it. What have your experiences been?
  3. This made me think of a quote attributed to Hippocrates: "Before you heal someone, ask him if he's willing to give up the things that make him sick." Anyway, I've found that as time has gone on since the vaccines were introduced the hostility I get to asking seems to increase. Some do seem receptive to hearing more information. Some have even had really good questions they want answered before getting it. More and more, however, the frequency and intensity of the hostile responses to my asking is concerning.
  4. If you don't want to compete with residents you'll have to find a gig with no residents. Taking ATLS and becoming proficient in ultrasound are good steps. I also recommend doing both. However, in a teaching facility with residents present you can pretty much count on the fact that they will always take precedence. That's why they're there. To learn how to do these things.
  5. I did similar calculations for the amount of time I worked as a medic. It turned out to be a ton of hours. I don't think anyone batted an eye. Discussing with program admin after graduating I got the impression that the hours I listed were considered quite favorably in the decision to offer me a seat.
  6. We use the CMAC in my department. I want to like it but no matter how often I use it I feel a disconnect between looking at the monitor and placing the tube. Oddly enough, I didn't feel that same disconnect when using a Glidescope. Our anesthesia guys use the Glide Scope but won't let us touch them. At the same time they won't touch our CMACs. I've played with a McGrath and like the feel likely due to muscle memory as it's pretty similar to DL. I've never used the McGrath on a real patient, though. I don't think I've used DL for an intubation in a few years.
  7. Waiting to get approval to get the vaccine. It'll come once they're done vaccinating administration and the non-clinical staff (and parading them on social media). Front liners (ED, ICU) have not been prioritized in my health system. Sadly, I'm not joking. There's a lot of really, really pissed off people.
  8. I'd recommend against trying to work during PA school, too. I worked as a flight medic during the didactic year. Monday though Friday was dedicated to school. Weekends were scheduled to work. There was no time off or down time. It was usually 12s but an occasional 24. (Or, for an extra load of stress, a 12 on Friday night then a 24 starting Sunday morning... you *will* get a late call that'll leave you scrambling to get to class on time come Monday morning.) If I wasn't in class or studying for class I was at work hoping we weren't busy so I could study more. MediMike has it right up-thread with the recommendation to do PA school first, become established as a PA, then do fire. Sure, do fire school this summer and get the certs you need. But get PA school done before trying to establish yourself in the fire service.
  9. 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.
  10. Color me surprised not just that they responded but with the quality of the response. Nicely done, AAPA.
  11. 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.
  12. 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.
  13. 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.
  14. 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.
  15. 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.
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