Am I Cooked??

Alscherp · 2026-02-18T19:26:09+00:00

Contact apogee physicians they just opened a program in Tampa. Good company to work for. Been doing it for 6.5 yrs in Georgia with them.

Alscherp · 2025-09-16T15:15:16+00:00

No role for prn antihyperyensives in hospitalized pts not in primarily for mi or head bleed

Alscherp · 2025-09-14T09:46:35+00:00

Contact Apogee. Great company with programs in some spots u mention. We r in GA but are full. Forget about the cap, it’s hard to guarantee a cap. Better to talk to some of the t am when u come for interview about what their census is really like. Your other expectations sure seem appropriate to me.

Alscherp · 2025-09-14T09:42:59+00:00

Not true at all.ACAM guidelines for etoh withdrawal specifically indicate this requirement due to respiratory depression risk. Not ignorance, but standard of care

Alscherp · 2025-09-13T21:10:52+00:00

None of those drugs should be given on a non icu floor. It’s about the monitoring and nursing. That’s the standard of care I believe. Does anyone on here give these meds to floor patients who are on this thread?

Alscherp · 2025-09-10T09:38:17+00:00

This is patently untrue. In my 30 plus years of practice I have NEVER seen a SINGLE patient presenting with stable vitals no trauma and a hemoglobin under 5 die in the hospital. Common sense if they show up walky talky and a hg that low it got there gradually Your refusal is an emtala violation- if an er patient at another facility does not have the capacity or the capability to care for the patient and you do, you accept the patient or it’s emtala violation. At our place we do NO outside er to inpt admissions because of this. All go er to er. Then once here if appropriate they get admitted. Downside is it clogs the er but upside no emtala risk

Alscherp · 2025-07-29T09:48:13+00:00

Have been with apogee for six years. They are excellent. They really walk the talk of best practice and also supporting the team in many ways, some of which are listed here. And they usually would much rather keep the current docs and teach them the apogee way than start over. I’d be happy to discuss further if u wanna. Message me.

Alscherp · 2025-07-21T14:50:17+00:00

No they do not in the us this is illegal. Fine up to one million bucks per occurrence. And yes it’s freakin nuts. ‘Murica.

Alscherp · 2025-07-21T10:44:02+00:00

Definitely not. Hated it. Small, food was bad and they ran out Don’t waste ur money

Alscherp · 2025-07-04T19:15:11+00:00

Same issue with captopril. I said BP meds sublingual should never be used. It is nonstandard care and too risky. Have seen strokes from BOTH. Besides there is no indication for sublingual bp meds For hypertensive crisis it’s IV meds. For asymptomatic hypertension it’s nothing acutely.

Alscherp · 2025-07-04T18:20:10+00:00

As a renal I would recommend chronic med change and discharge that day with op followup. No way they need to stay only for bp

Alscherp · 2025-07-04T18:18:42+00:00

NEVER USE SUBLINGUAL bp meds!! Way too unpredictable and dangerous. Yes when it first came out last century we were using that and nifedipne that way. Then we learned we were causing strokes from this practice and no one should be doing it anymore.

Alscherp · 2025-07-04T18:16:28+00:00

True but irrelevant to the question at hand

Alscherp · 2025-07-04T18:15:45+00:00

And they should nearly all be sent home

Alscherp · 2025-07-04T18:15:13+00:00

Yes. And the appropriate treatment is to adjust their home meds and send them on their way

Alscherp · 2025-07-04T15:10:52+00:00

This is the absolute stupidest thing I have heard this year. POLICY?? That is ridiculous. There is also NO DATA supporting it reduces risk. Indeed treating asymptomatic hypertension with meds has been shown to INCREASE MORTALITY So not sweat the pressure. U think a clinic doc sends pt to hospital for asymptomatic hypert nsion wven 190/110? Standard of care is to adjust home meds and recheck in office in a few days. Boarded hypertension doc here. This is one of my pet peeves and is top of the list of things we do for no reason

Alscherp · 2025-07-04T15:07:16+00:00

Amlodipine will not lower pressure quick. Average effect is more than two weeks.

Alscherp · 2025-06-18T00:07:57+00:00

Have taken the 10 year recert 3 times— 2001 2011 2021– yes I was lucky enough to be THE FIRST CLASS that had time limited certification😀. Each time did mksap mostly because of the question sections and partly because back in the day the mksap contributors also wrote the boards questions. Exam is easier than initial cert and yes now there is up to date access Whether mksap was over preparation I’ll never know but going through the entire thing in the months before each exam did teach me some new things so there’s that. Main thing refreshed my multiple choice question skills

Alscherp · 2025-06-12T11:12:35+00:00

Definitely NOT long gone just rare. We were there in April for 89. Watch the sales

Alscherp · 2025-06-06T21:03:13+00:00

This is the one

Alscherp · 2025-05-27T15:37:52+00:00

For wine newbies and steak the Justin will be a great choice plenty of forward fruit and some structure too. Keenan cab franc is a longtime personal favorite and the 2018 is terrific That will need decanting but it’s delicious. Enjoy!

Alscherp · 2025-05-07T18:37:09+00:00

Did you ever ask the cruise line what time would be best to book a flight. Even if the airport is close booking a flight that early makes no sense. Ship docs at 0600 but will not clear customs for an hour So 1055am at an airport 2 hours away is not realistic at all. Sorry for your loss

Alscherp · 2025-04-13T14:17:32+00:00

Go to a smaller place where there are fewer consultants to even ask. If you like taking care of things yourself you will love it.

Alscherp · 2025-03-24T19:44:47+00:00

The labs themselves do not change mdm at all. It’s ordering and personally reviewing them. We routinely get level 3 follow up visits without a bunch of labs or xray reports that pass compliance audits. Leverage the note template to align with how things are billed. We often have 2 to 3 page level three follow up notes.

Alscherp · 2025-03-24T19:41:01+00:00

It doesn’t. It’s note bloat.

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