Comments on: How PA’s and NP’s Can Help

By: lastoftheZucchiniFlowers

lastoftheZucchiniFlowers — Thu, 08 Jan 2009 09:18:59 +0000

Scalp – being retired and weary of YOUR hauteur, I happily decline. But please DO ‘attempt’ to write your parody post? I HAVE the free time for this. But YOU? Where do you get off having time to open fire with your bilious little word gun? How dare you? You -with the nerve to berate a woman old enough to be your MOTHER? YOU, a mere blip on the radar screen of shifting dullness who should be working your sniveling little keister off in the temple which pays your salary and NOT threatening to ‘write a parody’. (I’m enjoying this!) You, who purport to a pastime of ‘pushing buttons’? HA – given your alleged medical duties you ought to be propping your eyelids open with dermabond AT THIS VERY MOMENT (dermabond hat you likely steal from the sample closet ). Rather than attempting to inoculate others with your boorish attempt at jocularity…. try playing LEGOs with your kid as a responsible parent is supposed to. PS = He IS cute – good looks come from mom I suspect. Scalp, You are far too young to know a good parody from a bleeding rectal pruritus but out of pity I will refer you to the ‘Adventures of Bernie X – NYC Cab Driver” By the late, but great Gerald Sussman (National Lampoon circa 1977). That is parody extraordinaire unlike your pitiful scribblings here! NOW, take my advice and stop wasting what seems to be this inordinate amount of time on your hands. Since MY teaching days are happily at an end (and you correctly state that yes, I have taught many before you), I recommend you enjoy this moment. Now, good night, and thank you for validating my high index of suspicion where you are concerned. This truly WAS FUN but at my age I require sleep now! BTW – it’s Zucchini FLOWERS, which are in season only briefly and quite delicious when sauteed in olive oil and garlic.

By: scalpel

scalpel — Thu, 08 Jan 2009 05:35:11 +0000

I was going to write a parody post based upon the exploits of the Amazingzucchininurseofmanytitles, but I couldn’t improve upon the self-aggrandizing super-awesomeness of the original.

PLEASE continue sharing YOUR wonderfulness with us. I think (nay I KNOW) that you have much to teach us, just as you have taught many before us.

By: lastoftheZucchiniFlowers

lastoftheZucchiniFlowers — Wed, 07 Jan 2009 04:40:00 +0000

scalp – who said I just rxd steroid crm? You don’t read very well. But if you must bring up topicals, when did you last treated anyone with Zonalon, topical Dapsone or topical methotrexate? Or even know their indications? Do you write compounded rxs for specific conditions when nothing commercially available will do? No, I didn’t think so. Moreover, YOU are exactly the sort of practitioner likely to have inadequacy issues and feel it is incumbent on you to mock dermatology (but the first to call us when you encounter an odd lesion.) Please grow up – medicine already has a surfeit of immaturity. AND for the record, when we come up against a difficult case we do exactly what you do – consult, send them on and follow up. There is no mystery to it. AMA minions and folks like you notwithstanding, NPs are here to stay (having been here since 1964). This predates your emergence from the primordial ooze. Our dermatologic surgical skills are second to none which is why patients pay upfront $$$ to access them. I remain Elated to be retired and NOT to have to deal with your mind set. ARE you a safe, successful surgeon? This might excuse your hubris (IF you have the goods to back it up, otherwise, just noise).

By: scalpel

scalpel — Tue, 06 Jan 2009 17:58:06 +0000

“I like to think (nay, I KNOW), that without my expertise and management, lots of folks suffering with a multitude of dermatologic dz processes would have done without.”

So nobody else in town could prescribe steroid cream? Weird.

By: lastoftheZucchiniFlowers

lastoftheZucchiniFlowers — Mon, 05 Jan 2009 21:44:38 +0000

Now retired, but for years was the most experienced provider in my group when in came to derm. Colleagues came near and far to get my take on many cutaneous dxs (no one else used a dermatoscope) and identified several MMs who were sent immediately to surgeons for wide excisions. Although an an FNP/MSN/RN by ANCC/AANP certification I had ojt’d in derm for many years. I loved it, stayed with it and made my derm/mentor’s practice quite lucrative for him. When I re-entered primary care in a rural setting where there was ONE derm (transient) for the ENTIRE population of a 70 mile strip of East Coast and TONS of cutaneous pathology which was usually all reated with TAC when I got to town. I like to think (nay, I KNOW), that without my expertise and management, lots of folks suffering with a multitude of dermatologic dz processes would have done without. I wouldn’t go back to practice, now, since this vitriol has surfaced in the medical community. When I was active, I was accepted as a colleague by my fellows above and below the food chain. What in heaven’s name has happened? Leads me to think that some bad mojo is being disseminated in Med School Curricula today. Sadly, and as usual, the end result of all this turf warring is that the patient gets the short shrift. Think it’s any different in speciality practice these days? NOT. Behold now and observe the derms near and far now battling one another in the Moh’s arena. Fellowships/payment/reimbursement/who is allowed to charge for what…….most disheartenting. Glad to be retired in VA and recalling the ‘golden’ days of medicine. Nice memories, but gone forever are THOSE days.

By: artillerywifecq

artillerywifecq — Mon, 05 Jan 2009 18:25:35 +0000

I agree. They have their place and they are very good at what they do.

By: shadowfax

shadowfax — Mon, 05 Jan 2009 01:27:15 +0000

ERMurse and Ten, I wrote about this in more detail, but in short, just because the PAs identify a supervising physician, it does not mean they will be paid at the physician rate. If they document fraudulently that the doc SAW the patient, then they will get the full payment (at quite a risk). But more likely it's just so the billing company will know which doc to stick in the MD field on the billing form for the other payers.

By: dailymeds

dailymeds — Sun, 04 Jan 2009 20:11:55 +0000

Scalpel:

In the history of the PA profession, not a single PA has lost their license in my state due to negligence. Your bitterness towards MLP’s is clear and your agenda even more apparent. It’s a shame your in this noble profession.

By: scalpel

scalpel — Sun, 04 Jan 2009 18:14:00 +0000

When PAs get your daughter pregnant, don’t come crying to me.

By: dailymeds

dailymeds — Sun, 04 Jan 2009 03:36:49 +0000

Scalpel:

I fail to see your point. MLP’s aren’t going anywhere, in fact many of them are taking jobs from MD/DO’s. So, rather than make obscure remarks it might be conducive to venture into some intelligent discourse.