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taotaox1

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taotaox1 last won the day on March 19 2015

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About taotaox1

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    Physician Assistant

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    Physician Assistant

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  1. I am currently in Anchorage but due to a huge variety of factors me and my wife have decided to move back to the lower 48 and are planning on spending a year or two on the road to get a feel for various areas to consider settling long term and to have some adventures in general. My experience in is primarily FM/UC and honestly prefer to stay out of UC though I would do it in a pinch. I have browsed a number of the old locums threads but have walked away with the following questions: 1. I see people mentioning hourly pay the are getting eg.60-80$/hr in fm/uc. Is that would I generally should be expecting as base play PLUS house/travel/perdiem/etc or do those numbers look more like total comp? 2. From what I can tell the system in place with these companies sets them up to try to screw you as much as possible as they take whatever they don't give you. Any tips for not getting taken advantage of? Questions to ask? 3. What is the etiquette as far as working with more than 1 company? 4. Any suggestions for "Good" companies to approach? I have talk to Barton and while the guy seemed fine I could tell it was gonna be a hard sell kind of thing. (I suspect that is the norm)
  2. Has a mild cold. Came in to get antibiotics to "get ahead of it" or "nip it in the bud". No one walks away happy.
  3. Definitely don't plan on accepting the first number and will come back with a separate offer. Sounds like 40% is a good number to shoot for. Thanks for the feedback.
  4. Thanks for the insight on sleep! Not sure about retirement for the sleep job yet, No retirement for the UC. I don't really feel the difference is inappropriate, and if the volumes right the pay range more than makes up any benefits Imo, since I don;t need most of them. I don't have to take call like the docs do, supervise advanced practitioners, and didn't have to go to school for an extra 5 years. The pay difference is is they make about 30% more per patient. I don't know many jobs where the PAs are only making 30% less than the docs.
  5. Curious what you guys think of this offer for a PA with 2 years FM/UC experience: Mixed Family medicine and Urgent Care Clinic Production pay: 33 % of all net billed items (MDs get 45%, for reference) (99***, ecgs, PFTs, Procedures) or 55$ per hour . All private insurance/cash. Average reimbursement for a 99213 is around 160$ here without anything added. Apparently everyone is on production making around 75-95$ an hour. We apparently get detailed production reports so know what we are bringing in/getting paid. Three twelve hour shifts. Big positive for me... One or less weekends per month, solo coverage on the weekend (1.5-2 days) Average patient load per provider appears to be 15-20 per day. No Call Several other clinics in town for possible extra shifts if wanted. Flexible with work shifts, allowing me to go climb mountains (happy!) Seems like a collaborative environment. No non-compete BS No benefits (I get these through my wife, wasted at my current job) No CME except for Up to Date is paid for. No PTO have to go to a 45 min meeting on tuesday mornings, or at least call in. (bleh) Not much else. Second Offer (don't have all the details yet) Sleep Medicine 120,000 year Travel 5-6 days a month around Alaska (will be fun at first, might get old) 4 day work week 3 weeks PTO Unsure about holidays, cme specifics. Doc has not been super responsive with getting details laid out. Concerned this might get real boring, real fast but pretty good money for low stress. Anyone have experience with this? I like thinking but stress sucks.... So for comparison at my current job FM/UC with solo coverage, Lots of medicaid/medicare with highly complicated patients, all the autonomy I want (and help anytime I am stuck), great docs but terrible support staff system (some individuals are great), clinic won't be around long due to financial issues.... 46.50 per hour (~96,000 before OT, will make 110,000 this year with all the OT I have had to work that I don't really want...), I get overtime if have to chart late with no complaints... I am faster than the docs... 4 ten hour shifts Bad health insurance 70% covered that I don't use anyways. 3k CME 3 weeks PTO, 6 Holidays, 1 personal day, some sick time. (This adds up to 4$ per hour in a full work year) I can take my dog to work sometimes! (Alaska is awesome).
  6. Ask your MAs how they make their life hard and if there is anything you can do to make their day easier. I ask mine this all the time to make sure I am not doing easily fixable things with miminal benefit to me that are making their lives hell. I try to work as a team with my support staff and sometimes there a changes to my behavior that cost me little time or effort that can make a big difference for them. Just ask! Usually they tell me there is nothing, but I think (hope) that they appreciate the consideration.
  7. I can give out dangerous schedule 2 drugs, manage every condition under the sun, and order 5000$ imaging studies and no one bats an eye. God forgive I give someone diabetic shoes or have a PT work with a wheelchair bound patient at home.... I need a REAL doctor to THAT kind of complex medicine. lol.
  8. When it comes to unless the patient meeting guidelines for ARBS you are do the patient and the community (and the next provider down the line who has to deal with the entitlement) a serious dis-service by writing abx, even in a "fill this later" fashion. Even with high suspicion investigated by X-ray... only 1 in 15 get better any faster with antibiotics and 1 in 8 have an abx "harm". Specific situations are one thing, (eg traveling in a few days, no way to for pt to follow up with anyone, history of abrs, comorbidites, etc) but it is usually pure laziness (dealing with patient tantrums), greed (good for the clinic to have return visits), or a misdirected sense of sympathy (Think they are actually helping) that drives this. There is a reason these medications are RX and to be honest we have been awful stewards of them. Before you consider just giving out antibiotics to make a patient happy. Please consider the following: https://www.cdc.gov/drugresistance/ - 23,000 DIE every year in the United States due to abx resistant bacteria http://www.bmj.com/content/337/bmj.a1324 - 142 000 visits a year to hospital emergency departments in the United States due to antibiotic reactions. Atrovent Nasal, neti pot, cough suppressants, etc are your friends.
  9. I am convinced the only reason soma has not been taken off the market is to make it easier for the DEA to figure out who to bust.
  10. Inheriting patients like this is the worst. They have had horrible expectations set. It sounds like you are doing the right thing. Lots of these patients will move on until they find a provider who does what they want... thats how they ended up with the doc you are taking over for. Just grind through, stick to your guns, and offer to refer out to pain/psych as appropriate. The problems will self select themselves out of your panel and you will eventually not have to deal with it. Some will stick with you and will be healthier for it.
  11. As a PCP I tell patients that are on combinations like that that I am not qualified to manage their psych or pain conditions that require such powerful medication combinations and that they need to see a specialist and then refer them out. They get no option, I am not "able" to fill them beyond a short bridge. It makes for a very simple appointments honestly. I do not do chronic narcotic poly-pharmacy for patients as it is rarely to their benefit except in rare cases, and most of those rare cases actually DO need specialist care. It helps to be in clinic that the rest of the providers tow pretty much the same line. It would be really difficult in an office full of candyshop doctors.....
  12. If you want to be a immature about it just tell him that if he shuts his mouth you might be gracious enough to refer some patients to him for toenail clipping when you are done dealing with real medicine. That or just be an adult and ignore the ignorance. I like my local podiatrists and they do a good job (and certainly more than clipping nails), your cousin is obviously just a narcissist or an idiot.
  13. That is a MUCH better offer. In fact for a new grad it seems great. I would consider it with my 2 years of experience. I wouldnt count on much, if any bonus money that is production based as a new grad. That said, the offer is ok now even without bonus and as you grow you may start benefiting from it. Congrats on standing up for yourself and negotiating. Imagine if you had just taken the offer as is!
  14. Both of these offers seem a bit predatory to me. You realize that 92k at 50 hours a week is 35$ an hour (less considering it is OT work.....). RNs make that much at good gig. Unless that per patient bonus is gonna push you up to at least 10$ per hour it is still not a good offer. Personally, I would keep looking seeing as you are not trying to get into a hard to work in specialty. There a TONS of jobs offering better than this and you seem open to location/specialty
  15. Good for the AAPA imo. The NCCPA was obviously trying to railroad this. Their rigged questionnaire was poof enough of that.
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