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Everything posted by mgriffiths

  1. I don't agree with everything that zdoggmd says/writes, but I think his recent statement on vaccine mandates is as close to 100% spot on as it can get. Part of me wants to support vaccine mandates because the vaccine works, but all it really does is "confirm" in those who refuse vaccines based on conspiracy theories and COVID denial. There has been tremendously poor communication from the government, and government transparency has been an issue for 100% of my life that I've paid attention. It is problematic and there is plenty of blame to be spread around between Democrats, Republicans, Independents, etc. Personally, I think zdogg's townhall idea regarding having Democrats AND Republicans state together that the vaccine is recommended would help. Of course you can't reach everybody...there are just those too far gone the rabbit hole. But it would 100% help. We also have to get out of the massive hole that is two-faced politicking from news organizations. Fox News literally ran a story today about Nicki Minaj (can't even believe I'm referencing her) and her "research" on how vaccines are a personal choice. Fox News supporting Nicki Minaj!?!?!?! I was flabbergasted, and this is coming from a company that quietly has been pushing vaccines on its employees and requiring them to disclose their vaccine status. Why does it have to be two-faced...and the others (CNN, MSNBC, etc.) aren't any better on other topics. It's incredibly frustrating...
  2. and has stated that it is the Catholic church's position that it is the correct thing to do to get the vaccine (including other non-COVID vaccines with similar abortion related roots), and therefore to go against the pope's statement is tantamount to sin in the Catholic religion. As an evangelical Christian it really is mind-boggling. I don't agree with abortion...but the reality is that what is done is done.
  3. I could absolutely cut back, but it would of course impact my income. It is 100% the plan for the future, but don't want to be doing that yet.
  4. Absolutely true, and with the marketplace it definitely is easier to find my own health insurance. I am aware there are other options as well. Medical insurance is by far the biggest consideration, but it's not the others don't matter. I wouldn't have a problem going 1099...but fully per diem would give me significant anxiety.
  5. I've definitely thought about it...but with my wife being a stay-at-home mother I need benefits and stability. If we didn't have kids then it would be different. Or, if my wife worked and could get benefits through her work. Maybe in the future once we're financially independent...but even then we'll still need medical coverage unless we've transitioned to a single-payer system (not trying to get into whether we should or shouldn't...but I think it's obvious we'll be there eventually).
  6. dang...as an ortho PA I started my morning by reading this (https://www.physicianassistantforum.com/topic/61191-case-for-students/page/2/#comments). I'll just say not all the cobwebs cleared out...then to come here and read the above. Feels like shots were fired directly at my brain...but I guess I'd still be able to do ortho so it's ok!
  7. I honestly wouldn't be surprised if Washgul didn't have privileges anywhere...
  8. So there is some good news on this finally: https://www.nbcnews.com/news/us-news/judge-says-ohio-hospital-cannot-be-forced-use-ivermectin-treat-n1278576 Glad the guy is doing better...but at the same time this is just going to be fuel "proving" ivermectin works. By Tim Stelloh A judge ruled Monday that an Ohio hospital cannot be forced to give a patient ivermectin for Covid-19, reversing an earlier decision that ordered it to administer a parasite medication that has not been approved to treat the disease. In an 11-page decision, Hamilton County Common Pleas Judge Michael Oster Jr. wrote that there “was no doubt that the medical and scientific communities do not support the use of ivermectin as a treatment for Covid-19.” Based on the current evidence, Oster wrote, the drug — which is primarily used to deworm horses but has been promoted by some doctors, some Republicans and the popular podcast host Joe Rogan to combat the coronavirus — “is not an effective treatment for Covid-19.” Oster cited advisories from the Food and Drug Administration, the Centers for Disease Control and Prevention and medical associations that have warned against using the medication for Covid-19. Oster also cited problems with research into using ivermectin to treat the disease, including the withdrawal of a non-peer-reviewed study from a website that posts academic pre-prints. Julie Smith, the wife of the patient, Jeffrey Smith, had sued the hospital to force doctors to administer the medication. “While this court is sympathetic to the plaintiff and understands the idea of wanting to do anything to help her loved one, public policy should not and does not support allowing physicians to try ‘any’ type of treatment on human beings,” he wrote. Jeffrey Smith, 51, tested positive for the virus on July 9 and was admitted to West Chester Hospital nearly a week later, according to court documents. He was intubated on Aug. 1, and by Aug. 19 his chances of survival had dipped below 30 percent. Julie Smith demanded that the hospital administer ivermectin, but doctors refused. The medication had been prescribed by Dr. Fred Wagshul, a pulmonologist unaffiliated with West Chester who advocates for the use of ivermectin for Covid-19 and once told the Ohio Capital Journal that not using it was like “genocide.” A different judge issued a temporary injunction Aug. 23, ordering doctors to begin administering the medication for two weeks. Oster, who held two days of hearings last week, said Wagshul could not confirm in court whether the medication’s continued use would benefit Smith. Wagshul said Smith’s condition “seems to” have improved, Oster added. In a statement, an attorney for Jeffrey Smith, Jonathan Davidson, said he was disappointed by Oster’s ruling. “While he has likely received his last dose at UC West Chester hospital, we can only hope his condition continues to trend positively,” Davidson said, adding that his client’s condition had stabilized and is improving. UC Health, which operates West Chester Hospital, did not immediately respond to a request for comment. A spokeswoman told The Cincinnati Enquirer that the decision was “positive.” “We implore all members of the community to do what we know works: wear a mask, become fully vaccinated and use social distancing whenever possible,” Martin told the newspaper. “At UC Health, we respect the expertise of our clinicians and appreciate the scientific rigor used to develop treatments, medications and other therapies. “We do not believe that hospitals or clinicians should be ordered to administer medications and/or therapies, especially unproven medications and/or therapies, against medical advice.”
  9. vending machines are definitely more work unless you are willing to pay a few employees
  10. I was going to downvote his comment, but the auto downvote was already applied so didn't need to! (I actually remember when caadmission did that...and man that was a ride where I agreed with them)
  11. I have no first hand experience but am aware that it has a reputation for significant income with limited work. Just requires a solid initial investment, similar to a well located laundromat. I do have two friends who own separate storage unit businesses and both have made comments about how they make more from the storage units than from their other rentals combined.
  12. But it's not a valid prescription for the inpatient hospital pharmacy because the prescription cannot be placed within the hospital's system because the physician does not have privileges at the hospital. If the patient wants to go fill the prescription at a local pharmacy and take it at home...that's their choice. But, even when I worked FM, I couldn't prescribe medications to my patients when they were inpatient at the hospital because I didn't have privileges.
  13. Except, as the article states, the physician has no prior relationship with the patient and is not part of the patient's care within the hospital. The physician does NOT have privileges at the hospital. Therefore, for the judge to REQUIRE the hospital to follow an order of an outside physician is practicing medicine because it is against the policies and protocols of the hospital.
  14. I may have missed it, but I don't see in OP's post where they are sending patients to the ED if they are febrile, just that they don't see them IN the clinic. Obviously that could mean sending them to the ED, but that's not the assumption I have. When I covered at our UCs we did not see febrile patients in clinic - hospital policy. We set them up for a telemed and then would go from there. Usually I would order a COVID test and if negative then have them come into the building for an in-person exam.
  15. https://nypost.com/2021/08/30/ohio-judge-orders-covid-patient-be-treated-with-ivermectin/ Seriously! For those who don't want to click the link: An Ohio judge on Monday ordered a hospital to treat at COVID-19 patient with ivermectin — an unproven virus treatment and livestock dewormer — going against CDC and FDA recommendations. Jeffrey Smith, 51, contracted the coronavirus in early July and has been in the intensive care unit on a ventilator at West Chester Hospital in Cincinnati for weeks, according to the Ohio Capital Journal. His wife, Julie Smith, filed a lawsuit against the hospital on Aug. 20 for demanding an emergency order for the use of the animal medication in a Butler County court in a last ditch effort to keep her husband alive as he suffers “on death’s doorstep.” On Aug. 23, Butler County Judge Gregory Howard ordered that Dr. Fred Wagshul’s prescription of 30 milligrams of ivermectin to be daily for three weeks be filled, as requested by his wife and his legal guardian. Ivermectin is approved for both humans and animals, but animal drugs are concentrated at levels that can be highly toxic for humans. The FDA has no data proving ivermectin’s use as a COVID treatment, and warned Americans they are not livestock amid a rise in poison-control calls from people suffering side effects. Smith was admitted to the hospital on July 15, where he was moved to the ICU and treated with the hospital’s COVID-19 protocol, which included plasma, steroids and doses of Remdesivir, an antiviral medication, according to court documents. On July 27, “after a period of relative stability, Jeffrey’s condition began to decline,” the lawsuit says, and Jeffrey became unstable as his oxygen levels dropped. His condition “continued to decline” and he was sedated, intubated and placed on a ventilator on Aug. 1. Several serious subsequent infections left Smith with a roughly 30 percent chance of survival by Aug. 20, when he remained on the ventilator in a medically induced coma. “At his point, the Defendant [hospital] has exhausted its course of treatment and COVID-19 protocol in treating Jeffrey, which is unacceptable to Ms. Smith,” the lawsuit states. “Jeffrey has been on a ventilator for 19 days,” the complaint continues, “He is on death’s doorstep; there is no further COVID-19 treatment protocol for the Defendant to offer to Jeffrey; Ms. Smith does not want to see her husband die, and she is doing everything she can to give him a chance.” The lawsuit did not mention whether Jeffrey Smith had been vaccinated or not, however of the 21,000 COVID-19 hospitalizations since Jan. 1, only 500 patients have been vaccinated, The Capital Journal reported. The Smiths have been married for 24 years and have three children, according to documents. Jeffrey is an engineer with Verizon. Julie Smith took it upon herself to get in touch with Dr. Wagshul, a leading proponent of ivermectin from Dayton and founder of Front Line COVID-19 Critical Care Alliance, who wrote the prescription for the drug. However the hospital refused to administer it to her husband. Wagshul told the Ohio Capital Journal that there was “irrefutable” evidence supporting the efficacy of ivermectin against COVID-19, and alleged a “conspiracy” to block its use by the CDC and FDA to continue its authorization of the available coronavirus vaccines “If we were a country looking at another country allowing those (COVID-19) deaths daily … we would have been screaming, ‘Genocide!’ ” he told the paper. Dr. Leanne Chrisman-Khawam, a physician and professor at the Ohio University Heritage College of Osteopathic Medicine, called the FLCCCA “snake oil salesmen,” according to the Capital Journal. She cited several problems in the group’s published research. “Based on evidence-based medicine and my read on this large number of small studies, I would find this very suspect, even the positive outcomes,” she told the Ohio Capital Journal. An update on Smith’s new treatment has not been revealed by the hospital or Wagshul due to privacy laws, the paper reported.
  16. Having previously been a teacher before going back to PA school...I will say, the fact that she took off her mask in direct conflict with stated policy should be enough for discipline. Should that include the loss of her teaching license and/or her job? Probably not as a singular event, but if she has a history of not following protocols/policy or other issues, then I could potentially see that as a result. I do think a course on policy or something similar that is an annoyance for her is probably enough. Something that is hopefully a big enough hurdle that she will think things through the next time. I agree with many here who are saying that we are FAR too quick to grab our torches and go hunting the ogre, but we have policies and protocols in place for a reason and this teacher decided to flout the masking policy. Regardless of fogging glasses or some other hypothetical reason, the policy was disregarded improperly. That is a significant issue and the reason for the mask policy happened...MANY children became sick and that is a problem. I am the father to a beautiful 3yo little girl and my wife and I have/had every intention of sending our daughter to preschool this year. If you asked me 12/19 about preschool I probably would have said it wasn't the plan as she was involved in music class, bible study, community play times, etc. But with COVID, she has had basically nothing for 18 months. She needs the structure and interaction with other children and adults other than just her mother and father (and occasional grandparent visit...all vaccinated). While my state (MI) isn't having the same case load as other places in the country...we're definitely seeing an increase and unlike the south, schools JUST started. So what is to be over the next 2-4 weeks? With everything going on we are now strongly considering backtracking again and not sending her. Of course, my wife is pregnant (27 weeks gestation) with our son and that is playing a HUGE role...and on top of that the loss of our daughter at 38 weeks gestation April 2020 is also a HUGE factor. But, it's frustrating to know that there are teachers who disregard policies...just like every other profession out there (including many I work with every day at the hospital and clinic).
  17. I am not a lawyer but my understanding is that depending on locale the 2 year SOL is based on knowing when the potential malpractice occurred. So, using a somewhat goofy example: patient has abdominal surgery and a lap sponge gets left inside. If 10 years after the surgery the patient gets sick and the cause is identified as the lap sponge, as long as the lawsuit is filed within 2 years of learning that error (so 12 years after surgery) that is within the SOL.
  18. If you're not practicing why would you need malpractice? Do you mean getting tail because that isn't covered by your current/most recent employer?
  19. what a great word! Completely agree, and while people from all groups do it...those who identify as evangelical christians are some of the worst.
  20. As an evangelical Christian it really saddens me how poorly many who identify as evangelical christians have critical thinking skills, live a life that is defined by Christ, etc. But, I will say about the elevated D-Dimer...OF COURSE! A D-Dimer doesn't diagnose a blood clot. It is used to either rule it out or show the potential presence of a blood clot, but it must be confirmed by other means. I don't know the specific validity of this, but during my PA rotations many years ago I was told by one of the hospitalist MD's I rotated with that if the phlebotomist misses and has to re-stick to draw a D-Dimer that it could pop positive because it is such a sensitive test. But furthermore, a D-Dimer is an inflammatory marker and is therefore part of our immune response and again does NOT mean someone has a blood clot or damage to their blood vessels. Lots of things can trigger a positive D-Dimer...like simple exercise!
  21. Probably not the degree you're referring to, but I've had a few. One recently showed up on my Press Ganey as a "mixed comment" saying that I was a good provider, excellent exam, etc. but I needed to "shut up about the vaccine." "He is obviously knowledgeable, but I'm more knowledgeable because I'm an (name redacted, same hospital employer] nurse!" We live in a weird world.
  22. I haven't personally, but I also haven't pursued it. But, I know MANY PAs who have successfully done this. My recommendation - moonlight at an UC and/or ED to get your foot in the door. Your ortho experience will be a plus, but obviously not comprehensive.
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