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newton9686

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newton9686 last won the day on July 4

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  1. Yeah it’s a truly sad situation we are living in and that are ICU workers are dealing with. Young Patients are literally dying from preventable disease because they don’t trust the healthcare system and then yelling and getting the judiciary system involved for a treatment that has essentially proven not to work. Just take your vaccine Folks, whatever extremely small chance of ADEs it is worth it.
  2. All good advice, I personally would ask myself if i woke up 10 years down the road tomorrow on the other side of all the troubles, what would I have wish I did today? if you really want, not just okay with waking up 10 years down the road owning or working at a chill plant store, then I’d agree with quitting. But if you would want to wake up and be a PA years 10 years from now then I’d do everything in my power to keep going. You are going to need help and support regardless, it just seems like PA school is obviously flaring up everything you’ve worked to control and making things worse. But there are plenty of us with mental illnesses that manage in healthcare (some have better coping mechanisms and are more well controlled than others) but I know personally at this stage in my life couldn’t imagine doing anything else. Then there is some that really should quit because the trouble isnt worth it and they get there purpose elsewhere to a far greater degree. but that’s how I’d make my decision and be okay with it. if it makes you feel any better I’m going back to medical school and gave up a couple pretty great PA gigs makings close to 150k a year. Do I question my decision. About every other day, but I know I’d regret even more waking up in 10 years not being a physician when I was given an opportunity to be a physician.
  3. Well looks like I got my answer today. I got accepted last minute to medical school. Super excited and panicking at the same time. Someone dropped out last minute and they basically start on Monday so I had essentially 5 hours to make my decision. But i am super thankful for the opportunity. And thankfully my employers were understanding which was very helpful I will always be a PA at heart and will forever be a PA advocate. Hopefully I can be a part of helping make more bridge programs and other opportunities for PAs in the future. Thanks for all ya'll support & insight over the years. Cheers!
  4. Hey guys. I just wanted to see where everyone else thinks they will be in 10 years, especially us younger PAs (20s & 30s), or if any of yall oldies have any recommendations for us young guns. I have been practicing now for 3.5 years, mostly in hospital medicine, but I have started to stretch into urgent care & hopefully rural ER (credentialing currently) which I am excited about. However one of the things I really struggle with is while I love what I do on a day to day basis (I was designed to see and treat patients) I just wonder sometimes what I am working towards. Will I be doing the same thing in 10-15 years and just watch myself getting lapped by the MD & DO students I help along the way? It also really bothers me that I can have a great SP that I click with one day and then they leave and I am stuck with a piece of s**t the next. While I love the PA profession and that it gives me great honor in caring for and helping patients, I just struggled with how I will advance in my profession. Its hard enough dealing with certain opinionated doctors now, I can't imagine how bad it is going to be when I've been practicing longer than they have. I constantly flirt with the idea of going back to medical school, but right now I dont have the MCAT scores (500) & my wife isnt interested in moving across the country for a random program. I am also really passionate about ultrasound but it is a struggle to find a comprehensive learning experience such as the ER U/S fellowships that would really allow me to use and teach ultrasound. I looked at doing community college RDMS programs, but again this seems like a step back somewhat. And while I am able to commute 45 minutes to some rural environments there are no ERs nearby where PAs solo coverage which also seems like a great opportunity for independent pas that want to push themselves and practice at the highest extent of their license. I've looked at other degrees such as JD, MBAs, MHAs, PhDs, etc both those seem like they only push you away from the clinical side versus give you more clinical opportunities. Really liked the DMS program at LMU as it seems like a challenging clinical curriculum that would help me in my practice, but currently does not allow for any additional clinical privileges or responsibilities. Teaching is a possibility as well. Let me know what yall's future plans are and feel free to throw any recommendations my way.
  5. I’m pretty sure if you look at the S&P 500 and Dow Jones over the last 30 years they have averaged somewhere around 10-12 % Someone please correct me if I’m wrong.
  6. 2 million is a little low honestly. I’m trying to ball hard in retirement. Following the Dave Ramsey plan and just doing 15%, with his income over 30-40 years we are looking at 5-10 million easy
  7. I have not really put anything towards retirement so far. We have been trying to maximize the amount we put towards student loans and the rest of the consumer debt we had. I doubt many people will give you much push back with this plan since you are so young and you are not being offered a match. This is the one place where a lot of people have an issue with Dave Ramsey because he does ask people to stop taking advantage of the match for a short period of time. Just be aware many of these "math wizards" who dont have enough money come the end of the month. So while from a theoretic perspective they are correct, they underestimate the fact that personal finance is really only about 20% financial theory and 80% what are you willing to give up to get out of debt. Looking back on our journey just because we are on the 3-3.5 year plan, just given how much debt we had to begin with, combined with the fact that healthcare providers are usually playing catch up anyways when it comes to retirement, I MIGHT recommend someone take advantage of the match if they were in a similar situation or worse on a case by case basis. With that said the longer you stay in baby step 2, the less likely you are to get out (it gets tiring being frugal and not enjoying a similar lifestyle as you colleagues). And every dollar you put towards retirement is time longer in baby step 2. Regardless, if you can get out of debt and maximize yourretirement after baby step 3 you are going to have 30+ years of a six figure income. If you put 15%+ of that towards retirement and get anywhere close to 10-12% ROI, you are going to have more money than you or likely your grandchildren can spend, by the time you get to retirement.
  8. If I am correct boats is a Dave Ramsey guy so before you even start paying for your house you have a 15,000-30,000 (3-6 months of expenses) emergency fund & you are putting 15% towards retirement with the rest going towards your house. Baby steps 4,5 & 6. So even if someone had been puting lets say 50K extra a year before a crisis happened and lost their job, they aren't going to have to sell their house to stay a float. While yeah it looks great what you could of earned if you had put all your money in the stock market, or even crypto at this time, like Boats says you are not taking account for risk. For example if you had taken out a zero principal loan and invested all your money in the stock market in 2005 you would of lost everything in 2007. Yet many of the financial "gurus" at that time were recommending this at that time. While I don't agree we everything dave says (we had an issue renting the car we wanted with the company he endorses, Dollar, because we don't have a credit card), his plan on getting out of debt and building wealth is pretty solid, with minimal risk and reproducibility across income brackets regardless of how the market is doing. FYI my wife and I have paid off 167K in 20 months following his plan, so it works well for PAs early in their careers who have high amounts of student loans. Its not flashy, but it does work.
  9. "My chiropractor recommended you order."..... "No i don't have any medical history.".... "I only drink socially"..... "I have never used cocaine, but my boyfriend does, I think I got it from having sex with him.... "They usually have to give me two rounds of antibiotics for my "sinus infection" before it gets better".. "I get bronchitis every year and need a zpac to get better"... "A fever for me is 97 because i normally run 95"
  10. Yeah I typically don’t trouble shoot issues with post op patients especially. One I don’t have post grad surgical training. Two likely whatever you find either implies the surgeon did something wrong or they are going to have to fix something. Again if something is critical and you feel like the patient is decompensating, do what is right for the patient. But especially in small hospitals with like 2-3 surgeons I need those relationships and can do more good for my patients with a strong relationship with my surgeons than making a dx a day quicker than the surgeon would of on a particular occasion. This is just my approach that works for my setting. Perhaps would be different in the academic setting. But I usually talk things out with surgeons, especially imaging for this reason. And I believe because I focus on the relationship they generally value my opinion and appreciate the care I provide there patients while in the hospital.
  11. As a hospitalist PA it never ceases to amaze me how arrogant some ER physicians can be. You would think these people (some not all ER docs) would be a little more grateful when I spend half my day doing their job when they call me about a patient they didn’t appropriately evaluate and/or treat.
  12. I agree with everything that has been said, other than perhaps slashing her tires (we are better than that). Not sure if it applies perfectly to the OPs situation but as a new hospitalist PA I did have a cardiologist in the hospital that I butted heads when I first started . However what ended up turning our relationship around is I started copying some of his practice style. It is truly really hard to hate someone who practices medicine similarly to you. By learning what he liked to do in particular situations and purposely incorporated it into my practice, we really bonded and actually developed a friendship. Although I have shifted my practice to fit my new setting, I learned some tricks that have helped me as well with challenging patients and also built a relationship that earned me a LOR later when I applied for a new job. Again not sure if it applies to the OP situation, but definitely helped my situation and may help someone else in the future who is struggling with a similar situation, especially in the hospital setting.
  13. It depends on how crazy the patient sounds. Things sound straight forward and I trust the person behind me, I might just read their note and go through the labs and images. I don’t trust the person behind me or the situation doesn’t smell right and then I’m working my way through everything. I also look at what the consultants are always saying. Also always look through the med list, mar and see how much fluids they have received and so they still need iv fluids.
  14. UC providers also cannot pan scan everyone while ordering stat labs and then call the consultant like our ED brethren But yeah as a UC provider I wouldn’t recommend UC if all possible as a new grad. It’s really useful, at least it was for me to work in a hospital for a couple years before working UC as I learned what sick looked like and I learned how certain life and limb threatening conditions presented. While it is impossible to catch everything, you will either miss a lot or send everyone to the ER if you are a new grad especially working solo UC..
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