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Everything posted by EMEDPA

  1. allopraxician...you know , A kind of clinicist.....FFS.
  2. many of the programs are part of the association of postgraduate pa programs(appap.org). Most of the EM programs meet the sempa recommendations for residency programs, designed when I was on the board of sempa a few years ago. A few of the em programs also required passage of the caq at the end of the program.
  3. agree with above. I am a big fan of postgrad training and doctoral credentials for PAs. CAQ exams/certs as well.
  4. agree with this. NPs are an issue. Lateral mobility is going away. Yes, you can work in any specialty you want, but you may need to live in BFE to do it. Outside of formal residency programs, most physicians don't want to train PAs.
  5. If it was me I would go with B. established program with specialty focus of interest to you and quality rotations? Done.
  6. let's hope. I will never refer to my self as a clinicist or praxician. If it came to that I would say " I am one of the ER providers today" and leave it at that.
  7. the 6 elements are all well and good, but don't often reflect what goes on in a state. WA, for example is MUCH more PA friendly than OR, yet WA has 5 and OR has 6. PAs run ERs solo all over WA. Only 1 ER in OR was PA run, until it was purchased by a larger organization and turned into a 12 hr/day urgent care.
  8. fast track without higher acuity is the road to burnout. been there, done that.
  9. I did 17 years of low to medium acuity and very high volume with 8-12 hr shifts. I don't want to do that any more. I want medium to high acuity and low volume with 12-24 hour shifts. When I switched from a busy trauma center to a rural , critical access hospital I got a $35/HR raise to practice medicine the way I want to and don't have to report anything to anyone. I get a consult only when I feel appropriate. I turf procedures only when I think I shouldn't do them.
  10. I think in academics PhD>DHSc>DMSc at this point due to several factors, including academic rigor and duration of training.
  11. If I had lots of free time and money I would probably get a DrPH
  12. yup. two were somewhat reasonable. two were not even pronounceable.
  13. I saw a local PA who owns his own clinic for years until my insurance no longer covered his practice. Now I see a local doc walking distance from my house. happy with both.
  14. You've got this. After Iraq, this will be easier....
  15. the key to mesenteric ischemia is pain out of proportion to exam. those folks get a CTA. also check a lactate. generally it will be elevated in the setting of ischemic bowel. also make the MDCalc site your friend. Geneva for PE, pecarn for head injury, heart scores, curb-65, abcd2, etc
  16. As a general rule of thumb chance of badness is related to age. 10 yr old at the ED looking vague? 10% chance of a real dx 90 yr old, 90%.... Old people with belly pain ALL get CTs, young folks only if you really suspect badness. all women of childbearing age get pregnancy tests order a lipase for abd pain. it's a great test. get UAs on anyone confused, especially the elderly MRIs are Over-utilized in the ED. Get them only on the advice of a consultant or if you really suspect an epidural abscess. Order a magnesium every time you order a cmp. low mag levels contribute to fatigue, myalgias, arrhythmias, etc. If you are worried about the K , you should worry about the Mg.
  17. I had a surgeon tell me awhile ago " it is impossible to have appendicitis with a normal CRP" so I am getting them a lot more often now, whether or not he is right.
  18. I believe the DMSc will only be open to their grads at first. For someone starting from scratch, this option makes a lot of sense. I met with the director today. He was arranging rotations for em, surgery, hospitalist, and primary care at my hospital.
  19. Really depends on location. $9/hr more than your base rate sounds ok and you will get exposure to a new place and potentially work it into a better full time job. A lot of us in EM have multiple jobs at once. I had 6 for a while. Now I have 3 clinical jobs and teaching.
  20. Not a big fan of being in debt. we try to have all our expenses aside from the mortgage and a single car loan paid off by the end of the yr every yr. No vacation homes. no boats. no yearly ski trips to Switzerland. My last job had a great retirement plan and I was there for 15 years . I worked for kaiser for many years before that and have a pension and 401 k through them. my current part time job gives me 3% if I put in 6% (and I do). My current full time job is 1099 so I get no retirement through them.
  21. some em groups have call for sick leave, surge plans, etc
  22. the last time I took call was 15 years ago. I got 5/hr then and 1.5x for any hrs worked, minimum 3 hrs pay even if I just saw 1 pt.
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