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Sed

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  1. Whoa. Is there a position available to out of state folks as well? Lol
  2. This. And if critical care as an NP isn't for you, consider trauma where you'll have exposure to the OR, critical care, ICU, and procedures.
  3. Like some of the others said, you need to figure out what you want and if it's feasible. But, be sure to evaluate the compensation and benefits (financial, professional, fulfillment, etc) to make sure it all makes up for the additional living expenses and travel time. I am actually in a similar situation. I have accepted a new position 3 hours away. Unfortunately, the shifts are not 12's and cannot be stacked, so I will have to live there for it to make sense. The field is also not easy to get into, but it pays much more with better benefits and cheaper COL. I do have a spouse and so we will have to drive back and forth to visit. Now I'm sure the driving will get old, so it may not be a long-term gig, but it'll get my foot in the door and help us meet our goals. My spouse can also work remotely part of the time so they will stay with me some of the days and then at their work-sponsored condo the other days. As a side note, our goal is financial independence sooner rather than later, so the plan is to rent our primary residence out while living cheaply in my secondary residence. My poor spouse will be a little bit of a gypsy, but they're on board so what the hell. So as you can see, there are many factors at play here, so evaluate your situation to see if it'll work for you.
  4. Thank you for breaking this down.
  5. I did say "self-respecting" but no, I have not and thankfully so. Wow. Are these (MC and the like) the same employers that many of the forum posters refer to when they mention assembly line medicine? I think it was even you who posted about social media affecting one's work evaluation and the effects of "moving the meat" in corporations like this. Don't take this the wrong way, but are the job/field benefits so great or job market just so poor that self-respecting providers choose to work for corporations like this? I'm not above working in a small workspace but a storage closet? Good grief.
  6. I hope you love your job and have really good benefits to be forced to work in a storage closet. I mean seriously, what self-respecting medical organization has their revenue-generating medical personnel working in a storage closet? Please evaluate your work situation. There should be a standard in which you are treated, especially since you make the organization money and are expected to be high-functioning. I'm sure that's not easy to do in a working space like that with restricted ventilation.
  7. Southwest, surgical subspecialty private practice, $2000 for CME-related expenses, CME days taken out of PTO pool, and they cover any and all business expenses (DEA, licensing, credentialing) in addition to CME allowance.
  8. I have had physical therapists and PCPs intervene without contacting us, only to cause a dehisence and in some cases infection. I had one pt who saw her PCP for all of her post-op care for an open fracture in the setting of significant tobacco use only to finally follow up with us 3 months later after three rounds of antibiotics failed to heal her infected wound dehisence, nonunion, and stiffness due to failure to do PT (never prescribed or instructed to do or go to a PT). Do not mess with the special dressing, sutures or staples of surgical wounds without first contacting the surgical service!
  9. I do not see my numbers but have been told I barely make my salary from billable items alone. But only 1/2-2/3 my day is work in the OR. The rest is clinic, rounds, and charts. These are nonbillable tasks covered in the global surgical package. I believe approximately 20% of the package is attributed to post-op care, so you can deduce that a $1000 surgery breaks down to $200 allocated to post-op care such as rounds and clinic. Therefore, I am more profitable also covering the rounds and post-op clinic. The doc could do those but would be most profitable doing surgeries which pay more (approximately 70% of the package). Add to that your 13.6% assist fee and you're producing $336 for assisting, rounds and clinic per surgical patient during the 10 or 90 days of global. If you're also doing consults and seeing new patients or non-global established patients in the clinic, you're making the company even more. For example, the surgeon makes $200/hr and you're paid $50/hr. If you see a new patient at $150, you actually MAKE the company money (+$100) versus the surgeon who LOSES money (-$50). So doing a healthy mix of OR, clinic and hospital will actually work in your favor. Yes, you're not directly billing for your rounds or seeing post-ops, but these are necessary. It's either you do it at a lower rate or the doc does it at a higher rate. It's the company's choice. If the company is smart, they'll learn how to allocate your man hours appropriately to be the most productive. If the company isn't smart, then you can do what I did and break this down for them and explain why I should be paid more money than what I currently collect. You can even go so far as explaining the benefit of having a PA to reduce the workload for the surgeon, which in turn improves production and longevity. This is not something they can bill for, either.
  10. As an Ortho trauma PA currently, I can't go outside of my SP's scope of medicine. But since I'm a generalist by schooling, for simple things, I ask my SP if he's ok with me treating X, and if so then I do it. Otherwise, I tell the patient, "It looks like you might have X, but you should see an X expert since I'm actually a broken bone expert and not an expert in X. I recommend that you see your Z for evaluation. +/- You might need Y treatment." I can't say that I've ever said, "I don't know *shrug*" and moved on without at least directing the patient to someone else. I think it's our duty to help others, even if it's just directing the patient to someone else. I have had my fair share of the Dr. Lee type reactions, but limited given current my scope in Ortho trauma where patients rarely get far without seeing us almost right away. I'm sorry to hear that you've had the experiences that you've had, especially during such a trying time. I hope you find the help you need.
  11. Good point and makes sense. I didn't think of it that way. Thanks for your insight.
  12. Nope. I've heard nursing insurance was cheap but figured NP insurance would be commiserate with PA insurance.
  13. No kidding. $900 is unreal. Mine is $7000, albeit for the highest tier occurrence coverage. Glad I don't have to pay for it myself.
  14. Thank you for the information. I spoke with a malpractice lawyer who said the important thing to look for is a consent to settle provision. Basically, do I have the right to consent or not consent to settle. This may, in turn, affect what ramifications occur if a case is settled, e.g., the state PA board is notified that I settled a suit and the board may then inquire further. If there is no provision, the company/hospital can choose to settle even if I don't agree or consent. So even if I didn't do anything wrong and don't agree to settle but the hospital chooses to settle anyway, then I don't have the right to not consent to settling and I will have to deal with the ramifications out of the settlement, e.g., the board inquiring about a suit.
  15. I didn't think of it that way, but I see how that could be possible. Thank you for your thorough and thoughtful response.
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