BlueDevil, DNP

I wouldn't let a pregnancy deter me from hiring a candidate I really wanted on board, but I'd be cheesed off if I found out after hiring her that she planned to take 2 months off and didn't mention it. Everyone in our group has a favorite tie of year to be off. I take off 10 consecutive weeks in the summer. One of my colleagues takes off the 6 weeks from Thanksgiving to New Years. Another takes two weeks off every 3 months to fly all over the work for scuba diving, without fail. I would certainly hire someone who happened to be pregnant if we were given full disclosure and she voiced a clear plan for her maternity leave and a reasonable timetable for return to work after delivery, given they were the applicant I'd hire even if she weren't pregnant. Ditto for a Dad who was planning paternity leave (I always took paternity leave with each of our kids). Look at it this way, the practice is either family friendly or it isn't. If they wouldn't hire a pregnant woman, they aren't going to be too happy when the wee one gets hand foot and mouth disease at day care and you have to take off to stay home with them. lol. Meaning, they aren't going to be supportive of the other needs of your family. Here, we put family first for all the employees, but failing to disclose the fact that you will be taking 2 months off would be a hanging offense. I seriously doubt we'd keep her on through even the 6 months probationary period.

"They handle the addicts being seen for there post CABG f/u that have the flu with sarcardosis, maybe a little scaleraderma (sic) thrown in." I find this POV intriguing because I do not see it that way at all. I am curious about your feelings, because my experience and opinions are so different. I see the complaints you mentioned above. I'd be so bored and frustrated if all I got to handle were the easy cases. "So why settle for NP if you are doing the EXACT same thing, no deviation whatsoever? Maybe I'm being thick, obtuse, biased, mysoginistic, dopey, or grumpy, but there has to be something that the doc does that the NP does not." What do you mean by settle? I didn't settle, I did exactly what I wanted to do. I don't believe that you are obtuse, but I do think it sounds as if you have been in a state with a highly restrictive NP practice act, little respect and practice autonomy and that it has shaped your own practice and your view. I can only speak for myself and my colleagues, but here there is nothing the physicians do, diagnosis or treat that NPs do not, limited by specialty, that is. I don't put in IUDs anymore, I don't read MRIs or nuclear stress tests, I don't do MOHS surgery. But with regard to internal medicine/peds practice, no, there is nothing my MD pals do that I don't/can't. I don't really get paid less either so I guess that's fair, although truth be told, I don't really care about that outside of the philosophical argument. All of that said, I despise psych, and I do everything within my power not to treat BH conditions. It is simply impossible to avoid though, we just have too few BH providers so we are forced to have a go at it. I treat schizophrenia, BPD, personality disorders up the ying yang, along with the usual depression and anxiety. When I feel as though I'm over my head, I go to the clinical pharmacist for assistance with drugs. I always say that it is better to see a NP with a hunch and a library card, than to see no one but your imaginary friends. We muddle through and get the sickest of them to BH as soon as we can, but the 2013 state assessment suggested we are short BH providers by about 75%. The waiting list to see a BH provider here is almost a year. I have no preference b/w a psych NP or a psychiatrist for these patients. I'll pass them on to the first available person more qualified than I. Sorry your gig didn't work out. You made it 3 1/2 days longer than I would have.

Sure, if I was certain that it is what I wanted to be doing. IIWY, I might save a bit longer before beginning. You need to have 50% more in liquid savings than you think you need, otherwise you are sure to have car trouble, furnace trouble, roof trouble, plumbing and electrical problems, and possibly the boll weevil, because that is just how things go.

I don't give that information out, I"d be too easy to identify. It's easy enough to find our ads, they are in most of the big circulation journals for IM, FM, Peds and specialties we offer.

I think everyone covered most of it well. New people are learning. No big deal. However, when you give false information in report for whatever reason, expect to be called out on it. I wouldn't have said it the passive aggressive 3rd party comment as that nurse did, I'd have said it directly to you. There really isn't any excuse for that. But you have lived through the ordeal and learned from it I trust. Take the understanding derived from the experience and put the rest behind you. Good luck youngin'

It is probably against the TOS, but I feel they deserve to be mocked.

I wouldn't think it would be at all helpful, personally.

I don't see what the JR story linked has to do with HIPAA. They gave implicit consent to have the photos and gold records (lol) displayed when they signed them and gave it to her. I think I find it a little tacky (don't feel strongly about it, I just probably wouldn't do it), but then I'm a hypocrite because we still do have a baby/kid wall in our office. It is chair rail to ceiling cork board the length of the hall. We just request that the patients/parents pin the photo up themselves. To me, that is more than sufficient to provide proof of consent for a photo to be displayed. Change your mind and don't want your photo up there, take it down. Many of our adult patients have brought their old baby pictures as well, and we also have a lot of furr babies up there along with exotic vacation photos, head shots, glamour shots, graduation photos, wedding photos, family reunion photos, newspaper clippings, etc. There is no HIPAA violation if they personally pin a photo of themselves or their child onto the board. To my knowledge, no patient has chosen to write their diagnoses on their photo though. They don't mind people knowing they are a patient in our practice, but they want to keep their pediculosis pubis to themselves.

My suggestion is to try to negotiate being paid by productivity. as professionals, we should not be negotiating an hourly wage but compensation based on our value.

Chiropractic was founded by DD Palmer in 1895 in Davenport, Iowa. He described himself as a "magnetic healer." Palmer claimed to have learned Chiropractic manipulation from a spirit during a sèance. Should be 'nuff said, but wait, there's more! Below are the first 5 articles in my 30 second search. I could link another 3,332 of you like. The conclusion is that at best, there is no outcome difference between chiropractic manipulation and massage. At worst it is highly dangerous in practice, both due to direct risk and the fact that many patents are seeing a chiropractic provider in lieu of a qualified professional. It is nothing more than sham pseudoscience and any self respecting clinician should have nothing to do with them. A Cochrane review of combined chiropractic interventions for low-ba... - PubMed - NCBI Vertebral artery dissection and cerebellar infarction following chiropractic manipulation A randomized controlled trial comparing 2 types of spinal manipulat... - PubMed - NCBI Adverse events after manual therapy among patients seeking care for... - PubMed - NCBI A review of the evidence for the effectiveness, safety, and cost of... - PubMed - NCBI "No one ever went broke underestimating the stupidity of the American people." - HL Mencken

No one ever calls me anything unusual, I suppose at least in part because I'm male. A few that I have known for years and to whom I'm close call me by my first name, most call me Dr. Devil. I am holding out for Mr. Secretary (as in Secretary of Health and Human Services).

How do we know this? Her 21 days aren't up yet. She could come down with it any minute now! I have read this very comment I don't know how many times.

I agree. I have dry skin that sometimes cracks and bleeds around my knuckles in the winter. I shouldn't have to wash my hands, it poses a risk to me I could get an infection such as Ebola, MRSA or HIV from the breaks in the skin. Clearly the patients and visitors are a greater risk to me than I am to them. If we can't force them all to wash their hands before they come in to the facility and at specified intervals, I shouldn't have to either.

We can't decline insurance purchased on the exchanges, unless we want to decline ALL BC/BS, Aetna, UnitedHealth Group, Humana Group, Cigna Health Group, Metropolitan Life, etc. I don't know about my colleagues, but I cannot afford to refuse to take all of those, lol. What silly contention.

This is one of my all-time favorite comments. Brava.