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meaux

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Everything posted by meaux

  1. For what its worth, I have been Emed my entire PA career (5 years) in Seattle, I began in ernest applying for non ER gigs about a year and 1/2 ago. I applied for hospitalist medicine gigs, and actually was offered a couple in decent areas. I also applied for Ortho surg gigs and have recently been offered a position in a smaller town, but was interviewed in larger more desireable to live areas several times, all to no avail. The take away, is that lateral movement is definitely a possibilty, but as EMED and others have said, the more desireable the area, the more likely the competition is going to be equally as staunch.
  2. I scanned through the posts, so if someomne mentioned this forgive me. I dont recall any one here suggesting pseudotumor cerebri though. Neuro consult is the end result, but this Pt's bio,history, HPI soulnd a lot like PTC as well.
  3. I echo EMED and True, I chart as I go so I can get the hell out of the ED when its time. I occassionally will finish chats at home but no more than 4-5, so it doesnt take too long. I definitely bill my group if I stay over b/c of volume, or anything Pt related.
  4. I have seen numerous jobs in Richmond, as well as NoVa, all pretty close to the DC area. Hopefully you have a VA license, and DEA. Good luck
  5. A better Idea of your dismay might include what it is you want to do. I am personally 4 years into the game (all Emed) and still get hit with curve balls. But, I am feeling more comfortable, though not totally. There are definitely others out here who can provide more astute insight. I think being a PA is a lot like being a doc. Learn how to document, and then document again, and learn when to punt. my cherry opinion.
  6. I too was taught OJT. I do them them the same way everyone else here has said. I would like to learn the U/S guided ones for sure, that is serious RVU.
  7. Hello all, I have come across this website, and it is really facinating on several levels. please check it out for your own development. Here are two classes I will be taking. https://www.coursera.org/course/antimicrobial https://www.coursera.org/course/upperlimb Again, this is free, and worthwhile. There are tons of other classes that are not medical, if youre interested. enjoy!
  8. I twisted my ankle 2 weeks ago, and have been walking, and even running on it, but it still hurts.
  9. You should definitely get another state/s license. You have to figure that those applying for the same job have a state license or it is in the works. I know from 1st hand experience that applying w/o a license is recipe for not getting the job. I currently am licensed in 3 states, and It is not an issue.
  10. I see this was originally posted 1 mo. ago. However, I too work in an HCA hosp in the ED in VA. we can order and prescribe sch 2. Perhaps the difference is, I am actually an EMcare employee? For what it is worth, the administration at my particular hosp. is not very impressive.
  11. I didn't read all the comments, so forgive me if this has already been said. Im pretty sure the (18D) course is still the same, but when I went through, the PJs and Navy folk fresh out of BUDS did the 1st half of the program, and the IDCs SEAL guys stuck around for SFMS. I have heard the the PJs are now required to complete the entire 12 mos. I agree this program should be a little more open in who allowed to apply, but it is also a good start. Of note, I felt the 18D course was pretty grueling (mentally) then I went to PA school. No comparison in my opinion. PA school is much harder, but I owe most of my success to the 18D course.
  12. I imagine with your years experience this could be less than desirable. I feel this position will allow me some better exposure for a couple of years, putting me at the 5 yrs Emed mark. I am currently in VA, and the PAs when working the main ED see high acuity Pts with little oversight, and though this has been a great learning opportunity I feel getting back to Seattle is a better option. So I will present all of my Pts to the Doc and hopefully continue to learn. I will reevaluate at the 2 yr mark or there abouts. Perhaps after 5 yrs all ER medicine I will feel more comfortable in a rural ER.
  13. In my limited experience with CO I feel it is PA friendly enough, but the pay is pretty awful when you compare it to other states. Case in point, I was offered a hospitalist PA position salaried at $79K, standard benefits. CO is not the cheapest place to live either. I was also offered a hospitalist gig in VA, (Fredericksburg, which is a bit Mayberryish) but close to DC and Richmond at 91K, better benefits. There are countless factors that go into a state and the question, Is whatever state PA friendly" needs to specified to exactly what is you want or dont want to do. I can say that the licensing process for CO is painfully slow when compared to other states Ive been licensed in (WA, VA) I feel the bottom line is where you want to live and practice. If it s CO, there are jobs for sure. They just dont as much as other places, but you do get to live in an awesome state.
  14. I will be working in one soon, to reiterate what most have said we accept EMS, minus STEMI's stroke, trauma. Our particular model has 24 hr MD coverage at 3 eight hr shifts, and 3 PA/NPs that provide coverage spanning from 08:00-01:00. three different shifts. It is essentially mid-level run as all the PAs/NPs see the patients, and then report to the Doc. The Doc agrees with your plan or not and you move on. As well the Doc always sees the Pt so as to boost the 85% medicare reimbursement to 100%. We too have lab, U/S, CT, Xray. We have about a 10% admit rate. The current model we have set up has caught the attention of many other free standing EDs.Our press ganey scores are always high, thus the cash flow is coming in. There is no "fast track" per se, but anyone who has spent even 1 day in the ER knows that 90% of ED patients dont belong in the ED to begin with. The Pt load is on a rotational basis. So If its your turn to see a pt, then thats what you get. The group I will be working for is contracted through Swedish, and runs three different free standing EDs on the east side (WA state, Issaquah, Redmond, Mill Creek) I have worked at another one, it was brand new, and once word on the street got out we were soon over whelmed with Pt load. This was the group's fault for poor staffing. All in all I feel a free standing ED is a decent place to work Emed as long as youre not chomping at the bit to see trauma.
  15. Samll world FBIDoc, as I too relocated from WA state to VA for higher pay. Im currently in the ED in Northern VA. There are plenty of jobs in VA and my scope of practice is pretty remarkable. However, I am in a pretty small town and three isnt too much to do, but; I can drive N and hit DC in about an hour or S and be in Richmond (tons of jobs there btw)
  16. Hello all, I'm in the hunt for a new position and am curious to hear from others who have made a switch. I have been in the ED for past 3 years (ever since graduating), and even though my current position is much better than my last, I dont know how much more I want to work in the ED. I am looking into hospitalist medicine, and trauma/surg ( i have interviewed for both). Outside if interviewing I would like to hear other opinions on making myself more marketable outside of the ED. I realize there is always a fellowship should I apply, and better yet get accepted. What other ways do you think are possible? I think every year that passes it will become harder to get a different position. I welcome all opinions.
  17. Hello all, I'm in the hunt for a new position and am curious to hear from others who have made a switch. I have been in the ED for past 3 years (ever since graduating), and even though my current position is much better than my last, I dont know how much more I want to work in the ED. I am looking into hospitalist medicine, and trauma/surg ( i have interviewed for both). Outside if interviewing I would like to hear other opinions on making myself more marketable outside of the ED. I realize there is always a fellowship should I apply, and better yet get accepted. What other ways do you think are possible? I think every year that passes it will become harder to get a different position. I welcome all opinions.
  18. In the end I went to a lesser known PA program b/c of the tuition. I had rotations with students from the "ranked" schools, and Ill be honest, I wasnt really impressed. 10 years from now you'll wish you had less debt should you choose the more $ program, I promise you that.
  19. I went to PA school out of state, as did at least 1/4 of my class. We all moved back to our home states, no one had a problem getting a job at all.
  20. PM fuma102, Im positive he can give you great advise regarding your offer.
  21. Congrats on starting your new gig. Here is my advise to you, no offense. I would be extremely cautious working 5 days in a row, let alone 6! 3 in a row in the ED is plenty. Again just my opinion, but Ive been solely in the ED for nearly 3 years now.
  22. Im not sure about others but this is the way it worked for me. By the way ea state has their own regulation on what is considered OT. some states it is considered >8 hrs/day other >40 hrs/wk. In the last state I worked it was 40 hrs a wk. work was considered to be Sun-Sat. We were pretty short staffed for a period of 4 mos. 4 12 hour shifts x 7 days = 28 shifts with 4 FT PAs and 1 PT. you can do the math there. Quality of life went down, but the bank acct went North. If I was there just finishing up documentation and ran +/- 30min over I didnt worry about it because I wouldnt worry if I left a little early on another shift should it be the case. Im in VA now and its still the same as WA, all OT is time 1/2 and I would be leary if the hiring group didnt consider this to be the case, otherwise you might as well be salary, no?
  23. It means you owe NCCPA $ for certification. You have 2 years to complete 100 CME hrs. 50 cat I 50 Cat II. If you read it closely you'll see that will give you a discount if you complete these CMEs before a certain time frame.
  24. Here is some food for thought. My wife and I recently relocated across the country, literally from Seattle, WA to VA. I was given a 5K relocation bonus. We moved our household goods, and shipped 1 car. Granted this money helped, but it did not cover the entire cost. I dont know the mileage you are required to cover, but it is all relative; the further the more expensive and the reciprocal. I would look into Pack-rat, it is like PODs, but in our case $900 less expensive for the same exact service. U-haul long distance is a huge rip-off IMHO. Also, unless this company has their own auto shipper, do not use a middle man for shipping your car, again, it is far more expensive if you do it that way. Seeing as they will not provide you with a lump sum, I guess it will be tacked on to your 1st paycheck? Know that this will be taxed a shload, and also know all of your moving expenses are tax deductible, so this will help when Unkie Sugar comes collecting. Finally, make sure both this new company and you have all your ducks in a row, and credentialing will happen when they say it is supposed to happen, otherwise you will be delayed in working = waiting for money. This was a bit long winded, sorry. Please feel free to PM if you have any specific questions about moving etc. Best of luck
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