sillycibin

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About sillycibin

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  1. I don't know of any state where PAs legally function solo and without liability for anyone else. Your supervising physician will always be liable to some extent for your actions. As others have said, lots of red flags about this situation. Did this doctor really emphasize the on your own part? Because you need a supervising physician who you can contact whenever you need to because as a new grad you will need advice very often. And really you need that supervision early on to learn by discussing patients every day.
  2. Sorry but Michigan is just another disappointing illusion of independent practice just like the West Virginia law that was under consideration and the mess that is "optimal team practice." OTP is an attempt to make PAs more palatable to doctors and hospitals in states where NPs have independent practice by reducing paperwork and attempting to shift liability, but it does not get us anywhere near independent practice. Here is some info on the Michigan law which is just the annoying shell game with verbage: Q. Does the new law remove the terms "supervision" and "delegation"? Yes. PAs in Michigan are no longer required to work under supervision or delegation of a physician according to the new law. PAs will now be required to work with a "participating physician" according to the terms in a "practice agreement." Q. Can a PA practice without a physician? No. The new law continues to support the PA and physician team. PAs will now be required to work with a "participating physician" according to the terms in a "practice agreement."
  3. At my hospital for a while the hospitalist group refused to hear consults from ER PAs. Your attending had to make the call on your behalf no matter how much they were involved in the workup.
  4. What dizzyjon said. They usually have a little wiggle room on salary just so they can go through the motions of negotiating, but don't expect them to really modify much in the contract. It's going to be a standard contract for them and you are about to be another standard piece i.e. cog in their great big machine.
  5. Was your physician in the same building as you? My understanding is that the patient should be billed under the physician's number and you get 100% reimbursement and no he doesn't have to see the patient in follow up appointments, only the initial encounter.
  6. PAs are going to soon understand why doctors have fought for so long to keep the number of residency spots down. When supply and demand in our profession flip flops(don't forget NP programs are gushing out new grads as well), you are going to see our salaries go down, job requirements go up, and the amount of crap work foisted on us increase. And new grads will be especially hard hit when you see the number of years experience requirement continue to creep up. I rarely see "will consider new grads" in job listings anymore.
  7. So I just read through the text of the West Virginia bill that got vetoed and it is an utter disappointment. A joke really. I can't believe this is what the AAPA is fighting for. All that was done was "collaborating" was substituted for "supervising," but pretty much everything else remains the same. Instead of a supervising physician you have to have a collaborating physician. You work under a collaborating physician with a collaborating agreement and can not practice without any of this in place. The collaborating physician still oversees and assumes all responsibilities for the PA. Nothing has actually changed. It is as material a change as changing our names from Physician Assistant to Physician Associate would be. This is really sad. All while NPs continue to march on.
  8. What the NCCPA has done is reprehensible! The AAPA needs to create its own certifying process ASAP. The NCCPA just signed its own death certificate with this hostile action. I fired off my own angry email at the NCCPA demanding they lobby to undo their damage and get Governor Justice to rescind his veto.
  9. I posted this elsewhere, but it bears repeating, not that it will change anything for anyone. For new grads it's becoming very hard to find jobs and only going to get worse. Medical schools have only increased enrollment 27% in the last 18 years. PA schools have increased enrollment more than 200% and NP schools have increased enrollment almost 300% in that time frame. And there is no sign of a slow down. Continuing to see more programs open and increasing class sizes. Do you see a problem?
  10. It's becoming one and only going to get worse. Medical schools have only increased enrollment 27% in the last 18 years. PA schools have increased enrollment more than 200% and NP schools have increased enrollment almost 300% in that time frame. And there is no sign of a slow down. Continuing to see more programs open and increasing class sizes. Do you see a problem?
  11. I kind of like AP - advanced practitioner. Definitely more than APP. MP makes me think of military police. Physician Associate lets us keep PA and gets rid of assistant. It sounds kind of nonsensical but so does nurse practitioner.
  12. Stick it out. Start exploring other options. Remind yourself you're not actually stuck there long term. Heck in 2 more months you can give your 3 month notice. I remember how great it felt when I did that when I worked in the ER. It was amazing though how much more I enjoyed those last 3 months. Do what you can to learn. Remember that there is crap work with every job and the grass isn't always greener. That said, you should explore until you find the right fit. It took me several job changes before I found the right fit for me.
  13. What is happening to our profession is what happened to Law and Pharmacy. Here is a very common complaint echoed on pharmacy forums. Some of it doesn't exactly match up with issues facing us, but some matches well: "What a terrible state of affairs the profession of pharmacy has become: 1) Bureau of Labor Statistics scared everyone into worry about a "huge shortage". Yes I understand there may have been a shortage due to the graying of America and an increased population, but what is the worst that could have happened? When I was a kid the pharmacy was opened from 9-5 Mon-Fri and short hours on Sat and Sun. We all lived. Maybe the only thing which would have happened would be retail pharmacies would be open fewer hours. I also wonder if BLS stats took into effect the gains we have seen with technology such as robotics, central fill and all the advancements since 2000? 2) They never should have made the PharmD the "entry level degree". It should have remained optional. I guess that "doctorate tuition" rate was too good for those in academia to pass up. If we had retained the BSPharm as the entry level degree, it would have kept people's tuition low and the only "doctorate tuition" would be for the 6th year, which would be fair and appropriate. The PharmD should have been reserved for those interested in a more clinical pharmacy career. 3) The BLS stats rang the dinner bell for the greed and avarice of academia. Show kids they can make $125,000 a year and the student loan debt of >$135,000 doesn't sound so bad. They were building pharmacy school like they were going out of style… They have promised grads a "fool proof career" with no downside, yet I am reading there will be a 25% unemployment rate for kids who graduate in 2020.. The lesson learned…don't listen to government bureaucrats or academia who never worked in a pharmacy…they are bought and sold by big interests…I wouldn't doubt if the CVS' and Walgreens of the world had a hand in both selling the "shortage myth" and funding pharmacy schools…"
  14. I agree with a lot of this. I've contemplated at times becoming an NP so I could obtain independent practice. And it's going to become a bigger and bigger deal as practices are swallowed up and everyone becomes an employee of a hospital or a corporation. NPs who do not require additional paperwork, supervision, and fees are much more desirable over PAs. Plus hospitals are run by nurses, so guess who they are going to favor? And NP programs are churning NPs out at an even faster rate than our PA programs who are spewing new grads at ridiculous rates. NPs can at least fall back on their RN degrees. Eventually new grad PAs will get to join the newly minted lawyers and pharmacists in the unemployment line. This is why the MDs have always protected the growth of their numbers.
  15. I love how they tried to construct some sort of equivalence by stating that nurses complete four years of "nursing school" like that even exists and is anywhere near comparable to four years of medical school. And that the 2 year graudate NP programs and their 800 clinical hours compares to a three year residency and the 8000 hours a resident does.