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just_nelle

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About just_nelle

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  1. Rev - no this policy was not in place when I began this position 3 years ago. It was enacted shortly thereafter, but I was not aware of it until recently. Cideous - luckily no, not having to pay anything back. Yikes I can't even imagine that. I think I will finish these two cases, have the compensation directed through the university into a departmental account earmarked for professional development and use it towards doctoral program costs over when I embark upon that next year. Thanks for all of the insight!
  2. Update: my division chair just sent me the SOM's policy on this and it very clearly spells out that no monies can be paid directly to me and must be paid to the institution. From there, I can use the monies for: 1) support of departmental missions of teaching, research, and patient care 2) professional development such as conference travel or research support 3) support of the faculty member's base compensation (i.e. I cannot give myself a raise or be paid extra) If I do legal consulting and do not have compensation sent to the university I am subject to disciplinary action. I am in a tough position because I am currently involved in two cases. I don't want to abruptly stop consulting and come across flaky, but at the same time, I don't want to essentially work for free. My department chair gave me the name of the SOM attorney should I have any questions. I will likely reach out to her to discuss. Otherwise, I guess my two options are: 1) Abruptly stop in in the middle of these cases. 2) Continue to consult but begin using institutional time and resources (i.e. doing case prep/calls during business hours, from my university office, etc.) Any other thoughts? Appreciate the comments so far!
  3. Can we revive this thread after 6 or so years? For those of you who do expert witnessing (i.e. reviewing and providing expert insight on a case that you are not involved in) and are employed by a large health care system (or better yet are faculty at a university) would you mind sharing how your compensation is handled? I ask because although I have been serving as an expert witness for various cases for years, I was recently notified by my primary employer (where I am on faculty) that all compensation received for this work must be paid directly to my institution and can be used for professional development activities. This does not seem right. Side note: I only do case prep, calls, and depositions on my own time, without utilization of institutional resources. Curious to hear what others have to say/if they have encountered similar situations.
  4. We have a couple OB/Gyn PAs at UNC-Chapel Hill and UNC-Hillsborough. It is sort of an NP-dominated and CNM-dominated specialty in NC but there are some opportunities for sure!
  5. Looks like I was beat to the punch, but LOTS of GEL is your friend in this instance.
  6. Great list! Don't forget Alvarado score when you're consulting the surgeon in the middle of the night for an acute appy...not really a rule, but a helpful decision tool.
  7. I'd vote for PCOM...but I'm an alum :)
  8. Here's a gem from this week. Working in fast track for the first time in months. First patient of the day, triaged with CC: "rib pain" Triage note: 68 healthy male. Left sided lateral rib pain x4 days after bumping into door hinge. Afebrile P: 90 RR: 20 O2: 95% RA Easy enough I thought, until I saw the patient. Turns out he has no past medical history *other than* glioblastoma, last chemo 6 days ago (minor details, right?). He did bump his left ribs against the door hinge 4 days ago and he thought he might have broken a rib. Pain worse with deep breath, mild dyspnea. No extremity pain/swelling. No cardiac or VTE history. My exam: Speaks in full sentences, splinting due to pain, borderline tachy reg rhythm, decreased but clear breath sounds throughout, tender to left lateral chest wall without ecchymosis/crepitus, no LE edema/tenderness. Popped the oximeter on him during my evaluation, HR ranging from 90-105, O2 ranging from 90-96%. I thought to myself, this guy very well might have rib fractures or some atelectasis/PNA from shallow breathing; maybe even small PTX…but I'm more worried about PE. Got him moved to a monitored bed (after some head to head combat with ED resource nurse who didn't want to "waste" the valuable real estate on a "guy with rib fractures"), ordered labs, EKG, CXR, PE CT, passed off to colleague working in monitored area, and got back to tending to my lacs and FOOSHes in fast track. Checked in on the guy at end of shift. Sure enough…saddle embolus. No heart strain on bedside cardiac u/s, bnp and trop nonelevated. Anticoag was initiated, and patient was admitted. One left sided, non displaced rib fx.
  9. Hi Chica - I just sent you a PM. Haven't been on the forum for awhile!!
  10. I'll be attending and I live in Boston. I'd love a PA Forum meet up!! Let me know if you'd like me to scout out venues....
  11. I echo your irritation with the inability to sign the Section 12, just because it is something we deal with multiple times daily in the ED. Same as you said, ventana, sometimes I (and other PA colleagues) don't even bother seeing the patients who need to be sectioned and just let the docs see them...unless they need some sort of other medical workup other than just their psych c/o. Or, it just ends up being me filling out the pink paper and then handing it over to the doc for a signature. But...we can write the order to d/c the Section 12...
  12. Topic related, but not specific to the OP's patient... What do you know/feel about riboflavin (B2) for migraine prophylaxis? I had a patient in the ED the other day very resistant to initiate any sort of migraine prophylaxis. (The classic "I just don't don't like to take medications because they're unnatural"). After episodic symptomatic treatment, I got a neuro consult in the ED (one of the perks of working in a large teaching hospital...specialists at your fingertips woohoo) mostly because this patient had been lost to follow up to neuro despite many ED visits for her migraines. The neuro's rec for this patient with resistance to start a prophylactic med (but not necessarily against a "vitamin supplementation"? Riboflavin 400mg daily. I don't ever really recall learning about this utilization, but I've since stumbled upon a few papers suggesting it is good at decreasing frequency, but not severity of migraines. Minimal side effects, too. Thoughts? Anyone else use this? JMJ??
  13. Also, thanks for taking the time to attend the meeting in Worcester. Represent us well and give us an update, please!
  14. Just sent an email! Fired up about this issue, especially after a long day of hearing from all many of my patients that they were in the ER on a Saturday night for a chronic issue because "I can't get into my PCP for 2 weeks..." clearly we need more recognized PCPs! Thanks for bumping, ventana.
  15. I'm going to one-up you on this one... Patient on my fast track shift tonight. Same as you wrote, but trade the 2 weeks for SIX MONTHS. It's feeling pretty much better. But, I just wanted to make sure nothing was broken, you know.
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