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DizzyJ last won the day on November 8

DizzyJ had the most liked content!

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About DizzyJ

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    Physician Assistant

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  1. If you are an employee of CEP, then they should cover this fee. If you are a "contract worker", which I take to mean an independent contractor, then you pay. Whenever I was employed by a physician group that was contracted to staff an ER, they paid my fees.
  2. Had an older adult patient present with a white film on tongue as well as some white sore patches on the mucosa. Patient says: "I was with a friend, who is a doctor, and he took a look at it and gave me a prescription for a Z-pack" Me: "Well, this looks pretty classic for thrush and not a bacterial infection. What kind of doctor is your friend?" Patient: "A dentist"
  3. My street smarts understanding....documentation is perhaps most important then a signature on an AMA form. If a patient signs out AMA, but you didn't document that a clear conversation took place with an individual with capacity to make an informed decision, there is still potential liability. When an AMA form is used, it should spell out exactly what you want to do, pros/cons, why you want to do it, and the risks/potential death that could come if it isn't done. Important to note your opinion about capacity and NOT competency. Only a judge can declare competency.
  4. Excellent example of what is becoming more and more prevalent. Antibiotic demanders and their tag line "So, I came here for nothing basically?". That is correct if you value my medical opinion as "nothing". Cough/cold patients are not happy with a viral diagnosis and then on the other end we have patients unhappy because we think they have something more serious requiring an ER visit.
  5. Right there with you. Rarely does a patient walk out the door without their chart signed and closed. It doesn't matter if I'm working in the ED or working outpatient psych. I made this my habit right out of school as I don't ever want to work for free. When I worked outpatient psych I saw 22 patients a day, averaged 15-20 messages/med requests throughout the days, and always always always was sitting in the break room for my lunch break. I would arrive about 30 mins before clinic and would run through my morning patient charts to have a game plan in place should they need a med adjustment and notate if they have current labs.
  6. Agreed, this is not patient abandonment. If you say owned the practice and one day just closed up shop and walked away, that would be abandonment. You don't own the practice. You are giving your contracted length of notice. I understand being there for so long that you feel like your abandoning long patient relationships. With the corporate take-over of medicine, I feel moving around as a primary care provider is becoming much more common then staying in one place your entire career.
  7. I agree with many points being made. When I started PA school there was only 120's something programs. Fast forward 12 years and the addition of over 100 programs. Here in Ohio we have two reputable programs though being shut down. We have a good supply of PA jobs still. I've read far more posts about NPs having a harder time finding jobs as a new grad then PAs. There volume of new grads entering the work force though is greater. The comment about not being able to do anything else with the PA degree is very true. There are so many more options for someone with an RN behind their name. I went back to school because I want to leave clinical practice soon (like yesterday) and I enjoy admin work and education. As I search for positions that align with my passions and goals I come across far more positions wanting an NP/RN for admin/leadership roles that I want. I still apply for them, but never get a response. Would love to teach at a PA program, but don't want to relocate and my local PA programs aren't interested/aren't hiring.
  8. Common practice to just have one bank of days off to cover vacation and "personal days". 3 weeks isn't bad. The CME allowance is awful. Especially, if you have to cover licensure/certification/DEA with that money too. The salary really isn't that bad depending on how many patients you are expected to see. The schedule seems very straightforward. A lot of the working population doesn't get a paid lunch and have a work day that is 9 hours long, but only get paid for 8 hours. You don't need to stay in the office during an unpaid lunch and that is your time. So long as you don't find yourself returning patient calls, doing refills, and charting during this unpaid time. I would consider asking for additional pay for the every third Saturday or to have shorter office hours the Friday prior to even it out.
  9. The NCCPA uses that fee to keep its doors open and pay salaries. MDs and APRNs renew as well. APRNs with the ANCC renew every 5 years and pay a fee of $170.
  10. My street smarts opinion....they may put you on probation or fine you perhaps. I can't see forging a BLS card as a cause to have your license revoked. Have you since renewed your cards? It was a poor decision and you're owning it. Hopefully, you don't get a permanent mark on your record.
  11. Agree as well. I've jumped into very short term PRN jobs that have no presence on my CV. I make sure to list the main positions and not leave any gaps in employment. The more you list, the more work it will be. For instance, some medical staff offices want letter of reference/good standing from every hospital you've had privileges at. One company I worked at credentialed me at 5 of their hospital, but I only worked at one. So, what is the point of disclosing hospital privileges at a hospital I've never stepped foot in?
  12. I sometimes wish we could report providers for over prescribing antibiotics as we could with narcotics. Some of the things I see just blow my mind. Recently I saw a provider document clear URI/cough symptoms and 100% normal exam findings in a young, otherwise healthy, adult. Did a strep, back up strep PCR, mono, CXR, AND sent patient out on amoxil. All tests negative. WTF! Another provider has prescribed cipro twice in the past two weeks for uncomplicated UTIs in a young, healthy, non pregnant, female. WTF! Z packs prescribed over and over again for sinusitis and bronchitis. When patients come in specifically saying "I'm here for a z pack", I want to scream. Had a provider at another clinic a few weeks ago call my office and ask me what to use for strep if penicillin allergy?!?!? WTF!!
  13. Just to be certain....you have a claims-made policy then in effect that would require tail coverage when cancelling? Versus an occurrence policy. Have you asked your prior employer to cover the tail policy? Every position I have held, even when as a contractor, has covered my malpractice and tail coverage if needed. You can ask yourself if you are aware of any potential mistakes that could have been made and use that information to choose not to get the tail coverage. A risky choice that could save you $8,000. Of course you'll regret it if a lawsuit comes up. A neurosurgeon not having malpractice blows my mind, but okay.
  14. Such an important part of the chart. I have found that mostly ER skilled providers are the only ones that actually use an MDM section. Everyone should though. I was shocked when I started a new urgent care position and rarely does a provider discuss any MDM. It is where you tell the story of why it is what it is and why it isn't what it isn't. You are documenting that you thought of severe/life threatening differentials, other pertinent differentials, and how you excluded them. Working in urgent care my MDM is basically on repeat explaining why the signs and symptoms are consistent with a viral etiology and that there is no signs of a bacterial process....blah blah blah...antibiotics are not needed at this time.
  15. I agree, finish PT school. Gaining acceptance into PA school is highly competitive. Completing your PT program could be reflective that you are able to handle making it through PA school. I don't think it matters that you took anatomy with medical students. Anatomy is all the same no matter who is in the class with you. You need to shadow PAs....multiple PAs....and get a real feel for the profession. Get the pros and cons from various PAs to help you make an informed decision. My curiosity is how you got into PT to begin with? You state you don't like exercise/fitness and that is the "cornerstone" of PT, but you pursued it anyway. So, have you really thought about what the "cornerstone" of medicine is (whatever that is in your opinion) and if you like that or not?