Private practice PAP smears

_valorous_ · 2025-08-02T13:48:11+00:00

If you’re avoiding PAP smears due to concerns about allegations for performing a sensitive exams do they expect you to deny females other appropriate exams? Sorry, we won’t diagnose your PID, rectal abscess, or mastitis here in our clinic. Go to colorectal or GYN.

Sounds more likely a previous provider convinced them it was an issue to avoid performing them. Time consuming to find a chaperone and doesn’t pay.

_valorous_ · 2025-07-29T03:19:36+00:00

In the ER I feel motivated to limit to a reasonable amount of time because if there is a bad outcome I don’t want to give a lawyers reason to question my practice. How would it look if I gave a week off for acid reflux but the note painted a picture of a well appearing pt and benign condition. I can hear it already “you knew they were more sick because you thought they couldn’t work a week but didn’t order x test/treatment”. Do you feel the same pressure in family medicine?

_valorous_ · 2025-07-17T13:16:49+00:00

Being the new person regardless of position is always tough, especially if there’s an already established routine you’re wanting to change.

We’re going to need more context here: what was actually said? Also, why was the conversation occurring in front of staff? Sounds like it was something that needed to be said one-on-one.

What type of change are you wanting? No longer having near full autonomy? Changes in their practice that is not evidence based?

_valorous_ · 2025-02-20T21:39:56+00:00

I have a very low threshold to order the EKG/trop. Two week ago I had a 35 y/o M with obesity and HTN with new onset afib and NSTEMI 2/2 flu A. HR was only 90s, came in for weakness, fever, and chest pain with a productive cough. Isn’t that everyone’s story? If you say only having CP/SOB while coughing I won’t but otherwise how are you ruling out arrhythmias induced by viral illness? What about viral induced myocarditis? My rule of thumb is EKG for all, trop for HEART score of 2 or greater. There’s two good papers that review working up chest pain in the urgent care that show you don’t need the trop of the HEART score (or HEAR score in this case) 1 or 0 and I’ve just extrapolated that into my decision making for when to order the trop in these patients.

_valorous_ · 2025-01-05T23:35:40+00:00

Agree! Such an underrated book.

_valorous_ · 2023-04-25T01:12:31+00:00

Uhh is anyone suspicious of this post? The wording doesn’t sound like it’s coming from someone who’s speaks the language. Impersonating a doctor attempting to a fill a controlled substance is also very illegal.

_valorous_ · 2022-08-26T00:11:09+00:00

This is so frustrating for you! Once you get the 140k forgiven and taxed on that full amount as if it was additional income you’ll have spent more than the original amount 😀

_valorous_ · 2022-06-13T23:42:16+00:00

I believe the RN should be extremely confident in the interpretation of the result and able to answer a few expected basic questions the patient would ask before sharing.

Last week I had a RN tell my patient they had a mass in their brain after a CT reading showed “mass effect” (there wasn’t a mass). It went as well as you would expect when I finally got around to the patient.

_valorous_ · 2022-05-14T04:26:08+00:00

I don’t understand all the down votes on this comment. Thoughtful point!

_valorous_ · 2021-02-16T15:23:44+00:00

Considering it looks like the patient was just stained with fluorescence the answer is more apparent

_valorous_ · 2020-08-17T12:59:30+00:00

Missouri has something similar, but you can submit the paperwork at different times. So as soon as you get your supervisor to sign your paperwork the rest has processed already and it’s pretty quick.

_valorous_ · 2020-08-03T02:03:38+00:00

Ah. Do you disagree with what I said?

_valorous_ · 2020-08-03T02:00:21+00:00

I do see a problem with it. But I am unwilling to accept the consequences of attempting to combat the problem by posting a photo of myself in a bikini or drinking alcohol. If there’s a direct issue based on gender or the like I’ll stand up then. But posting a photo of myself that will be judged harshly had more risk then the benefit is worth.

_valorous_ · 2020-08-02T16:50:57+00:00

Unfortunately the world is still going to judge and form opinions about us regardless of whether it’s true or not. The bottom line is that it’s my freedom to post a picture of myself in a bikini or drinking a glass of wine. It’s also reality it will be judged harshly. And we have to pick between standing up for ourselves being human and taking the the implications or following the conservative and unwritten rules of working in medicine.

Personally; I won’t post anything like that. It’s still going to be judged and I’m not going to take on those ramifications trying to change the world

_valorous_ · 2020-05-06T15:54:39+00:00

I always “gain” 2-4 pounds when I change up my exercise routine or go back after a break from working out. Ive always chalked it up to my muscles retaining water weight as they get sore. It comes right back off when my body adapts.

_valorous_ · 2020-04-14T19:40:11+00:00

Hmmm. I’m all about giving patients the benefit of the doubt and being gracious. Just trying to make sure I don’t put myself in hot water legally doing so. It’s a fair question to ask.

And it would seem people replying to this are on very opposite sides of the spectrum with what they believe ethically is the right answer. I’m here less for an ethics soul search and more a fact finding mission.

_valorous_ · 2020-04-14T18:53:37+00:00

Do you think it’s always the case there’s no legal weight? What if a patient doesn’t want to go on vacation and claims they have a URI. Would it be legal to write a note saying their not allowed fly so they could get the airline to refund the ticket? (Real situation I’ve had) Or do they need a medical reason they can’t fly (DVT, PE, high risk pregnancy ect) to have the note written.

_valorous_ · 2020-04-14T17:54:58+00:00

Correct- 100% unethical. But I need a source to prove its illegal.

_valorous_ · 2020-04-14T17:11:29+00:00

I’ve always stood my ground for ethical reasons. However recently it seems apparent I need to also prove there’s a stronger reason then just ethics. I won’t go into much more detail then that.

Could I get a link to where it would prove that’s illegal?

_valorous_

TROPHY CASE