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Everything posted by quietmedic

  1. Hi all. In short, a medical situation has me mostly stuck around the house for the time being, and, to be honest, I was already very much burning out of clinical practice in my field. I've been scouring online for alternative/remote opportunities, but keep hitting brick walls. As I've been a decent editor/writer, that was my first avenue of inquiry. Medical and technical writing seems to be just what the doctor ordered, but thus far, every opportunity demands, at minimum, 3-5 years of "professional regulatory submission/writing experience," "Years of proven expertise in AMA and AP style and journal submission," "Mandatory PhD/Doctoral degree," or, more often than not, all three of the above. Jobs in content creation for medical sites have similar demands, or are entirely unpaid. Of course, how do you get 5 years of regulatory experience when nobody will hire you with less...? General medical editing/review jobs are nearly all in-house and, again, demand years of professional journalism or editing experience backed by large portfolios....an advanced medical degree only seems incidental. Insurance peer to peer/review and jobs are also either on-site only or demanding years of experience (or only open to MD/DO). Teaching jobs are not a good fit due to my medical situation, and, it seems, despite being within communting distance of about 10 PA schools, none are ever looking for staff. So, it looks like unless I am able to return to the burnout grind and see patients, which I simply cannot do now, a PA degree is about as useful as toilet paper. Frustrating. Looking for any thoughts/advice, and sorry if it came off a bit ranty.
  2. Hey all. I used to do cardiac stress testing, and I was wondering...was that job actually safe? I was doing standard Technetium 99 stress tests all day at that practice, which of course, involves standing next to and in front of patients injected with rest and stress doses of Tc99 for large periods of time. I did my best to keep distance, but as anyone in the field knows, there's a lot of time spent right next to the patient taking pressures, keeping them from falling, running the stress machine, putting electrodes on and off, etc. I could not find any data online, anywhere, about radiation risks to us stress technicians (only articles about the nuclear techs, who arguably might be exposed to far less patient contact). Wondering if anyone had thoughts on it...I did wear a dosimeter badge most of the time, as far as I recall, and nobody ever alerted me to overexposure...however, who knows if they were even reading rhe reports. I don't think I ever saw any personally. I wonder if those are still kept on file? Any other stress PAs here have any thoughts on the matter? Any health risks in particular to watch out for in the future? Thanks all.
  3. So I've recently developed tinnitus, and I'm really concerned that I may no longer be able to work in any field with pediatric patients (UC, Family, etc). When that febrile 4 month old comes in screaming their head off, it just seems like there is no earplug in the world that will block that 120db sound. And I can't exactly come in to work wearing giant aviation earmuffs to deal with Peds. Anyone have to deal with this? A search of "pediatrics" and "tinnitus" oddly came up with no hits, neither here or on other forums. Odd. Do I have to change specialties to one without peds? Feeling pretty shaky about the future. Thanks.
  4. It's even worse! I get a letter every 3 years from an agency claiming to be the DEA, demanding a sum of $1400 or threaten to remove my two state DEA registrations! Oh wait, that's the DEA. It's legally approved.
  5. I think the best one would be: PP - Physicianlike Practitioner It also correlates well to our relationship with some doctor organizations...pronounced: Pee-Pee Or maybe PN - Physicianlike Nonnurse - pronounced Pee-On... -------- In all seriousness, though, something that includes or reassigns the P.A. initials makes the most sense from a let's-get-real, streetwisestandpoint. We have spent decades telling people that there is a thing called "PA," and now we have to try to somehow deprogram all those people...changing just the correlating "expanded" version of the initials seems the most logistically and psychologically sensible. I really like "Medical Practitioner" but telling everyone, every time, "Hi, I'm MP so and so formerly called PA so and so" seems to stretch sensibility.
  6. The best ads, which I see CONSTANTLY, are something like this:
  7. Thank you, I guess that makes sense. With there was a good guidebook on these sorts of medico-legal vagaries for PAs. (Perhaps there is?)
  8. Thanks....sorry, would you be able to explain a bit more? Sorry, just never really learned the medico-legal rules well...I'd look them up, but no clue where to find this sort of question. Isn't the fact that I am a PA set up an expectation of a certain standard of care...and if I fail to act, even at the PCP's express instruction, or a the instruction of my SP (who I assume has a full MD scope of practice regardless of being employed as an "assessment" doc) isn't that a failure to act/dereliction/negligence? Thanks, sorry for what might seem to be simple questions...if you could point to me to the correct medicolegal resource for this, I'd be grateful, if such exists...
  9. That's ultimately the question. Like if I walk in there, and it's a situation that might need more emergent assessment, or needs a full workup, the visit just went from wellness assessment to full emergency room DDX...
  10. Thanks....yeah, it's the home version, I assume they have no other departments...that's my concern, is there a risk of a malpractice suit, if you are a PA but not acting (and not permitted by the company to act) in the scope of a PA...just as an "assessor"...i.e. the patient obviously needs X prescription, but you are told to leave it to the PCP that the patient will be told to follow up with... What might that risk be, I wonder, in light of my concerns about not performing with a full PA scope of practice, and possibly abandoning a patient who needs further care...not even sure who to ask about this stuff....
  11. You made the right move. Unquestionably. A few extra bucks are not worth a career lifetime of explaining things. And that's only if there isn't another lawsuite while oyu are working there. When I first graduated, I was offered a job at some...questionable place, processing no fault cases, for what was 2x the normal starting salary for PAs. Luckily, I followed my gut and said no. If it sounds way too good to be true...there's a reason. Don't even lose a minute's sleep over it...you would have been losing a lot more sleep for a lot longer if you had given in to the allure of the green paper.
  12. Well....this is a comlex question. Complex because...we do not know you. Sometimes it's bum luck. Sometimes it's something about you, personally. Sometimes both. Sometimes neither. I struggled to find work after graduating. It took me about 6 months, and that job lasted for barely three...then I was back on the search again for about five months. Granted, this was when the economy hit bottom. It took me 5 years to get into the field I wanted. Part of it, for me, was lack of connections. I used to be shy, including in PA school, and finished rotations without as much as a business card to call. My fault, for sure. And as time went on, the sadness of not finding work surely bled through during my interviews. It's a difficult thing, to be confident in the face of no experience. That's why I say, without watching you in action, hard to give good advice. Perhaps you are too nervous. Too (understandably) pessimistic. Perhaps this shows though on interviews. Perhaps you need a better, more hip haircut. I don't know. There are a million personality traits and body language signals that send the wrong messages, and this is something you have to explore personally. On the flip side, perhaps you have to learn positivity. When you walk in the room shining, sit down and grill your own interviewer like you own the place, and act like you already have a million bucks, that shines through as well. Perhaps you need to coaching or some CBT type therapy to learn to <fake> unstoppable confidence. Nothing to be ashamed of in that, I'm sure more than a few here have needed to do the same. You have to really examine how you are coming across, and honestly address any deficiencies. You gotta be hard on yourself right now to make this work. Might take some pain, but that's the only way to own up to shortcomings and improve. As I said, none of this may apply to you. I don't know you. In terms of pure job stuff, obviously, you already mentioned...may be worth to start in your hometown to avoid those questions about location. Truth be told, if you are at places that are talking about location and lifestyle (i.e. "near fishing, great schools, outdoors"), those might be the wrong jobs. Those are looking for established providers, family types, ready to settle down. That is not you. You have to aim..lower. Apply to everything. Everything. Don't turn down a job, even if it pays crap and has no benefits. My first two jobs paid practically a bus driver's salary, and the first had no benefits. The second lasted for 3 years at that same bus driver's salary. But that's the way you start. This is not the time to hold out for better. This is the time to be humble, take whatever you can get, and understand you have to "put in your time" the way we all did, in the beginning. You might have a few experiences along the way that you didn't expect, and even change your life. Hope I don't sound too harsh, but recounting to you the precise reality check that I had to endure for years, until the pieces started falling into place.
  13. I was offered a job for home assessments (I assume Mc/Mc type assessments) in NY for geriatric patients not seen in the past year. As I understand, this is for assessment only, no specific interventions. I was trying to figure out if this sort of thing is medico-legally risky (like if there is something that needs nonemergent but urgent treatment, but I am told or required to leave it to the PCP, is that abandonment/failure to act/etc.?) Any general thoughts from those who have done similar jobs? Thanks!
  14. I have not...but still, a lot of money, objectively. And especially for, again, questionable returns.
  15. I'm still waiting for the AAPA to confront the DEA about their outrageous registration fees. Until that happens, I can't think of anything the AAPA could do to benefit my life or practice. Oh, and lower their membership fees a bit. Not all of us work full time or in cheap-lifestyle markets. $295 a year for...not much of anything seems a bit steep.
  16. NYC greater metro area: from 50-65/hour usually. 75 for per diem if you get very lucky.
  17. This might get moved by a moderator to the PA-Student section or Pre-PA section. Though I can imagine why you would ask practicing PAs, students could give you a far better answer as to what is currently the typical things that PA school seek in 2018/2019. It's changed a lot in recent years...especially on the GREs, priorities in being competitive, etc. That being said, one note...don't do paramedic, it's a waste of your time if you intend to do PA school. That's a professional track for a career in pre-hospital medicine, not an easy way to get a few hours. EMT might be a bit much as well, with 4-6 months of training, but it's not a bad thing to do if you have time...but I assume you don't. I'd guess CNA/MA is the most timely and cheaper way to get experience, but i'll leave it to the students to advise you if that worked for them, when this question is moved to the other forums...
  18. This state breakdown seems roughly accurate on "Average" https://www.bls.gov/oes/2017/may/oes291071.htm#st This looks somewhat accurate: https://www.physicianassistantedu.org/salaries/ Some more comparative info here : https://www.pacents.com/2018-pa-salary-reports-overview/
  19. Still no answer to the obvious...if that day comes, when our institutions of employ come to us and say, "hey, we need you guys to get your doctorates", who exactly is going to pay me for the hours I will have to spend doing ridiculously dumb online coursework and wasting my time writing theses? Gosh knows, it's not going to go down like "ok, well give you life credits for your decades of work, here's your doctorate!" And maybe they will make us pay for it too...PAs seem to be the darlings of nobody in the healthcare world, especially all the administrative supervisors who happen to often be RNs. Good friend of mine had to move from AS-N to BS-N to MS-N. Worked for a big, very well respected institution, but one that only insiders know is run like North Korea. She was told, get your degree or get another job... Didn't matter that she had three kids to raise on their own. Her evening entertainment became irrelevant online coursework for months on end. I think those here who are apparently gung-ho might not be as such when the reality of what this will mean actually hits... I'm not saying it's not inevitable, I'm saying it might very well not be all fun and games.
  20. Sure. And who will foot the bill for any "bridge" program, and pay me for the months (years?) ill have to take off work to write a doctorate, or whatever their equivalent is? I think we should do everything in our power to fight this kind of nonsense...because once it's remotely standard, or even expected, we're all screwed. it's bad, bad, news. Diploma bloat is already screwing thousands of professionals. We are not doctors, and the minute we start playing wanna-be, we devalue our profession and ourselves. The minute this starts, employers will all demand we all go back to school, just like happened to every nurse I know who was a working, AS-N diplomate with years of experience, who then had to then scrounge, first for a bachelors, then a masters degree, in their "spare time" because their institutions succumbed to diploma bloat fantasies. The PAEA/NCCPA/ARC-PA/AAPA needs to refuse to accredit any such program. There is no good in this. Sorry for the strong response, nothing personal, but I feel very strongly about this...
  21. One pediatrician I know made such parents fill out a waiver releasing the doc from any liability should their child become ill or dead. Worded it as morbidly as possible. He had a big practice though and could afford to lose patients who refused to sign.
  22. Wow. In a sense, I understand a little bit, early in my career I was really shy and was so glad to just have a job that I was almost afraid to ask for my rights. I don't know if that's your situation, but certainly I was once much more intimidatable and far more desperate, and was afraid to risk the one job I could scrounge. On the pay stub thing, oddly, some states actually don't mandate or require employers to provide them: https://primepay.com/blog/state-state-pay-stub-requirements. Of course, still shady, but not necessarily illegal. As far as credentialing, it really depends what you mean by that. For most small places I've worked, credentialing literally involved ten minutes of work...signing up for malpractice, quick web check of my license information, and Bam! You're credentialed. Other places required two months and fifty pages of applications, a record of every breath I've taken in the last 5 years, and private investigator level of inquiry. I think for smaller places it's not a big deal. Of course, you better be damn sure you are under insurance. Beyond that, not sure how much is mission critical, besides any mediacare/caid enrollment and state supervisory agreements if mandated. overall though, you shouldn't be somewhere where you feel scared at just to ask for what you have a right to as an employee, and you shouldn't be intimidated into not making sure you are legally covered... After all, it is your license, which is more important than any individual job. a truly good company will understand that you are a professional who cares about his or her reputation and license, and should have no problem providing you with what you need. As I mentioned, I don't know if it was part of the problem, but part of the journey is accepting this and demanding what is legally your right at the outset, and let the chips fall where they may if a place is too shady to give you what you ethically should be seeing.
  23. For some reason, I have always found it very hard to use first names, even when they introduce themselves saying "oh, call me Kate". Perhaps it's subconscious awareness of PA "lower rank" (for whatever that's worth) or something from my PA-S days...but I still call doctors, even years my junior, "Doc". Where do y'all stand on this?
  24. What about speaking to the practice owner? Are you on good terms with him/her? Honestly, if you really think she is a risk, you are better leaving a job than getting sucked into a lawsuit I would think...but I definitely understand the struggle. See what headway you can make with the owner of the practice, i.e. whoever hired her. Out of curiosity, how do you know about her being flagged?
  25. So. I offered them a smaller radius, and they outright refused, and told me all the PAs in their system agree to this, and this is the standard that their administration has set. It is, though, only binding after one year of employment...so I guess, worst come to worst, I'll quit on day 364...
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