I have had a long bedside RN career in many areas of nursing, I have physicians already asking if I want to partner with them. Physician Assistant vs Medical Doctor. Respectfully, most of us don’t. NPs in many states and federal facilities do not need physician to practice. This can be complicated in actual daily practice but it doesn’t change our responsibility to be clear about who we are and correct patients when they are confused about credentials. I, for example, had 2 years pre reqs, 3 years for my associate in nursing. Similar to NPs and physicians, PAs must also pass a lengthy certification exam after graduation. In my current position, I certainly am not just an assistant to a physician; I carry my own patient load, write my own notes, do my own admissions. I would encourage you consider the tone of your words here and what they are intended to imply. Physician Assistant vs. Family Practice Physician (updated ) *Programs vary and the following represents averages for each vocation. I would urge you to do a bit of self-reflection…you are not coming off as a caring person with this type of article. They don't want to put the time into training or into the practice of medicine. im not scared of blood or anything gory, i just pass out for no reason. This extends beyond other staff to patients, who refuse to be seen by us and ask for a “proper doctor” instead. I am truly sorry you have stopped precepting NP students! Most importantly we are being placed in roles where we are doing exactly the same thing as Doctors. This article is about a PA gone rogue. However, that does not change the fact that each role is unique and important in its own right. Why do they have laws about who can be a supervising physician? I did not question the competency of thousands of clinicians. I commented below about the professions not being comparable: there is no us vs. them. Especially for new graduates. As a pediatrician, I have written about a missed diagnosis of an infant by an unscrupulous midlevel provider who embellished his pediatric expertise. Horses and Zebras are very much “like” one another, but it is ill-advised to call them the same. Maybe a loved one in remission for cancer starts losing weight or re-experiencing symptoms. 1. “ Why are you so bent on trying to put down the PA profession by pointing out what you perceive as the differences in training or in practice? In this day, it is so important to shed light when an individual or group fails to comply with truth in advertising and proper supervision in the medical setting. It’s apples and oranges. All nurse practitioners were registered nurses before receiving either a master's or doctoral degree. I can out diagnose and give flat out better care than many MDs I have worked with but that doesn’t make me go around claiming I had more training and education by passing myself off as an MD. By Lisa Esposito, Staff Writer Aug. 1, 2014. Truth-in-advertising is a central American tenet we’ve all come to respect and expect from our service industry. Interestingly this article has touched on a different issue, the role of midlevels or perhaps just PAs in healthcare. Hello Doctor, Yep, i think people have insecurities is all i can say. The way you word this entire post shows your real opinion and feeling about the physician assistant( yes it is spelled this way, and no there isn’t a apostrophe followed by an s) profession. See the above. Somewhere in that blurred line trouble is brewing. The truth is, you may not always need a traditional physician—and may have a difficult time finding one. People can get great healthcare from people other than MDs. This is not degrading PAs or midlevels as a whole at all. You would have an endless supply of content. I should also note that there are PA residencies for those interested in specific fields of medicine, e.g. As a PA, this is concerning. Your article is more of a window into your perception of midlevels and likely your problem with your ego than it is an interesting article about misrepresentation. Regardless, I work side by side with awesome NPs in my practice, and ones that I’m sure wouldn’t make these erroneous accusations about PAs and our training. I am a PA who greatly respects the MDs I work with and who feels incredibly grateful for their mentorship. I am surprised that as a caregiver you lack the self-awareness to know that your tone and demeanor would likely be offensive to PA’s. Some new patients show up in my office and can’t believe I look and talk “just like them” (their words not mine.) Can you say the same? Suddenly, a person with less expertise and perhaps too little expertise is the one throwing the electrical wires all throughout the house leaving live wires exposed, ungrounded outlets, etc. Then everyone will be unhappy with me, but will they talk about how to make things better for all of us? In healthcare, transparency about background, education and expertise are so important. Who would ever even ask that statement? It may well not be a doctor: ... what type of medical provider would they want to see. It was later modified to reflect she graduated from the Physician Assistant program at USC. You walk into the exam room or emergency department, or you are making the rounds for a physician. There is no need for anyone to fill another’s shoes when the shoes don’t fit. It’s sad when there are some who take offense when no offense was intended however. Most of it will be yes or no questions. Sorry to disappoint you there. However, no matter what degree you obtain, there multiple prerequisite course requirements in biology, inorganic chemistry, organic chemistry, statistics, and upper-level science courses ranging from microbiology to embryology. I have been a PA for 20 years and serve in an underserved area with mostly low income struggling minorities. The fact that this person would try to obfuscate her credentials speaks to her character. Never would I want to cheapen the sweat equity of MDs. What you call insulting is simply the truth. Trust me there are much easier ways to make $ than medicine. It is the inflammatory statements in this article that make this a PA vs MD discussion and not about misrepresentation. I am not insinuating anything. As a new NP, I find myself running into this frequently. The U.S. has always been the best, no doubt partly due to stringent educational and practice standards. For all intents and purposes, Christie Kidd, PA-C is running an independent dermatology practice directly under the nose of an apathetic California State Medical Board indifferent to regulations. We take a difficult board exam, are required to do CMEs and repeat boards. Medicine needs to recognize a PA with ten year’s experience is able to do many things with more autonomy than a … Why is this so disagreeable to you? But when patient safety is at risk because MDs/DOs/PAs/NPs allow blurred lines, we must stop and fix it. ” it is incredibly difficult to get into a quality accredited PA program, many say it is harder than med school.”. Don’t forget the history of the PA profession is one of battlefield medics being converted to civilian medical providers. For the record, dermatology is not a specialty that I enjoyed either. Regardless, admission to PA school, subsequent training, clinical rotations, and certification are extremely rigorous. NP programs generally involve 500-750 hours of clinical rotation. She kept repeating that the supervising plastic surgeon had no complaints against him. Now at least clinical hours are required” . In my opinion, the gist of the article is a failure to be truthful in advertising one’s title, education and practice. This is learned in Medical School and Residency/Fellowship. I see this quite frequently as I live in a rural state that grants NPs independent practice, even as new graduates. While a PA is educated in the ‘medical model’, as is a MA, and an AA, this level of training is not at the same level of detail, nor does it specifically train to provide the necessary prerequisites for independent practice; hence all non physicians trained in the medical model are called ‘assistants’. As a child, I remember not wanting to see the doctor or sit in those exam rooms, with their fluorescent tube lighting and antiseptic smells. NPs are able to perform minor procedures and assist physicians in major procedures, but are not permitted to perform invasive surgeries. Sometimes we try any idea. In this infographic, we explore facts and figures behind the American addiction epidemic, what you can do to keep helping, and how Barton can guide you through next ste... Are you an NP or PA who has fielded patient requests to see a “real doctor”? Lets just be transparent with the titles. I have a similar problem, i want to be a doctor but everytime i see blood i pass out. Your comment is incredibly uneducated, damaging, and inaccurate. Regardless, I agree with you that collaborative environment with respect amongst colleagues is the best choice and yes, many of us in rural areas are so darn busy, we would love to have an MD, NP, or PA join us; because our patient loads can really be overwhelming.. Anon91, Great question. My fellow providers (yes, even physicians) often seek out my opinion on treatment plans or for help establishing differentials for a complicated patient. How strong or not strong are the components of the rotator cuff and other muscles around the shoulder? This post about misrepresentation clearly has you upset. And you think it is a good idea to go backwards? I find her knowledgeable but also see her as a mentor in my life for many reasons. emergency medicine, psychology etc. Don’t need no stinkin regulations. Thank you for this article. This is a common problem in society and not just the medical profession. I like “Truth in Advertising” better. #beinformed #itsoktoask #doyouknowyourdoctor. Patients should have the right to know who is treating them and clearly understand the differences in their health care provider. In this situation, the doctor may not have your best interest at heart and, therefore, this would be a valid reason to change physicians. Who else would have titled it? Of course not. It all does beg the question as to why I really valued my 10 years of medical education (2 years extra during medical school for M.S. It is about teamwork and collaboration. Just because a state law grants NPs independence does not mean that you SHOULD have independence. In addition most nurses work at bedside while pursuing advanced degrees. Yes, it would have benefited our profession to actually prominently display herself as a PA, being clearly very good at what she does. I am the one repeatedly reminding patients I am a PA after I have introduced myself as one, so I can certainly see how more unethical PAs might take advantage of this and not correct patients and yes that is a problem. Hell, I helped raise many of them from baby docs to attendings. He graduated first from Chadron State College in Chadron, Nebraska, with a bachelor’s in biology (human biology option), then from the University of Nebraska Medical Center in Omaha, Nebraska, with a bachelor’s in clinical laboratory science. Contrast this to PA education which is 8 hours per day, 5 days per week for the majority of the program (maybe 1-2 week breaks during the first year). Until you’ve been both you can never understand how you just can’t know what you don’t know. “On the other hand even a nurse who graduated and goes straight to NP school has 2 years prerequisite, 2 to 4 years nursing school and then 2 to 3 years NP school.” Lets do some math. It’s also worth stating that you really don’t get to abdicate responsibility for the ultimate title of this article. And please do not say you aren’t as your entire post reeks of opposition against the career. If you’re not comfortable with them, you should see someone else. The individual case you call out is exactly that – one example. Even dermatologists often cannot make a diagnosis, and treat empirically accordingly. I know that I am treated differently than my African American colleagues, as well as other minorities, when their credentials are far superior to mine. PA and NP are two different routes to the same kind of position. As to the title change, ALL of the editors, whether at THCB, KevinMD (titles are ALWAYS altered), and even at my hometown newspaper where I write a monthly column, take liberties with titles and they are intended to grab readers attention. Perhaps Dr. Al-Agba could ask the editor to restore her original title, as the current title appears to be a point of contention with the mid-level practitioners. Thanks for bringing this up. “Patients are sometimes confused by the word FAMILY because they think it means they need to have children in order to see that type of a primary care doctor, but that’s not the case,” said Stephanie Proszkow, a referral specialist with Beaumont’s Physician Referral Service. ” I don’t think we can make generalized statements about the quality of current PA and NP graduates ”. Nursing is a noble profession and they should be proud of it, as should PAs, who really do help out as a team when supervised. “, TPNA, where do you come off saying that? That is a fact, not an opinion and not a merit-based statement about the profession. If it was simply the years of education then the rest of the civilized world would be duplicating our system when in fact the length of education for Physicians in the rest of the world is much shorter. You are literally comparing apples to oranges. While you may feel this piece was demeaning, it was truly not intended that way. I think patients deserve transparency. “Clinical time is required in all nursing rotations”. https://www.youtube.com/watch?v=48yd623jNts, https://www.youtube.com/watch?v=HAhzIb6G3AY, Who Owns Your FitBit Data? I am sure that Dr. Al-Agba has faced unfair prejudices. Mid level providers have a great role to play in supervised practice acting as physician extenders but holding themselves out as board certified specialist physicians is unconscionable. The first open-heart surgery, the eradication of polio due to the development of the polio vaccine, the treatment of certain congenital disorders, antiseptic technique, the development of artificial skin, the first test tube baby, etc. PAs practice and prescribe medications in all 50 states and the District of Columbia ; A PA is a nationally certified and state-licensed medical professional.
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