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Evan

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  1. I did heme/onc right out of school and it was a good experience but I have to agree that you need to have a good relationship with your SP. Make sure up front (in your contract) what your role will be. I spent waaay too much time babysitting the infusion room and not enough time seeing patients. It is rewarding in its way. Despite what some would have you believe there are cancers out there that can be "cured". For the stage 4 folks with poor prognoses quality of life is a BIG deal and a good oncology team can make a HUGE difference. In many cases cancer is becoming a set of chronic diseases, much like DM2 or COPD. (In a few cases, DM has a worse prognosis.) So, in our setting, we became the patients' primary care provider. With the addition of chemo and new comorbidities to the patients' (often long) problem list, it just made sense in a lot of cases. It did make us quite busy and sucked every bit of extra time out of the day (would have gone better if they'd have cut me loose on some of this stuff). Good Luck! Evan
  2. Evan

    HippoPA

    Hello! Question for some of you guys, like Iain... How do you like the Hippopa.com review? I just got approval from my supervisor (so I can get reimbursed the $500) but before I take the plunge I just wanted a little validation. Thanks! Evan
  3. Agree... I have to field the "so when will YOU be a real doctor?" question already 2-4 times per week. If the title changes we have to agree on something to which we can transition easily. Physician Associate has the benefit of getting rid of the word "assistant" (which I like), of being less offensive to certain egos (Like the OP above), AND maintains the initials "PA" (which will make our transition to the new title quicker/easier)...
  4. There is a derm office to which we refer on a pretty regular basis. They have a couple of PAs over there and both have their own "Pt list"... In fact, many of our patients that are going over for more routine things (AK, rash, etc) have never seen the SP... I hear very few complaints about their office, staff, or procedures so I figure that must be working pretty well...
  5. Don't forget about malpractice (with tail coverage) and the schedule (you want this in writing for sure). As for salary: you know the guys you work with and they know you. Presuming they want to keep you around they know that money talks... It won't offend to ask for more... In fact now is a good time to bring up pay. It needs to be in the contract and should be discussed out in the open... Going to a lawyer (IMHO) is like going to the ER... if it crosses your mind, it's time to go...
  6. Early on in my medical career, pre-pa days, I had a part time gig where I had been a student and where the manager had "promised" to consider me for a full time position. Long story short, 2 full time opportunities came and went to others. I was (IMHO) justifiably upset. I met with the manager and he, once again, promised to consider me the next time a position came around. He was not really able to give me good feedback and couldn't (or wouldn't) tell me areas to improve. I needed the cash and I was volunteering for every extra shift that came along. Essentially I was working full time hours without the benefits or stable schedule of an actual full time gig. When I mentioned this to a friend (mentor) he suggested that I was being used for my (decent) skills and agreeable (flexable) attitude. If they offered me a full time position they couldn't use me to fill hard-to-staff shifts (nights, weekends, holidays, unexpected call-offs). I made the decision at that point to move on. Sometimes it is better to start fresh in a place that didn't know you as a student or as a "new grad". Even in this economy there are still jobs out there to be had. Don't limit yourself, you may actually like another facility or group better than your current gig. Just my 0.02... Good Luck...
  7. Wait till you get hired. The DEA is expensive... I just set up my license for Az, my new SP is a DO and it does not appear that there is any difference down there...
  8. I had an encounter that was quite similar a few months back. The pt with cancer came in with her husband. She was quite ill, on chemo, cancer progressing. Husband kept trying to move our discussion over to his extensive history of low back pain and how hard it was for him to take care of his wife. After a few minutes his wife just got quiet and was letting him do all the talking. It was all I could do NOT to tell him to shut up and let her speak/answer a question or 2... Some family members just feel left out when they aren't the sick one...
  9. Long ago on my first RT clinical day I watched as my instructor suctioned a gallon of thick, yellow secretion out of a pt's lungs and I remember my stomach flopping over... I didn't vomit but damn, it was a close one... Never happened again though and I've certainly been closer to the action not to mention seeing and smelling things that were much worse... A co-worker and I were intubating a pt on the post-op ward and were both sprayed with vomit: it didn't phase either one of us... The pulmonologist on call recommended buring our scrubs after that one... I think it's just something you eventually get used to...
  10. Hmmm... a good set of oral and nasal airways w/ a bag/valve mask... maybe not for hiking but good to have following the zombie apocolypse... Did anyone mention antiseptic of some kind for cleaning potentially reusable supplies (like the BVM)? In a disaster the one-to-a-customer rule might go out the window in a hurry...
  11. A similar situation occured in my clinic just a little while ago and I posted a thread about it here... I was pretty bent out of shape about it for a bit (as a few of you will recall). No one had pulled anything like that in quite some time around here and I think that was the main reason it bothered me so much... I thought I'd put that issue to bed long ago... Well, here it came back again... My point is, I suppose, that some people won't be happy no matter what. The fact is: there are more and more PAs out there treating patients. Eventually even the most subborn patient will have be seen by a PA if they want timely, affordable, competant medical care... I'm trying to remind myself of that for when (not if) this situation arises again so I can be more like the duck and just let it go...
  12. Also in the FWIW collumn: I can totally see why a PA would "move on" to medical school... for a lot of reasons that many above have stated: Including greater respect for one's work, increased scope of practice, and increased depth of medical training. These are good reasons to pursue a medical degree (MD or DO). Certainly $$$ is NOT king in this instance and if one's choices are not limited by economic concerns a bridge program would be a good option. It would be great to have a group of SPs out there that were once where we are now... So, No, I don't think that PAs moving on to become doctors is bad for the profession.
  13. The thing is... Independance is not what the upper echelons of the NP profession are shooting for. They're after equality with the MD/DOs... If that happens it would be a simple matter (at least on paper) for an NP to supervise a PA... However... I see a lot of associated "what ifs?" here... Although I do like to mention NP supervision of PAs every once in a while to rattle someone's cage I think there are plenty of other, more real concerns for our profession to think about. If this issue is truely getting under the skin of a pre-PA (you know who you are!) then you should seriously consider (and reconsider) your future career path...
  14. The problem I have is with the institution giving different levels of care based on socioeconomic status,fame, skin color, or whatever. I'm not talking about a few extra square feet of room space or nicer artwork on the walls or a better quality of carpet on the floor. I'm talking about giving folks better medicine, fewer RNs per pt, faster access to scans/procedures/etc, or bumping someone to the head of the line because they are on the preferred insurance network... What you do for one patient, you do for all patients. No matter if it is the lowliest homeless guy to a member of the hospital board to the president of the United States... Everybody gets the same level of competant care! But, no, the quality of the window treatments is the least of my concern... Doulas in L&D? That's a whole other discussion... In my experience they just get in the way of real healthcare providers so no I don't think they should be in there at all... but we can talk about that another time...
  15. PA school (anywhere) is no walk in the park. IMHO when you put a group of people who have an intense desire to succeed (like your average PA student) into a pressure-cooker environment (like a typical PA school) you may get a pretty volitile mixture... Hang in there. Keep your head down (low profile is good, posting caustic messages on a public forum may not be the smartest idea... just sayin'...), study heard, and, most of all, don't get caught up in the petty sniping that you are describing... Certainly stay away from those who may be cheating, there's no need to be guilty by association... I'll second those who have already posted that your education is about you... not about the guy 3 seats down who's sleeping through today's IM lecture. I hope this doesn't come off as harsh, Good Luck.
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