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sas5814 last won the day on July 1

sas5814 had the most liked content!

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About sas5814

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    President Elect, PAs For Tomorrow


  • Profession
    Physician Assistant

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  1. Does Infantry to PA school count? I was standing next to an 81mm mortar in Alaska and it was -21 degrees with the wind blowing and I thought...there has to be something better than this. The rest, as they say, is history.
  2. Generally, except in extreme circumstances, I advise have a place to go before you leave. Its stressfull now but imagine quitting your job and then taking way too long to find a new one. Unemployed and broke is way worse than employed and unhappy. Fatigue makes cowards of us all.
  3. How old will you be in 10-12 years if you don't go to PA school? I was 31 when I went. I had a classmate that was 57.
  4. Lets try to break it down. Hiring of civilians on military bases is handled by the personnel office. I don't know where that would be for Okinawa but a little research should yield the answer. I'd start applying now. The civil service officials move at a glacial pace. I applied for a job on a military base and was accepted by the hiring authourity. Then nothing for 4 months until one day I get a terse email from personnel saying "send these documents so we can start processing you" and went on to list everything down to my high school diploma. I just laughed them off. A 2-3 year gap right after graduation would be a very bad thing. When you graduate you have the most book knowledge you will ever have and the least amount of practical knowledge. 2-3 years later you will still have no more practical knowledge and your book knowledge will have eroded significantly. I don't think shadowing, volunteering, and CME can make up for that. It is something but it isn't like full time work. Also being in Japan those opportunities will be limited. I don't think telemed is appropriate for a new grad. I could give you a long opinion piece as to why but it just isn't. Check this out for opportunities and employemnt contacts: https://www.usajobs.gov/
  5. Scott, Can you send me your email address? Are you president or president elect of PAFT? Bob

    1. sas5814


      I am president elect but I'd be happy to help if I can. scottstegall@gmail.com

    2. surgblumm


      Since I am a founding member and former first vice-president, I wanted to be able to contact the executive board. thanks Scott. We have met a number of times both in Texas and at the AAPA.

  6. There is a lot to unpack there and I won't presume to try and give you an answer to all of it. I will, however, try to give you one huge tool. Stop feeling bad about anyone who gets mad at you for doing the right thing. This is a skill you will have to learn and it takes active effort and practice and it is HARD. However I found it to be the single biggest tool that changed my attitude about people. Once mastered it will give you a great calm in uncomfortable circumstances. People who seek drugs, want disability they aren't entitled to, want handicapped placards they don't need, or otherwise want to game the system USING YOUR NAME AND PROFESSIONAL TITLE aren't worthy of your concern and stress. They are simply wrong. Stop giving them space in your head. Politely say no and move on to someone you may actually be able to help. You are being mistreated on so many levels. It isn't your fault. Fix what you can. Learn to cope with the rest. Change your circumstances when possible. Best of luck.
  7. Tough spot. In artillery there is an expression called "area of effect" that essentially means you weren't hit by the exploding round but killed by a piece of schrapnel 200 yards away. This is your risk here. It is highly likely when something bad happens from this physician's pracctice you are going to get splashed. With your patients do what you know is right. When you have to see his patients make whatever changes you think are appropriate and explain to the patient why they need to be made. It will get back to him I'm sure and I'd be interested in seeing what happens. In any case you always do what is best. It is hard to go wrong with that approach. I had to change jobs once in similar circumstances. I had a house and a family and there were no other jobs nearby because I was in a rural area. It sucked like a Hoover but worked out well eventually after a lot of lost nights sleep. Good luck. One of these days you will be telling this story as a cautionary tale to some other PA.
  8. You could just slow down to about 2-3 patients an hour and not worry about the people in the lobby. The problem will then fix itself
  9. I'm still saving for that kilo of pure coke... gonna step on it 6 or 7 times and retire
  10. The grunt work gets done at the state level. AAPA is doing what it can but the legislative changes have to be made state by state by state.
  11. ^^This. I hear a lot about residencies these days and see they are a growing thing but there are other approaches too. I spent the majority of my post military time in rural health clinics and under served areas. It was a much better pace. There was a great deal of challenging medicine because of the scarcity of resources. I was genuinely respected and appreciated by the patients and my physician colleagues. I was a voting member of the medical staff. The cost of living was much much lower than most places. I know it isn't for everyone. Some folks need the amenities of bigger places but, if you want to try something different that has much higher satisfation go somewhere where you are really needed.
  12. We have a simple protocol. Any chest pain that does not have a clear non-emergent cause goes to the ER. The only variable is POV or ambulance and we generally prefer ambulance. I have been in this particular UC for 2.5 years. I average 1-2 MIs a week (Non-STEMI). I have had 2 pneumos since I have been here and more PEs than I can remember. This is a bad policy and it will bring harm to a patient and, concurrently, the provider's whose names appear in the chart. I wrote a blog piece about holding administrative people legally responsible for bad policy that brings harm to a patient or provider. I think if 1 administrator gets personally sued by a provider (after relieving the administrator of the protective umbrells of their organization) it would be national news and alter corporate medicine in this country forever. BTW you remove them from the protection of their organization by claiming they acted recklessly and beyond their mandate.
  13. Congrats! You will find it an experience like no other in the profession. Its funny reading the post about all the things we are more or less compelled to learn because it was often just me (us) in remote locations and deployments. My oldest and dearest Army bud's wife got her finger tip pinched in a boat motor and it ruptured and had a tuft fracture. They were sitting in the ER after having been seen by a PA waiting for a determination and treatment. He sent me a picture and I said "clean up that fatty tissue a bit, clean it and irrigate it, close it loosely, start antibiotics, see ortho in 24 to 48 hours. He replies that the PA is afraid of infection so he did no primary closure. He prescribed antibiotics and they were seen by plastic surgery (!) the next morning where the surgeon did exactly what I said to do. My reply? yeah... he trained for 14 years to lean that. Sheesh. Plastic surgeon for a 65 year old woman with an uncomplicated open tuft fracture. That is the difference in approaches and experience.
  14. A good summary. However keep in mind deployments and field problems and being sent off to different military training programs many of which won't have anything to do with medicine. I don't say this to discourage you just to raise the issue to the front. I was already career military when I went to PA school in the Army (before it was all-services) and my extimate is I was gone somewhere 6 of the 12 years I was married and on active duty. If you are single it can be a great adventure. If you are married and everyone understands the arrangements it can give you some real appreciation for time together. If you aren't prepared it can break a marraige. Just food for thought
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