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BruceBanner last won the day on July 6 2017

BruceBanner had the most liked content!

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About BruceBanner

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  1. About 45,000. 30 has only happened a few times, typical school year day is now about 20.
  2. I work at a big-10 university health service. Overall I like it. It can suck during the school year I wont lie. But I'll most likely stay until my loans are paid or I leave the state. Pros: Amazing summer flexibility and low volume. Summer here is May though September. We still see patients, but only 8-12 a day (easy), and we can take as much time off as we want. Some providers leave for 6 weeks. Benefits. 6 weeks paid vacation (includes a week of CME), 2 weeks paid sick, paid paternity/maternity, 6 months ext sick and 6 months ext sick @ 50%. Excellent health insurance, dental/vision/legal, etc. Good patient population. College students are for the most part healthy and easy to work with compared to the adult public. Good autonomy and variety. It's primary care + urgent care with a college focus. So lots of sexual health, minor injuries, mental health (if that's your thing), URIs, derm, and some infectious disease. Cons: Endless colds from September to May. Lots of hypochondriasis (whiny, cant deal with simple sx, every little tingle needs a diagnosis, etc. ) High volumes (20-30 ppd) in the school year Overt political initiatives ( LGBTQ everything) Parents sometimes get involved
  3. We had to go through a forced (do it or you dont graduate) diversity course, AND a group diversity "immersion experience" that involved living a mock lifestyle of someone else for a day, AND had to sit through a mandatory "gay day", where people of various LGBTQ persuasions came in and talked to us about their lives and how we can treat them better. Listen , I seriously could not care any less about my patient's sexual/gender orientation unless it is somehow pertinent to the clinical scenario, nor do I need to be force-fed all this propaganda to know that you should treat all of your patients as equal human beings. 99.99% of all providers do not need to be taught this, at least in their formative years.
  4. The guys sounds like a narcissistic a$$hat that should at the very least lose his job. But lose his license? Certification? Is there any evidence he caused someone harm or gave substandard care? Were these words said behind closed doors among staff or to patients directly? I think we need to be very careful and highly specific when we talk about yanking someone's credentials or license to practice. In the age of outrage and big brothering everyone's opinions it could be a very slippery slope. Loss of certification or licensure should be for demonstrated, dangerous incompetence that has failed attempts at remediation, or endangering patients through any medium. If it could be proven he delivered dangerous or substandard care, then yes let the boards have at him. But if he's just a delusional racist a$$hole who otherwise delivered competent care, then that's an employer or civil case issue. They can fire him, someone can sue him, etc.
  5. Mainly liability, but also managing your plate. There is so much administrative burden now. I constantly see patients who pull "oh by the ways" and "what about this". Our clinic even restricts each visit to one complaint, generally. But patients (humans) are rarely cognizant or sympathetic to the fact that maybe they are your 16th patient of the day or maybe you have 3 people in rooms waiting to see you, and you really dont have the time to dig into their other issues. You dont want to stay late and chart past dinner. They just want to get answers or get well. It's frustrating as a patient feeling like every symptom needs it's own doctor! I dont think that is fair or efficient. But sadly the days of the country doc GP are gone. I worked for a guy like that once and he was awesome. Patients would follow him to the grave, literally. Also, I hope you are getting better and I think about you from time to time. Health can be a tenuous thing.
  6. I can accept limited shadows in Ann Arbor, MI. The specialty is college health. It is more or less family practice for ages 18-30. During the school year I only accept shadows for 1/2 days because we are too busy. PM me for info. -BB.
  7. Get out of UC and EM. It is very hard for PAs without fantastic mentorship or a residency. Urgent Cares are meat-grinders and we see more PAs get used, abused and discarded by these than any other type of job. It's not you. You aren't incompetent. The problem nationwide is the system, not providers. It sets unreasonable standards for production, expects us to not make any significant mistakes, and on top of all that expects us to make every patient happy under penalty of our job. In no way is that fair or humane. The best advice I have is to A) find a more reasonable office-based job, or B) reduce your work hours, or both. Those are the only things that have kept me sane in this profession. I work in college health where the volumes are HIGH in the school year, but mostly super-acute sore throats, URIs, minor skin issues, minor injury, and STI checks. So it's super easy to keep my production high above the slow-poke IM docs and still be able to down-regulate enough to not get (too) burnt out. Dropping to 4 days a week was also a game-changer.
  8. Ok that's concierge care or membership practice. MD VIP is a brand name. Hard to advise you on that one---I worked for a membership doc a few years back but did not see his membership patients; just the general public. He did it to keep his practice afloat. I think at minimum you should make a lateral change--meaning same salary. The default for a physician no matter how good a friend will be to underpay you. Also if you havent already get allll the particulars about taking call, etc. My old boss took calls 24/7 from members.
  9. Do you mean DPC as in concierge primary care?
  10. Been fired before myself. It's oddly not uncommon for PAs to get fired. GOOD PAs too. Usually it's administrative or has to do with patient satisfaction, rarely a medical error. Admin will often leverage a minor infraction against someone when firing them. In any case, resign if you can. You will be ok. Like others have said always be able to float your boat for 3-6 months in the event of a job loss.
  11. I dont know how your group is structured but it sounds to me like your main job is to represent the PAs, not so much "manage" them. So really you just need to show up to meetings, be a good example clinically, speak on behalf of the PAs when pertinent, and be a diplomat who represents your cohort. This means having friends up and down the chain. Especially nursing---I would make it a point even if it pains you to try and make friends with nursing staff. I do this by jokes and commiserating with them on some small issues. Not complaining per se, just relating. Another thing I think you should do is stop calling yourself a bad leader, even in your head. It becomes a self-fulfilling prophecy. Nursing has way too much power in most organizations and all they have to do is pull the "patient" card and it's like you've already lost. This is how they get what they want, that and majority representation. If you argue against it, it makes you seem defensive, if you go along with them you are just bending under their will.
  12. Out of pure curiosity I wonder if I could challenge the NP boards and pass without studying. I think I could. They arent for us and never will be. Nurses look out for their own, and PAs have to play catch-up with whoever will listen, because we dont have the representative clout. I think most of us just want to do our jobs and go home. Which is well and good until the NPs you work with are making 10% more for doing the exact same job.
  13. It depends on what you mean by 'skilled'. I'm probably more skilled at FM procedures than any of the 12 docs I work with, but that's not because I'm some hot shot. I just had a lot of training and experience after school and became the go-to guy. Most docs I've worked with in primary care do few procedures. Now as far as diagnostic repertoire in the IM spectrum, the IM docs I work with are wayyyy more skilled than me. I can get by, but I have a low referral threshold with things like anemias, metabolic disorders, GI disorders, etc. As a PA your level of skill is largely up to you and where you end up working. Residency is not built-in to our training, so we have to be assertive and seek it out on the job. There are plenty of PAs in primary care just seeing colds, rashes and sprained ankles; and there are some highly competent PAs who could stand toe-to-toe with any junior attending.
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