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rev ronin

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Everything posted by rev ronin

  1. Imam. You get an imam if you're Muslim, you get an Iman if you're David Bowie.
  2. I offer shake hands with all my sick patients, even if they conscientiously defer. I then go wash my hands before conducting the rest of the exam, and note that while hygiene is important, so is respect and human connection.
  3. I would also ask for the licenses of all your co-workers and physician providers on staff. If they have a bunch of reprimands and CANNOT work anywhere else.... Run.
  4. At what point does control over the environment of practicing medicine (e.g., restricting visit time frames, restricting MA or nursing support) constitute "practicing medicine" for liability purposes?
  5. What is your relevant pre-PA experience? Are loan repayments guaranteed?
  6. I'd do one better, if I got that question: I'd ask what the problem was--why they didn't honor the line I signed. I'd rather nip it in the bud in a polite phone call.
  7. That's an excellent question for a new thread.
  8. When I was doing sleep medicine, so many of our patients had to go through AIM specialty health, I got to know the prior auth docs by name. Most of my requests were handled by one of 3 board certified sleep docs who were pretty reasonable, for the most part.
  9. One clinic where I work has a series of chimes and other noisemakers--wind chimes to let the MAs know a patient is ready for rooming, a desk bell to let them know a patient is ready for discharge. Small office, the noise carries reasonably well.
  10. Yes, but this is America, where how much money you have matters far more than how you got it. Where we don't actually cover the Hippocratic oath or ethics in any depth in medical school. Where the government has to force pharmaceutical "gift" disclosure. So yeah, I'm not surprised that (gasp) certain clinics would do useless but not necessarily harmful things to increase payments.
  11. Honestly, the applicants with the oddest backgrounds--and a police officer is going to be reasonably uncommon in a pool of PA school applicants--have much better chances than the one with a moderate-GPA BS in biology who's worked as a scribe or CNA.
  12. Are you saying that illegal immigrants don't need good healthcare? I'd say they most certainly do.
  13. There are only three interview questions. All of them are variations on one of the three: 1) Can you do this job? 2) Can we get along with you? 3) Are you going to stick around?
  14. Mike, I just had a mildly analogous experience with my own kidney stone. I didn't have to order anything because either one of my collaborating physicians, or even one of my NP or PA co-workers, would have. It felt weirdly collaborative, but we were both on the same page: "Can I get some more zofran 4 ODTs?" "Sure, how many you need? When should we do a follow up plain film?" "I dunno, gimme the rads order and I'll probably go Monday if it hasn't passed by then." "Sounds like a plan..." I tried not to be a bad patient, but it was somewhat empowering to know that in my case--albeit much milder and conventional than yours--I had a clear handle on why I was suffering, what I could do about it, what I needed to run by other medical providers. It actually felt like a team approach, with me as patient actually being part of the team.
  15. @medic25 Then maybe the answer is a PA (or NP, I suppose) who maintains an active prehospital credential, be it EMR/FR, EMT, EMT-I/AEMT, or Paramedic. Right now, mine mostly just helps me teach EMT class...
  16. A lot of PA specialty societies have student membership opportunities once you do get in, but not too many have pre-PA membership categories. AAPA is clearly the best "bang for the buck" for pre-PA memberships
  17. I applied to five after narrowing it down from about a dozen I looked into seriously. Mind you, this was in 2009, so there were only about half as many programs then. I interviewed 5/5, 1 accept, 2 waitlists, and 2 rejects, but the program I was outright accepted to, Pacific, was hands down the best fit for my personality. Each of those five interviews cost money--travel, time, rental car, hotel. I learned from each interview, what I liked and what I did not, how responses helped and did not. Frankly, it's based on my experiences that I strongly recommend mock interviewing until you CAN'T screw up. I think 10 is too many and most likely pointless. Some people will get in anywhere they apply, some will get in nowhere ever, and there are those of us who will get in based on school/applicant match and/or whether you had a good interview. If your GPA is 2.6, you should apply to ZERO PA schools until you fix that, and no, applying to more schools doesn't really raise your absolute chance of getting in, even if it does raise your relative chance of matriculation.
  18. Everyone in family med has some specialty, some little bit of extra knowledge in a few areas--we aren't all cookie cutters. Your Uro knowledge will be very valuable. At the same time, we all need to know not just the big, board things, but the bread-and-butter stuff. Yes, DM, HTN, HLP management... but rashes, well exams, UTIs/BV, URIs/Strep/Flu/whatever, and all the little stuff they don't really spend much time on in didactic year. You'll want to know what OTCs you like and why. Oh, learn to manage constipation, too.
  19. We tell them to come back tomorrow. Non-emergency cases (anything short of an actively bleeding lac or chest pain) get turned away at 15 minutes until close.
  20. @Kaepora Flight RNs are awesome, but the ground EMS equivalent seems to be CC/ICU RNs who accompany critically ill ground transfers to manage drips and vent settings that may be a bit beyond most paramedics, or they work with non ALS-response private carriers to enable critical transport on a rig that isn't normally paramedic staffed. In the case where you have PAs or NPs doing at-home follow-up for frequent fliers, I think you've got a different skillset needed. You want someone to be able to review meds, propose dosing changes, draw labs, and do patient education to keep them out of ERs. That's not the same skill set as a flight nurse at all. While some of that is definitely within FNP scope of practice, who trained them to be safe in patient homes? I'm proud of the way I train my EMTs to provide care safely--to themselves, mostly--in an uncontrolled environment. An EMT/FNP would certainly be fine in such an environment, but as folks around here are used to pointing out, NP clinicals are, at their minimums, quite inferior to PA clinicals. I wouldn't want a PA who was only ever an MA, CNA, or PTA in such a situation either, just like a direct entry RN/FNP, but last time I checked we still had plenty of EMTs and Medics going to PA school, and this sort of job seems to be to be totally up their alley.
  21. https://www.firerescue1.com/fire-ems/articles/393536018-Calif-fire-dept-adds-nurse-practitioners-to-EMS-crews/ I am uncomfortable this trend for a number of reasons. Paramedic->PAs should be leading this charge, with EMT->PAs, since this is our space and we are better suited to both provide realistic out-of-hospital care and supervise community paramedics.
  22. I just did 20 questions tonight. Some were *ridiculously* simple--almost to "The patient states his name is John. What is the patient's name?" level. Others were things that, in clinic, I would take far more than 5 minutes to look up, especially the peds stuff that I don't see all that commonly.
  23. Rural environments tend to be better for PA respect and compensation. I would recommend learning to like working there, and then go into the big city for shows or weekends or whatever. Rural's not bad if you can get out once in a while. Derm is a very sought after, well regarded, well compensated specialty--after a few years, you will have a lot more options.
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