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ventana

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ventana last won the day on February 16

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About ventana

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    Moderator, Past Practice Owner

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    Physician Assistant

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  1. ventana

    Job offer contract negotiation

    Sounds like you sold yourself a little short. A doc doc would be north of 200k if it is the perfect job and you are newer in your career and low cost of living area might be ok. But I was at that level 10 yrs ago for salary lot more then salary going into the decision but realize they will likely define you by what they pay you (meaning they will never be excited to get you up to a wage approaching a doc even though you are doing the same thing.) not ot meant to be critical and sorry if it comes across as such. I would honestly say in the $100 per hour range.
  2. ventana

    What would you have done?

    https://www.mdedge.com/clinicianreviews/article/79156/nephrology/management-hypertensive-urgency-and-emergency HTN urgency V Emergency
  3. think a lot of this comes down to how much you are paid if you are >$200k - sure go if you are under $140k - say that you would need to be compensated in the $140-200k range is tough - paid well, but....... Then their is the other side of it.... do you want to be one of the "in the know" people for a new EMR? This likely might put a LOT more stress on your job, and then they make you a super user and expect you to help everyone else get up to speed, then you are up at midnight at home, not getting paid, dealing with IT issues...... overall you need to define the expectation, and make sure it is reasonable
  4. ventana

    Taking a CAQ

    and yet NCCPA does not yet offer an IM CAQ Thanks NCCPA - let us PCP PA's get smoked by the NP!!!
  5. the entitled ones who demand things and think they know something "I want an MRI for my 2 days of back pain after raking the yard all day" "I want an xray for my elbow pain after playing gold" of best yet "My attorney told me I needed an MRI" earlier in my career i might try to educate them, now I just move on
  6. I too had some strange feelings about saying PA SoandSo, till I started doing it.... and you know what, now it is natural. People know I am a PA and established patients call me by first name This post is the PERFECT sumation of why we all need to insist on PA at least some time in the day. I NEVER NEVER NEVER say the dreaded Ass______ word - nope, never, not going to happen - for people asking I will explain out schools as medical training, and even might compare to an NP if that helps, but never the Ass_______ word.... Used to have more weight when some states you didn't need to pass NCCPA - but is there any of those left? i agreee on the whole -C being redundant, and when people ask I end up having to explain it.... PIA.....
  7. ventana

    What would you have done?

    thoughts our system is broken you can't NOT fill her scripts - how does this sound "sorry judge I didn't fill her HTN and DM meds as i am not a PCP" (on trial for a wrongful death due to DKA or CVA or MI - - you can't not treat what is in front of you and she is HTN and DM Yup it sucks, but you have a DEA, and License and the training to help her I would have approached it a little differently - a missing fact - WAS SHE OUT OF HER MEDS AND IF SO HOW LONG? You would expect HTN and elevated sugars if she was out of her meds and had been for a little while - think 3-5 days I would have refilled, and given her a sheet listing local PCP's, and had her sign AMA if you had EKG? of infarction (don't order the EKG next time - she had no complaints - all you did was increase your liability) Then I would have sat with her and called some of the PCP's on the list and gotten her set up with a more urgent appointment - in 2-3 weeks MAX - sometimes the provider being on the phone really does help!!
  8. ventana

    How to deal with bad reviews

    get all your friends and family to fill out reviews Now realize that they have proven that online reviews mean NOTHING NADA and same goes for pressganey - the ER doc who gave everyone they wanted - against his medical advice (nothing dangerous) had great scores. someone that practices medicine will get crappy scores.... fogetaboutit...
  9. I agree first names = not overly professional I introduce myself as PA SoandSo I am fine with first names for doc's in my local system - but when calling out of the system I ALWAYS say PA SoandSo calling as Patients XYZ PCP..... I think more and more use of PA (and NP) in the everyday professional medical setting helps.....
  10. ventana

    HLD in young adult

    Unsure on your fbs question. I would think more likely was not a true fasting. Hence the elevated fbs and trig. Utd is attached I would check another fbs and see if it was a true fasting to begin with
  11. ventana

    Drug Reps

    Drug reps influence your prescribing. Period. To say they do not is not proven by the data. Drug reps = used car salesmen. Believe little of what they say. Samples = bad for your patient. Sure they work and are free but do you really think the drug companies loose money on them. I have strict no drug rep policy I will very occasionally attend a dinner but insist I pay my own way. And ask challenging questions and call BS when I hear it. Drug reps are your enemy to delivering high quality cost effective care.
  12. NO!!!!! Read. Educate yourself. Practice medicine not gate keeping!!!!!
  13. ventana

    HLD in young adult

    Sounds like a statin in order BMI is what? <25? Plug the numbers in online calculator Review guidelines Honestly would consider OGT test if they were really concerned with DM Open honest discussion with patient TC 288 and LDL 188 both stink and likely familial send for nutrition consult Encourage 39+ min aerobic exercise daily Zero trans fats eat well recheck in 3-4 months
  14. hope you did not do this this is an insulting offer - I worked for a few of those practices, and left....
  15. Actually thinking of taking my kids with me They have a DOD school on the island and my kids are young might consider a short stay now, and then a longer stay in few years....
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