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place123

Day in the life of a PA in Endocrinology?

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Met one during an interview with a school I had but never got a chance to ask what a PA does in Endocrinology.

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Diabetes and Hypothyroidism, if the PAs I know in Endo are to be believed. Pretty much just these two things, with a sprinkle of hyperthyroid before subsequently treating them for the resulting hypothyroidism.

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2 hours ago, place123 said:

Met one during an interview with a school I had but never got a chance to ask what a PA does in Endocrinology.

they worry about their ability to pass panre due to their narrow specialty focus....ditto folks in urology, addiction med, low-t clinics, cosmetic derm, marijuana card clinics, retail medicine, etcIf you work in any of these fields you really owe it to yourself to volunteer regularly doing primary care at a free clinic or something similar so you remember how to treat everything outside of your specialty...

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17 hours ago, EMEDPA said:

they worry about their ability to pass panre due to their narrow specialty focus....ditto folks in urology, addiction med, low-t clinics, cosmetic derm, marijuana card clinics, retail medicine, etcIf you work in any of these fields you really owe it to yourself to volunteer regularly doing primary care at a free clinic or something similar so you remember how to treat everything outside of your specialty...

Strange job description. 

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2 hours ago, place123 said:

Strange job description. 

it was a tongue in cheek/sarcastic way to basically say "you don't want to do this right out of school".

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1 hour ago, EMEDPA said:

it was a tongue in cheek/sarcastic way to basically say "you don't want to do this right out of school".

Thanks for the advice. 

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While I don't honestly have much of a clue what an endocrine PA does I'm willing to bet if you contacted your state organization they could set you up with the contact info of one.

And I'll go ahead and disagree with the above post, do what you want out of school. Unless you happen to fall into IM, FM or EM you're going to run into the same issue. Hell, you'll have a better chance at a lot of the material (in 10 years when you recert) than someone in CTS or ortho

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On 12/5/2018 at 12:40 PM, EMEDPA said:

they worry about their ability to pass panre due to their narrow specialty focus....ditto folks in urology, addiction med, low-t clinics, cosmetic derm, marijuana card clinics, retail medicine, etcIf you work in any of these fields you really owe it to yourself to volunteer regularly doing primary care at a free clinic or something similar so you remember how to treat everything outside of your specialty...

You wouldn't happen to have any suggestions for a specialty that would be a better fit, would you EMED? Jokes aside, I think that the fact that endo is part of internal medicine gives you more a wider background than you'd think. Also, it seems like most groups that do endo also have a primary care component to their patient population, so you get plenty of practice with the bread and butter diagnoses.

As an endo PA, I agree that my main population is diabetes and thyroid patients. We also see a fair amount of reproductive topics (irregular periods, PCOS) and neurology that intersects endocrinology (pituitary adenomas, we even see some Sheehan's syndrome). It's a basic outpatient schedule- I'm currently seeing 10 patients per day and working up to a goal of 16 per day, with time for charting in the middle of the day. It's not the most adrenaline-inducing field, but I'm fine with that. I will admit freely that it's not for everyone- I do a TON of chronic disease medication management and motivational interviewing for diabetic patients. However, my SP is a really supportive teacher, and I like the idea of getting to know patients over time and seeing the results of all of my work play out.

I do wish we had an excuse to rock scrubs every day though, business casual is not comfort forward...

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I really liked my endocrinology rotation. Lots of diabetes, osteoporosis/zoledronic acid infusions and thyroid disorders including nodule workups/FNA's, RAI's. Commonly saw prolactinomas, PCOS, calcium disorders, occasionally non-congenital adrenal hyperplasias, and sometimes incidentaloma workups. If you work in a hospital clinic, there is a lot of consults for insulin management of inpatients while they are taking steroids, or for the psych inpatients. It's a very functional science, and it the management of diabetes beyond lab numbers is a lot more complicated than people think if you keep up with the research.

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*Anecdotal info warning*

 

Our system has been pushing us to send pts to endo for DM with A1c above 8.0. My CP and I have a good record of controlling A1c and even bringing pts back from 8.0+. I have been doing this all my career.

 

The endo dept has a well meaning APP and a overworked Doc but it seems our pts get worse with them. They give them new meds they can't afford (newer gen dpp4i, SGLT2i etc) and still don't alter their diets.

 

We often have to change or tweak the meds they are given from endo and end up just managing the pt ourselves. Admin doesn't like it despite our good record of control (but not up to snuff according to admin's metrics ).

 

We do it the old fashioned way. Regiment their diet and exercise, start with Metformin and add or taper meds depending on response over time.

 

I have even taken several pts off med including insulin over the years due to their good control. I have several "lifestyle controlled DM2" pts in my panel that were once on insulin.

 

My point is I don't think we need endo for mgmt of DM or even thyroid unless they have failed conventional therapy.

 

Oh by the by, I do send them my Statin non responders for repatha tx's.

 

So I'll agree with whats said above that endo is a very narrow part of IM/FP and would only recommend it if you were close to retiring lol

 

Sent from my SAMSUNG-SM-G891A using Tapatalk

 

 

 

 

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