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Everything posted by Sed

  1. I read something on Reddit recently that got me thinking: The more I hear about independent practice rights being obtained and the associated opinions of other colleagues, specifically physicians, the more disdain I hear. Does anyone think there will be a turning point in which the independence will be revoked and the traditional "supervised" role will be reinstated? Or has the fate been sealed?
  2. I'll just leave this right here...
  3. That is silly. So who is actually mandating these new changes? You mentioned "they," "the nurses," and "the OR." Are these OR staff members/nurses or directors? Are you a hospital employee? You could be implicated if you do not follow hospital policy, unfortunately. However, if you're a private practice employee, you could always use your surgeon as backup. Either way, it doesn't make a whole lot of sense if your surgeon continues wearing a cap while you're forced to cover every stand of hair. You could always argue that wearing the other garb negatively affects your work (e.g., headache, hot, etc) and you will not compromise patient care to adhere to rules that have been disproved by other studies.
  4. Interesting times indeed. Thank you for your insight!
  5. Agreed. As for the discussion about revocation, I suppose I was just wondering about the NP independence. And yes, it's too early to think about for PAs, but like you said NPs have had it for years. However, it is understanding that most hospital systems still require physician collaboration and cosignatures despite independence. Do you think this will change as lobbyists gain more ground? Do you think we'll see change as more green PAs/NPs are graduated, which seems to be the recent trend?
  6. I too had difficulty finding practices that would allow shadowing. I cold-called random offices and no one would allow it, siting HIPAA. I ended up calling my own health care provider who was/is a PA and they welcomed it. I also joined a club in school that invited an orthopedic surgeon to speak about their career. They also allowed me to shadow, and after graduating, I ended up going into ortho myself. The PA career can be a great career for the right person. Like the others said, do your homework and see what the career is like for yourself. Consider volunteering at a hospital to gain more valuable experience and start developing relationships with nurses and providers. Consider using your bilingual skills as an interpreter or scribe to also get your foot in the door. Good luck!
  7. Definitely find out about the call schedule and what kind of call. Is call included in the 40-hour work week or in addition? Is it M-F or will you have to work weekends? Do they compensate call/weekends by giving you time off post-call, for example, if you work a weekend, will they give you that following Monday off? Is there a potential to work more hours if you want in order to make more or bonus structure?
  8. Oh man, that blows. We rock scrubs in our ortho practice. Although I will throw on my white coat every now and then for sh*ts and giggles.
  9. Loving your work is one thing and a great thing. But if you're working so much that your off days are spent recovering and/or you're still not doing all the things you want to, you might be on your way to burnout. Like the above posters said, burnout can creep up on you. Be sure to utilize all your PTO. Consider cutting back on your extra shifts periodically to give yourself a break, hang with family and enjoy your hobbies (see your twice a year comment). Handling your professional, personal, familial, and social responsibilities can all contribute to burnout, so make sure you take a step back like this every now and then to evaluate how everything is playing out. Like some of the others said, you can't get these years back. So make sure you're doing what you want with your time.
  10. That's the way I read the regulations, too. Thank you for the information.
  11. I was discussing surgical roles of ortho PAs recently. I've heard some surgeons allow PAs to assist with plating, drilling, second side joint replacement, etc, while other surgeons prefer the more traditional assistant role of PAs just retracting and closing. The state regulations I found stated that PAs can perform ANY task delegated by SPs so long as it meets certain criteria (within physician's scope of practice, supervised, and within PA's skill set). We can also perform minor surgery, of course, as well as assisting. But they did not specify anything about major surgery, specifically. Does anyone know about the legality of PA assisting and if doing more than the traditional retracting/closing is lawful or unlawful? What is "assisting" exactly? I'm assuming the hospitals also have their own bylaws as well. For instance, if a PA performs part of the surgery, does that reach past the assistant role and embarks on the second surgeon territory? Can there be legal recourse if a PA is found to have done more than just assisting?
  12. That's the impression getting, that it's surgeon-dependent. I just can't seem to find any information suggesting that there is or isn't an issue with us doing more in the OR...
  13. And I'm assuming that he hasn't had any legal issue with him doing that in his 22 years, right? I know a few PAs who have a similar scope as your friend, minus the residency. But just because someone does something, it doesn't necessarily make it legal. Ya know? I wanted to reach out to see if anyone knew of any possible legal recourse to PAs doing that much work in the OR.
  14. EVH is a different beast, and some hospitals require some sort of EVH course or proficiency proving your ability to harvest. There aren't any specific restrictions for ortho that I'm aware of. Regarding orthopedic surgery, I had a surgeon suggest that a PA performing part of the surgery could implicate the team down the road. Not to say that the PA isn't competent enough to perform part of it, but let's say there's a complication and it comes to light that the PA performed part of the surgery. Would that mean anything? After all, PAs are "assistants" and not surgeons, so in the law's eyes, how are PAs allowed to perform surgery rather than just assisting? Do you catch my drift? My main concern is where is the line drawn between the assistant role and second surgeon role. I'm all for doing more in the OR and advancing my skill set, but I also do not want to implicate our team nor do I want to practice unlawfully. Is it enough for the surgeon to say that my doing part of the surgery IS assisting and therefore within legal parameters?
  15. I've heard figures on the order of $500-1000+ per weekend. Some pay hourly to just be on call and then add compensation when actually called in/assist.
  16. They'll learn the hard way about office coverage and schedule congestion if and when you leave. Is the PTO approval by the director written into your contract? If not, you could just tell the schedulers to move your schedule around and schedule the future time off. Behind the director's back, yes, but it doesn't sound like this individual will ever approve your PTO. If that's not an option, you could always have her record the U/S on her camera for this first one and plan out the others. Or maybe Skype/FaceTime for a sec in between patients if you want to see in real-time.
  17. Do your research. Hopefully that'll allow you to figure out such information. Consider reading a book focused on the specialty you're trying to obtain high-yield info in. If you still haven't found your answer and once you've gathered some basic knowledge of the basis for your question, then ask it in a way that the provider knows you already tried looking it up. For example, "Hey John Doe, I was looking up a high-yield-topic and it mentioned Xa for X scenario, why would one do Xa instead of Y, which seems like a reasonable alternative?" Or something like that. Other tips: don't ask questions in high stress situations, don't ask questions that you can look up the answer for yourself (I hate when students do this; see advice above), don't ask a hundred questions in a row or a hundred throughout the day, etc. Ask the provider if you can have a few moments of their time to ask a question you've been trying to figure out and/or pick their brain. That way you get their undivided attention and you've asked their permission to interrupt whatever they're doing.
  18. I too had a mentor say this.
  19. I don't mean to stray from the topic of this post, but you mean you started training but you haven't actually spoken with your direct office manager or worked with your SP? I implore you to please get acquainted with these individuals ASAP.
  20. The high bonus is likely so that the company doesn't have to match it for the 401k. Also, if you're saving 30k on a MA and the associated benefits, they can put that towards your bonus.
  21. Why don't you just use that nice bonus and hire a personal MA?
  22. They get a 30k bonus but cannot afford an MA? That's some BS. Don't you think your time between patients is better served doing other things, like helping the doc see his patients, research, CME, documentation, etc, rather than scanning in papers, rooming patients, checkouts, etc?
  23. I honestly can't believe you're willing to accept this and start working under the terms you've listed. How do you think your patients are going to feel when they're being taken care of by the MA, oops, I mean PA? C'mon, seriously think about this. You've trained to practice medicine and treat patients. How are you supposed to be doing that if you're too busy scanning in papers and all the other MA tasks? Do not do those things. I hope you haven't already agreed and said that you will. Insist that you get an MA. You are doing yourself and your training a disservice if you work as an MA 75% of the time and a PA 25% of the other time.
  24. Might I add that I work in ortho trauma, and my patients don't always have the same postoperative treatment plan, yet rehabs ignore my personalized discharge instructions and do their own thing.