Can PA's deliver babies
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ayndim said:
A good friend of mine just retired (more or less) as a PA, and he specialized in OB/GYN. For 10-15 years he specialized in labor and delivery.
His advice to me: Don't get involved in OB/GYN if there is any way to avoice it. 😛
Actually I started out wanting to go to med school to be an ob. However, I realized the midwife model of care was more what I believed in. So I am studying to be a nurse, will work in l&d and go on to be a CNM. I never thought of PA's delivering babies until someone at all nurses asked. Still I think I CNM will be a perfect fit for me. I haven't had any experiences with PA's but have with NP's and CNM's and I am very pleased with the "midlevel" provider care. More time for patients and better bedside manners. I use midlevel providers almost exclusively for myself.
Don't flame me but do you see PA's more like NP's and CNM's in their attitudes towards medicine, more like DO's or more like MD's. When I see my NP or CNM I know that I am getting someone who is first and foremost a nurse (hopefully they haven't lost that). What about PA's? What are you getting. Really just curious and not looking as to why they are better than any other provider just what they are like. As a future midlevel myself I think all midlevels provide a valuable service.
Don't flame me but do you see PA's more like NP's and CNM's in their attitudes towards medicine, more like DO's or more like MD's. When I see my NP or CNM I know that I am getting someone who is first and foremost a nurse (hopefully they haven't lost that). What about PA's? What are you getting. Really just curious and not looking as to why they are better than any other provider just what they are like. As a future midlevel myself I think all midlevels provide a valuable service.
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ayndim said:
I agree with you about the value of midlevels (within the limits of their ability). I think PA's are more in line with physicians, than NP's are. NP's are first and foremost nurses, their training is in the nursing model rather than the intense, basic sciences physician model, etc. I don't see a big difference between MD's and DO's, I have NEVER found a working DO that actually did OMT.
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Just curious: If the labor goes to Caesarean, the PA can go in an first-assist in the surgery. Does an OB/GYN NP or CNM do that?
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flighterdoc said:
I have seen DO's for OMT since I was a child. The first 2 had practices exclusive to OMT. (Northern IL and southern WI.)
I also now know of a number of FP and gen. med. DO's that perform OMT -- if you ask them to... but it is not routinely offered as part of the treatment. IMO, the managed care system/ins. has driven most docs (DO and MD) to move pts through as quickly as possible -- and this means less time w/ pt/write a Rx or two.
The DO's I saw growing up were almost magical -- they would identify the areas w/ their hands, no x-rays, no medication, take their time...and I would always feel better. The waiting rooms were always full. One was open on Sundays so the farmers and working folk could come in on their days off.
But then, I'm really aging myself now...my pediatrician made housecalls 🙂
I did see a job ad for a CNM and assisting in c-sections was part of the job. Since RN's can first assist, I would imagine that NP's and CNM's can. I think there is even a cert for RN's who want to first assist.timerick said:
Do NP's, CNM's and PA's basically do the same job? Well except that NPs don't normally deliver babies and that CNMs are only women's care providers. I know PA's have to have MD/DO supervision, but from what I understand that just means that Drs review the cases. And consult with the dr when necessary (which NPs and CNMs also do). Right?
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I know a lot of MDs are dropping delivery and only providing gyno services due to the high malpractice ins costs. Would a PA delivering babies run into similar expenses?
Not sure about that but I do know that cnm's get a good deal from acnm. Not necessarily the cheapest but from what I understand the rates are decent and there is no bait and switch. Also, the coverage is supposed to be good. And any dr who works with CNM's can also get coverage through them. Might apply to PA's who work with CNM's as well.Sher9mm said:
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Yes, PA's can deliver. Frequently PA's a well as NP's face restrictions on delivery at the hospital level, though. Legally, however, PA's are allowed to deliver. Only four states specifically delineate PA delivery. In seven states PA are actively involved in delivery in various hospitals. PA's can definitely first assist during a cesarean delivery. PA's can legally do everything a CNM and a NP can do and can also move into largely every field of medicine (except podiatry). By contrast CNM's can only practice in women's health and NP's can only practice in their specific certification area (FNP, PNP, etc.). NP and CNM training is very focused on one specialty only. PA training is broad, very similar to MD, DO training. One major difference between NP's and PA's is that PA's receive extensive training in surgery as a standard part of their training while NP's receive very little training in surgery as a standard part of their training. Another caveat: PA school is much more difficult to get into than NP school. So if you want a fairly easy entry and an easier training route, go the NP route. PA training is much more difficult to enter and much more extensive and in-depth in the level of training that is provided. PA clinical rotations are also more structured, extensive and in-depth than either NP or CNM clinical rotations.
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I know PA's have to have MD/DO supervision, but from what I understand that just means that Drs review the cases. And consult with the dr when necessary (which NPs and CNMs also do). Right?
-In answer to the above comment from post # 9: In reality the collaboration/supervision concept is the same for PA, CNM and NP. Only six states still require any type of review and countersignature for PA's and most of these six states are in the process of removing even that requirement. In largely every state NP's and CNM's must have a signed written agreement with a physician if they want to prescribe medicine or do any procedures (this is true for even primary care). This agreement must specify that the physician can be reached at any time by the NP or CNM for backup. The same is largely true for PA's. At the end of the day a PA needs a signed written agreement with a physician that must specify that the physician can be reached at any time by the PA for backup. NP's have a little more latitude in primary care than do PA's to run their own clinic, but only in primary care. The main reason for this is that NP's can only practice inside their specific certification area; by contrast PA training is much more broad-therefore you can't really give PA's complete autonomy in every field without bringing in major residency requirements.
-In answer to the above comment from post # 9: In reality the collaboration/supervision concept is the same for PA, CNM and NP. Only six states still require any type of review and countersignature for PA's and most of these six states are in the process of removing even that requirement. In largely every state NP's and CNM's must have a signed written agreement with a physician if they want to prescribe medicine or do any procedures (this is true for even primary care). This agreement must specify that the physician can be reached at any time by the NP or CNM for backup. The same is largely true for PA's. At the end of the day a PA needs a signed written agreement with a physician that must specify that the physician can be reached at any time by the PA for backup. NP's have a little more latitude in primary care than do PA's to run their own clinic, but only in primary care. The main reason for this is that NP's can only practice inside their specific certification area; by contrast PA training is much more broad-therefore you can't really give PA's complete autonomy in every field without bringing in major residency requirements.
