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99 Cards in this Set
- Front
- Back
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What year did the Surgeon General identify a shortage of medically trained personel?
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1959
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What year did the first PA class start? At what University?
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1965, Duke
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What year did Barefoot doctor's arise? What was their purpose?
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1966
Emerged in response to Chairman Mao's purge of the elite and intellectual. |
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What year did the child health associate program start? Where and what arose from it?
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1966
University of Colorado origin of Nurse Practitioner and PA specialty |
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What year was the AAPA established?
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1968
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What HMO was the first to employ a PA? What year?
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Kaiser Permanente 1970
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What year di dthe AMA recognize the PA profession?
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1971, and began work on national certification
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What were the contributing factors for the PA innovation?
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1. The war in SE Asia was ending in the 60's and 70's, and advancement in trauma medicine was a result.
2. Social climate in US. The war on poverty |
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What is the Comprehensive Health Manpower Act? What year did it happen?
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1971
funds for medical schools to increase # of students to meet perceived shortage of medical personnel. Also included funding for PA programs. |
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Define Primary Care
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comprising family medicine, general internal medicine and general pediatrics (sometimes OB is listed too)
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What are Loblolly Boys?
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1799
Act of Congress mandated all Navy ships provide an area where sick and injured men could be cared for by other crew members (John Wall 1st one) Replaced by "surgeon steward" |
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Describe Practicante's
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In Puerto Rico there were lots of isolated areas that physicians couldn't get to, so they needed someone who could fill in.
Empowered to treat the sick and injured as soon as they arrive and involving the surgeon by notifying him of Dx and Tx you have provided. |
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Who was Imohotep and why was he important?
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Egyptian deified as God of Medicine
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What year was the Papyrus of Thebes made? What is its significance?
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1552 BC. Most important scroll: mentioned mental retardation, pediatrics and cosmetics
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Who is the Father of Medicine?
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Hippocrates
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What were Hippocrates' contributions to medicine?
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Wrote Airs,Waters,Places
1st public health, climatology, bedside manner etc |
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Who were the main contributors to medicine in Ancient Greece and what did they do?
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Hippocrates: Father of Medicine
Diocles: 1st anatomy text Hilophilus: Father of Anatomy, 4 humors Erastratus: capillaries, lung as a vacuum |
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Who was the Father of Anatomy?
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Hilophilus
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Who were the main contributors to medicine in ancient Rome and what were they known for?
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Celcus: described inflammation, meningitis, amputation
Arataeus: 4 physiological diagnosis features, disease transmission Galen: (130-200AD), father of Osteology |
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Who was the Father of Osteology?
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Galen
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Who were the main contributors to medicine in ancient Arabia?
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Burzuya (532 AD)
Sustra (Indian) 1st pharmacy, 5 senses Asoka: built hospitals Ali-al-Taban: merging of science/medicine in Islam Rhazes: treatment of mental illness, hospital built by location |
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Who was Roger Bacon? When did he live?
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1214-1294, anticipated radiology
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Who is the father of Modern Anatomy?
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Leonardo da Vinci
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Who was Vesalius and when did he live?
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Grave robber, performed theater dissections
1514-1564 |
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Who was the Father of Modern Medicine?
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William Osler (Canadian) one of John's Hopskins founders. Established residencies
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Walter Reed- describe what he discovered and where the hospital is named after him is located.
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1851-1902, yellow fever vector was the mosquito.
Walter Reed hospital- Washington, DC |
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In what year was the Colorado Health Associate program founded? By whom?
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1968, Dr. Henry Silver and Loretta Ford, RN
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Did the first class at Duke get a certificate or a degree?
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Certificate
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What year was the Health Profession Educational Assistance Act? What did it do to the profession?
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1972, caused a PA boom
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What program was the first to award a Master's degree? When?
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Child Health Assoc. at University of Colorado in 1985
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Who started the MedEx program? When?
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Richard Smith, 1968
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What was a result of the MedEx program?
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PA's were allowed to practice under licensed physician
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What year did the UTMB medical school begin development?
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1881
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How many people were in our first PA program?
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6, in 1971 called the "clinical associate program". Brought together by Dr. Bing
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Who was Truman Blocker?
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1st UTMB president
brought in his horse to demonstrate tendonitis |
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What program started here first, medicine or nursing?
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Nursing (1 year before)
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Who was Frank Ambriz?
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helped run the neophite UT Pan Am PA program
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Who is our medical director?
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Dr. Courtney Townsend
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What were the Feldsher's? When did they start and what is their current role?
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1650's, German military medical assistants, introduced to Russian army by Peter the Great
Now they serve like a PA in urban settings, serve as primary care in rural. |
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What are loblolly boys?
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1778 Assistant to physician on navel vessels (replaced by surgeon's steward in 1842)
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What was an Officer de Sante?
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1803, in France, to assist with a healthcare shortage, Rene Fourcroy established them. No major operations, could suture, fairly independent.
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What are Chinese Barefoot Doctors?
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village aides with 3-6 months of training. Mosly in rural villages.
Emerged in '66 Cultural Revolution Now work privately in a fee-for-service capacity |
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What was a Practicante?
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In Puerto Rico, in 1866 allowed to Dx, provide Tx, sutures. Had "major" and "minor" practicantes.
Phased out in 1931 |
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What is the historical definition of Feldsherism?
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term or policy for interim healthcare personnel.
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Where was the first surgical assistant program started? By whom?
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University of Alabama Birmingham
Dr. John Webster Kirlin |
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What are Alaska Community Health aides?
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local residents trained to provide emergency and primary care services in rural villages.
Use procedures set forth in manuals, consult by telephone. |
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What is the AAPA and when was it founded?
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1968 American Academy of Physician Assistants, founded by the student's at Duke.
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What does the ARC-PA do?
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Establishes the standards for U.S. PA education
Evaluates programs to ensure their compliance with the standards |
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When was medical licensure first introduced?
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931 AD in Bagdad
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What was the Comprehensive Health Manpower Act?
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1973, marked inclusion of PA program funding support programs
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What the the AMA house of delegates do in 1970?
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Passed a resolution urging statutes and regulations be updated to permit PAs to qualify as medical practitioners.
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When was the NCCPA founded?
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1973
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Who was Charles Hudson, and what did he do?
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President of the National Board of Medical Examiners- called for a "mid-level" trained provided based on military experience
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What was the premis of the program at Alderson-Broaddus?
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4 year private university 1968
Founded by Dr. Hu C. Myers First Bachelors |
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Who is the current UTMB president?
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David Calendar
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Who is the SOP Dean?
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Betty Protus
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What year did the PA postgraduate programs start?
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1971
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What is the internship model of PA residencies?
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Practically oriented, didactic curriculum combined with intensive clinical rotations and educational experience in a hospital setting
Usually leads to a certificate of completion |
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What is the academic model of PA residencies?
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Combines a highly structured and formalized didactic education (through courses taken for graduate credits) with clinical rotations
Leads to a master’s degree or credit toward a master’s degree upon completion Tends to focus on skill development in clinical and nonclinical areas |
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Compare certificate and license
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Certification: from NCCPA when you pass boards
License: some states require it when you practice, Tx does |
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Who is the largest employer of PA's?
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The federal government
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What is the PAES?
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The Physician Assistant Education Association
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What is productivity?
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The quantity of services PA's provide to their patients.
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What is compensation?
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The combination of salary and benefits.
It is the amount hte employer forgos to retain the service of the employee |
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What do you have to do to be eligible to take the PANCE?
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graduate from an accredited program
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What is the Tx Occupations code?
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OSHA- safety regulations board
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What is the TX Health and Safety Code?
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subject technique
permits when you set up clinics |
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What is the TX Family Code?
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Reporting abuse
knowing which parent to release info to in custody cases |
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What is the TX penal code?
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Negligence
Things that harm people purposefully |
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What year was a Master's degree required?
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2007
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What is the substitution ratio for traditional primary care medical office visits (PA/physician)
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.83
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Define substitutability
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replaces a service with something in kind, implies that the quality of care is not threatened.
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Define Complement
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Something that enhances the service being provided.
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Describe delegation
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THe percentage of primary care medical responsibilities that can be safely handled by a PA under optimal conditions.
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What is an opportunity cost?
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The trade-off between going to PA school compared to starting/continuing in a current career. Aggregated factors are the opportunity cost.
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What are the NCCPA and Texas requirements for CME's respectively?
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NCCPA 100 hours (50/50 every 2 years)
TX 40 hours (50/50 every year) |
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What does the DEA regulate?
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Tracking prescribing patterns. Have to apply for a DEA number
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What does the DPS regulate?
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Prescribing of controlled substances
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Where was the 1st PA postgraduate program? When?
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1971, Montefiore hospital, NY
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As of 2009 how many post graduate programs were operating?
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44
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What was the Norwalk Hospital program for?
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Surgical anatomy and physiology postgrad program
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What year was the APPAP founded? What for?
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1988, association of postgrad PA programs, formed to further the specialty education of PA's
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What are the physician/PA substitution ratios for primary care, adult, pediatric and military medicine respectfuly?
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83%, 75%, 90%, 99%
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What factors affect PA cost effectiveness?
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Practice Arrangement
Delegation Supervision Consultation Rate Clinical Productivity |
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What is the limit on the PA/Physician ratio?
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4 per physician, can apply for more
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What are the types of delegation?
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Legal vs. Economic
F/U vs new inpatient vs outpatient procedures vs first assist |
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What is an RVU? What does it deal with?
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Relative value unit
Deals with productivity |
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What are employer costs? (list)
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Salary
Benefits Insurance licensing Clerical Support Staff Credentials CME PTO Retirement Social Security Supplies Bonus |
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What are costs we should expect as PA's?
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commute expenses
parking uniforms meals professional memberships liability additional insurance |
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What are factors influencing future attitudes of PA/Physician roles?
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Practice Patterns of PA's
Whether PA's are viewed as colleagues of competitors Whether economics of PA employment infringe on a physician's income |
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What 3 Issues influence PA effectiveness?
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Prescribing authority- doctor has given you full authority, more room to be effective
Prescribing behavior- are you willing/able to do it? Barriers to performance- preconceived notions, language, moral beliefs |
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What are the 3 types of APNs? What is an APN?
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Advanced Practice Nurse
CRNA's- certified registered nurse anesthetists CNMs- certified nurse midwives NP- nurse practitioner |
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Respondeat superior
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letting the master answer: taking your voice away
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Negligent supervision
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lack of monitoring
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negligent hiring
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not discovering previous wrong when hiring
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captain-of-the-ship doctrine
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MD liable for employees
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borrowed servant rule
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we are not in control of our own actions (it wasn't my fault)
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What was the surgical papyrus? What did it mention? When was it written?
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1600 B.C. (actually copy of text from 1000 years ealier)
15 ft. long now (was longer) Documented surgical cases of men only Probe the wound Pulse monitoring Fever documented Cranial nerve injuries |
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What was the Therapeutic Papyrus of Thebes? When was it written? What did it describe?
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Dated 1552 B.C.
Most important of all Egyptian Scrolls HEENT considerable space Chapter on pediatrics Dermatology – burns, gangrene, flogging injuries >70 cosmetic preparations Freckles, sunburn, wrinkles, bad breath, hair color |
