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Joelseff

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Everything posted by Joelseff

  1. I have read many PAs here who have said they have either lost a job to NPs or were not hired/considered for a job due to PA regulatory restrictions. I came across this survey in the huddle (I know I know...) but it's to voice your experience with difficulties in job finding/acquiring because of these antiquated restrictions. https://docs.google.com/forms/d/e/1FAIpQLSfD54mlTN-cNiI_a7L11CZbtcNOOW6YC7qXYJPuPu24IL3Lcg/viewform While I haven't lost a job to any NPs, likely because my state does not grant NP FPAR (yet), I still have seen plenty of misunderstood bias about what we can do and wh
  2. Try locums. And Network, Network, Network! There seems to be a dearth of jobs since covid. Prior to March there were tons of places (in the bay area anyway) that had postings. Now, I only see lots of PRN jobs. I would recommend taking one of these and always accept when called to work. While still always looking for another job. Best wishes! Sent from my SM-G975U using Tapatalk
  3. Well... There's a difference between "asymptomatic" and "pre-symptomatic" if someone is exposed to known covid + person they should be tested. Sent from my SM-G975U using Tapatalk
  4. Yeah I remember the PPI and the Ranitidine hoopla when I worked in GI last year. I always give my pts the choice but I fully go over risks of stopping acid control esp PPI like Barret etc. Esp if my pt has esophageal erosions. It's like the ARB scare a few years ago too. I agree that this may likely be more correlary vs causative as with everything else in medicine, we gotta have the conversation with our pts and ultimately have them decide with our guidance. Sent from my SM-G975U using Tapatalk
  5. I remember this coming out early on and tjoght I read it was debunked or at least found that PPI use in covid pts were not significantly affected... I can try to find the followup article. Edited to add: I take it back! [emoji23] ok... Found a recent one saying that PPI do increase risk of covid 19 by up to 2x as likely while H2RAs carry a 15% less likelihood of infection. It's thought to be from the reduced acidity that promotes more susceptibility to enteric pathogens which SARS-cov2 is. https://www.medscape.com/viewarticle/933645 https://www.medscape.com/viewarticle/933697 Hmmm
  6. [emoji23] Mah bad! It's a tough DX but really true Celiac vs Gluten sensitivity is relatively rare (about 1/100 or 1%) but most of my pts with IBS sxs swear they have celiac despite negative testing. They may have gluten sensitivity so I just suggest elimination diet... Funny most of them after a week or two on the diet no longer have a "gluten sensitivity" and go back to their normal diets [emoji23] (BTW I live in the bay area very near Berkeley where everyone is convinced theyre gluten intolerant) Sent from my SM-G975U using Tapatalk
  7. Pt is asymptomatic... But if pt was symptomatic that's a good point about anemia. If OP is drawing blood add a CBC. The algo for celiac though is usually in symptomatic pts: +TTGA Serology---> DAGL/EMA if positive --->Duodenal TX Bx if pos ---> Dx:Celiac. If the TTGA was low or negative can do HLA testing since 10% can present with Neg TTGA Sent from my SM-G975U using Tapatalk
  8. I was in GI... So if the pt has no sxs I would reassure him. The genetic test (as I'm sure u know) doesn't mean the pt will have it. If he is asymptomatic I would just have him observe. I wouldn't scope him unless he has sxs. If he has GERD hx maybe (and I would use the GERD sxs to justify the EGD only) and do a duodenal bx with the EGD. You can do serologies WHILE THE PT IS CONSUMING GLUTEN (very important) but I would only order this if he is symptomatic or is really wanting to know. Sent from my SM-G975U using Tapatalk
  9. Sorry to here your issues with the Huddle Jamie... But I am not surprised... I stopped posting on there a while back and I remember your posts as constructive and I don't think they should have banned you regardless of your stance unless you were attacking people etc but the huddle has many bullies. By the way I just got this email a few minutes ago! [emoji23] [emoji23] [emoji23] Sent from my SM-G975U using Tapatalk
  10. https://knowledgeplus.nejm.org/products/pain-management-and-opioids-cme/ Here's one good for one hour online for free. I'm sure you can find more. If you have prescriber's letter or UptoDate you should be able to get some hours from there as well. Sent from my SM-G975U using Tapatalk
  11. Happy Corpsman Day to all my fellow Corpsmen! 122yrs today! Corpsman Up! Sent from my SM-G975U using Tapatalk
  12. +1 for Jeremy he's been instrumental here in California. Great guy and great vision. I like Notabartolo's notion to have "parity with" MD/DO in 10 years. Steep hill but gotta give him credit for having balls! U can vote for 2 so Adler and Notabartolo are my 2. Sent from my SM-G975U using Tapatalk
  13. SF is accepted by you guys [emoji23] Sent from my SM-G975U using Tapatalk
  14. Yeah that's what we call it. Outside the city like Oakland Richmond Vallejo etc we would call it "Frisco" Some San Franciscans hated that [emoji23] Sent from my SM-G975U using Tapatalk
  15. True I text it sometimes to save letters [emoji23] but still cringe when I do... Also those of us in the bay area hate when outsiders say "San Fran" immediately tells us you are from out of town and just trying to be cool [emoji23] Sent from my SM-G975U using Tapatalk
  16. Everything right now seems to be scarce because of covid but I've been seeing a lot of jobs in Modesto/Stockton area. Pretty much the dust bowl areas... Hanford, Fresno, etc. Sent from my SM-G975U using Tapatalk
  17. My only qualm about expanding PA to Doc bridge programs is that the product will no longer be a PA but a Doc... If this became the norm or at least a significant number of us did this wouldn't the PA profession be losing members/supporters? I'm not necessarily saying PA to Docs dont support us, I know some do like Prima and others but let's face it, they have more incentive to support docs than PAs... Sent from my SM-G975U using Tapatalk
  18. ATSU just added a clinical track. They were offering 20% off tuition for ATSU Alumni. Hmmmm.... [emoji848][emoji848][emoji848] Sent from my SM-G975U using Tapatalk
  19. I worked at a nonprofit that didn't charge for services and we used paper charts. No superbill and no EMR. EMR implementation (along with meaningful use) was a Trojan horse used by non medical admins and government to destroy the very foundation of our profession (trust and relationship between patient and provider) under the guise of "making our jobs easier..." In actuality it was used to quantify our value in the Healthcare system BY THEIR standards thereby polluting our great profession. It is universally hated by providers [emoji23] and I hope it dies a fiery death soon... Whew had to g
  20. Thanks for explaining that. That makes sense. I can see the panic in a lot of PAs during this time and can see why various groups would start petitions. I for one was inundated with petitions and did think it was rather chaotic... I agree with you that we need to be united in our endeavors that was why I asked why our PA groups (AAPA, PAFT, States etc) were not the ones pushing this. Now, having said that, do you see a united petition some time down the road? Is there consensus in the leadership regarding FPA? Sent from my SM-G975U using Tapatalk
  21. From what I remember it was a very simple thing. They just changed the name... I've brought it up here back then and got a myriad of answers but mostly along the lines of "it's harder for PAs legally because XYZ..." [emoji2369] Sent from my SM-G975U using Tapatalk
  22. I asked some physician colleagues whom I know are pro PA too. Sent from my SM-G975U using Tapatalk
  23. I just did a linked in blast and texted all the PAs I have phone numbers for... Gotta get this one through. It would be huge! I also emailed CAPA and asked them why they aren't promoting this. Sent from my SM-G975U using Tapatalk
  24. I think I signed this like 4 or 5x [emoji23] Now... With all the clamoring I hear from PAs who want independence, why only 15k signatures? Why didn't AAPA or state chapters or even PAFT send this out as a media blast? Sent from my SM-G975U using Tapatalk
  25. So in VA, WV, PA, MD there is a significantly higher rate of PA unemployment or longer job hunting times than in other states vs NPs? Proof please? I mentioned the VA in my post the VA passed a rule to change that and make APP pay the same. It has to go through each clinic though but things move slow in the VA. Sent from my SM-G975U using Tapatalk
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