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BruceBanner last won the day on July 6 2017

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About BruceBanner

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  1. Where I work there is a robust nurses union (that NPs are part of), but PAs have none. About the only thing they get that we dont is higher base pay and regular raises. And it's near-impossible to fire them. I was part of a union when I worked for Kaiser. Very competitive pay with biannual raises, overtime, killer benefits, but some annoying restrictive seniority policies with vacations, etc. Unions are give and take. Ultimately they protect you from being sh!t on by your employer but it comes with restrictions.
  2. Well look at it this way; it's better than a high-stakes, 4 hour, proctored exam!! And we have a safety net.
  3. I thought the second set was a bit more difficult. I got a couple wrong.
  4. The commercialized system we practice in takes every possible measure to make it hard for you to be compassionate, yet still demands that you do so. Inasmuch as it effects their bottom line anyways. It's a sad irony. It reminds me of this recent video ZDogg did on burnout, which he calls moral injury.
  5. So for me it was about figuring out how I study, and getting the right study guides. I was trying to study like my classmates in groups, and I wasnt retaining anything. I had to study alone, near a window, doing questions, most commons, and spot reviewing material. Every 30 minutes I'd take a mini break and every 2 hours Id take a longer break. I also got some amazing study guides from the class before us that were passed down and basically told you what to focus on. I think those saved me and many others from failing. Ask people what they use for study guides.
  6. It is still an expensive place to live! I live in a township outside the city where prices are much more reasonable.
  7. Ann Arbor. Yes UC is definitely relevant!
  8. I posted this in Jobs but if anyone is interested my practice is hiring for a full time college health position. See the ad on our job board here or PM me for more info. I'll tell you anything you want to know. If it was an awful job I wouldnt post it here
  9. We are hiring a new APP for a 1.0 (full time) position. We see 90% undergraduate and graduate students; it's a mixture of acute care and family med. Lots of sick visits, skin issues, STI concerns, minor injuries. A fair amount of infectious disease as well. High volumes from September to May, low volumes from May to September. Good benefits, good colleagues, lots of opportunities to curbside. I work here, if you have any questions you can PM me, and if it seems like it would be a good fit I can give my input to admins. The posting will be active for 2 weeks, starting today. Apply though the link. http://careers.umich.edu/job_detail/170516/advanced_practice_professional_physician_assistant_university_health_service
  10. I wont certify pets or support animals. I wont (generally) do FMLA. I wont give notes for time missed prior to seeing me unless they are obviously ill and they missed the last few days. I wont do airfare refund paperwork unless they were under my care before their trip and mentioned it. I wont refill controlled drugs prescribed by another provider. I wont get bullied into giving antibiotics by patients or their doctor parents when it isnt warranted. I wont order tests just because doctor dad/mom wanted to have them done. If they want it so bad they can order it. I wont order random "curiosity" labs that I would end up being responsible for should they be abnormal.
  11. I think you have to break it down into 2 discrete areas: 1) the job 2) the location Being a PA in Michigan feels the same to me as being a PA in any of the other 3 states I've worked in. Michigan is a PA-friendly state in terms of legislation, but it all boils down to the job. Regional pay here is good, not the best not the worst. Competitive area due to NPs and saturation. I cannot recommend living/working in Michigan. I'm in Ann Arbor which is a major university town, but i am REALLY having a hard time with the weather here. Outside of the city there is some beautiful countryside, but also a lot of economic depression and dilapidation.
  12. Great video, I saw it on the reddit PA forum. So pertinent and true---burnout is everywhere. But so many of us suffer in silence. There is a sort of professional pride in medicine where you just keep taking it until you are at a breaking point. The culture of "see more, chart more" is everywhere. It's in academia, it's in commercial medicine, it's in private practice. And I might revise my statement earlier in this thread about not caring about patient's problems. I want to--especially when it counts for someone. But the demands make almost impossible sometimes. You cannot see 30 pts a day, or 5 an hour, and care about each and every one of them. You are just trying to survive. You get calloused, angry, bored, cynical, resentful. Cutting back my hours has really helped, but this is a systemic sickness in western medicine. I'm not sure what it will take to change the culture. We cant all go part-time or just "find new jobs".
  13. Yeah, I see the ones that bill insurance going belly up and transitioning to the retail model, which may flood the market enough to get the DEA involved and start shutting them down.
  14. Wear a mask with ALL sick patients, even ones that might be sick. Sanitize your hands after every visit like you have OCD. Sanitize your stethoscope and laptop if you use one, at least twice a day. Dont wear it around your neck. Wash hands with soap and water every day before you leave work. Anecdotal, but I find 1,000 mg vit C and 8,000 units of vit D (i live in MI) helpful. I take vit C year-round. If I feel something coming on I load up on 3-4 grams a day. Placebo? maybe, but it works for me. Aside from that, after 1-2 years at the same clinic you should have pretty stout immunity.
  15. Fraudulent billing. There is no medical reason to have a person back in your office for an E&M once a week for what is a fairly straightforward diagnosis. An office I used to work at did injections for some patients and it was billed as a nurse visit injection (not sure the code). Provider doesn't even see them. At most your office should be seeing them every 3 months, but 6 months is the norm. Then you can do your H&P, exam, etc. But anything you are coding for on those weekly visits is made up. Are you doing the injection? Or other staff? As I'm sure you know by now, retail testosterone clinics are a very shady business. The new trend is online men's clinics. They charge a flat fee for "membership", fee for labs, dont bill insurance, use only compounded meds, prescribe high doses and "ancillaries" like HCG and aromatase inhibitors, etc. Not putting you down at all. You needed a job. I almost worked for one! But that is fraudulent billing.
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