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LT_Oneal_PAC

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LT_Oneal_PAC last won the day on February 23

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About LT_Oneal_PAC

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    PA-C. EM PGY-2

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    Physician Associate

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  1. Part of the logical error here is that physicians are not all the same. Doctor of osteopathy and medicine are different and many states have their own unique boards. They both do are allowed to do the same things and trained in similar, but not identical, manner. Up until recently there were osteopathic only residencies. Further into that realm, and only slightly off topic, their is not requirement to be trained as a specialist in any state. All states require one, and some two, years of residency. Make no mistake, there are physicians practicing emergency medicine in BFE who have less time in residency than me. They have hospital privleged and bill insurance, same as their BC colleagues. Correct, we do not have text entirely written by PAs, with the exception of some procedural texts, but we could. We have our own distinct residencies, our own curriculum (med students aren’t required to do an EM rotation for example, my peds resident buddy did NICU instead). We could be entirely trained by other PAs. so given that there are two professions with similar scopes already in medicine, I do not see why there can’t be a third. Now I’m not saying we should have the same unlimited national scope that physicians have (legally an IM doc could do open heart surgery and it not be a criminal act), I don’t they should either, but we definitely have carved out a set our skills that we have mastery of.
  2. I agree. There are plenty of names that describe what we do and have a good chance of passing, even if some think they are “ridiculous”. Further, I believe the name change should not only describe our medical practice, but also show we are a separate profession from physicians. We are members on the healthcare team, same as NPs, RTs, paramedics, pharmacists, that deserve our own distinct scope of practice separate from physicians. Some of us in our profession do “assist” physicians, but so do some nurses and pharmacists, but that doesn’t mean they are incapable of acting alone.
  3. 1st, this is terrible legislative strategy. 2nd, please refrain from unnecessarily referring to political figures to stir up controversy. This thread is not about the current administration.
  4. I really like medical practitioner, I still believe that it just won’t work legally speaking. Other providers will say we can’t legally protect the term and prevent them from using it. Still think Clinical Officer is the best of those most likely to be accepted. Used by other countries so there is precedence to argue public would not be confused (an argument they WILL make), very specific about being a clinical authority, CO doesn’t phonetically sound like anything other health profession, doesn’t tie you to anything (for the argument that some PAs have health science degrees and not medical degrees ect).
  5. “Pigman, an emergency room physician, offered a 153-page amendment to the measure that added physician assistants to the bill, a move that made doctors, and some lawmakers, more uncomfortable with the measure.” Representative Pigman who introduced the bill and got it out of committee, and is also an EM physician, added us on. We should all write him a thank you letter.
  6. I've only held salaried positions. Military, residency, and my upcoming job at a CAH. The first 2 are obviously non-negotiable, but I have it spelled out at my new job that I will be required to work no more than 12-12 hour shifts in a 28 day period and no more than 3 shifts in a week with 4 hours per week of admin time. I have a float month that I will work 2 of in 10 months, that will randomize my schedule, but still no more than 12 in one month and no fewer than 6. Any shifts that I chose to work over 12 will be paid at $90/hr. Being a CAH that sees low volume-high acuity, I prefer this so that I'm still paid a full salary on those float months that I may be working fewer hours and I have my schedule very spelled out and can't really be abused, because honestly I don't want to be forced to work even for extra money. There are days in residency, usually when I'm going in for that 25th shift in 28, that I think even if they were going to pay me $200 per hour I wouldn't go in if I wasn't required.
  7. Some shady UC that would make your life miserable (IE work you to death until you quit) might take you. Legit places want someone who can hit the ground running and will be a long term source of help when they have someone take vacation or what not.
  8. Current PGY2 EM resident after working 3 years in military/FM. You got questions, I got answers. It depends on what you want out of being a PA. Wanna see urgent care and fast track work while making decent salary, residency probably isn't for you. Want to do full scope EM, work in a CAH, command higher negotiating power when applying for EM jobs? It's for you. Doing a real residency, not these 6 month training programs for private groups, is grueling work, but the results are excellent.
  9. Could go to a CAH. Half the volume. No hospitalist to argue with. No glut of admin.
  10. Here is an article by the amazing Brett Faine. IMO, the smartest pharmacist alive. He’s pretty amazing at ED pharmacology. http://epmonthly.com/article/the-calcium-quandary/
  11. Oh. We do chloride literally all the time, especially when gluconate was in shortage. We just squirt the amp into a d5w 100cc bag. great case!
  12. Why gluconate, if I may ask? My inpatient pharmacists, who are about half as good as our ED pharmacists, always want it because of the risk of exstravasation. In this guy though, with history of alcohol abuse with probably liver disease (gluconate requires liver metabolism) and severely depleted (more elemental calcium in CaCl), I’m surprised they did not recommend this.
  13. Yeah, I have no desire to do 1099. The only other option is working for the university and become faculty, which would also be good, but they have no FTE available at this time, so I would be having to hope something would open up. Also you have to work as staff for at least a year before faculty status, and the pay for that is terrible with a much worse schedule. Plus, honestly, I’ve learned I hate academic medicine. The expectation to consult services when it isn’t needed, people not wanting to see patients and work because they aren’t paid more, and the glut of admin is horrible.
  14. Agreed! Having done some urgent care when I was in FM, would do rural ED with only a glucometer before I do UC again.
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