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Everything posted by BruceBanner

  1. I tip my hat to people bold enough to work with a bandana or no mask at all. But that's where I'd draw the line. Yes I value my own life but I also value my family's safety perhaps even more, and what good are you doing anybody by exposing yourself, becoming ill, or becoming a disease vector?
  2. I'm a bit late to this party but another update from the front lines: At a Big 10 University health service, we have had multiple presumptive positives in the past week. Things hit the fan after students returned from spring break, as we predicted. We have a lot of resources at our disposal, but we are still woefully under-prepared. As of Friday, we were still seeing routine and walk-in visits! Many well students are still coming in "just to be checked". Tests are very limited. Nothing is in-house yet. It is nearly impossible for front end staff to appropriately risk-stratify patients. We
  3. Family medicine can be like that, for sure. The patients per day can be deceiving. 16 ppd doesnt sound too bad but it's all about the complexity and back-end work involved. Not to say there arent good FM gigs out there, but you will probably only find them in small private practices. The most stressful job I ever had was in FM. And every doc/PA in that practice worked part-time to stay somewhat sane. Now that you have 2 years under your belt I'd suggest finding a new job. Some suggestions: College health (PM me if in Michigan), urgent care (be VERY careful, most are meat-grinders),
  4. Sorry, not accepting any more new shadows at this time.
  5. Oh I told them exactly what I thought about their titles.
  6. 2 of the names are absolutely ridiculous. Like they sat around with a joint and just started making up words.
  7. Honestly I havent been there since 2012, so many things may have changed. We had SPs, an H&P lab, and a robotic mannequin for intubations, etc. Went I went through it was a very difficult program and staff was punitive in some ways, with punishments that did not fit the crime. I hated them to be honest, but I was well-prepared for boards. That was 7-8 years ago so take that with a grain of salt.
  8. U of M PA here. It is a highly saturated/competitive area. We could use another PA but sadly we dont hire new grads. Pace is too fast. I empathize with you. If I had the time I would love to train a new grad. But I barely can accommodate a half day shadow.
  9. About 45,000. 30 has only happened a few times, typical school year day is now about 20.
  10. 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 heal
  11. 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 pat
  12. 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 h
  13. 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 fe
  14. 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.
  15. 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-b
  16. 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.
  17. Do you mean DPC as in concierge primary care?
  18. 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.
  19. 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
  20. 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.
  21. 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 an
  22. Sounds like a nightmare. Our good friend Scott Stegal says you have to speak to them in a language they will understand---which means slowing down. This can work in a walk-in clinic, but in your scenario all it will do is put you behind, piss patients off, and reduce your productivity from admin's perspective. Unfortunately it is just a losing game. Corporate primary care is maybe one of the worst areas in all of American medicine. They literally do not GAF about you as a human being and this is evidenced by their expectations of you. They only care about throughput and patient satisfact
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