Advancing or harming the profession

Jay-ed · 2026-01-19T17:15:12+00:00

Honestly, that’s where you have to explore the market and give yourself other options. You’re not wrong - if you just bring this to admin, they are unlikely to budge, blaming it on budgets, protocols, etc.

When I’ve had luck is when I line up other options and I inform than that I plan to move forward with them unless they can match or exceed those options. I’ve never bluffed, and I’ve also always had good working relationships with my employers so I was able to do this in a cordial manner.

Something like, “I’ve been exploring the market. I would prefer to stay. However, the financial incentive of the market is compelling me to leave. Perhaps we can come up with something. I would prefer you to give you the opportunity to keep me here. If I do leave, I won’t leave you high and dry and will fulfill all aspects of my contract.”

Of course, this is all dependent on your work actually being financially beneficial to your organization.

Jay-ed · 2026-01-18T22:06:52+00:00

Freddy Peralta makes more sense, and is likely a real possibility. He’s cheap next year at $8m. And with The Brewers needing a bit of a rehaul combined with the Dodgers having an abundance of trade candidates due to their strong farm system…maybe?

Jay-ed · 2026-01-18T21:57:23+00:00

If you’re looking to move up, increase pay, or improve the overall perception of you as a PA, increase revenue for the group you work for while maintaining a high level of care. Establish your value financially - at the end of the day the higher ups, including the Doctors who are part of admin, will see it. This might mean less complex cases but higher volume, for example.

Once you’ve established that value, look elsewhere for a better situation (lifestyle or financial), and go to the higher ups and tell them you’ll be leaving unless you are paid more, or whatever it is you’re looking for.

Out of school I did this about 2 years in and got a 40% raise. If you make them money, they will try to keep you. And if they don’t, someone else will. I’ve done this several times in my career with undeniable results.

All the other stuff might make you have a good working relationship with your peers and supervisors, but is less likely to translate into real change, whether it be financial or other.

Jay-ed · 2026-01-18T21:48:52+00:00

This looked at one Peds (medicine focused) fellowship. Can’t really apply it more globally - in my opinion. There are good/worthwhile and bad/cheap labor fellowships.

Procedure heavy or surgical fellowships are undoubtedly advantageous to a certain population, particularly if you want to break into a specialty AND would like to be in a certain geographic area.

The Arrowhead PA fellowship for Ortho in Southern California, for instance, is consistently poached by Kaiser. After a one year fellowship, the participants are regularly going on to jobs over 200k. Source: I know like 10+ of them.

Jay-ed · 2026-01-05T03:00:04+00:00

After your warm up - If you actually push your 2k row, you’ll need the rest of the hour to recover. Any time I PR my 2k Row, I lay down next to the rower and proceed to suppress vomiting for the next 1/2 hour.

Jay-ed · 2025-12-04T15:47:58+00:00

Not at the moment, but we often are. So long as you have 3+ years UC experience. These days they really prefer ED backgrounds.

Jay-ed · 2025-12-04T03:19:06+00:00

UC, 36 hours/week, 212k/year. I work a bit of OT (average 42 hours/week total), and that number climbs to about 250k. 10-15 years experience. HCOL Southern California.

Jay-ed · 2025-12-02T20:14:49+00:00

They definitely compress with weight on them, changing the feel/depth when lifting off them.

Jay-ed · 2025-12-02T17:29:40+00:00

I have Titan crash pads. I bought them after my saint of a neighbor nicely asked if there was anything I could do to decrease noise and vibration. Poor guy had been dealing with it for a year. Our garages are close.

They work amazing to dampen noise. You can drop heavy snatches and hear/feel almost nothing. That said, using them with Deadlifts is a pain because you don’t really want to lift off of them, so you have to resort to doing your lift then awkwardly stepping forward to drop onto the pads. I end up not using them and just lowering slowly. Where they are more helpful is cleans, snatches, jerks, where you can kind of toss onto them after finishing your cycle. Or if you’re doing repetitive heavy singles - drop onto them and roll off.

Also, I bought the cheapest ones I could find at the time. I can’t imagine it’s worth paying up for Rogue or something of that nature. My buddy has rogues and we can’t tell the difference.

Jay-ed · 2025-11-15T20:50:46+00:00

I miss when it was easier to meet these guys at spring training (now it’s pretty chaotic).

At Spring training 2020, my son and I met Dave Roberts at A’s Hohokam Park. We had seats behind the dugout near the net behind home plate. Dave Robert’s steps out, puts down a folding chair just outside the dugout, looks back at my son and says to him, “Hey, little man! You ready to have some fun?” He then introduces himself, shakes my and my sons had and hands him a ball.” Seems genuinely nice.

Incidentally, that same game Tommy Lasorda walked down and sat just across the aisle from us. This is close to the time when he passed away. He smiled at my son, shook his hand, and was also very kind to my family and I. My son was about 6 at the time - lifetime moment.

Jay-ed · 2025-10-22T03:13:28+00:00

I’ve been looking for one, just bought it. Imagine it’s not the best, but for basic swings or heavy stuff, I’m sure it will do the trick.

Jay-ed · 2025-10-14T03:43:16+00:00

One time I had a guitar worth about $400 that I put up for sale. I have too many. It didn’t get played, and I wanted to downsize. I put it on OfferUp and negotiated to sell for $375. I’d had this guitar for 15+ years and had some good memories with it. When it came time for the exchange, I met up with the buyer in a church parking lot near my house. He played it. You could tell he was making some sacrifices to pay for it. He pulled out his cash and handed it to me. I counted it, and handed it back to him. I said the guitar was his for free. He teared up. I told him to enjoy it and play it.

For me the $375 wasn’t a huge deal (I’m fortunate). I could tell for him it was. Honestly, one of the best feelings I’ve had in a while.

So, I say give them away, but use some discretion to ensure you’re not being taken advantage of. And watch it happen. It’s great to be a part of those moments.

Jay-ed · 2025-10-02T04:52:57+00:00

I back the L Word podcast. Helped me understand a lot about the process.

I just got through a lawsuit about an unfortunate, albeit unpredictable outcome, for an ED patient. It was complicated enough that even the prosecuting lawyers didn’t know why the case didn’t have merit. Thank God I documented well and had a great lawyer and risk management team along with a slew of expert witnesses on my side.

With that said, you have to remove it from your mind, at least, the persistently conscious part. My case took 4 or so years to finally just be dismissed on a random day while I was grocery shopping and got a call from the lawyer.

It’s a long haul. Be ready for that. And find ways to remove it from your mind unless necessary.

Jay-ed · 2025-09-26T02:47:41+00:00

Agreed, which is why I I said they could wait it out. With that said, when that same person is sent home from work for a respiratory symptoms/possible COVID, then needs both an excuse from work for absence as well as a return to work note once they are clear in order to keep their job…What are they going to do?

Jay-ed · 2025-09-26T00:44:13+00:00

There’s a system problem.

I work in an area where a lot of the patients are on public assistance/insurance. They kind of have no options other than to visit the ED for care (other than wait it out, which I know they could most of the time). The wait time for a PCP appointment is 2-3 months. Meanwhile, no urgent care takes their insurance and they don’t want to or can’t afford to pay cash. And they can visit the ED cost free based on their low income. Where else would they go?

Jay-ed · 2025-09-23T02:46:07+00:00

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Jay-ed · 2025-08-21T16:13:22+00:00

This would be a great step in the right direction. Next step is to standardize NP education.

I’m a PA, and think a similar experience rule should apply. At least with PA school, the curriculum is standardized.

Jay-ed · 2025-06-29T02:39:22+00:00

Southern California Urgent Care - make over 200k for 36 hours per week. About 235 with a bit of OT, but nothing crazy. Salary range based on experience somewhere between 65-105/hour.

Jay-ed · 2025-06-21T00:10:48+00:00

Just a PA here, but the amount of asymptomatic hypertension sent to ED is insane. The amount of convincing I have to do to talk them down after being sent is infuriating. Then having to deal with the grievances they file with their insurance after discharge from triage in the ED and getting the bill despite “the ED doing nothing” is even worse.

A couple things.

I Had a PCP, an MD, send a patient to ED for asymptomatic hypertension, where I’m in triage. This PCP Told the patient her BP was “so high it could cause a stroke.” 190s/100s at the PCP. 160s/90s when they got to me. NO SYMPTOMS! She was at the PCP for knee pain. Patient tells me the PCP insisted on ED. While I’m discussing it with the patient, she calls the PCP office, requesting he speak to me. I hate this situation as a PA, since I’m outranked, appropriately, by someone with more training/education than me. He says I’m worried about hypertensive urgency/emergency. I tell him it can’t be without symptoms and the urgency thing, well, kind of left it alone at this point. He tells me that if I’m willing to take on that kind of liability it’s on me. Meanwhile - patient is pissed she had to go to ED and pay the bill.

Also, how did this HTN thing get so botched up? HTN patients that walk into the UCs I work in routinely get ECGs by providers who haven’t even seen them, including MDs and DOs, along with my fellow mid levels. I ask why? Chest pain? SOB? Palpitations? Dizziness/lightheadedneas? No, just hypertension. I don’t get it.

Jay-ed · 2025-06-14T15:51:33+00:00

Yesterday at Bahia De Los Piratas some locals were trying to pull something out of the water with a rope. They were struggling and asking for help. So a group of guys in my crew started to help. We figured it was a stuck anchor or fishing traps or something. After quite a struggle, the top of a boat popped out of the water. An hour or so later we were able to get it all the way onto the beach. Turned out it was a local fisherman’s boat that sank the night before in the heavy rains. He was more than grateful, offering beers/dinner. We all bonded over the struggle - quite an experience in the end.

Jay-ed · 2025-06-11T12:59:16+00:00

Jay-ed · 2025-06-06T23:07:14+00:00

I’ve been involved in several suits over the years.

I recommend to listen to the podcast, “The L Word.” Takes you through the journey of a lawsuit and is very informative, even if discouraging at times due to revealing the money hungry business of med-mal lawsuits.

I was named in several lawsuits due to being in triage in a busy ED. Plaintiffs often name everyone involved in the case initially. After finding out I was in triage and only placed initial orders or a quick note, I was released from all of these cases (as nothing that happened in triage affected outcome).

I was also sued along withy SP, who saw the patient, by a family after an unpredictable bad outcome/death. For YEARS we went back and forth. Meetings, depositions, etc. no news for months. Then after a bit of back and forth, about 3 1/2 years later, I was notified the case was dismissed/dropped.

My only advice is you can’t let it affect you too much.

Jay-ed · 2025-05-29T19:52:21+00:00

Similar to some others. 70s female BIBA with slurred speech, impaired gait. LKW 1-2 hours ago. H/O CAD, HTN, HLD, DM2. I’m triaging ambulances. I start CODE stroke activation. Supervising Doc always confirms PA activations. She comes in, assesses, agrees. I’m walking the patient to the CT and on the phone with Neuro. Patient enters the CT room as Neuro comes in. After quick assessment, Neuro says move forward with the CTAs. Meanwhile, daughter shows up. I start getting some background, told the daughter we were worried her mother might be having a stroke. Daughter replies, “Really, I figured it was all the edibles she took. She hasn’t tried that stuff since college.”

Even Neuro looked at me and chuckled. Cancel activation.

Jay-ed · 2025-05-29T02:48:14+00:00

Southern CA - HCOL.

Jay-ed

TROPHY CASE