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jmj11 last won the day on October 25 2019
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1,013 ExcellentAbout jmj11
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I have to decide if I keep my cert by the end of March. The only thing I lack is Cat I CME. With my COVID vaccinations done (had work restriction due to bone marrow transplant) I could go back to work if I wanted. I miss it, but other times I don't. Am staying busy writing, hiking daily, building a stone cottage, but there are times I miss medicine. I have two more years on my disability, which ends if I draw a salary, so it makes no fannical difference to me. But it raised he intriguing question if people loved medicine enough to do it for nothing.
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I have not seen the 2021 E&M guidelines, but if that is the way they are written, then it will be the death of the full exam. Money and time-saving, always trumps. I'm not saying that is a bad thing (although it doesn't feel good to me) but the question stands if this is good for medicine? Is the hands-on exam superfluous? What about, as mentioned, the human aspect of face to face time and touch? Are we heading to a Dr. Jones on Star Trek medicine, a hand-held device that does a full body scan and finds any abnormal state and not touching required? I'm a great believer in the con
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This is a question for new graduates as well as us old timers. When I was in PA school, we had a very good course on the art of the history and physical exam (taught by Glen Combs). It was emphasized with use, that our sight, touch, smell, and feel, using nothing more than our eyes, pocket scopes was how we make a diagnosis and labs, X ray, (we didn't have MRI or good US) only confirmed what we had figured out. We measured organs with percussion and a tape measure, etc. We knew what each heart valve was doing, or not doing by auscultation. I have the sense that young doctors (haven't obse
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Working in Allergy/Immunology as first job??
jmj11 replied to PAQueen2021's topic in Professional PA General Discussion
Not bad. For someone with a GFR of 23 and a HGB of 12, I feel pretty good. Climbed our local mountain twice this week with a snow-shoeing trip in between. I’m working hard on my eight book, a novel with a protagonist that’s a PA and fate assigns him the task of saving the entire world. Working hard to make it the best book I’ve written and one to make PAs proud. Will hopefully hit the market in the latter half of 2021. Will become a COVID vaccinator as soon as my own vaccine has had time to kick in. I hope you are doing well. -
Working in Allergy/Immunology as first job??
jmj11 replied to PAQueen2021's topic in Professional PA General Discussion
Ventana reminded me of something. I did work a PT job in an industrial clinic while at a headache center in Michigan, then when I was a headache specialist at Mayo, I volunteered at a Salvation Army free clinic and moonlighted doing a fast track in a local ED. So, it was rare that I only did a subspeciality. So I agree with Ventana's comments. -
American PA in other countries?
jmj11 replied to silverstarlight's topic in International Physician Assistant
Long time ago, 1991-94- 6 replies
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medical business An Irrevocable Medical Model?
jmj11 posted a topic in Professional PA General Discussion
I observed something today that caused me to stop and think. Sign makers were replacing a clinic sig nwith one for a laundromat and there is a story behind that. This space is in a good location in the center of our town. About ten years ago, it came open when the previous optometrist office built a new building. I had been contemplating opening an urgent care clinic in our city and that space caught my eye. Our local medical groups had wait times for weeks and most did not offer same day service. We have a level III ED at the hospital that had a very low satisfaction score for minor ailm -
Unbelievable.....we don't hire PA's
jmj11 replied to bike mike's topic in Professional PA General Discussion
So they advertised for a PA, but then told you that they can't consider you because you're a PA? Sorry for your experience with this. Did they state why? I've seen practices, hospitals that prefer NPs (and that's another discussion). I would love to know why in this case. -
Working in Allergy/Immunology as first job??
jmj11 replied to PAQueen2021's topic in Professional PA General Discussion
I agree with both viewpoints. It is best to start your career in a broad field (primary care) because you are still learning a lot of medicine the first few years. With that said, a smooth switch from a pigeon hole job is possible with some effort. So, if life dictates a narrow field to start, don't lose sleep over ruining your career. I started out briefly (6 months) in primary care in a horrible job. Jumped to a very narrow field, headache medicine for five years. Then did more like public health in the developing world for 4 years. Came back and jump into family medicine and ED 50:50 f -
This is a big issue that I faced many times in my career, including at Mayo Clinic. I was required to bill "Incident to" (as you know better revenues) but as you are arguing, it did not follow the CMS rules. Mayo wasn't trying to be deceitful, but even they were reading the laws wrong. We finally fix it where all my billing was independent as it made no sense to have an attending see my patient first. But I had two other clinics try to do the same thing. When I owned my own clinic I followed the letter of the law and coloradopa has stated it well.
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Nice photo. Haven't been around orthopedics in a very long time, but was easy to figure out due to good quality of photo. Sometimes the photos on line look to me like a Rorschach test.
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PA Military Spouse working Overseas
jmj11 replied to eswilcox88's topic in International Physician Assistant
I haven't checked recently but the department of defense used to hire contract civilian PAs for bases in Germany, as I looked into it for myself. However, that was 15 years ago. Outside of our own Department of Defense, it would be challenging finding a PA job unless it is in the UK or possibly The Netherlands. I just looked here, and they had no overseas civilian jobs for PAs listed. I did find this job listing. -
It will be fascinating, while tragic, some day to know exactly why the diverse outcomes of this strange disease. It is beyond comorbidities, while they contribute.