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Simplify last won the day on July 16 2016

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About Simplify

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    Physician Assistant

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  1. Curious about your practice-- are you treating high risk patients with tamiflu even if they are more than 48 hours from onset off illness? High risk being defined by CDC guidelines (pregnant, >65, <5 but especially less than 2, significant comorbidities). I have scoured the CDC guidelines and they seem vague about this. They state that treatment should be given as soon as possible in high risk patients but do not define a 48 hour window, they also state there may be some benefit up to 5 days. Obviously tamiflu has side effects, limited benefit, cost issues etc. So, hypothetica
  2. Curious if anyone has experience with this. If you work rural EM but your supervising physician is a primary care physician (standard for many rural departments) are you able to apply for NHSC loan repayment? Appreciate your thoughts.
  3. Curious, how many of you rural EM folks (solo coverage) are reading your own films? Recently started at a solo coverage position which will does not have a radiologist reviewing X-RAYS but will have a radiologist reviewing CTs (remotely). I have been relatively spoiled until now with radiology interpreting all imaging. I am not worried about the obvious pneumonia or fracture however the thought of missing a hairline fracture or subtle finding on lateral neck film makes me a little nervous. Thoughts? Also, for those of you without 24/7 formal ultrasound what are you doing with folks that n
  4. Do you have POC US available? I have been getting in the habit of walking into the room w/ US at the ready when I pick up geriatric SOB patient. It's actually pretty slick. A few windows over the anterior chest looking for diffuse B lines (not hard to spot once you have seen a few although can see localized B lines w/ lobar pneumonia) and bam, you are done.
  5. I vote for ED. Adenosine is a well tolerated drug that works wonderfully in SVT. That said, even the best of us has been fooled by an afib w/ RVR that appeared regular-ish enough to pass for SVT. Giving Adenosine to a WPW, fib, aflutter or any polymorphic rhythm etc can quickly lead to hemodynamic collapse. I would ask if your UC is equipped to run a resuscitation? If not, they should go to the ED. I would definitely advocate for vagal maneuvers in the meantime however; the latest and greatest:
  6. I have received some great financial advice on this forum. Curious if any of you seasoned PA's have invested in land (either to sit on or to build on). If so, was it a good idea? How do you see this fitting in with your other investments?
  7. Agree with Boats. I am neither rural nor solo coverage and I would say this contract sucks. I work ~100 hours per month and make 10k more than this. At 144 hours per month would be in the 140k - 150k range. Obviously region plays a huge part but I would not be happy with this offer. Salaried EM work is a non-starter for me in most cases. Many perks to getting paid an hourly rate.
  8. Agreed. I currently work 12, 8 hour shifts per month in ED. Make just around 100k. Could easily pick up extra shifts (which I do occasionally if we have a big purchase coming up) or second job altogether and make substantially more but I choose not to. Everyone has to sort out their own definition of fulfillment and happiness. For me, it is having plenty of free time away from work. I am in the process of setting up a non medical side-hustle which has been fun and keeps the creative juices flowing. ~18 days off per month also allows me to occasionally coach in a sport I have a strong
  9. Life is too short. Find something else. Plenty of jobs out there where work and life can meet in the middle. I work 12, 8 hour shifts per month in ED. Make just under 100k. Work is demanding but ~ 18 days off per month helps an awful lot.
  10. Sound advice above. I agree that the key to financial independence is paying off debt early. However, I would advocate that you also live a life worth living. Take vacations. Take lots of vacations. Travel and have lots of incredible experiences along the way. Don't sacrifice your life now in order to boost a 401K or a ROTH by a few % points later. You will regret it.
  11. Interesting case. Way to stick to your guns. I don't work in cards, but my guess is she developed a cardiomyopathy and her decreased CO is under-perfusing her kidneys. This kicked her renin-angiotensin-aldosterone axis into high-gear, causing sodium retention and vasoconstriction.
  12. Awesome! Congrats! Could you discuss what loan forgiveness incentives the ANG has for PA's?
  13. E- Curious as to what programs these are? My understanding is that a residency doesn't meet the hours requirement for the CAQ because of the time spent on off-service rotations (even 18 month programs).
  14. A doctorate degree will definitely help you in the academic realm such as obtaining full professor status although these positions rarely pay as well as clinical work. It will likely not be of any benefit in a clinical setting either as far as higher compensation is concerned. Look to our slightly lower paid doctoral equivalents (Doctoral Nurse Practitioner per the latest salary report) for proof.
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