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mgriffiths

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mgriffiths last won the day on December 1 2018

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About mgriffiths

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    Physician Assistant

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  1. mgriffiths

    What would you have done?

    I don't understand why patients are coming to an UC for med refills. There is absolutely no way to review their full medical history, medication history, etc. in an UC appointment. I also work in FP and have started covering a local UC here and there...I would not have refilled her medications. It has nothing to do with her current symptoms and medical issues, it's that by filling them I am setting up a patient-provider relationship for her to begin abusing the UC for chronic medications. Maybe I'm wrong... As for her BP and ECG, you can only educate as best as you can and make your recommendation. It is up to the patient to follow through. You just have to make sure you document like you have never documented before!!
  2. I just get a viagra/cialis commercial going in my head...
  3. mgriffiths

    Physician assistant mortgages

    The 4.04% was laurel road. Very quick, easy process - and I have 30 days to accept the offer.
  4. mgriffiths

    Physician assistant mortgages

    I have actually been looking into refinancing my student loans - have a guaranteed rate for 4.04% already, but am looking at another bank that may be able to do 3.5%. In the process I came across Kasasa checking accounts. You have to jump through some hoops, but there are banks offering 4.5% interest rates!!! I am trying to learn more - biggest question is whether the interest rates can decrease once the account is opened, but to make some debit card purchases and have a direct deposit...seems WAY worth it! Washington Savings Bank has 4.5% return, but only on the first $10,000. Kalsee Credit Union has 4.25% return up to $25,000. No affiliated with either, but might be soon.
  5. mgriffiths

    FM Patient sent to ED

    Kind of what I figured...but probably not a bad idea to ask the coders to have some support behind me when I talk with my CP.
  6. mgriffiths

    FM Patient sent to ED

    So had a conversation at work today and was curious if any others had input: How does the billing work if I evaluate a patient in my FM clinic and deem the patient needs to be seen at ED? Does the insurance cover my evaluation/visit as well as the ED visit or only the ED visit? Does it matter if the FM clinic I work at is owned by the same hospital as the ED? At my last FM job it was a privately owned practice, and I was told that if I sent a patient to the ED I could still bill for my evaluation/visit, but today I was told that is not true. Now I'm not sure what to believe, but my current job is owned by the hospital. But, I find it hard to accept that if I send a patient to the ED I can't get reimbursed for making that decision. I never would, but seems like a major reason to not send an acute patient to the ED, or at least not to the partnering ED? It came up as my collaborating physician (CP) had a patient with dyspnea, leg swelling, and majorly positive D-Dimer. Obviously our immediate concern is PE or at least a DVT, so sending patient for Chest CT and US. We were hitting roadblocks and I mentioned about just sending the patient to ED to not delay treatment. CP mentioned about not being able to bill for our work - leading to my above question. Result: after rechecking patient's BP with measurement of 250/110 - ambulance called and patient went straight to ED and was admitted/treated for saddle PE.
  7. Every job I have ever had was this way...but I do agree with you.
  8. mgriffiths

    Physician assistant mortgages

    I was not quoted a rate from the beginning, I was just told that it was competitive with a normal 30 year mortgage. Then when it came time to actually apply for the loan the 6% was quoted to me, I literally hung the phone up on the guy after telling him he lied to me. Rates have dropped recently, but I ended up around 4.5% but had to put 5% down because I had owned a home in the last 3 years...a long story. Again, we ended up with PMI but it is negligible. The whole goal is to pay off my student loans as rapidly as possible. I could leverage my debt by refinancing my student loans, but I only subscribe to that theory to a point. A home generally is an appreciable asset (of course there have been exceptions...especially 2008), while student loan debt is not (of course ignoring the higher income I make as a PA compared to being a high school teacher). I can't sell my student loans as an asset for someone else to take over the debt like I can a home.
  9. mgriffiths

    Physician assistant mortgages

    I have been using an Ally Bank savings account for several years. They have a 2.20% interest rate. When I started with them it was lower, but has gradually increased. Don't know when it increased to 2.20%. I have seen some banks advertising higher interest rates but it requires certain requirements be met (like direct deposit, automatic bill pay, etc.) and I have not looked into that yet. As for Ally, it is very simple and I have had ZERO issues with them.
  10. mgriffiths

    Physician assistant mortgages

    To actually answer your question: I just bought a home and almost went with a "professional mortgage." This is a loan reserved for specific industries where the individual's income is significantly higher than average, and also usually considered to be more stable. The loan I almost went with was 0% down WITHOUT PMI and I was initially told the interest rate was essentially the same as current averages...I was lied to. The interest rate was over 6%. Totally not worth it. While not ideal, we ended up with PMI, but we were able to work with a local lender and our PMI is $3.73 per month.
  11. mgriffiths

    Physician assistant mortgages

    Boatswain2PA: time is huge factor here. I'm not saying you're wrong, I think it's a difference of philosophy. The reason it is helpful to have a paid off home during retirement, or when approaching retirement, is that it mitigates risk - and the nest egg you need to be able to retire is MUCH smaller because your monthly budget is that much smaller. For me at 29, I have time on my side. It is WAY better to invest any extra $$$$$ I have into the stock market at a higher return rate than pay of my mortgage early, but of course that return rate is NOT guaranteed. Therefore that is where it comes back to philosophy. What level of risk is someone willing to take on? And of course, we are also ignoring that most people don't take all of the extra money they have at the end of the month and invest it, while they may take 100% of it to pay toward a mortgage. Some gets spent on new toys, vacations, home maintenance, etc. So for the general population, it is absolutely better to pay off the home early because that money has a defined use that is a positive financial decision, as opposed to spending that money on other items that should have been invested. So, in my opinion the idea of paying off a mortgage early is based on philosophy and how much risk someone is willing to take on. This changes as one gets older and therefore closer to retirement. As a 29 year old I can afford to be somewhat risky with my investments as I have time to recover. I lost approximately 7% in the stock market in 2018, which sucks, but overall not the end of the world. In reality it is just the perfect time for me to drop as much cash as possible into the stock market (assuming it doesn't continue to fall). For my father, who is in the process of setting up his timeline to retire, losing 7% is a bigger issue. He doesn't have the time to "catch up." So unless the stock market goes gangbusters like it did after 2008, he is likely going to have to work an extra year that otherwise he would not have needed.
  12. Unfortunately I agree, I think the only exception may be programs associated with medical schools - like mine is/was.
  13. Yeah, that came across weird. I meant many of the schools I applied to paid for preceptors, which meant their tuition was significantly higher. The one I went to did not pay for preceptors, and therefore was MUCH less expensive.
  14. This...most of the schools I applied worked like this, thankfully the school I went to did not.
  15. mgriffiths

    DFW CUSH job opening!

    good grief...I would be all over this if it made any sense at all for my family to live in TX!!
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