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About NewtonsApple

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    Emergency Medicine PA

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  1. I was working EM on east coast making base plus RVU and averaged 74 an hour at the end of the year for my first job out of school ( PAs worked fast track, intermediate, the overnight PA worked cardiac while doc worked critical, and we all took shifts in dedicated pediatric ER and took mental health evals. required ACLS, ATLS, PALS). I now work in the southwest in retail medicine making 55 hour with available bonus and plenty of overtime. The new job requires I understand in detail coding and billing unlike the ER gig. I never realized how changing a wording can make such a drastic difference
  2. I have read multiple reviews, including a 2001 by Denkler, stating since the introduction of lido w/epi in 1948 there have been no recorded cases of commercial lido w/epi resulting in gangrenous digits. EDIT: quick pubmed search pops up a 2013 Norwegian review stating the warning of lido w/epi is without grounds. It depends on the wound of course, but you could saturate the wound with LET, go see some patients, then throw in the sutures without the need for a needle. Happen with a guy who took a machete to the palm after refusing to give up a smoke.
  3. Leaving first job out of school to be with SO who landed dream job out of state. I was not sent any paperwork regarding tail insurance, etc. Is that normal for no contact after the 90 days is in, or should I contact the group asking for specific information?
  4. I pull out my sterile skin saw and trusty grinder anytime I suspect shingles
  5. The ED I work recently switched companies so we just re-signed our contracts after negotiation, they require 90 days or you open yourself up to a lawsuit to pay compensation for any locum tenens hired until the position is filled. 90 days seems reasonable to me considering the length of time credentialing takes.
  6. Thanks for the responses. The feedback is helping. Shot in the dark, but any resources that show pitfalls, pearls, billing issues, etc. of EM charting or charting in general. I found some info online dealing with liability which helped some, but something more detailed would be nice to review.
  7. For reference. Recent grad 3 months working first job in EM. Mostly 5-3, occasional 2. The doc signing my charts the other night asked if I would start listing diagnosis I ruled out by either selecting them in the diagnosis section or typing a little blurb (which he preferred). Considering the same workup is done for a patient, what is the assumed liability for charting "ruled out ___ diagnosis versus only listing present diagnoses? For instance, I had a pt c/o anxiety attack and listed "headache after the episode" as a complaint. my primary dx was anxiety attack with secondary dx of
  8. I know Mayo Clinic in Arizona has at least 3 PAs for the ENT group. Apparently they do pretty well, but some are only clinic so I am sure there are pay differences.
  9. Passed ATLS and received certification. I was told to expect that I would only receive "attended" or "completed" on my review as a 'Physician Extender'
  10. Working in Virginia, can't wait until I have your comfort level.
  11. Thanks EMEDPA. I am actually receiving my card, as I am 2nd in line for trauma after the docs (they told me to be prepared to work gunshots and stabbings). The ER I work expects PAs to work all levels including cardiac, and we have to do initial reads on all x-rays before discharge. Very nervous as a new grad, but this is what I wanted. I bought many of the books you and RCdavis recommended on the forum, any other advice would be great
  12. The college/university may choose to afford you grade forgiveness when calculating your GPA for graduation, however, CASPA wants every grade of every class you took (true when I filled it out), regardless of forgiveness/retaking. Utilizing the personal statement and even the supplemental application (if required) is your chance to paint the picture you want admission committees to visualize.
  13. I am taking my ATLS course at the end of the week, have my book and should have my access opened to the pre-test any day now. Any thoughts from those of you that have taken the course. I have heard it can be difficult to pass and was curious if you fail the test do they give you another shot or have to re-pay and take again? As a new grad I have not performed many of the procedures in the skill section, so not sure of the margin of error.
  14. What class did you fail and how heavy are your sciences otherwise. Like others have said, one failure does not account for the 2.8, so how have your grades been overall? what are your patient contact hours in? being an EMT or paramedic will help a lot more then being a medical assistant.
  15. I think where you do your rotations have more of an impact than the program you graduate from. One of my ED rotations was at an inner city academic center and level 1 trauma with pediatric commitment. The other, my elective, was at a community hospital and level 2 trauma center. I was able to complete my 2 family medicine rotations at a primary/urgent center. I also did my thesis on the accuracy of ED PA's performing bedside compression US. I landed a good job working in the ED right out of school.
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