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About hlj25950

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  1. Imposter syndrome is a reality for almost everyone, and if you don’t feel like you’re winging it, then maybe you are too confident? A little fear is a good thing. It helps you to not miss something. You were in a bad environment. Really think about what you want to do. What drew you to ER in the first place? Procedures? Consider interventional rads. Variety? Consider primary care. There are lots of specialties out there. Lots of schedules. You can do this. Medicine can be brutal, and you aren’t a failure. You aren’t broken. The system is. Good luck.
  2. I applied. Made it to the interview. They accepted 4 out of a hundred or so. 25 interviewed. At least one was an internal candidate. I was crushed when I didn’t make it. I’ll try again next year.
  3. Thanks. I’ll start looking for hospital-based positions. Strict hospitalist? Is there another specific field I should look closely at? Most seem to be nocturnist hospitalist jobs around here, and even those are hard to come by. The job market here is rough.
  4. Hey all. I graduated PA school in 2017 and have been working in family medicine. I’ve been trying, to no avail to get into ER since graduation. When I did my ER rotations, my clinical site promised me a job, but that job didn’t happen. Their group was bought out by a new larger corporate group. It seems that every ER in my area is run by these large national companies. All of these companies require at least a year of dedicated ER experience. It seems like the urgent care centers also want at least a year. I’ve seen some postings asking for a minimum of 5 years. I live in Central Florida and the job market here is very tight. I’ve talked to recruiters. I’ve applied to local fellowships. I’ve applied to everything out there. I’m willing to drive a fairly long distance, but I cannot move. I have a child in high school and a child with medical issues that cannot move. My husband is a surgeon with a busy practice (hospital employed). I’ve done courses in ER (bootcamp), POCUS, ACEP, SEMPA. I’m ACLS, PALS certified (I can get ATLS). I’ve networked. I’ve talked to ER docs who tell me they’d hire me, but they aren’t hiring. “Try talking to....”yup, I’ve talked to them. I’m frustrated. Beyond frustrated. I’ve tried and continue to try everything I can think of. I cannot break in. What more can I do? I’m wondering why I went to PA school at all. If I could move, I could get a job. But I can’t. This is what I want to do, and I’m about to give up and open an escape room business or a bakery. I’m only half joking. There isn’t really another specialty I can see myself in. If you are an ER PA in Florida, especially central, and know of anything out there and want to PM me, talk to me, etc., I’d be happy to. I’m willing to basically work for nothing at this point to get experience. I’m open to part time, full time, PRN, etc. I’d work my ass off if given the chance. Thanks for any advice.
  5. I emailed and tweeted my representative in FL. No response yet. She’s not on the committee, but I asked her to speak with members of the committee. I did steal some of the language from a FAPA Facebook post, but felt it was better to have something anyway and they wouldn’t mind.
  6. I will not certify medical necessity for disability or disabled parking permits for most requests, especially things like arthritis which might benefit from exercise and weight loss and parking further away. I will not certify emotional support animals. I do not refer to chiropractors, ever. I will refer to ortho or PT.
  7. https://www.flsenate.gov/Session/Bill/2019/00821/?Tab=BillHistory Bill was passed by the house. Is before the Senate.
  8. As a Florida PA, I’m encouraged by this direction. This bill has been all over commercials, but only for NPs. I’m curious as to what changed to put PAs on the bill as well, but I hope this goes somewhere. It would really be nice to actually be ahead of the curve here. I don’t know if FAPA was involved, and I can see nothing about their involvement. I am ticked that PAs make the bill “less appealing.”
  9. Anything that doesn’t jive with evidence based medicine or chronic pain. Fibromyalgia, chronic Lyme disease, essential oils, 1000 “allergies”, etc? Can I just use reiki and crystals for that? “I know my blood pressure is 160/100 all the time, but I don’t like taking medicine, isn’t there something natural I could take?” I don’t drink. I don’t smoke. I eat a vegetarian fresh diet with no salt. I’m thin. But, like what if I take some more vitamin C? I took the lisinopril for a few weeks and my blood pressure was better, but I just don’t want to take it.” “Are you having side effects when you take it?” “No.” “I recommend you take your lisinopril as prescribed.” “I just don’t like taking medicine.” What the actual f*** do you want from me? I don’t have a magic wand here.
  10. I love being a PA. I didn’t want to be a nurse. I hate our title and stagnant leadership that sits by and does little no nothing to promote our profession. I work in primary care right now (trying to do ER, hopefully soon). I have little interaction with my SPs. Once I am in that room with my white coat on, Im the provider. I’m often called doctor. I always introduce myself as a PA. I had to fight for my job because “they only hire NPs because we have to supervise PAs and sign off on their charts.” I had to find the laws and correct them. I got my job. I have people ask me in the community. “What do you do?” “I’m a PA.” “What is a PA?” [emoji849]”I’m a physician assistant. I diagnose and treat patients. I write prescriptions.” “Huh?” “Kind of like a nurse practitioner.” [emoji362] “Ohhhhhhhhhh!” Which I get is part of the problem, but do I really have time to explain everything in every interaction? The public knows what an NP is. They think I’m a “medical assistant.” Meanwhile commercials are running all the time here about nurse practitioners and independent practice and how wonderful NPs are. We have no effective lobby. We have no effective public education measures. Our title is not reflective of our training, of our practice, of what we are. We are getting demolished.
  11. I was at work on Wednesday, and had a situation come up that caught me off guard. Right now I’m only working part time in an antiquated FM office, biding my time until my hopeful next job comes through (have an offer to start at a new free standing ED, but it’s still under construction...I digress). My current job sucks, but I don’t want to leave without something else in place, and this isn’t really the fault of my office completely. We still write out paper prescriptions as well as are completely on paper charts. I operate pretty autonomously in my office. When I was hired, I had to advocate for myself because they didn’t want “the extra work that comes from a PA vs an NP like signing our charts.” I’m in Florida, by the way, cannot move, and have been trying to get into ER, but it’s been difficult to say the least. In any event, a pharmacy kept calling the office and saying that on December 1st a new law went into effect that all my prescriptions require me to designate my supervising physician and their NPI. To my knowledge, they are not requiring this from NPs. I was busy, and this circled my SPs name and wrote SP by it on all my scripts that day. I came home and have looked for something about this, and couldn’t find anything. On a Facebook group for PA professionals, they have said that all CVS’s are going to require this of PAs starting January 1st. I cannot find much about this requirement, but it really hurts PAs, and seems to be a corporate requirement. This is the only article I could find: https://capanet.org/2018/11/cvs-prescriptions-alert/ As insurance and patient preference often dictates what pharmacy they use, and I don’t have time to urge all of my patients not to use CVS and I cannot e prescribe from my office, I’m stuck. This is making it even harder for me to compete for jobs and to practice as a PA. What is our leadership doing about this? What can I do? I’m a member of AAPA as well as FAPA for all the good it’s doing. We cannot afford to slowly change minds. We need a better lobby. I’m frustrated today.
  12. I meant that there is a political and hiring bias in favor of NPs, not that we aren’t suited for it. I’m in FP right now, and I had to fight this perception all the time.
  13. Very true! It should be based on what is best for you and family. Also, in general, you can probably work during an NP program, and you cannot work during a PA program.
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