My friend Maria is in nursing school right now. Of my hometown circle of friends she's the only one going into health care. She also plans on eventually going on to become an NP. This is a dangerous situation because Maria is a very aggressive in your face person. I get along well with her, but you don't want to get on her bad side.
My other friend one time unknowingly started a small NP vs. PA battle. He had jokingly said something to me about coming to me when he needs the "good stuff." Maria then looked at me with a confused face and said, "But aren't you going to PA school? How will you get him the 'good stuff." She had no idea that PA could prescribe medication. I don't think she has any idea what the role of a PA is. I'm fairly sure the only PA she's ever seen on rotations was a surgical one and she admitted that they were doing hardcore work with the surgeon. But I still don't think she realize PAs see their own patients in most medical specialities.
Tonight I was playing a drinking game against her and at one point called her "Nurse Maria." She immediately got offended and said, "Whatever. I'm going to be making more money than you." I was taken aback. Not because she was so delusional about that comment, but that she thought I was trying to be offensive. I think nursing is a very respectable field. I don't compare it to being a physician or a PA because they're not the same. Nursing does their thing, and Medicine does theirs.
I try to avoid this whole NP/PA battle as much as possible. I don't judge people's performance at work based off their title. I base it off their actions. If they're a competent provider then I respect them and their opinion. I don't care if that comes from nursing, PA or medical school. Medicine is not this big secret where only med students get taught the magic words.
Sunday, July 05, 2009
Saturday, July 04, 2009
Classic Convo
[Watching Fox News about Palin's resignation]
Me: (After listening to grandma defending Palin on and on and on..) I'm just going to throw this out - I don't like her.
Grandma: How can you say that?! You don't even know her! I love her!
Me: I know her just as well as you do and we come to two different conclusions.
Grandma: (jokingly) I think you're just a liberal!
Me: Yes, I'm a big liberal that refuses to shave.
[I do in fact refuse to shave because regardless of what my grandparents think, facial hair is not some hippie protest and is actually my attempt to look hot. I've got the Grey's Anatomy scruff going on for the past 5 years. They skill haven't accepted this.]
This side of the family might as well be Evangelicals. Fox News is basically the only channel they watch. They'll watch CNN late at night. But they basically consider everyone outside of Fox News big liberals.
I personally think the liberals and conservatives have run away with what the original Democrats and Republicans stood for. I consider myself Republican and NOT conservative. There is a difference between the two, but the line has been greatly fogged.
Me: (After listening to grandma defending Palin on and on and on..) I'm just going to throw this out - I don't like her.
Grandma: How can you say that?! You don't even know her! I love her!
Me: I know her just as well as you do and we come to two different conclusions.
Grandma: (jokingly) I think you're just a liberal!
Me: Yes, I'm a big liberal that refuses to shave.
[I do in fact refuse to shave because regardless of what my grandparents think, facial hair is not some hippie protest and is actually my attempt to look hot. I've got the Grey's Anatomy scruff going on for the past 5 years. They skill haven't accepted this.]
This side of the family might as well be Evangelicals. Fox News is basically the only channel they watch. They'll watch CNN late at night. But they basically consider everyone outside of Fox News big liberals.
I personally think the liberals and conservatives have run away with what the original Democrats and Republicans stood for. I consider myself Republican and NOT conservative. There is a difference between the two, but the line has been greatly fogged.
The Salesman
Again I wonder if I'm a bad person for telling people the reasons I chose PA school over med school. Some people respond well. Tonight I had the exact opposite experience that I had in that older post.
The pre-med student asked questions about what I thought about her goals, and I answered them truthfully. She listened to the reason why I chose PA over medschool. After everything she said I was a "very good salesman." That made me feel dirty. I'm not trying to "sell" the profession. The profession sold itself to me. I'm just showing her what I liked about it.
I truly am not someone who tries to talk people out of med school. We need doctors. For some people medschool is a better match than PA school. But also there are many, many doctors who realize too late that this isn't what they signed up for. I listened to those doctors and took those opinions into account when I made my decision. I'm a big fan of basing decisions off other people's experience. I realize that I'm not that different from others. If a lot of people tell me one thing, chances are I will react the same way. So if most docs tell me "DON'T DO MED SCHOOL" and most PAs tell me "I LOVE MY JOB," then what's the logical thing to choose?
This specific pre-med's concern was whether she could have a family life, while being a physician. I think this is one of the hardest things to accomplish. Some specialties lend itself better to family life than others. She said cardiothoracic surgery. That is not one of them... I told her that 70%+ of most PA classes are woman. If you asked them why PA and not MD most will tell you "because it's easier to balance being a PA with having a family." It's true.
In college I shadowed a very intense breast cancer surgeon. She was trained by the best and wasn't above name dropping. She talked about job offers she got at Mayo Clinic and such. She was full of herself, but she was good and she was also very happy. The latter was surprising. I asked her if she had any children. She said no, and "by choice." Her profession was her love and enjoyed going home and spending time with her husband. I respected this answer immensely. She knew what she wanted in life, and was honest with herself. She was happy because she understood the reality of the situation.
I'm not the one crushing dreams. It's the reality of life that does that. In the long run I think I'm helping people by pointing out the truths that people like to ignore. Ignoring reality doesn't help anyone, it only prolongs disappointment.
The pre-med student asked questions about what I thought about her goals, and I answered them truthfully. She listened to the reason why I chose PA over medschool. After everything she said I was a "very good salesman." That made me feel dirty. I'm not trying to "sell" the profession. The profession sold itself to me. I'm just showing her what I liked about it.
I truly am not someone who tries to talk people out of med school. We need doctors. For some people medschool is a better match than PA school. But also there are many, many doctors who realize too late that this isn't what they signed up for. I listened to those doctors and took those opinions into account when I made my decision. I'm a big fan of basing decisions off other people's experience. I realize that I'm not that different from others. If a lot of people tell me one thing, chances are I will react the same way. So if most docs tell me "DON'T DO MED SCHOOL" and most PAs tell me "I LOVE MY JOB," then what's the logical thing to choose?
This specific pre-med's concern was whether she could have a family life, while being a physician. I think this is one of the hardest things to accomplish. Some specialties lend itself better to family life than others. She said cardiothoracic surgery. That is not one of them... I told her that 70%+ of most PA classes are woman. If you asked them why PA and not MD most will tell you "because it's easier to balance being a PA with having a family." It's true.
In college I shadowed a very intense breast cancer surgeon. She was trained by the best and wasn't above name dropping. She talked about job offers she got at Mayo Clinic and such. She was full of herself, but she was good and she was also very happy. The latter was surprising. I asked her if she had any children. She said no, and "by choice." Her profession was her love and enjoyed going home and spending time with her husband. I respected this answer immensely. She knew what she wanted in life, and was honest with herself. She was happy because she understood the reality of the situation.
I'm not the one crushing dreams. It's the reality of life that does that. In the long run I think I'm helping people by pointing out the truths that people like to ignore. Ignoring reality doesn't help anyone, it only prolongs disappointment.
Friday, July 03, 2009
Obvious Revelation
This whole time I've trying to get into PA school and waiting for it to start it never dawned on me what that really meant. It means that I'm GOING BACK TO SCHOOL. Gaaaaaaaaah.
I enjoyed working. I liked doing what I liked, getting paid for it, and going home and not working anymore. Doing the school work was the part of college I don't miss. I mean I always knew PA school was going to be hard but I'm just remembering now what the actual act of studying feels like. It's the shit.
Now I'm going to have to remind myself that it's only 12 months of classes. Rotations I can handle. I prefer the abuse during the day and then going home, rather than sitting in class all day just to study more at home. And yes, I'm well aware that there is studying during rotations, but there is just something different about that I think. Maybe I'm completely wrong. I guess time will tell.
I'm going to go stare at my profile on facebook now. Specifically the education "Grad School: M.S., Physician Assistant Studies." I know I'm kind of pathetic.
I enjoyed working. I liked doing what I liked, getting paid for it, and going home and not working anymore. Doing the school work was the part of college I don't miss. I mean I always knew PA school was going to be hard but I'm just remembering now what the actual act of studying feels like. It's the shit.
Now I'm going to have to remind myself that it's only 12 months of classes. Rotations I can handle. I prefer the abuse during the day and then going home, rather than sitting in class all day just to study more at home. And yes, I'm well aware that there is studying during rotations, but there is just something different about that I think. Maybe I'm completely wrong. I guess time will tell.
I'm going to go stare at my profile on facebook now. Specifically the education "Grad School: M.S., Physician Assistant Studies." I know I'm kind of pathetic.
Monday, June 29, 2009
Introductions
I know this is a topic that has been talked about, but I never came across this option.
Physicians always introduce themselves as Dr. Smith, and from what I see PAs generally always introduce themselves like "Hi, I'm John a Physician Assistant." Many PAs have said that they like to keep it personal by using their first name only.
At the same time though many PAs feel they are not taken as seriously as they should be. People question them and we mainly attribute it to the word Assistant being in the title.
While I think the word "assistant" definitely contributes to this, I wonder if introducing oneself as "John Smith the Physician Assistant" may help make the difference. If we want to be treated like the professionals we are, then maybe we have to start carrying ourselves like that. Lawyers, business men, etc never introduce themselves by just their first name.
I personally think I'm always going to use my first+last name. Let your bedside manner make the patient feel comfortable, not the name you use to introduce yourself.
Physicians always introduce themselves as Dr. Smith, and from what I see PAs generally always introduce themselves like "Hi, I'm John a Physician Assistant." Many PAs have said that they like to keep it personal by using their first name only.
At the same time though many PAs feel they are not taken as seriously as they should be. People question them and we mainly attribute it to the word Assistant being in the title.
While I think the word "assistant" definitely contributes to this, I wonder if introducing oneself as "John Smith the Physician Assistant" may help make the difference. If we want to be treated like the professionals we are, then maybe we have to start carrying ourselves like that. Lawyers, business men, etc never introduce themselves by just their first name.
I personally think I'm always going to use my first+last name. Let your bedside manner make the patient feel comfortable, not the name you use to introduce yourself.
Advice
If anyone ever has questions for me it should be known that you can e-mail me at gregoryhousepa[at]gmail[dot]com. And I think I'll post the questions and responses in order to make this blog a little more useful. I'll even try to start using the tagging feature, so that maybe one day I'll have an easy to access archive of advice. And also, questions don't have to pertain to PA school and such. I'm pretty sought after for advice because I'm coldly logical and honest.
Question:
I read in your blog that you have an EMT degree and was able to get a job as a medical assistant. Do you also have a medical assistant degree or was your EMT degree enough for you to qualify for this job? I hope to hear from you soon and goodluck on your first day of PA school. :)
The reason that I got the EMT-B was because from what I saw many, many PAs started out as EMTs. I should actually say many of the "older generation" PAs use to be EMTs. They all told me that it was a great entry field for health care and would give me good experience learning how to do an initial examination and assessment. The training did just that, but to be perfectly honest I didn't learn much in terms of medicine outside of doing a history. But learning how to do a history is critical. Before the class I had a B.S. in biomedical science, and knew much more on the science side than my classmates and maybe some of the instructor EMTs. I digress.
I also did the course because I thought it would help me get a job as an EMT. I later found out in my area there are very few paying EMT-B jobs.
I know that I would have gotten my job as a medical assistant without getting the EMT. However, I can't say that I would have gotten into PA school. They did ask me about my EMT training and why I did it. They liked my answer about how I did it because senior PAs told me to and that it gave me a valuable knowledge on taking a history.
So in short. No, the EMT-B did not help me get my Medical Assistant job. My college degree did. And no, I did not get a medical assistant degree. The EMT-B did help me get into PA school though, and so did my job.
Question:
I read in your blog that you have an EMT degree and was able to get a job as a medical assistant. Do you also have a medical assistant degree or was your EMT degree enough for you to qualify for this job? I hope to hear from you soon and goodluck on your first day of PA school. :)
The reason that I got the EMT-B was because from what I saw many, many PAs started out as EMTs. I should actually say many of the "older generation" PAs use to be EMTs. They all told me that it was a great entry field for health care and would give me good experience learning how to do an initial examination and assessment. The training did just that, but to be perfectly honest I didn't learn much in terms of medicine outside of doing a history. But learning how to do a history is critical. Before the class I had a B.S. in biomedical science, and knew much more on the science side than my classmates and maybe some of the instructor EMTs. I digress.
I also did the course because I thought it would help me get a job as an EMT. I later found out in my area there are very few paying EMT-B jobs.
I know that I would have gotten my job as a medical assistant without getting the EMT. However, I can't say that I would have gotten into PA school. They did ask me about my EMT training and why I did it. They liked my answer about how I did it because senior PAs told me to and that it gave me a valuable knowledge on taking a history.
So in short. No, the EMT-B did not help me get my Medical Assistant job. My college degree did. And no, I did not get a medical assistant degree. The EMT-B did help me get into PA school though, and so did my job.
Sunday, June 28, 2009
The Move In
Pick up 14' U-Haul at 8AM. I've been dreading driving this thing for weeks.
Start packing up my stuff at my family's home.
9AM call from unidentified person confirming my installation at 12PM. I assume this is the Cable company because they've called multiple times lately to confirm even though I cancelled my appointment. I say to the guy "I don't want Cable. I cancelled my Cable installation. I said the Cable companies name many times in the conversation."
An hour later I get a call from Satellite company confirming my cancellation. I go "Nooo. That guy never told me he was Satellite. He never corrected me when I kept calling him the Cable guy." So he confirmed my 4-8PM installation.
Satellite Installer calls back to confirm my 12PM appointment. "Noo. It's a 4-8PM appointment." He then asks 4-8PM on Sunday? NOOOO!!! 4-8PM TODAY (Saturday)!!!!! He says okay and that it would be around 5-6PM.
I get everything packed up. Drive the truck without issue. And get everything into the apartment.
When I got to the apartment I see a note from UPS saying they tried to deliver a package but no one was home to sign for it, and that's it's at their pick-up center. They were trying to deliver the modem I order to be sent to my GRANDPARENT'S ADDRESS. When I order internet I made this perfectly clear that I needed it sent to the grandparent's address. I spent an hour on the phone to get this shipping address corrected. I finally did, and they sent it to the wrong address anyway. FUCK MY LIFE.
The note says that it's going to be returned to the sender on the 29th. I call UPS and they said they already sent it back, even though it's 2 days early. Bastards.
I call Internet Provider and they apologize but I'm going to have to call Billing to get a new modem sent. Billing is only open on weekdays. Fuck my life again.
So 8PM rolls around. Satellite guy never shows up. I decided there is no way I'm staying at this apartment without internet or TV and go back to the grandparent's.
Today I call Satellite when I wake up. They say that the installer showed up at 4:15PM and no one was home. I'm 95% sure that I was at the apartment by them. But am willing to accept that I might not have been. So I ask why they didn't call my phone when they had been calling me all day. They claim that they did call and left a voicemail. Yeah, right. Because you know if I got a voicemail I would be calling with all these questions.
Blaaaaaah. Moving is so much fun. At least my apartment is looking good.
The End.
Start packing up my stuff at my family's home.
9AM call from unidentified person confirming my installation at 12PM. I assume this is the Cable company because they've called multiple times lately to confirm even though I cancelled my appointment. I say to the guy "I don't want Cable. I cancelled my Cable installation. I said the Cable companies name many times in the conversation."
An hour later I get a call from Satellite company confirming my cancellation. I go "Nooo. That guy never told me he was Satellite. He never corrected me when I kept calling him the Cable guy." So he confirmed my 4-8PM installation.
Satellite Installer calls back to confirm my 12PM appointment. "Noo. It's a 4-8PM appointment." He then asks 4-8PM on Sunday? NOOOO!!! 4-8PM TODAY (Saturday)!!!!! He says okay and that it would be around 5-6PM.
I get everything packed up. Drive the truck without issue. And get everything into the apartment.
When I got to the apartment I see a note from UPS saying they tried to deliver a package but no one was home to sign for it, and that's it's at their pick-up center. They were trying to deliver the modem I order to be sent to my GRANDPARENT'S ADDRESS. When I order internet I made this perfectly clear that I needed it sent to the grandparent's address. I spent an hour on the phone to get this shipping address corrected. I finally did, and they sent it to the wrong address anyway. FUCK MY LIFE.
The note says that it's going to be returned to the sender on the 29th. I call UPS and they said they already sent it back, even though it's 2 days early. Bastards.
I call Internet Provider and they apologize but I'm going to have to call Billing to get a new modem sent. Billing is only open on weekdays. Fuck my life again.
So 8PM rolls around. Satellite guy never shows up. I decided there is no way I'm staying at this apartment without internet or TV and go back to the grandparent's.
Today I call Satellite when I wake up. They say that the installer showed up at 4:15PM and no one was home. I'm 95% sure that I was at the apartment by them. But am willing to accept that I might not have been. So I ask why they didn't call my phone when they had been calling me all day. They claim that they did call and left a voicemail. Yeah, right. Because you know if I got a voicemail I would be calling with all these questions.
Blaaaaaah. Moving is so much fun. At least my apartment is looking good.
The End.
Friday, June 19, 2009
Wednesday, June 17, 2009
Get What You Asked For
Some people have given me shit about voting for McCain even though he's not for gay rights. Back in November I wasn't overwhelmed by Obama's support for homos. My instincts have proven me correct, as usual.
Tuesday, June 09, 2009
Retired and Moving to Florida
Friday was my last day of work. It was a busy day and actually not a pleasant one, so it wasn't a sad departure. It was sad in the fact that I was so busy that I didn't really get to say good bye to anyone. The office wasn't able to gather around to say bye because I was so busy. I ate my departure cake more or less by myself, with maybe 5/20 co-workers. Lame. Oh well, Florida vacation here I come!
So lets see. College: done; EMT Training: done; Getting job: Done; Getting into PA school: Done; Finding roommate/apartment: Done; Moving In: Pending.
Moving is the next great step. I'm trying to get the family clan organized so that this can be done in one great sweeping motion. Tomorrow I'm getting the keys from the landlord. I think next week Roommate said he was going to move a few things in. I'm hoping to meet him there and get things like room layout, tv/internet and utilities things all straightened out. Once that's out of the way I'll know what I need to bring, buy and schedule. I must say I rock at this.
On an entirely different note I've been reading a lot of commentary by nurses and physicians about PAs. Some of the stuff they say use to outrage me. Now I honestly laugh at the misinformation they put out there. NPs making their claims of superiority and Physicians dumbing down the work of PAs. It makes me laugh out loud. My attitude now is they can say what they want about the profession. It really doesn't change the reality of the situation. All these physicians talk about how they could never be intellectually fulfilled doing the work of a PA and that they can't handle not being the final say. You know, that's totally fine - to each their own. I think the fact that I don't have issue working under someone works to my advantage. I say this because when I ask physicians if they would go into medicine again, most say no. PAs say the opposite. So lets see, I could be the final say and be miserable, or work under someone and be happy. I'll take the latter.
I've made a very concerted effort to develop an attitude where I don't have issue asking questions, admitting I'm wrong, willing to try new methods, and letting someone make the final call that I disagree with. You know why I'm cool with my opinions being totally disregarded? Because the blame can never be thrown squarely on me (normally), since I'm not the supervising physician. I will do my best to voice my opinion and have an intelligent discussion. The physician can do with it what he likes. I think I would get more satisfaction in occasionally being the PA that's right, than the physician who's often right during disagreements. I think this attitude of openness to learning from others but at the same being able to diplomatically disagree are going to be my greatest assets.
So lets see. College: done; EMT Training: done; Getting job: Done; Getting into PA school: Done; Finding roommate/apartment: Done; Moving In: Pending.
Moving is the next great step. I'm trying to get the family clan organized so that this can be done in one great sweeping motion. Tomorrow I'm getting the keys from the landlord. I think next week Roommate said he was going to move a few things in. I'm hoping to meet him there and get things like room layout, tv/internet and utilities things all straightened out. Once that's out of the way I'll know what I need to bring, buy and schedule. I must say I rock at this.
On an entirely different note I've been reading a lot of commentary by nurses and physicians about PAs. Some of the stuff they say use to outrage me. Now I honestly laugh at the misinformation they put out there. NPs making their claims of superiority and Physicians dumbing down the work of PAs. It makes me laugh out loud. My attitude now is they can say what they want about the profession. It really doesn't change the reality of the situation. All these physicians talk about how they could never be intellectually fulfilled doing the work of a PA and that they can't handle not being the final say. You know, that's totally fine - to each their own. I think the fact that I don't have issue working under someone works to my advantage. I say this because when I ask physicians if they would go into medicine again, most say no. PAs say the opposite. So lets see, I could be the final say and be miserable, or work under someone and be happy. I'll take the latter.
I've made a very concerted effort to develop an attitude where I don't have issue asking questions, admitting I'm wrong, willing to try new methods, and letting someone make the final call that I disagree with. You know why I'm cool with my opinions being totally disregarded? Because the blame can never be thrown squarely on me (normally), since I'm not the supervising physician. I will do my best to voice my opinion and have an intelligent discussion. The physician can do with it what he likes. I think I would get more satisfaction in occasionally being the PA that's right, than the physician who's often right during disagreements. I think this attitude of openness to learning from others but at the same being able to diplomatically disagree are going to be my greatest assets.
Tuesday, June 02, 2009
4 Days of Work, 40 Days Until Class
This is nuts I'm almost done with work for good. Since I started training people I can see huge changes in myself in terms of being capable. Everyone keeps reminding me of how unsure of myself I was when I first started. And now the new people have moments where they wonder how I'm so knowledgeable about the office. It's good assurance that in the future I'm going to be able to adapt even without good training. These new medical assistants are getting some real TLC from me, unlike how I was received when I started.
I'm starting to freak out about a little about moving. I'm moving to Too Big City. A city that I've lived near my whole life and am well acquainted with. I worked there for two summers and go in often enough with friends. I've never liked it. Too many people, too congested, too dirty, and even though it was good public transportation I still feel like it takes forever to get anywhere. But it's impossible to avoid the fact that this is where my school is. Technically, I'm not going to be living in TBC. I found a slightly more manageable city that has a super easy commute to school.
I'm going to be without my car for the first time in a few years. I'm truly converting into an urbanite. This scares me, because I don't know how living like an urbanite works. I'm a suburban boy damn it!! I don't know where I'm going to get my groceries, how I'll get them home, especially during the winter. Things like that. I also don't know my neighborhood that well. I'm going to have to do some real exploring when I first move in. God help me if it's not safe. When is move in? I have no idea. I need to figure that out.
Eep. Starting to freak out a little.
I'm starting to freak out about a little about moving. I'm moving to Too Big City. A city that I've lived near my whole life and am well acquainted with. I worked there for two summers and go in often enough with friends. I've never liked it. Too many people, too congested, too dirty, and even though it was good public transportation I still feel like it takes forever to get anywhere. But it's impossible to avoid the fact that this is where my school is. Technically, I'm not going to be living in TBC. I found a slightly more manageable city that has a super easy commute to school.
I'm going to be without my car for the first time in a few years. I'm truly converting into an urbanite. This scares me, because I don't know how living like an urbanite works. I'm a suburban boy damn it!! I don't know where I'm going to get my groceries, how I'll get them home, especially during the winter. Things like that. I also don't know my neighborhood that well. I'm going to have to do some real exploring when I first move in. God help me if it's not safe. When is move in? I have no idea. I need to figure that out.
Eep. Starting to freak out a little.
Saturday, May 30, 2009
Old People
Why are senior citizens and others of that generational mind set against gay marriage? I propose it's because most of them haven't even thought about it.
[While watching a segment on gay marriage on CNN with grandma]
Grandma: But what if they got into a fight or something and wanted to split up? What would they do?
Me: Get a divorce like 50% of heterosexual marriages....
Clearly she has put a lot of thought into it. I can't put her at fault though. Most of my hetero friends don't seem to really care what happens with gay rights because it's not something that affects them, or regularly think about.
[While watching a segment on gay marriage on CNN with grandma]
Grandma: But what if they got into a fight or something and wanted to split up? What would they do?
Me: Get a divorce like 50% of heterosexual marriages....
Clearly she has put a lot of thought into it. I can't put her at fault though. Most of my hetero friends don't seem to really care what happens with gay rights because it's not something that affects them, or regularly think about.
Friday, May 29, 2009
"Real Doctor"
Even though Cosmetic Doctor likes to see primarily cosmetic "patients" he still sees mainly medical patients, since this is before anything else a medical dermatology practice. I can tell that he doesn't like seeing medical patients though, especially pediatric patients. This is a little odd since the practice specializes in pediatrics, but nonetheless this is where he decided to work. Fair enough though, since Boss Doctor is board certified in Peds Derm, so I guess not all Derms would handle kids as well as him.
Quick example of this:
We get many children with Molluscum Contagiosum which Boss Doctor will always attempt to treat. The condition is self-limiting, but we'll try to move it along by using a blistering agent like Cantherone or liquid nitrogen. The Cantherone treatment is immediately painless, but the kids often freak out on us cause they're generally very young. If it becomes too much of a struggle then Boss Doctor just lets it go and gives them a topical that is slower acting but normally less traumatic.
Cosmetic Doctor has been presented with this situation an inordinate number of times lately. How does he handle the situation? By telling parents that pediatric derms generally don't treat it. I'm not sure how true that is since both Boss Doctor and the PAs will attempt treatment every single time. There was one really bad situation where the child was screaming uncontrollably and the parents just weren't convincing us that they wanted us to continue, even though they told us to go ahead. Cosmetic Doctor more or less froze during the situation. At one point I had to interject so that the parents and doctor would stop staring at each other with blank expressions.
Anyway... Fine he's not comfortable treating kids. Pediatric derm isn't his thing, but surely general derm is something he could handle. So a psoriasis patient came in with a history of failing topical treatments, but being successful with biologics in our practice. The patient had to go off the biologics because of insurance problems, but could now continue. Well at least he could of continued if Cosmetic Doctor hadn't replied to his request with, "I haven't prescribed biologics in years and am not comfortable prescribing that." Excuse me?!?!?! THIS IS STANDARD DERMATOLOGY!!! HAVEN'T PRESCRIBED IN YEARS?!?! THERE IS NO WAY YOU COULD BE MORE THAN 5 YEARS OUT OF RESIDENCY!!!
Boss Doctor's verbal reaction to this - "What? Isn't he a real doctor?"
How did we resolve the situation? Referred the patient to the 1.5 years of experience PA that is comfortable handling biologic patients.
Let this be a lesson to all the asshole physicians I've been reading lately who say P.A.s aren't capable of the same level of care as Board Certified physicians. P.A.s are totally capable of being trained to the same standard as board certified physicians. I don't even want to know how Cosmetic Doctor would have handled Senior P.A.s erythrodermic psoriasis patient...
Quick example of this:
We get many children with Molluscum Contagiosum which Boss Doctor will always attempt to treat. The condition is self-limiting, but we'll try to move it along by using a blistering agent like Cantherone or liquid nitrogen. The Cantherone treatment is immediately painless, but the kids often freak out on us cause they're generally very young. If it becomes too much of a struggle then Boss Doctor just lets it go and gives them a topical that is slower acting but normally less traumatic.
Cosmetic Doctor has been presented with this situation an inordinate number of times lately. How does he handle the situation? By telling parents that pediatric derms generally don't treat it. I'm not sure how true that is since both Boss Doctor and the PAs will attempt treatment every single time. There was one really bad situation where the child was screaming uncontrollably and the parents just weren't convincing us that they wanted us to continue, even though they told us to go ahead. Cosmetic Doctor more or less froze during the situation. At one point I had to interject so that the parents and doctor would stop staring at each other with blank expressions.
Anyway... Fine he's not comfortable treating kids. Pediatric derm isn't his thing, but surely general derm is something he could handle. So a psoriasis patient came in with a history of failing topical treatments, but being successful with biologics in our practice. The patient had to go off the biologics because of insurance problems, but could now continue. Well at least he could of continued if Cosmetic Doctor hadn't replied to his request with, "I haven't prescribed biologics in years and am not comfortable prescribing that." Excuse me?!?!?! THIS IS STANDARD DERMATOLOGY!!! HAVEN'T PRESCRIBED IN YEARS?!?! THERE IS NO WAY YOU COULD BE MORE THAN 5 YEARS OUT OF RESIDENCY!!!
Boss Doctor's verbal reaction to this - "What? Isn't he a real doctor?"
How did we resolve the situation? Referred the patient to the 1.5 years of experience PA that is comfortable handling biologic patients.
Let this be a lesson to all the asshole physicians I've been reading lately who say P.A.s aren't capable of the same level of care as Board Certified physicians. P.A.s are totally capable of being trained to the same standard as board certified physicians. I don't even want to know how Cosmetic Doctor would have handled Senior P.A.s erythrodermic psoriasis patient...
Tuesday, May 26, 2009
Monday, May 25, 2009
Shoot Me
My grandmother sent me out to get an ice cream cake for my uncle's birthday. She wanted something plain like chocolate or vanilla, something everyone would like. I come home with chocolate chip. She kind of freaked out as if chocolate chip was something no two people in the world could ever agree upon liking. It's freaking chocolate chip! That's as plain and boring as it gets outside of chocolate and vanilla. AHHH!!!! SHE'S CRAZZZZYYY!!!!
One more thing. This weekend there were plans to have a BBQ at my parents' house on Monday and have lasagna at my grandmother's on Monday. For some reason we didn't do lasagna Sunday and my grandmother says "Oh well we'll have it tomorrow (Monday), which is just as well because it's suppose to rain today (Sunday)." Why just as well? Were we planning on eating lasagna outside? I guess lasagna on Memorial Day is standard tradition...
One more thing. This weekend there were plans to have a BBQ at my parents' house on Monday and have lasagna at my grandmother's on Monday. For some reason we didn't do lasagna Sunday and my grandmother says "Oh well we'll have it tomorrow (Monday), which is just as well because it's suppose to rain today (Sunday)." Why just as well? Were we planning on eating lasagna outside? I guess lasagna on Memorial Day is standard tradition...
Friday, May 15, 2009
15 Days
I only have 15 days of work left. I've been the moodiest bitch in the world lately. I'm not exactly sure why, but I'm sure it's because I'm almost done at this place. The shit that I use to put up with so well, I can no longer stand. I also have just not been as on top of my game as I usually am. I forget to get simple things ready when seeing patients, my notes are lack luster. It's just all going down hill.
The entire office knows how many days left I have. This is mainly due to the fact that announce it many times throughout the day. Many people are upset about this. I too am upset that I'm not going to see these people every day. I like all of my co-workers and everyone seems to like me. I'm the jokester of the office and make everyone laugh. But I'm not going to miss my role in the office at all. I feel like there are always a million different people asking me to do stuff. The front desk is asking me to answer patient questions, office manager is always on our ass about doing things faster (although she's gotten better since I snapped at her), the providers are snapping at me if I'm not doing every goddamn thing that needs to get done in the room. Honestly, it's as if they want to sit on a cloud and watch from afar the medical assistant do everything. DON'T COMPLAIN TO ME BECAUSE YOU HAVE TO WRITE HALF OF THE NOTE. IT'S YOUR FUCKING SIGNATURE THAT GOES AT THE END OF IT!!!! Jesus Christ these people are so needy. I'm very interested to see what I'm like on the other side of the coin.
Senior PA often says that I make a crappy medical assistant, but will make a good PA. I don't know how much she means that though. She most recently said this because one day she asked me to call in some medication and I never remembered to do it, but in all fairness I wasn't even working with her that day. I had my own things to do, had another provider to work for and then she just gives me some random job to do. God knows that she has plenty of instances where she doesn't have any work to do and could have called in the god damn medication herself. She sits in the back corner doing online surveys for 40 dollar checks, while I never have a moment to sit around and do nothing. God I can't wait to stop working for $10 an hour.
The entire office knows how many days left I have. This is mainly due to the fact that announce it many times throughout the day. Many people are upset about this. I too am upset that I'm not going to see these people every day. I like all of my co-workers and everyone seems to like me. I'm the jokester of the office and make everyone laugh. But I'm not going to miss my role in the office at all. I feel like there are always a million different people asking me to do stuff. The front desk is asking me to answer patient questions, office manager is always on our ass about doing things faster (although she's gotten better since I snapped at her), the providers are snapping at me if I'm not doing every goddamn thing that needs to get done in the room. Honestly, it's as if they want to sit on a cloud and watch from afar the medical assistant do everything. DON'T COMPLAIN TO ME BECAUSE YOU HAVE TO WRITE HALF OF THE NOTE. IT'S YOUR FUCKING SIGNATURE THAT GOES AT THE END OF IT!!!! Jesus Christ these people are so needy. I'm very interested to see what I'm like on the other side of the coin.
Senior PA often says that I make a crappy medical assistant, but will make a good PA. I don't know how much she means that though. She most recently said this because one day she asked me to call in some medication and I never remembered to do it, but in all fairness I wasn't even working with her that day. I had my own things to do, had another provider to work for and then she just gives me some random job to do. God knows that she has plenty of instances where she doesn't have any work to do and could have called in the god damn medication herself. She sits in the back corner doing online surveys for 40 dollar checks, while I never have a moment to sit around and do nothing. God I can't wait to stop working for $10 an hour.
Friday, May 08, 2009
Due Process My Ass
February of last year a got a ticket for driving while using a mobile phone. The officer told me if I pled not guilty and brought a hands-free device the judge would probably let me off. I bought that hands free device (on a drive that lead to that annoying accident) and pled not guilty to be told that I would be given a court date in about three months.
I graduated college, left that town, and sent the court a signed letter saying what my new address was and that I wanted to plead guilty.
1 year, 3 months later they finally gave me my court date in that town that I no longer live in. WTF?!?!? Where the fuck is the due process in all of this. I can't go to this court date. I just want to plead GUILTY and pay my effing penalty. What is going to happen if I don't show up to this court date?
Shoot me.
[Edit:]
My brother claims (who's had LOTS of tickets), and the DMV website suggests that if I don't show up then my license will be suspended and I will then have the opportunity to pay the fine then. I'm going to send the court a letter again trying to plead guilty. Otherwise, I'm just not going to the court date and hope I get something in the mail allowing me to pay my fine off.
I graduated college, left that town, and sent the court a signed letter saying what my new address was and that I wanted to plead guilty.
1 year, 3 months later they finally gave me my court date in that town that I no longer live in. WTF?!?!? Where the fuck is the due process in all of this. I can't go to this court date. I just want to plead GUILTY and pay my effing penalty. What is going to happen if I don't show up to this court date?
Shoot me.
[Edit:]
My brother claims (who's had LOTS of tickets), and the DMV website suggests that if I don't show up then my license will be suspended and I will then have the opportunity to pay the fine then. I'm going to send the court a letter again trying to plead guilty. Otherwise, I'm just not going to the court date and hope I get something in the mail allowing me to pay my fine off.
Wednesday, May 06, 2009
5
Maine legalized same sex marriage today. You go Maine!
New Hampshire's legislative branch passed it, and it waits to be signed by the governor. Lets do this NH!
Washington D.C. City Counsel has passed the acknowledgment of same-sex marriage, but needs to pass the 30 days review period in Congress. In general I don't believe Congress generally goes against the Counsel's decisions, but this could be interesting.
A decision in New York is pending. The governor there introduced a bill legalizing same-sex marriage. The state currently recognizes marriages done in other states.
That is your gay update of the day.
New Hampshire's legislative branch passed it, and it waits to be signed by the governor. Lets do this NH!
Washington D.C. City Counsel has passed the acknowledgment of same-sex marriage, but needs to pass the 30 days review period in Congress. In general I don't believe Congress generally goes against the Counsel's decisions, but this could be interesting.
A decision in New York is pending. The governor there introduced a bill legalizing same-sex marriage. The state currently recognizes marriages done in other states.
That is your gay update of the day.
Monday, May 04, 2009
I'm not THAT stupid
I checked out an apartment yesterday that I thought was too good to be true. Surprisingly, the place ended up looking just as it did in its online posting. I did not play it cool and made it quite obvious that I wanted the apartment badly. (TWENTY MINUTE COMMUTE TO SCHOOL!!!) But I did press upon him how good of a tenant I am: great reviews from past landlords, professional student, minimum year lease with probability of 26 months.
They sent me the Rent Application and I faxed it over today. They then told me that I would be getting lease papers tomorrow. horrah! But wait! There's a catch! He said I was going to be the sole signer on the lease. whaaaaaaaat?! Yeah that is definitely not happening.
I called him and long story short, I gave it to him. I told him how there is no way in hell I'm going to be held responsible for Roommate. I understand that it's in the landlord's best interest to only have one person to deal with legally, but ummmm I'm not retarded. I have to cover my own ass. He tried to act like proposing a multi-tenant lease as some unheard of idea. I then pointed out that every lease I've ever signed included every occupant, so this is not some novel idea of mine. He then changed his tune a little and said that maybe his lawyer could work something out. And by lawyer he probably meant Standard Multi-Tenant Lease from Google.
As I typed this I received an e-mail from Landlord saying that making up a multi-tenant lease was not going to be a problem and that I'll have the papers by mid-day tomorrow. DAMN RIGHT BIOTCH! I OWN AT LIFE!
Can you say shortest apartment search ever? God I amaze myself sometimes. I don't know which is more impressive, my job search last summer or this apartment search. I'm going to say this apartment search because the job pays so shitily, yet my job was the reason I got into school.
They sent me the Rent Application and I faxed it over today. They then told me that I would be getting lease papers tomorrow. horrah! But wait! There's a catch! He said I was going to be the sole signer on the lease. whaaaaaaaat?! Yeah that is definitely not happening.
I called him and long story short, I gave it to him. I told him how there is no way in hell I'm going to be held responsible for Roommate. I understand that it's in the landlord's best interest to only have one person to deal with legally, but ummmm I'm not retarded. I have to cover my own ass. He tried to act like proposing a multi-tenant lease as some unheard of idea. I then pointed out that every lease I've ever signed included every occupant, so this is not some novel idea of mine. He then changed his tune a little and said that maybe his lawyer could work something out. And by lawyer he probably meant Standard Multi-Tenant Lease from Google.
As I typed this I received an e-mail from Landlord saying that making up a multi-tenant lease was not going to be a problem and that I'll have the papers by mid-day tomorrow. DAMN RIGHT BIOTCH! I OWN AT LIFE!
Can you say shortest apartment search ever? God I amaze myself sometimes. I don't know which is more impressive, my job search last summer or this apartment search. I'm going to say this apartment search because the job pays so shitily, yet my job was the reason I got into school.
Tuesday, April 28, 2009
Blindsided
Cosmetic Doctor explained to a patient that to get rid of the lines on her forehead she would need botox and that it would cost $400. She was hesitant because of the cost and since it only lasts about 3 months. As she was leaving I told her to check back for specials in May because it could go on sale and in the past had gone for $150 and sometimes needed to be packaged with another procedure. She got really excited about this and even booked a microdermabrasion and laser hair removal at the front desk once she saw they were on sale.
When I walked back to the examination rooms Cosmetic Doctor said to me in a hushed voice, "Guy, don't tell patients to wait on cosmetic procedures to see if they go on sale. We want them to get them now." I gave a simple, "Okay." And I meant it. I wouldn't get involved with that in the future. Even though I have to say I was surprised since Cosmetic Doctor is always trying to give patients fair prices, something Boss Doctor doesn't.
During my lunch break Boss Doctor came in to speak to me. He told me not to talk to patients about past and future prices of cosmetic procedures and that we're trying to get them to do procedures day of. I told him I understood and that I wasn't going to talk pricing anymore. Now I'm not sure how Boss Doctor caught wind of this, but I feel Cosmetic Doctor must have said something to him. I did give him my said of the story though about how I told the patient AS THEY WERE LEAVING and that the patient became very excited and was definitely going to eat up these specials. He actually then seemed to agree with how I handled the situation.
I was shocked that Cosmetic Doctor did that to me. I had never heard him ever go to Boss Doctor about another employee. In the rooms he's ALWAYS asking me about the pricing of things and always seems shocked when I tell him about the prices we charge. I couldn't believe he was trying to get more out of the patient.
But what surprised me more: Boss Doctor later in the day APOLOGIZED TO ME for speaking to me in front of Senior PA. He said it was unprofessional and should have done it in private. I COULDN'T BELIEVE IT!!! It wasn't even a big deal to me when he spoke to me about that. I come from Irish Catholic breeding. I can handle being told I did something wrong and accepting it. I can't remember a single time he ever apologized to someone for being unprofessional and he is OFTEN much more unprofessional. I'm really happy that Boss Doctor looks at me as someone that deserves respect. I started the job with Boss Doctor wanting to fire me badly, and now he's freely apologizing to me!!! This is insanity.
When I walked back to the examination rooms Cosmetic Doctor said to me in a hushed voice, "Guy, don't tell patients to wait on cosmetic procedures to see if they go on sale. We want them to get them now." I gave a simple, "Okay." And I meant it. I wouldn't get involved with that in the future. Even though I have to say I was surprised since Cosmetic Doctor is always trying to give patients fair prices, something Boss Doctor doesn't.
During my lunch break Boss Doctor came in to speak to me. He told me not to talk to patients about past and future prices of cosmetic procedures and that we're trying to get them to do procedures day of. I told him I understood and that I wasn't going to talk pricing anymore. Now I'm not sure how Boss Doctor caught wind of this, but I feel Cosmetic Doctor must have said something to him. I did give him my said of the story though about how I told the patient AS THEY WERE LEAVING and that the patient became very excited and was definitely going to eat up these specials. He actually then seemed to agree with how I handled the situation.
I was shocked that Cosmetic Doctor did that to me. I had never heard him ever go to Boss Doctor about another employee. In the rooms he's ALWAYS asking me about the pricing of things and always seems shocked when I tell him about the prices we charge. I couldn't believe he was trying to get more out of the patient.
But what surprised me more: Boss Doctor later in the day APOLOGIZED TO ME for speaking to me in front of Senior PA. He said it was unprofessional and should have done it in private. I COULDN'T BELIEVE IT!!! It wasn't even a big deal to me when he spoke to me about that. I come from Irish Catholic breeding. I can handle being told I did something wrong and accepting it. I can't remember a single time he ever apologized to someone for being unprofessional and he is OFTEN much more unprofessional. I'm really happy that Boss Doctor looks at me as someone that deserves respect. I started the job with Boss Doctor wanting to fire me badly, and now he's freely apologizing to me!!! This is insanity.
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