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Joelseff

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Everything posted by Joelseff

  1. Joelseff

    Am I Setting a Good Example...

    You should be fine! Their "THIN MINTS" so they're Fat Free, Carb Free and low Calorie! Eat up...[emoji6][emoji16][emoji16][emoji16] Sent from my SAMSUNG-SM-G891A using Tapatalk
  2. Our place does not pay PAs or NPs to precept and its voluntary. Docs get 300 bucks. I do it so I can influence the next generation of PAs. Sent from my SAMSUNG-SM-G891A using Tapatalk
  3. Joelseff

    Alternative PANRE

    Wow that's reassuring. I did well on the PANRE a couple years ago but I admit it was tough and took a review course. I still have 8 yrs to go but hopefully this alternative shakes out. Sent from my SAMSUNG-SM-G891A using Tapatalk
  4. I used to take work home like 7-10 charts but have found that if I do I spend hella more time trying to finish at home than if I stay after work. Today I was swamped! Messages were crazy (been crazy all week) and I'm covering another provider while he basks in Disneyland with his family lol. I had 11 charts to finish. If I took that home it would probably take me a good 3 hours to finish. I stayed after work and finished all those charts answered all my messages and the one I'm covering's inbox and resulted out all my results and his in under 2 hours. Now I'm home chillin' watching the warriors game and just had a wonderful dinner and cheesecake for dessert [emoji39][emoji513][emoji106][emoji1690] I refuse to take work home. Sent from my SAMSUNG-SM-G891A using Tapatalk
  5. KTVU San Francisco: San Leandro physician's assistant gets 10 years for prescribing opioids. http://www.ktvu.com/news/san-leandro-physician-s-assistant-gets-10-years-for-prescribing-opioids Sent from my SAMSUNG-SM-G891A using Tapatalk
  6. Anyone know anything about Vit K2? I've done some research and it sounds, to me, it's just another Fad magic cure pushed upon our magic pill seeking pts. I have at least 3-5 pts per week that asks me about this and I tell them I don't know much about it but give them my usual answer of "so I cannot recommend it but will look into it." and I have looked into it but there is not much out there on it from reliable sources. The pts apparently are already taking daily supplements of this. I have heard pts say that "they read online" or "heard from a friend (or naturopath or chiro or nurse friend or magic genie whatever) that it is known that deficiencies of K2 are linked to CVD, atherosclerosis, DM etc... Maybe even global warming [emoji848] What I do know or at least from my research is that we are unable to test for levels which leads me to ask then how do we know if we are deficient? Also the daily recommended dose is miniscule. Like 0.01mg/kg. It is found with K1 so any green leafy vegetable or other K rich foods contain it. And since it is miniscule in necessary daily intake, won't a serving of broccoli be enough? I usually don't recommend supplements since I think a bunch of it is overreaction by some researcher or practitioner who has found the "magic source." I do recommend B12 and D etc for those who are ACTUALLY deficient confirmed by serum studies. And I only treat to replete not to have super high levels. Much to the chagrin of my many B12 injection addicts (inherited pts) who swear they still need a B12 shot even though their current level is ">2000" on their labs. [emoji849] And recent studies have shown MVI and most supplementation has no effect on disease or mortality... Anyhoo, just wanted to pick you guys' brains and see if I'm missing something here. Sent from my SAMSUNG-SM-G891A using Tapatalk
  7. Joelseff

    Anti-Vaxxers

    They didn't answer mine either. I find it odd the poster cites "authorities" believe ASD is caused by "environmental and genetic factors" yet in the same paragraph casts a shadow of doubt in an authority (CDC). Sent from my SAMSUNG-SM-G891A using Tapatalk
  8. Joelseff

    Bay Area PA busted...

    I thought the article stated he was in pain mgmt? Edit: nope you're right article didn't mention it. It did mention though that he knowingly prescribed to pts who told him they were selling the meds. Sent from my SAMSUNG-SM-G891A using Tapatalk
  9. Joelseff

    Anti-Vaxxers

    Are these the same or different "authorities" and how do you decide who is ok to listen to? [emoji848] Sent from my SAMSUNG-SM-G891A using Tapatalk
  10. Joelseff

    Bay Area PA busted...

    Actually, I was thinking about this even more. In California, Docs are required to co sign any charts within 7 days where a PA prescribes a schedule II drug. Perhaps the PA didn't submit the gazillion charts to the Doc... [emoji848] Sent from my SAMSUNG-SM-G891A using Tapatalk
  11. Wow this was from a long time ago. Lol. I want to update this and say now I use my NPI to bill etc. My current practice has all APP's bill on our own NPIs Sent from my SAMSUNG-SM-G891A using Tapatalk
  12. AAPA's update on this: https://www.aapa.org/news-central/2018/12/advocacy-partnership-stops-rejection-pa-prescriptions-cvs/ Sent from my SAMSUNG-SM-G891A using Tapatalk
  13. Joelseff

    Bay Area PA busted...

    I bet this guy got AWESOME Press Gainey scores! [emoji16][emoji16][emoji16] Sent from my SAMSUNG-SM-G891A using Tapatalk
  14. Yeah but at least they made the playoffs... My Niners have a terrible Red Zone Offense and are in the cellar of the league [emoji17] Sent from my SAMSUNG-SM-G891A using Tapatalk
  15. Joelseff

    Bay Area PA busted...

    I was going to point that out. I keep telling PAs and Docs that we stand on our own when it really hits the fan. All the doc has to say/prove is he was not around and this was outside of the 5% required chart review and he's off the hook... If the Doc was really "Supervising" though why isn't he on the hook? Sent from my SAMSUNG-SM-G891A using Tapatalk
  16. [emoji15] Sent from my SAMSUNG-SM-G891A using Tapatalk
  17. That's exciting! I wish you the best sounds like a great plan! Sent from my SAMSUNG-SM-G891A using Tapatalk
  18. Most definitely! Sent from my SAMSUNG-SM-G891A using Tapatalk
  19. I wanted to add to my post. Having said what I said, I for one still think PA is a better path for a non physician medical practitioner than NP. Lobby be damned, the training I have vs my NP colleagues (at least those I have met and worked with thus far) was vastly more in depth and it shows. I have made a great career, though still in my first decade of practice and though I wish for a better bridge to MD/DO or a bridge pathway for parity with physicians, I don't regret being a PA. My life unfolded the way it did and PA was the only feasible path for me. So I just wanted to add to my rather gloomy sounding post and the gloomy overall theme of this thread and remind my fellow PAs and those who aspire to be a PA (and I have said this before. Check the record lol) once we get OTP (or independence) and we grow in number the PA lobby will have a stronger presence and offer a BETTER product. Hang in there PAs and PA wannabes! Lots of exciting things in PAdom left to come. Sent from my SAMSUNG-SM-G891A using Tapatalk
  20. Joelseff

    Paroxetine

    All SSRI's by the way can alter sodium levels so use with caution with thiazides and I usually avoid in the setting of SIADH. I usually check BMP q3-6 mos on my MDD pts on SSRI esp elderly Sent from my SAMSUNG-SM-G891A using Tapatalk
  21. Joelseff

    Paroxetine

    I have used it for pts with more activation/anxiety sxs and (anecdotally) have found it to help with depression/GAD pts who are predominantly insomniacs. Treating MDD and starting meds is really a symptom based approach. There is no one size fits all as you know. So while I usually don't start with Paxil I will not rule it out like I wouldn't completely rule out other meds if appropriate. Sent from my SAMSUNG-SM-G891A using Tapatalk
  22. Joelseff

    Christmas gifts for MA

    Just add a cardiac warning disclaimer lol. I did the same thing this year. Starbucks Cards for everyone! Sent from my SAMSUNG-SM-G891A using Tapatalk
  23. I wouldn't say this is "why" they are blowing past us... This is the RESULT of the true reason why they are blowing past us. That reason is, unlike us, they never went under another profession except their own (nursing) which happens to also be one of, if not the most powerful political lobby/union in America. Bloody brilliant move on their part if you ask me. We can tote our "better training" but at the end of the day they hold the cards at the negotiation table. Doctors (who clearly have the best and most thorough training) who have great numbers and are a quite powerful lobby in their own right can't even slow NPs/Nursing down. Sent from my SAMSUNG-SM-G891A using Tapatalk
  24. I just got through reading (and re-reading) and comparing the curricula of LMU, Lynchburg, ATSU (so far the only MS to DMS programs out) and I am still leaning towards LMU. It is the only ony I see that has a clinical focus and as I have expressed before, that's all I'm interested in. In fact.... I downloaded the application. [emoji51] I *just might* do this!.... Might... Sent from my SAMSUNG-SM-G891A using Tapatalk
  25. Well according to their DNP program they charge $921/unit Kaaaa-ching! Sent from my SAMSUNG-SM-G891A using Tapatalk
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