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SCPA

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About SCPA

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    Physician Assistant

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  1. The following echo was ordered for a murmur in pre-operative evaluation for TKA Notable for diastolic dysfunction and mild concentric LV hypertrophy Any further cardiac w/u recommendations pre-op?
  2. anyone have experience with giving prolia in office? any potential pitfalls to consider? most of my pts are on oral bisphosphonates but would like to offer something easier.. thanks.
  3. Anyone have suggestions : Having trouble getting my nurse when I need her. She always seems to be busy getting vitals or doing something else where it's not appropriate to interrupt her (and then I end up doing the nursing task -- inefficient). Anyone have a good system to let the nurse know you need them? Our work stations are not very close together. I'm darn near strapping a walkie-talkie on her..
  4. I'm on straight RVU based compensation - in other words, if I'm not seeing patient's i'm not generating income. Admin wants my input on a new EMR and asked me to come along with them to look at the system. It will take a day away from clinic. Think I should ask for some sort of compensation for this or let it go? If so, any idea what to ask for?
  5. I agree. They have been educational in many instances. But most of the time it's a used car salesman vibe that's hard to shake. It's the sales aspect of things that kills me. As per the link in original post..
  6. https://www.bostonglobe.com/business/2019/02/13/rap-video-opioid-salesmen-boasted-their-prowess/YsPTTbiDYDq1ZIpEtobmXL/story.html?fbclid=IwAR12z4mrT9lVHvg8T9dmKwm9NslPimoxkNf9nMPfecQJRfnsruvULPrWxlI Anyone else tired of these soul suckers? I understand how they may be genuinely helpful for surgical devices and such, but man, in family med major PITA. They all want to be your best friend -- as if nonstop patient interaction wasn't tiresome enough , dealing with their shallow interactions is unbearable. And the blatant abuse of my time for their gain. Sick of it. Really , I need to hear how your SGLT2 will save the world for the millionth time? Oh and yes, let me assure you, you have my wholehearted commitment to prescribe your drug. As if there's any real difference between the 5 other drugs in your class.. Thinking about going to a no rep policy. GTFO!
  7. How would you manage the following 26 yr old M with no sig PMH. No Rx meds. In for checkup, fam hx of t2dm and wants to be checked. The following labs were drawn after a very strict fast . Pt does intermittent fasting and had been > 12 hours with only h20 at time of labs. Lipids: Total: 288 Trigs: 236 HDL: 52 VLDL: 47 LDL: 188 Dutch lipid criteria negative for familial hypercholesterolemia. Father on XOL medicine, but otherwise no known family history of ASCVD. Normotensive, no smoking, no DM, normal BMI. BGL: 127 , follow up a1c 5.1% Find this to be interesting BGL with that a1c.. Pt EXTREMELY nervous about the blood draw and nearly passed out. Elevated glucose from stress response?
  8. Unfortunately I do not have subscription! Thanks for input though.
  9. Are there any guidelines for managing pts who require long-term antiplatelet Tx but are already on anticoagulant? I.e. - > 60-something year old M on NOAC for afib , has a carotid scan which shows moderate carotid stenosis -> pt is completely asymptomatic. Statin is optimized. Is chronic antiplatelet + anticoagulant warranted?
  10. How is PTO typically handled in a RVU only , eat what you kill, type salary situation? Has anyone seen a mechanism built in where you get an average RVU reimbursement for your PTO or something similar? Or are most places saying you don't get paid if you're not working?. Because if you're not getting paid for time off.. well ...it's not really Paid Time Off now is it... THANKS!
  11. Anyone know how this generally works? My employer is offering loan repayment to the tune of 10K per year for 3 years, but wants to apply it directly to my loan -- in other words, they pay my loan servicer directly and I never touch it. Curious if this is always how it's done or if there is a viable option to have the money directed to me. I'm assuming this is some sort of write off for them? Thanks in advance..
  12. Sorry to hear this. What's the rationale for employer to change your codes to a lesser value? Don't you both lose in that scenario?
  13. Here for advice: Family medicine.. NEW SP hired to replace previous SP is doling it out HEAVY -- even seemingly pushing narcs on people. "you need pain meds." She's full of theories that piss all over conventional wisdom on the matter. Found out a big box pharmacy won't fill her scripts -- apparently she's flagged in the system I'm not doing anything wrong, i'm quite scrupulous about prescribing, and obviously my Rx habits will not change but I really worry my association to this person(she is my SP afterall) will bring unnecessary attention from governing bodies, not to mention the unsavory seekers that are about to start lining up.. I really do not want to leave this job. WHAT'S A PA TO DO?
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