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TDIowa

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Everything posted by TDIowa

  1. As a physician assistant that was a Commander of a Medical Company in the National Guard I had two soldiers who were attending PA school locally. I sat them down and told them my expectations. I told them that they were to come to drill isolate them in a quiet corner of the Armory and they were to study. I even let them split train and come in during the week and "drill" ie: study. They were required to complete anything mandatory Army requirements but their focus was successful completion of Physician Assistant school. In addition for annual training I was able to get them both home station training. Meaning they didn't have to go with the unit and had to come to the Armory when not attending classes and study. I retired in 2005. Both soldiers were commissioned in the National Guard as physician assistants and are on the verge of completing 20 years service. Both thank me when I see them telling me that my leniency helped them get through PA school. My recommendation is sit down with your 1st Sgt and Commander and be up front with them. Ask if concessions can be made.
  2. Good for you and your persistence. Now go change the world!
  3. Not usually. It would depend on how many open slots are available in your state. That being said if all were filled, and I doubt they are they would allow you to join and double slot you against another PA slot or slot you with a empty Physician slot
  4. Emergency Residency Trained Physician Assistant
  5. Here's a suggestion. Department of Defense working at US military bases around the world. Below are some links. https://www.usajobs.gov/job/629141800 https://www.usajobs.gov/job/646210400 https://www.usajobs.gov/job/627171400
  6. As a recently retired VA disability examiner when I would see these nexus letters I would usually ignore them and make my opinion with disavowing the nexus with a counter rationale. Let me clarify though some of the nexus letters were totally based on opinions only. No medical rationale would be given. Example: The Veterans back pain from his service 30 years ago has caused his degenerative arthritis in his back. No medical rationale would be given. With the Veteran not being seen for back pain until recently. Really???? Other nexus given made would no sense at all. The Veterans knee pain has cause his sleep apnea. No not really. His Sleep Apnea is caused by 37 BMI and his addiction to cigarettes. Another nexus is secondary connections. Ankle pain causing knee pain or hip pain or back pain. A VA examiner has a well known medical rationale, with quoted medical sources that disavows the nexuses. Don't get me wrong I wasn't a heartless examiner. I wrote many favorable opinions. Its just that the VA disability system favors quantity over quality. The system is broke. And when the scammers of the world figure out they can take advantage of its mismanagement they come out of the wood work If you keep in mind that what you are doing is medical evidence based not opinion then you will be fine.
  7. Yeah most surgeons wanted to go to law school but couldn't get in.
  8. I've have worked Occupational Health and Compensation and Pension at the VA. Both jobs had its contentious patients. I learned early on that it was the patient only in the exam room. Absolutely no family members allowed. Only exception was a minor patient. Stand between the patient and the door. Obvious reasons. At the first sign of trouble pick up the phone, look at the patient and say I will not tolerate your aggressive behavior and if it does not stop I will call 911. That usually gets their attention. On several occasions I have had to proceed with the call. Once I make the call there is no going back. I instruct the police to remove the patient. At the VA we have to fill out a Disruptive Behavior report. This goes to a committee for review and recommendations. I have found them very supportive of the health care personnel. Sanctions range from police escort to banned from medical care at the VA. Quick story, When I was working Workers Comp we had a female who worked for a local bakery. She hurt her lower back and was seen by my supervising physician. Told her she had a low back strain. She demanded a MRI. He said no. She left and filed a patient complaint. The patient advocate said that when she returned for follow up she would see the other physician. She returned and saw him. He told her she had a low back strain. She demanded a MRI. He said no. She left and filed a patient complaint. So now its my turn. She now complains of upper back pain with no complaints of low back pain. I said good news you no longer have low back pain and you can return to work without restrictions. What about my upper back pain. Not related, it is a separate and different injury not related to your original on the job injury. You are now discharged. I turned and walked out the door. She became unglued, disruptive and began screaming profanity as she left the exam room. She walked by me and stopped and said I don't know why the F*** I had to see you you are even a f****** Doctor. I looked at her and said the reason your seeing me is that know else in this clinic wants to see you. "Now there's the door. Leave this clinic before I call 911." She left.
  9. Drove past a local Chiropractor's office the other day. Big letters advertising School Sports Physical Examinations and DOT Exams. Made me think of this thread
  10. I pretty much use all of the tricks listed. If I can't get it dislodged I'll send to Optho. One other option would be a Optometrist. Used them before and never had one say no.
  11. If you were to go into the Guard I would ask to be assigned to a line unit such Battalion Aid Station or a Field Treatment Medical Company that has a PA(s) assigned to it and complete your undergrad. Thru out this time make it known to the powers to be that you want to go to IPAP. Get your name out there. Make yourself marketable. Take all the medical courses you can. Become BLS Instructor Qualified. The Army has a ton of medical correspondence short courses. Max your PT testing. Strive for expert marksman. If you can find a Expert Field Medical Badge Course take it. Close to graduation start looking for Guard units within your state that has a PA slot assigned to it but no PA filling that slot. Don't worry about finding a empty slot there are plenty. Early on contact the State Medical Professional Recruiter and tell them that you would be interested in filling a PA and PA slot and what would be the possibility of the Guard sending you to PA school. If you get this far the application is a long process. Do Not rely on anyone do the required paperwork. You should take a active roll in completing the application process. That way you will know its done and done right. I was a commander in a Field Medical Company. During that time I was able to get 5 of my soldiers into IPAP using this strategy. There really isn't a selection process once your packet leaves the state. As far as how completive, not really, if you are selected by the sate for that slot and meet all the criteria you go. Your packet will be screened by IPAP to make sure you meet the criteria but that's about it. IPAP really plays no role in the selection process for National Guard and Reservist. There role is the selection process of Active Duty. Its the state that your from that picks up the tab for your schooling. The National Guard is extremely doable while you go to college. Plus they throw a lot of money at you to pay for college.
  12. Can't really tell you what to do or path to take. If you join the Army National Guard and become a Combat Medic Specialist (68 Whiskey). You will be well trained and have learned a skill to help you while in undergrad. In addition the fact that you are serving your country plus the experiences and the skills you learn will look good on any application for PA school no matter where you go. First things first though. Get you undergrad first. Go to the IPAP site and read on the prerequisites you will need for a successful application to PA school. It is not impossible to go the IPAP route. I went that route many years ago. I have found that funding isn't a issue if the state you are in needs PA's. If you join the Army National Guard and become a medic you have a opportunity to excel and get noticed. This networking will aid you when asking your peers, supervisors and commanders you are serving with for letters of recommendation. Always a plus when applying for a military school. More Info on IPAP https://medcoe.army.mil/ipap If you have any question fire away and I will see if I can help TD
  13. I don't think that is right. I believe you've been given bad information but I don't have the sources to back that up. I work in Compensation and Pension at the VA. I had a young man who came off active duty and attended West Point. He was injured severely in the Army and medical boarded. He told me he was in Pharmacy School using the VR&E program. I would drop by your local US Congressman's office and get the definitive answer. They love solving a problem like this.
  14. I've always been of the opinion that the more letters you have behind your name to less you actually do. Keep it simple!
  15. See this often in the Veterans I have for patients. Especially Vietnam Veterans. I'll evaluate what they are seeing me for and then I will just look at them and ask them how they are doing with their PTSD? More often then not they are taken back by the question and give me a blank stare. I reemphasize to them that when they came back no one was their for them. One day they were in the service and the next they were home. They had no one to talk to to share or even explain their experiences to. So they got a job, got married had kids and closed that chapter of their life and tried to forget about it. Now that life is slowing down for them they start to think about it again. I ask them some basic PTSD questions. Do you like load noises? Anger issues? Substance abuse? Antisocial Behavior? Crowds? More likely than not they will admit to all of the above and some will even break down. I then listen to their tales. They know that they can talk to me because I tell them that I too am a Veteran. I then tell them that I would like for them to talk to someone. The PTSD counseling services are the best thing that the VA provides to the Veteran. When I am done I walk the Veteran out to their spouse and tell them both that here is the number for counseling services and that I want them to make a appointment. More often then not the spouse will look at me and say that they always their significant other had PTSD. I did this for a Veteran last month. Stepped on a land mine in Vietnam. Literally had to piece his lower leg back together. Was in the hospital at Great Lakes in Chicago for a year. Ended up with a horrible angulated right lower leg that left him with a pronounced limp. Was new to the VA system and because of his altered gait was being evaluated for a knee and hip replacement from years of walking with a limp. Asked why it took 50 years for him to use the VA. He said the US Government sent me to Vietnam, I was wounded and my life changed forever. No one ever awarded my a Purple Heart for my pain and suffering. After he left I was able to review his medical records from his service. Halfway through them I found orders presenting his Purple Heart. Obviously he was never made aware of its existence. I made a copy. Put it in a frame and took it to his house and presented it to him when he opened the door. He immediately broke down and I gave him a hug and he sobbed uncontrollably on my shoulder. Once both of us regained our composure he thanked me profusely and I left. Now that's a good day tp be a PA!
  16. Cash up front. Lawyers have a of forgetting to pay you.
  17. It might be because they are such a new program and haven't completes all their credentialing requirements.
  18. Also volunteer Firefighter and EMT. And serve on local City Council. Lots of opportunities to get involved with your community. Tons of small committees needing volunteers. i.e. Trees Forever, Downtown Beautification, etc.
  19. To each their own. Before you go making a caustic remark like that I wish you would get the facts and not stereo type about a specialty. There are specialty fields I would have no interest in but won't comment on them and run down someone else's interest. Please be careful about negative comments about our specialty fields.
  20. So I volunteer at our local fire department in a First Responder role. Got called and responded to a call of a lady who dislocated her hip. This was the 2 - 3 time we had been there in the last year for this complaint. We made her as comfortable as we could and awaited the paramedics to arrive to transport. Anytime we tired moving her she would scream bloody murder. So we just let her lay. The paramedics arrived and told her they were going to give her some Fentanyl to control the pain before we moved her. She replied that Fentanyl doesn't work and she needed Ketamine. Unanimous hmmm could be heard by all the medical and police in the room. Paramedics said they didn't carry Ketamine and all the had was Fentanyl. Well if that all you have then give me that. Another unanimous hmmm.
  21. 1. Schedule a new patient as the last patient of the day. My experience is that the day never ends well. They always need x-rays or blood work. Then come in the next day and get b****** at for overtime for myself and the staff that I make stay. 2. Schedule a "new" patient without records.
  22. I agree with CJ, Confront her. Ask her about the comments made behind your back. Then shame her with this is not the way a professional medical provider acts. Tell her you have too much respect for her profession and expect better. Tell her you want to learn from her. Isn't medicine a learning profession? Ask what can be done to improve the interaction between yourself and her. Put her on notice that you will not tolerate this type of behavior. If nothing changes then Human resources. Your case will be much stronger if you have at least mad a effort. Oh and of course document.
  23. I work part time for the VA doing Compensation and Pension Exams. I see these contract exams all the time. Unfortunately more often then not its quantity over quality. I can not begin to describe some of the sub standard exams that I have seen. Absolutely no quality control. It is really a embarrassment when you compare a contract exam to a VA exam. Examples: Service connect a 68 year old obese Veteran who had been out of the service for 48 years for degenerative arthritis of the knees. No X-rays or examination was done. Had xrays been done his bilateral knee replacements would have been found. The Veteran received a 60% rating which is 1300 a month for life Service connect a Veteran for Diabetic Peripheral Neuropathy. The Veteran wasn't Diabetic. Service connect a Veteran for Coronary Artery Disease without a Coronary Angiogram. He had chest pain with exertion Service connect a Veteran 42 years post military for Cervical Degenerative Arthritis with bilateral radiculopathy. No xrays, No history of neck pain in the service. Just a newspaper article that he wrecked his car and complained of neck pain at the scene. Service connecting a Veteran for PTSD because his drill sergeant yelled at him. Service connecting a Veteran for PTSD because when he looked through the night vision googles he saw the enemy Multiple instances of service connecting a veteran without reviewing any records Doing compensation and pension examinations in a motor home parked in a motel parking lot. Don't get me started. I have complained to the VA IG about the substandard examinations. There response is that they are apprehensive to look into these charges of fraud because it will make the VA look like they are against the Veteran. You would be sick to your stomach if people really new what went on with contract examination scams. That's why I tell all Veterans to refuse to go to these exams and insist on going to the VA. This is your tax dollar that is being used to pay these fraudulent claims. Sooner or later we are going to run out of money
  24. Was given another 50 doses Thursday and we were able to vaccinate 59 people yesterday. All over 70. Our oldest was 97 followed by a 95 year old!!! We told our Cedar County Public Health Department we wanted to do a 100 dose clinic this next Thursday. They said they will see what they can do to accommodate! Not bragging but... https://www.facebook.com/WestBranchTimes/photos/a.949239288846774/1144916299279071/?type=3&theater
  25. Go to USAJobs. They list all the government PA jobs to include civilian PA jobs on military facilities. I have a friend who took a 3 year stint as a PA at Anderson Air Force Base on Guam. Worked Primary Care at a AF clinic
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