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PAinPenna

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PAinPenna last won the day on January 24

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About PAinPenna

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    Physician Assistant

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  1. The craziest part is my only Press Ganey complaints from patients were that I was "too rushed" . I wanted to bang my head off a wall when I saw those.
  2. Ideally she should have been confronted, without judgement, about her past and current substance use, and if opioid addicted, referred to a medicated assisted treatment (MAT) program and offered Bupenorphine , a partial agonist, while in a mild state of withdrawal .
  3. On the pricing list they misspelled "qualitative"
  4. I heard somewhere recently that increasing access to care does not improve overall population health. This is evident in the corporate primary care office I have recently resigned from. Here, we have central schedulers at some call center (none of us even know where it is) just popping patients into any empty holes in the schedule, resulting in us full to the gills by that first screen refresh at 8:08 am or so. So , here you have first come first serve, 25 yo 2 day URI's that close out the schedule so we end up overbooking the fluid overloaded CHF-er that walks in SOB. In fact, all our oldest and sickest tend to walk in because they do not like to talk to a call center, so we end up having to accommodate them. Our front office and nurses are exhausted, and our providers are fried. I miss the connections I have made in my years in Family Medicine, but will never go back.
  5. Wow- I could not imagine loudly scolding or verbally threatening a patient who comes to me seeking help to recover from addiction. Addiction is not a moral failing- it's a disease. Sure, bad choices play into it- but don't all of our greatest health problems in the U,S. ie DM2, CAD and HTN? Medication Assisted Treatment (MAT) using medications like Suboxone and Vivitrol can turn lives around, and we see it every day. It appears to me you may have been involved in more of a "pill mill" situation than a true recovery model. I'm sure you are well-qualified for Family Medicine, however choose very wisely, as the burnout is real. Read the boards here. And best of luck with whatever you choose . It will get better for you.
  6. I agree with UGo Long- A hospitalist position may be a good fit for you. Lots of walking around, social interaction, variety in your day. You are not crazy for wanting to see daylight in your workday. I'd be insane if I couldn't. And hospitals have lots of windows! I have to tell you I was feeling the same way, and posted something similar a few months ago. I transitioned into Addiction Medicine. While it's certainly not for everyone, these patients WANT to get better, and there is true reward in seeing a patient go from rock bottom to functioning well in a job, marriage is better, etc. And hey- you flunk your drug screen 3 times you're out. It's great to have "rules" to back me up, so there's no room for the back and forth bs we see with chronic narc users. AND- no "list" of complaints. We are there to get them off opioids or ETOH and that's it. Other issues go back to PCP. Of course we help facilitate as needed, but there's an office RN for that. It's invigorating to practice medicine the way I imagined. I highly recommend to those of you who are considering it!
  7. I agree to seriously think very hard about this before you make the switch. Primary care in the US is a holy mess, particularly if you are employed by a hospital and/ or corporation. Call centers managing your schedule - not you. Pressure to schedule more and more patients per day- and then overbook on top of that. 15 or 20 minute slots to deal with acute exacerbation of increasingly complex medical issues . Endless documentation , lab and imaging follow ups. The EHR work never ends Not trying to scare you away, just want you to go into this with your eyes wide open. Now- if you are lucky enough to have hooked up with an independent doc who runs his own show, maybe that'd be ok, but those jobs are few and far between.
  8. Please consider a specialty. You sound like a very bright and caring person. Primary care- whether it's FM, IM or UC is horrible these days, and you are not alone at all in your experience. You will be ok.
  9. Pennsylvania House Rep. Jesse Topper plans to again introduce legislation that would grant independent practice authority to certified registered nurse practitioners (CRNPs). Rep. Topper has issued a co-sponsorship memo asking his fellow House members to support the proposed bill. In a letter sent to House members on Feb. 11, 2019, the Pennsylvania Medical Society (PAMED) expressed our STRONG OPPOSITION to the proposal. The Pennsylvania Chapter of the American Academy of Pediatrics, Pennsylvania Chapter of the American College of Physicians, Pennsylvania Academy of Family Physicians, and Pennsylvania Osteopathic Medical Association signed on to our letter and joined PAMED in opposing this effort. Read the letter. “We believe that current law requiring certified registered nurse practitioners (CRNPs) to collaborate with physicians when providing care is the most appropriate and effective way to ensure that patients receive the safest best possible care,” the letter says. “Removing physicians from healthcare teams simply doesn’t make sense.” There are significant education and training differences between physicians and CRNPs. Physicians complete 12,000 to 16,000 hours of clinical training. By comparison, CRNPs complete 500-720 hours of clinical training. Rep. Topper’s proposal fails to recognize the important role physicians play as the leaders of healthcare delivery teams and ignores the benefits of medical school education and training. “Legislating medical degrees to nurses will neither improve patient care nor expand access to care in Pennsylvania,” the letter says. PAMED asked lawmakers to oppose Rep. Topper’s proposal and encouraged legislators to meet with physicians in their legislative districts to discuss how CRNPs differ from medical doctors. PAMED President Danae Powers urges physicians to contact their representatives to reiterate why this proposed legislation is not appropriate for Pennsylvania. It is important that lawmakers hear directly from their physician constituents. You can find contact information for your legislator here. Scope of practice is one of PAMED’s advocacy priorities for 2019. We advocate for team-based care within a physician-led team, and we will oppose bills that would allow non-physician health care professionals in the state to practice independently. Learn more about PAMED’s advocacy priorities here.
  10. CONGRATS! I too, am very much over corporate Family Medicine. Had a great interview with an independent doc today. There IS life after endless data entry work to satisfy insurance companies and bean counters (aka FM) Again congrats.
  11. Been looking to get out of Family Medicine Have been interviewing in the large health system where I work, and nothing feels like a fit, because I've realized bottom line I'm over corporate medicine. I 'm sure I do not need to elaborate on the reasons. . I took your great advice- sent my resume to an independent doc who was advertising a new location 8 miles from my house. Office manager called me the very next day, and interview is tomorrow. Thanks again, I do not know why I didn't do this sooner.
  12. Good for you and awesome advice - sad part is that around here most docs are employed by a large hospital system . Again great advice though !
  13. Who told patients I'd complete their FMLA ( Friday and Monday Leave Act) form for anxiety issues
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