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Everything posted by ventana

  1. crud, I am in the wrong profession... how long to get CDL, airbrakes, tanker, hazmat??? (just asking for a friend...)
  2. recruiter/head hunters most only care about how much money they make - how do they make money?? they charge factility > $100 (more likely around $125/hr) and then hire you for $60-80 per hour - then they avoid the taxes expense by making you a 1099. Then they make $50/hour off your labor. Honestly - if you are intersted in locums - get your own med mal and workers comp - then send out your CV to hospitals in your state and undercut the head hunters - - you can bill $90-100 per hour.... recruites lie all the time - you have to get it in writing and be firm. I had on locums that was an occ health clinic about an hour away - first shift was supposed to end at 5pm, 4:59 they are still checking in patients and I am > 8 patients behind..... I spoke with the recruter the next day, told that that in no uncertain terms I was leaving on time next shift unless they want to pay be double overtime. They cried, complained, and generally tried to guilt me into doing extra work (beyond the contract) at the same rate. I swas professional and held firm. Next shift I left on time, all the emoployees were thankful, said they never had someone stand up before and demand to leave. The only one that is going to advocate for you is you - so be firm and getting everything in writing or just say no - and if they want more they pay more. Currently in my area I would think $75-80 as employee or $90 as 1099 is the base pay for highly experenced in the field you are covering (this for PCP
  3. but the flip side is an employer mandating that a provider learn a new professsion is not in my realm either - heck they fired the first shot - remember they can not and should not force you -- no guilt just reality Great if the OP has Admin that will listen - but the fact they are mandating this shows they are just suits looking at cash flow.... both these are very clear issues once you do them - easy answers that I will not go into here also pretty stright forward - need consult from the treating provider, phone call or some type of documentation - we always push this responsibility back on to the patient to do the leg work. I am paid to do the exam not chase loose ends easy these days - A1C <10 if not on insulin just get whom ever is treating to do the non-insulin form, if on insulin and no MASS school bus just get them to fill out, if bus in MASS then need boarded endo to fill out form. Forms are standardized so it is just mandating that they return the completed form. neck circ, OSA simple screening test - I only worry about the obvious cases also very clear by the guidelines - easy - no CPAP - either no medical card or have to retake a sleep test to document no longer OSA requiring CPAP This is correct, I decide, but it only takes a brief phone call with them to get them to "See the light" that the feds mandate that the treating clincian works with me to evalute - A few times I have has some PIA, high on their horse, providers refuse. I simply tell the patient that their treating provider is refusing to talk to me and they should go ask them why..... has worked every single time.... follow the guidelines - in MA it is q 6m exams- just follow the guidelines Employer is responsible for drug testing - guidelines actually clearly state this - is you suspect substance abuse you have to refer for an evalution. This is the easiest one - Feds specifically ban MJ use and medical card. Sorry nope. - I just give them the printed out regulations. game over. It really comes down to a familiarity with the regulations, i.e. s/p cardiac stent needs a neg stress < 6 months after, after CABG you are good for 5 years then needs a stress. A few of my memorable patients old gentleman with likely undx parkinson - fails rhomberg - neuro said he was fine - I did pass him by the regs and he wa able to pass rhomberg a second visit young guy smoked MJ daily - immediate fail middle aged on 6mg klonopin for years - (this was a renewal and had a DOT for many years) immediate fail - I will not go in to the BZD guidelines on a public forum but it is crystal clear) Also patients on MTD are immediate fail - no questions asked MH - tougher - but recent SI or HI - which I had one - is a no go most the issues come up around cardiac stents and cabg and the requirement to do stress tests I follow guidelines and the local cards folks quickly realized they just need to stress them - now they send the paperwork already filled out. Worth gold to reach out to them as you are starting and explain the process. Only "feather in my hat" one was on a gentleman late 50's who had a previous stent - in office he was brady and I got an EKG (nope didn't get paid the $6 for EKG but who cared) it was mostly normal, until you compared to his last one - and there were some really sig changes from prior and he never exercised even a little bit. Cards provider refused to order stress - I refused to certify(and as stated above sent patient back to this cards provider stating I would not certify with out an updated stress) I ended up having a conversation on the phone with said cards provider and they were pissed I was "forcing them to order it" but they did....... + stress, ambulance ride to cath lab, widowmaker re-occulsion of LAD, stented again..... Saved his life. That cards provider now educated themselves about the guidelines and sends me the paperwork on shared patients before I even see them. (not to throw stones but that cards provider was a new grad whom should not have been working with out supervision - as demonstrated by this case and a few others I shared with them.... ) Most patients now bring in the required paperwork and medical exams all done. stress tests, a1c, letters from treating providers, cpap compliance reports are provided by the patient with out asking > 50% of the time now.
  4. I have likely done >4000 DOT/CDL and school bus exams over the past 20 years As SAS says most are easy If you end up doing them this is how i handle the tough ones - I have the PDF link for the current medical guidelines I print out and highlight what the guidelines are, hand to the patient and appologize that I have to fail them (or need more info) but I have to follow the guidelines 99% of this diffuses the situation Rarely I have to actually have to say "are you truly asking me to lie and committ malpractice to pass you?" This corrects almost everyone Then there are a select few that just keep going - I just ask them to leave I have given up getting emotionally vested in these patients - they have created their own health and well being issues, not me. I feel back for failing them but "them be the rules". Back to the OP Just fail the exam - no pass, no exams....
  5. Sure he would. “I am sorry but you have to at least be a nurse for that discount. It is not available to medical assistants”.
  6. https://www.greatwolf.com/heroes https://www.greatwolf.com/heroes Exclusive Offer For Howlin’ Heroes! You keep our communities safe, and we want to say thanks (with a little splash). The Howlin’ Heroes Offer applies to military (active, retired and veteran), fire, emergency medical service personnel, doctors, nurses, 911 dispatchers, police and correctional officers. Need a dream vacation that's perfect for everyone? Save up to 30% on your next getaway. Our indoor water park resorts offer family-friendly fun all across the country. From splashing to relaxing, there's slides and rides for every age and ability - and indoor water park access is always included in your stay. PROMO CODE: HEROES BOOK BY: 3/31/2022 Offer valid at the US Great Wolf Lodge locations listed above, and only on dates listed above. Offer must be mentioned at time of reservation and based on 2021 standard rates. Limited number of rooms available for each date. May not be valid during holiday and blackout periods or combined with any other discount or promotional offers. Discount may vary by date. Must book and stay by dates listed above for offer to apply. Offer based on four guest per room and may be terminated at any time without notice. Must have one individual 21 years of age or older staying in each room. Offer is not redeemable for cash. Exclusively discount to military (active, retired and veteran), fire, emergency medical service personnel, doctors, nurses, 911 dispatchers, police and correctional officers A valid ID must be present at check-in for promotion to apply. The qualified person(s) must be present.
  7. just fail the test...... your SP would also need to be certified
  8. this is an RN certification PA>RN FA you are fine with PA degree - just needs education to the employer
  9. My only thought on the solution Insurance takes away the "facility fee" and revamps the pay for primary care and out patient medicine (not the specialities) The big hospital corps will divest of the physician practices when they loose money The doc's will go back to private practice (hopefully they appreciate the ultimate control that happens when you answer ownly to the patient and their best answers) PA get OTP and can open our own practices easily.... These steps might just make a difference.... but then again the suits will figure out a way to keep the providers under their thumbs somehow..... cause the benjamin rules all.... ($$$$$)
  10. yup sad but true We need to stand with NP and Doc's and take the power back away from the suits. no more "corporate policy" that is acutually practicing medicine.... just unsure how on earth to ever do that
  11. Sounds like a lot to loose and little to gain. Maybe just do emt basic and try it. Prehospital very different.
  12. I looked into these crazy high salaries for travel jobs as a PA. I am NY licensed and would have been easy to do. Yes they were huge dollars but the hours worked was insane. Something like 70-80 hours per week. Figure 1.5 time for > 40 hrs and us close to 100 hours of pay a week. In the case I looked at it figured out to an hourly in the low 70’s and they had made you a 1099. Actually lower hourly then I earn at my regular job. only easy money in health care is executives…. Providers always get abused Best to only do what is right and reasonable cause a corporation (rather hospital, private office, staffing company) is just trying to maximize profit by screwing its staff
  13. I really wonder when a corporate structure will be sued fir bad policy that in fact is practicing medicine with out a license???
  14. First congrats on parenthood!! It is the hardest job you will ever have!! 1) 6 years of doing it and new kid. No worries about dropping it 2)do not be the one to pick up extra shifts. Kids are only little once 3) $1000/month for 10-15 hrs/m is 66-100/hr pay. About what salary is 4) covid has sucked the life out of most jobs in medicine. And increased stress and burn out. In the last 2 months about 4% of the US workforce has quit job per month. That means almost one in ten people have quit their jobs in past two months! Society is burned out!!! Medicine jobs seem to be lagging a bit but they are opening up 5)you have the worst job. Period. Their is no joy in what you describe. You are basically paid 1000/m to do schedule and protect the ER director from the PA complaints so with a new kid and 6 yrs of doing it. And post covid. Time for some change. Yup it might blow up and you get laid off so think before you leap Write pros and cons list. Talk to Sig Other. Maybe talk to boss (but they will screw you if you give them the chance). Most of all figure out what you want.
  15. Your state PA chapter - and donate to them AAPA - yup they are the ONLY one fighting for us in DC SEMPA Beyond that it is a mix - I always like to support those groups that recognize PAs a members and not just affiliate, second class members......
  16. start looking interview find better paying position and if you like current position ask for a raise to stay, or move... tend to only make huge improvements in pay with changing jobs.... BUT DO NOT LET YOUR CURRENT JOB KNOW YOU ARE LOOKING AT ALL TILL IT IS A DONE DEAL
  17. Special Election AAPA is conducting a special election to fill the president-elect vacancy on AAPA’s Board of Directors. In accordance with the AAPA Bylaws, the immediate past president fulfills the duties (but not the office) of president-elect until a new president-elect assumes office. Once elected, the new president-elect will immediately assume office and serve the remainder of the unexpired term before serving subsequent terms as president-elect (beginning July 1, 2022), president, and immediate past president. AAPA encourages all eligible voters to engage and participate in the Special Election. To learn more about the Special Election please visit our FAQs page. Meet the Candidates Choosing who to elect to lead the PA profession is an important decision. Now is your opportunity to get to know the president-elect candidates who want to lead AAPA and the PA profession into the future. Click on each candidate’s webpage to hear from them and learn more about their visions for the future of the profession and their strategies to achieve these goals. Michael Clyde Doll, MPAS, PA-C, DFAAPA Ben D. Johnson, PA-C Folusho E. Ogunfiditimi, DM, MPH, PA-C, DFAAPA How to Vote Voting in the AAPA 2021 Special Election will begin on October 29 at 9 a.m. ET and conclude on November 8 at 5 p.m. ET. Voting will be conducted by an independent third-party election vendor -- YesElections. Eligible voters will receive an individual electronic ballot by email from YesElections at the start of the voting period. To vote in the AAPA 2021 Special Election you must be a Fellow member by October 14. To ensure you receive your individual secure ballot, please verify your Fellow membership before Oct. 14 and that you have your preferred email address listed. If you have any questions regarding AAPA’s 2021 Special Election, please visit aapa.org/elections or contact AAPAelections@aapa.org. AAPA | 2138 Mill Road, Suite 1300, Alexandria VA 22314 | 703.836.2272 Email not displaying properly? View it in your browser.
  18. As I sit here next to the ocean I ponder life. Work. Salary. Benefits. Happiness. I am hopeful the job I have taken which starts in about a month will work. 3.6 day work week. Exceptional bennies and just under 120. should provide some balance for me I how. Time will tell. Honestly it is about the whole package these days meaning I have to be on a team and like the people I work with and be practicing good medicine at the top of my license. Hard to find but thinking I have the unicorn.
  19. Min $300 per hour plus prep time contract for services signed before hand. If not do not testify. I testified in a will dispute. It was a less then enjoyable experience. Will never do it again unless paid up front.
  20. Father has one. Loves it. He is HOH agreed on a Cardiology3 for most is fine.
  21. very true..... have 2 funerals and one wedding coming up
  22. Only thing I am surprised at is they didn’t price it higher. Hep C drugs came out at 130,000!!! our system sucks. what we need to see is what it sells fir in other countries. just only more money grab by large companies (hospitals, pharma, device, imaging, and most other companies in health care are just profit centers, not health care) sad
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