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ohiovolffemtp

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Everything posted by ohiovolffemtp

  1. I do EM in a critical access hospital and cover the IP unit at night. The two biggest things you should ask about are: a) what resources you have available and b) how's the culture. For example, at night I have 2 nurses or 1 nurse and 1 medic in the ED and the floor has 2 nurses and sometimes 1 tech. 1 rad tech and 1 lab tech complete the entire night shift. No R or other specialized ancillary staff. You probably won't have all the meds, tools, etc that you're used to in an academic center. Also, you may not have any other provider other than the ED provider in the building or even close enough to come in. Since it's a small facility there will be a small staff. Often they're very close knit group. If you fit in well there's nothing better, but if you don't it won't be fun.
  2. My thoughts: Keep the position so that you are in control of the schedule. Make it clear to everyone: the PA's and NP's as well as the medical director that you're not the person who can be called at the last minute to fill all schedule holes or last minute outages. Let a shift go unfilled to make the point. Be honest with yourself and your peers about how little control you have. Realistically, few if any lead PA's have much if any control over any ED policies.
  3. Physician benefits vary a lot by employer. Even within the large EM staffing groups like TeamHealth, Envision, and USACS there are lots of variations based on site, region, prior history if the physician was part of a smaller group that the large company purchased. I've not seen the physicians get PTO when the PA's & NP's did not, but it could certainly happen in other locations. I've worked for both TeamHealth and Envision and neither provided any PTO to any level of provider. In some cases the physicians were pushed to be 1099 contractors while the PA's & NP's were W2 employees. If the docs were W2, the healthcare benefits tended to be the same as everyone else's. Partnership benefits tend only to exist in the smaller physician owned groups, not in the large staffing companies.
  4. SEMPA - only one that will contribute directly to personal growth. Conferences and emails very beneficial. State PA organization - their lobbying is what removes legal barriers to your practice. AAPA - however, some state organizations require AAPA membership, though less and less these days.
  5. Don't fool yourself. Salary is not everything. Job satisfaction, benefits, how many PTO days you get... everything counts. All of this matters. Also, area of medicine matters. EM, which is what I do, tends to pay better, though almost always has no PTO. My job satisfaction and other benefits are great - best job I've ever had. Planning on being the last FT job I have before retirement.
  6. I'd recommend getting your EMT and then get a job as an ED tech. You'll see much more than you would working as a CNA in a nursing home. You'll also see much more than you would working on an ambulance because as a new EMT without firefighter certification you'd likely be working for a private ambulance service doing interfacility transfers.
  7. Definitely recommend the community college route for taking/re-taking the science prereqs: less costly, smaller class size, in person instruction by faculty vs teaching assistants. That's what I did. Besides retaking classes in which you got below a B, look at other potentially useful classes: genetics, microbiology, cell biology, pathophysiology, nutrition. I don't remember when I went back for my pre-reqs but I started PA school at 53 and got my license at 55. You are NOT too old.
  8. I would love for this to be the case. Best I've gotten was about 40% of what an EM boarded attending gets. Is the $110/hour in a high cost of living area?
  9. You typically have some sort of call-backs periodically, so you'll see the entire class every few months. How close you stay to your friends really depends on you and your friends. I stayed close to my best friend from PA school during our clinicals. We still see each other 2-3 times/year 8 years later.
  10. Where you go to PA school is only important to: ensure you get a good enough education to pass PANCE. BTW, except for residencies, no one will care what your PANCE score was as long as you pass give you an initial set of contacts to help you find a job Once you have your first job, it's all about what you learn while working and the reputation and contacts you make. It won't make a lick of difference where you went to school. Since both schools do the 1st well, is school B really going to be worth $90K more (before you factor in the cost of living)? Even if going there lead to a job that paid $10K/year more (very doubtful), you'd still be looking at > 10 years of work to break even.
  11. Just remember. it's not about what the job, area, etc, "should" pay. It's about what the current local market is paying.
  12. I keep noticing how many of my nurses are younger than my children.
  13. Sorry lost me with that one. Sigh, the lack of a classical education including a lack of knowledge of mythology. Trivia question: how many folks notice the member of these boards who has a quote from Virgil's Aeneid as their signature line?
  14. Experienced EM in the right location: $85/hour at my FT job, $75/hour at my PRN job, both W2. Locums companies calling offering $90/hour also W2. Work enough hours you'll easily surpass $150K/yr. Living and liking a relatively low cost of living area (near where I grew up).
  15. Thoughts: $50/hour is low, even for a starting/training rate. Is this a low cost of living area? $56/hour is low, I was at that 8 years ago in a low-moderate cost of living area Number of shifts depends on length of shifts. 10-14/month is typical, with usual goals of 120-150 hours/month EM jobs are hard to get as a new grad, though the market for experienced EM PA's has improved significantly in the past 3-6 months. ~5 years experience is typically the transition point to being considered experienced. No PTO/sick time is common in EM since you'll be only working 10-14 days/month. Be sure you ask about med mal, especially tail. Be sure you ask about other benefits: health, vision, dental insurance, 401K, CME allowance This is for your consideration - only you can decide what's right for you.
  16. You could do this informally. It would also be helpful to approach your program's clinical coordinator and ask if they could contact the physician as well.
  17. Well, just remember I'm depending on younger folks like you to pay for my social security in under 7 years. Did this patient survive? From the progression I'm very concerned that her discharge might be to her eternal home. Oh, but don't ever ask me to start a patient on precedex - it would be faster for me to fly the patient to a hospital that has it vs getting it couriered to me.
  18. Also from the "downstairs": Progressive mottling is extremely concerning. Air in the ureter and renal parenchyma is concerning for either gas from the infectious process or a fistula to the bowels - did anything like that show on the C/T Any coagulapathy? Platelet count? Coag labs? Patient's temp? Anything that looked like ischemic gut?
  19. My recommendation is to pick something that would be helpful in your job search and future practice, especially if it's in a geographic area in which you hope to live and work. First, you'll get a feel for what life is like working in that area of medicine. Secondly, you'll get a chance to make a good impression on practices in the area, which could lead to good references and possible job offers.
  20. Yes, had prior hx of in-patient mental health care followed by non-compliance. I'm sure the meth exacerbated that, especially these sort of paranoid delusions. I've seen it too many times.
  21. Had a patient last night who was COVID negative but insisted "I AM COVID". Demanded that I call the pope, the president, and the sheriff from 2 counties over. Said bad things would happen if I didn't. Not sure why he felt this way, but prior hx of in-patient mental health care, non-compliance with meds, and meth use just might be contributing. Prophylactic haldol, ativan, and benadryl seemed to work well. We were able to find an appropriate secure facility for him.
  22. Don't feel hopeless - go to a community college for the pre-reqs. Cheaper, smaller classes, more likely to be taught by staff vs TA's.
  23. $50/hour in an extremely high cost of living area - based on $600/day and 12 hour days (which will probably be longer than 12 hours) sounds terrible. But, what is the current job market like there?
  24. The hardest thing for me is accepting that whatever I do, even if it pushes the bounds a bit, can't fix many things. In particular, I have a hard time accepting the fact that I almost always have very little to no influence on what management, committees, organizations, etc do. If it's a consultant, I make sure I never refer to them. In your situation, where it sounds more like a co-worker, I don't have a good answer other than to make sure that any cases from that person that you are even tangentially involved in gets completely reviewed, orders changed, etc. That doesn't fix the root cause, but likely is all you can do.
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