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    Physician Assistant

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  1. I agree, not a fan of online grad school. I always thought it separated us (in a good way) from NP programs to not be online. Some of the nurses I work with are currently doing online NP programs and so I have some familiarity with them and feel they are nothing compared to what I went through in my PA program. They also have to set up all of their own rotations. One of them is being allowed to count a family med practice as her pediatric rotation and a midwife as her women’s health (not going to any deliveries, surgeries, etc). I sincerely hope this is not the direction PA programs are heading.
  2. To address the OP issue, I wonder if you could use some counseling and/or an SSRI because it sounds like you’re in kind of a dark place. I have a friend who went through a horrible time at his physical therapy job in an inpatient rehab center that led him to question his career and also caused some pretty serious hypochondria and paranoia about his health. He switched to an outpatient, sports rehab type job and started Zoloft and it’s been like night and day. He loves being a PT now and hasn’t had any more ER visits or MRIs for anxiety that he thought was MS, cauda equina, stroke, etc (the hypochondria got pretty bad and really expensive).
  3. That is evil. I hope that babysitter gets sued and imprisoned and karma comes after her. I’m so glad the baby was okay. I would be pretty shaken up by that case, too.
  4. As a parent of a toddler, this makes me feel murderous... and might give me nightmares. What is wrong with people!? This actually happened on the show Shameless and I didn’t think it was funny and worried me that stupid, horrible people might get ideas from it. :( Did they do a tox screen when the baby came back? How did they figure out the sitter did it?
  5. Alas, I think there will be some confusion about our profession for years to come. People seem to understand NP, but are thrown off by PA for some reason. Physician associate doesn't quite work in my mind because that seems like it could be anyone. Lots of professions "associate" with physicians and it also reminds me of working in retail. Like, you're shopping at Target and they find an associate to get something from the back for you. Honestly, I'd be happy just getting rid of the "assistant" but we do practice medicine, so I feel like MP would be an accurate title. The fact that it sounds like NP might actually be kind of helpful for the general public. It would take a few years and some explaining, but people get used to anything with time. I wouldn't mind if people thought I'm a member of parliament, but I doubt they would with my American accent. ;)
  6. Can we change PA to MP already? I think Medical Practitioner is so perfect, let's just make it happen!
  7. Good news! I emailed the medical director and he and our site director got right to work on correcting that language in our EMR. It might seem like a small thing, but it made me feel good that they agreed that it was something that should be fixed and that we will not be using that term, here.
  8. Our EMR has recently had an update that allows the physicians to sign off on our charts with phrases that refer to the PAs and NPs as "physican extender" and my gut reaction to this is that I do NOT like it. I consider myself (and my colleagues) medical providers not extenders of physicians. Usually when I staff a patient with them it's because of a technicality in our rules like I have to staff anyone I order a CT on and I'm seeing my own patient, not extending care of a physician or whatever it is that that term implies. I'm already feeling a bit sensitive because scribes have just been implemented in our ER for the physicians only even though a PA will often see 25-30 patients in our fast tract and could really benefit from having one. When we asked why only the physicians were getting scribes, we were told we could hire our own if we wanted. [emoji52] Anyway, I'm here to rant and also get other perspectives on this because (like a previous post) I'm trying to gage if I'm overreacting or if I'm not completely off base in feeling slighted and disrespected, again.
  9. This sounds like a true nightmare that you've inherited. Chronic pain patients are my least favorite in the ER and I can't imaging being the one who has to prescribe their regular meds. I have met a handful of people who really have had pain and I don't think they knew what they were getting into with their pain meds and are now pretty miserable on those meds. Is it just me, or has anyone actually met a chronic pain patient who is doing well on 120 Percocet and 90 XR morphine a month? I really don't think those drugs are even helping with chronic pain, seems like they just create an addiction in an otherwise normal person. I've been offering trigger point injections and talking to people about things like PT and dry needling (acupuncture without the voodoo) and you'd be surprised how many of them never had alternatives to opioids presented to them. Usually I see these people because they took more than prescribed and ran out, so it's a good opportunity to talk about how dangerous opioids are, hyperalgesia, people ending up on heroin and developing tolerance, etc (although sometimes there's not a ton of time for that in the ED). Talking about that stuff and offering alternatives really separates the people genuinely looking for pain relief from the ones who have...other intentions/issues. Anyway, the long winded point I'm trying to make is that opioids are great for acute pain, but the evidence supports you for trying to get these patients off chronic narcotics and your efforts to clean up that mess will make the world a better place. Don't let your concerns about your small town reputation stand in the way of doing what's right.
  10. One of the ED docs I work with was telling me about an ED doctor friend of his in TX who has only done locums for years. I guess he won't take a shift for less that $350/hr and when they tell him they can't get hIM that, they always end up calling him an hour later and saying they were able to work it out. I wonder if it would be a good experiment to pick up locums work on the side and decline working for less than $100/hr and see what happens. [emoji848] I honestly don't know much about locums but during that conversation, a couple other docs said that was a trend and a lot of ER docs are doing that, these days. Maybe PAs could try that strategy, too. I don't know, just throwing out ideas to see what the seasoned and wise PAs have to say about it. [emoji846]
  11. It's been a while since I've looked into this, but loan reimbursement jobs tend to be primary care and in underserved areas (aka places where it's hard to get people to come work).
  12. I hope it makes you feel better that I've had the opposite experience. I work 12-13 nine hour shifts a month. The MDs I work with tend to work more shifts and end up staying late at their shifts regularly when I rarely get out more than a half hour after my shift is over. I've seen a lot of MD burn out and a lot more PA satisfaction, maybe because it's easier to switch jobs? Our group is easily, fully staffed with PAs and NPs so we have great work life balance, but we have a hard time recruiting MDs and they are all working a lot more shifts. I have also been told by a few MDs that they wish they would've done PA instead and I know one who told his kid to consider PA over MD (she ended up doing RN, so maybe she's going to be an NP). I don't question all those years of experience and what EMEDPA has seen, but I don't think it's like that in every situation. For example, the OBGYN I was precepted by worked about 80 hours a week because of surgery, delivery, clinic hours and being on call. The NP she worked with did M-F 8-5 and never took call (she didn't deliver babies so no reason). The peds and PCP preceptors I had were PAs and worked bank hours. The orthopedic surgery PA I shadowed did clinic days and then first assist for surgery and worked great hours, no weekends (to be fair, I think his surgeon did the same). I did two hospital internal medicine rotations. The hospitalist PA I was a student with worked weekends and holidays but did 40 hour work weeks, took about an hour when he first got to work to chat and eat breakfast and had hour long lunches. The MD hospitalist I was a student with pretty much worked 7 days a week and did 12-14 hour days (he took long lunches, too). I kind of suspected he did that to himself and wanted to avoid being at home or maybe it's because he and his partners owned the practice? I don't know what his deal was but he was just always working. This isn't a factor for everyone, but it's worth noting that all of the doctors I work with had their kids either in their mid to late 30's or early 40's (they were talking about it one day, not just me pondering their reproductive lives). A PA friend of mine works with a neurosurgeon who is in her early 40's and doing IVF with a sperm donor because she says she just never had time for a personal life but wants kids now. I also work with a doc who told me the best thing about finishing residency was being able to have dogs again. I have a friend who is married to an EM resident and they had their first kid just before he started. They're doing fine but he is at work all the time and as someone who has a kid the same age, I can't imagine missing so much time with my toddler (seems like they change by the hour sometimes). I think it would be really hard. I'm all for deciding never to have kids, not having them in your twenties, prioritizing career, being a stay at home parent, etc etc, no wrong way to do it (or not do it). I don't want to offend anyone by mentioning this stuff, but some people like to consider it when looking into their career. Sorry this turned into such a lengthy stream of thought post! I just want you to feel warm a fuzzy about your PA choice, again.
  13. I agree. I've only been in practice for two years and I don't quite feel ready for that. There are still things I've never seen in person, yet. I have let pre-PA students shadow once or twice because I do feel comfortable answering questions about that process and PA school stuff.
  14. No, I just have to give 90 days notice and the wording in the contract makes it sound like that's flexible if my employer is okay with a shorter time.
  15. Kudos to you for thinking so far ahead and so practically about your future. You are a very different 18 yo than I was! Lol I'd say stay open during undergrad (PA is fantastic, but there are a lot of careers out there) and do something that includes science. My didactic year was pretty chemistry-intense and those of us who had more experience with those classes had a much easier time than those without. Plus, science is awesome. Look into what are commonly pre-reqs for PA programs and maybe pick a major that includes them. I think getting patient care experience is very important, if you're going to be a PA. I've noticed that nursing experience is what sometimes makes people think that NPs are more qualified than PAs and I'm always glad I have my first career to kind of level the field, if that makes sense. It also helped me a lot during clinical rotations. If you're really trying to keep costs down, consider working during undergrad and taking a lighter course load and/or doing community college first. I did community college first and even though I was a full time student, always worked about 30 hours a week. I'm really glad I kept costs down before grad school debt because those loans are more than enough. Also, remember that you're 18 and even though it's great to have direction, you should make the most of the next few years. Explore your options, try new things, meet people, travel, make mistakes, find yourself and all that. Get your education, get good grades, but don't feel so rushed to get right to the end. You'll likely be working for a looong time, but this stage of your life is limited and you'll miss it when it's over.