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About BrianR

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  1. Interesting sidebar: that's actually how I became aware of the PA profession about a hundred years ago. I was a paramedic at a hospital-based EMS service and noted that many of the ortho cases in the ED were attended by one of these "COPAs". I got to talking with the guy one day, and he told me about his training and what he did. The above replies are correct; their training was limited to strictly orthopedics, and I haven't run into one in many years. But that sparked my interest, and I discovered the PA profession in my research, and here I am.
  2. I'm a deputy medical examiner for my rural county in upstate NY. It's an appointed position, and we are independent subcontractors. The chief medical examiner is an FP doc (he is a paid county employee) and the deputies are myself, an NP, and a couple other PAs. I personally take call about 10 days per month, and usually handle 4-6 cases monthly. I don't do it for the money; it's part time, and the pay is low. But I absolutely love the work. I usually find it more rewarding than my clinical position. We do everything except the autopsies. Since we have no forensic pathologists in
  3. When I came, we were fully staffed with two PAs, one of whom has since left. So we worked either Sun-Mon-Tues nights or Wed-Th-Fri. No Saturday nights. They put a second resident on Saturdays. That was the hospital's choice. We told them we could cover six nights, and it was up to them which one was uncovered. Every six weeks we'd swap, so every three months you'd have 7 consecutive nights off without using any PTO. (Of course, every three months you also work six out of seven, but it's tolerable.) We just don't have any need for daytime coverage, as there are usually two attending
  4. Fortunately, ours are pretty decent, want to learn and work hard. Most of them are grateful to have a PA here, as they are terrified. A few are indifferent, and it is the very rare cocky one who will try to give me any grief. If that happens, they are promptly put in their place by the ICU director. It's only happened once in the year I've been here.
  5. Northeast, 500 bed hospital, 29 bed ICU, mostly medical. About 1/4/ - 1/3 of patients are neurosurgery, managed by their PAs. We consult on request for vent management and other medical issues. Nocturnist, 3 x 12 consecutive nights weekly. Hospital-employed. PA and a PGY-2 overnight. Resident does all the admission H&Ps. PA either performs or supervises procedures, primarily tubes/lines. Keeps residents from killing patients. A bit over $160k. No bonuses, no extra shifts, no incentive. 200 hours PTO annually plus hospital holidays. Standard hospital benefits, CME, 401
  6. Agree with my colleagues that those jobs do exist, though you may have to search for them. You are correct that a teaching hospital will offer little autonomy, and the residents will be jumping up and down to do all the procedures. But there are plenty of hospitals, even in the cities, that aren't teaching sites and don't have EM residents. I spent 30 years in rural EM, mostly in critical access hospitals, where I was it. No attendings, no back up, just me and 1-2 RNs, maybe an RT if we were lucky. If the patient needed a procedure, I did it. But with all due respect, with 1.5 year
  7. I think it's absolutely doable for the right job. I commute 1:15 three consecutive nights each week for 12 hour shifts. To me, it's worth it, as I like the hospital, the job, and my coworkers. And I like my home, and moving isn't an option. It's 90% rural driving, so traffic isn't generally an issue. Years ago I commuted 2.5 hours for two 24 hour ED shifts weekly. Didn't mind that either, as I loved the hospital. But staying awake on the way home could be difficult if I was unable to get any rest during the night, which was, fortunately, rare. I did some locums work a few years
  8. A result of the market saturation in some areas, and of NPs who are willing to work for ridiculously low salaries. I agree with Sed; try not to be the first to mention salary when talking with a potential employer. 32 years of experience here. I live in a rural area, but drive 75 miles one way to work. I don't work too hard, and I make what I consider a pretty good salary, but I was able to offer the employer a background and skill set that they wanted and needed. I could work closer to home, but wouldn't make near as much, or would have to work a lot more hours to do so. It's always
  9. Just goes with the territory. It's all well and good to be nice, have patients like you, and don't miss obvious pathology, but people can and do sue for anything with nary a care in the world about the effect it has on us. As someone else pointed out, you can be sued simply for coming to work that day. Patients/families expect 100% accuracy, nothing short of perfection is acceptable. God help you if you miss anything, no matter how trivial. For certain segments of the US population, it's like buying a lottery ticket - little cost, no risk, and a potential big reward. And there's no short
  10. CCM nocturnist, 3 consecutive 12s per week in 300 bed community hospital, PTO similar to Kaepora, plus cme time.
  11. Cuomo's a moron who never saw another onerous law he didn't like. I've been practicing in NY for 33 years and I don't know what the hell this even means. And doubtful the governor does either. A "lifetime" license? No idea.
  12. Not sure how much my experience will help you, but I've been a deputy county medical examiner in upstate NY for a few years. It's an appointed, not elected, position, and there are only three of us in the office: an IM MD, a nurse practitioner, and me. We don't share cases; whomever is on call gets the case. It's a rural county, so we only average a few cases each per month. We do it all - scene investigation, whatever additional investigation we deem necessary, decision on whether to refer for autopsy, coordination with law enforcement, pathologists and funeral directors, determination o
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