delco714

Are you in Vegas? If you are... There's better situations.. I'm thinking you're not though?

At least it wasn't about nurse practitioners? For the love of all that is holy https://www.nytimes.com/2019/02/11/health/artificial-intelligence-medical-diagnosis.html

Congrats dude! Cheers!

Hahaha.gif Yeah. I ain't spending a fourth year in med school. What a joke. I understand there's a shortage of FP, but there's a shortage of plenty of specialties. Plus, my education and experience as a PA is worth more than 3 years already. Realistically, clinicals should be optional, just close the education gap (and we can forget all the fluff later).

I disagree with dropping 70k more for a better name. Interest? With someone paying back loans from the second most expensive school in NY, I'll tell you.. As great as the program is, that's a lot of dough. Unless your going to pay your loan back and have another person's salary to live off for a few years.. think about it

You are beyond petty. You want me to bow to you, now? All of my urologists but one so far have told me I function at their level. Quite specifically. They share patients, ask my opinion, and give me as much respect as I give them. I have collegial banter with them as they do amongst themselves. Maybe you're not used to that after 47 years? Sorry it didn't take me that long to get there. I remember one PA that influenced my career before it started, more than any other. One I know you know. Patients are far less apt to start a malpractice claim against a PA and/or surgeon that they like. Showing them respect, humility, dignity, and general compassion trumps all else. I've seen that play out both ways.

No offense to OP But it's Ortho. Doesn't take that long to be highly proficient and knowledgeable. Sorry not sorry. Respectfully, I think you need to get off your 47 years high horse sometimes. I respect your career longevity and experience, but there's many times and ways to frame post operative events in less than incriminating ways. You don't need to bring your Demi God worship here. You and I both know we pick up dirty laundry constantly. I do it all the time. There's an art to it. Especially when the MD is out of office. Op. The lady sounds like a crotchety drug addict maybe with underlying mental health issues including dementia. Pain makes people do and say mean things as well. She's frustrated, concerned, nervous and who knows maybe partially deranged. I think you just need to let your manager and sp deal with it and move on. Do your Sunday best to just block it out and move forward.

Beats me getting crap press ganey scores last week for telling a patient I can't fill their regular non Urology meds and them getting pissed off at me.

I'll add..I see the worst of that!!! Oh we don't know what to do with this... But don't even start the work up or do basic testing!! Ordering testosterone but not FSH LH.. no scrotal sono for ball pain.. the wrong imaging for renal masses and hematuria. My favorite.. dipping positive for blood and not testing microscopy.. We need to find a better way through and through

Urology is a surgical based specialty that has internal medicine thinking... But that goes right back to the point of if there's no changes and just need a refill. It's an easy enough appointment.. But a lot of patients would prefer to not have to go to multiple doctor's and it would be more cost effective, and open my schedule for a complicated re referral... We're both not Wrong. Who's the intermediary? Tele medicine!?? Ah! I may be on to something

I make a lot of patients prn if symptoms have been controlled. I would expect you can continue to refill finasteride, Flomax, and basic anticholinergics If the symptoms get worse or refractory, then send them back That's how my note is written As a specialist, I hate seeing controlled symptom patients coming in for refills with no changes otherwise. Or they tried to have pcp refill and they refused, so they ran out of pills waiting to get in to be seen. I know urology meds typically aren't that scary Also, stop using doxazosin to treat bp and Flomax.. That's soOoOoOo 1995 We don't have a billion open spots to see follow ups.. So when you have a yearly or similar routine follow up.. Maybe I'm jaded to but.. It's easier for you to see them. We need more room for new patients, and I'll admit a lot of the new referal patients are BS.

Expand your horizon.

I believe in lavender for relaxation and peppermint for nausea. I'm not too keen on the rest. I'll leave you with this: the mind is a mysterious and wonderful thing. Just don't discount the power of psychosomatism!

Vegas is super affordable overall. There is TREMENDOUS bang for buck here

Update 45 hours a week (including time for lunch). 1/4 weekend call from 8a-12p only Gu with 1st asst, clinic, hospital coverage in rotation With base, call pay, pt satisfaction bonus, rvu bonus About $208-215k. (Not including benefits). In a state with no income tax 5+ years experience.