Jump to content

surgblumm

Members
  • Content Count

    390
  • Joined

  • Last visited

  • Days Won

    1

surgblumm last won the day on October 15 2018

surgblumm had the most liked content!

Community Reputation

140 Excellent

1 Follower

About surgblumm

  • Rank
    Registered

Profile

  • Profession
    Physician Assistant

Recent Profile Visitors

892 profile views
  1. excellent Response, Ventana and I agree 100 5. I am of the opinion that PAs are far more ethical than their physician counterparts and we find fewer excuses to destroy
  2. Members 423 713 posts Report post Posted 1 hour ago Homan is a tool, just as every other tool in the bag...it should still be taught in my opinion, but in addition, should be taught that it does NOT rule out a DVT (i.e. sensitivity vs. specificity). I agree wholeheartedly with your assessment and would place emphasis on the fact that it does NOT Rule Out a DVT. DVT is ominous, it is like a Ninja warrior, stealth and unseen until it strikes, and we have the embolism. I cannot speak to all of the comments separately but can say that a good history that includes cramping and pain, as well as congestion, cough and difficulty in breathing, will lead you to follow the algorithm that Rai sent as we have the D-Dimmer as well as radiographs and even an EKG. We become detectives in medicine and we cannot afford to have "cold cases'" I like what Lt. Ryan stated as he is a PA and a Resident with experience and his comment diffuses the difficulty. I argue that this course can teach you on a three day weekend and offers much more assistance later. check out the link as it is one of the best I have seen and if Rev Ronnin is going that puts more gas into its efficacy. Maybe he can report on this after August.
  3. This topic kind of brings you back to a historic question asked by a Roman Governor; "What is truth?" Like Scott, I do not feel that we need to give everyone a dire diagnosis or an absolute prognosis because there is no absolute prognosis. I have seen pancreatic cancer patients expire in a month and I have seen them comfortable and able to have a normal life for three to four years. We are not the Judge and Jury but we are the witness. We share what we know to be clinically correct and offer hope. Rather than play the Grim Reaper, we have the ability to "be a rainbow in someone's cloud." Maya Angelou Just a thought not a hardline expectation.
  4. Ral- this happened thirty years ago prior to the advent of POCUS. There was an intelligent response on Huddle to this post from a PA who was expertly aware of POCUS and our need to have this course in PA programs, nationwide. &5% of the profession has been taught what is now archaic medicine in terms of the diagnostic approach to this problem as well as others. Thanks for your question.
  5. I just looked at it and it seemed to post OK. did you get this? A number of years ago I lost a close friend who died of a pulmonary embolism secondary to a DVT that he was seen for by a PA and two physicians. It is so important to look beyond erythema, tenderness and a negative Homan's sign when trying to rule out a DVT. Homan's sign is as antique as your grandfathers model T Ford. Today as clinicians we have a responsibility to either order better and gold standard tests or know how to perform them ourselves. Here is a very important summer course for Rural Health Personnel to learn to perform Ultrasound Diagnostic Exams. If you are a cutting edge PA or NP than this is for you. PracticalPOCUS.com/CriticalAcess2019
  6. A number of years ago I lost a close friend who died of a pulmonary embolism secondary to a DVT that he was seen for by a PA and two physicians. It is so important to look beyond erythema, tenderness and a negative Homan's sign when trying to rule out a DVT. Homan's sign is as antique as your grandfathers model T Ford. Today as clinicians we have a responsibility to either order better and gold standard tests or know how to perform them ourselves. Here is a very important summer course for Rural Health Personnel to learn to perform Ultrasound Diagnostic Exams. If you are a cutting edge PA or NP than this is for you. PracticalPOCUS.com/CriticalAccess2019
  7. Good reply and I personally would not tell a patient all of the differential diagnosis of presenting symptoms lest they decide on using a razor to their wrist. We can talk about questionable diagnosis with the need for more clinical correlation. As far as the patient with a possible testicular cancer; I remember when my SP told a patient that they had melanoma when he had not performed a biopsy. This became a malpractice case for creating severe psychological damage. I forget the outcome but an insurance company does look at the number of cases presented against you.
  8. Perhaps this physician was on a call list and was unaware. I've seen this happen because of lousy administration.
  9. After the next fifty years PAs will say that our group drank the Kool Aid to put up with this abuse.
  10. Another employer who does not know the job description of a PA. So there is sugar and three substitutes but the substitutes will give you dementia or early onset Alzheimers.
  11. This was a confusing post because it was unclear if the PA is in a practice that has been sued or whether they are an expert in a case involving another PA. I have been an expert witness for more than twenty-five years in cases involving other PAs. In 95% of these cases, I did the workup for the defense. This workup involves an agreement with the attorney as to the reimbursement. I charged for reading the transcripts, which includes everyone's notes as well as for giving a verbal summary. When requested, I charge for a written summary. I am then paid for travel and room and board and for a minimal number of hours for deposition and for testifying in court. This is somewhat lucrative but also highly stressful and I stopped five years ago because as an added means of employment it became too nerve-racking and the attornies are usually just as up to date, if not more, because of services they use. If an injustice is being perpetrated against one of my colleagues and I have a good feel for the case as well as both the experience clinically as well as the academic knowledge, I would always consider being a witness. Do not do this work if you are a novice.
  12. In the News This article appeared a few days ago on MDLinx. I thought it was worthwhile to read and was surprised at the findings. I think that this is a good question for discussion on Physician Assistant Forum. When is it ethically acceptable to lie to your patient? Naveed Saleh, MD, MS, for MDLinx | May 29, 2019
  13. There are many doc's who will get a call not asking for a formal admission but is presented with the crux of the presentation. should that Doctor give no res[onse and hang up or at least be given enough information where they can make a comment, not necessarily on the patient but upon their participation without comment. Id that doctor even in the same system? all points of debate and confusion. I assume it is better to stay within the legal guidelines of consultation and be able to chart the advise given. http://bit.ly/modern-meded-clinical-documentation
  14. What you enter on a patient chart or what you fail to enter has huge implications on your future as a PA. This is not a school subject but of significant relevance to your ability to stay out of a courtroom. this is a short read and worth your attention. http://bit.ly/modern-meded-clinical-documentation
  15. Informal consultation is just that, informal. It is a breach of medical ethics to document a thought that the expert had given. this was the best answer thus far; I also will provide a curbside consult to colleagues when asked but always specifically tell them to leave me out of the note. If they want my input in the chart they need to refer the patient to me so I can personally evaluate the patient.
×
×
  • Create New...

Important Information

Welcome to the Physician Assistant Forum! This website uses cookies to ensure you get the best experience on our website. Learn More