TWR

When I graduated in 1986 NYC, pay was $25,000 in FM.

Son of a friend, an adopted 26 y/o dx with aortic valve regurgitation. surgery coming next month. Choice of Pig valve replacement with Coumadin for life or mechanical valve replacement good for 10 years. What would you recommend for an active 26 y/o ??? Thanks

I got my TX license 15 years ago and although a large pain was nothing like KMorg is describing! Why doesn't TAPA address this issue with the board??? It looks like they don't want PA's in TX!! Do the NP's have to jump through hoops like PA's? Who elects or appoints the TX medical board? Is it a paid position?

I graduated in 1986 from CUNY (City University of NY). The experience was wonderful and absolutely prepared me for my 32 year career in Family Medicine. The didactic classes were taught by physicians from Columbia University Medical School and were great teachers and very supportive of our profession. I did all of my 2nd rotations at Harlem hospital and lived there in the nurses dorm for 1 year. The only rotation I did off site was family medicine at an office on Long Island. I wanted to be exposed to as much clinical medicine and surgery as I could. I saw every disease from A to Z and actively participated in all patient care. My decision to do all rotations at Harlem hospital prepared me for my career in Family medicine in medically under served areas where physicians did not want to practice for reasons IMO, included personal safety and the all mighty $$. Me, I loved it. I was treated with respect and I was able to utilize what I had learned. Thank you Harlem Hospital PA program.

Back to the original question. I can no longer recommend being a PA to anyone. Corporate medicine is taking over all of medicine. The CEO of LIJ/NSH made 9 million last year!! HMMM maybe they do know more than those that practice it! There will be plenty of jobs for PA's and you will be told when to turn right or left, up or down. Autonomy will definitely be gone. Even physicians see the handwriting on the wall and who pays for all this nonsense in the end are the patients.My first years of practice in Family medicine in Queens, NY from 1986-2004 were the absolute best years of my life in medicine. I was treated with respect by physicians and 2 hospitals. From 2004-present absolutely down hill on a slow but steady decline (in Houston the past 14 years).

Rev, I would be forever unemployed and blacklisted if I came at any employer they way you suggest. It just isn't realistic in the real world basing my opinion on 32 years experience in FP. As en emploer if some PA came at me with this is what I will and will not do or have done, I would politely get up and hold the door so it didn't hit them where the good lord split him! There are a lot of PA's out there looking for jobs. Just my opinion based on life experiences as an employer in NYC and an employee in Texas.

"Free" is for tuition only. Associated costs like books, eating and a place to sleep are not included so be prepared to kick in an easy $25-$35K a year and no income for 4 years.

Weezianna, Look in a mirror and picture prison scrubs!! A lot of the above responses are excellent . Start your paper trail today and get the hell out of that job. You might even want to speak to an attorney. How long have you been practicing?

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Joel, 401 match of up to 7%??? You must be young and don't realize how much money that could be when you retire not to mention 4 day work week. Put crazy glue on your but and stay there!!

After a rocky start, the Trump administration has gotten on board with addiction medications, which also include methadone and naltrexone. The nation’s top health official, the Health and Human Services secretary, Alex Azar, said recently that trying to recover without them is “like trying to treat an infection without antibiotics.” Last year, Congress temporarily began allowing nurse practitioners and physician assistants to prescribe buprenorphine if they go through extra training, and more than 7,000 have gotten licensed; a bill that passed the House on Friday would let them prescribe it permanently. Still, half the counties in the United States don’t have a single buprenorphine prescriber. You have 4 free articles remaining. Subscribe to The Times [The Trump appointee overseeing addiction treatment says “we have a lot of work to do” to get more doctors comfortable with prescribing addiction medication. Read an interview with her.]

I read an article about opiod addiction and Bupenorphine that helps patients with opiod addiction. PA's are being allowed to do these injections. How can we qualify?

American Family Physician I subscribe and get CME every 2 weeks. They have a great list of patient handouts for various FP topics.

I think some form of therapy is a good idea several mentioned in above posts most I never heard of. After 32 years of practice in Family Medicine MOST evenings/nights I review in my head what I did during the day. That is normal (I hope). No one prepares us for the fact that people put their lives in our hands, same for docs. I think the anxiety thing is more common in the young PA's. Need life experience in everything to take the edge off the anxiety. It should get better as time goes on. ED medicine is stressful just by the nature of the first word "Emergency". All the above is my personal opinion.