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About ran2much

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  1. Thanks very much for your expertise. I appreciate all the thought you put into the response. It is helpful.
  2. Thanks EMS2015. To be clear, I am not trying to treat their addiction. I just wanted to know about how they would treat the person's pain from the emergency med perspective and if there were any standard guidelines for severe acute pain management when dealing with an active IV drug user (with a new, severe elbow fracture)...like would the ED instead use something like a nerve block and keep them til the next day when ortho could see and manage or just like prescribe 10 percocets and say you have an appt with ortho tomorrow? All I wanted to know was if there were any standards related to this typee of scenario. Thank you again.
  3. Hey friends, Can anyone point out to me any standard procedure for treating severe, acute pain in the ER from a fresh elbow fracture in a patient who is a known IV drug user? Obviously, you dont want to neglect to treat the pain from their acute fracture, but tricky situation when you see track marks on their arm. You know potential for misuse is there. I am sure how you handle may also vary whether you are in a rural setting or in the burbs. Any direction towards the guidelines in a situation like this would be helpful because of course the PA would want to show what they did was what a reasonable PA or MD would do. Thank you. I've been searching online in PUBMED and can't find what I am looking for. Thanks.
  4. Thanks Rev Ronin. I had seen the legislation. Just hadn't heard the outcome. Joining WAPA now.
  5. Hey friends - As a state, have we who practice in Washington state made headway with regards to legal progress in OTP as yet? At present, I know I still have a "supervising" physician and back ups to that physician in my community oncology practice. Is this still true for all at the state level? I didnt know if we are getting traction especially in terms of underserved areas or in disaster/volunteer situations. Is anyone clear on whether it is listed as direct, indirect, or remote in terms of "supervision"? I will dig in on the state site and make some phone calls next week. Just checkin to see what our practicing peeps know. I like to think the pacific northwest is progressive. I need to join WAPA and dig in. Thanks in advance. tracy
  6. Birddogpa - Did you do it (DMSc from Lynchburg)? I just applied. If so, Im sure you are done now. Curious what you're doing. I graduated from PA school 9 years ago. I figure I will pursue it because after 10 years... it may give me more options.... whether I exercise my options right away or down the road.
  7. thank you. I did this once before and they matched and brought everyone up to market value with me. I just didn't want to pull that card again unless I had to. but, youre right. I may have to and I may have to accept that I will have to be ready to walk.
  8. So, its a year later. Any updates from Hahnemann/ Drexel DHSc? I checked their website. No program listed so far. I graduated from Phila U six years ago and now live in OR. Would love to learn more. Thanks. - Tracy
  9. Any business/ negotiation savvy folks, pls weigh in! So - The Portland, OR and Vancouver, WA market is hotter than anywhere else right now. In our community based oncology practice, they have not kept up with the market. Our HR leader for our 6 sites knows it as do the APPs. We are about 20-25k under the average market price in our region right now (based on actual payroll data in our region)... or, if you wanted to go to Kaiser we are 50k under. They obscure our RVUs so we can't see what we bring in (and they say it is unintentional and not sure how to fix). They tell us if we want to get paid the market average, then where will the money come from? You need to see more patients (oh, but you have a diff MA every day and some visits have to be 45-60 min long ones) or where else should we get the money? Um, docs whose bottom lines we pad! Half the docs like APPs, the other half are indifferent or opposed. But, in PA school, you're taught don't get between the doc and his/ her money. I feel like they want to create a Lord of the Flies scenario. He has told us look, the parent company doesn't get it no matter what he tells them. The physicians can choose not listen to the parent company, but they never have. I just don't think you are going to get the market average, but I may be able to get you halfway there. But, think of the advantages of working with us. We are flexible, if your kid is sick and you need to go, you make arrangements and go. There is some flexibility that way and its why I stay. Our health insurance is too expensive for families (and doesn't cover enough) so we are covered under my husband's. Our 401k has a roughly 3% profit sharing distributed in April each year. You don't get it if you leave before then. Ive been here six years and get 4 weeks PTO and a week for CME with $2500 to spend on it. Pretty typical, I think. He says we hire people because they want to work in oncology, they want to take care of patients and thirdly is compensation. $200 end of year bonus. As a group of APPs, we are trying to figure out how to negotiate. Honestly, I wanna get paid the average market rate and go home to my kid and the hiking trails after 40-42 hours a week. I excel and see the 2nd highest # of patients in the clinic. THAT is clearly has never been rewarded and especially now if we can't even get to average. I'd much rather do average volumes and get average pay and some (like those without kids or spouses who stay home are willing to crank patients out like a puppy mill), but what they are saying to everyone is do more with no support and we'll pay you what an average PA gets. Anyone who is business savvy pls, weigh in. Is there no strategy and I should just take one of the many urgent care jobs popping up all over that do value APPs and do pay the market average and incent with sign on bonuses if I'm gonna have to crank out patients like no tomorrow regardless? Thanks!
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