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rpackelly's Achievements


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  1. If they arbitrarily restrict the terms “residency” or “fellowship” without going through the appropriate state legislative channels, it is meaningless and unenforceable. Those terms, unlike “doctor”, are not Officially protected in any state. Their statement is anti-competitive and could be reviewed by the FTC; this has actually happened with other initiatives issued by professional organizations who have been warned against restraint of trade issues.
  2. Sub specialty consult service (oncology, endocrine, ID, rheum, etc) in an academic medical center.
  3. I am seeing only one rotation with MD preceptor, not to belittle the rest of us, but that is standard of education in medicine. And, as EMDPA said, curing my ER Residency at LAC/USC I put in almost as many hours in one rotation alone as the entire student experience listed above; that was over and above my initial training where we had to clock 2000 hours. I see no evidence of ED, surgical, or inpatient experience or care of acutely acutely ill patients in this CV. Some direct entry NP grads do not even meet the minimum pre-requisites for courses and for clinical experience needed for PA Program entry in many places. We consistently sell ourselves short.
  4. Hiring a lawyer experienced in medical board matters in your particular state could be the most important $$$ spent for your entire career. Any restrictions on your license will limit job opportunities and after 13 years you don’t deserve that.
  5. Nice table. NSU also has student fees of $405 per term in addition to the $671 per credit hour tuition. When I was the PD students typically took between 2.5 years and 4 years to finish. Average was a little under 3. There were, and still are as far as I know, 4 terms per year with two required residential institutes of 3-5 days apiece, so travel costs are extra. The program is interdisciplinary, so not all PAs, and, of course, many PAs now are going DMSc, choosing the briefer degree because of the large number of masters credits PAs typically have.
  6. To Shakahoo....you are an ortho PA in an ortho UC and interpret bone radiographs........given some experience in the specialty this would be very reasonable. New grad, unspecialized, Interpreting skull films, C-spines, chests, abdomens, and who knows what else without over read? A stretch. From a patient standpoint I wouldn’t accept it and as a provider I would not advise it. I had to do it myself in a UC for a bit and marked lots of films for over-reads, especiallly older folks. Would not want to miss a very small lung cancer, potentially curable, in a 65 year old, which I did once in a walk in clinician 1985.. Both the patient and I were saved by the radiologist!!! All films were over-read in that practice, even the two docs. Since the patients are asymptomatic at that point (-you were probably looking for pneumonia rather than lung CA) there is no reason for them to return for this likely unrelated finding until it is far advanced. She sent me a postcard five years later from a cruise to Alaska. I do agree with the postings above who say that the acuity is really increasing. Subdurals, MIs, lots of stroke vs. TIA, new onset A-fib. I worked in a UC located in a resort area with lots of retirees for my last clinical job. Very different from the 1980s clinical UC scene. There are really no “cold, cough, and flu” UCs any more. As far as I am aware, and this was 10 years ago, I didn’t miss anything in that setting, but by that time I had been practicing for 30 years. I consider myself lucky.
  7. Lack of radiology over reads will bite you sooner or later, probably sooner. There is a reason that they have a residency and radiologists still miss things. At a minimum have your SP review and document concurrence or not on each radiograph, although this is not totally protective (at least you will go down together). On the issue of no doc on site for a first job, unless they are willing to talk to you over the phone a lot or you have a super select minor illness practice like a mini clinic at a pharmacy, not a good idea. Maybe if you had five years of Independent Duty Corpsman experience or ED RN prior to PA school. If you take all comers, not a good idea. If you limit patients to over 8 and under 65, maybe. But then you do not get any personal professional development. Did you know that there are formal UC fellowships for board certified pediatricians and family medicine docs? Full scope UC requires lots of experience. I would at least try to negotiate on these two points to at least 50% doc or experienced PA on site for first employment period.
  8. Have you thought about continuing to work at the VA through your probationary period and then applying for open VA PA jobs in DFW? Keep your tenure and seniority.
  9. It is possible and relatively common. Especially for substance use issues. BTW, congrats for this result, you have worked hard and overcome quite a bit. I commented on your prior thread. Any evidence that you have of rehabilitation and recovery is helpful and also, a licensed and experienced attorney in your new location is a must. Do not exclude substance use programs in looking for your new position, or PA education programs; other non-traditional roles. Contact the substance use caucus of your new state’s PA and medical organizations as well. Network extensively.
  10. For COVID patients and during the emergency. Also, liability is partially waived unless gross negligence occurs.
  11. The term “resident” is not currently legally exclusive. If you look at a number of state practice laws “holding out” legislation legally prohibits individuals from identifying themselves by certain terms like doctor, physician, physician assistant, PA, etc. Resident has not been one of those terms in any state I have examined. So the AAEM can opine however they want but they have absolutely no authority in the matter.
  12. They have misinterpreted the law. PAs bill through their collaborating physician at 85% of the rate. But they are identified as the provider. You do have to apply to be credentialed but the money flows to the doc or hospital. NPs can bill for themselves at 85% of the rate as well. In terms of Part A it all flows to the hospital or doc that employs you eventually, just a question of where the reimbursements are sent. No difference. Contact AAPA for the exact language.
  13. Within the past ten years I know of a child pornography felony situation by a family doc. He served four years and got his license back with 10 years probation. I know a PA who got a new state license in another state, who served almost a year for Medicare fraud, and he had had a previous suspension prior for controlled drugs. He was on probation for a year or so. The results of all of these are so variable depending on the skill of the lawyer and the sympathy factor and rehab status for the defendant. There is never a “never” unless you die.
  14. Not totally. Under Cali law PAs can own part of a medical practice, and then the practice can employ you as a PA. PAs usually working only 1 day a week as a per diem are the ones usually hired as 1099 independent contractors (or were). They then had to pay all of their social security, Medicare; had no vacation, benefits, sick leave, FMLA, etc. BUT.......they get to deduct all expenses from compensation. If they owned part of the practice and were an employee it would be the best of two worlds, except for the loss of all business expense deduction. CRNAs will really fight this because they are often 1099 contractors collecting their own fees. Believe me, corporations know how to warp themselves into new legal structures to take advantage of most everything.
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