ventana

lawyer up

not really related, palliative care is not hospice care I do agree that this will open up more jobs for PA in Hospice thought

maybe just take terminal leave and not actually "work" the last week if not just renew - and then get some other job or volunteer or better yet - ask your employer to pay for the license.....

what is the numbers behid this offer? it is still a full time work position I would say it depends on the life you want to lead and what the pay is. Palliate care is a sort of warm fuzzy field but you really need to know your medicine and have great family skills

I have not worked for the VA but get my care there and have tried for 15 years to get hired there. They are one interesting backwards agency This is how I would handle it 1) write a formal request for opinion to your medical director - get them on record with a medical opinion 2) if they say it is against policy - simply stop doing it. State that your director has said you are to no fill them 3) If this other doc tries to force you refer them to your director 4) if they director then changes stance I would then state that you are not comfortable with it and that you have a responsibility to protect your own license. Offer to take a drive to the clinic a few times a week - in a government vehicle, on the clock, to meet with the patients before refilling. You are showing a willingness to help, not being a D*** and trying to help the team - while not allowing yourself to be bossed around 5) if the above does not work and the director tells you to do it..... (and I would mention you need to also be consulting you SP as that is the person likely responsible for your script and in fact might even overrule the medical director as it is the practice of medicine) Well then i would look at the regulatory bodies - but this is sort of scorched earth policy and you are likely going to be fired and black balled... A thought - have you just picked up the phone and called the offending doc and told them you will no refill these scripts? and why? sometimes facing it head on helps (but have a witness as the doc might pull out the Doc v PA card and sink you) As a final thing - yes i have refilled (on comfortably so) high dose scripts for when a doc was on vacation (for a week or so, no a month!) and it is indeed common practice in my area. So be careful as there are more land mines out there Finally - how old are you, how many years in practice, and how long at VA? (no need to answer specifics but these might influence how you are treated) ie young, new hire you might not have much to stand on in their eyes, versus crusty old been around the block, been at the VA for 20+ years and have a solid reputation..... and finally - going outside the chain of command might be necessary, but might end your career at the VA - same for involving regulatory agencies (and that is a step you only take in dire situations cause you would not want it done to you) The other doc might just need remediation....

humm maybe I should get this on my card (oops I don't have any cards) to compete with the nursing lobby ventana, AS, BA, MS, MBA, PA-C, DFAAPA, FO2, Revered Son, awesome husband, Assistant professor of life, generally good dude.....

my jobs in order and how many hours worked 2002-07 M-F 8-5 with one day off and 2 Sat(4 hours per day) pay was okay for the time 2007-08 Radiology 7:0-4 M-F better pay and hours, by to much radiation 2009- Er med - crazy shifts, not great er - sometimes 16+ hour days, 32-60 hours per week, lots of overnights and weekends great pay, awful schedule and work place 2010-2012 IM office based urgent care - three 10 hour days - worked my ars off, 30 patients a day, and got paid less then 1/3 of collections - I left 2012-2016 practice owner - house called - 35-60 hours per week at 80-105k per year 2014-now - 20 hours (over 3 days) clinical commitment, always on call, IM, highest paying position I have ever had also have a per diem that pays under $100/hour as an employee that I will make about 15-20k at this year So early on , not great, lots of work and little pay, but now, honestly I feel I am paid fairly and my schedule it not bad,., A few days a week i am responsible for getting kids to day care (or having a daddy day) and home 2-3 weekends a month - and this is for about 140k/yr so early on it is tough to get a great family work balance job - but I have friends that did it, but as you progress if you keep your ears open you might find something great

careful - one or two missteps might not be worth this, did they just close it, or did they fabricate your note? If it is just closing it might be so they can bill it and this might be more common then you think for the other providers (ie the doc's or practice owners) need to get to the root of the problem and state in NO UNCERTAIN terms that no one but yourself uses your sign on information I would be using strong passwords and changing weekly and monitoring rather this is a common occurrence.... This might not be a battle you want to fight oh yeah and polish up you CV because you are likely going to need it once again let the powers that be know that this was done and should never be repeated - I would write a note to them and keep a copy. As well to the person that did it - make sure that they know to never do it again. (they might have been doing it under orders from their boss) If you really want to throw a hand grenade over the fence and run - put out a mass email to the whole company that states your position Be careful, there is likely more to the story then you know and if you bite the hand that feeds you you might go hungry...

a few thoughts residents at my hospital make 55-70k (not bad) many do only work 40-50 hours per week many weeks (not on wards/ICU) but otherwise pretty reasonable schedule on graduation with IM they are making 200k + over a career they are FAR out earning PA's by many times a new grad PA is nothing like a for knoweldge level a experienced dedicated PA with 10+years the difference is less yes doc's know more (trained longer) but experienced PA's are great HAve to be very careful with the "PA"s don't know enough" logic This logic applied to medicine means only cardiologist should treat HTN, and only ortho should treat a sprained ankle and so on.... Docs deserve to be the top of the pile, but PA are highly valued critical parts of the team (that should be 100% responsible for ourselves.....

get the insurance company to hire a PI and video tape them doing all the things they say they can't

print out some of the reports on white coats being dirty dirty dirty (like worse then toilets) if they are mandating it, they can provide it and they should launder it as well

20 hours per week. 125k per year half time. Just cleared 2000 in two days at my per diem

Know of a PA that gets $120 per hour for corrections. I have per diem job at 90 per hour.

I get 3 hours pay for a weeknight call coverage - never have to go in, but get 1-5 calls at all hours other job i get $100/day for call, and I am on call 345 days a year, typically 1-3 calls per day

please realize that this is what I "think" it should be..... it is not what the current job market it (local IM doc's start at 200 in my area and go up from there, and top of scale for PA in the hospital system is somewhere in the $140k range)) but a PA rate of 80k is insulting...