bike mike

Horrible place to work for a PA. Believe me....I know.

I just don’t see how these “providers” (I’m using this term loosely) can advise patients to stop taking potentially life saving medications. I just saw a post CABG pt who was told to stop his ASA and statin and was told to start taking some “natural supplements”. His LDL has gone from the 60’s on a statin to 120 on this “better, more natural medication” and he refuses to take ASA. The kicker is that the naturopath wants the patent to get a Calcium score.....hello, he is s/p CABG. Friggin idiots that have their patients blindly following their advice and ignoring all others advice.

I had this happen the other day. A chiropractor who also practices naturopathic medicine ordered a boat load load of lab work for a pts knee pain. When I asked why all this lab work was ordered for an orthopedic issue the patient said “well he is an all body practitioner”. Yeah, well Vit D levels and TSH has nothing to do with knee pain...so, no I’m not ordering the labs your quack wants ME to order.

This. I can’t stand the patient that doesn’t trust a word I say because I’m not an MD. Had a pt with poorly controlled HTN the other day who didn’t want me to titrate one of his meds since I didn’t originally prescribe it. Yeah, I used to work in critical care cardiology....I think I can handle titration of antihypertensives. When he refused my recommendations I got out of there ASAP. Not gonna waste my time.

This was my approach....and then I just laughed inside a little. You can't get upset about this kind of stuff. There are certain people that want to go to a provider (I'm using this term loosely) that will tell them what they WANT to hear.

So I recently had a patient come in who was recently diagnosed with a TIA. She has a h/o PAF and refuses AC other than low dose ASA. When I saw her I went over the risk of thromboembolic stroke with PAF without adequate anyicoagulation. That is when she told me that her naturopath who “used to be an MD” told her that her symptoms of facial droop and aphasia were due to “lack of oxygen in her blood because of a lack of protein” and that she didn’t have a TIA and that “no offense, you don’t know as much as her because she used to be an MD”. Yeah, I’m just a knuckle dragging PA.....what do I know?

Good Lord, a K+ over 10.....yeah, they’re dead.

Who the hell is ordering a LHC for pre op clearance for a pt with low probability of CAD? That is insane. When they eventually inadvertently cause a dissection on an otherwise healthy patient they’ll get sued for a pretty penny.

At my old job this pt probably wouldn’t be a candidate for ECMO given that long of a downtime and unlikely neurological recovery.

I usually don't pay much attention to the machine's interpretation. Wrong too often. Can't tell you how many STEMI's I've been called to for someone in atrial flutter and the ECG reads anterior STEMI.

You could always do a CT surgery residency. After that you could get a job anywhere.

It is in my desired specialty - cardiology. Not critical Care cardiology which is what I do now but I’m ok with that given that I get to live in the area where I always wanted to retire.

Just landed one of those coveted jobs and plan to stay a looooong time.

Ha ha...so true. And if you end up moving to San Francisco call it "The City" because if you call it Frisco I think they throw you out.