SERENITY NOW

Just a follow up for those researching later who come across this thread. I did a deep dive, reached out to multiple brokers who all spoke with claims specialists / underwriters from the big disability insurance companies. Not one of them has in writing any specialty specific language for PAs. @ventana, this included Guardian - they also confirmed that PAs wouldn't qualify for specialty specific like physicians do. I'm sure there is a lot of confusion out there because insurance agents/brokers have frequently been telling me that it would be specialty specific for us, but when I get to the contract details and confirm with the claims specialists / underwriters, they confirm we wouldn't have it. Yet another example fueling my rising frustration with these salespeople who are either ignorantly or maliciously spouting misinformation. Our occupation is that of a general PA and the only case we could make would be if we are in a surgical specialty, our billing codes would be sufficiently different such that if you couldn't work in surgery, they might pay even if you could work in a medical specialty. But that is just a possibility and they won't put anything in writing to that effect from what I could find. All in all, this leads me to believe that long term disability insurance is not nearly as valuable to PAs as it is to physicians. If I lose function of a hand and can't work in EM, now knowing they'll just tell me to go work in sleep medicine or psych or be forced to find some other crappy job, I think this insurance is borderline worthless to me. I did still get a policy to ensure I'd be protected if I am gravely disabled, but I opted for a much lower benefit/premium because of the realization that its much less likely we'd ever be able to benefit from it than our physician counterparts who so highly recommend getting it. If anyone else over the years has went down the rabbit hole and found something in writing contrary to what I've found, please let me know! I'd go with that company in a heartbeat.

@Cideous We were told that people individually submit to the state for unemployment on a week by week basis, so they would just submit for these two weeks, then go back to work for second two weeks, rinse and repeat. But since we are paid on a monthly basis I could see how it might get confusing.

@greenmood, For those with the rolling 2 week furloughs, are they cycling between working 2 weeks and furlough 2 weeks? Or just keeping the furloughed employees as is and extending every 2 weeks until volumes go back to normal? Did the way I framed my question make sense? It is admittedly a confusing situation.

Hey all, Our EM group is in the not-so-unique situation of having lower volumes and cut hours, and our group is starting with a "voluntary furlough" plan. They were hoping to get volunteers for 2 months at a time, but after discussing with some colleagues, we were wondering if we could do it differently. I'm curious if anyone out there has heard of APPs doing 1 or 2 week furloughs, while still working some of your shifts on the other half of the month? This would make the pay while on a "furlough month" quite a bit closer to normal pay, while still decreasing the number of APP hours our group would have to staff to meet their bottom line. We just don't know who to ask if this "cycling in and out of furlough" is actually an option, especially considering we are higher earners. Anyone have any experience with this? Thanks! SN

@EMEDPA Thanks for the reply, E. Is your policy specific to emergency medicine? Which company did you go with? @GetMeOuttaThisMess That was what I was worried about, but I don't understand how they can bold face lie to me and say that it is specialty specific for PAs as well. Is there not any company out there who can make a specialty specific PA disability contract?

Hey gang, Any of you have experience with long term disability insurance as it applies to PAs? Specifically with regards to the own occupation portion of it that is a key part to physicians since it is specialty specific. If for whatever reason an EM doc couldn't work in EM (say, lost function in a hand), they would still be paid their disability benefit even if they could work and did work later in urgent care. I have been talking with reps and they all tell me that the specialty specific own occ would apply to PAs as well, but I've also read online that some of these insurance brokers will say anything to make the sale. What has been your experience with this? Also, there is one company in particular, northwestern mutual, that my work is affiliated with so they are offering me a discount. I've read horror stories of them online, but their rep is saying that they completely revamped their policies last year to address all of those old concerns, and now the new policies are just as strong as other insurance companies. Anybody heard if this is true or false? Last, are there companies out there that are notorious for denying claims and should generally be avoided? Thanks for any help able to offer! -SN

Add me to the list of folks looking for short term work in the interim until things get back to normal. PM me if you guys hear of anything!

So true. Anybody know of more that we could read about these types of situations. Liability during "times of crisis". I wonder if things blow up in our ED if we should be documenting such in each patient record?

As others have mentioned in the forum, my ED hours have been cut with our volumes low as everyone stays at home. I looked into that other travel PA/NP gig from NYC that was posted here and there were all sorts of red flags with a very last minute deployment. It did however open my eyes up that these types of opportunities do exist for us as well, and made me realize I'm not too familiar with the things I should be looking out for before considering these types of positions. I was hoping to pick the brains of the collective forums mind, especially those of you who have done travel / locums assignments before. What are the things that newbies should be aware of before venturing into this field of short term contracts? I've started to compile a list of questions I saw from others during my research that I'll share here; please add any insight you have into these questions and any other things you'd add as well! Things to ask about every travel assignment: -what would our roles and responsibilities be? [the NYC travel assignment would just place us wherever the highest need at the time was, be it parking lot, ED, ICU, floor... it could be another specialty you have no experience with, and you have no say as to where you go. Is this typical?] -what kind of physician support will we have if we find ourselves in over our head? How is the state mandated supervision requirement handled? -what PPE will we have access to, and if it runs out mid assignment, can we stop working until more arrives? -do they provide medical malpractice insurance coverage WITH tail? What is policy limits? [the NYC assignment didn't know if they had tail coverage but essentially said because it is in a state of emergency we essentially have zero liability... is this true? What legal or government document can we reference to verify this thought?] -if we get sick during assignment, ie from covid, what happens? Covered under worker's comp? -who is our point of contact throughout the contract if we have questions? -how is housing arranged, how is transport to hospital, etc. -pay, benefits if any, opportunities for extension, etc -what else should we ask about and keep in mind? Also curious if people have found other unique ways to supplement income while keeping a semi full time job during these bizarre times... Any online work out there for us? telemedicine work? Insurance company work? etc...

Any other PAs follow the FIRE (financial independence, retire early) path? I'm planning my exit strategy from the beginning of my career haha. The wife and I both have jobs making good money, we have been working and living with low expenses while investing the difference for 3 years now. If our projections are correct, we should be able to have flexibility to drop to part time (EM around 4-6 shifts per month!) within 4-5 years from now just to cover our living expenses with the part time work, while the nest egg investments will grow huge with compound interest on its own over the years. Leveraging compound interest early in our career gives pretty awesome possibilities. Effectively only having to work hard and invest hard for 7-8 years then dropping to part time sounds pretty amazing. Hopefully we can make it happen! Would be great if we had others in our community doing the same, sharing the unique pros/cons/challenges for PAs...

Mostly for EM but might have some crossover... search on App Store: resuscitation

Great list. Some other things to look for off the top of my head: -happy current / past residents - make sure to reach out to a few! -a competitive program to get into probably bodes well for its quality. I interviewed at one program who literally had no other potential candidates, whereas the one I ended up choosing had around 30-40 applicants for the 2 spots. You can ask how many applications they've received to get a sense for this.

I wonder if there are PAs who ever work with the coroner haha

I'm frequently on interviews for PA/NP candidates in our group. We look for a few key things... 1) experience related to the job (even if before PA school) and dedication to the field 2) personality and how well spoken they are. Do we think they'll fit in with local culture of group. 3) likelihood to stay. What ties you to the group / the area? We want longevity, so convince us of that. 4) some questions we ask: what are your weaknesses you've noticed so far in practice? What do you want in a group? What's your 5 year plan?

Students, beware of a few cognitive biases / traps that are super common and easy to fall into: anchoring bias and diagnosis momentum. It happens all the time and results in many misses / lawsuits. This case is a perfect example. If we hear, "sent with shortness of breath from likely GI bleed and concern for anemia", many people anchor on that and go down that one pathway of "GIB". Look at all factors in the case and see if any don't fit.... does GIB and anemia cause hypoxia? Would you expect hypotension from a GIB have a normal HR? Don't let yourself be pigeonholed! This patient is significantly hypoxic, and is in shock... expand your differential to address both. Great case so far, E... excited to see where this goes.