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Found 3 results

  1. Hi All, I am currently a PA who is in a fellowship for epidemiology which is about to end and I am trying to move back closer to Nevada where my family lives (we have a baby boy, now, and really want him to have grandparents around). I was wondering if anyone who lives in Las Vegas/Reno or SLC can share their thoughts on the job market, practice environment, and salaries in NV vs. UT? I have a strong background in public health and epidemiology/research, but I am thinking I might switch back to medicine for a while for the pay (my parents don't have enough money saved for retirement) and to keep my clinical skills fresh. I am interested in emergency medicine or any positions that might be well suited for someone with 2 years of Emed experience. Thanks for your consideration!
  2. Hey folks, I've been working in emergency medicine for about 1 year in a setting with a good mixture of high acuity and fastrack patients at a teaching institution. I've also worked during this time per diem at a low volume urgent care. While this has been an outstanding first job in terms of resume building and learning, it of course has the downside of wild hours, nights, weekends, holidays, etc. at a rather noncompetitive hourly rate/salary. I don't hate the job, but I also don't see myself doing emergency medicine forever. Or at least...not at this salary. For those who started in emergency medicine, what are your thoughts on transitioning to an urgent care job? I have heard some describe a miserable existence of patient volumes upwards of 60 patients a day, but I am guessing this is very dependent on the institution. Are there other specialties that make for a natural transition from emergency medicine? Am keeping all my options open at this point. Thanks!
  3. Question that I've been struggling with...when do you pull the trigger on firing a noncompliant patient? We terminate after 3 no shows, if they are threatening, if there is a lawsuit (haven't seen that happen but obviously policy). I know many also terminate for failure to comply with recommendations. Almost all patients are noncompliant in some way, whether it's not making dietary changes, taking meds as prescribed, etc, and we don't terminate them. What about extreme cases? What is the breaking point? I work in neurology and we have a patient with epilepsy secondary to craniotomy for aneurysm many years ago. She has been in status epilepticus many times. She continues to have seizures but refuses further testing (EEG or neuroimaging), labs, or even adjustments in medication. She does seem to be compliant with the medicine she takes, but obviously the dose is not adequate and she won't increase it, so basically a moot point. She continues to be admitted for breakthrough seizures, refuses EEG, and leaves AMA. She refuses to see my SP due to personality conflicts I guess, so I'm her main neurology provider, which is fine. I'm getting more and more nervous however about possible legal ramifications if she goes into status and doesn't wake up. I know I have tried everything I can and I document at length that we discussed the various risks associated with her not complying with our recommendations, that she is aware of the risks and continues to refuse, etc. I am getting very anxious about the eventual disaster that will happen with her and me being the main person treating her epilepsy. I feel like my documentation is thorough enough that if a lawsuit would happen, it wouldn't go anywhere. Obviously I don't want it to even get to that point however. We have other neurologists here so I wouldn't be abandoning her per se, I just feel very guilty about giving up on her. As I type this I'm seeing exactly how bad her situation is and I think I know my answer. I know there are practices that terminate for less, even if patients don't get vaccinations. I would however like to get other people's opinions and see what other PA's breaking points are for when they just don't feel they're getting anywhere with a patient or if a patient blatantly ignores their medical advice. Thanks! Edit for additional details I forgot, which don't help her case at all, has had hemiparesis, thought to possibly be Todd's paralysis, but has been recommended to start daily aspirin which she also refuses.....
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