Jump to content

deborah212

Members
  • Content Count

    207
  • Joined

  • Last visited

Community Reputation

12 Good

About deborah212

  • Rank
    Registered

Profile

  • Profession
    Physician Assistant

Recent Profile Visitors

The recent visitors block is disabled and is not being shown to other users.

  1. Anyone work/ed at One Medical? I interviewed with them several years ago and opted to stay in academic medicine. What's the day-to-day experience like in primary care?
  2. Experienced PA in internal medicine x 9 years. My husband and I are thinking about moving oversees to a country without an established PA role. Is anyone familiar with regulations surrounding PAs being able to practice telemedicine for a US organization from another country? Anecdotal accounts are welcome. Thanks in advance.
  3. Our society is undoubtedly litigious. I try to stay up to date on EBM as much for this as for giving patients the kind of care I'd want for my family. :) The situation as I understood it was hypertensive urgency with no labs as is often the case in EM or primary care on initial visit. I do not believe is is below standard of care to use norvasc in this setting until a clearer picture is formed. By history, physical exam, and ekg, a fair formulation of of their cardiac status can be made. Severe CAD or an EF of 18% has both symptomatic and objective manifestations. From my point of view, that is not the type of patient we are describing.
  4. These same patients are coming into my office with hypertensive urgency/SBPs in the 180s-200s which is why I care about this. I'm fairly certain that amlodipine has been shown not to affect LV function, but will check tomorrow certainly. When I don't know a patient's renal function, I'm reaching for that or labetalol. Most hypertensive patients in primary care don't end up with cardiac imaging either.
  5. I am not aware of amlodipine having negative ionotropic effects as it works peripherally, which is different from 1st generation dihydropyridines like nifedipine. Do you have data on this? The cost without insurance is another issue.
  6. Don't forget that atenolol is metabolized and excreted renally. It's not a good choice for patients with CKD or those who you don't know their renal function. I would think that in the above scenario (HTN urgency in the ED with no PCP follow-up) norvasc would be the safest option.
  7. I wholeheartedly agree with this. I have voiced before my opinion that HCE is not the be and end all to being and excellent PA. When I have participated in hiring, new grad with 10 years of HCE vs no HCE and 2 years of PA experience- choose the one with PA experience. Working as a PA is so different that any prior HCE. That what makes us special. New grad with 10 year of HCE vs no HCE, it depends on the interview. HCE certainly is factored in, just as are references and ability to be a team player.
  8. Any recommendations? I've had friends do PriMed. Anyone been to one by Mayo?
  9. I'm not in CA; rather MA and also in a medical home. 14/day is right on target for me as well. 16 if super busy. Even with these low numbers, I'm charting through lunch at my desk and come in early/leave late/work from home. It would be impossible to see 20-30 in this model because of both the complexity of our population and work generated both during visit and after. For instance, we screen everyone at every visit for depression and domestic violence. If you ask these questions, you have to follow-up on the answers. So an easy UTI visit could/has easily turn into UTI, and I'm also being abused/suicidal/depressed. Hopefully healthcare in the future will compensate based on quality metrics like HgA1c, blood pressure, and ED usage, which is where we strive, as opposed to fee for service.
  10. I agree with work status, outside employment, and noncompete. I'm a bit confused with the malpractice piece as my jobs have always included tail. With prior-acts, is this for your current 8 month employment, or does for the current urgent care job? Did you pay for tail for your prior job? I do think you are far overreaching with the CME. $1500 with 5 days CME is comparable for some full time positions. I think $500 is reasonable for PT/prn. However, if you are looking to become full-time, you should renegotiate this when hired for full time. Agree that required training for work should be covered- ie BLS, ACLS. I can't speak to pay. PAs on the west coast are apparently making a lot more than those on the east coast!
  11. Are you first call on all of these patients? How does that work if you leave the hospital premise?
  12. My max was 12-13 at first job where I didn't admit Cap of 8 when doing daily admissions. (ie discharge and admit to this number) If you're a new PA or this is your first hospitalist medicine job, I hope you're SP is proving you with good support.
  13. Depends on how the service is set up... Are you solo or rounding together with a team? Are you admitting every day on top of your patient load or continuing care for those already admitted the day previous?
  14. AHRQ ePSS: USPTSF recommendations. Enter a patient's age, sex, whether smoker, and sexually active. Get the updated task force screening recommendations with graded level of evidence ACIP IA: Immunization advisor. Enter age, clinic on medical conditions, get suggested immunizations (this one is pretty straightforward)
  15. Boston is a great place to be a PA. There are a fair amount of options and patient population is neat because of the multiple top notch academic medical centers in such a small radius. I know that both Harvard Vanguard and Brigham are hiring in primary care. I've heard good things about HVMA as far as collegial atmosphere between PAs and MDs. The Brigham is the Brigham meaning that there's a mix of academic snobbery AND cutting edge medicine/practice/caring for patients depending on where you are. MGH is more NP centric though they do hire PAs. If you're looking to start working in spring when you move, I'd be applying around now as most primary practices here are affiliated with hospitals (besides HVMA), and it generally takes 3 months to credential even if you aren't going to be practicing inpatient medicine. I always recommend checking indeed.com for PA jobs. I've never found one that wasn't posted there. Welcome to east coast!
×
×
  • Create New...

Important Information

Welcome to the Physician Assistant Forum! This website uses cookies to ensure you get the best experience on our website. Learn More