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ventana

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Everything posted by ventana

  1. You can bill medicare tax benefits of you elect sub s status general liability coverage , but no different for medical mal. Mine costs me about $500/year. I loose a little money after all said and done but it is better then paying my Med mal out of pocket.
  2. Yes to both in my state Need to have SP at each job pretty much never take PRN job with out malpractice unless you get a lot higher hourly.
  3. funny DOT physical today, states she can't wear a mask due to asthma - course I said "if you asthma is that bad you should not get a DOT" bingo story changed......
  4. I have and MBA and get little value from it I will be getting a DMSc I think that is the one that long term is going to level the playing field and get us independent
  5. just make sure you report it just had a PA apply for a position that is likely going to loose his license as he was not honest with the other state. Second violation showing ZERO integrity means life long loss of license..... (nope we didn't hire him) Beyond that live and learn
  6. It is likely going to change. The &600 bonus payment were not extended. Some People are gready and making more at home then working so they are trying to stay out. I tell them I see no medical issue for them not to work. Even had to do to a friend. goback to work! I did give a note to a clearly severe copd PT. And counseled then to not go out as the disease would likely kill them.
  7. I didn’t miss a single day. I am in a small clinic. Private have seen a few positives as a 6-8 employee practice we are trying but you can only do so much. I likely had covid early feb so a little less apprehension.
  8. and yet a PA can't be hired in a admin roll in the local hospital.... DMSc and professional advancement (independence please)
  9. did it for about a year would have been manageable if I was let out on time, but I was not, so the 12 hr day turned to 14-15 and that was just down right dangerous..... few times I slept in an old gross wing of the hospital.... yuck...
  10. I dislike attorneys most the time. this is not one of them hire an attorney that specializes in docs and nurses in similar situation in your state.
  11. maybe you did, maybe n ot 1:5 is wrong by their data - 20% chance
  12. Guardian has mine, yes occupation specific - in a specialty
  13. This is just simply NOT ready for prime time you can hedge and qualify, but NONE, not one, of the tests have been independently verified. Worse then not having a test is having a bad test As for the Hep C comparison, we really don't know what covid-19 does, that is the issue.... lets not mistake creative marketing for EBM - remember the companies have a vested interest in making you think the test works so you buy it and they make money. That is all this is.... nothing more till they get validated by an independent agency I do agree that we need to study this, and this should be in controlled studies on high exposure groups - ie front line health care workers.... but the IRB needs to be involved, and we can't loose the purity of studies and data just because this is a scary infection - it is more important to have good data..... simply believing something might work or be useful does not make it so (but the company selling the test will try to make you think so)
  14. correct. AB test does NOT confir immunity Hep C AB and HSV come to mind. AB only proves past exposure then don’t forget the test likely is positive for corona virus and not specific to covid-19. It is just a money grab folks. Bad medicine. Don’t endorse it.
  15. a good summary - - - https://www.npr.org/sections/health-shots/2020/05/01/847368012/how-reliable-are-covid-19-tests-depends-which-one-you-mean Lets stop the madness and call a donkey a donkey and not a though bred horse....... Antibody test What it does: Antibody tests identify people who have previously been infected with the coronavirus. They do not show whether a person is currently infected. This is primarily a good way to track the spread of the coronavirus through a population. SHOTS - HEALTH NEWS A Next-Generation Coronavirus Test Raises Hopes And Concerns How it works: This is a blood test. It looks for antibodies to the coronavirus. Your body produces antibodies in response to an infectious agent such as a virus. These antibodies generally arise after four days to more than a week after infection, so they are not used to diagnose current disease. How accurate is it: There are more than 120 antibody tests on the market. The Food and Drug Administration has allowed them to be marketed without FDA authorization, and quality is a great concern. A few tests have voluntarily submitted to extra FDA approval. Other tests are being validated by individual medical labs or university researchers. In general, these tests aren't reliable enough for individuals to act based on the results. And researchers say, even if you were certain you had antibodies to the coronavirus, it's still unknown if that protects you from getting sick again. Still, these tests can provide good information about rates of infection in a community, where errors in an individual result have less impact. How quick is it: These tests generally produce results in a few minutes, based on a drop of blood taken from the finger. Some research labs use a more sophisticated antibody test, called an Elisa (Enzyme-linked immunoassay) that are more accurate but are not as widely available.
  16. Hold on. please look at this he quality of he tests. They stink. not only are you collection money for no reason, you are likely dealing with a test “maybe” with sensitivity and specificity in the low 80% or possibly worse these tests should not be used clinically till we get a handle on them. 20% false positive and false negative is horrible. as for the data. Look at the PI. Google the test. it is the wild Wild West out there for AB testing for covid and we owe our patients better
  17. But what about the fact the tests sensitivity and specificity stink, like in the toilet bad..... Zika also had a direct effect on fetus and i think future preg, so that is relevant. Testing for COVID with a cruddy test for knowledge sake seems unwise (when the knowledge gained is very possibly flawed)
  18. nope, no way your first question assumes that we have a good test (Which we do not) I am no OB but I don't see the utility in testing even if we had a good test (Which we do not) if there is not a direct causal link to the test why bother ordering it? Also, how would it change the clinical management at this time? (disclaimer - I have just about zero OB knowledge other then no ASA and avoid NSAIDS)
  19. LOVE IT Yup - 19 years in, and I still get sleepless nights.... less now then before, and more right now with the COVID issue keeping people out of the ER (and on my patient case) In my tiny 2 provider practice we have had MI, PE and sepsis patients demanding to not go to the ER - and only after we tell them the imminent risk of death from their current medical condition is far worse then the possible risk of exposure to COVID and don't even get me going on the LTC/NH patients whose families have said under no circumstance to transport... sleepless nights....
  20. (Disclaimer here - this is a ranting post) I think it would work I seriously looked at the AA program a few years back and a neighboring state is one that you can work in I just could not wrap my head around ANOTHER degree with more debt and still stuck to the whim of organized medicine PA who has advanced training in anesthesia is the way to go - I have been startled and left feeling defeated when I have gone out and compared RN/NP (Admittedly not CRNA) to the education we PA's get. It is not fair to say we are better educated because i truly don't believe you can draw this comparison due to the total lack of quality education an NP gets. Seriously I have been hiring for a new job in my clinic and 1:10 ratio fo PA:NP and EVERY SINGLE NP applicant did an online course and SHADOWED for a total of a min of 500 hours - some made it all the way to 600 hours. This is not an education or instruction - this is just a formalized observation period. To compare PA to NP is like comparing a Telsa to pedal bike. Both get you down the road, but they are simply not the same (sorry that is my rant for today - and I have worked with some AMAZING NPs - but they have been life long RN's and returned to rigorous programs that FAR exceeded the NP min education standards - and that is NOT what the NP schools are now turning out) Good luck in this - I think it is a winning idea and very very do-able - and yup the nursing lobby will fight politically cause they know they loose on the education side.
  21. NO - not for anyone but the highly experienced provider very hard to read into these conversations, and the loss in info to process due to trying to do things on a screen or over the phone is difficult to overcome New grads needs help, mentoring, back up and you will get none of that on a phone line....
  22. at my nursing home - they said if I disrobe it correctly it can be re-used - this was the very cheap thin yellow gowns that come folder up like 50 to a box I tried for about 2 seconds, realized it was a no-go, tore it off in pieces and never again considered re-use I seriously think that MD/PA/NP need to stand up TOGETHER on this issue and FORCE their employers to provide PPE for all future issues -this time everyone got caught but it should be 100% required to do our jobs.... Many many years of pre-hospital drilled into my head "don't become a victim" and "scene safety" as rules to live by - yet somehow the bean counters didn't get this memo and now demand that we risk our lives and our families lives by not having the correct gear. I honestly believe the back office exec's should have to be a CNA on the COVID floors at least 20's hours a week in till this is done - let them share the risk (which was their own short sighted money driven decisions) Let them get sick and get their family sick......
  23. EMR's are getting better I had my own house call practice and was on practice fusion (Was free at the time) It was okay Benefits - no paper charts - if you price these you might fall over at how expensive the supplies are - seriously a lot of money easy to access - with a computer I could see in anyone's chart any time - makes a difference when you are starting up and doing everything all yourself Scripts are easy - non-controlled - poof off they go integration with the fax machine is nice.... fax machines, phone lines, paper and toner are all expense. after closing (my doc moved and due to dependent status I pretty much gave up finding another one that would not want too much money, or try to micromanage me) I have been able to keep track of all my records with ZERO expense - no disposal fees, no storage fees, any records requests come through and dealt with electronically Negatives - first time loading patients does take more time - don't do shortcuts - get em loaded as it makes a difference in the long run cost - I had a free one, but then had to pay the billers 5.5% - now it seems the EMR companies do the billing and collect about that much. If you are not billing insurance then this might be up for debate with the company - getting a flat rate might be worth while takes computers and wifi - but yo likely have that already So overall - I would find a flat rate EMR that can prescribe. They are slower then paper FOR THE MEDICAL ONLY but the administrative benefits are HUGE and as a new practice you are going to have ZERO extra time - if the EMR does not have a fax server consider getting an online one like UPDOX - again to save time and money in the long run
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