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Can a PA be employed in occupational medicine?


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39 minutes ago, PA2020Candidate said:

Can a PA be employed as the primary healthcare provider in the occupational medicine department at a hospital?  Can you make a career out of that?

It varies from state to state, but I could have 50+ hours of well-paying Occ med patients if I wanted to make that my sole focus, so yeah, I'd say you can make a career out of it.  This is Washington state; I understand in Oregon a PA can only be the attending provider on a case for the first 120 days or something; no idea about other states.

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I was for 2 years. Depending on the state, there are generally "levels" of Occ Med providers because worker's compensation is partly a state-funded thing. Basically the level dictates the medico-legal care you can provide for worker's compensation cases. I'm probably explaining it crudely but that's how it was in Colorado.

I cant say Id recommend it as a specialty.

 

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3 hours ago, CJAdmission said:

That was the question I was going to follow with: why would you want to?

Because people who don't get better right away are discarded by society: their employers, friends, spouses and families... They will typically lose everything.

I didn't intend to get into occupational medicine.  But, having stumbled into it and built rapport with my patients, and seeing how many other incompetent, dismissive providers they have been victimized by, I cannot bear to NOT take care of them.  Grown men and women at the mercy of a system they do not understand and cannot control--they need an advocate.

I just had an ortho MD IME examiner double down on his statement that he is at least 51% sure that a janitor's CMC arthritis has nothing to do with her working with her hands repetitively for the last 12 years.  When evil men like that take a paycheck to turn a blind eye to the suffering of injured workers... how can I not stand up for them?

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Oh, I completely agree--fakers suck.  Since so many of my patients are the long-term ones, the ones whose cases have dragged on and on, I really don't have to deal with THAT aspect of the system: if you've been in the system for 2+ years, you're pretty much not faking, because there are waaay easier ways to get a meager income for free.

Having worked through an initially ridiculous panel of old cases that I inherited, I mostly take old cases when someone else has ceased seeing the patient.  I do do some straightforward new cases, but it's not the emphasis of my current clinic.

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Most occ med jobs have two camps.  Either you work for a place that answers directly to the company/Insurance adjuster/case manager and treat the patient like they do...a criminal OR you work for a clinic that is co-owned by a defense/litigation worker's comp attorney and take the patient off work for 3 months.  I have yet to find the happy middle ground that lets providers treat the injuries like any other non-workers comp injury.  In Urgent Care we do a LOT of worker's comp, and I was told on day one...you are NEVER EVER under any circumstances to take a patient off work.  Even for fractures.  It's lovely.

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On 2/10/2018 at 7:29 AM, Cideous said:

Most occ med jobs have two camps.  Either you work for a place that answers directly to the company/Insurance adjuster/case manager and treat the patient like they do...a criminal OR you work for a clinic that is co-owned by a defense/litigation worker's comp attorney and take the patient off work for 3 months.  I have yet to find the happy middle ground that lets providers treat the injuries like any other non-workers comp injury.  In Urgent Care we do a LOT of worker's comp, and I was told on day one...you are NEVER EVER under any circumstances to take a patient off work.  Even for fractures.  It's lovely.

That's sad.  I guess I kind of stumbled into the middle ground, because I don't do either. My boss is a DO who's likely going to retire in a few years, has had plenty of opportunities to sell his private practice and hasn't.  He's actually been my PCP for ~18 years and wrote an LOR for me for PA school, to boot. :-)

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