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About Brigid2010

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  1. Drop the 'associate' suggestion--advanced medical practitioner, or something akin to that designation. Physician associate sounds like I'm selling cars at the used car sales lot in the Doc-O-Bell/Doc-in-a-Box strip mall clinic...
  2. Yeah, I've worked at an FQHC for the last 7 years w/ NextGen--big time utilized by the gov't clinic world (well, not the VA). Every comment I've heard for this system, and I will concur--it's terrible. EPIC seems to be one of the top-notch systems This makes FP a totally inefficient system. I couldn't even imagine using this for an urgent care...ugh!! My sympathies--you do learn to use what you need, and leave the rest of it's "bells and whistles" as ancillary useless IT crap designed by people who've never set foot in a modern clinic in the last decade. But, it's an onerous beast that is it's own obstacle in terms of not getting in the way of seeing patients...
  3. Advocate for independence of licensure-slam out some concrete legislation for scope of practice and what that entails. Advocate for name change that doesn't sound like a frickin' used car dealer sales person. I ran the name, physician associate, by my fiance, a very health-literate/well educated person. He thought it sounded worse than physician assistant. I don't see a problem w/ Advanced Medical Practitioner, or some other title akin to that, but that's me. A black-sheep PA if there ever was one...
  4. May since we're all under the umbrella of Advanced Practice Provider, we could claim Advanced Medical Practitioner, to differentiate use from NPs, and not have the dreaded Assistant and Physician part be tacked on???
  5. You mean like working in an FQHC?? Or some other gov't entity like a civilian provider on a military base?? OR the VA?? I know in terms of FQHC crazy zone, I can claim Federal Worker status for DEA renewal, and it's written off, which is a nice perk. As far as practice laws, collaborative physician status is subject to my state (IL). That doesn't matter what setting you work. I've always understood the malpractice coverage in TORT to mean, basically you as an individual provider, cannot be sued in a malpractice case if you employed in a setting as a federal status employee. The Federal gov't is who gets brought to the table in lieu of an individual provider. I've never looked into the origins of that, but I don't wonder if that's due to the more complex social-economic along w/ chronic comorbidity status patients typical of such settings?? And somewhere, I think I recall reading that TORT coverage with a federal status job is occurrence based vs claims. I don't know if that's correct, but in the case it is, you shouldn't require tail coverage, right? I only know, I've always been told it's good practice to get a copy of your coverage terms/limits for your personal file. I'm still responsible for paying my own state licensure and controlled substance state license (req'd in IL for DEA...)when they come due ever 2 years. I'd be interested to know other's insights here. Cheers;)
  6. I don't wonder if OTP or some "divorce" from the term "SP" won't model, in practice law revisions, how the Certified Nurse Midwife role appears to operate in Canada right now. My friend worked up there as a CNM from the US for a few years, and while CNMs operate as purely independent providers in Canada (as opposed to US, where they still operate via collaborative agreements w/independence in their scope of practice...similar to other APPs), they found that the actual scope of "independent" practice was actually much more limited, and VERY specifically confined, as to what they were allowed by their practice law to manage. In terms of specialty practice for PAs, I can't really comment on how dramatically scope of practice would change from how they operate now w/in individual settings in relation to their SPs. I gather the changes from OTP would have much more of an impact on PAs in more traditional primary care settings. Not so much in how most of us are already functioning in the practical day-to-day of patient management in settings like family practice or internal medicine, but rather in terms of the logistics like billing, and the scrabble-headache of being tied to a physician's licensure to validate our own licensure (which, frankly, to me, has been the real issue of "independence of licensure" vs "independence of practice"). I don't know how I feel about doing completely away w/ the collaborative role of a physician-APP team, not b/c most more experienced APPs won't necessarily grow into more independence, but b/c, as I was trying to say above, in a somewhat garbled form, I think implementing a practice law, for full independence for PAs, while definitely doable, would get tangled up in a lot of legal lingo regarding VERY specific parameters of what exactly that scope needs to entail, especially if it's to be adopted as a national standard, but according to each state's preferences. IDK, is there a potential this might actually end up limiting the scope of practice within which some PAs are utilized, who have quite a bit of autonomy and laterality in their patient management, suddenly finding themselves forced to conform to more restrictive practice laws which no longer require an SP, but conversely, also limit what had been, perhaps, a more liberal practice setting? Just thoughts I'm throwing out there. Frankly, working in an FQHC, I don't really think what/how I practice, would change that much as our PAs and NPs already operate with a fair amount of autonomy, in the scope of our practice, and what's determined as outside of our scope is really the provider comfort level with the complexity of the patient. Just sayin', in the long and short, there might need to be a differentiation in the language between what's meant as "autonomy of licensure" vs "autonomy of practice"/"independence of practice". And that an independent practice law for PAs, while beneficial on certain fronts, might end up introducing unintended limitations to the scope within which certain individual practices, and APPs--primarily PAs in this instance--already function as essentially independent providers. Guess we won't know unless we try though, eh?
  7. I was an out-of-state candidate, and would have had to jump through the state to state licensing issues. Plus, the salary--there's no way I'd do 40hr/FTE at $75,000/yr, especially with 5+years experience.
  8. Thank you--while the job itself didn't come through (which I'm not surprised), I do appreciate the insights. It's been a while since I've exercised the interview chops, while I do keep my resume/references current. So, this was probably a good way of getting feet wet. I'm fine staying at my current position, for now, but as I said, I'm getting a bit run-dry having been in the community health/chronic disease management merry-go-round for the last 10 years. Hopefully, I'm hire-able? And I could use a break in a less intense setting for a time. Overall, there were more issues with this position upon reflection, so it's probably for the best. I don't know of any APP worth their salt, of 5+years experience, which is what they were asking for, who would take the pay scale they were offering, despite the population being somewhat less medically complex than what I see in an FQHC (not underestimating student/college populations--there's always some left-curve ball out there...). I think my first full-time position was at least $10,000 more than what the going salary was at this student health clinic 10 years ago. Anyway, such as life. Again, thanks for the insights-I'll definitely keep them in mind.
  9. Having been employed in family practice/FQHC-community health style for last 10 years, and getting a bit "crispy" around the edges (though, fortunately, not 'needing' to be seeking a job at present), I've been putting out feelers for a different direction in terms of professional/personal growth over the last year or so. A good part of my current position is family practice/reproductive health/care of young adults/adolescents, etc. Thus, when a job at a student health center for an APP (PA or NP) presented itself, at a large Midwestern university which I and my fiance would be quite interested in relocating to, I submitted my resume/cover letter/references-all solid. They offered a "pre-screening" interview w/in the week--which classically was a week we were all the way out on in SE Canada (Quebec City) since I was on a previously scheduled vacation. And having to be attending a CME in New England the next week after my vacation, with only a few set dates for the interview at this university, we disrupted our plans, essentially curtailing our vacation to return home so I could interview back in the MIdwest on a Friday. Subsequently, requiring me to drive 16 hours back East by the following Monday to be back in New England. Long story short-interview was pretty generic. From my end, I spent an hour fielding questions on various patient management, working with diverse populations, dealing with issues relevant to young adult/university populations, etc., including mental health/addictions screenings and management. There really wasn't a yay or nay, nor did I expect one upon the conclusion of the interview, but body lingo-wise, there were nods, and 'hmms' as the interview committee was jotting down, and I"m sure, scoring various responses. I will say, and I did point out to them, there seemed to be some confusion over what their job advertisement specified (primary care focused), and what, by the interview conclusion, I had an impression they were actually seeking (someone with a heavily skewed urgent care background). Which was fine. I mentioned I would be more than happy to brush up on certain suturing/toe nail removal skills that haven't been utilized since my first job almost 10 years ago, in urgent care, but they were part of the repertoire. I do enough varied procedures in my clinic routine that it wouldn't be that 'foreign' to get things like basic suturing/splinting for uncomplicated sprains back under the belt. And as for other 'acute care" visits, I certainly see enough of those in any given day, mixed w/ my CHF/diabetes/undocumented immigrant/suicidal/COPD/anxiety crisis/etc folks typical of rural underserved FQHC population. And my young adults growing up in the vicinity of my clinic, including a share of university and young adult student types. Anyway, upon interview's conclusion, I was told by the head PA (interviewed by head PA, lead clinic RN, care coordinator, and one of the student health physicians) they would be back to me with a response regarding hiring decisions after they'd completed screening interviews with other applicants, at the latest by mid-next week following my interview date which had been on Friday. After 2 weeks of crickets, I sent a follow-up email to the HR contact associated w/the job advertisement. It was politely stated, thanking them for their time, and just inquiring as to the status of my application, fully accounting if they had gone with a different candidate. I'm an adult. I can take rejection, and I"m fine staying at my current job for the present (where I've been for 7+ years...). I'm just wondering, is this routine nowadays, for potential employers to glibly state, "We'll be in contact within the week," (one way or the other--I fully realize they may be other candidates better fitting their qualifications...though, I'm wondering just how much of their patient population base constitutes procedural urgent care w/o being equipped as a proper urgent care), and then not hear anything at all? This isn't about an acceptance or rejection. It's about receiving a proper professional reply, the way job interviews, and follow-ups used to be conducted "in the old days"--meaning, only 5 to 10 years ago. Has something changed in the work/interview culture in the interval since then? I don't know how often I should continue to contact them until I hear something one way or another, since the reply I had last week was, "Sorry for the delay. The committee is still in the process of reviewing applicants. They will be in touch as soon as they've made a decision." I'm guessing they're not interested in me as a potential hire, or they wouldn't take 4 weeks to decide on this, but can they at least send a reply actually closing this out? I'm also wondering, along with this being the standard of interview protocol nowadays, is there also a possibility this is a reflection of the work-place itself? I would have imagined a state university would be more organized and prompt than an FQHC, but maybe I overestimated the professionalism of the setting. I don't know. I'm just a little confused here, and feel like, continuing to bother their HR with a weekly, "any news yet?", kind of inquiry will make them feel on the defensive to force a reply. I'm guessing this is a 'let it go, and move on,' sort of thing, which is fine, but ugh if this is the standard (which I've more and more colleagues claim over the last few years) of interview/job search ethic these days. Sorry for the rant--my booboo lip is officially put back in, and big girl undies back on...but any insights might be welcome. Thanks
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