Renaming of Physician Assistants to Physician Associates

[deleted6669]

Most folks who see a specialty pa think they have seen a physician despite:
1.brochure handed to pts in hospital waiting room explaining what pa is and our role
2.intro as a pa
3.nametag that says pa
4.lab coat that says pa
5.script that says pa
6.aftervisit summary that says pa
7.business card that says pa....

then at the end of the visit: " thanks doc".

when folks send notes to our medical director either positive or negative they almost always say " I saw dr smith and he was wonderful" or "I saw dr smith and he left me in pain", etc

in a private practice folks probably know what a pa is but for single visits to a hospital based em/ortho/surgical/cardiology pa despite all of the above folks just don't get it.

case in point-many physicians don't even know what to call us appropriately. they say physician'S assistant. there is no 's. we don't belong to them. and when we nicely correct them they say" same thing, right?".
how do you think opthalmologists would respond if they were constantly refered to as optometrists?.

some consultants(maybe 5-10% of md's in some settings) only want to speak with our attendings about OUR pts despite the fact that our attendings know nothing about the pt because, well, it's not their pt, it's ours. in the normal course of things most of our pts are never seen by our attendings unless we ask them to.
it can take a long time to find a job where all the md consultants are willing to discuss cases with a pa. I went through 3 jobs over 7 years before I found a setting where this was so. mostly it was about moving to a more pa friendly state with a long history of pa utilization and where the docs trained alongside pa's and knew we were more than medical assistants. seriously, some surgeons won't believe a pt has ct proven appendicitis unless a doc tells them EXACTLY THE SAME THING THAT I JUST DID.

We take far more crap from physicians and other health care professionals that we do from pts.
nurses who are pro-np hate us as we are "taking away np jobs". they even go so far as to refuse common orders unless cosigned by an md/do(totally illegal by the way).
know what happens if no one stops them? pa's quit and only np's will work at those places.don't tell me it doesn't happen.I have seen it first hand. it took firing every nurse who refused appropriate orders for this to stop. that took ten yrs. in the interim all the pa's quit and they hired np's. it took the er medical director becoming chief of staff of the hospital and firing all involved nurses for this to end. now he wants all the open slots to be filled by pa's and whenever an np quits he hires a pa to replace them.

just like I wouldn't presume to tell a member of an ethnic minority that they are not oppressed I don't think non-pa's have any idea of what our day to day practice/experience is like. it's taken me > A DECADE to find a place that appreciates pa's.
trust me on this. I've been involved with the pa profession longer than you have been alive.
pm pacmatt or bandit here at the pa forum. they are em docs that used to be paramedics and pas. they will tell you about some of the frustrations involved. they get it. that's why they moved on. over the years I considered going back to medschool multiple times, even took the prereqs, etc but I just couldn't justify the expense at this point in my life(they are both younger than I am). I would break even financially the year I retire having missed years of my kids lives. my real cost to attend medschool is> 1 million dollars when you consider lost wages and price of school, etc.

ps regarding DO's name. there are multiple threads here about changing the name. do a search for MDO. that is the current name many of them want( medical doctor of ostepathy).

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[RGMSU]

I don't think the workplace frustrations are unique to PAs. After all, those of us who are training to be physicians are the ones watching ourselves slowly be replaced in many fields by mid-levels. You think that isn't frustrating? As far as treatment by the patient, sounds like if they're treating you like a doc, you've been de facto promoted, which is a positive.

 

[deleted6669]

I can see how your situation would be frustrating as well.
if you play your cards right you can end up supervising pa's and making more money than working alone while having them split call and night/holiday coverage with you.

 

[RGMSU]

I can see how your situation would be frustrating as well.
if you play your cards right you can end up supervising pa's and making more money than working alone while having them split call and night/holiday coverage with you.

Yes, I'm sure that's the way it will need to be. I just wonder how long it will be before the powers that be blur the lines between all of us as practitioners. I wouldn't rule out the possibility that physician supervision in some fields such as primary care will fall by the wayside in the not so distant future. Then any physician in primary care will just be over-educated and in too much debt compared to their primary care substitutes. In many ways, all of us in medicine should be lamenting that medicine in America is legitimately in crisis.

Honestly, here I am up at 3AM CST on a Fri night studying for a Mon exam. I can't tell you why anyone with half a brain would do this considering the uncertain future for MDs in this country. I like medicine, but I sure as hell think it's a stupid thing to get into, especially as a physician.

 

[deleted6669]

.

Honestly, here I am up at 3AM CST on a Fri night studying for a Mon exam. I can't tell you why anyone with half a brain would do this considering the uncertain future for MDs in this country. I like medicine, but I sure as hell think it's a stupid thing to get into, especially as a physician.

you sound like someone who actually wants to make a difference, not just big bucks, so I'm sure you will do well whatever the future holds for american medicine.

 

[deleted87716]

if you play your cards right you can end up supervising pa's

Believe it or not, that isn't everyone's dream job.

 

[lov2xlr8]

Why do mid-levels have a problem just being who they are? Never understood that one. If you're at KMart and you bump into the assistant manager, it's clear he isn't the manager. He's the assistant manager.

Opening this back up. You are correct, he is the assistant manager, but PAs are not called assistant physicians (this name has been debated). Let's reverse that. How about the managers assistant (like PA)? What does that sound like? To me, I think glorified secretary at most. And also, you have never had to explain the role of a PA to someone because it doesn't come up in your normal conversation. But in the real world, when I say PA or physician assistant, 1 out of 3 people look at me like they have no idea what I am talking about.

 

[RGMSU]

And how would saying "physician associate" help anybody know what you're talking about?

 

[Shoushu]

First of all, to me "physician associates" for PAs is a bastardization of the English language since it implies more of an MD physicians group practice than PAs. If you do a Google search on "physician associates" many of the results will be names of private MD practices. People who are associates of a firm generally have the same academic degree as the partner. For example the associates in "Attorney and Associates" refers to the JD associates who are working to become partners, not paralegals. Similarly, a research associate (mostly postdocs) has typically the same PhD as the PI.

Why stop there? After changing to "physician associate", why don't they change title to associate physician? Or assistant physician. It'll confuse the heck out of patients when they call for nurses and PA, "Oh you are a nurse with DNP, so you a a PhD doctor." "You are Physician Associate, and have Doctor of PA Studies, so you're also a doctor, doctor"


Somewhat related, some patients are now being changed to be called "Clients" and customers to a hospital. Clients to a practice.

In legal world, Paralegals are demanding they be called Para-Lawyers. "Hi, I'm an associate of Big City Law Firm. I'm Paralawyer John Smith."

 

[GoLytely]

Ugh...Enough with the mid-levels trying to find sneaky ways to be called "doctor" without actually becoming one. Have some respect for your colleagues who have gone to medical school. It was bad enough back when it was just the NPs doing it...

 

[dragonfly99]

I agree that "clinical associate" (? someone said they were called that in Canada) seems like a better name.

I agree that a lot of patients probably think that a PA is like a MA (medical assistant), which requires lots less education and training.

I wouldn't worry too much about NP's abusing you...some NP's just have an attitude. My experience is that a lot of the PA's are better...or maybe it's just that they think more like us (physicians) because of the similar schooling.

 

[Shoushu]

I agree that "clinical associate" (? someone said they were called that in Canada) seems like a better name.

I agree that a lot of patients probably think that a PA is like a MA (medical assistant), which requires lots less education and training.

I wouldn't worry too much about NP's abusing you...some NP's just have an attitude. My experience is that a lot of the PA's are better...or maybe it's just that they think more like us (physicians) because of the similar schooling.

wait, so is the pecking order: Physician > Doctor of Nursing > NP > PA?

On the levels on the Totem Pole. If NP and PA are called mid-levels, then are MDs/DOs the high-levels?

Who are the low-levels?

 

[deleted6669]

wait, so is the pecking order: Physician > doctor of nursing > np > pa?

On the levels on the totem pole. If np and pa are called mid-levels, then are mds/dos the high-levels?

Who are the low-levels?

md/do>crna/aa/pa/np> rn/emtp/rt>emt/cna> administrator

 

[wholeheartedly]

md/do>crna/aa/pa/np> rn/emtp/rt>emt/cna> administrator

then administrator>cafeteria staff> environmental services>>>>>>> hospital lab staff

 

[Shoushu]

then administrator>cafeteria staff> environmental services>>>>>>> hospital lab staff

I actually thought

High-levels= Hospital CEO, other administrators, Doctors

Mid-Levels = Nurses and PA's

Low-Levels = Orderly, Cafeteria staff, security guard

 

[cbrsmurf]

Ugh...Enough with the mid-levels trying to find sneaky ways to be called "doctor" without actually becoming one. Have some respect for your colleagues who have gone to medical school. It was bad enough back when it was just the NPs doing it...

It has nothing to do with respect. It's about using a proper title to give a pt, staff or anyone unfamiliar with the profession a better idea of what the person does.

For example, most people know what a medical assistant does... they perform many basic clinical skills and assist the clinician but don't diagnose or write orders. Nurses and doctors are well-known professions with well-known roles.

Most people (including this forum), however, do not know what a NP or a PA is. However, the NP title - Nurse PRACTITIONER - gives a better idea of what their role is than a Physician ASSISTANT, even though their roles/scope are nearly identical. Just go around asking a bunch of random people about NP's and PA's... I bet more people will associate NP's with a more clinician/provider role while PA's will be associated with EMT's, techs, MA's.

 

[badasshairday]

Most people (including this forum), however, do not know what a NP or a PA is. However, the NP title - Nurse PRACTITIONER - gives a better idea of what their role is than a Physician ASSISTANT, even though their roles/scope are nearly identical. Just go around asking a bunch of random people about NP's and PA's... I bet more people will associate NP's with a more clinician/provider role while PA's will be associated with EMT's, techs, MA's.

I agree. I don't think there is anything wrong with called PA's "Physician Associate." Physician Assistant seems like a secretary type name, which totally is not the case. I don't even think there is a problem with Assistant Physician. It seems even more appropriate and along the lines of what they really do. This is not any different from Assistant Manager, Assistant Professor, etc. Think about what Manager Assistant or Professors Assistant sounds like. You get the picture?

 

[deleted6669]

there is a pa program starting in saudi arabia next yr taught by american pa's.
at the request of the saudi govt. the profession and program there will be called "assistant physician".

 

[orangele]

Bottom line is that if someone wants the respect, and title of doctor, they should go to medical school. Unless you go to medical school, then you are not a physician. You may be very good and skilled at what you do, and may indeed deserve respect for that, but you are not a doctor.

These days, it seems like many non-physicians are attempting to be granted the rights and privileges of a physician by legislative decree rather than education.

 

[mwppa]

Bottom line is that if someone wants the respect, and title of doctor, they should go to medical school. Unless you go to medical school, then you are not a physician. You may be very good and skilled at what you do, and may indeed deserve respect for that, but you are not a doctor.

These days, it seems like many non-physicians are attempting to be granted the rights and privileges of a physician by legislative decree rather than education.

Actually, doctor != physician. Just because pts tend to popularize the term doctor does not mean anything. Your college professors were doctors, I presume. Whether they taught biology or humanities. Doctor only means you have obtained a terminal degree.

I see a great deal of bashing of NPs on here which I don't understand. I have yet to meet a female who didn't prefer seeing an NP over an OB-GYN. I personally did the PA route but I have respect for NPs as well.

Perhaps one problem with MDs is their ego, not the ego of PAs. Would you like to be called "Junior Doctor" while in residency? Then why would you wish for PAs to be called your assistants, like we serve you coffee or the like? It's easy to be critical when it isn't you being disrespected. Associate Physician is prefectly valid and you all know it. Saying "you aren't a physician" is funny because we do the job of one in many cases and many patients can't tell us apart unless they are told.

PA or MD doesn't really mean anything in the long run. It's about how skilled you are at what you do. There are many crap MDs but PAs have very few that are thought bad of. I have my own opinion for this but I'm sure it has something to do with the average age and experience of PAs entering PA school vs the typical med student. I'm not trying to insult anyone but how much wisdom can you truly acquire in your mid 20s? Many PAs have already been in healthcare under other titles and carry that experience with people into their profession.

I hope the day comes when PAs (or whatever you call them) will have the same autonomy that NPs have.

 

[cpants]

Actually, doctor != physician. Just because pts tend to popularize the term doctor does not mean anything. Your college professors were doctors, I presume. Whether they taught biology or humanities. Doctor only means you have obtained a terminal degree.

I see a great deal of bashing of NPs on here which I don't understand. I have yet to meet a female who didn't prefer seeing an NP over an OB-GYN. I personally did the PA route but I have respect for NPs as well.

Really? Most females prefer to see NP's over OB/Gyn's? Why? Do you mean female NP's vs male OB/Gyn's?

Perhaps one problem with MDs is their ego, not the ego of PAs. Would you like to be called "Junior Doctor" while in residency? Then why would you wish for PAs to be called your assistants, like we serve you coffee or the like? It's easy to be critical when it isn't you being disrespected. Associate Physician is prefectly valid and you all know it. Saying "you aren't a physician" is funny because we do the job of one in many cases and many patients can't tell us apart unless they are told.

PA or MD doesn't really mean anything in the long run. It's about how skilled you are at what you do. There are many crap MDs but PAs have very few that are thought bad of. I have my own opinion for this but I'm sure it has something to do with the average age and experience of PAs entering PA school vs the typical med student. I'm not trying to insult anyone but how much wisdom can you truly acquire in your mid 20s? Many PAs have already been in healthcare under other titles and carry that experience with people into their profession.

I hope the day comes when PAs (or whatever you call them) will have the same autonomy that NPs have.

There are many crap MD's but few crap PA's? That makes no sense. Personally I don't give a damn if the A means assistant or associate. It doesn't matter. PA's or NP's should not be called doctor in a clinical setting however. While you are right that doctor can be an academic term, in the clinic it implies that the person went to med school and if practicing independently, completed a residency. To use the term without those standards is dishonest to patients. I know I would be pissed if I had an appointment with Dr. Soandso and upon arriving discovered that she was a PA.

 

[Instatewaiter]

Actually, doctor != physician. Just because pts tend to popularize the term doctor does not mean anything. Your college professors were doctors, I presume. Whether they taught biology or humanities. Doctor only means you have obtained a terminal degree.

In the english language, doctor=physician. When you're in an airplane, and someone yells, "Is there a doctor on board?" they're not asking for a PhD in German Literature, they're asking for a physician.

When one of your friends says, "I have a doctor's appointment" do you ask, "why do you need to go see a Doctor of Art History?"

No. And this is all outside of a clinical setting. In a clinical setting, it is even more explicit. Physican=doctor and Doctor=physician. Using the term "doctor" in a clinical when you're anything but an MD or a DO is misleading, especially if you dont completely explain it. Even then, people will have no idea.

I see a great deal of bashing of NPs on here which I don't understand. I have yet to meet a female who didn't prefer seeing an NP over an OB-GYN. I personally did the PA route but I have respect for NPs as well.

I think a lot of the animosity is directed at the lobbying of the nurses rather than the NPs themselves. Their lobbying agency is pushing for equal practice rights despite clearly very weak training. Most DNPs- the doctoral version of the NP- require only 1000 clinical hours and are only about 70-90 credits- total.

Of those credits, roughly 40-55% (depending on the program) are fluff courses that are things like nursing history, nursing leadership, nursing activism, research design and statistics instead of clinically useful courses.

The fact that NPs aren't standing up and saying, "hey perhaps this isnt a great idea" just means that most are on board.

Perhaps one problem with MDs is their ego, not the ego of PAs. Would you like to be called "Junior Doctor" while in residency?

Sure. I start residency in a few weeks. I would be more than happy to be called Junior Doctor Instatewaiter, because quite frankly that is what I am.

Then why would you wish for PAs to be called your assistants, like we serve you coffee or the like? It's easy to be critical when it isn't you being disrespected. Associate Physician is prefectly valid and you all know it. Saying "you aren't a physician" is funny because we do the job of one in many cases and many patients can't tell us apart unless they are told.

Assocaite Physican would probably be construed as telling someone you are a physician and practicing medicine in my home state. A patient would never be able to tell you weren't a physician since Associate is just an adjective that modifies the noun, physician. So saying you are an Assocaite Physician is saying you are a type of physician- which you're not.

Physician Associate is better but still many would think you're a doctor. Being one of the physician's associates could be taken as being just another physician. Physician Assistant is best since it clearly shows you are below the physician in terms of training. Quite frankly I don't care if it is physician associate or assistant. Associate Physician is out of line though.

PA or MD doesn't really mean anything in the long run. It's about how skilled you are at what you do. There are many crap MDs but PAs have very few that are thought bad of. I have my own opinion for this but I'm sure it has something to do with the average age and experience of PAs entering PA school vs the typical med student. I'm not trying to insult anyone but how much wisdom can you truly acquire in your mid 20s? Many PAs have already been in healthcare under other titles and carry that experience with people into their profession.

I hope the day comes when PAs (or whatever you call them) will have the same autonomy that NPs have.

I'm sorry- what?

 

[deleted6669]

I agree that assistant physician or associate physician would not be appropriate as it would imply one was a physician.
physician associate is clearly the more appropriate title to describe what we do.
interesting aside, they are starting a pa program in saudi arabia this yr and they call it an "assistant physician program" and grads will be AP's.

 

[mwppa]

The ego of some of you MDs in training is staggering. Why don't you just call PAs "whipping boys who do all my grunt work" or WBWDAMGW for short. I don't mean to insult, but if any of you plan to open your own practice one day, you might want to learn how to give others respect. Unless of course you want to be one of those drs answering your own phone.

Ok, since PAs are not "physicians" or "doctors" of any sort then it makes sense that residents should not be called physicians or doctors either. I have yet to see or hear a difference between what most residents do and what PAs can do. Sure, you can point to the difference between med school and PA school but in the real world, people don't care what you have learned in school, they care what your scope of practice is. When I go to a restaurant, I could care less if my chef has a BA, AA, or a certificate as long as the food is good. Much of the stuff learned in med school is not actually relevant in many cases which is why the PA/NP was created and is a viable way of expanding healthcare, not to mention helping physicians expand their practice.

It is staggering the level of disrespect that some of you med students have for a career field that could quadruple your practice. Here in CA, one Dr can supervise 4 PAs. If you know anything about business, look at the earning potential that gives you? You could effectively tee off with a pager on your hip while those people make you a fortune.

 

[Instatewaiter]

The ego of some of you MDs in training is staggering. Why don't you just call PAs "whipping boys who do all my grunt work" or WBWDAMGW for short. I don't mean to insult, but if any of you plan to open your own practice one day, you might want to learn how to give others respect. Unless of course you want to be one of those drs answering your own phone.

Ok, since PAs are not "physicians" or "doctors" of any sort then it makes since that residents should not be called physicians or doctors either. I have yet to see or hear a difference between what most residents do and what PAs can do. Sure, you can point to the difference between med school and PA school but in the real world, people don't care what you have learned in school, they care what your scope of practice is. When I go to a restaurant, I could care less if my chef has a BA, AA, or a certificate as long as the food is good. Much of the stuff learned in med school is not actually relevant in many cases which is why the PA/NP was created and is a viable way of expanding healthcare, not to mention helping physicians expand their practice.

It is staggering the level of disrespect that some of you med students have for a career field that could quadruple your practice. Here in CA, one Dr can supervise 4 PAs. If you know anything about business, look at the earning potential that gives you? You could effectively tee off with a pager on your hip while those people make you a fortune.

As to your assertion that residents shouldn't be called doctor either, I could be on board with that to an extent- definitely for the first year. After that first year though, you are a pretty competent provider and have a medical license. Even then, since we aren't done with the training, I wouldn't really be opposed to being called doctor only after you are done. While I definitely have an ego (and an Id and a superego... hahah) I don't have any illusions that I am just at the beginning of my training and despite the fact that I will have "doctor" before my name I am nowhere near the level of an attending.

I'll agree, PAs and interns/junior residents do very similar things. The difference is, in a few short years, the residents leap frog over the PAs and become the leader of the team in both authority and ability. I imagine that has to be frustrating but it speaks to the quality of the undergraduate physician training.

I have a lot of respect for PAs. I have worked with some great ones who were also great teachers. They were great in many (most) situations. They are good for expanding practices However, the difference in education was obvious in those more difficult cases.

Expanded practice of both NPs and PAs is dangerous.

 

[mwppa]

I have a lot of respect for PAs. I have worked with some great ones who were also great teachers. They were great in many (most) situations. They are good for expanding practices However, the difference in education was obvious in those more difficult cases.

Expanded practice of both NPs and PAs is dangerous.

Yes, in more difficult areas, a physician shines and a PA is beyond his/her scope. However, I feel that in certain capacities that PAs should have the same level of autonomy as NPs. For instance, in family medicine. Rather than requiring a PA to be directly supervised (as in being employed by or working in the same practice) that PAs should have to carry their own insurance and sign agreements that they will consult with MDs or direct patients to MDs when a case is beyond their scope. I see no real reason why PAs should have to have MDs sign off on their charts (5% in CA) I mean, what good is it to sign off on 5% of charts? It sounds like everyone knows the value of PAs and realizes that they serve those that otherwise may not have a physician so why not give them enough autonomy to go full force in helping the underserved? It's not like MDs are losing out to PAs because PAs do what most MDs dread anyway. How many MDs really want to have a rural family practice? Not when you have 300k+ to pay back.

As far as the title, I change my view on that. I think PAs should have a unique title that isn't linked to Physicians or Nurses. Perhaps "Dependant Practitioners?" Just a thought.

 

[deleted6669]

Perhaps "Dependant Practitioners?" Just a thought.

that's worse than physician assistant. no thank you.
advanced practice clinician and affiliated clinician have been proposed as well as clinical associate.
the only thing that really works is physician associate as it keeps the initials PA and the small amt of recognition that goes along with it. physician associate was also the original name of the profession so it would just be returning to our roots.
see a current similar discussion about this over at www.physicianassistantforum.com

 

[mwppa]

that's worse than physician assistant. no thank you.

Well, we are all entitled to our opinion but I feel that if I had "practitioner" somewhere in my name that I would be less likely to be confused with a medical assistant. I can't tell you how many times that happens. Then again, I'm sure you know this.

Physician Associate really isn't any better, in all honesty. Unless you have some need for nostalgia then you are just playing semantics. When I was a teenager, I was an Assistant manager under an Associate Manager and few people thought there was any difference in the naming, although the Associate was slightly higher.

The issue isn't just one of comparing PAs to MDs but also one of PAs vs NPs. Since the NPs got the ball rolling, many believe that NPs are somehow superior to PAs in training, which just isnt true. I would argue that PAs are superior in training because of the medical model making them closer to MDs. If "Physician Associate" is the best our profession can do then we might as well keep Physician Assistant as the name and not waste money or effort.

 

[Instatewaiter]

Comparing the training, I have no idea how anyone could think that NPs have better training than PAs. PA training has 2-3x as many clinical hours alone, not to mention a real foundation in sciences instead of a bunch of fluff courses and some real ones thrown in there for good measure.

I am concerned that nurse practitioners have the amt of autonomy that they currently have when you consider the paucity of education. It is only because of their lobby rather than their skills that they have such independence.

 

[cadoobie]

WHOA!!! A lot of posters are posting the "if you want to be called doctor then go to med school..." junk. PA'S DO NOT WANT TO BE CALLED DOCTOR!!!! Jeez Louise!! really guys The PA profession has always EMBRACED their dependant relationship with the Physicians they work closely with. PLEASE do not confuse the renaming movement or love in PA's with those in other professions who plan to usurp Physicians by straight out DEMANDING to be called Doctor in clinical settings. PA's ARE NOT DOCTORS!!!! They never will be unless they finish MD/DO school. I dont think any PA would argue this so those of you getting butt hurt about it chillax!

I also wanna say A LOT of the posters here understand this movement and dont feel the least bit threatened by it...They probably have worked with PA's in their careers or are very familiar with the model. Thank you guys for posting!

 

[J1515]

Would you like to be called "Junior Doctor" while in residency?

I'd have no problem with it. It's the perfect description of my status at this time. In fact I make sure all the nurses and doctors on the floor call me by my first name. I introduce myself to patients as "the resident or intern working with Dr. _______"

Saying "you aren't a physician" is funny because we do the job of one in many cases and many patients can't tell us apart unless they are told.

So why correct misinformation, right?

There are many crap MDs but PAs have very few that are thought bad of.

By far the dumbest, most biased, and untrue comment. If only you knew how many PAs our hospitals have gone through... You have MD envy. Get over it.

Many PAs have already been in healthcare under other titles and carry that experience with people into their profession.

And many haven't. Many PAs around here are in their mid 20's. You come off as much more egotistical and obsessed with titles than any MD I know.

 

[deleted6669]

. Many PAs around here are in their mid 20's. .

although more pa's today than in yrs past have less experience, age alone shouldn't be your criteria. I know lots of pa's who had significant prior experience by their mid 20's.(most of my class in fact).
for example when I was 25 I had been an er tech for 5 yrs and a paramedic for 2 yrs and had a bs from the university of ca..

 

[LeemerDO]

So what other name could we call PAs that doesn't invoke false connotations or misrepresentations?
We don't like associate because the word "associate" pertains to and implies someone of equal footing and qualification which education alone does not.

Advocate...maybe, since you are representing a physician, and can execute certain actions when instructed to by a physician

Avatar...nah, we're not really "driving you." You all can think and act more independently.

Apprentice...that implies that you will eventually be suited to take over a physician's position and stature.

Auxiliary...Well, you are a supplement to a physician's practice. You're an adjunct that can be called upon for additional support. The name though just doesn't roll off the tongue as well.

Granted, I would most definitely hire a PA before I consider a DNP any day. I just wish you'd all abandon this fruitless venture of deciding what to call yourselves just so you can feel better about yourselves. If the physician you're working for has enough confidence in your ability to allow you to see patients on his behalf, what else should matter?
Besides, it's not that PAs are the only ones with identity crises. I equally cringe every time I hear a fellow colleague of mine wanting to advocate a name change for DOs. Again, pointless mind numbing semantics.

 

[Rabbit Hole]

Behold, the thesaurus!

Assistant (synonyms):
abettor, accessory, accomplice, adherent, adjunct, aide, ally, appointee, apprentice, associate, attendant, auxiliary, backer, backup*, coadjutant, coadjutor, collaborator, colleague, companion, confederate, cooperator, deputy, fellow worker, flunky, follower, friend, gofer, help, helpmate, mate, partner, patron, peon*, representative, right-hand person, secretary, subordinate, supporter, temp, temporary worker
* = informal/non-formal usage

Associate (synonyms):
accessory, accomplice, affiliate, aid, ally, assistant, auxiliary, branch, buddy, chum, clubber, co-worker, cohort, collaborator, companion, compatriot, comrade, confederate, consort, cooperator, crony, fellow, friend, helper, joiner, kissing cousin, mate, offshoot, one of the folks, pal, pard, partner, peer, playmate, sidekick


I vote for Physician Sidekick

 

[deleted87716]

It seems to me that the least confusing term would be the one that didn't require the public to look it up in a dictionary...

I'd it ain't broke, don't fix it. Any patient who doesn't understand "Physician Assistant" isn't going to be any less confused by more complicated terminology.

 

[Starpower]

You just have to remember that NPs are nicely termed 'Nurse Practitioner' ... their title says, 'hello, I'm capable'. Physician Assistant sounds like ... dog doo-doo. PAs can't do 'MP' (Medical Practitioner) because then everyone will think they're Murse Practitioners.

There has to be a compromise somewhere ... I really like Physician Auxillary, personally.

 

[deleted87716]

I really like Physician Auxillary, personally.

No offense, but that's the lamest one yet. It sounds like you should be selling doughnuts to raise money for the doctors.

However, if reimbursement keeps tanking, that might be a great idea!

 

[AegriSomnia]

I like physician accomplice.

Behold, the thesaurus!

Assistant (synonyms):
abettor, accessory, accomplice, adherent, adjunct, aide, ally, appointee, apprentice, associate, attendant, auxiliary, backer, backup*, coadjutant, coadjutor, collaborator, colleague, companion, confederate, cooperator, deputy, fellow worker, flunky, follower, friend, gofer, help, helpmate, mate, partner, patron, peon*, representative, right-hand person, secretary, subordinate, supporter, temp, temporary worker
* = informal/non-formal usage

Associate (synonyms):
accessory, accomplice, affiliate, aid, ally, assistant, auxiliary, branch, buddy, chum, clubber, co-worker, cohort, collaborator, companion, compatriot, comrade, confederate, consort, cooperator, crony, fellow, friend, helper, joiner, kissing cousin, mate, offshoot, one of the folks, pal, pard, partner, peer, playmate, sidekick


I vote for Physician Sidekick

 

[J1515]

although more pa's today than in yrs past have less experience, age alone shouldn't be your criteria. I know lots of pa's who had significant prior experience by their mid 20's.(most of my class in fact).
for example when I was 25 I had been an er tech for 5 yrs and a paramedic for 2 yrs and had a bs from the university of ca..

I don't have criteria. My med school class was made up of paramedics, pharmacists, PAs, nurses, and physicians who practiced in other countries. Ages ranged anywhere from 22 - 50. I was responding to the brilliant <sarcasm> post by mwppa who was bashing medical students and praising PAs because he claimed that the majority of PA students are not in their mid twenties and have significant experience. Just pointing out once again his point was purely false. Read below and perhaps you can see his idiocy. You really can't get much dumber without the intention of trolling.

mwppa said: "There are many crap MDs but PAs have very few that are thought bad of. I have my own opinion for this but I'm sure it has something to do with the average age and experience of PAs entering PA school vs the typical med student. I'm not trying to insult anyone but how much wisdom can you truly acquire in your mid 20s? Many PAs have already been in healthcare under other titles and carry that experience with people into their profession."

 

[MrBeauregard]

The ego of some of you MDs in training is staggering. Why don't you just call PAs "whipping boys who do all my grunt work" or WBWDAMGW for short. I don't mean to insult, but if any of you plan to open your own practice one day, you might want to learn how to give others respect. Unless of course you want to be one of those drs answering your own phone.

Ok, since PAs are not "physicians" or "doctors" of any sort then it makes sense that residents should not be called physicians or doctors either. I have yet to see or hear a difference between what most residents do and what PAs can do. Sure, you can point to the difference between med school and PA school but in the real world, people don't care what you have learned in school, they care what your scope of practice is. When I go to a restaurant, I could care less if my chef has a BA, AA, or a certificate as long as the food is good. Much of the stuff learned in med school is not actually relevant in many cases which is why the PA/NP was created and is a viable way of expanding healthcare, not to mention helping physicians expand their practice.

It is staggering the level of disrespect that some of you med students have for a career field that could quadruple your practice. Here in CA, one Dr can supervise 4 PAs. If you know anything about business, look at the earning potential that gives you? You could effectively tee off with a pager on your hip while those people make you a fortune.

mwppa, it seems obvious that you do not fully understand the steps in training that physicians (MD/DO) go through. To say that 'since PAs are not "physicians" or "doctors" of any sort then it makes sense that residents should not be called physicians or doctors either' fully demonstrates this. We, as medical students, go through four years of medical school training and are required to take three Step exams in order to receive our medical licenses. At the end of our fourth year, if we have passed all necessary exams, we are given a medical license and deemed competent to practice medicine. Therefore, we are doctors. When we start our first year of residency, we are called Interns. But mind you, we are still doctors. We have the knowledge gained during four years and the license to prove it.

For you to say that there is no difference between what residents do and what PAs do shows that you do not understand the fundamental issue here. Residents are doctors/physicians, because of the reasons I described above. PAs are not doctors/physicians. Therefore, just because we may do some of the same jobs does not mean our titles or level of education is the same. Please make sure you understand this.

To say that patients don't care what I have learned in school is an absolute joke. They are coming to see a doctor because they care what I have learned in school! They are coming to see me because I am a doctor!

And lastly, please do not equate my role as a doctor/physician with that of a chef. I am not cooking food. I am treating human beings and their illnesses. There is a HUGE difference. For you to say that "much of the stuff learned in med school is not actually relevant in many cases" makes me literally laugh at my computer screen. The vast amounts of knowledge gained during medical school consists largely of those tiny, seemingly "irrelevant", little factoids which may one day be the key to a diagnosis. Those are little factoids that YOU DON'T HAVE.

 

[mwppa]

You really can't get much dumber without the intention of trolling.

Who are you fooling? You don't like me because I'm not an MD worshipping yes man. You think you are special for going to med school? I hope not. You think I or any other PA on this board couldn't actually go the med school route if we really wanted to? Seriously...

I chose to become a PA because I DO like the position it puts me in. I get to treat pts but yet I still have a safety net. I don't WANT the responsibility you hold so dear. I don't want the on-call thing. I don't want to not watch my daughter grow up. I had considered med school and did pre-reqs toward that path but I decided it wasn't for me at this point. Maybe when my daughter goes off to college, I might go back to college and finish the pre-med work. Whether I do or don't, it doesn't mean I am less than you as a human being. I assure you I could be where you're at if I chose to be. You aren't special.

And I should have clarified my point. My point is...in MY experience people I've came in contact with have spoken more favorably of PAs as a whole than Doctors. Those people have said that their PA spends more time with them, they feel like they are listened to more, and they feel more respected and able to ask questions of a PA. I hate to admit it but these same positive traits have been mentioned of NPs from what I've experienced. I realize there are advanced cases that must be seen by a doctor. But people can feel what they want to feel even if you don't agree with them. (And I can imagine your reply will be something like "well, lets see how much they like their pa/np when they contract [insert esoteric illness here]")

 

[cpants]

Who are you fooling? You don't like me because I'm not an MD worshipping yes man. You think you are special for going to med school? I hope not. You think I or any other PA on this board couldn't actually go the med school route if we really wanted to? Seriously...

I chose to become a PA because I DO like the position it puts me in. I get to treat pts but yet I still have a safety net. I don't WANT the responsibility you hold so dear. I don't want the on-call thing. I don't want to not watch my daughter grow up. I had considered med school and did pre-reqs toward that path but I decided it wasn't for me at this point. Maybe when my daughter goes off to college, I might go back to college and finish the pre-med work. Whether I do or don't, it doesn't mean I am less than you as a human being. I assure you I could be where you're at if I chose to be. You aren't special.

This wasn't directed at me, but I will respond. I do not think that many PA's could have gone to medical school but decided against it. I think that most of them were interested in medicine, and for whatever reason (low grades, poor MCAT, advanced age, finances, low motivation, etc) that door was not open to them. Many PA's and NP's, especially on this board, like to claim that they were qualified for medical school but decided against it, but in reality, there are not many mid-levels out there sitting on a 4.0 GPA and 35 MCAT.

And I should have clarified my point. My point is...in MY experience people I've came in contact with have spoken more favorably of PAs as a whole than Doctors. Those people have said that their PA spends more time with them, they feel like they are listened to more, and they feel more respected and able to ask questions of a PA. I hate to admit it but these same positive traits have been mentioned of NPs from what I've experienced. I realize there are advanced cases that must be seen by a doctor. But people can feel what they want to feel even if you don't agree with them. (And I can imagine your reply will be something like "well, lets see how much they like their pa/np when they contract [insert esoteric illness here]")

We really don't care about your anecdotal accounts about PA's and NP's being more beloved to their patients. As I recall, you made an even more outrageous claim that most females prefer to see an NP for their OB/Gyn care, which you chose to ignore when I called you on it.

Even if you were showing me a blinded research study in which patients didn't know if they were seeing MD, PA, or NP to prove your point, I wouldn't care. Because even if patients like you better (which I reject) it doesn't make your care or your training equivalent. It also in no way justifies expanding your scope of practice. PA's have a valuable role, but that role is and should be recognized as below that of a board certified physician.

 

[J1515]

Who are you fooling? You don't like me because I'm not an MD worshipping yes man. You think you are special for going to med school? I hope not. You think I or any other PA on this board couldn't actually go the med school route if we really wanted to? Seriously...

I chose to become a PA because I DO like the position it puts me in. I get to treat pts but yet I still have a safety net. I don't WANT the responsibility you hold so dear. I don't want the on-call thing. I don't want to not watch my daughter grow up. I had considered med school and did pre-reqs toward that path but I decided it wasn't for me at this point. Maybe when my daughter goes off to college, I might go back to college and finish the pre-med work. Whether I do or don't, it doesn't mean I am less than you as a human being. I assure you I could be where you're at if I chose to be. You aren't special.

And I should have clarified my point. My point is...in MY experience people I've came in contact with have spoken more favorably of PAs as a whole than Doctors. Those people have said that their PA spends more time with them, they feel like they are listened to more, and they feel more respected and able to ask questions of a PA. I hate to admit it but these same positive traits have been mentioned of NPs from what I've experienced. I realize there are advanced cases that must be seen by a doctor. But people can feel what they want to feel even if you don't agree with them. (And I can imagine your reply will be something like "well, lets see how much they like their pa/np when they contract [insert esoteric illness here]")

 

[IDBasco]

Behold, the thesaurus!

Assistant (synonyms):
abettor, accessory, accomplice, adherent, adjunct, aide, ally, appointee, apprentice, associate, attendant, auxiliary, backer, backup*, coadjutant, coadjutor, collaborator, colleague, companion, confederate, cooperator, deputy, fellow worker, flunky, follower, friend, gofer, help, helpmate, mate, partner, patron, peon*, representative, right-hand person, secretary, subordinate, supporter, temp, temporary worker
* = informal/non-formal usage

 

[MrBeauregard]

mwppa,

Your "clarification" of your point only reiterates your fundamental misunderstanding of the real issue.

As cpants pointed out, anecdotes are fun, yet they are pretty useless as evidence. It doesn't matter if most of the people you have come across prefer to see a NP/PA instead of a MD/DO. It doesn't matter if they think you spend more time with them, are more sympathetic or are a better listener. This is just useless fluff upon which you attempt to base an argument for an expanded scope of practice. The real kicker is this: you don't have the knowledge base or clinical experience to back up your argument. Period.

"And I can imagine your reply will be something like "well, lets see how much they like their pa/np when they contract [insert esoteric illness here]"

It isn't about contracting an illness. It's about missing a diagnosis because of lack of knowledge and experience.

And you're right, I'm not special. And I would never think you are any less of a human being because you chose to become a PA. What you are not, however, is a physician. And until you go to medical school, you never will be. Because of this, your attempts at an expanded scope of practice or a play on semantics with the renaming of your profession will fail.

You play an extremely valuable role in the medical field. A role that should stay just as it is.

 

[Starpower]

mwppa,You play an extremely valuable role in the medical field. A role that should stay just as it is.

Am I missing something? I don't see any PAs clamoring for expanding scope of practice.

One thing I need to remind people of (and I'm putting my flame suit on), is that yes, med school is 4 years and PA is 2 years, technically. However, PA students have to take classes as pre-reqs that you end up taking in medical school (anatomy, namely). We also don't take summers off, you do. So, there's a little bit of give in that 4 versus 2 comparison.

And I'm not saying that we take ALL of your classes, I'm starting to understand how deep your education in physiology and pathology goes ... for instance, PA students get very little training in embryology.

As for the testing, yes you take the Steps and I imagine they are very difficult. We also take very difficult tests, altho they don't have names which will sound familiar or impressive to you. The thing that really separates you from us is, besides the extra education you receive, your residencies. No matter how much experience we can have before PA school (I was a licensed EMT for 7 years and had a ton of volunteer experience in ICUs, Hospices, etc), it doesn't match up to the rigorous training and testing you go through in your residencies. Now, over time, if we work with an awesome Doc who wants us to learn and grow, if only to better help them at their job, PAs can hopefully gain more on the job training in these areas of knowledge. It won't make them a Doctor ... but it will make them a stellar PA.

One thing, to the poster above who thinks that PA students aren't known for having high GPAs, you are incorrect. Many students in my class were straight A coming in. And too, there are med schools who will take students with GPAs much lower than 4.0, but who ace the MCAT.

All in all, these threads have been light-years more productive than some threads that were here a couple of years ago. Those were pretty hateful and nasty. Maybe those medical students (who I notice don't post here anymore) were dismissed for their lousy attitudes and are serving popcorn at my local movie theater. Or maybe they've started working with PAs and understand their role better. Or maybe, and this I suspect most of all, they've actually gotten out into the world and started practicing medicine and have finally realized what that means.

I hope we all continue to work together well. In all my rotations, I've only had one Doctor who wasn't PA friendly ... I still wonder, why the hell did he decide to precept them? But the rest have been great, seriously, they've recognized my abilities and nurtured them to the fullest.

 

[mwppa]

Ok, I got it. You are a doctor. A physician. A Dr. Physician. A doctor of Physician studies. In fact, I think they should call you Dr. Physician, M.D. I get the picture.

Still though, it isn't going to change that PAs WILL get a name change eventually and NPs ARE AND WILL CONTINUE to practice and expand. "Mid-levels" aren't going away.

 

[mwppa]

This wasn't directed at me, but I will respond. I do not think that many PA's could have gone to medical school but decided against it. I think that most of them were interested in medicine, and for whatever reason (low grades, poor MCAT, advanced age, finances, low motivation, etc) that door was not open to them. Many PA's and NP's, especially on this board, like to claim that they were qualified for medical school but decided against it, but in reality, there are not many mid-levels out there sitting on a 4.0 GPA and 35 MCAT.

No, it wasn't directed at you. And many PAs aren't sitting on ANY MCAT scores because they didn't even wish to become a doctor in the first place. Of course, to hear you tell it, we are just B-rate pre-med dropouts who are only PAs because we couldn't cut it your route.

Think about how ignorant your statement is. If we were the type of people (like you , for instance) could we really handle playing second fiddle to a Physician? And, to be honest, there are statistics that show that every year, there are some med students accepted that have <3.0 GPA. Some RN programs won't even allow a GPA that low. Granted it's not the norm but it does happen. Not every med student is sitting on >3.5 GPA with 35 MCAT.

 

[J1515]

. If we were the type of people (like you , for instance) could we really handle playing second fiddle to a Physician?

Clearly you can handle it - you don't sound bitter in the least

Some RN programs won't even allow a GPA that low.

Proof please. Link? You do realize an "RN program" is just a 4 year college degree, right? What college will not allow you to be a nursing major with a GPA of 2.8?

There comes a point where you really need to stop calling everyone else arrogant and take a look in the mirror. There's a little birdie on your shoulder whispering in your ear "it's not them...it's you."

 

[Rabbit Hole]

I'm going to step back and explore a different point of view.

Physicians and physician assistants are both professionals in health care. Both have degrees of overlapping knowledge and experience which goes without saying - it allows us to work together and communicate using the same medical language.

Despite the overlap, it is clear that the education between these two professions is different and the approach to medicine and scope of practice is DIFFERENT.

It's futile to argue about who is better, you don't know what you don't know, etc, whatever. The point is - It is important to recognize that these two professions have overlap as well as boundaries that should rightfully be recognized and respected from both sides.

For example, physician assistants must respect the fact that physicians are held accountable for the decisions they and the PAs make for their patients. That accountability is awarded to them due to their training, therefore, they are held to a higher standard of responsibility even when **** falls apart and it's not "their fault". Physicians know that when they sign up - and they pay for it as well with malpractice insurance.

Physicians must respect the boundaries of physician assistants. Recognize that their training is different and just because they are held to a lesser degree of responsibility does not mean their credentials are inferior - every health care profession will seemingly be inferior by default in the eyes of physicians due to the responsibility factor that I described above. PAs are experts in their own regard and by excelling in their profession - they allow physicians to breathe easier knowing they have competent people working for them. They recognize their limits and won't f*ck things up by crossing the line of complete autonomous practice.

Also,
If a PA wants to be an MD - they must go through medical school, no matter how much they think they know.
If a MD wants to be a PA - they must go through a PA program, no matter how much they think they know.

Mutual respect is important and has to be earned between physicians and physician assistants. But when boundaries are crossed like what we are seeing with nurse practitioners, all bets are off. The bottom line is - patient safety and quality of care is the common thread amongst all health care professions. When that is compromised for personal/professional gains - don't expect any respect or sympathy when you get disgraced in the court of public opinion. No matter what propaganda you sell - you will ultimately get called out and have to answer for it ethically as well as with the number of body bags you contribute to in the long run.

I think some of this apprehension towards the name change of PAs can be attributed to the DNP stuff going on right now. I think there is a concern from physicians whether this will be a "gateway" for possible exploitation down the road. I thought the proposal was well thought out and I believe some of the reasons presented in the proposal are valid, I also think some of the opposing concerns are valid. I think it's worth it to hear out both sides.

The End.