thinkertdm

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About thinkertdm

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  1. http://www.onemedical.com/jobs/details/?id=126082&gh_jid=126082 If you have any questions about one medical message me, I'll be happy to let you know about them
  2. Two days ago I had a grandmother literally scream and call me a "f***ing a**hole" because I wouldn't prescribe her granddaughter antibiotics for her allergic rhinitis. (and I'm pretty sure "feeling warm" isn't a fever). Every day I see 25-30 people who want antibiotics for their "sinus infections", who race to the clinic an hour after their sore throat starts, but who don't do a damn thing about their blood pressure, weight, or smoking- but then they want to sue me when their face droops or they feel the chest pain they spent a life time culturing. They insist the flu shot gives them the flu, yet when the DO get the flu, they lack any sort of common sense of what to do. They can not afford thermometers, blood pressure cuffs, and are more terrified of strep than cardiac arrest. The answer to your question- no, I don't think it is worth it.
  3. I hate to say this, but this rotation is probably the closest to real life as you are going to get. If you are working for a corporation, if you have an "administrator" with a high school education, if you have a "dual leadership", if your clinic has fancy logos, if they subscribe to press-ganey, then your job is primarily making money for XYC system; practicing is secondary, and not what they hired you for. I went to school to help people, to guide them through their health concerns, not to look at my watch and then usher them out. The best job I ever had was at the VA- there I had the feeling I was practicing REAL medicine, with patients who needed me. Anyways, yeah, it's unsafe; yeah, its not how it's supposed to be. But I don't see it changing. In fact, I had a VP tell me the other day that "patients WANT 'burger king' style medicine" as he was talking about rolling out an electronic visit service. Do they now? They also want antibiotics for every damn thing, but get upset when c-diff and MRSA eats them.
  4. Not talking to their patients. Not during the history, and certainly not when discussing with the patient what they have and how to treat it. I have- we all have- patient coming in without a single clue of what they have or how they are treating it. I get it, some of them are not so bright, and no matter what you tell them, they will ignore it, but maybe if someone took some time to explain what they have, there won't be so many misconceptions. For example, the baloney about colored sputum. So many people drop what they are doing- sometimes literally- whenever they cough up some yellow phlegm because somewhere, along the line, they were told it was an infection. And that seemed to stick in their head. Anyways, remember, our job is not to satisfy our insurance overlords, or Press Ganey, or the CEO- it is to treat the human in front of us. And that means slowing down. Turning away from the computer. Looking them in the eye. Actively listening - not hearing, but listening to what they are saying to you. They may be saying "I have a sore throat" or " I have a sinus infection", but maybe what they are saying is "I'm scared of being sick". Tell them why they aren't. Did I write all that? Forgive me, its early. So my beef is not talking or listening to patients. Boom.
  5. This morning as I was listening to Doctors Radio, I heard that there was going to be a segment later today where a "nurse practitioner" will be discussing the role of physician assistants. I didn't hear anything after that, and the site is blocked at work. Can anyone post details and/or listen to the show? I can't imagine why a NP would be talking about the role of PA's, especially without a PA representative. Tom
  6. I was referring to this: ...the immune response when ones body is given 3-4 vaccines at once and those shots have multitudes of antigens. What is this immune response (potentially overload) doing to these children. I am glad that diseases have been eradicated, but there needs to be studies completed on these combo. vaccines... And this: ...there needs to be studies completed on these combo. vaccines... And this: ...on the MMR study which makes me think twice about their intentions (i.e. money in their pockets vs safe vaccines)... Your comment was the most cogent response to any of this. I am not sure about the background of many of the people posting here, but it's clear to me that vaccines aren't the problem, ignorance is.
  7. When people trained in medicine are simply reiterating the "antivaxxers" speaking points without any obvious basis in fact or science, a vaccine commission is the least of our worries. My six year son has thirty kids in his class. His immune system is working, literally being bombarded by billions of antigenic particles hourly. We live in a sea of microorganisms. I'm not going to debate this, but one can clearly see that the two years of basic science mds get may be worth it.
  8. Start applying yesterday. Most places I've applied at don't require references right away, and since you are a relatively new grad, you could probably use some school references. No need to tell your employer anything until the day you quit. I'm not sure if the box marked "do not contact current employer" is used by the hiring company to weed out applicants, but then again, a place that does that is not the place for me. And as somebody mentioned up above, when asked why you are leaving, just state "it really wasn't a good fit", and if asked why, use generalities. Don't use it as an opportunity to bad mouth your previous place or NP's. Just keep it general and specific to the question. PS don't wait to quit. You are literally wasting time and your knowledge base is shrinking with nothing to replace it. You need to get a position that starts to fill it back up, one that you can grow and learn, not one that beats you down.
  9. Please move this to the student forum.
  10. In my program, we were working with patients within the first month, and had to wear professional attire, and this included grooming. I agree with the above, however, you are not working TOWARDS being a professional, you are one starting on the first day.
  11. onlinemeded.org is a nice one. The lectures are all on youtube, you pay for questions, but the lectures are free. I find them especially helpful in moving knowledge to practice.
  12. No one is going to protect your license like you will. Ask yourself if one of those patients overdosed on the prescription YOU wrote, would he step up? No, he wouldn't. All of my positions I have been treated as a colleague with my own clinical judgment.
  13. I get zero from the VA. They might (probably not) pay for a conference, but I prefer journals and things I can do randomly.
  14. So, even though several services offer to store the certs digitally, as well as NCCPA, they want hard copies? What's the point? I suppose I'll just put them in a folder.
  15. I've never gone for the prescription to take "if it doesn't get better". I have a suspicion 99% of those people just take it as soon as they leave the office. Also, when you get sued because of any number of reasons, what is your defense going to be? "I TOLD them only take it if they needed it!"? I would estimate that 99% of what people come in for don't need antibiotics at all. Bronchitis, pharyngitis, even UTI's.