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rev ronin

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Everything posted by rev ronin

  1. rev ronin

    Post interview tips

    I sent an email within 24 hours of my interview to Pacific, praising what I liked about their program, highlighting why I thought I would be a good fit, and letting them know that, if accepted, I would be attending. I was accepted outright, after being waitlisted and rejected other places. Did it make a difference? I don't know; I basically treated it like a follow-up letter after a job interview that I would have wanted.
  2. Businessmen(1) are the problem: * They patent this and that gadget and medicine, and push it with the primary effort being to profit, and the betterment of patient outcome at most a means to that end. * Then other businessmen decide to try and rein in the first set of profiteers, and, lacking any medical acumen whatsoever, hire medical people to decide what care will or will not be covered, with the primary goal of cost constraint, with the betterment (or maintenance, really) of patient outcome at most a means to that end. * And then other businessmen come in to try and improve the customer experience given the above two facts, with plenty of experience in customer service and none in medicine, and here we are. (1) Businessmen is used in the gender-inclusive sense and such usage is in no way intended to leave businesswomen off the hook for this malarkey.
  3. rev ronin

    Job issues- legality?

    Depending on the state, it's entirely possible you're "at will" and they can fire you for any reason whatsoever, as long as they don't articulate a discriminatory one. I don't know your state, let alone your state laws, but suspect that might be the case. You should contact an employment law attorney licensed to practice in your state, sorry.
  4. And whether or not you can get a license without a job already lined up. It would be stupid to move into a metro area where there are already PA new graduates. I have had people ask my advice on moving to Portland as a new grad My answer? Don't! OHSU and Pacific churn out a ton of new grads every year, so you're going to be competing against people who've rotated locally.
  5. rev ronin

    Am I Setting a Good Example...

    I tell the girl scouts all my money goes to support the Boy Scouts, tell the Boy Scouts all my money goes to buy girl scout cookies... No, I'm kidding, I actually just say "Not today, thank you" and move on.
  6. rev ronin

    Crazy FB removals

    I've wondered, would a contemporaneous video recording of the consent process help? That is, videoing (and saving forever, obviously) you going through, in detail, all the list of things that could possibly go wrong with the patient. Of course, no sooner do we all have cell phones that would enable that, then we have deepfakes such that anything so documented could legitimately be challenged. Sigh.
  7. In my 2011-12 clinicals, I logged everything into Typhon very meticulously. Before I left my PA program, I got a data dump of every. single. encounter. Still have it. I spent a couple of hundred hours logging everything in, you better believe I still have it...
  8. rev ronin

    Organic Chemistry Fears

    Definitely a reason to go to a community college rather than a university! I recommend Ochem in small doses. I took a combined intro to organic and biochem course (Ochem for nurses, basically) that did NOT meet prerequisites, but it did both help my GPAs (cGPA, sGPA, Ochem, AND BCP CASPA GPAs) as well as giving me a running start at "real" Ochem when I took it the following term. I do not think I could have pulled off an A- in real Ochem 1 without that running start.
  9. rev ronin

    Volunteer Hours

    The closer it is to human healthcare, the better a typical AdCom will look at it, but there's not really such a thing as "bad" volunteer hours, unless you're tone deaf and listing things contrary to the mission of the school, I suppose. I struggle to think of a real example of that, though.
  10. If you're going to sign a contract, make sure it specifies they pay you regardless of credentialing status as long as you maintain national certification and state licensure.
  11. rev ronin

    PA/MD/DO/NP Letter of Recommendation

    I'm not sure 'most' is the best word there--I didn't encounter any of that when I researched schools for the 2009-10 cycle, although I've definitely heard of some schools wanting it broken down that way. It would be interesting to see how many programs do, and it's certainly possible that it's most, but I would like to see the data.
  12. rev ronin

    PA/MD/DO/NP Letter of Recommendation

    The point of a PA LOR is essentially to make sure that someone who knows the field from the inside thinks you're going to be a good fit for the profession. Why would you want to skip that?
  13. rev ronin


    GPA averages, HCE accumulates. No matter what courses you take to improve both your cGPA and sGPA, you're going to need to pull a 4.0 (or ridiculously close to it) from here on out. I think I had something like a 3.95 in coursework once I decided to apply for PA school--Got A-'s in statistics and physics, IIRC.
  14. rev ronin

    Number of attempts

    I've made no secret of the fact that I got in on my second try. No dishonor in continuing to apply and improving your portfolio at the same time. The possibility of rejection is why I advise pre-PAs to be aware of the limitations/shortcomings in their applications and work to remedy them concurrently with applying/interviewing.
  15. rev ronin

    Masters or Graduate Certificate

    The one year graduate certificate programs like you describe sound like a traditional "post bacc" program, geared towards students looking to apply to med school. I'm sure it would serve well in applying for PA school, but the RN/BSN direct entry program is a good option, too. You can't really do much more for PCE or employment with a 1-year postgraduate certificate than you can with a BS.
  16. rev ronin

    Paramedic CEU's

    I've had no problems keeping NREMT based on my CME. I think for the cycle I was actually IN PA school I did count coursework.
  17. rev ronin

    Do patient hours "expire"

    I have heard of this as well, specifically from programs that want a lot of HCE/PCE. They seem to want at least some portion of it to be current-ish (within the last year or two) but never stop counting older HCE/PCE
  18. You got me beat. I only had 10.
  19. rev ronin


    Hearing no objections... (locks thread)
  20. rev ronin


    Super; now post quotes from appropriate textbooks, or withdraw the assertion. You've made sweeping statements and failed, repeatedly, to back them up with any cited source. When you DID supply sources, they were unworthy. On the surface, you're right: Thinkertdm didn't discredit you, you discredited yourself when you posted statements from unreliable sources, he just pointed out where you got what you did post. I'm losing patience. I expect your post on the topic of vaccines, in this thread or any other, to contain appropriate references, cited sufficiently well that anyone can check on your quotes and facts, backing up your above statements. You may, of course, choose not to post at all, and that would be fine with me too. There's nothing really for you respond to here, since we're not arguing about anything at this point other than your lack of sourcing.
  21. rev ronin


    Thinkertdm does appear to have thoroughly discredited what you've said. If it really is Immunology 101-level truth, surely you can find an actual peer-reviewed scientific source that covers it? NVIC is an advocacy site; Mercola is, at best, a profiteer. I'm sorry, but the the sort of discussion I'm interested in does not involve rehashing benefits that have been well demonstrated in the peer-reviewed medical literature on the basis of Internet conspiracy theories. Mind you, peer-reviewed isn't perfect, but the solution to bad peer reviewed papers is GOOD peer reviewed papers...
  22. rev ronin


    Again with the insults. Again the same answer: When I tell patients what's good for them for my own ego, yes, it would be out of place. When I tell patients what's good for them, putting my own economic livelihood at risk (i.e., they go elsewhere, I lose money) to tell them an uncomfortable truth for their own good, it's much better described as "doing my job." I am, oh, probably down close to $500,000 in expenses and lost income since 2010 when I left my previous profession to become a PA. If by doing so I didn't gain (at a minimum) the ability to conclusively tell the people I serve the most basic of medical facts, then I have engaged in a colossal waste of time and money. God complex? Not a chance. To the extent there are medical contraindications to vaccination, yes, the risk/benefit equations differ. I've said that repeatedly and consistently throughout the thread. But what does not change the health benefit of vaccination is the patient's (or, worse, their medical surrogate's!) opinion. Patients always have a choice: Stop smoking or find another provider. Treat your diabetes or find another provider. Get vaccinated or find another provider. Of the three, only the last never (or, actually, extremely rarely) involves a lack of willpower sufficient for follow-through. I tell most my patients facing medical decisions "You are the CEO of you. I am your consultant; I can give you all the information in the world, but I can't make your decision for you." If that sounds to you like my running roughshod over patient autonomy, sorry, but it's not. Where on earth did you get that herd immunity quote? I'll paypal you $5 if it's from a reputable, peer reviewed journal, because it sure sounds like it comes from a scaremongering anti-vax website. You will have to provide the cite and PM me the paypal account you want me to forward the money to, of course. The debate is not about whether schedule-recommended vaccines are safe and effective for those without medical contraindications to them, but rather how to convince patients of this truth for their own good. There are vaccines where the cost/benefit may be there for some but not others. I got Pneumovax as a PA student at my own expense years ahead of recommended schedule after "doing my research." I did the same thing with Zostavax a few years ago, only thankfully my insurance picked that up even though I wasn't over 50 yet. Do I badger everyone to get those? Oh, heck no. I do mention the possibility of Zostavax to those about my age who had chicken pox as kids, but thanks to the varicella vaccine's acceptance and efficacy in the general population aren't getting re-exposed to wild type chicken pox. Never gotten a rabies shot, though, because it doesn't make sense for me or most people who don't work with potentially infected animals. So I'm not seeing you saying anything new here--just repeating the same allegations (ignoring patient choice, playing god, yadda yadda...) restated after I've already refuted them. If you can't add something else, it's probably time to close this out.
  23. rev ronin


    Vaccination is the single most cost-effective way to stop the spread of vaccine-preventable diseases. We have a finite pot of money to spend on health; why divert it to less effective methods? Sure, border control and good health checks would be another method to reduce external sources of infections, but they're brittle defenses, much like the 1990's where company intranets had complete access from anywhere to anywhere, with only firewalls to protect them from the exterior. The human impact of travel delays and vaccine checks at the border (oh, wait, how else were we going to ensure travelers are low risk?) are non-trivial. Like I said earlier, people just don't understand the risk of low frequency, high-impact events. It's not just about vaccines, either, in that many, perhaps most, patients are too mathematically illiterate or emotionally impaired to be capable of making an informed decision. The balance of risks and harms isn't even close; there aren't any rational justifications for a person without any specific risk factors to refuse a routinely scheduled vaccine, even assuming worst case scenario for both harms and benefits. The most dangerous part of any non-medically-contraindicated scheduled vaccine administration is the drive to get to the administration point! I do invite you to support or retract the statement that herd immunity doesn't work. If you mean to parrot arguments you don't hold yourself, It'd be much more helpful if you'd clearly label them as such.
  24. rev ronin


    I agree. Healthy anti-vaxxers don't spread measles. Once they get it, however... Also, it's not just about risk to ME, it's about risk to my staff and other patients. MRSA is contact; measles is airborne. Ignoring your insults, no one is forced to do anything: I don't force anyone to accept life-saving treatment, I just acknowledge their rejection of a therapeutic relationship. But the rejection of herd immunity is a fascinating topic that I'd love to hear you expound on more: Do provide some peer-reviewed research justifying your statement, please?
  25. rev ronin

    Should I confront a patient?

    I echo Ventana's advice, although I get that there was no intent to undermine the surgeon in your initial concern expressed to the patient. By making the patient a "do not schedule with me," you're not doing anything she didn't already implicitly ask for. Confronting her with her vileness would be different. I would keep the voicemail as insurance, though. Should she try and sue you or the SP, provide the vile VM to your defense attorney, and they will probably make the problem go away: No one on a jury wants to give a large award to someone with that much hate in their heart.

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