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donwinder last won the day on September 22 2009

donwinder had the most liked content!


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    Physician Assistant

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  1. I appreciate the responses but I was not asking about a visit with Dave Ramsey. I understand budgeting needs and actions. I am not going to go into greater details but several life events have diverted a large amount of funds, including several major surgeries and lengthy hospitalizations for my son. I am grateful for my higher than average salary that has allowed us to get through all of that. So, my real question was to see about creative options to continue to chip away at loans in addition to what I already pay. I feel it would be a creative way to negotiate my upcoming contract renewal. Has anyone been able to set something up similar to what my post suggested?
  2. I do many peripheral nerve blocks (lateral femoral cutaneous, occipital, auricotemporal, supraorbital, iliioinguinal, iliohypogastric, peroneal, etc), sphenopalatine ganglion blocks, De Quervain's, trigger finger injection, TPI's all over, mainly with ultrasound guidance, Botox for HA and dystonia, all the joints, PRP at any joints outside of facet joints. I can technically do SI joint injections BUT there is a much better auth rate and reimbursement if MD does it. Check on that where you are. Technically not a procedure but we also do SCS/DRG/PNS lead removals at the end of the trial. We are looking into starting stem cell injections and ozone injections. So I continuously review pain medicine to see about other interventions and medications to keep patients improving which ultimately means great things for the clinic if the public and medical community knows you get results and not just hand out pills.
  3. I ran into this article about ozone injections for OA. Looks to have promising results. http://www.clinicalpainadvisor.com/arthritis/intra-articular-ozone-injections-shown-to-be-beneficial-for-knee-oa-pain/article/684149/?DCMP=EMC-CPA_Update_DMD_20170825&cpn=cambia95638&hmSubId=Erc4RB5Wl0E1&hmEmail=3EwM6qFINfqvevRqbSxSiviAWyDGhZct0&NID=1336411636&dl=0&spMailingID=17958328&spUserID=MjA1NzMxMjY2MDAS1&spJobID=1081696380&spReportId=MTA4MTY5NjM4MAS2 -Any experience with this? Does it really help at all? -How does insurance feel about it? We do PRP injections and insurance is useless for that injection. -Is the required equipment expensive? Thanks for any input.
  4. i am coming up on contract negotiations. Most likely I plan on staying. I have been here for 5 years and really like it, mainly because of who I work for/with. Something that would help me progress financially would be paying down student loans. I am already at a high salary and get some bonuses. The only thing I could think of that would improve the money situation would be some sort of loan repayment. Ideally, tax free for me and clinic, money goes directly to loan, lowers principle and overall cost of loan, and I still write off loan interest. I do understand there are some tax codes against this but it is changing. (https://www.congress.gov/bill/115th-congress/house-bill/108/text) I have run into another option through https://studentloangenius.com/. Does anyone have experience with them? Any other creative options to minimize tax implications but still drive money to loans? I would even accept slight decrease in salary for larger amount to loans IF there were also tax benefits.
  5. Everything is negotiable. I worked really hard and long days at the beginning, understanding I was new. But once I was comfortable and producing I renegotiated a 4-day work week. As NJPL1213 mentioned if you paint it in a way that shows productivity won't change shouldn't matter as much in a private practice. Offering seeing 2-3 more patients a day helps. I would also try to negotiate some admin hours if your charting, etc is getting overwhelming. I have a buffer of 20 min before lunch and 20 min end of day to help.
  6. C'mon befriend me on this finally...we are going to be classmates.

    Don Winder

  7. So I received the original email from the Director and then email from Ruth Fry with my confirmation date. Have you received additional emails? I feel like I have bugged them so much, I don't want to keep calling if I'm jumping the gun.

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