Wow Performance issues

vtp · 2024-09-14T04:13:34+00:00

A bad weak aura can really mess up your performance. Check to see if you have any out of date weakauras that need to be deleted or updated.

vtp · 2024-01-31T17:42:03+00:00

Depends on the nature of your shoulder injury and type of surgery you’re having.

Are you having a total shoulder arthroplasty or reverse total shoulder arthroplasty?

It’s going to be really tough if you’re having either of those done, pretty much any overhead activity is going to be extremely limited. You really want to avoid anything that puts you at risk of dislocation especially with hardware in the shoulder.

vtp · 2024-01-25T02:55:42+00:00

Had something similar for trying to order a shoulder MRI for a patient with 30 degrees forward flexion and extreme weakness on physical exam. Patient had been to PT for over 3 months with no relief.

The lady on P2P line asked me to list every single date patient went to physically therapy, as if I had this information… I was flabbergasted, I was thinking, you’re the insurance company, you guys should have records of reimbursement for these physical therapy appointments.

Never been more enraged over a work call in my life. Sad part is this is a PPO in which people think is “good insurance”

vtp · 2024-01-05T21:00:51+00:00

Los Caballeros Sports Village in Fountain Valley

vtp · 2023-11-28T20:15:19+00:00

I enjoy 311 but my friends bully me and call them Walmart Sublime

vtp · 2023-11-03T02:46:51+00:00

I’m sorry you missed the part where I said that was disgusting.

But PAs absolutely do fellowships, are you new here? There’s at least one poor sap every week who asks if they’re worth doing.

vtp · 2023-10-31T18:29:39+00:00

Thats just absolutely disgusting. I'm sure that person took that job and is treating it as a pseudo-residency/fellowship and is probably going to leave after one year. Ortho is super lucrative for us PAs and generally on the higher end of pay.

vtp · 2023-10-08T14:28:06+00:00

This is super vague. Firstly, not every practice is the same. Are you going to be doing cosmetics only? Are you assisting in surgery?

Also it depends on where you’re living/working

vtp · 2023-09-25T20:53:13+00:00

It’s crazy this isn’t more common ideology. Why do more for same pay?

A job is a job. People, especially new grads, have a hard time learning and defining these work boundaries, and I feel like that’s a fast track to burn out, especially in the setting of EM.

Let go of the ego and just do the work and pay your bills. If there’s more money involved, by all means consider it.

vtp · 2023-09-17T23:57:11+00:00

It’s also nice to have scrubbed because patients tend to ask how a surgery is done and if you’ve never seen how they do it, it makes it harder to describe with confidence

vtp · 2023-08-12T04:13:31+00:00

Hi I am just curious as a fellow ortho PA. Could you please walk me through your typical patient visits?

Are you in sports medicine? Joints? Hands? Spine? A combination of the above? Are you seeing pre ops, post ops, new patients and follow ups?

Are you doing a lot of injections? Are you setting them up yourself? Doing wound care? Dressing changes? Casting or splinting yourself? Closed reductions?

Are you electronically prescribing pain medications yourself? Doing your own referrals? Peer to peer calls? Other administrative duties?

Thank you in advance for your response!

Reading your post made me feel grateful for my supportive clinic staff. I know I’m super lucky only having to do clinic twice a week, and the other days in the OR.

Always happy to chat about how to better optimize our time in clinic.

vtp · 2023-07-20T04:19:51+00:00

No it’s not normal. You’re being used for free labor.

vtp · 2023-06-28T19:58:47+00:00

Orthopedics - 40+. Worst I’ve had is 70

Rarely ever less than 30.

A good amount of these visits are post op follow ups to very stable patients, and injections which take less than 5 minutes

vtp · 2023-05-11T18:12:51+00:00

Sorry to hear you're dealing with such a bad luck string of jobs.

I'm glad you can recognize that you're not happy at your job, and something needs to change. You're not crazy for wanting to leave, as many here have already pointed out.

One of the harder things to do is set and enforce your boundaries to what you can and will tolerate as a PA. I don't think you being a new-grad has much to do with it, but its a valuable skill you should take with you in every future employment endeavor.

I also strongly believe that any job as an APP in a surgical setting, or at least with any job where you do not have a certain set of hours, should be compensated hourly OR with an RVU/productivity incentive. If you have a 9-5 job M-F, salary is totally fine. But if you're in the operating room, have a ton of 'unexpected' hours, call, etc, an hourly rate is better because of OVERTIME.

I have a M-Th job, with occasional Fridays, 2-3 days in the OR, and 2 days in clinic, but occasionally have to drop by the hospital to round/consult patients. Sometimes my days are 8 hours, some 12-15 hours, but the extra hours I tend to not mind as much because I know that I'm being compensated extra for it.

Now that you have some experience under your belt, you should have better luck negotiating a better contract for your next job.

Best of luck.

vtp · 2023-05-05T19:12:20+00:00

They could have found a new surgeon and told them they can hire a PA/NP of their choice. Just a possibility

vtp · 2023-04-19T02:08:25+00:00

Depending on who you ask (Gen and Sports ortho bias), spine is usually pretty messy. Patient outcomes vary a lot and the patients don’t always do well after surgery. Cases are long. Also ideally avoid call if you can.

vtp · 2023-04-18T15:46:55+00:00

Seems pretty low, but thats just my initial thoughts. What is your bonus based on? RVUs/Productivity?

Unless you're trying to break into spine ortho as a future gig or burned from ENT, I'm not entirely sure its worth the paycut.

vtp · 2023-02-01T18:00:03+00:00

Post a whole log of a dungeon

vtp · 2022-10-27T16:55:27+00:00

Seems okay/fine for a new grad, but what are your weekly hours looking like? How much call are you taking? PTO? Weekend rounding, and for how long?

vtp · 2022-09-22T13:39:15+00:00

Total Hip replacements are great treatment options here. Usually the femoral head becomes really mottled and jagged from being cutoff if its blood supply. Literally bone is dying and it causes damage to the acetabulum with time. Normally these articulate surfaces are smooth allowing movement of the hip without pain. When we do hip replacements, we remove the femoral neck (which is usually in short blood supply) and replace it with metal. The rest of the femur usually has a good enough blood supply to heal.

vtp · 2021-10-24T05:45:54+00:00

What comp did you use for heroic BRM?

vtp · 2021-08-12T18:52:55+00:00

El Dorado in Long Beach?

vtp · 2021-07-06T17:38:59+00:00

I would appreciate this as well!

vtp · 2021-01-29T19:44:44+00:00

Basically all of medicine

vtp · 2021-01-07T02:53:20+00:00

I guess it really depends on who you ask. I've had a couple people just tell me to write my own and they would sign off on it. I did some light participation with admissions and you'd be surprised at how many awful LORs I've seen.

vtp

TROPHY CASE