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LT_Oneal_PAC

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LT_Oneal_PAC last won the day on July 22

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About LT_Oneal_PAC

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    EM Medical Care Practitioner

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    Physician Associate

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  1. Oh I’ll be getting mine. It’s time to ask for that 30k US machine. Also, I’m using all the PTO and I’m not going to work a single day in November
  2. 184 hours worked in 216 hours (9 days). 280 hours in 3 weeks. Student half the time on top. Burned out doesn’t feel like it accurately describes my mental state. Medical director is on FMLA and others were taking vacation. I estimate I saved them 30k in locums fees after paying my salary plus OT. Burned out doesn’t feel like an accurate description.
  3. “It is difficult to get a man to understand something when his salary depends upon his not understanding it.”
  4. Seriously though, congrats! Go forth and do great things my friend!
  5. The mental gymnastics we will see is going to be astonishing. They’ll speak a lot to trends and how it the care was showing a trend to improvement with physicians and it would have been shown if it was powered right, even though this was a very well powered study. Honestly, I see EMRA and AAEM just using this to highlight how inept non-EM trained physicians are in the ED. “See! Only EM boarded physicians should work in the ED! Non-EM dragged the stats down to the PA level of care!”
  6. This is the best study to date on comparing PA and physician outcomes. The caveats are these were very experienced PAs, they had taken a course in advanced procedural work, and there was a mix of physician specialists with half being EM. Also it is single site. The study was really well done though. also, finally a reason to read JAAPA https://journals.lww.com/jaapa/Fulltext/2021/07000/Comparing_physicians_and_PAs_as_solo_providers_in.15.aspx?fbclid=IwAR27JWPC8Psh8qvWA4Vqps3S9KnB_iUhIkp6tSpCyoATf_j_LABgvhJefb8
  7. No idea. Part of me hoped that I can be the medical director for my very rural ED one day, but that probably won’t ever happen. Maybe chief Pa position if I’m lucky, but doubt that either. Maybe teaching and part time clinical? Some days I think about going back into the reserves to finish out my last 15 years and get my pension. really though, I wish I could own a food truck made from an old ambulance. Call it the Hambulance, making deli sandwiches.name sandwiches after medical procedures you’ll need for eating to much like a greasy burger the lapchole. Maybe a vitamin rich smoothie
  8. I get half the CME funds that physicians do. I tried to subtly make the point to admin if they think the physicians know more than me, I need the same or more funding to increase my knowledge, unless they think I know more than they do and then I agree I need less funding. Didn’t get it, but I think my point was well made.
  9. lots of excellent advice here. Take all of it to heart. Realize you aren’t alone. I could have written this exact same thing my first few years in FM. Staying late everyday to read, often staying until 7-9 at night, looking tons of things up, calling all my patients with their lab results, coming in on weekends to finish notes and call patients to check on them making sure they were doing better, double checking everything I told people. Anxiety everyday on the drive home from work. Praying to God every morning that I would do good and not screw up. I took being the manager of my pane
  10. I would love precedex. I brought it up to the committee, but it was shot down
  11. Thanks for the advice all. I sent an email to my director, being very clear I don’t want my name mentioned at all or any kudos. Just a concerning trend regarding quality and integrity. If he wants to do nothing with it, that’s fine. It’s not my place to publicly call him out.
  12. To clarify, I’m overall letting it go. I’m not going to whine to anyone. Im not a spotlight kind of guy and prefer my anonymity. I’ve learned the fewer people that know your name the easier life is. I’m mainly considering bringing it up to my medical director as he has already been compiling complaints such as: him making up lab tests in sign out that support his diagnosis, him putting patients on Eliquis and heparin for a “PE” (there was no PE ultimately) that bleed into their chest, countless unnecessary antibiotics (2 weeks zosyn for small wound debridement), giving fluconazole wi
  13. I’ve also been using a lot of ketamine infusions. Like 0.5mg/kg in 100cc given over 6 hours once daily. Works like a charm to reduce opioid use. love the lidocaine use. I’ve never seen that before. Definitely will give that a try.
  14. So, I’m not entirely sure if he claimed credit, or they gave him credit and he didn’t deny it. While covering the floor on the weekend the nurses called me because a bullous rash was getting worse. She’s a skilled patient that I normally don’t deal with. Get a history and immediately recognize this is bullous pemphigoid that’s been misdiagnosed for months as cellulitis. Call derm at the referral center. They think it’s medication reaction, which I disagree, but it’s treated basically the same. The next note he says he spoke with derm and patient has working diagnosis of bullous pemph
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