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How much "preventive" work do you do in your PA job?


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Jim Hammond described PA's as such:

 

...[PA's] perform the most fundamental yet complex tasks in medicine - the diagnosis, treatment, and prevention of a wide array of diseases and disorders - tasks not commonly done by nursing or allied health professionals."*

 

I definitely know that PAs diagnose and treat patients.

 

How much do PAs in general (or you specifically) work in "prevention" ?

 

 

 

 

* (p.24, Ballweg/Stolberg/Sullivan - Physician Assistant: A Guide to Clinical Practice)

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working in em I do a bit but not as much as folks in primary care. I see a lot of folks on meds who no longer have a pcp and on occasion I will do some tweaking to their med regimen. for example I saw someone last week who comes in all the time with really high blood sugars on metformin and glyburide. I took them off glyburide and started daily low dose injectable lantus insulin, got them a glucometer, strips, lancets, syringes, glucose log, etc and diabetic teaching from the local free clinic and arranged close follow up for them with a volunteer endocrinologist at the free clinic.

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Int Med PA here. I do it almost at every encounter. It helps pump-up billing $ amt. I usually quickly review the preventive health screening section in their chart before leaving the room. e.g. for a female pt 45 or older; will check to ensure that mammogram, pap smear, HIV test, FOBT & colonoscopy etc are up-to-date. If pt are smoker, will counsel them of risk & will usually offer treatment. If pt decline, will document in chart.

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generally try and have a conversation about birth control with patients not using protection.

yup, almost daily:

me: are you sexually active

15 yr old: yes, all the time

me: do you use condoms or other birth control

15: no

me: so you're trying to have a baby?

15: no

me: well, let's talk about that.....

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yup, almost daily:

me: are you sexually active

15 yr old: yes, all the time

me: do you use condoms or other birth control

15: no

me: so you're trying to have a baby?

15: no

me: well, let's talk about that.....

 

One of my more common responses to these patients:

 

Me: Are you using condoms?

Patient: Sometimes...

Me: If you were jumping out of an airplane, would you use a parachute "sometimes", or every single time you jump?

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counsel pregnant patients to breast feed; bikers, cyclists, motorbikers to wear a helmet; people to wear seat belt ;exercise one hour for 6 days a week; safe sex practices (always test for the whole spectrum of diseases to hopefully scare the crap out of them and get them to use a condum!)

 

and many more..... this is the "money" for me as if I get behavioral changes now I don't have to tell them they have an STD, TBI, GC, or all the stuff they avoid..... not a large part of my day but a part of it for sure

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