New PA Student Site

Check out the new microsite dedicated to PA Students! I was part of the team that worked hard to put this together and the AAPA was an integral part of giving us the funding to get this up and running. It is a "one stop shop" that was created BY PA students FOR PA students!

Check it out. Write a blog entry for the site. Submit a new scholarship that you found that is relevant. The continued success of the site is dependent on YOU the PA student to help keep it alive with content!

See the About Us section to know where to send your content!

www.PAStudentEssentials.com

Brown-Sequard syndrome

Brown-Sequard... Jekyll-Hyde.... that's kind of how I remember what it is. Two different sides to the spinal cord, one good (uninjured) and one bad (injured). Brown-Sequard syndrome is characteristically seen in penetrating injuries (but can be seen in unilateral blunt injuries as well). The syndrome results in one side of the spinal cord being injured.

What do you see clinically?
Motor, position, and vibration are gone on the SAME side as the injured spinal cord (these tracts cross at the brainstem)
Pain and temperature are gone on the OPPOSITE side of the injured spinal cord (these tracts cross at the cord at or near the level of innervation)

http://nhananhana.wordpress.com/2010/01/28/brown-sequard-syndrome/

What to do clinically?
The diagnosis is generally made clinically based on hx and physical. This warrants a neurosurgical or orthopedic consult and MRI if requested. Lastly, studies have shown that high doses of steriods (methylprednisolone) decreases inflammation by suppressing polymorphonuclear leukocytes and reversing increased capillary permeability.




Sources: 
1.http://emedicine.medscape.com/article/791539-workup#a0720
2.Abernathy's Surgical Secrets by Harken and Moore

Do You Use Social Media?

Do you use social media personally or professionally? If the answer is yes to either, you should check out this recent JAAPA article on social media. As we all know, anything that goes up on the internet has an infinite lifespan. Think about protecting your personal life and career...

Managing Your Digital Footprint

http://www.socialable.co.uk/

Post-Brain Tumor Resection





The American Association of Neuroscience Nurses put together this awesome 40pg document: Guide to the Care of the Patient with Craniotomy Post–Brain Tumor Resection,

AANN Reference Series for Clinical Practice. Some of it is more relevant to nursing than PA practice, but I've found the majority of it VERY helpful in getting a general idea of what's going with tumor resection patients (especially as a new graduate). Of course, each institution is a bit different, but this is a great start.



Image:

http://medicalxtourism.com/wp-08/Top-Brain-Cancer-Treatment-Centers-Abroad.gif



Billing and Coding. Who Cares?

Reimbursement? Who cares? In short, YOU should.

Scenario 1:

It is time for your annual review and you've been working hard all year. You've stayed late to see extra patients and come in occasionally on your days off to cover the shifts of sick co-workers. You decide that you are going to ask for a raise based on the extra efforts that you've put in, but when you do the office manager states that everyone has been working hard so that alone does not justify a raise. Where do you go next? Your next step should be to present objective data. You should be prepared with not only the number of hours that you have put in this year, but also with your revenue (which you get from your billing records!) If you are able to show that you have increased your billings by a significant percentage, you're more likely to get something extra than if you just say you've been "working extra hard". Know what you are being reimbursed - check your billings bi-weekly or monthly to stay on top of it.

Scenario 2: 

You are working for a small family medicine practice with a couple physicians. You are the only PA. The family practice employs a billing and coding specialist to bill for all visits and procedures completed at the practice. You don't know much about billing and coding so you leave it up to the "specialist" to take care of all that. After all, you care about is seeing patients, right? This year, Medicare decides to audit the practice that you work for and they find several fraudulent mistakes in your billing. You have apparently been upcoding* several office procedures and double billing for some office visits. You are now facing criminal charges for defrauding the federal government and are facing jail time and a $300,000 fine. You try explaining that you never actually did any of the billing yourself, but in the eyes of the law, you are still at fault. Know what codes are appropriate. This is a two-way street. Don't overbill, but don't under bill either. Under-billing can be misconstrued as favoritism toward certain patents or it can just hurt the bottom line of your business. Its a Goldilocks and the three bears thing... not too much, not too little... but just right.






Both of these scenaios are real and they show the importance of understanding reimbursement/billing/coding. You've worked really hard to become a PA, don't lose it all because you didn't want to be bothered with the paperwork of billing. 















*upcoding = adding additional codes so that you are paid more money than you should get

Pic: http://www.tormont.com/en/Products-in-English/English-Products/GOLDILOCKS-AND-THE-THREE-BEARS/102518-118-1042.aspx