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mgriffiths last won the day on March 19

mgriffiths had the most liked content!

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About mgriffiths

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    Physician Assistant

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  1. I'm in Southwestern Michigan. Our clinic received patient vaccines, but our vaccines provided by the hospital are separate and we have been told CLEARLY not to use patient vaccines on employees. I don't know if pharmacies in town have received them yet, but the hospital is self-insured so they have also requested us to wait and get our "employee vaccine" when available. As I said, I usually plan to get early to mid October so I'm in no rush, but won't be waiting much past then.
  2. Haven't yet because they have not made it available. Whoever orders our vaccines screwed up and didn't order enough for the clinics and for employees, so there will end up being a shortage. I usually wait until early to mid October anyway...but really curious what they're going to do about our "mandatory" flu vaccine when they don't have them available.
  3. Yeah, that was my thinking for why it would be a no go, but was talking with a coworker about this and she knows someone who had a MRSA outbreak shortly after caring for a patient in the hospital with MRSA and they were able to get it. Again, more of a curiosity...I would much prefer to just not get the flu...but if a complication were to occur, that could seriously be 2-4+ weeks off work and maybe even a hospital stay. If that were to occur it would be nice to have workman comp cover the bills and missed pay rather than losing the majority of my PTO.
  4. So I posted in another thread that I diagnosed my first flu of the season yesterday...now my MA tested positive. With having exposure to two documented cases of influenza if I were to get sick and test positive for influenza could the be considered a workman's comp situation? Probably wouldn't do it unless complications arose (i.e. pneumonia), but how could you "prove" it was work related? Curious if anyone has done this or has information.
  5. I had my first flu diagnosis yesterday covering our UC...with 4 more later that day. Add that to all of the other sniffles that walked through the door it would be impossible to keep them all straight in my head until the end of the day. Which ones mentioned ear pain, which ones had headache, which ones had fever but took ibuprofen/acetaminophen, etc., etc.? It's the same reason I chart as I go during my normal FM clinic days. Could I see patients faster if I charted after their visit or at the end of the day? Yes, but overall I would be less efficient because the charting at the end of the day would be slow...not to mention the interruptions. A doc I used to work with always charted as he went, but left ALL of his messages and refills to the end of the day. For whatever reason he would spend 1-1.5 hours at the end of the day completing these tasks, while I was able to get them done during my day in between patients. Plus, I actually was seeing more patients than him and generally received more results, messages, and refills than he did on a daily basis - because I saw more patients. My theory is that while he is in clinic at the end of the day he is being interrupted by his MA or the front desk with questions, or people want to talk, etc. These all make the work less efficient. Now, it is absolutely a good thing (usually) to develop relationships with co-workers, but for me that doesn't occur at the end of the day when I want to be home with my wife and daughter.
  6. My way around this is that I chart as I go. If something acute walks in, fine, I will stop charting and evaluate, but I don't just mow through patients all day without any charting leaving it for the end of the day. Yes, it slows me down, but also ensures my charting is accurate, and that I'm not working unpaid after the clinic closes.
  7. I'm not sure if the billing/coding tab would be a better place, if so, please feel free to move...but, I am considering a change to orthopedics (from family medicine). I have worked ortho previously, but my question is about wRVUs and surgical billing. When I assist in surgery there is a surgical fee that is collected (I am aware there are exceptions, like most arthroscopies), but is this a specific CPT code with RVUs attached to it? I'm asking because my bonus is based on my producing wRVUs. When I'm in surgery assisting am I producing wRVUs under my name or is that surgical fee not considered wRVUs?
  8. https://www.zdnet.com/article/first-long-distance-heart-surgery-performed-via-robot/ Article talking about long distance heart surgery performed via robot with surgeon 20 miles away. Obviously the idea is similar to current telemedicine in the sense of "distributing" providers to rural or high-need communities without actually relocating them, but this is also SCARY! What happens if the connection is disrupted mid-surgery? They mention that concern in the article, but doing a surgery remotely that will ALWAYS be a concern. Who is at fault, who is liable? Obviously things change over time, but I don't see myself ever being a part of this (as a provider or patient) except in the most dire of situation.
  9. All of your questions are state and contract dependent. Whether you discuss with a lawyer is up to you. Bottom line...how attached are you to this job? If you go after them with a lawyer what will be the response? Maybe you won't be terminated because that could be deemed retaliation, but could they divert patients lowering your productivity? Could they increase the number of meetings you are required to attend lowering your productivity? Could they start giving you more administrative work lowering your productivity? In other words, could they just kill your productivity slowly but surely, lowering your bonus further and further until your productivity drops below goal giving them a "reason" to terminate you? If I were in your shoes I would discuss with administration and attempt to find a solution. Then, depending on the results of that conversation and how you are treated following I would strongly be considering a job change. Furthermore regarding a lawyer...whose pockets are deeper and who potentially has multiple lawyers on retainer? In other words...again...who could just continue to drag out any potential court case until you are bled dry by lawyer and court fees? Tread carefully...it's a tough world as an employee.
  10. I've had multiple patients ask to record me, and I have ZERO problem with it. After probably the second time I was asked, I discussed recording visits with every new patient (and continue to do so) making it clear that I have no problem being recorded as long as they ask ahead of time. If they do not ask and record surreptitiously then it is grounds for dismissal as I would consider that a breakdown of the patient-provider relationship. Has only happened twice where discharge occurred, but I'm sure I've been secretly recorded many more times.
  11. "About a third of patients stop taking their meds as early as 90 days after a heart attack, according to earlier research." What an amazing statement...as a PCP it's honestly quite terrifying to be honest - especially when we are in an era of insurance reimbursements more and more being tied to outcomes, rather than actual visits/work. When will patients be held responsible for their health? Granted this article (link below) seemed specific to Europe, but wouldn't be surprised if the stats are worse here in the USA. Thought this was rather amazing as well, "For those with a history of heart problems and strokes, the drug combo was only half as effective compared to the control group, who received advice on healthy living but no drugs." EDUCATION people!! Would also love to know what exactly was in the "polypill" as it just says, "...once-a-day pill combining aspirin with drugs that lower blood pressure and cholesterol..." I would assume aspirin (obviously), lisinopril, and atorvastatin, but it doesn't say. https://gulfnews.com/world/europe/heart-attacks-halved-by-daily-polypill-strokes-reduced-too-study-1.1566554872779
  12. I have never seen or heard of a PA in anesthesia...but wouldn't be surprised if there is 1-2 exceptions.
  13. Completely agree...but that is an ER, not an UC. Furthermore, patient wasn't in the office. Grandmother called...don't even know the concern.
  14. Again, it's not that I turfed to the ER. It was that the ER can assume consent and provide emergent care if that is needed. This was considered, but how do you confirm the identity of who you are speaking to on the phone? I will be honest, I don't know the specific legality of doing this in MI, but that would be my main hesitation.
  15. It's not that the ED is the place to commit medical battery, but in MI (and most states) the ED is able to provide emergent care with assumed consent. The ED is also attached to a hospital that has resources to obtain consent from the appropriate guardian.
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