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surgblumm

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surgblumm last won the day on October 15 2018

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About surgblumm

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  1. I have three friends, all PAs , two who were the Chief Medical Examiner and one who was the assistant chief medical examiner in NYC.
  2. surgblumm

    Verbal offer

    Well John, this depends on what state ypou practice in. normal first year wages in NY are a starting salary of 104,000.00 and that is in FP. Psyche is a specialty well entrenched by NPs who make a small fortune and the PA with appropriate training should make at least an equal amount considering the fact that both professions do the same thing in Psychiatry. You will never get a response that is all incusive of hourly pay or annual salary that crosses the country.
  3. I think you have been given excellent advice and your personal summation is accurate. Go for the gold, look ahead. Capture your destiny. "To accomplish great things, we must not only act, but also dream; not only plan, but also bevel." Anatole France
  4. surgblumm

    Crazy FB removals

    My greatest patient treatment mistake that I made was when I treated the Mayor candidate of my village for an allergic reaction to shellfish. He trusted me more than the local hospital and I had all the supplies at home with the exception of a tracheotomy tray, oxygen and a back-up. I went though the treatment procedure of a patient in the early stages of anaphylaxis but post treatment I could not beleive that I let my ego get the best of me. What I did was absolutely stupid as no malpractice insurance that I have would have protected me. I was a Lone Ranger without Tonto. It's tempting to meet the patients demands or trust but can be foolhardy. since you brought up the scenario, it's up to you to judge your motivation. My patient did well but he could have expired in my living room.
  5. Your situation is not unlike hundreds of other PAs who have gone out to the workforce. Regardless of what PA program you attended and what scores and award you received, you still need to have the experience. I used to tell my students that you are not a PA when you get your "C" but two years later as it takes that much time to pull it all together. Look at your first job or jobs, as a residency. It's a time to learn and remember you have those hundreds who have gone on before you and are now professors.
  6. It's like joining the armed forces of a country. It's an honor, it's a privilege and it's preparing a new generation of PAs to become excellent at a faster rate because of our guidance. Yesterday, I received an e-mail from a person who I choose to help and she finished her program with honors and recieved the directo's award. I sahe in her success and that is payment enough.
  7. https://opmed.doximity.com/articles/a-spoonful-of-sweet-advice.
  8. surgblumm

    Should I confront a patient?

    Happy New Year to all and a year without hostile patients.
  9. How often do we take the things that life has to offer and fail to recognize that they are good fortune or gifts? We observe special things such as the health of our family members, our dwelling, our two cars, the fact that we are healthy and fortunate enough to have employment and that some of us can choose to operate today, consult tomorrow, or care for patients in our office the following day. There is always food on our tables, a place for our heads at night, a trusty CPAP (continuous positive airway pressure) machine that makes me sound like Darth Vader, parents, children, and grandchildren. Both my son and daughter are employed, my son as an RN and an actor, and my daughter as vice president of a company in New York City. Life is not as rewarding for everyone. What if you lived in a town in the Midwest hit by a tornado? What if your home was washed away or destroyed by torrential rain? Consider the individuals who get into their car, drive to work, and are suddenly hit by a truck or SUV. They wake up in an intensive care unit fighting for their lives. Life is always in flux and situations can change from minute to minute; you or a family member could undergo a complete change in destiny. Destiny is not a matter of chance; it is a matter of choice! We must choose a path that will lead us to a place of security, for both the present and the future. It requires involvement today, not tomorrow. To justify your decision to become a PA or an NP, it was necessary to make a choice. For many of us, that choice was made based upon our past involvement in medicine or nursing. Many PAs were former medics and corpsmen or perhaps EMT’s or paramedics, and realized they could do so much more as a PA. Many NPs were former nurses or specialty nurses in fields like emergency medicine, critical care, pediatrics and psychiatry and therefore decided that they could accomplish more as a NP. Upon making this decision it was required that we follow the educational path that would lead to a licensed medical professional designation. We all paid a price to gain the prize of calling ourselves PA or NP. When thinking of security, it involves not only your choice of profession but also how to maintain that professional designation and how to have appropriate defense in the real world of patient care. Our decisions are often life saving and yet we need to be able to justify those decisions with our peers and medical and nursing societies. Security comes from being able to point to proper medical care references and also by having malpractice insurance. Most institutions provide that insurance but its liability protection is extremely limited. Locum Tenums insurance is not provided, neither are curbside consultations or per diem jobs or moonlighting. This requires a company that writes professional liability insurance policies and not all of these are created equal. I use CM&F because I have personally heard of disasters with some other companies. Research is mandatory in making this decision as your destiny is involved. You and I share the responsibility of being vigilant and staying informed. Knowledge is the key to understanding the issues, and that knowledge cannot be attained by existing in a vacuum. The issues that we face, we face together, and there is no room for bystanders. If you look back at the accomplishments that have been made this year, they would not have been successful without joint effort and the desire to improve. Your career decisions are shared, thoughtful decisions and are best learned from your colleagues. As we enter a new year, 2019, let us strive to recommit ourselves to our patients, to patient care, to our professions and to ourselves and our families by rethinking our security and how to improve it.
  10. surgblumm

    Should I confront a patient?

    I read your opinion and have been an expert on many malpractice cases and comments like yours are great for the plantiff’s attorney. It’s not my 47 years that should bother you but ten years is enough time regardless of how knowledgeable you are to remember that whatever happens in Las Vegas stays in Las Vegas. You should send me a bottle of good red wine for my comment. I’ll reach from my high horse and accept them.
  11. surgblumm

    Should I confront a patient?

    This comment". He does not hav a big ego, we have a good relationship, he's completely fine with me breaking bad news to the patient if necessary. ' , if it were ever sent to your surgeon from anyone on the forum who may not appreciate you or knows the Doc from previous encounters, is enough to have him fire you.
  12. surgblumm

    Should I confront a patient?

    I both echo Ventana's advice as well as rev ronin's. You are obviously too confident of your diagnosis after three years, your questioned your Surgeon's procedure, you made room for a malpractice suit against him because of your remark and obviously you are dealing with a senior citizen , who may be just cantankerous or possibly in early dementia. Under no circumstances should you call this patient, turf it where it belongs, with the surgeon. I have practiced forty-six years with the same surgeon and have never undermined his skill in the OR.
  13. The single most effective thing you can do in an interview is to make your experience come alive through stories or examples. Yes, you need to get other things right in an interview as well: ask the right questions, prep for handling issues with your candidacy, follow-up effectively and so forth. But telling a good story is the most powerful way to stand out from the competition, since our brains are wired to remember the imagery, the drama, and the emotion that’s conveyed in a good story. Think of your story as a picture painted with words. Use it to describe either a) how you would tackle a problem your prospective employer is facing, or b) how you previously helped another employer with similar problems. Since in most interview situations you just don’t have enough information to effectively illustrate what exactly you would do in the prospective new role, we’ll focus on the latter case, sharing an example of how you helped another employer. Follow the guidelines below, and then make it your mission to get at least one of your success stories heard in your next interview! 1. Prepare just two or three stories (not 15) To tell a story well, you need to practice it over and over. If you’re trying to memorize a dozen or more stories, you won’t have time to properly prepare and rehearse the individual examples. Plus, you don’t need more than three stories; three (and sometimes just two) is enough to demonstrate both a track record and versatility. Keep in mind that just one story can be used to answer multiple questions. For example, one of my clients used the same story about how he landed a new account in answer to the questions a) what’s your greatest strength, b) give me an example of one of your work achievements, and c) how did you handle a difficult employee. He just told the same story from different perspectives. 2. Use a story-telling format I like PAR – Problem, Action, Result – because it’s easy to remember and implement, and every good story contains these three elements: -The Problem, or obstacle you had to overcome, is part of any great story. They are also hiring you to solve problems, so you want to demonstrate problem-solving ability. -The Action, i.e. how your brain works in addressing problems. Sharing this element enables the interviewer to envision what it would be like to work with you. -The Result demonstrates your value to an organization. 3. Go for the Drama Think about stories you’ve heard that have been memorable. In describing why they were memorable, you might use words like “important,” “dramatic,” “engaging,” “fascinating,” “emotional.” Ideally you want interviewers to describe your stories the same way. You can fit a lot of the drama in the “Problem” and the “Result” portions of your story. Don’t just say “One of our accounts was considered a retention risk, so here’s what I did to keep them.” Instead say “One of our key accounts was considered a retention risk. If they left, it would have cost us a quarter of our revenue and threatened our stock price! So there was a lot on the line. Here’s what I did to keep the account.” Go for the same high-impact message on the “Result” side as well. Don’t just say “So the account ended up staying with us.” Say what that meant to the company, and/or how you were recognized for this achievement. 4. Try to use a story in your answer to any question Let’s take a typical interview question- “What’s your greatest strength?” You could say, “My greatest strength is my ability to build productive relationships.” OK, well you’ve answered the question, so that’s good, and if they are looking for someone with strong relationship skills that’s also good. But the end-result is sort of blah because your answer just isn’t memorable. You’re not really differentiating yourself from your competitors. Now let’s try this again, with the answer my client Linda gave. She said “Well my greatest strength is my ability to build productive relationships. Why don’t I share an example so you can see what I mean?” Here Linda shares the Problem: When I started my last role running a sales team, I could see that the team was struggling. Sales numbers were trending downwards, threatening layoffs, and the best sales people were leaving because they felt were set up for failure, not success. This trend was a big problem for the company, and I was under a lot of pressure to solve it quickly. Now comes the Action: My first thought was that I needed to understand what was going on. Was it the competition, the quality of the team, something else? Turns out that my reports in fact excelled in their jobs; their problem was that organizational support for sales generation was missing; they didn’t have the marketing materials they needed. They didn’t have the support from Finance to close deals quickly. And they didn’t have the IT infrastructure support so they could analyze the sales data and optimize their efforts. Once I had this insight, I started building bridges with marketing, finance, and IT, so the sales team was no longer isolated. I set up regular meetings with these teams, and cemented these relationships with just plain human connections—lots of lunches, coffees, after work get-togethers, and so on. I also succeeded in pushing a strategy of incentivizing these support areas to truly partner with us, by giving them a share of the spoils; I got the buy-in from top executives for this strategy. Three months into my new role, I had turned internal adversaries into partners. Marketing was now working closely with my sales team to meet their specific needs. Finance set up a new approval process so that deal-making decisions could be made quickly, and with greater flexibility. And IT brought in a vendor to help us capture and analyze the sales data that would enable us to optimize our efforts. And equally as important, I got the best sales people on my team to defer leaving the company, because they could see the actions I was taking. And finally, the Result: In six months, the downward sales trend began to reverse itself, and within one year we were on to record revenues. Turnover of top sales talent fell to zero from around 50%, and we landed our three biggest clients ever. I was formally recognized for my work by the company president. I share this story because I think this type of internal relationship-building could be potentially be useful for your situation…” Notice how at the end of the story Linda turned it back to them. She wanted to ensure that the story was relevant to them (“How can you help me?” is their number one question). When you tell your story, be prepared for lots of follow-up questions. Good interviewers will want to know what you enjoyed or did best, what motivated you, and so forth. 5. Avoid these common mistakes If you keep your stories to roughly two minutes, you will avoid the most common issues, including too much detail (boring) and too little detail or too high level (not interesting). I find that many clients are great at describing the problem and the result, but give short-shrift to the ‘Action’ part of the story. This part is key to the interviewer understanding how you operate, and is vital to making the example you’re sharing relevant to them. Introduce this part of the story by explaining your strategy, that is, show them how you think; say “I approached the problem in three ways…” or “the key to addressing this issue was…” Also, make sure you don’t use “we” too much. “We” is good if used occasionally to show you’re collaborative. But ultimately the interviewer wants to understand what YOU did. So it’s great if you mention how you partnered with others (always desirable), but say it just once or twice, as in “I partnered with two of my colleagues in creating…” Then focus on your contribution. SOURCE: Forbes.com -- Robert M. Blumm, MA, PA, PA-C Emeritus, DFAAPASurgical PA, National Conference Speaker, Author, Suture Workshop Director, Former AAPA Liaison to American College of Surgeons, Editorial Advisory Board Clinician1.com, Advisor
  14. It's difficult to discover PA social Media sites that have few restrictions. I feel ours is one of the best if we avoid discussion on politics which not only divides PAs but also families.
  15. I received this article from Tom Roselle this morning and it represents a solid answer for the inquisitive mind. Are PAs Part of the Solution to the Physician Shortage? | Patient Advice | US News Really good article. One of the best I have read regarding PA's and the differences and similarities between us and "THEM" (NPs : )
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