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Hey that's great-two months in, you are feeling comfortable. 

I'm curious as to what you mean "ppd tests don't require you to do any work at all".  Do you have the nurse assess for risk level (HIV positive, potential sources of contact) and potential levels of positivity- or a check off sheet?  At least sit down and document this discussion, that you considered false positive and false neg.  You can bill for that.

Also as a new grad, what is your policy on the drug seekers?  I'm not talking the narcotics, I mean the "I know a sinus infection folks".  Good time to practice because in four months, there's going to a line out the door.

Just bringing this up because my first flu season in a walk-in was the most terrible time of my life, and I've been through some hellacious times.  I'm much better now.

 

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I’ve been a new grad for about as long. However I would just caution you on getting too confident. Being a provider is not easy and you usually don’t know you missed the boat until it’s too late. I’m reminded everyday that I have a lot more to learn. I don’t think it’s a bad thing, I just consider it growth opportunities, most of which I didn’t know I needed to learn. What drugs cause syncope, what are common causes of thrombocytopenia, what do you look for when you read a Hida scan? So while I’m glad you are feeling confident, remember us new grads still have a lot to learn. 

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To be honest the longer you practice the dumber you can get. 

You get much better clinically, but unless you intentionally read and stay up-to-date on relevant practice topics you will cut your groove so deep that you forget there is a whole world outside of your well-worn path and, in fact, an embarrassingly large volume of information you have forgotten or are simply ignorant of.

I can get through most days in my job without looking anything up but from time to time I am reminded of just how dumb I am. I couldn't read a HIDA scan, I couldnt tell you more than a couple causes of thrombocytopenia, I couldnt manage type 1 diabetes right now.

To be a good clinician, yes you need a good fund of knowledge, but more importantly you need to know what to DO. When do you refer, to whom do you refer, what is within your scope to understand and manage, what are you responsible for and how much responsibility should you take on for a given patient. You are a decision-maker, not necessarily an oracle.

But as others have said, the feeling of 'knowing enough' usually precedes a bad outcome, so dont ever think too highly of your competence.

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