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About Dobbyrocks

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    Physician Assistant

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  1. My employer has furloughed all providers and asked us to sign a contract amendment to change us from base salary to percentage. Of course, 25% of nothing is.....
  2. Ok I know it’s tough on the frontlines. But last night my corporate office furloughed 260 providers and all support staff. I don’t even know what to think.
  3. You guys know this is hyperbole, right? Medicare reimbursement for cryosurgery of a single AK (17000) is 55.14, each additional lesion is 2.52 (subject to multiple surgical procedure reduction, of course) and 15 or greater AK (17004) reimburses a whopping 102.71. The first tangential (shave) biopsy pays $41.08, each additional biopsy is reimbursed at 23.79, ALL SUBJECT TO MULTIPLE SURGICAL PROCEDURE REDUCTION which cuts reimbursement by 50%, and then of course, as PAs we are reimbursed at 85% of the allowable charge. Complicated, right? And I know it’s not bad money, all in all, for a
  4. Re: forms/prior authorizations, I will usually sign the form and fill in any clinical info I need to contribute, then ask my MAs to fill out the rest. You should realize there may be pushback, especially if you have been doing some of these things yourself. Smile, ask nicely, and expect what you ask to be done.
  5. Has anyone seen this? https://www.policymed.com/2018/07/cms-proposed-evaluation-and-management-e-m-documentation-and-payment-changes-are-sparking-backlash-and-may-hurt-patients.html Under the scenario envisioned for Table 22, rheumatologists would be in for a 3% cut. Allergy/immunology and hematology/oncology practices, along with neurologists, would receive a more minor, less than 3% estimated decrease in overall payment. Nurse practitioners might see a 3% bump, while psychiatrists and physician assistants are among the group that might get a less than 3% increase in overall payment
  6. So.....2-4 months of training and you would essentially be on your own? Nope nope nope. That’s the kind of crap that gives derm PA’s a bad name on the MD boards, and with good reason. Sure, you’ll be able to biopsy lesions and treat acne but do you think you’ll be able to manage blistering disorders or complicated skin cancer patients on your own without direct and easy access to a board certified dermatologist? And don’t think it doesn’t happen...I know a colleague who saw Sweet’s syndrome her first week in practice. Dermatology is a wonderful field but you can’t learn it in 8 weeks. I’ve be
  7. I have been at the same location since my graduation from PA school in 2002. For years it was just me & my doc, but in 2015, my supervising physician retired and sold the practice to a large company. I stayed on, as did most of our patients, but I am growing weary of corporate medicine. I have not worked with another provider in over two years...my current supervising physician is brilliant and approachable but 55 miles away. I have met him once, talk to him on the phone maybe once a month. The company tells me they are “actively recruiting” for our location...whatever that means! I don’t
  8. What is the American Board of Physician Specialties? Is this a legitimate medical board? Are these physicians trained through a proper residency? Dori Hite MPAS, PA-C
  9. Ok, after 13 years my boss is retiring and selling his practice. He has not disclosed to me who he is selling too (although I have a pretty good idea...my medical assistants could be CSI agents). He tells me I will meet with the new group sometime in March. Here's the rub...my current contract has a non compete AND an assignment clause which means my non compete goes right along to whoever buys us out. This may be no problem if I like the guys but a SERIOUS problem if I don't. I went to my boss and asked him to sign a release (drawn up by my attorney) stating essentially the non compete wo
  10. I was out of town once on vacation and on a Sunday morning woke up with a raging UTI. I walked in to the Walgreens pharmacy across the street from my hotel, found the pharmacist and told her the problem. She let me write myself a 4 day supply of Cipro...enough to get me home. The pharmacist was really nice about it. I just gave her my prescribing #, she looked me up in their system, and I used one of their in house RX pads. She filled it right away while I waited. Oh, and I charted it all when I got back to the office :)
  11. Anyone ever work for a practice that was sold? All signs indicate that my SP is considering selling, including the unannounced addition of an assignment clause in my employment contract (which I have not yet signed). Neither the boss or his wife (yes...wife) have mentioned anything to me or any of the other staff members but it's pretty apparent that change is afoot. Anyone else worked for a practice that sold or been in any similar situation? I'm looking for guidance as I navigate these very murky waters.... Thanks!
  12. I have been at the same practice for 10 years so I seem to get less and less of this (thank goodness). I usually will say something like "I'm sorry if there was a misunderstanding, but you were on my schedule today. I'd be happy to get started with you now or you can wait to see the doctor." That's it. If they say they'll wait, then I make sure they do (wait, that is. In our office we probably wouldn't reschedule them but you can bet they'll be cooling their heals in that exam room for quite some time before I get a chance to let my SP know that they only want to see him). I used to t
  13. Over the years, I have become less sympathetic (meaning, less likely to offer reduced prices) to patients without insurance and MORE likely to reduce my fees to patients with insurance that carry a high deductable. So often THESE patients are paying huge costs out of pocket just to have insurance, then turn around and have to pay again when they receive medical services. On the other hand, patients with out insurance at all have no initial out of pocket costs. I realize not every one can get insurance (maybe turned down due to pre-existing condition) but I see just as many driving a nice ca
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