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Reality Check 2

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Reality Check 2 last won the day on May 14

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About Reality Check 2

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    Physician Assistant

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  1. That survey was bizarre. Not able to NOT pick adjectives to describe something - HAD to pick words that didn't even come to mind. And no choice for WTF? Bizarre. Pretty sure this group was next door to a cannabis test room and they just pulled names out of orifices..........................
  2. haven't received any such survey...... who sent it out and when?
  3. Met my next new PCP today and had a great visit. Respectful interaction and he appreciated that I typed out my medical hx for him. Spent time talking about things affect me and what could/should/ needs to be addressed. My BP was great - I wasn’t stressed about talking to him. So - good match and mutual respect - deep relieving sigh.....
  4. https://issuu.com/paassist/docs/aapa_summary_of_physician_assistant_ownership Found this on a google search. See the state by state listing at the end. Not sure of the provenance of this document - who wrote it etc, but it has some good info.
  5. I will likely stir up my millennial counterparts but - oh well, here goes..... Overall, I think we have lost some human touch and politeness as a society and think of things in Text Mode or online - no emotions detectable in many cases or taken out of context in others. We have forgotten common human decencies and social skills. We rely on technology too much and think everything fits into a neat little box of Evidence Based Best Practice. Maybe we are training new providers to be less human, less interactive and more "diagnostic" or scrutinizing. I don't think it is a good thing by any means. Somehow we managed to establish with patients, diagnose and care for folks without UpToDate, without a computer and without Google for a very long time and without telemedicine, stereo stethoscopes, etc. I fear we are losing our humanity and interpersonal skills. The internist I just saw could be a MENSA scholar, valedictorian and booksmart out the yang but she wasn't a warm or engaging person and she didn't want to actually listen to me or hear who I am or where I come from. I have to remember that with each of my patients. Some are highly educated, some are type A, some depressed and some not mentally capable of making self care choices. We can't lose our humanity or capacity to care for people as people - not statistics. Ok, done with soap box............................
  6. For those commenting on the handshake issue - YES, I get the infection thing. But, my point is...... YES, it DOES affect the interaction with the provider. NOT acknowledging a patient's existence with even a common courtesy sets a poor tone for the encounter - I get more polite interaction with the kid at the local coffee hut than I got from this internist. NEVER saw her before, know ZERO about her - the corp med did NOT put her bio online. She did nothing to set the tone for the interaction - no introduction - such as - "Nice to meet you. I know you were a patient of Dr X and she went to full time teaching. I would like to hear about your needs and concerns". Instead I was another sheep in the herd of her daily patients with no more concern for me than someone in line with her at the bank. She mumbled that her name was Dr Y and went into my med list as though I was nothing more than a statistic. Common decency and politeness are professional necessities. I have worked with my share of colleagues who have borderline Tourettes or appear to be on the autism spectrum for social capacity but interpersonal skills are necessary to work with patients - Especially patients never seen before. Instill some confidence. Show some empathy. Be human. Then we get to the point of having no respect for any knowledge I might have - whether I am a plumber or experienced provider. And, I do shake a lot of hands and wash them a lot and offer hand sanitizer to the patients as well. And, yes, some patients hug me. So, back to original post purpose - as a medical professional do you have a good relationship with your own PCP?
  7. Thanks Ventana - I WILL get a copy of my record and check on the billing. I am going to ask for my copay back. Got an appt with my husband's PCP who is now also seeing one of our grown up kids. He seems to respect me in the room with my family members but not afraid to point out knowledge points or his insight. I could never treat a patient like she did me. Even the basics - INTRODUCE YOURSELF and shake my hand. Tell me something about yourself since I have never seen your face before and know ZIP about you - the person I would like to entrust with my care. RESPECT my level of knowledge as well. Some of my patients are retired Flight Surgeons, full bird colonels who are physicians and EMTs or medics who have seen some wild stuff. I respect their thoughts. Some of my patients are tin foil wearing and a bit odd - I listen to them too. EVERY patient deserves the respect as Thinkertdm said - spill your crazy and let me process it - there are nice ways to tell folks they are off base or misinformed. jmj11 - I am so sorry to hear of your journey and all the issues. I hope you are being heard and doing well. Thank you all for the feedback. Let's keep up the good fight and the good work - set the bar high!
  8. Forget my license - save my soul. NOTHING in practice is worth compromising your individual integrity.
  9. Who do you, as a practicing PA, see as your primary care provider? How is your relationship? Can you talk professionally and share knowledge? Is your professional knowledge respected? Can things be discussed in a nonjudgmental manner? I recently had a less than stellar interaction with my newly assigned PCP after mine went to full time teaching. New one is an internist and probably young enough to be my kid. I felt completely disrespected from the absolute lack of introduction and NO handshake to the poo pooing attitude toward any of my medical concerns and medications. I am a once a year patient. NO ER visits. No controlled substances. No on-call phone calls. Stuff is controlled and I have a couple of specialists who take care of special things on a once a year basis. Two issues of concern for this visit and both shot down without investigation - told I should not try to self diagnosis - it was actually the start of a hopeful discussion on my part . She NEVER EVEN TOUCHED ME. Obviously did NOT read any of my chart and had a dismissive body posture and never made eye contact. I left. Deep Ugly Sigh Back to searching for a new PCP..... Would love to hear what others have experienced.
  10. The means test does indeed still exist and is still done on a daily basis. It determines travel eligibility and costs of copays. My patients are asked daily to go do a new means test if it has been so many years or their circumstances have changed. The VA DOES bill outside insurance as well. The Service Officer is on each campus and some locally at CBOC - Community Based Outpatient Clinics for the VA. You call the center closest to where you live and asked to be seen. If their panels are full and you qualify - you will be offered The Mission Act and a local PCP on the VA dime - as long as contracted. It is complicated but persistence is key and educated persons especially in medicine will get there faster - sad but true. Keep us posted on the journey!
  11. My husband had an a-flutter right sided ablation at 45 and the left sided fib ablation a year later. He is now 58 and doing fine. Our local EP cardiologist who is also a personal friend did both of them. He had the ablations after failing 4 meds and being highly symptomatic with difficult rate control. Heart valves are fine. He remains on rythmol and xarelto now - symptomatic fib about 3 times a year and one night run on a 2 day monitor. Echo is awesome and blood pressure normalized. Statistics said ablation 65% successful but I would say his is about 90% or more. No regrets. He has had both knees replaced in past year - he was a defensive linesman football player thru college.... both his knees and afib are related to his size and football. I have few reservations about ablation when done by an experienced EP. Many blessings to you and your wife.
  12. I think technology has done a lot for her ability to care for patients. However, I would never give up the hands-on and intuitive history taking to assess a patient. The ability to function and use your brain should not always rely on technology. When the power goes out, a stethoscope still works. Out in the wilderness, a stethoscope works. In remote areas of Third World nations, a stethoscope still works. Just like cursive handwriting, I hope we never lose the old tactile skills and the listening and reasoning ability that will always serve the patient, even when the power is out. Let technology complement the art, not take it over.
  13. But I slept at a Holiday Inn Express......................... Wonder if anyone credentials Naturopaths?
  14. My Reality Check Razor If it sounds awkward and wrong ----- it is..... If a physician is listed as a supervising physician or collaborating for the PRACTICE of a PA - then their specialty must match that of the PA - ie. Family Med/Family Med or Family Med/Urgent Care. This is state to state variable but likely in most states and likely to be a must have for insurance/malpractice. It's also common sense. A physician can technically be the medical director of an Urgent Care and be whatever kind of doc - surgeon, etc. However, the licensing agreement with a PA should match - ethically and often legally. I would find it unwise and immoral for a semi retired Urologist to be the medical director or SP/CP for a group in an Urgent Care as the knowledge/skill base don't match at all. Internal Medicine shouldn't supervise anything involving kids - they don't see kids. Beware of semi retired docs who still want a hand in the game or a paycheck. You get what you pay for. Think of answering a question with the following start "Yes, your honor, Dr. BlahBlah is a pathologist and doesn't treat patients clinically...and has been my SP for x years." .....and then change the specialty again and again until it matches what an Urgent Care does. Plumbers don't wire houses and roofers don't pour concrete. Just my crusty old 2 cents
  15. More likely a Large or XL Large is often 12/14 and XL sometimes 16/18. Whomever is ordering them should have samples. Or find someone at work and ask to try theirs on.
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