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jusgatr

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About jusgatr

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  1. jusgatr

    Gastric balloon

    Do your due diligence on this and read case studies recently. There is a mortality rate that has been in question in regard to deployment. There has not been a specific study yet to link the two. But it is definitely something as a PA I would not want the liability. I’m in GI and we have managed complications from bariatric guys for years. These balloons carry a risk of a gastric outlet obstruction, esophageal perforation, and gastric volvulus ischemia. Words of advice, steer clear.
  2. jusgatr

    Changes thanks to OTP?

    Agree with the above. Sad but true. Even more the reason for OTP to be the big push on state to state level.
  3. jusgatr

    Changes thanks to OTP?

    I guess it’s all semantics between production considering not all providers are built the same. But on average, at least in a specialist field, PA with more experience trumps PA with less experience from a collection standpoint. For at least the first 3-5 years, assuming not residency trained. And the more experienced PA even has more time off. I will concede a bachelors PA vs a MPAS for an administrative position would not be the same. However, I think the administrative jobs (managers, CEO/CFO, director) are not having MPAS degrees fill those positions. Because our masters training teaches us nothing about business or managing, or at least the one offered from my old school doesn’t. Even a masters of nursing teaches more about health care management than a MPAS, just look at the curriculums. So if we continue to offer masters (assuming clinical doctorates are out), then why not MHA, MBAH, or possible MPH be the standard? All of which give you an option of doing something later in your career. If you stay a provider, a private group isn’t going to care if you have a masters or not. Hospitals and VAs may though which has been pointed out. Might be something to think about when all these NPs are taking the hospital jobs with their doctorates.
  4. jusgatr

    Changes thanks to OTP?

    You’re telling me a PA with 10+ years of experience with a bachelors was passed on in DFW(assuming other poster is from NJ) for a 1-2 year experienced MSPA? And paid more? Plus whoever the office/administrative manager is deserves an award for biggest risk taker with their own job. Production alone from the bachelor PA vs the less experience masters PA won’t even be close. I used to get paid based on collections and saw what a 1-2 post grad billed compared to 7-8 year PAs. The organization could pay the 25k for the bachelors PA to get their masters that year and still come out ahead. Those organizations that are doing that like degrees and not money or production (at least at first-everyone gets better with time). I agree with MediMike, that’s truly sad for our profession. As Medimike mentioned, many of the bachelor trained PAs have decided against the MPAS because it literally adds nothing to your actual ability to be a PA, but cost you 25k. Which is why I’m currently enrolled in a MBA in healthcare for that reason. Both cost 25k. Both online. MBA gets you a seat at the table. Indeed, it’s an interesting finding that hospitals are lumping us like associate RNs and requiring upgrades in degrees to work in their hospitals.
  5. jusgatr

    Changes thanks to OTP?

    Below was a comment I posted in another discussion, but applies here as well. It was in regard to a clinical doctorate or the DMSc. My point was to focus on tenured/older PAs to be the push to getting those doctorates and get into administrative roles. MBA or MHA would likely be sufficient as well, but everyone seems to push towards a doctorate now to sit on an administrative board. Our MPAS degree does nothing for health care/administrative roles and does not prepare us to be offered these positions. Not that the DNP does either, but they can be the DON with that degree or a principal investigator on a clinical trial. “Tenured was meant to be a PA of 10+ years of experience. The providers primed for leadership positions and roles in health care organizations and interested in seeking further need of a “doctorate” to gain a seat at the table in those positions. The argument made on here often is for a “clinical” doctorate that would prepare us for those positions. A MPAS now is literally a sunk cost and has no value for a tenured/bachelor/certificate PA. It gives no more rights or value for a PA from 10-20+years ago. Just cost 20-30k more. And by 2025 NPs will be 100% doctorates while we are putting out 100% masters. I like the concept that EMEDPA pointed out that bridges both and gives some credit to already lower your sunk cost. Some people don’t see it that way. This is just my opinion. I also get the the concept of being able to work while you achieve these options. A PA with 1-3 years worth of experience but sporting a doctorate is not going to advance the profession. The PA with 10-20 years worth of experience with ties to the medical boards, administrations at hospitals, and the medical doctor colleagues who know them would. As those fore mentioned experienced PAs would be the ones offered said advancing positions for the profession. Btw this comment was not meant to offend PAs with less experience, but more to point out the necessity for change sooner than waiting 5-10 more years for all the masters trained PAs to finally have doctorates. DNPs will already have accepted those executive positions far sooner.”
  6. Tenured was meant to be a PA of 10+ years of experience. The providers primed for leadership positions and roles in health care organizations and interested in seeking further need of a “doctorate” to gain a seat at the table in those positions. The argument made on here often is for a “clinical” doctorate that would prepare us for those positions. A MPAS now is literally a sunk cost and has no value for a tenured/bachelor/certificate PA. It gives no more rights or value for a PA from 10-20+years ago. Just cost 20-30k more. And by 2025 NPs will be 100% doctorates while we are putting out 100% masters. I like the concept that EMEDPA pointed out that bridges both and gives some credit to already lower your sunk cost. Some people don’t see it that way. This is just my opinion. I also get the the concept of being able to work while you achieve these options. A PA with 1-3 years worth of experience but sporting a doctorate is not going to advance the profession. The PA with 10-20 years worth of experience with ties to the medical boards, administrations at hospitals, and the medical doctor colleagues who know them would. As those fore mentioned experienced PAs would be the ones offered said advancing positions for the profession. Btw this comment was not meant to offend PAs with less experience, but more to point out the necessity for change sooner then waiting 5-10 more years for all the masters trained PAs to finally have doctorates. DNPs will already have accepted those executive positions far sooner.
  7. I respect that some already have a masters and for an “educational/teaching” doctorate I believe they can be of value from a research standpoint. But you are discussing a “clinical” doctorate, where no masters is necessary. Examples, DPT, DNP, PharmD, JD, and so on. And my experience as a PA is far more valuable in the setting of a clinical doctorate than an essay paper wrote for a masters program. In my opinion, one of the reasons we don’t have more of a push from established PAs for a clinical doctorate already is because everyone forgets that the vast majority of tenured PAs have bachelors, not masters.
  8. The day one of these doctorate programs gives credit for all us bachelor trained PAs to then go to a doctorate, I’ll sign up. I’m not paying for a masters to then turn around and pay for a doctorate. All while, not making any additional money and adding 3 more years to my education after already completing a 4 year undergrad and 2.5 year PA school. Might as well go to a 3 year Med school program in that setting.
  9. jusgatr

    PANRE, need encouragement

    Passed! How'd everyone do?
  10. I'll add...ortho spine S: post-op # O: looks fixed A: will fix again at some point P: narcs. Hopefully they don't come back (pun intended)
  11. jusgatr

    PANRE, need encouragement

    Took it today as well. Feel the same way. Worked in GI for 6 years. GI questions didn't even make sense. Hopefully I did enough to pass.
  12. Thank you everyone so far for the provided insight. Does anyone have any of the contact information of the above mentioned people or groups? If you could personally message me their info that we be great. I want to obtain a good guideline for requirements before I present all the information to my supervising physician. Thanks again.
  13. I wanted to reach out and see if anyone has any information on GI PAs doing EGDs and colonoscopies. I have been in GI for 4 years now and work currently in Greenville, NC. My supervising physician and I have been discussing lately about PAs doing EGD and colonoscopies as well, specifically the more straight forward cases with minimal sedation requirements (conscious sedation). The physician has shown interest in teaching me. I was told to research some information about limitations, billing, requirements, and any additional information. I have been able to find that Johns Hopkins trained 3 NPs in the past few years to do EGD and CLNs with the same adenoma miss rate as the physicians. Does anybody have anyone they know or any information in general to help me? The other option I have considered is contacting one of the medical schools in NC to consider taking a PA in an altered fellowship set up to teach me. I do plan to look at the GI fellowship requirements and tailor my requirements to be around the same before I start solo. I have already reached out to the President of GIPA for information nationwide. Thank you
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