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sk732 last won the day on March 2

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  1. At least there the patient is out of pocket for an non-emergent visit...here, the tax payers are out close to $1200 for someone to just check in with a cold for less than 24 minutes duration...had a dude the other day that showed up with wounds over 2 weeks old that were quite healed "just to make sure I wasn't missing anything, since I was getting labs drawn anyway...oh and how were my labs?" that were ordered by the FMD for one reason or another...I didn't comment on them. In fact I was barely polite. Here's a suggestion for those in these UC situations - have a chat with an investigative reporter and tell them what's happening and get them do some fake visits. Suggest they then have a chat with the state medical board regarding ethics, legalities, etc of these clinics doing this...then have them drop the bomb on the evening news or the local rags for their shady practices. If all the suits are worried about are satisfaction scores, this ought to make them sit up for a sec, since it'll be their scores, not yours. $0.02 Cdn SK
  2. Funny this thread came up as I was trolling YouTube... SK
  3. I have found pimping to be used in 2 different ways - one is the formal/informal way of gauging knowledge in a definite teaching environment (with the added "benefit" of education through humiliation ) , the other is to draw out what you do actually know when confronted with something that's truly perplexing, such might also be so obvious that you're not seeing it. In the OP's case, they might have been pimping them to draw out stuff so that "AH HAH!" moment happens - kind of guiding your thought process as it were. However, not having been there and not heard the tone of voice involved, I'm only guessing. $0.02 CD SK
  4. We pretty much had our hand forced in my province because a local health care union decided that they unilaterally were going to represent us without even being polite enough to ask us (a weird quirk in labour law here), largely as a way of generating more income for the organization (1.2% of gross income from people with high 5-6 digit incomes will bring in cash). Given the numbers of us vs the others being represented, didn't look to us a fair deal...that and the fact most of us coming from a largely veteran population at the time, felt it was rather undemocratic. The "Welcome Aboard" meeting caused a largely impolite response to the union leadership that I don't think they were expecting. In the end, we took them to labour court on donations from future members, won, and now have a province wide bargaining unit. SK
  5. I got a call from my boss one day asking about a patient of mine at the military college many moons ago regarding why we weren't treating Jimmy Joe's tonsillitis...I replied " The kid has mono - is Mummy or Duddy Dr or Colonel/General Mummy/Duddy?" "No - they're just concerned because the family doc says he should be better already and that he couldn't possibly have mono with a throat that sore". I stared at the phone for a sec (my boss was one of the best PA's trained by the Canadian Army at that point) and said 'Perhaps you should suggest they find a new FMD, as clearly they've not seen someone with mono anytime in the last century". Had another kid not want to follow up with us properly regarding his ORIF and hardware that was sticking out - "My mom's a trauma radiologist' with the upturned nose a lot of these officer wannabe's have. I suggested "Ask her what osteomyelitis is and how long it would set your healing time back, your degree and graduation/commissioning." No problems with them again... SK
  6. I remember that movie...it's autobiographical IIRC. The end was perfect with all the medical students being on the wrong end of something not pleasant - enemas, catheters, etc. This book sounds a bit like Brian Goldman's book that came out last fall "The Power of Kindness", which is about empathy. For those not familiar with Dr Goldman, he's an ER doc and talk show host, as well as author and speaker. https://www.harpercollins.ca/9781443451062/the-power-of-kindness/ SK
  7. This...one might wonder if they're actually an Agent Provocateur vs someone who now wishes they went to medical school and has an inferiority complex. Let's hope that they're not wandering about passing themselves off as a "physician" on their LinkedIn profiles, business cards, etc. We must be related...I had a laugh when a physician colleague of mine wandered up to me when they were looking after my mom and said "I didn't know your mother was a doctor"...I said "yes, of Canadian History". SK
  8. Medical microbiology would be pretty safe...unless you allow a specimen to escape, you're unlikely to kill anyone and you rarely have to talk to anyone.
  9. Sorry took awhile to get back - was rewriting this a bit. I worked with an ER doc that used to abuse the RN's, other docs and me...I finally had it one night. I went home and then went back to work and asked to speak to them in private and then lit them up...they tried to tell me they were teaching...I told them they were a horrible teacher and that people don't learn anything like that...and then I told them I wasn't even allowed to talk to my soldiers the way they talked to me and I also mentioned that when I was in school, when people started doing the education through embarrassment thing, I called them on it. I finished by saying I was no longer a student and had been practicing for several years. If you're gong to call someone out, do it in private if possible - keeps people from getting their backs up in public and keeps potential disciplinary action to a minimum for the same reason. Only time I actually lost it at someone in public was for actual insubordination in public and for safety issues. I was working on a longer bit of prose, but, if you don't like John Matthis" "Be polite, be professional, but always have a plan...", go with this one "Do not strike others and do not allow others to strike you. The goal is peace without incident" (Chojun Miyagi, founder of Goju Ruy Karate). All I'm saying is having a plan one way or other gives you a psychological boost going into something like this...knowing you're walking into a potential kill zone but have a counter ambush immediate action to get you out with an ultimate final conclusion is much like imagining people naked when doing public speaking - puts the audience at a disadvantage because they're naked and vulnerable. Be a hard target - bullies don't pick on them. MM
  10. If you haven't, you should read what I thought of doing with a parrot in the "What won't you do?" thread... I remember coming into the OR my first day on my ortho trauma rotation... after my attending introduced me, this 5'6'" 4th year resident who was acting team lead while the fellow was on leave, looks up his nose at me (I'm 6'2" and change) and says "You can leave - we only use PA students for scut work on the floor". Being a Senior NCO in the Army, I bent over, stuck my nose in his face and said "That's not what I'm here for, so I really don't see that happening." It was a long couple weeks of me having to fight to get on the call rota (imagine that??!!), get a beeper, get involved with fracture /dislocation reductions, etc..all the things I needed to learn, that this hospital was getting paid an awful lot of money for teaching me, but people weren't doing. The best part of the rotation was the last OR I did before leaving - we were doing a bone graft and I got tasked with the bone marrow harvest, with one of those old school apple corer BM aspiration butterflies...After coring into the pelvis, I was having trouble getting the stylette out so the surgeon freaked out and tried himself - didn't work. We pulled the thing out and it turns out I bent the thing like 90 degrees. Attending shows Dr Napoleon "Look what SK did" - dude was Indian and he turned into a Caucasian when he looked at the device and then at me...I had been a hair's width from tossing him from the top floor of the hospital for about 2 weeks and at that point I think he realized I could have snapped him in two. Be polite, be professional...but always have a plan to kill every person you meet... SK
  11. Sounds like something their head shrinker should be signing as an Rx then...As much as I think this "poor me" society thing makes me shake my head, reading this has me thinking that maybe I should get an ES parrot I could have on my shoulder at work and train it to squawk things like "Manager X is a phuquetard" when they walk by, since that would be insubordinate of me to do it to them in a public place and they frankly make me angry all the time. I could just blame it on the parrot hearing someone mentioning repeatedly... You might have me onto something ;-). SK
  12. I won't give sick notes retroactively - they get what I think is necessary based on what I see at that point. I'm trying to figure out how you all would have to certify someone's service dog/pet - those animals have to be certified as service animals from a service animal school do they not? Don't the handlers/owners also have to attend to ensure they're a good fit? We can certify that the person is a nutter/whiner/too emotionally immature to cope with life/has an actual mental health diagnosis requiring the animal, but how are we non-veterinary/animal training folks supposed to certify the animal? I'd have to say that's a big scope of practice issue that I don't recall learning about in PA school. Parking permits - I used to actually watch people wandering in from the parking lot and back out, then compare from the waiting room to the office (I had my receptionist do it too) and casually mention it to them if I felt there was a discrepancy. Disability for welfare - not without a prior chart from folks and if red flags like "referred to physio for chronic knee pain, continues to be no show at same and only shows up here to have disability reconfirmed/renewed", they were confronted and usually didn't return. SK
  13. Been in EM 5 years fulltime, dabbled previously, primary care prior as well as some admin stuff...rarely get sick doing clinical stuff, though did get influenza last flu season - got my shot late and a patient gave it to me . I got sick mostly when I was doing admin stuff, since you're not thinking of washing your hands every thirty microseconds. SK
  14. When worked in a small town, since I wasn't paid to be on call and such, I chose to live away from the place - people often didn't understand boundaries well where I worked. Some got bent right out of shape when they asked me for my phone number and I'd give them the office number - "but what if I need to talk to you after hours?"..."Call the office for an appointment, call 911 or drive to Town X's hospital". SK
  15. CAPA has an active lobby in Nova Scotia...however, things are pretty slow to change there. Frig, other than the military PA's there, I can't think of any that are actually practicing there that live there - most are in off shore stuff or in mining/construction/drilling sites...usually out of province. Talk to New Brunswick, as PA's are at least regulated there. Pitch something and see if someone swings.
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