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coast2coast

coast2coast

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Primary care NP for underserved, high-risk, and complex chronic care populations.

coast2coast's Latest Activity

  1. coast2coast

    experience with Barton ?

    Thanks all - the original post was from me but I had lost my login credentials. I have done a lot of boundary setting with this rep in no uncertain terms and he clearly isn't listening. Hasn't brought me any good offers either - similar to BCgrad, he seems to deliberately ignore my interests and push sub-optimal openings which I'm sure they have a hard time filling. I think my next step is to just block his number. Anyone have a great experience with another locums company?
  2. coast2coast

    Per Diem/locums rate in Chicago area?

    Anyone have recent experience with locums salary in and around Chicago, or IL in general?
  3. coast2coast

    Now THAT'S a lab result

    he was severely hypothyroid due to med noncompliance due to mania ...
  4. coast2coast

    Now THAT'S a lab result

    Chronic hgb in the 3.5-4.0 range. Dying of metastatic probably rectal dancer, survived almost a year. a1c 16.9, very alive and one of my best-behaved diabetics now. TSH 490. Manic but definitely alive a1c's of 15, systolic BPs in the 200s, and trigs of 3000 sadly become very mundane very quickly in community practice. It's amazing how resilient the human body can be.
  5. coast2coast

    Negotiating my salary is exhausting!

    I may be too late for this but ... THAT IS WAY TOO LOW! Waaaaaaaaaaaaaaaaaaaay under average for SoCal. New grads in community centers are starting over 90 at multiple locations in metro LA. I know you are a new grad and need to get hired, but man oh man I would tell this doc to stuff it and call me when she was ready to discuss a serious salary. You will never successfully renegotiate for lost income. Realistically you will do well to get 2-3% per year in most places unless you have an RVU structure in place. When you take the job is really your only moment to get what you want/need. anyhow. PM me if you want to discuss the LA market.
  6. coast2coast

    Do you text your patients?

    Never. I have also stopped giving out my direct extension at work and am now directing patients to the receptionist or nursing line. 99% of my calls and messages could/should be handled by someone else. I found that by my being involved they generally took much longer to resolve and wasted a great deal of time. You REALLY, SINCERELY, URGENTLY need to speak to me and only me? You know where I work every day ... If it's not worth making an appointment to you, why on earth should I give you my time off the clock?
  7. coast2coast

    Is it just me, or is this rude, sexist, and condescending?

    More importantly, other women will just assume one of THEM left pee all over the seat ... Let them fight amongst themselves over such petty garbage. yes, it's sexist, but it's also a battle you will never win. Seriously. Just pee on the seat next time!
  8. coast2coast

    California NP licensing and job search

    Until recently I always had the impression that CA BON was staffed by 2 people. The same man and woman always answered the phones. Response times certainly suggested that 2 people were doing all the work for the entire state .... Now no one answers and I'm concerned those two poor overworked souls have finally thrown in the towel, turned off the lights, and left. It could take years for anyone to verify that our BON is a ghost ship
  9. coast2coast

    California NPs feedback

    What is a family care center? $45/hour is the lowest end of the pay scale for so cal ... And the market seems pretty robust right now, you could do better. No benefits for a FT position is just a joke. I wouldn't even negotiate with someone that out of touch.
  10. coast2coast

    Chronic care at retail clinics?

    Really interesting to hear this perspective, thanks for sharing. I always wondered about ability to refer out from this setting. It sounds like you have an official referral network? What about labs and referrals for uninsured patients?
  11. coast2coast

    National Health Service Corps Loan Repayment 2014

    Yes I have wondered about that! I even re-checked my HPSA score and it still says 13. I got funded late in the cycle, maybe I was really lucky and there weren't many 13's accepted. Who knows. They most definitely funded me ! I'm full time.
  12. coast2coast

    Question on the NP Furnishing License in Calif

    a few thoughts .... Something is very wrong with CA BON staffing right now (more so than usual). So it might be a realllly long time before you hear anything official. Depending on how recently you applied they are saying up to 90 day wait for response. It it seems like they might require more recent pharm. I know Fitzgerald has review courses and UCLA is advertising their FNP review right now. It's supposed to be a great course, if you are near the area.
  13. coast2coast

    National Health Service Corps Loan Repayment 2014

    I was funded last year with a site score of 13. I think they give more funding each year to NP's which is why I made the cut.
  14. coast2coast

    Thoughts on designer resumes?

    Pretty but not professional.
  15. coast2coast

    DMII Victoza med management

    We added levemir to formulary a few months ago (in addition to NPH and 70/30) and I have been pushing it pretty hard with my DM2's. It's amazing to see how fast A1C's normalize with a long-acting insulin + metformin after, in most cases, years of struggle and strife with 3 or more meds. It requires a few weeks of regular BG checks by the patient, but then they decrease to 2 or 3 fingersticks/week to monitor fasting BG's. And they feel SO much better when sugars finally normalize. .... Now if I can just convince my colleagues to follow my lead ... I am convinced that half the issue w/ starting insulin in DM2 patients is provider resistance.
  16. coast2coast

    DMII Victoza med management

    Somewhat similarly, my preferred escalation is: 1. Max metformin. Hard & fast. No weenie 5 year slog at 500mg/day. You either need it or you don't. 2. Max glipizide ( and wait for the inevitable ). 3. Long acting insulin (lantus or levemir depending on formulary). Titrate up over a few weeks and then titrate off the glipizide. 4. Bolus with meals if/when the lantus becomes inadequate. My DM2 mantras are K.I.S.S. (for providers)(ie don't waste time and money hand-wringing over 12 orals/injectable for anyone with A1C >10) and "insulin isn't the worst thing that can happen to you!" Repeated ad nauseum to patients until they believe me. I don't have access to invokana (sp?) but am curious... I take it you have had a good experience w/it Boston?