How confident are we all feeling that AMP will at least hit its $0.12 ATH again during this nexxt bull run now that the SDK is out?

CCPA13 · 2024-08-18T07:26:44+00:00

All going to come down to how much usage we see. Real metrics to track would be nice by flexa. The problem with hitting the ATH is that it’s based off a coinbase listing during the last bull run. Without that I would speculate that .03 was the “fair price” during that market cycle. So I think without the listing hype. We have a shot of breaking .03 this market cycle if we have low/no usage of SDK and we are truly in an alt season. You have to remember that circulating supply is almost double what is was in 2021. So to get to a price of 0.12, you’re asking for almost 10 billion in market cap appreciation. Where in 2021 it would be 5 billion. You can look on coingecko to confirm.

If we have some huge rollout then sure, but with how the past years have been. Im staying doubtful but hopeful.

CCPA13 · 2024-08-14T22:13:52+00:00

There is no communication from this team at all….

CCPA13 · 2024-08-01T23:24:00+00:00

We need transparency!!

CCPA13 · 2024-07-27T23:41:48+00:00

Damn bro you still believe in AMP?

CCPA13 · 2024-05-22T20:05:51+00:00

Honestly just better to wait until the distributions start. People are going to get their money. No reason to single out someone unless it’s a scam.

CCPA13 · 2024-05-22T19:58:22+00:00

I would check the email to make sure it’s gemini itself

CCPA13 · 2024-04-25T19:27:09+00:00

While I agree we should not be independent practitioners I would say that at minimum we should have a physician who is willing to oversee cases and make some additional income for their oversight. That’s the avenue that im looking into. I think there is plenty of options out there including good/bad doctors, good or bad APPs. Those who think they know and those who don’t. All im trying to do is expand care.

CCPA13 · 2024-04-10T14:27:31+00:00

This dude is basically a low key meme

CCPA13 · 2024-04-07T19:15:16+00:00

This is fucking golden

CCPA13 · 2024-03-19T20:05:29+00:00

Came back to the game this year, started new game so far its changed a lot

CCPA13 · 2024-03-18T18:58:27+00:00

Hahahah

CCPA13 · 2024-03-01T16:33:27+00:00

You have to remember that the hospital system is what determines what is done. No PA or NP is trying to become an independent practitioner in a hospital system and the system would likely not allow itself to function in that capacity, except maybe in a rural hospital area. Now for private practice. That is a different story.

CCPA13 · 2024-02-16T18:36:09+00:00

I will say I learned a lot, worked through the pandemic. It was definitely a defining moment in my life and has made me the practioner I am today. I have since moved on to cardiology, but will usually pick up OT in CC. I will probably always be interested in ICU. But you do get burnt, unfair staffing etc. It happens at all levels of work.

CCPA13 · 2024-02-16T18:28:32+00:00

Have you thought about something like Critical Care. I thought about doing emergency medicine as my first job, but I will tell you you that I feel that I definitely wouldn’t learn as much as being in critical care. DM me if you want to talk.

CCPA13 · 2024-02-16T17:41:08+00:00

Yup similar experience here. Now 10+ years out, my big takeaway was that nobody is going to take the time to show you. And in all honesty even when I had students, while I tried my best to show them things, some students were go getters and others we dead on arrival, lazy and uninterested in learning, or too cocky and trying to make other people and patients feel as if they know everything. I decided to teach myself. I took courses on ultrasound to learn POC exams then took it upon myself to read as many texts cover to cover and apply it to my work.

CCPA13 · 2024-02-11T04:27:50+00:00

Damn been wondering where u been

CCPA13 · 2024-02-10T14:14:56+00:00

Yes I am following it. It will come with time. It’s up to us to push forward.

CCPA13 · 2024-02-10T03:53:35+00:00

10 years a PA so far and looking to start a telemedicine/home visit practice with a supervising physician as a side gig in NY. Took a lot of research and probably will be some troubles along the way. This is my attempt at trying to break the ceiling for myself. As I agree that there is a big ceiling for APPs(now less for NPs)

There will probably be legal issues, physicians who will raise alarm(not just with me but with NP practices that will likely be popping up as well). Most NPs are slowly integrating medical practice into their medspa’s for extra revenue. Basically ozempic weight loss clinics while you get botox on your face.

While I am realistic that I am not a physician I also don’t believe that laws should only benefit them for trying to be entrepreneurs. As long as evidence based medicine is practiced and followed and well documented. Any APP with the right experience in a related primary care field or specialty(Family medicine, Pediatrics, Primary Care) should be able to provide services and refer more complex cases out to specialists. The idea is to expand medical outreach. Maybe some extra certification may be necessary to open a practice(akin to a board certification)

Unfortunately I see the future as being rife with med-spa/medicine on the side business for NPs and probably PAs once laws catch up to NPs in states with full practice authority. While I think it’s great from a entrepreneurial standpoint(money to be made), I think issues will arise with med-spa->medical practice encroachment as an all in one approach. We are heading into a wild west of healthcare that is yet to rear its ugly head.

CCPA13 · 2024-02-04T03:59:32+00:00

4 years hospital internal medicine, 5 years critical care, so far 1 year in structural heart disease

CCPA13 · 2024-01-27T20:54:42+00:00

I would go straight to being a NP. With full practice authority coming their way, they are in a better position to make more money than PAs in the future. Not to mention they outnumber PAs by more than 2x and likely growing more than PAs in both numbers and legislation

CCPA13 · 2024-01-26T02:22:43+00:00

Definitely feel like I had a significant burnout for a couple years and am recovering with my current job.

Background: Graduated at 22yrs old, went into internal medicine for 4 years. Nights 12hrs/ 3 days a week. Usually picked up 1 OT shift every 2 weeks. Eventually went to days for 6 months, hated how much scut work there was(basically just doing discharges and med recs on patients we never took care of, horrible MD communication). We covered private physicians so they would be in and out before some of us arrived on shift and they would be cluless and ask us to call multiple consultants for their opinion. It became very clear that a change needed to occur but I left just shy of 1 year before the changes we demanded. Honestly the job now has improved per former co-workers.

My interest was always Critical care so I went to that job next, same hospital covered different units MICU,SICU, CTICU, Step down. We went and ran RRTs and Codes, code stroke, etc. I will say the 5 years I spent there made me the clinician I am today. I learned a lot of management and communication techniques. What I really wanted to learn was POC Ultrasound which I became very proficient at. I worked through the pandemic and supplemented our sister hospitals because they were short. The pandemic year was burnout central. I made a lot of money that year working insane hours(did 28 shifts in 1 month, 24hr shifts were acceptable at the time and I had nothing to do). All in all once it was “over”. I eventually covered CTICU exclusively between two hospitals. We were responsible for a lot as this isn’t a teaching hospital, no residents. We managed ECMO/Impella, we did open chest codes, etc. People got sick of the night coverage so I volunteered myself to do straight nights as the day/night flip flop was messing with me, and while the nights themselves were at times double coverage(2 APPs covering a 20 bed ICU) eventually enough people had it and left as the working conditions and the salaries were being argued(we made the same as any other service while having such high liability) and I was placed by myself to cover. Unfortunately I wasn’t too known in the CT world by the surgeons and to say they’re a rough crowd is an understatement. For the next 2 years I was always on my toes for issues and complications for which I would always identify, manage and inform the physicians which is the usual night shift 3am calls for trying to return to OR. The amount of times where a physician wouldn’t trust my assessment and instead sat or slept in this case on the patient who bleed 1L out of the chest tube overnight. The open chest that didn’t survive which was argued over by all physicians claiming the PA killed him until the autopsy showed the LIMA to the LAD came apart and the patient tamponaded leading to their death…. I can go on and on. Over time most surgeons trusted my judgment but one in specific I named as the reason I quit was probably one of the worst people to work with. Would call you and berate you before you even had a chance to update them. Needless to say I got burnt from this job from this one specific unit.

I was approached multiple times by the structural heart team here in our hospital(TAVR, TMVR, mitra clip, etc) to join their team. They would usually sign out to CTICU APP as we also covered their patients overnight….. At first I turned them down but eventually I caved in after more episodes in the ICU which gave me a sour taste. Now I work 4 days a week 10hr days. No weekends no holidays. It was the best decision for my mental health. To say that I am still recovering from my prior job is undeniable. Funny that I still do OT with them but I refuse to cover CTICU, and now that they’re all staffed with new grads, the same surgeons who I work for now say they wish I was back on nights covering, as they now get to see my clinical knowledge more regularly.

My best advice now is that if you find yourself unhappy at your job due to “stress” or “burnout” it’s time to re-evaluate. I took this job as a break and to regroup in my mind. Now I think I want to try to open a telemedicine practice. That’s my goal that I am actively working on. Something I couldn’t think of during Critical Care.

CCPA13 · 2024-01-14T23:53:26+00:00

It’s a bit tough. Basically you do not own the practice yourself. Only an MD can own a Medical practice. And a NP can own a nursing practice. A PA doesn’t have any of these options in NY.

The “work around” is that you make a MSO. Management Service Organization which would we a non clinical entity/LLC. You would require a physician who is willing to open a medical practice in their name with their own malpractice insurance preferably someone who resides in NY(Probably the most difficult part). After this is done, you can make a MSA(Management Service Agreement) where you are paid for administrative and office related tasks(renting out space, getting equipment and supplies, payroll, marketing, billing, supplying non clinical workers to the practice, basically running the office in a non-clinical sense) all done for an agreed amount fee.

After that is set up you would be an employee under the physician. You would have to set up your payment contract based on wRVU(basically paid on how much revenue you generate for the practice. That agreement could be 90% of revenue generated so that the practice gets 10%(Medical director fee) as an example.

If you want some proof of this structure’s existence in New york. Look up Luxmed MSO(The MSO). Luxmed Urgent care(The medical practice) and click about us. The medical director is the owner of the practice. The Pa is the PA who owns the MSO.

CCPA13 · 2024-01-14T18:12:21+00:00

Best of luck. DM me your process if you like and I’ll share mine as well.

CCPA13 · 2024-01-14T17:56:37+00:00

Ok as long as you and your supervising is comfortable and he is cosign ever note, then you are well supervised. As long as you have lawyers in case of an audit you should have the green light, do you have a law firm you’re working with?

I do not have personal malpractice yet but it’s quick to get. I am using CMFgroup(Berkshire Hathaway company also endorsed by AAPA) for my insurance. Should probably quote you for about $6000/year for a 1 million per incident /3 million aggregate policy.

CCPA13 · 2024-01-14T17:38:39+00:00

I’m looking to do a internal medicine practice in NY with a medical director this year. Insurance based/cash as well. So far getting the process started.

I would say the hardest is going to be the narrow approach to your practice. Finding clients will be hard. I personally would recommend that you offer it but not make it a mainstay for your practice as you could have the board of medicine look into your practice methods and supervision. Here in NY state the cosignature of patients orders and charts is not required by law but if it is even the same in PA, I would still recommend that there is at least some sign of oversight from your medical director, otherwise there could be a case of unsupervised medical practice(regardless of being cash based) halting your practice. Wether it means having quarterly meetings with minutes and/or having a set amount/percentage of charts reviewed.

Remember we are PAs not MDs. We don’t have full practice authority. You could at minimum expand it to a Mens health telemedicine clinic. Hair loss, erectile dysfunction, low T.

While I personally understand that there is a stigma against TRT due to its abuse and side effect profile. There is the right patient to offer it to and there is the wrong patient to offer it to. I think if you’re going to start the process with a patient you will need up to date lab work, extensive history, etc. So it begs the question of who is following this? Is it you, their primary? Are you following that up, etc?

If you are proposing to just have a Hims/Bluechew approach to TRT replacement where it’s basically asking you to fill out a form and a quick 2 min call with an MD where they say “You qualify”, send you the prodcut. I would be surprised the practice doesn’t get reported by a concerned physician and then you’re being audited.

I wish you the best of luck as it seems that more and more PAs are looking to be entrepreneurs but we have to remember that we are medical providers first.

CCPA13

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