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  1. Pachinko

    When to use Quantiferon?

    Apparently there is a new Quantiferon test that is less time intensive to perform (not cheaper though). It's new to our clinic system at least. I am not able to find guidelines for determining whether to use PPD or Quantiferon with patients. Quant is best for the immunosuppressed, but are there any other populations where it is preferred over PPD? TIA.
  2. Pachinko

    Question about insurance coverage and FQHCs

    Just curious, why do you have it? It's my understanding that the gov takes over and defends cases of malpractice leveled against a clinic.
  3. If I buy malpractice insurance today, will it cover me if I'm sued in the future for something that happened before I had the insurance? I'm not talking about buying insurance when you are under investigation or a lawsuit has been filed. I mean buyimg insurance and then, maybe a couple of years down the road, being sued for something that happened before you had the policy. thanks
  4. Hello-I work for an FQHC that has tort pretection. Do I still need to get my own malpractice insurance?
  5. Pachinko

    Yale GEPN 2018

    Is tuition for this program $135K total?
  6. Pachinko

    From NY to California, LA?

    Dranger is correct. You might find something cheaper if you scour Craigslist, but a 1 bedroom in a decent area will be around 2k, a 2 bedroom 2.5k. S/he's also correct about salaries of 120-140k. If you decide to rent, try to find a rent-controlled building, which applies to all buildings built before a certain year. Otherwise your rent can be raised with impudence. Buying is insanely expensive. People are moving further and further out of LA in order to own and are now localizing around Palmdale/ Lancaster, which are 45-60 min away. I work primary care so can't recommend employers based on NP experience. I worked bedside at UCLA for ten years before becoming an NP and the experience was very positive, excellent standards of care, good benefits, etc.
  7. Pachinko

    Metal worker needs MRI

    All very helpful, thanks.
  8. Pachinko

    Metal worker needs MRI

    Thanks. What about metal embedded in skin? Is that a concern?
  9. Pachinko

    "Noctor?" Offensive title?

    It's better tham "midlevel," which I find extremely offensive. Because, you know, MD=high level, NP/PA= mid level, and RN= low level. It's a political term. Noctor as a combined nurse/doctor is kind of cute, but I've only heard it referenced as a contraction of "not a doctor," which is derogatory.
  10. Pachinko

    Metal worker needs MRI

    I have a metal worker with severe radiculopathy. Has undergone CT, EMG and is being told by both neuro and ortho that he needs an MRI. Ortho apparently told him that he could undergo a simple eye exam and that this would be sufficient for clearing him for MRI, but it's up to me to order it. Does anyone have experience with this and can recommend how I go about evaluating him for MRI safety? I've looked around but can't find a good guideline. thanks
  11. Pachinko

    Odd patient medical issue. Help?

    Thanks for the help.
  12. Pachinko

    Future Market Saturation

    I would be careful about doing online/for-profit NP programs. When hiring gets competitive, companies will likely look toward educational background in making hiring decisions. Its similar with law. There's a glut of lawyers, and those from top ten schools will be hired before a second tier school or below. My company has had open positions for NPs but doesn't hire graduates of online programs, so they remain open.
  13. Pachinko

    Nurse Practitioners or FNP salary in Bay Area/San Francisco Area

    In the Bay Area, a family of four with an income of 100K annually is considered "low income" and qualifies for low income housing. http://www.cnbc.com/2017/05/12/if-you-make-105000-in-san-francisco-youre-considered-low-income.html
  14. Pachinko

    Odd patient medical issue. Help?

    I have a primary care patient who is demonstrating neuro changes. She developed numbness and tingling of fingers bilaterally and slow onset right-sided facial weakness over the past year. When I checked her lab work, she was found to have extremely low LDL ( I'm doing an MRI and will refer to neuro thereafter. To which specialty would you refer for evaluation for the lipid abnormality? Or would you keep it with neuro and let them navigate the work-up? Thanks.
  15. Pachinko

    I quit the PA rat race.

    Non Sequitir, you would look much better with some soft curls, and lay off the neck exercises. Your rationale for NP school is good. Working bedside is where you will receive your real education. Start with whatever unit interests you most and will hire you, but shoot for ICU at some point, especialy cardiothoracic if possible. This will teach you to think critically and prepare you for the advanced practitioner role. It will also help you determine which kind of NP you want to be. I would only add that one of your main reasons for not pursuing your PA, market saturation, is also an issue for NPs in some areas. It's hard to know where it will be in 5-6 years, but NPs are not necessarily better positioned than PAs in that regard. ETA: yes, NPs do have more freedom than PAs. We can practice independently in some states. I don't think that there is much difference in pay, I recall salary surveys showing a difference of 2-3K in annual income, with PAs having the slight advantage. In my experience (underserved primary care), there is no different between what PAs, NPs, and MDs do. What makes the better practitioner is how dedicated and interested in helping the provider is, not education level. Have seen this repeatedly. I will say that MDs are less likely to miss major issues, though. That's why you need solid hospital experience before you practice. Nurses also have a lot of good will from the public, which is nice.