I have been employed as a PA for nearly 3 weeks now. I still don't have my license though thanks to the bumbling bureaucrats in charge of licenses here. My company has had me shadowing my supervising physician since I started but they are getting antsy and I am getting bored.
The Occ Med practice I work at sees a lot a trauma because one of our big clients is a meat packing plant. They take cattle from the feed lot to packaging. As a result we see a fair amount of lacerations, hand, wrist and shoulder injuries, and more than a few crush injuries including forklift injuries. We see other patients in other occupations like office workers, health care providers and numerous blue collar occupations. We saw a concrete finisher who got too close to a power line with his float pole and was electrocuted. He lost a portion of one foot and needed a skin graft on the other. Another day we saw four forklift crush injuries that were all pretty nasty.
The breakdown of the types of patients I have seen are:
50% orthopedics
20% neurological
15% trauma/urgent care
15% DOT and employer physicals
There are more than a few patients who are faking or playing up their injuries in hopes of getting some big payout from the insurance companies but most just want to go back to their $12/hr job hacking apart a cow or driving their truck.
4 comments:
This is an excellent blog you've kept up, thank you so much for sharing your experiences. :)
I have you linked from my blog which will hopefully follow me all through school- http://azkitty.wordpress.com.
If you want your link removed for any reason, please don't hesitate to ask. Thanks!
Wow. Sounds like great experience. Did you have any training on identifying malingering when you were in school? I'm guessing that it could be tough deciding how to handle those patients.
I noticed you saw quite a few forklift injuries. I know someone who was nearly crushed to death by a forklift several years ago. They have had a burning sensation all over their body since that time. Did any of the patients you saw have a similar complaint? The person I spoke of is very dejected because Dr.'s are treating them like a headcase. I've always suspected some kind of nerve compression. They can walk, just in pain/burning pain all the time. Physical therapy only made them feel worse. Do you have any advice or suggestions on what they should get checked out for or a possible treatment path to pursue? Thank you.
No prob with linking to this blog - good luck.
Malingering is something you can recognize only after seeing it several times. We got no training on it at school though. Basically I choose to believe my patients and then give the the little nudges and encouragement when needed.
Nerve pain is a tough condition to treat, let alone cure. Besides the "standard" course of treatment including neurontin and SSRIs, some sort of counseling regarding their pain, brush with death, struggle with their providers' skepticism and outlook on life in general might help. But that is just an idea. Don't take this as professional medical advice, because that would be foolish of me dispense and you to accept from such a venue as this one.
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