Differences between duties of physician and PA?

[Shanana]

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What are the main differences between the duties of a physician and a PA? To what degree is a PA able to make decisions independently?
My younger sister is interested in applying to PA school and I am just curious what the exact differences are. Also, she has always been interested in pathology - is there such a thing as a pathology PA?

Thanks in advance
By the way I am a pharmacy school applicant so that is why I am pretty much ignorant of the PA/physician relationship.
Shannon

 

[timerick]

Hi there!

PA's do mostly the same thing physicians do. Unless you get high into specialization or surgery, there is little difference between the responsibilities of a PA and those of a physician in the same field.

PA's work under their supervising physician. That physician decides how much autonomy they have. Some PA's need consultation on nearly every patient (especially during the first year after school)... other PA's have decades of experience in their field and consult only once a day or so. The range is wide. The decision as to what the PA is qualified to do and how is made by his/her supervising physician.

 

[deleted6669]

in answer to the second half of your question, yes there are pathology pa's. the i.d.'s of all the victims of 9/11 at the twin towers were done by a pa pathology unit at the nyc coroners office staffed by 6 pathology pa's.
there are also postgrad masterrs programs for pa's in forensics at the univ of az if I am recalling correctly.
http://www.aapa.org/members/news/23_12_071502.pdf

 

[Brachial_Plexus]

Originally posted by timerick
there is little difference between the responsibilities of a PA and those of a physician in the same field.

Riiiiiight........except that the physician is ULTIMATELY responsible for the care of the patient. Something a PA will never have to stress about. Makes a big difference!

 

[Rob77]

Riiiiiight........except that the physician is ULTIMATELY responsible for the care of the patient. Something a PA will never have to stress about. Makes a big difference!

Right of course it will have absolutely no impact on the life/career of the PA if he/she makes a mistake. Im sure OPMC would just say "well it was a PA who made the error and killed the little child so we'll just blame the supervising attending who was 50 miles away".

 

[deleted6669]

don't kid yourself. a pa who screws up big gets fired just as fast as a doc who does the same thing, probably faster.....
check out the medical board reports from any state. every month they list physicians and pa's who lost licenses for selling drugs, having sex with patients, writing too many or too few schedule 2 scripts, etc

 

[PublicHealth]

Originally posted by emedpa
in answer to the second half of your question, yes there are pathology pa's. the i.d.'s of all the victims of 9/11 at the twin towers were done by a pa pathology unit at the nyc coroners office staffed by 6 pathology pa's.
there are also postgrad masterrs programs for pa's in forensics at the univ of az if I am recalling correctly.
http://www.aapa.org/members/news/23_12_071502.pdf

Pathology Physician Assistants or Pathologist's Assistants? I believe there is a distinction between these two professions. Can someone clarify this?

 

[deleted6669]

YES, there are 2 separate professions. the ones in nyc are physician assistants though.

 

[greatdane]

Right of course it will have absolutely no impact on the life/career of the PA if he/she makes a mistake. Im sure OPMC would just say "well it was a PA who made the error and killed the little child so we'll just blame the supervising attending who was 50 miles away".

....ummm, i dont think PAs have that much autonomy....The MD has to be on site....

PA's do mostly the same thing physicians do. Unless you get high into specialization or surgery, there is little difference between the responsibilities of a PA and those of a physician in the same field.

I am not trying to start a pissing contest here, but I think this statement is a little misleading for someone looking for info. For example, many PAs work in EDs, and large university trauma centers and do an awesome job, however, you will not see a PA running a major trauma or managing super sick pts while the attending is seeing a runny nose. That is not to say they do not take care of sick pts. This is one example from my field...and I am sure it can be said of others...I just think Shanana should get all the info...and speaking of, Shanana, listen to emedpa, he/she is a pa instructor and can probably give you a great view of a PA's scope of practice. I beleive he/she has posted alot in the EM forum and seems tobe very knowledgeable and seems to be strait up....if ya have any MD questions, i will be glad to answer

 

[deleted6669]

GREAT DANE-Most states do not require on site supervision all the time. many pa's work in solo rural practices where a physician is only present 1-2 days/month. the supervision takes the form of being available for phone calls whenever the practice is open and reviewing charts in a timely fashion.

 

[CVPA]

This is unbelievable. The same rhetoric, again, and again, and again, and again year after year. It never ends. Somebody asks a question about the PA profession, a PA student responds, medical student/ resident rebuts, flames ignite and it starts all over again. This is why I got away from this forum. EMEDPA, I don't know how you stay on so faithfully.

Hey Wart, this is EXACTLY what I was talking about in my 2/24/04 post.........

 

[papilloma]

Medical school is a complete waste of time. Why would the US ever implement such an educational system? Train people for 10 years and they can easily be replaced by someone who has 3 yrs of training. Also, doctors are paid a lot more than PA for no reason at all. They can do the same things, but doctors get paid much more (at least twice). I have no idea how society allows that to happen. I mean, 2 people who can do the same exact thing, but 1 gets paid much more than the other. I guess that's the American dream.

 

[deleted6669]

HEY WART BOY...
GUESS WHAT...I MAKE MORE THAN MOST FP DOCS YOU WILL EVER MEET. HAHAHAHAHAHAHAHHAHAHAHAHAHAHAHAHAHH
WE ARE TAKING OVER THE WORLD HAHAHAHAHAHAHAHAHAHAH

 

[papilloma]

I have no doubt in my mind you are posting from an asylum. The posts you put up are perpetually biased with the attempt to gain equality and respect comparable to professionals from other fields, with the sense of insecurity and insanity.

For others, take a look at some data:
http://www.allied-physicians.com/salary_surveys/physician-salaries.htm

http://www.allied-physicians.com/salary-surveys/assistants/

You compare yourself. Whether emedpa makes more than most FPs or not, that's for him to say and for you to believe. You can go with non-proven anecdotes. I only comment on and believe facts.

Originally posted by emedpa
HEY WART BOY...
GUESS WHAT...I MAKE MORE THAN MOST FP DOCS YOU WILL EVER MEET. HAHAHAHAHAHAHAHHAHAHAHAHAHAHAHAHAHH
WE ARE TAKING OVER THE WORLD HAHAHAHAHAHAHAHAHAHAH

 

[papilloma]

And to increase sources to reduce bias of one specific site, here is another:

http://fastweb.monster.com/betaclub/content/career_db/medicine/salary.ptml

http://fastweb.monster.com/betaclub/content/career_db/physician_asst/salary.ptml

I dont know about emedpa's case, but apparent from these websites "on average," doctors make at least twice as much as PAs. Beware I am referring to salary, not the fact that doctors are at least twice as knowledgeable about medicine as PAs. However, I do hypothesize doctors are getting paid more not because they have two initials behind their names but because their work/"duties" in treating patients are more valuable monetarily (this of course, is an assumption).

 

[deleted6669]

I would hope that you folks noted the sarcasm in my above post re: taking over the world. yes, as wart boy says I am constantly trying to elevate my profession so that we receive the same respect as other professions. is this a problem? I have the utmost respect for my physician colleagues and have not been trying to downplay their importance or relevance as team leaders in any way. regarding salary:
primary care pa's on avg made 76k last year
source www.aapa.org
specialty pa's make significantly more.
primary care pa's make approx 50% of the base salary of the md/do's they work with so a pa in fp/im/peds makes around 75k and the doc makes around 150.
specialty pa's can make approx 60%+ if they make production bonuses or get first assistant fees(many surgical pa's work this into their contracts-1st assistant fees are 10% of the md share of each procedure on top of base salary and production.)
pa's also get overtime and differentials for nights/weekends/holidays because they are employees for the most part. the doc who owns the practice obviously makes more, but he can't bill more per hour for a visit at 5 pm vs 430 pm.
all the pa's in my group make 110k + per year based on speed and production. the senior pa's make over 150k while the senior er docs are making >300k.granted the pa making >150k works most holidays and lots of nights and weekends. the docs work 12-14 8 hr shifts a month and the pa's all work > 16 10-12 hr shifts a month.er/ortho/surgical pa's with > 10yrs experience make > the 90% on the aapa surveys every year.THE TOP GROSSING PA IN OUR GROUP(NOT ME) MADE > 200K LAST YEAR.
regarding a pa's knowledge base:
obviously an er doc knows more about em than an em pa, but the em pa knows significantly more em than your avg primary care doc who works in a clinic all day.and before you start to argue this when was the last time you saw an internist reduce a fx or suture a complex lac under conscious sedation. yes, the internist knows more about chest pain but then knows squat about peds or obgyn.when we have im residents moonlighting in our dept the phrase they master fairly quickly is" I can't see this pt because it's(peds/obgyn/trauma/ortho), can one of the pa's see them while I go see something else".
the em pa has a knowledge base for the full scope of em while individual md specialists know more about their field of specialty but lack skill in other areas of em.this is by no means a disrespect to other specialists. I would much rather have the neurologist evaluate the pt with new onset seizures(although I can start the workup in a pinch) and they would rather have me remove a deep metalic fb in their eye(although an ophthalmologist can do it faster than I can). see what I am saying. jack of all trades, etc
not a master of any specific field but competent at a high level in many.....a little info on what empa's do every day...
http://www.sempa.org/resources/sempa_guidelines.html

 

[papilloma]

Again, comparing apples and vegetables.

Why are you comparing an average FP to a head senior surgical PA? The sites I referred to is based on averages. The salaries of an average FP and general pharmacist at similar locations can be compared with high confidence. But when one is referring to a senior specialist pharmacist owner of a pharmacy store to a FP who just finished residency, obviously the pharmacist will make more. Why are you misleading your readers by making such comparisons? For PAs, you compared top senior specialist PA with average FP. A more accurate comparison would be a top senior specialist PA with a top senior specialist doctor/pharmacist/dentist. In that case, 200k is great for PA, but orthopedic/neuro/cardiovas surgeons make up to 1 million or more, probably more with the working schedule you stated. Who are you trying to fool?

The sites I posted gave comparisons of PA and doctors in the same site. Fastweb is an informative career website that is not created by physicans OR PAs. It was made for ALL students to make an informative choice on their careers. Why are you giving us a PA website that is made GEARED FOR PAs? How biased is that? I couldnt even find the salary you are claiming by searching at the aapa site.

At this rate, I wouldnt trust anything emedpa states. All of his posts are more misleading than guiding for anyone trying to choose a career.

 

[deleted6669]

http://www.aapa.org/glance.html
The reason I quote a pa source is that they do a survey of every practicing pa every year. this is the most accurate pa salary source available.regarding salary I was answering wart boys statement that md's all make at least twice as much as pa's by showing that some pa's make as much or more than some md's. that's all. obviously the avg md makes more than the avg pa(duh)
don't you have to wonder why wart boy is so interested in pa's?
I'm guessing he couldn't get into a pa program so now has to mock anyone who can. and why name yourself after an std that causes cervical cancer? ladies beware of this guy!
so papilloma/mcgyver how about it , list your stats. are you a high school student, college student, wanna be health provider of some kind.....
everyone on this site knows about me but you haven't offered us squat to make us trust you....
let me guess? head of neurology at the mass general? somehow I doubt it.....

 

[papilloma]

Someone with no bachelor's degree can make more than MDs, ie Bill Gates. Obviously, from this example, if one does comp sci they will make so much more than MD, multibillion dollars (emedpa's method). Another way is to compare the average salary of a comp sci with an MD (my method). Obviously, any given comp sci has a shot at making more than MDs. However, most likely by statistical fundamentals, the average will be the most likely salary one will earn, which would be 70k for comp sci. That is why I suggest to look at averages.

Emedpa should really open a math book. By stating average means bell curving. Any given person can beat the bell curve and be placed 3 standard deviations from the mean. That goes for PA, comp sci, business owner. An average salary does not limit any PA strictly to that particular salary, because a PA can be placed above or below more than 1 standard deviation. I did not state the average to mean all PAs will earn that salary. I automatically assumed everyone has the understanding of basic statistics, probability, and standard deviations, but I was not aware emedpa has no statistical background.

Emedpa can feel free to continue to act immaturely using name-calling. For everyone else, my alias is to remind everyone daily that a papilloma is not merely a benign skin wart, but sexual promiscuity can bring about serious carcinogenic consequences. Papilloma is also involved in skin squamous cell carcinoma. I hope to help raise awareness in females and the general community.

 

[papilloma]

One has a choice to believe in the aapa site. I personally prefer to place my trust more on salary surveys compiled by multiple career counseling websites which provides direct comparisons between PA and doctors within the same website. However, even from emedpa's website, I'm sure most of you agree "mean" PA salary rest in the range of 60-75k, and the "mean" FP salary is in the rnage of 130-160k. As I've said, twice as high "on average." Whether they are getting paid more because they can provide better diagnosis/treatment to patients or merely because they just have this extra degree, now that's up to you to decide, because no statistical data will show that.

 

[deleted6669]

you didn't answer the question.....are you a medstudent, a nursing student, a high school student.....
I regret the name calling however it is mostly in response to this posters antagonism to pa's in general( see his post" this forum is a joke".)
ps recently took a grad level stats course, thanks though.
I will admit to not being a math whiz but a b+ in grad level stats satisfies the prereqs at the medschools I am considering as I have no intention of taking calculus

 

[papilloma]

I dont think "what" I am has much relevance to this discussion, but my language and my knowledge about medicine probably imply I am older than a high school student.

I have nothing against PAs or the PA profession. I am just against the attitude I see in this forum, and that very attitude is described in the This forum is a joke thread. The one PA I've met in real life is much nicer and less concerned about respect than PAs posting in this forum, and I respect her a lot because of that. My respect goes to positive attitude rather than degrees or medical training, and I respect nurses who are caring much more than docs who are arrogant.

 

[deleted6669]

fine...I'm willing to let this die....

 

[CVPA]

Papilloma:

In this thread, you have successfully managed to both prove my previous point and discredit yourself. In so doing, you also made your thread entitled "This forum is a joke", null and void. Congratulations, I knew you had it in you.

 

[rdennisjr]

Alright folks - this thread is just continuing to degenerate - the basic discussion is just fine, but folks are getting pretty wrapped up and becoming rather personal in their statements and accusations. Let's not make me do the mean-ol-moderator thing and just have everyone step back for a minute, take a cool drink of water, and then continue on with a civil discussion.

Thanks

Dennis

 

[papilloma]

CVPA:

In this thread, you have successfully managed to both prove my previous point and discredit yourself. In so doing, you also made your thread entitled "This forum is a joke", null and void. Congratulations, I knew you had it in you.

Also proved the point this forum is filled with arrogance, egotism, and a need to gain respect.

Originally posted by CVPA
Papilloma:

In this thread, you have successfully managed to both prove my previous point and discredit yourself. In so doing, you also made your thread entitled "This forum is a joke", null and void. Congratulations, I knew you had it in you.

 

[papilloma]

It's interesting to see posters in this forum worry so much about putting down nurses and putting themselves equal to/higher than professionals. It's a perpetual fight inside these posters because the general public will never view PAs as "prestigious" as professionals, and PAs in here will never be willing to focus on anything else other than respect. The fact is that almost all of these threads are concentrated on how similar PAs are to other professionals and better than nurses instead of discussing how to improve care of patients. I dont even see one thread in here who helps applicants with admissions with specific PA schools. I'd much enjoy reading chiropractors who post in forums discussing how they can better help patients, accurately explain how exactly they help patients and the PA career. The threads I see in here are all bickering about how much greater PA is and ego stroking.

It is not a tradition that physicians have to pass step1, 2, 3. It is a law. The reason why accredited medical school courses and usmle completion exist by law has a reason. There is also a reason why PA schools exist. They are two different tracks and professions created by the US government to serve society. Thus, there is a DIFFERENCE. So I dont see why timerick, for example, stated that PAs and physicians basically do the same things. This would've been a much more informative thread if the clear differences are stated/discussed rather than brushing the OP off by simply stating PAs are similar/better than physicians with a one-sided view.

 

[deleted6669]

COULDN'T LEAVE IT ALONE COULD YOU....
timerick is correct. pa's and md's do essentially the same thing. I am working in an er right now with an er doc. we alternate charts in the rack regardless of acuity. if I have an exceptionally difficult pt I will talk to him about it and at the end of the shift he will sign all of my charts but the vast majority of my pts will never be seen or dicussed with him....I write my own prescriptions on my own schedule 2 dea # and send pts to specialists on a referal basis as needed.
regarding admissions to pa schools, there are friendlier pa forums out there devoted to just that topic that most pre-pa students are aware of. the pa section on sdn has just become a place where pa's defend themselves against the slander of high school students like papilloma/mcgyver.....

 

[CVPA]

This is pointless. Its like trying to reason with an insane person. Say whatever makes you feel good, Papilloma. I am done with this idiocy.

 

[globetrotter99]

For what it is worth...In a recent interview, the program I was looking at stated that their recent PA graduates salary (1-2 post grad) was $68K. I know a couple of PAs at the Mass General who have been working with the Neurosurg department for under 2 years with no prior specialty experience and are making close to 100K

 

[papilloma]

I wasnt even talking to you emedpa. I was talking to CVPA.

"timerick is correct. pa's and md's do essentially the same thing. I am working in an er right now with an er doc. we alternate charts in the rack regardless of acuity. if I have an exceptionally difficult pt I will talk to him about it and at the end of the shift he will sign all of my charts but the vast majority of my pts will never be seen or dicussed with him....I write my own prescriptions on my own schedule 2 dea # and send pts to specialists on a referal basis as needed."
You have a right to reserve to your own biased "opinion" and so do I. I refuse to believe 2 workers who do the "same" job, one gets paid lots more etc.

"the pa section on sdn has just become a place where pa's defend themselves against the slander of high school students like papilloma/mcgyver..... " no frikkin kidding. thank you thank you for defending my exact point.

Funny, CVPA, you are still posting in a discussion that is "pointless." You are right on one thing; this is the biggest waste of time. I have never had any discussion with more egotistical, insensible, biased group of people ever. I am out. You've been successful at kicking me out with instoppable stubborn biased egotism. Wish you luck on your fight to mislead the public and sdn.

Originally posted by emedpa
COULDN'T LEAVE IT ALONE COULD YOU....
timerick is correct. pa's and md's do essentially the same thing. I am working in an er right now with an er doc. we alternate charts in the rack regardless of acuity. if I have an exceptionally difficult pt I will talk to him about it and at the end of the shift he will sign all of my charts but the vast majority of my pts will never be seen or dicussed with him....I write my own prescriptions on my own schedule 2 dea # and send pts to specialists on a referal basis as needed.
regarding admissions to pa schools, there are friendlier pa forums out there devoted to just that topic that most pre-pa students are aware of. the pa section on sdn has just become a place where pa's defend themselves against the slander of high school students like papilloma/mcgyver.....

 

[papilloma]

Lastly, I'm a bit surprised to hear you say this since I have not ever encountered any "reasoning" or discussion with you at all.

Originally posted by CVPA
This is pointless. Its like trying to reason with an insane person. Say whatever makes you feel good, Papilloma. I am done with this idiocy.

 

[deleted6669]

"the pa section on sdn has just become a place where pa's defend themselves against the slander of high school students like papilloma/mcgyver..... " no frikkin kidding. thank you thank you for defending my exact point.

YOUR POINT IS THAT YOUR ARE A MALIGNANT TROLL SLUMMING IN OUR FORUM? YES, WE ALREADY KNEW THAT.....

 

[timerick]

Interesting to see how some folks on this forum view you, emedpa. I haven't seen that in you at all during the past year and a half I've been hanging on forums with you. You are usually quite wise and respectful, knowledgeable of resources out there, and genuine but not completely undiplomatic.

I can sense your frustration, though, when you're pushed over and over again on this particular forum.

Thanks for hanging in there.

 

[deleted6669]

THANKS TIM- I KIND OF GOT CRANKY THERE FOR A BIT. THIS IS DAY 5 OF ALTERNATING DAY/NIGHT 12 HR ER SHIFTS FOR ME SO THE NERVES ARE WEARING A LITTLE THIN. I WILL TRY TO BE MORE DIPLOMATIC AND IGNORE THE OBVIOUS TROLLS.

 

[papilloma]

So labeling one a "troll" is what emedpa resorts to when one provides legitimate viewpoints/arguments which does not coincide with his "opinions." Very respectable.

Timerick, a very convincing unbiased post on your support for a fellow PA colleague and his pro-PA attitude.

Originally posted by emedpa
THANKS TIM- I KIND OF GOT CRANKY THERE FOR A BIT. THIS IS DAY 5 OF ALTERNATING DAY/NIGHT 12 HR ER SHIFTS FOR ME SO THE NERVES ARE WEARING A LITTLE THIN. I WILL TRY TO BE MORE DIPLOMATIC AND IGNORE THE OBVIOUS TROLLS.

 

[rdennisjr]

Just to try and get back to the original post, I'll add my .02 cents. One of the early comments was that PA's and Doc's duties are about 85% similar - and in my experience that is pretty correct. Notice I say duties - not training. In my position in a Trauma Center/E.D. we do pretty much the same thing - Hx/Px, order labs/studies/consults, dx, rx, splint, reduce fx, place art/cent lines/chest tubes/g-tubes, etc. Now generally, the doc is the one that concentrates on the more critical/complicated patients which is a wise use of our limited time and resources, but depending on how busy we are that can go out the window pretty quickly.

Now it's nice that I always have a doc available to back me up on my medical decision making process and to take a quick second look if there is something I have a question on - but then again the docs will also check with each other, and we both order consults on the patients that need them.

Things I don't do - sign of on residents charts, generally run codes (but I certainly do assist and can run as needed), declare death.

I think you can see that our duties are pretty similar - but our jobs are pretty different as well as our training. Now also, this is just one setting - size of hospital, state laws, type of clinic setting will all drastically change the job details. One of my class mates is a neuro PA - does clinical work, patient prep in OR, opens, disects down to the spine, doc comes in and inserts the hardware then the PA does all the closing work. Another one is in a FP clinic and almost everything he does gets second checked - it really varies greatly as you can see.

Dennis

 

[MacGyver]

wow I'm touched that emedpa thinks about me constantly that he brings up my name even when I'm not around.

The fact is that papilloma is right. The only thing discussed on this forum (and the NP forum at allnurses.com) is about how PAs are supposedly better than MDs and a bunch of ego-stroking.

Its rather funny to see the hypocrisy on this forum. PAs blast NPs for doing the same ego-stroking that they do on a daily basis.