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thinkertdm last won the day on April 3

thinkertdm had the most liked content!

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About thinkertdm

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    Physician Assistant

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  1. The machine just takes a voltage pattern and compares it to a number of stored patterns. Unlike a machine, you are able to think a step ahead and see more complex patterns. in short, if you ignore the tracing and only read the machine interpretation, better have a good malpractice lawyer on speed dial.
  2. thinkertdm

    Flu is here

    Just curious- did they get flu shots?
  3. thinkertdm

    Another bad op/ed on PAs

    PS: Some may argue it's not the MD's fault everything is so pricey. But they did nothing to stop it, did they?
  4. thinkertdm

    Another bad op/ed on PAs

    If KevinMD and his ilk were doing the job, they wouldn't need us. To clarify, doing the job includes providing low cost health care. Boom. I can't tell you how many times lately I've looked at the person trying to pay for: -the office visit, necessary work up, and the treatment. Sometimes it's easy to blame the patient; if he didn't smoke, if he didn't use drugs, if he didn't do whatever. However, I've started to realize (especially trying to pay for insulin that is nearly the cost of a car payment) that these people are me. Are my mom. Are my dad. Are my son. I am ashamed to work with MD's sometimes, because the patient is, figuratively, and a lot of the time, literally, using money he doesn't have, to find out what is wrong. And the MD is more than glad to take that money, only giving the patient a pat on the head. Demeaning. I speak from experience because I don't tell the office what I do. And I hate, Hate, going to the Dr. office. It makes me feel diminished as a person, especially when I am sick. So at work, I try to do what very few do- listen. I take as much damn time as I need. That's why I work at the VA, because they allow me to do that, and I don't have a bean counter telling me I'm not making enough money. So, KevinMD. You can suck it. Because while you may make your patients feel better that they have been blessed that a true MD has swept into the room, my mom will call me frustrated because she doesn't understand what the hell you are talking about, because she doesn't know what an echocardiogram is. And she is scared. And you did shit to help her with that. And that's why she went to see you. The chest pain was secondary. Sorry. the point is, the good MD's are too busy to write posts, and will gladly work with you. The bad MD's sit and whine, like little babies who no one wants to play with.
  5. I would have said thanks but no thanks, either med school or learn the computers. The art of medicine is a long lost idea set aside in favor of making money- for someone else. The problem is, no one told the patients that.
  6. thinkertdm

    Life after a lawsuit

    You hit the nail on the head.
  7. Put a good reason as to why you went with the diagnosis you did- and just leaving it off doesn't make it disappear. Remember, you are documenting for three reasons: to keep track for yourself, for legal and billing, and to tell the next provider what you did and why you did it. "Low suspicion for xyz due to lack of fever, normal labs, etc". This is true in any clinical scenario, not just the Ed.
  8. thinkertdm

    My reaction when

    I shouldn't discriminate, this is my face with flu shots, antibiotics, refills of antibiotics, people who swear they don't have allergies, people who "SWEAR" they aren't having a heart attack, who refuse to go the ED, and colonoscopies. As in refusing to get them. Actually, for people who refuse colonoscopies, I prefer this: https://www.youtube.com/watch?v=N9YpnklYhxY
  9. thinkertdm

    My reaction when

    "The flu shot gives me the flu" "The last time I got the flu shot, I was sick...FOR A WHOLE YEAR"
  10. thinkertdm

    AOA Warning on PA "Independence"

    So as EmedPA points out, you are coming up with this "differential beast" on the fly, while the patient is dying. By necessity, it is a working list, with items being added to it and taken away constantly. You can't just go to "differentials.com" and put in chest pain, and run around with that list; it's useless.
  11. thinkertdm

    AOA Warning on PA "Independence"

    Don't they start the IV while driving?
  12. thinkertdm

    AOA Warning on PA "Independence"

    Anyone can simply put a list together, this is not a differential. The differential is a living thing; I have a preliminary list in my head when I read the intake sheet, but another after I see the patient; this includes everything I see, hear, feel, smell...and think. No one else can do this. I use data from everyone around the patient, that would include nursing staff and any ancillary staff who might be present. It's nice to think someone with a few weeks of training sitting at the periphery who is watching me can adequately come up with a "differential", but its a false positive. A foil. Don't trust it. A paramedic, on the other hand, is a bit more than an observer on the edge of the action; they are the action.
  13. thinkertdm

    PA/Provider Burnout

    It's a common scenario. My previous gig offered PTO but no coverage, or had you find your own coverage. This was in a walk in where 70 per 12 hours was the norm during cold and flu season.
  14. Do you really think we have the intelligence to sign for shoes? Think of the children!
  15. The best way is to google "state physician assistant license", with state being the state you want, obviously. Start early, because some states are ridiculous, with fingerprinting. The answer to your question is yes, just like you are out of school. You will probably need to get copies of your NCCPA cert, diploma, and in one state, I had to get references. In another, I just filled out the forms.

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