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sas5814 last won the day on June 22

sas5814 had the most liked content!

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About sas5814

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    Physician Assistant

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  1. sas5814

    Ethical Question

    The thing about fraud is the difference between what you know and what you can prove. "I misunderstood" or "that wasn't my understanding" along with the fact that you, the alleged fraudster, didn't benefit at all makes the chances of a fraud action about as close to zero as you can imagine.The chances you'd spend time in jail is less than zero. Most insurance fraud efforts are in the arena of looking for big money frauds and fraudsters. They have limited resources to chase nickle-and-dime stuff like getting a patient a test they need just because the insurance company didn't want them to have it. I am a (much) former fed who spent a bit of time in economic crimes. I have personally turned in 3 different people who were on disability who had full time off-the-books jobs and incomes in their spouses names. I included specifics and, in one case, a picture of a person who supposedly couldn't work for neck and shoulder pain, zip lining. All are continuing, years later, to draw a check and work full time. Nobody cares if I fudge a bit to get a test one of my patients need.
  2. sas5814


  3. sas5814

    Job Outlook

    I have been away on vacation so I am catching up on a lot of threads and this has been interesting. I think what you are hearing is a spectrum of experience and opinions and that is, really, a good thing. No one of us has had a career that defines the profession but only what it was for us. I was a medic in the military so, when I reached a fork in the road where I was either going to push troops or stay in something medical, PA school was a logical way to advance in the professions and in the military. I applied and was accepted first time (24 slots for about 400 applications). The military was...the military. I was respected and well treated because I was taking care of troops and their family members at a unit/community level where we, along with 1 or 2 doc, were health care. My first tour the nearest hospital and/or consultant was 90 miles away. Then there were field problems, combat deployments, advanced training programs etc etc. When I retired I had spent the last 6 years caring for young healthy people. My experience in IM and the like was non-existent. I had never managed insulin. I barely remember having any diabetic patient but if you were on insulin you were showed the door. It gave me a very steep learning curve. I started in the "real world" in rural health/family medicine and until recently was in rural, small, private owned practices including private UC clinics. I have always been well treated, reasonably well paid, and in demand. That has mostly been a function of geography. I have been where the majority of PAs don't want to be and that can make a huge difference. Now, because we needed to be closer to aging parents I am in a small city working in corporate medicine and, in a word, it blows. Bean counters and nurse administrators run everything. Money is the driving force behind every decision and staff satisfaction is so far down the list of concerns I don't think it even got a number (though they make a lot of feel good noise about it). Staff gets an opinion about nothing. Mid management can't manage anything because all decision making power is accumulated in a very small group. I haven't met anything that faintly resembles a leader. When a physician acts like a fool I just tell them I will document their comments in the patients chart and kick it up for QA and med staff to review. I'm too old to dither with their tender egos. The youngsters don't fare quite so well but I am teaching them. I think the single biggest issue confronting the profession is staying competitive in the market with NPs. They are years ahead of us and the same aforemention bean counters are doing the hiring based on the afore mentioned worship of the dollar. Physicians don't get a vote on hiring. I sincerely believe the profession will be on life support in 5 years if we don't address this. I could be wrong but some pretty smart folks share my opinion. So would I apply for school now? I don't know. It is hard to take my experience and translate it to now in the civilian marketplace. I am not heartened by what passes for leadership in large health care organizations.
  4. kind of what mgriffiths said. We have an ortho doc who is a total horse's ass and gives any APP that calls a hard time. I just started cutting him off and I say "I'm either going to chart you refused to consult on this patient and send it for med staff review or I'm going to document your guidance. That is the sum total of what our conversation will be." It isn't up to me to fix crappy attitudes or burn out. I have my own patients and things to worry about.
  5. sas5814

    NPR article about NP residencies

    well the good news is rather than do that they wrote a great position paper about separating children from their families at the border.
  6. The only time this happened to me I told them I would be at my desk when they decided to turn off the recording and, if that wasn't satisfactory, they should leave. I'm not going to be recorded or broadcast without my permission.
  7. I sent an inquiry to management about 2 weeks ago about this and haven't received a response. I have people frequently try to record the visit or, just as often, want to have an open phone line or Facetime during a visit. I firmly but politely shut it down. Admin doesn't want to give me guidance I assume I am free to do as I feel appropriate.
  8. yeah.....not appropriate but not malicious. Just tasteless.
  9. I don't think you are wrong if we remain complacent. I believe, as do many people currently in leadership positions, we will be on life support in 5 years if we don't level the playing field. OTP should be a big help but it is going to take time to roll out. I'm hopeful that once the first state goes the rest will follow in fairly quick succession. Sadly we have some states and some of our own organizations that are resisting and even working against OTP. By the time they are officially wrong, if OTP doesn't start happening quickly, I wonder how many will be pleased that they spent a lot of time and energy trying to stop it from happening. Oh yea.... most of them will be retired leaving the detritus for the young PA to live with....
  10. I'm stunned they gave you the pay raise. Nurses look after nurses. (They also eat their young but that is a different conversation).
  11. sas5814

    Unused scripts, resigning

    That is what I did with mine. It seems a secure document shredder is about as good as it gets short of shredding them yourself.
  12. sas5814

    Violent Patients

    If they threaten I tell them to leave. If they don't immediately I have the front desk call the police. If they actually try to assault me I disable and control them as quickly as possible by the most expedient means. Then they go away in hand irons. Being a pretty big guy that hasn't happened often but angry or mentally ill folks don't often think or act rationally. Defense of self, staff, and other patients first. Other concerns second.
  13. Thread hijack: "Former? Who gives a ? Should I start putting all my former things on my CV? " Several years ago I was engaged in a heated online discussion with a bunch of people and, as is often the case, people started putting titles and former positions held under their signature and as time went on it seemed to get longer and longer. I finally listed everything I had ever done in my life finishing with "Perfect Attendance Mrs Tiller's First Grade Call- 1966" It cooled off the conversation and the chest-thumping.
  14. No reason to start. He is a zealot which means he is following a belief and nothing reality based is going to change his opinion. No reason to engage. That just feeds the fire. Best ignored while he becomes irrelevant.
  15. That is a nice little article from a group that has no bias.

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