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Everything posted by sas5814

  1. This. I did this for a few years and had more work than I could do. I had a head start because I had been working in the area for years and just reached out to every practice and provider I knew and told them what I was doing. It wasn't long before I was scheduled full. I had one UC that was owned by a loon and they couldn't keep staff so I practically had a full time job there and I didn't suffer any of the craziness because I wasn't an employee. If it got too crazy I just wasn't available to them for a while. It can be a little iffy sometimes. I had one episode when I check my booking for the following month and I had none... I took a job through a locums company for a couple of weeks to fill the gap. It is nice to set your own schedule, charge your own rates, and be the captain of your own ship.
  2. LOL. I don't think I'd advise showing up without having made a reservation and gotten some assurance (and kept a record).
  3. I bet money if you use the code and say you are a PA they will give you the deal. Its an advertising gimmick and they want as many takers as they can get.
  4. I'm going to strongly disagree with this. I have done hundreds of DOT exams and many are very simple but you WILL find yourself in a position of failing someone and getting the full blast of their anger because YOU are taking away their ability to earn. The fact that they are grossly overweight, smoke, drink, think exercise is lifting a fork, and can't eat anything healthy because "I'm a truck driver" will mean nothing to them. They take no responsibility for their own problems and will blame you. I have been screamed at, threatened, even had my life threatened and my family's. My DOT is current for a few more years and, as Reality said, will never do another DOT physical. Oh yea... the alternative to the above is clearing someone who shouldn't be cleared and staying up nights wondering when the lawyer is going to call because they guy you cleared passed out behind the wheel and drove his tanker full of gas into a school bus full of children and nuns. Never again...
  5. Oh my yes.... you will get a lot of advice I suspect but here is the biggie.... locums recruiters will say and do anything to put you in a position. They will lie to you. Be doubtful of anything they tell you. They will poor mouth and tell you the low rate they offered is absolutely the best they can do and, to get more, they will have to go ask the employer for more money. That is hogwash. They have a contract for an hourly rate and the less they pay you the more they get to keep. I had one try to get me to take a 90 day job with a neurosurgeon (including OR time) and I spent my whole career in primary care. The recruiter will paint a rosy picture of the job so ask lots of questions about hours, overtime, support staff, physician backup etc etc. If it is a 1099 position do the math considering you have to do 100% of your own withholding and you have to pay all taxes yourself with no matching contribution from an employer. Generally when I was doing locums work I expected about %35 more per hour than I would expect if I was employed with benefits. There is a lot more and I suspect others will have a lot to share. Just be wary, ask a lot of questions, and don't be shy about insisting on more money if the offer seems to low. Good luck!
  6. Them that signs the checks makes the rules.... Welcome to corporate medicine.
  7. I have occasionally opined that managed care costs more then in the glory days when we just did what we thought was best without interference of bean counters and insurance companies. I don't know if its true but I'd love to see good data on what managed care "saves" vs the cost of having managed care....all the administrators and clerks and bean counters and phone calls and lost patient care hours due to administrative burden etc. A colleague at my new position asked me if I was insane yet and we spoke about the clunky cumbersome methods of getting anything done. She said "lower your standards.....and then lower them some more. If you care too much you'll go insane." Its a sad statement but probably more so because it rings true.
  8. There's a few variables that would shape my answer. If the shift is a hard 10 hours with patient handoff at shift change it is managable. What is a typical patient count? What kind of acuity presents that you'll need to manage? What is your support for advice, specialists, transfers? These, and probably a few other things I forgot, will weigh heavily on how stressed and tired you are after 7 10's in a row. If you have good support in place it makes a big difference. My second job after I retired from the Army was a critical access ER where I did 2 24 hour shifts a week. I thought awesome! I have 5 days a week off! It rarely worked out that way. If I got flogged for 24 hours my off time was generally used up sleeping and trying to feel human again. Once I fired the only other full time PA before I had a replacement and I ended up working 5 strait days because there simply was no relief. So add up all the variables and you'll have a good idea of how it will work out.
  9. I'm glad you have things turned around. Congrats on pulling out of a tailspin! The NCCPA is a testing and certification organization. Their only business should be have you paid your money and taken your test and passed. That said they are pretty opaque. I have heard over the years of them looking into conduct issues but that was a long time ago and it was barely more than a rumor. I just remember thinking it was none their business. How long ago did you report it to them? If it has been a while and you haven't heard anything then you are probably just fine. Even if they contact you, you have already done everything right and gotten strait with the board. It would be a pretty big power trip to stomp all over that.
  10. Let me add (having recently started doing pre-ops after a long hiatus) you don't clear anyone. You stratify their risk. I have found a form in our computer (that I cannot share unfortunately) that lets me fill in a few blocks , check a few more, and then rate their peri and post-operative risks. At the end of the day the anesthesiologist and surgeon make the final decision based on your assessment. Good luck!
  11. I had a 3 year contract with a FQHC and left at 2 years. it was nothing like the snake pit you are describing but, as Rev said, they are often run by well meaning morons. Our CEO started out as the CEOs secretary and had no formal training or education in between those 2 positions that would qualify her. We had a well meaning board made up of lay-people who basically rubber stamped everything. I too was often asked how long I would be there. The last PA got fired for writing crazy amounts of benzos and narcs for a staff member. Protect yourself and be gone from this place as soon as you have a place to go. You are well intentioned in your desire to help the patients but you will destroy yourself eventually and be no good to them or yourself. You didn't create this mess. You can't fix this mess.
  12. So..... how much back up do you have and what is the response time for an emergency? Really if you have good backup you can muscle through this. Its OK that you are a bit anxious. That means you aren't complacent. I have worked clinics that were attached to the hospital and urgent and emergent problems just moved on over to the other side of the building. I have worked places where I was alone and the nearest medical facility was 2.5 hours away by fixed wing aircraft IF the weather allowed it. If you generally like the job and the backup is really there then this is very do-able. Your comfort level will improve with time.
  13. I am not shedding tears for pharma but at the same time I'm not demonizing them either. Like most big issues it is more complex and nuanced than "they are evil" or "they are wonderful."
  14. These stories always sound horrible but how much did they spend developing it? How many other drugs did they spend millions developing not make the cut? There's a lot more to drug pricing that just the cost of manufacturing after it is fully developed.
  15. yup. Its a seismic shift in our lives when we get to the point peers are passing on. I have lost a couple of people I went to PA school with. I was pondering how I had become more emotional in the last few years when historically I was an emotional brick. My ever smart wife.... "you realized there are more days behind you than in front of you." Old tropes about seizing the day seem less like greeting cards and more like truth.
  16. me too at my first job after I left the Army...in 1990. Its the job and location. I worked for a UC where I live and the starting salary for me was 164k but more like 190k with OT. It was soul crushing work but the money and benefits were great. Now I work for the VA at about $140k but no call, great benefits, and an actual lifetime pension.
  17. I remember a night time news piece several years ago that went undercover to a Chiro conference to see about their CME. The whole thing was about selling supplements and services and what words to use to stretch the number for visits a patient could have authorized by their insurance company. Nothing...and I mean nothing about the actual practice of their craft. I think selling things in the office is tricky. I always felt the appearance of conflict of interest probably was and I err on the side of caution.
  18. One of the things I have learned over the years is money isn't everything. My work environment is as important as pay. I won't work somewhere where I am verbally abused. 50 a day isn't safe. Period. When you miss something, and you will, "he made me do it" won't be any kind of defense. You are responsible for your own conduct. You are working in a cash register and, of all the horrible things a practice can be, this is among the worst. Nothing is more important than making money. One man's opinion but UC isn't a great place for a new grad anyway unless there is a lot of cover and support. There are oceans of trivial crap and then, in the middle rushing by like everything else, is something bad. I can't count the number of MIs I had walk into the UC. Then there was the pneumothorax, the C2 fracture, pleaural effusions, the occasional accidental cancer find etc etc. Then there are the obvious wrecks like the dog mauling and gunshot wounds and a stabbing or 2. It just goes on. The magic sauce of the UC is to not miss something bad amongst all the white noise. It isn't for new grads. Combine that with a poisoned work atmosphere and its time to move on. Do what is best for your patients while you find a better place to be. Jumping ship early can raise eyebrows but lots of new grads land somewhere that turns out not to be a good fit. It is explainable.
  19. you could just run around town hugging people and giving them immunity. Like a Marvel character.
  20. well.... to wander a bit from the original thread CAA is correct though I wouldn't suggest complete silence. That can be connoted several different ways and sometimes gives them leverage in the "resisting" venue. It isn't resisting but some jurisdictions have laws about resisting, delaying, or obstructing which can be pretty broadly interpreted. By the time you have your charges dismissed because you weren't doing any of those things you will have already been mightily inconvenienced likely including a night in the pokey. Provide ID when asked. If questioned simply say "I'd rather not answer any questions." If someone asks if is ok to search simply say "no. I don't consent." If someone reads you your rights invoke them. I had a brief but glorious career as a fed and probably 90% of everyone I put in prison helped me do it. I also have a great story about being the subject of a felony stop I'll share over a beer with anyone I happen to meet. Back to your regular programming.
  21. I wanted to stop your quote where I thought it was most pointed. I'm as tired of COVID as anyone. I'm tired of fighting about vaccinated and not vaccinated. What I am ABSOLUTELY exhausted form it the political bickering and the political finger pointing. When they finally prove this was a manufactured virus that accidentally got loose in Wuhan we can all hold hands and gang up on China. The sooner the better. OK... that may or may not ever happen but it would be nice to have someone to blame that actually is responsible.
  22. Lets further dilute our brand.... I forgot...and reinforce the notion we are all the same.
  23. Be honest with everyone. Its a minor infraction (nobody wants to see repeated) and the real big deal starts when you try to hide it or minimize it with any regulatory agency or potential employer. Be strait up, don't deflect, take responsibility, and be repentant. You'll be fine. Last time I checked we are all human...except the lizard people that walk among us. That is a different discussion.
  24. I've heard this argument applied to poor people, people living on government subsidies, and now the unvaccinated. It isn't a simple subject but I'm often frustrated by this argument because I always want to know what the people are doing about these circumstances they don't like? Again I know its a very complicated issue but in the case of COVID they could get their free vaccine and then conduct themselves like they have a brain in their head. People's right to choose, even if it is a bad choice, ends at public health and greater good. Refusing to get vaccinated and then wandering around asking to be tested every few days is just madness. Filling ERs and ICUs with people who could be kept out with a simple vaccine is just idiocy.
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