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About piteog

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  1. Does anyone work for Schumacher? I don't know how consistent their benefits package is from site to site. Like all things, I imagine it varies with the market. However, does anyone have a sense of PTO benefits, CME, health care, retirement, etc? Thanks!
  2. After searching this topic, it's clear that EMEDPA is working in solo coverage, but are there others? Which states are you in? I'd love to hear your experiences.
  3. How do your groups handle vacation in groups that contract you to work a certain number of hours per month? For example, you get 4 weeks vacation a year, but are contracted to work 150 hours per month. What do you work in the month you take 2 weeks vacation? Is there a minimum in vacation months? What about summer when everyone wants off?
  4. Given the incredibly small number of respondents, the AAPA salary data is almost worthless. Meanwhile, reading the responses to many of these posts often makes it seem that almost any offer is too low! Does anyone here practice in the southeast (Virginia, North Carolina, South Carolina, Georgia, Tennessee)? I think Florida is a separate animal and it's still hard to know if comparisons between states translates well. However, given a more or less standard benefits package as a full-time employee (health, CME, PTO, 3% escalating to 10% retirement 401K), what do you think is a fair hourly salary range for a new grad in EM? What about for an experienced person, e.g. with 3+ years of experience?
  5. If so, I want to hear from you. For example: Are you working in the highest acuity area of your ED? Are you managing elderly patients with multiple comorbidities who present with sepsis, ACS, PE, respiratory failure, etc? Are you doing all of this relatively autonomously? Did you learn by doing, or were you specifically trained in a PA-residency? Did you complete the CAQ? Did it matter? If so, I would love to hear from you. I'm trying to establish what our group is interested in with respect to PA "implementation" and I'm trying to convince them to set a high bar. It would help me to understand your experiences in your groups about how you got to do what you're doing (and whether you're one of many or the only one).
  6. We have had folks go to both conferences and have heard good things about both conferences. Let us know your feedback!
  7. From a scope of practice standpoint, though, what would think if the scope of practice was vague and allowed broad discretion in PA-led care but also included a caveat allowing individual doctors to "tighten" the scope off practice when PAs in the practice specifically work with those physicians. I think it could be problematic, but I'm looking for a way to throw a bone to some of our more conservative doctors. As I noted, conservatism isn't always rooted in a lack of trust in PA-led care but rather in an anxiety about risk-management. Do you think it would be possible to follow something like that? I think it may be difficult but essentially just codifies what is already routinely done. For example, say you're training a new PA. You might say, "Dr. Jones is a heavy admitted of low risk chest pain and wants to hear about all those cases before disposition unlike Dr. Smith . . ." or whatever.
  8. Really curious how this turns out. Background: I supervise a very large group of PAs (and a few NPs) in an urban EM group. We have been trying to revise and simplify our scope of practice agreement. Unfortunately, we have two buckets of doctors: the risk tolerant and the risk averse. Meetings about the scope of practice are naturally dominated by risk averse doctors who force the risk tolerant doctors to capitulate. There's such a strong emotional response in risk averse doctors as they feel a real stress when PAs or NPs evaluate patients. Some of our doctors are true "helicopter doctors" who insists on evaluating everything, even in patients with obviously benign presentations. I agree with Ventana. Demonstrating your competency will change minds over time. This requires substantial patience on your part, but if they are open minded, things will change. If they're not open-minded, you'll find another job. One thing you could do is propose that they evaluate your performance with respect to specific patient presentations. Ask for critical feedback in 6 months about managing patients with chest pain, or DKA for example. Then, make sure you know the algorithms, how to interpret the blood gas, etc. When you knock their socks off, ask them to loosen the reigns. On the other hand, I was going to post a question about how YOU all deal with "helicopter doctors" since some doctors won't change and are difficult to manage for their doctor colleagues. The reality is that most people will approach these things with common sense. Once you show you're capable, they'll let you do more.
  9. Thanks for your input so far. Keep it coming! I guess my thought would be this: I want someone to come out of "orientation" able to be useful in some capacity. The easiest path to usefulness is ensuring that the new hire can handle straightforward, uncomplicated complaints. This is what I had in mind, what am I missing? Lacerations (suture selection, cleaning, basic wound repair, not the details of every special case) Upper and lower respiratory infections (nasal congestion/"sinusitis", ear pain, sore throat, neck pain, cough, PNA vs bronchitis) Nausea, vomiting diarrhea without abdominal pain and "dehydration" Basic fractures -- distal radius, hand, ankle fractures Nursemaid's elbow and shoulder dislocations Common GU complaints - Nonpregnant pelvic pain and vaginal discharge or bleeding plus first trimester pregnant vaginal bleeding, pelvic pain, or discharge UTI diagnosis and management Rash basics If you can handle that list, I think you can probably handle 85% or more of a typical fast track. Agree/disagree? What am I missing?
  10. Our group has hired a few new hires but the established members disagree about how best to approach training the new people. In one camp, there's the "expose them to everything" group. The other camp is "make sure they learn how to do simple stuff." Either way, it's hard to design an orientation "program" for new hires. What would you include? How long do you orient your new PAs (specifically in emergency medicine)? How do you train them? Do you just scheduled them to work double coverage where they are not actually needed and can work at their own pace and then help them as they go? Do you do suture/abscess/other procedure labs? Do you have them read anything? Thoughts welcome.
  11. How often are the meetings? Are they monthly? What types of things you discuss? What are the consequences of skipping them? Are they useful? Do you hate them?
  12. As a physician, I am curious about your views on what characterizes the ideal PA-physician relationship within a group practice?
  13. I'm a physician, and I wholeheartedly disagree. 1. PAs have been embraced by my group and are a fast growing segment of our large practice. We predict that our future labor needs will be PA (or NP) dominated. Most practices are well behind ours and market forces will eventually cause them to change their approach. 2. We treat NPs = PAs, but among midlevel providers, > 90% are PAs. Our PAs (for whatever reason) tend to be slightly stronger as a group than our NPs. 3. PA residencies are in their infancy. In the future, PA residencies will proliferate and organize. They will continue to mimic existing physician residencies and will reduce some of the heterogeneity among PA graduates in terms of quality. Ultimately, I see the "CAQ" taking on a more prominent role (analogous to physician "boards") to certify quality. Accreditation is coming and will be important for those post-graduate programs. 4. PAs don't need to do much to "advance" their field. The marketplace will accomplish this without any assistance. If anything, PAs should be jockeying for position to ensure that they are preferred midlevel providers "over" NPs. NPs, meanwhile, are planning the same thing as PAs, looking to make their own education requirements more rigorous to enable them to make a quality claim. Ultimately, however, both fields will remain in high demand. 5. The squabbling about name changes (assistant versus associate), and political standing, etc. are, in my opinion, a meaningless waste of time. Most patients will base their opinion of the provider on the manner and quality of the information being provided. Internists, emergency physicians, family practitioners, and pediatricians all speak regularly with patients who may initially approach them with some skepticism with respect to matters they consider to be better handled by a "specialist." As a result, for many patients, generalists are on the bottom of the "trust" totem pole. However, a good provider can change minds quickly, no matter his or her background or title.
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