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Wish1pa

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Wish1pa last won the day on December 25 2018

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About Wish1pa

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    Physician Assistant

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  1. I did try to send her. She wouldn’t go. She did sign AMA, the question was basically if the patient refuses ER do you still treat
  2. She says she ran out of her HTN meds 3 days prior, the others about a week prior. She couldn’t find a pcp because 1. She only wanted a female provider 2. She has a crappy Medicaid plan 3. She was busy going back and forth to New Jersey because both of her parents passed away. So I did feel bad. And It was a Sunday so I don’t think any pcp offices were open that day. But she said she was willing to see a male and had a couple names she was going to call
  3. We don’t really have a policy unfortunately. They’re kinda like, encourage the patient to find a pcp but still refill their meds. It’s the kind of business that doesn’t like to turn patients away if you know what I mean. the best part was when I said ok I’m going to do an ekg she said I was only doing an ekg to get more money from her. I’m like lady I don’t get any financial gain from doing an ekg and plus it’s included in your copay
  4. I gave 0.1 mg. We didn’t recheck because by the time the ekg was done she was agitated and just wanted to go. Normally I would have had them wait a bit and recheck
  5. I work in primary care now but pick up shifts occasionally at the urgent care I used to work at. Saw a 62 yo lady at the UC today who came in for refills of her prescriptions: hctz, amlodipine-Valsartan, metoprolol (all for her HTN), metformin and simvastatin. BP was 212/115, sugar was 364 NF. She complained of no symptoms, just needed refills because she was having trouble finding a new PCP with her insurance. Did ekg despite her protests, HR 102 and LVH with evidence of Myocardial infarction (possibly old). I gave her a clonidine (at the suggestion of my SP) to bring it down and Of course I advised her to go to ER which she refused so I had her sign AMA. I refilled her meds anyway because I felt like not doing so would be causing harm. Would you have done anything differently? Was the clonidine plus all those meds overkill? I get nervous about cases like this even with the AMA form but I didn’t want to just send her home without her meds which she needs. This is why I can’t stand UC anymore (that and the 5 or 6 cold symptoms x 2 days pts)
  6. Agree with the above about the cover letter. I had a generic letter that I would modify depending on the job I was applying for. And I wouldnt put an area of interest on my resume unless I absolutely would only consider jobs in that specialty.
  7. It depends on what you want. If you are happy seeing patients but not being the "super one in charge with the final say" aka the doc, then do PA.; If you're not passionate about med school then I think it would be miserable to go. Me personally, I like being able to bounce things off the docs I work with, and I make a very decent salary and graduated 5 years ago, and am in a position where I feel respected. I am happy.
  8. Yep. This has happened too, They get even more mad and say “but dr so and so gave me two years last time and I had hypertension then!”. Also I have been pressured by non medical corporates at my company to sign cards to appease an angry patient. Not cool. I show them the dot handbook and say nope sorry.
  9. How strict are you with things like blood pressure for DOTs? The guidelines say BP should be <140/90. We had a guy who's BP was like 148/82, was told he could have a 3 month card and must get referral form signed by pcp saying his blood pressure is controlled ( we have these special referral forms in our urgent care), 3 months later he comes in without signed form, BP no better. We said we're sorry but we can't give him anymore time until he gets that form signed by a physician and BP lower than 140/90. He is livid. He can't go to work tomorrow and his doctor is on vacation. I feel bad, but.. I am currently in the middle of a DOT/workers comp/fraud investigation in which I cleared a guy who ended up coming in later for workers comp and he is now being investigated by the school board and I don't like being in the middle of these things so I am pretty strict, but I do feel bad. What do ya'll think? ...I HATE DOTs....
  10. Why isn't it on the women's list? Im pretty sure its why my husband married me ?
  11. I’m considering a job in an adult internal medicine office. I’m currently in UC. Some of the docs I work with used to be PCPs and are constantly bashing primary care and making me discouraged as I Always thought I would end up doing it one day. I might get a job offer at what seems like a decent practice with nice docs and supposedly nice, compliant patients. I just wanted to hear from people who do IM/primary and love it. I have also interviewed with a Peds practice which I’ve done before but I think adult IM would be more interesting too. Thoughts?
  12. Hey, I am a PA of 5 years and currently work in Urgent care..I work typically 4 days a week and am usually home by 630. So I generally get to have dinner every night with my husband and child and sometimes stay late when it is busy. I however work some weekends but then I have days off during the week so I get to spend those days with my baby. My last jobs was peds, M/T/W/Friday 9-6. As a PA there is a lot of options and flexibility which is nice. I personally probably wouldn't want to do ER because I like being home for dinner but some people like working 3 12's. So it is what you make of it. It is very possible to have a work-life balance. And because I'm in urgent care I leave my work at work, when I clock out I am done.
  13. What is typical as far as response time when asking for a raise? I have been here a year, sent first email 11 days ago, didn't hear anything, emailed again 4 days ago, they said they would be reviewing it that day, and now nothing. So what Is a normal amount of time to wait? I don't like to be a pest but I also want to make sure I get what I am due. Thanks! Ps. My contract does not state I will definitely get a raise but that it is likely with good production/behavior etc
  14. I didn't vote because it goes both ways for me. It started out as a calling but now that I have been practicing for 5 years and I am realizing that medicine is become more of a customer service than true medicine practicing (its a sad truth) some days I feel like it is just a job (one that I enjoy for the most part though). I would not be happy sitting at a desk crunching numbers lets say that. At it does feel pretty darn good when you realized you helped someone feel better
  15. I had a 30yo guy yesterday in the UC that said it feels like his organs are going to fall out of his back. Had low back pain and felt like when he lays down his organs are pushing outward and will fall out. When I examined him he asked if I could see them sticking out. Not sure if he was drug seeking but he sometimes takes Percocet for prior "back problems", he's allergic to NSAIDS and said hes been "putting things into his body lately he shouldn't be.."
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