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GetMeOuttaThisMess last won the day on December 16 2017

GetMeOuttaThisMess had the most liked content!

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About GetMeOuttaThisMess

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    Physician Assistant

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  1. GetMeOuttaThisMess

    DFW CUSH job opening!

    Yep. Off 190 and 78. A side benefit to the position, one is next to Best Buy (about to go pick up some Kuerig coffee I ordered online), Home Depot, and Lowe’s. Now who wouldn’t want to work in that environment?
  2. GetMeOuttaThisMess

    Am I Setting a Good Example...

    I have failed our profession. My wife and I consumed a sleeve last night (mostly me).
  3. GetMeOuttaThisMess

    DFW CUSH job opening!

    We have a wonky system tailored toward teachers. Other professionals have to read between the lines regarding information requested, or as in this case, may require assistance from HR personnel. Addendum: wonky system refers to the online application process. Now that I think about it, I’m not sure that I remember an easy online application process.
  4. GetMeOuttaThisMess

    DFW CUSH job opening!

  5. GetMeOuttaThisMess

    DFW CUSH job opening!

    C’mon folks! I’ve had to work for 2 1/2 days by myself. I’m feeling lonely. Surely someone wants some easy money.
  6. GetMeOuttaThisMess

    Today's medicine in a nutshell

    In my setting where the employer provides the clinic service to the employee AND eligible dependents as a benefit; if someone rarely gets unruly then we just contact the department supervisor if the employee is out of line. I don't know that we've done this but we also have the ability to black ball someone from the clinic if they don't play nice. There are no such things as satisfaction scores, though we do provide an opportunity to respond to a survey annually with regard to likes and dislikes. I ask them too many questions about their own health to allow them to interact I'm told and the majority of them are SCHOOL TEACHERS!
  7. GetMeOuttaThisMess

    VENT - "our NP just got her Doctorate"

    This was all said tongue in cheek. Wouldn’t shock me if something along this line happens down the road after I’m out of the game.
  8. V, I hear you but allow me to throw a monkey wrench into the machinery. About a decade back I attended a CA conference on a Saturday at one of our local major health network facilities (think Ebola in Dallas). There was a urologist talking about PSA’s and CA and after he was done I asked him a simple question, “What do you do in your practice regarding PSA screening?” He was taken aback for a moment and then told a story about a peer along the east coast of the U.S. who followed the guidelines and both he and a patient elected to defer on the PSA. Next year, metastatic prostate CA in the same patient with a subsequent malpractice claim being filed.. The urologist’s defense was that the current speciality guidelines, as well as USPSTF recommended an informed discussion with the test being optional. Where he lost his case was that in spite of the specialist following the guidelines, the standard of care in the community was antiquated and thus was not current. Since the specialist didn’t follow the standard of care for his community he lost the malpractice case. As a result of this story, he PSA’d everyone in spite of what he had just lectured about!
  9. They were all "at risk" patients since they were referred by their PCP's with CV risk factors. We always made time to see a referral the same day. You have to take into account that this was in the era of no PTCA w/o CVS standby (6% likelihood of emergent CVS during PTCA nationally at the time). There were no small town hospitals doing these procedures due to the lack of this standby capability. It was one of the things that drove me away; having a quiet day, about to walk out the door, and the cardiologist pages me to tell me to hang around another hour or two while we await the arrival of an out-of-town transfer just so I could do the H&P. This practice was very highly respected and known regionally, if not nationally. How many of us get to play with the groin of an Academy award winner who is snuck into the hospital on a Friday night to avoid knowledge by the media. We were the first to have an EP specialist as well our own nuclear med radiologist to read scans. We did have our share of hospital staff cardiologists who would troll the ED and suck up to staff IM docs so as to do some procedures.
  10. In our setting where we were the game in town in our neck of Dallas for cath/PTCA (pre-stent) it was too easy to see folks in the office and just perform the ETT. Interestingly, we rarely did stress echo's at that time presumedly due to the fact that it was just too easy to send them down one floor in the hospital, stick them in for a same day cath, and then send them on their way the next day (after I would go by and listen to the groin to make sure that we hadn't created a dissection/aneurysm as a result of a new bruit) with the most definitive answer at that time. One has to take into consideration that sand bags were kept in place for 12 hours I believe it was after sticking the femoral artery. Over 3 1/2 years I think we ran across maybe 2-3 cases of Prinzmetal's angina.
  11. Just to play devil’s advocate here. Back in late 80’s-early 90’s we were quoting ETT sensitivity rates at 85% on studies done in our cardio office. I will add that when we had a false positive I’ve seen sails on boats shorter than the ST segment elevations.
  12. Went to go eat our weekly Tex-Mex with the wife tonight and then was promptly assaulted just outside the door by a Girl Scout cookie table. I was forced to make a purchase of two boxes of Thin Mints by the Girl Scout on duty who threatened me within an inch of my life. How am I supposed to face my 99.9% overweight patients on Monday after such an ordeal?
  13. GetMeOuttaThisMess

    DFW CUSH job opening!

  14. GetMeOuttaThisMess

    em photo quiz( occasional series)

    Moved from room to room by a donkey. I think I’ve still got some calipers lying around. Wonder if anyone thinks anything of the deep Q waves right precordial leads (or so they appear) and the IVCD?
  15. GetMeOuttaThisMess

    em photo quiz( occasional series)

    Okie dokie.

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