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Everything posted by EMEDPA

  1. most of these positions are 72 hrs/week( 6 12s in a row, off one day then repeat). 288 hrs/month into $27,000/month = $93.75/hr. Pretty good money, but they are definitely earning it.
  2. One of my per diem jobs just gave all PAs/NPs a $13/hr raise out of the blue, retroactive to July 1. That bought them a lot of loyalty I imagine. They are also giving RNs and techs double time for any hrs over 12 or any additional shifts.
  3. This sounds very similar to one of my jobs. I kind of wonder if it is with the same group. PM me if this is in the PNW and you want an inside scoop.
  4. will keep that in mind if I see them again, thanks!
  5. total protein 4.6 alb 2.1 ast, alt, T. Billi all nl INR 1.4
  6. Just discharged with a dx of " edema due to protein calorie malnutrition".
  7. I was also at a loss. Hospitalist had me bolus fluids at 30 cc/kg for poor perfusion as evidenced by the high lactate and give rocephin pending blood and urine cultures. The next day lactate normalized and edema and bnp worsened. He thought the edema might be due to a nutritional issue as albumin was low, but not ridiculously low. I will check on pt again today and see what else has been done or discovered.
  8. 80 yr old male with c/c of "Don't feel good and swelling all over" x 1 week. high lactate (say 4.0), no fever, and no obvious source of infection. No abd pain or diarrhea, so ischemic colitis less likely. Significant new peripheral edema( 3+ b/l to mid-thighs). BNP 15,000. Cxr nl and minimal crackles b/l bases. Mild sob with nl vbg and covid neg. Nl sao2. Nl dimer. Nl lytes. bun/cr ratio 30 ( say 30 to 1.0) with concentrated urine. Lab evaluation indicates both volume depletion/poor perfusion and volume excess. pt not tachycardic and has a nl bp. On low dose lasix ( 20 mg/day) from pcp for mild chf with EF 65% on recent echo. do you: A: fluid bolus and abx for poor perfusion and/or sepsis without source B: diurese for volume excess C : Both D : Neither (something else).
  9. I did a lead PA position for two years and hated every minute of it. Writing the schedule meant I got the worst schedule after everyone else got time off for cme, vacation, etc. I worked ridiculous hrs and got 10% over base pay. I got called every day to cover shifts. Every single day, even when I said "don't call me for this shift as I am not available". I had to attend lots of 7 am meeting at which nothing was ever decided and my input was not valued, all after getting off work at 0100. There are places that empower their lead PAs. I was not at one of them.
  10. but...they get "partnership" perks that we can only dream about. At one place I worked for 15 years the docs got 50% of the RVUs of every PA chart they signed, 75% if they were at all involved in the care. The PAs basically bought each doc a new BMW every year and bought their house if they worked there for 20 years.
  11. The larger groups still provide PTO and benefits. Many jobs at smaller facilities are either 1099 or do not provide PTO. Every full time W2 position I have ever had has given me full bennies. I have been 1099 since 2018, so I self-fund all of that now.
  12. Pay rates in EM are very regional. Higher cost of living area(say SF bay area) or very rural generally means more money. Higher scope of practice/solo coverage generally means more money. I have 4 different clinical jobs now and pay rates are all over the place. some are W2, some are 1099. Some pay for mileage while others do not. I live and work in the pacific NW. I know I could make more if I moved to the east coast, but as others have said, money is not everything. I like the mix of places I work at now. Each one is different. My lowest paying job pays $30/hr less than my highest paying job, but I have been there for 14 years, am the highest paid PA on staff, and have no intention of ever leaving. Scope of practice, interactions with your colleagues, and autonomy and respect are all important factors.
  13. Agree. Trauma is pretty cookbook. The tough stuff is the older patient who is a full code with multiple comorbidities and a million abnormal labs who is definitely sick and trying to die.
  14. Work a lot of hours at a high rate of pay The easiest way to do this is to work long shifts.
  15. I have an attending who could be my kid...
  16. Fairly quickly I have become the oldest member of the ED staff at 3 out of 4 places that I work....and I probably still have 15-20 years left before cutting back to part time....
  17. have you met his siblings delta and lambda? I saw delta hangin with sasquatch earlier today, just for a minute, and he was gone.
  18. Pfizer #3 this AM. I am knee deep in covid and stealth covid(no sx, but found to have covid when tested for admit for something else) every day, so it just makes sense.
  19. There are some 5 year BS/MS in PA programs out there. A better bet would be to take the traditional route of getting some medical experience as an EMT, CNA, or medical assistant while acquiring a BS degree, which meets PA school prereqs. Here are the 42 direct entry programshttps://www.thepalife.com/direct-entry-and-dual-degree-bsms-physician-assistant-programs/ There are over 200 traditional programs. Good luck whatever you decide.
  20. https://www.pacificu.edu/doctor-medical-science
  21. Nice summary above. Treat the patient, not the diagnosis. Febrile, seizing 30 yr old gets IV fluids, ativan and abx before we know why they have a fever, etc
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