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  1. What’s In A Spoonful? Robert M. Blumm, MA, PA-C Emeritus, DFAAPA Being a grandfather or grandmother is one of life’s most rewarding experiences. While reliving the early stages of life with our grandchildren we can enjoy their movies and get a second chance at some which we may have missed. I was recently watching Mary Poppins with my grandkids and found it delightful and uplifting. For days, I was rehashing that famous song in my head, “just a spoonful of sugar helps the medicine go down.” As a clinician, I paused with some concern as I had to ask myself: What, actually, is a spoonful? It is in the purview of physicians, NPs and PAs in pediatrics, family practice, internal medicine, urgent care, emergency medicine, retail health care and geriatrics to examine their patients who present with symptoms of a cold, allergy symptoms or a cough, resulting with a note recommending some form of OTC medicine. We commonly use the phrase “one or two teaspoons” and either document (or fail) to document this dosage. Either way, the potential for creating an iatrogenic poisoning or a drug reaction is quite high. It is always important to know what medications your patient may be taking - a critical practice which should accompany every patient encounter, whether new or not. Most PAs and NPs enter healthcare with the idea of working for 30-40 years but prudent attention to malpractice prevention can never start too early. Thorough, thoughtful practice can illuminate cross-sensitivity to prescribed OTC drugs. We need to look at OTCs as carefully as we would any prescribed medication, and it is equally important to know the age and weight of your patient, as a spoonful may be too little or too much. If the patient is a pediatric patient, the parent may be confused by the description of a spoonful and give a tablespoon, a teaspoon or a pediatric feeding spoonful. Children who are taking a drug, particularly an OTC drug, have a much greater possibility of a reaction. For many of our senior citizens on polypharmacy, there are many potential drug-drug-interactions that will increase or decrease the effectiveness of their other medications making way for hypertension, severe hypotension or rhythm changes related to their cardiac drugs. For a moment, consider the patient on Coumadin. This drug has restrictions on other medications, as well as foods and alcohol which can greatly affect the INR and create a life- threatening bleed in the brain or in the GI system. I was scolded by my cardiologist a few years ago for taking a class lll antiarhythmic with herbal drugs or vitamins and minerals. He made me wait an additional hour in his office, then had me step into his private room and asked me, “What is it that you don’t understand about taking NO additional supplements or herbs?” As a healthcare professional, he was shocked at my actions. These substances can interact with my prescribed drug regimen to the degree that I could have developed Torsade’s De Pontes. He asked me if my need to take supplements - including fish oil, glucosamine and chondroitin - surpassed my need to live. His direct approach about my nonchalant attitude regarding supplements certainly got my attention! Being careless can lead to a poor outcome for the patient, as well as a possible lawsuit. What can the collective “we” do to prevent a patient incident that is negative or life threatening? Check for other medications, review current drugs, look at age and weight and be cautious to write an OTC medication unless aware of all of the possible reactions. Is there anything else to glean from this? Another related concern is failure to document the other medications and to cross reference all contraindications, which are frequent causes for litigation involving PAs as well as NPs and particularly in the setting of the Retail Healthcare Clinic or Urgent Care Center. The same focus should apply to Telemedicine since it has become particularly popular during the pandemic. These concerns should encourage clinicians to consider how to best protect themselves, their professional futures and their families from litigation due to negligence. Accuracy is the name of the game and is the mandate for all healthcare professionals but owning proper professional liability is the safest solution for potential error. It is not a coincidence that you are reading this today, but a heartfelt concern of a colleague who wishes all PAs and NPs a long and successful career. You do not want to create a life-threatening situation or worse. Our ultimate goal is to retire with professional pride and satisfaction – with NO history of careless nonchalance or, pardon the expression, “sloppiness”. Perhaps this “spoonful” of advice might help…
  2. Hello all! My name is Kim and I am a demonstrated pre-PA coach and a current PA-S with a high success rate of client admission. I am currently available to take on new clients. I offer services including the following: personal statement editing/feedback, supplemental essay editing/feedback, interviewing prep/coaching, mock interviews, general pre-PA application advising sessions and pre-PA planning for the future. During the 2019-2020 cycle, I was invited to 7 interviews but only chose to attend 4 as I was accepted to my top choice by the 4th interview. I was accepted to ALL programs that I decided to interview with. Please email me at prepacoachkimberly@gmail.com if you are interested in learning more about my services. I also offer these services to other pre-health students as well. Happy holidays, Kim
  3. Hello all! My name is Kim and I am a demonstrated pre-PA coach and a current PA-S with a high success rate of client admission. I am currently available to take on new clients. I offer services including the following: personal statement editing/feedback, supplemental essay editing/feedback, interviewing prep/coaching, mock interviews, general pre-PA application advising sessions and pre-PA planning for the future. During the 2019-2020 cycle, I was invited to 7 interviews but only chose to attend 4 as I was accepted to my top choice by the 4th interview. I was accepted to ALL programs that I decided to interview with. Please email me at prepacoachkimberly@gmail.com if you are interested in learning more about my services. I also offer these services to other pre-health students as well. Happy holidays, Kim
  4. Hello Everyone, Is anyone aware of any virtual shadowing opportunities through zoom or any other video platform during this COVID-19 Pandemic?
  5. Is anyone on here (pre-PA, PA-S, or PA-C) a business major / have a business degree? Just out of curiosity, why did you leave the corporate world?
  6. Hi everyone, I am hoping that someone will be able to point me in the direction of some hospitals or private practices that have preceptors who are willing to take PA students in the scottsdale, mesa, Glendale, chandler, Tempe, Gilbert, Phoenix area of Arizona. I am currently a first year PA student at Hofstra university in New York and we are getting ready for rotations this year. For my program, we are allowed to do two rotations out of state so I hoping to go to Arizona. However, we are responsible for finding the preceptor and giving the information to Hofstra. I will be staying in Scottsdale but I am willing to drive!! Any information will be helpful as I am not really sure where to begin looking or who to contact. Thank you SO much in advance!!! Hunter
  7. There is an awesome organization called ThePAC (Physician Assistants of Color) that holds diversity events in multiple cities across the U.S. The next one will be in Detroit, Michigan on September 28, 2019. The event is a great opportunity for all three levels of the profession! https://www.eventbrite.com/e/thepac-takes-detroit-tickets-70091765357 Pre-PAs get to talk directly to program directors from the local/surrounding region (this event will have 7), and get specific advice about their application profile from programs directly as well as experienced PA students and PA-Cs. PA-S and PA-C get to fraternize and network with each other as well as tap into resources such as job recruiters, financial advisors, and transition to practice information. There are always lots of giveaways such as medical equipment, PANCE/PANRE prep, discounts on scrub companies, and more. This event is open to any and everyone no matter the race, ethnicity, religion, sexual orientation, etc. If you cannot attend this event, give them a follow on IG @thepa.c or FB 'Physician Assistants of Color' so you can get notified of when the next event/location will be.
  8. Hi everyone, I am hoping that someone will be able to point me in the direction of some hospitals or private practices that have preceptors who are willing to take PA students in the scottsdale, mesa, Glendale, chandler, Tempe, Gilbert, Phoenix area of Arizona. I am currently a first year PA student at Hofstra university in New York and we are getting ready for rotations this year. For my program, we are allowed to do two rotations out of state so I hoping to go to Arizona. However, we are responsible for finding the preceptor and giving the information to Hofstra. I will be staying in Scottsdale but I am willing to drive!! Any information will be helpful as I am not really sure where to begin looking or who to contact. Thank you SO much in advance!!! Hunter
  9. Hello! I feel blessed to be coming to you guys with such a problem, but it's been weighing on me and need advice from current PA-S's and PA-C's. I have been accepted to two schools: School A which is 20 minutes away from my current living space and School B which is closer to my parents, but still about an hour away. Schools A and B seem pretty comparable in terms of curriculum, program length (A: 27 mo versus B: 25 mo), PANCE pass rates (A: 97 versus B: 99), tuition (a difference of 3K), and employment rates after graduation. The main differences that I see are that school B is associated with a medical school, so networking opportunities and strength in name and that school B will end up costing almost 40K more due to cost of living expenses. School B was my top choice prior to interviewing but was not the first school to get back to me, therefore, I have not placed my deposit. School B is also where most of my college friends settled and has an opportunity for research, which is important to me. School A has cheaper living costs, and somewhat of a support system from my current workplace friends. l have seen two basic schools of thought for this quandary, which include: Go to the cheapest school, you'll thank yourself later. Go to the school that you will regret not going to if you choose otherwise. Do you agree with either of these or have your own idea based on your own experience? Any anecdotes proving either correct or other statements would be helpful. Thanks in advance!
  10. From the perspective of a PA-S who is on the cusp of completing the journey through the bowels of hell known as "Didactic Year" and going into the Clinical Phase, I've heard a lot of pros and cons on CAQ's. Basically, I started this topic with the motivation to find out if there are any major differences in benefits other than just sharpening your knowledge in a particular area, such as pay increases, responsibility/ duty increases, increase in the amount of procedures you can perform, hospital/ practice privileges, job availability, etc. Any and all input is greatly appreciated. Thanks.
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