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ventana

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ventana last won the day on March 28

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About ventana

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    Physician Assistant

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  1. needs a sleep deprived EEG also trial of AED for presumed sz d/o (EEG does not rule it out) once liver issue resolved.... THAD - no idea
  2. admission H&P chronic care follow up acute care simple stuff procedures include suturing, FB removal, joint injections, eye exams, splinting, wrapping All these were learned before going to corrections lots of nursing management as they are my extenders I run a jail with 200-250 inmates with an average lenght of stay about 8 months, everyone gets seen
  3. i work in corrections work is amazing - focused solely on providing appropriate care with a great nursing team... yep it is a great field that can be made or broken by your administration...
  4. because we can..... not because we should... read some of the data coming out about polypharmacy in the elderly and the problems with hospitalists service starting to many meds and the simple picture is the PCP has lost the ability to advocate for their patients.... sad
  5. ventana

    Patient education

    wow two that I use all the time that are great!! www.UpToDate.com www.epocrates.com Get your employer to pay for both - get CME that stacks up, and great hand outs Seriously this is my main resources and they are amazing!!
  6. ventana

    Medical Model vs. Nursing Model

    Shouldn't have one with out the other but medical knowledge with out bedside manor and "nursing skiils" can still be good solid medicine Nursing skills with out medical knowledge ie bug/drug or drug/drug issues can and IS dangerous...
  7. lets call them a CP (not SP) Collaboration is the name of the game.... Darn I love this one, but it might not be to PC "Are you an egotistical bastard who's intimidated to work with a strong PA?"
  8. tough call my informal rule of 50's for elderly hip fracture is 50% done leave hospital, of those 50% don't leave the nursing home... with 50% death rate Afib is the devil we know and can manage - and in it self is not fatal hip fx is the unknown - 50% occur in people with out osteoporosis - can can be fatal (and with a possible low energy bony fracture that might be real - what is her T score - more on that below) So I do not see this as an absolute contraindication, but instead one that takes talking to the patient. Good cardio look, risk benefit assessment and what is the patient afraid of? Sometimes that last question is the one that holds the answer - some patients are scared to death of a stroke and will do anything to avoid, others are afraid of bony fractures..... seems to be coordinated to what the have personally seen as a loved one's demise So yes a great point, and goes back to the point that overall patients need to be educated. Also goes to the providers (and legal professions) desire to do something to maybe help then to do nothing and let mother nature determine things.... As a final question what do people think about the new data showing Vit D and Ca might not be of benefit???? Course then we have a Hx of renal stones so what should the Ca++ recommendation be???
  9. ugh inhumane care is what comes to mind overall med simplification is needed get rid of everything that is absolutely not essential honest discussion with she and the HCP about goals consider reporting the person whom broke her rib - might or might not have been high energy injury needs a provider that will slow down and listen and be their advocate As for the injection - ah no - especially en-light of the most recent data..... CMO is the rule
  10. be honest get a book on how to interview really the only thing you are trying to assess if they are going to be a good doc to work with so focus on past relationships and bias with PA's
  11. ventana

    2nd Interview, ED, what attire?

    ALWAYS go with suit and tie to first Second Always go with suit and tie Really are they going to NOT hire you because you oeverdressed? It is trying to get something for the next 2-30 years of your life - it is important to look your best so show you care to put the effort in. Interviews are not to be taken lightly - as well most interviewers are old school (like me) and business casual is likely a negative. The above applies to newer PA's - I think as you age and define your position, skill set, and marketability it is less important and maybe it becomes variable - however I felt very awkward recently when I attended a "discussion" that ended up being an interview and I was in business casual...
  12. quick call to your state insurance commissioner by the patient will likely get it resolved in rapid fashion.....
  13. take to the MRI department head and demand to know why they performed and exam with out a providers order yep that is illegal they should in fact report this to the state as an event.... then tell the patient that if they do not remove the charges immediately that they should contact the local paper and have them write a story on it....
  14. I am looking to find out about where to find grants? I work in corrections and interested in starting and Transitional clinic in the community to provide PCP services (or self fund hiring at a local established clinic with grant money) to recently released inmates (State and local) They would only be on my panel for a Max of 90 days till they got into a full PCP office. Anyone have ideas where to find out about this for grants?
  15. But after just under two decades in medicine I know with out a doubt I am an internal medicine guy. No need for matching into other specialties. Just IM for me. Maybe FP so I could go rural but that is it. I saw 1 to 2 years Total, give me 8 to 10 months of the stuff I need to pass step 1 then the remaining as a fast track residency. Okay maybe e years total. 1 academic, 2 residency. Done. But honestly 3 years is almost a 1/2 million in lost salary and bennies and then 150k min in school loans and I would still decline it. Okay so about that terminal doctorate with independent practice.....
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