Get ur Xannies and β-blockers ready - "PA Myth Busters" campaign

[cbrons]

---

Members don't see this ad.

The American Academy of Physician Assistants Myth Buster Campaign

https://www.aapa.org/WorkArea/DownloadAsset.aspx?id=2147486572

The First Myth buster is really profound. Ready for it? ---->

 

[Psai]

Um their job title was actually physician's assistant. It's still the job description. They just changed the name recently but that's a Dwight Schrute level game.

Myth number 6 kills me. People are so obsessed with looking like doctors.

 

[Señor S]

There's now a move for PAs to call themselves "Physician Associates."

http://paprogram.yale.edu/curriculum/

Physician autonomy is over. Your future is as an expendable cog, another white-coated "provider" being exploited by CEOs and bullied by self-appointed regulatory committees made up exclusively of vindictive nurses.

 

[deafdealer]

Just let them all keep pushing for equal pay and they'll price themselves completely out of a job.

 

[cbrons]

Just let them all keep pushing for equal pay and they'll price us completely out of a job.

FTFY

 

[jw3600]

Everybody wanna be a body builder but don't nobody wanna lift no heavy ass weights.

 

[deafdealer]

FTFY

If you're paying the same you're going to choose the person with more training

 

[Brorthopedic]

The medical field is evolving, physicians can't hold onto their ground because we own too much of it and there just isn't enough of us to defend it.

 

[751866]

If you're paying the same you're going to choose the person with more training

That assumes people don't suffer as a result of lower priced "labor". The docs who are paid less to start might survive until there's an equilibrium. At some point, the finance heads will say, "Why are we paying K times more for this physician? We have these other docs who take less. If we fire the expensive docs, we can get by with the cheaper docs, and hire some more [non doctors] to pick up the workload."

It's not like one day, out of the blue, [non-doctors] will be paid just as much as physicians (in which case, why not take the guy with more training/experience/education). It would be more gradual than that, and the cheaper "labor" would replace some of the more expensive kind-- as a "pricey" doctor, you either lower your fees or whatever to compete, otherwise, you've got a lot of convincing to do...

 

[cbrons]

If you're paying the same you're going to choose the person with more training

That's if you are paying the same, maybe their push for "equal" pay will just result in across the board cuts to physicians. Esp in light of the fact that most idiots in these legislatures are allowing them increased scope of practice. Nurse practitioners can now practice with NO supervision in 21 states. That's right. Someone with 0 days in medical school, 0 days in residency, and passed 0 steps of USMLE (or board-specific licensing examination) can now functionally become a cardiologist or gastroenterologist if they feel like it.

 

[Psai]

That's if you are paying the same, maybe their push for "equal" pay will just result in across the board cuts to physicians. Esp in light of the fact that most idiots in these legislatures are allowing them increased scope of practice. Nurse practitioners can now practice with NO supervision in 21 states. That's right. Someone with 0 days in medical school, 0 days in residency, and passed 0 steps of USMLE (or board-specific licensing examination) can now functionally become a cardiologist or gastroenterologist if they feel like it.

Man there was a time when we had an icu patient getting continuous eeg and the neurologist sent a ****ing mid level to do the initial consult. They couldn't even read the eeg. I was like uhhh why are you even here?

 

[deafdealer]

That's if you are paying the same, maybe their push for "equal" pay will just result in across the board cuts to physicians. Esp in light of the fact that most idiots in these legislatures are allowing them increased scope of practice. Nurse practitioners can now practice with NO supervision in 21 states. That's right. Someone with 0 days in medical school, 0 days in residency, and passed 0 steps of USMLE (or board-specific licensing examination) can now functionally become a cardiologist or gastroenterologist if they feel like it.

The Oregon bill, for example, requires equal pay but prohibits reducing physician pay to make up the difference. This bill might set the precedent for other states to follow, and maybe the VA on the federal level. This is really the only way forward for us to get out of this as no one will be taking away practice rights already granted

 

[cbrons]

The Oregon bill, for example, requires equal pay but prohibits reducing physician pay to make up the difference. This bill might set the precedent for other states to follow, and maybe the VA on the federal level. This is really the only way forward for us to get out of this as no one will be retroactively taking away practice rights

So what has happened in Oregon? Are NPs getting jobs over physicians or what?

 

[cbrons]

Is it wrong for me to have as some my check-list items for residency interviews/program rank list order factors:

• Health insurance
• Outpatient clinic setup
• Moonlighting situation

• Happiness of residents
• Number of general floor month

• Night float for interns
• ICU months for interns
• On-site daycare/school
• Zero contact with or supervision by NPs or PAs
• Good malpractice state
• Low tax state
• Low crime and low tax area
• State does not allow independent NP practice

 

[musicalfeet]

That assumes people don't suffer as a result of lower priced "labor". The docs who are paid less to start might survive until there's an equilibrium. At some point, the finance heads will say, "Why are we paying K times more for this physician? We have these other docs who take less. If we fire the expensive docs, we can get by with the cheaper docs, and hire some more [non doctors] to pick up the workload."

It's not like one day, out of the blue, [non-doctors] will be paid just as much as physicians (in which case, why not take the guy with more training/experience/education). It would be more gradual than that, and the cheaper "labor" would replace some of the more expensive kind-- as a "pricey" doctor, you either lower your fees or whatever to compete, otherwise, you've got a lot of convincing to do...

Until people start getting seriously hurt or killed due to these mid-level provider's lack of knowledge. I'm only a lowly MS1, and while I know a lot of people say our years 1-2 basically are useless for clinical practice, I can see how important it is in playing a role in our understanding of how all the basic sciences of medical practice work. If anything, it gives us the ability to reason through things because we know the logic/science behind it versus people who only follow a flowchart/protocol. And only physicians can handle the zebras because of all the science learning we've done.

 

[FindMeOnTheLinks]

I realize there are probably deviant motives at play here, but at least all of those claims are actually true and are not in and of themselves undermining physicians. It's not going nearly as far as the NP propaganda touting their equivalence or even SUPERIORITY to physicians. Rather, just serving to highlight the utility of PA's by demonstrating that they are more than just an overqualified nurse. Furthermore PA autonomy is not NEARLY as dangerous to the patient as NP autonomy; I at least have a good deal of respect for PA training. I think the ad in the OP is probably intended to attract prospective PA's who otherwise might have only considered medicine (for obvious reasons). This is most likely me being my optimistic self, and the PA campaign in question is probably an early step in an ongoing series of attempts to chip away at physician dominance in healthcare.




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[cbrons]

I realize there are probably deviant motives at play here, but at least all of those claims are actually true and are not in and of themselves undermining physicians. It's not going nearly as far as the NP propaganda touting their equivalence or even SUPERIORITY to physicians. Rather, just serving to highlight the utility of PA's by demonstrating that they are more than just an overqualified nurse. Furthermore PA autonomy is not NEARLY as dangerous to the patient as NP autonomy; I at least have a good deal of respect for PA training. I think the ad in the OP is probably intended to attract prospective PA's who otherwise might have only considered medicine (for obvious reasons). This is most likely me being my optimistic self, and the PA campaign in question is probably an early step in an ongoing series of attempts to chip away at physician dominance in healthcare.

This is most likely me being my optimistic self,

delusional optimistic self

 

[bananabreadhunter]

Part of the reason this may be a response towards a laughable Women's Health article - http://imgur.com/IexJe5E . The other part is probably an attempt to promote undergrads who want to go the PA route. Nothing wrong with these things.

 

[bananabreadhunter]

delusional optimistic self

There are plenty of good IM and FM jobs available for recent grads. However, I generally agree with the sentiment that medicine is changing and the primary care field is tightening as np and pa's make themselves attractive employees. They work for less money. That's more than enough incentive for hospitals and department chairs to off-load easy work and 'chores'.

If you are seriously concerned about your future value as a practicing physician, specialize. Surgery, fellowship - whatever it takes. A medical degree has great value in the real world and can let you pursue things other than clinical medicine. Many MDs go into consulting, pharm, and leadership. Don't sell medical school short. The sky is not falling but US healthcare is adjusting to new economic forces and business models.

 

[68PGunner]

...

 

[68PGunner]

There are plenty of good IM and FM jobs available for recent grads. However, I generally agree with the sentiment that medicine is changing and the primary care field is tightening as np and pa's make themselves attractive employees. They work for less money. That's more than enough incentive for hospitals and department chairs to off-load easy work and 'chores'.

If you are seriously concerned about your future value as a practicing physician, specialize. Surgery, fellowship - whatever it takes. A medical degree has great value in the real world and can let you pursue things other than clinical medicine. Many MDs go into consulting, pharm, and leadership. Don't sell medical school short. The sky is not falling but US healthcare is adjusting to new economic forces and business models.

Pts are using NPs and PAs because they're being turned away by physicians. The pts don't pay any extra or less when they see a midlevel over a physician.

 

[deafdealer]

There are plenty of good IM and FM jobs available for recent grads. However, I generally agree with the sentiment that medicine is changing and the primary care field is tightening as np and pa's make themselves attractive employees. They work for less money. That's more than enough incentive for hospitals and department chairs to off-load easy work and 'chores'.

If you are seriously concerned about your future value as a practicing physician, specialize. Surgery, fellowship - whatever it takes. A medical degree has great value in the real world and can let you pursue things other than clinical medicine. Many MDs go into consulting, pharm, and leadership. Don't sell medical school short. The sky is not falling but US healthcare is adjusting to new economic forces and business models.

Again, they're removing this incentive themselves through the push for equal pay.

And we shouldn't have to specialize to have any kind of economic security. We represent the highest standard in our field, and only in America would this get distorted so badly--through what has become a de facto war on physicians--that the public would actually side with midlevels.

 

[751866]

Until people start getting seriously hurt or killed due to these mid-level provider's lack of knowledge. I'm only a lowly MS1, and while I know a lot of people say our years 1-2 basically are useless for clinical practice, I can see how important it is in playing a role in our understanding of how all the basic sciences of medical practice work. If anything, it gives us the ability to reason through things because we know the logic/science behind it versus people who only follow a flowchart/protocol. And only physicians can handle the zebras because of all the science learning we've done.

I don't need convincing...I'm a big fan of the (loose) phrase: the eyes cannot see and the ears cannot hear that which the mind does not know.

 

[FindMeOnTheLinks]

delusional optimistic self

Haha alright man, sure. Overly optimistic. It's a good attitude to keep a happy, low stress existence. But it's far from a naivety. Delusional is probably too harsh a word to use there. If you read my post, you should see that I realize my attempt to see the best in people is wishful thinking.


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[FindMeOnTheLinks]

the eyes cannot see and the ears cannot hear that which the mind does not know.

I know someone who can



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[Frazier]

The handout is certainly cringe-worthy.

That said, I know a decent amount of PA's both at my institution and through my gf (who is a ED PA herself) in an entirely other state.

They complain about attendings largely in the same way that we complain about attendings as med students. (XYZ is an ***hole. ABC doesn't even listen to my presentations. Etc.) Not so much "I want to take over and be independent."

I did hear a story about one particular guy that referred to himself as a "surgeon" while giving a lecture (he was a surgical specialty PA). He basically got scoffed at everyone in the audience and labeled as a *******. The audience was entirely PA students.

This handout was written by the likes of that guy.

Overall, they tend to like their role in healthcare working with the docs.

 

[Obnoxious Dad]

Anybody who failed to foresee the push for independent practice by PAs is a fool. Anesthesiologists, who think PAs are their buddies and CRNAs are their enemies, are deluding themselves. The lesson here for every physician is that routine medical tasks are going to be performed by midlevels. Demonstrable and applicable superior knowledge and skills are the only factors that will keep physicians employed. Comparisons between physicians and midlevels regarding the length of training and the rigor of licensing exams won't cut it.

 

[Mad Jack]

Um their job title was actually physician's assistant. It's still the job description. They just changed the name recently but that's a Dwight Schrute level game.

Myth number 6 kills me. People are so obsessed with looking like doctors.

The legal title has always been physician assistant.

There's now a move for PAs to call themselves "Physician Associates."

http://paprogram.yale.edu/curriculum/

Physician autonomy is over. Your future is functioning as another expendable cog, another white-coated "provider" being exploited by CEOs and bullied by self-appointed regulatory committees made up exclusively of vindictive nurses.

This proposal has been overwhelmingly rejected by PAs and the PA leadership. Only Yale seems hell-bent on changing things, but they're the same school that is digging in trying to make an online PA program...

 

[VA Hopeful Dr]

Anybody who failed to foresee the push for independent practice by PAs is a fool. Anesthesiologists, who think PAs are their buddies and CRNAs are their enemies, are deluding themselves. The lesson here for every physician is that routine medical tasks are going to be performed by midlevels. Demonstrable and applicable superior knowledge and skills are the only factors that will keep physicians employed. Comparisons between physicians and midlevels regarding the length of training and the rigor of licensing exams won't cut it.

PAs are overseen by the Board of Medicine in most, if not all, states. They can't get independent practice unless we allow it. Period. Sure, the legislature could theoretically override the BOM but that sort of thing is quite unusual - they tend to assume that the various boards know what they are doing when it comes to internal matters.

 

[Goro]

Fixed that for ya.

There's now a move for PAs to call themselves "Physician Associates."

http://paprogram.yale.edu/curriculum/

Physician autonomy is over. Your future is functioning as another expendable cog, another white-coated "provider" being exploited by CEOs and bullied by self-appointed regulatory committees made up exclusively of vindictive CFOs and accountants.

 

[Lord_Vader]

I vomited after #6.

EDIT:

Is it wrong for me to have as some my check-list items for residency interviews/program rank list order factors:

• Health insurance
• Outpatient clinic setup
• Moonlighting situation

• Happiness of residents
• Number of general floor month

• Night float for interns
• ICU months for interns
• On-site daycare/school
• Zero contact with or supervision by NPs or PAs
• Good malpractice state
• Low tax state
• Low crime and low tax area
• State does not allow independent NP practice

WAIT. This is an actual thing in some residencies? WTF??

 

[cbrons]

I vomited after #6.

EDIT:



WAIT. This is an actual thing in some residencies? WTF??

Yes. @Perrotfish I believe it was posted something a few years ago about FM interns being supervised by NPs in the clinic (I think it was only for the first few days of residency - like they had to "check-out" to the NP). He can correct me if I am wrong, but I believe I am remembering it correct.

I know one FM program where residents are supervised on L&D by Midwives.
There's one IM program where residents are supervised by CRNAs for certain procedures (or have to call them anytime someone needs to be intubated and get their permission and direct supervision). I am fairly certain this is extremely rare and most of the time you are supervised by a fellow or attending.

 

[Señor S]

Yes. @Perrotfish I believe it was posted something a few years ago about FM interns being supervised by NPs in the clinic (I think it was only for the first few days of residency - like they had to "check-out" to the NP). He can correct me if I am wrong, but I believe I am remembering it correct.

I know one FM program where residents are supervised on L&D by Midwives.
There's one IM program where residents are supervised by CRNAs for certain procedures (or have to call them anytime someone needs to be intubated and get their permission and direct supervision). I am fairly certain this is extremely rare and most of the time you are supervised by a fellow or attending.

Are there any lists circulating of places where residents are supervised by midlevels? If not can we get one going?

 

[JB50]

I vomited after #6.

EDIT:



WAIT. This is an actual thing in some residencies? WTF??

Lol'ed. Those damn white coats get some panties bunched real quick.

 

[Obnoxious Dad]

PAs are overseen by the Board of Medicine in most, if not all, states. They can't get independent practice unless we allow it. Period. Sure, the legislature could theoretically override the BOM but that sort of thing is quite unusual - they tend to assume that the various boards know what they are doing when it comes to internal matters.

The jurisdiction of each state's board of medicine is defined by each state's legislature. It would take an afternoon for a state legislature to remove PAs from its BOM's jurisdiction. People need to understand that the states are going to be under enormous fiscal pressures stemming from medicaid. Politicians are going to be looking for savings under every rock. Whenever and wherever midlevels can show a politically acceptable level of performance and large health care savings, they will eventually be employed.

 

[cbrons]

The jurisdiction of each state's board of medicine is defined by each state's legislature. It would take an afternoon for a state legislature to remove PAs from its BOM's jurisdiction. People need to understand that the states are going to be under enormous fiscal pressures stemming from medicaid. Politicians are going to be looking for savings under every rock. Whenever and wherever midlevels can show a politically acceptable level of performance and large health care savings, they will eventually be employed.

The rate limiter isnt even the legislature. They would let an MA prescribe drugs if it wouldnt look bad in a newspaper. The rate limiter are the hospitals and other organizations who will be held liable for mistakes made by autonomous non-physicians practicing medicine.

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[VA Hopeful Dr]

The jurisdiction of each state's board of medicine is defined by each state's legislature. It would take an afternoon for a state legislature to remove PAs from its BOM's jurisdiction. People need to understand that the states are going to be under enormous fiscal pressures stemming from medicaid. Politicians are going to be looking for savings under every rock. Whenever and wherever midlevels can show a politically acceptable level of performance and large health care savings, they will eventually be employed.

You ignored the second half of my post quite expertly. I'll say it again - legislatures rarely override the internal workings of the BOM. You think they will do differently, prove it. Show me where they've stepped in and overridden the BOM before.

 

[Psai]

Yes. @Perrotfish I believe it was posted something a few years ago about FM interns being supervised by NPs in the clinic (I think it was only for the first few days of residency - like they had to "check-out" to the NP). He can correct me if I am wrong, but I believe I am remembering it correct.

I know one FM program where residents are supervised on L&D by Midwives.
There's one IM program where residents are supervised by CRNAs for certain procedures (or have to call them anytime someone needs to be intubated and get their permission and direct supervision). I am fairly certain this is extremely rare and most of the time you are supervised by a fellow or attending.

LOL that's pretty sad
There are plenty of programs, sounds like these need to be shut down

 

[Donald Juan]

It's pretty clear why these midlevels are attempting to encroach on our field and think they can. Let me reference you to myth 6:

"A shorter coat signifies a healthcare provider is in training. When PA students complete their education, they begin their practice with a longer white coat—equal to that of any other clinician. "

It's clear where they are getting their power from. It's the long white coat. I know any of the resident or highers here can attest to that feeling the first day when you walk into the hospital with a long white coat, some nurse looks at you and says, "Good Morning, Dr. Juan 😉," the patients are finally happy to have you walk into their room, and when you call someone for a consult they don't hang up the phone on you after saying, "tell your goddamn resident to call me next time you ****ing *****" (amazingly, the power of the white coat transcends over phone lines).

We gotta cut their coats short. We need an outward symbol of their subservience. This is the only option if we hope to not be drowned in a melting pot of white cotton-polyester blended fabrics, where MDs come out as nothing more than another piece of the puzzle: no more or less important than the PAs, nurses, NPs, case managers, pharmacists, social workers, nutritionists, x-ray techs, or whoever the hell else wants to wear a white coat.

Alternatively, we could just wear white coats that drag the ground 2 feet behind us. This would also work as it would literally trip up those who are walking behind us and trying to follow in our footsteps.

 

[JB50]

It's pretty clear why these midlevels are attempting to encroach on our field and think they can. Let me reference you to myth 6:

"A shorter coat signifies a healthcare provider is in training. When PA students complete their education, they begin their practice with a longer white coat—equal to that of any other clinician. "

It's clear where they are getting their power from. It's the long white coat. I know any of the resident or highers here can attest to that feeling the first day when you walk into the hospital with a long white coat, some nurse looks at you and says, "Good Morning, Dr. Juan 😉," the patients are finally happy to have you walk into their room, and when you call someone for a consult they don't hang up the phone on you after saying, "tell your goddamn resident to call me next time you ****ing *****" (amazingly, the power of the white coat transcends over phone lines).

We gotta cut their coats short. We need an outward symbol of their subservience. This is the only option if we hope to not be drowned in a melting pot of white cotton-polyester blended fabrics, where MDs come out as nothing more than another piece of the puzzle: no more or less important than the PAs, nurses, NPs, case managers, pharmacists, social workers, nutritionists, x-ray techs, or whoever the hell else wants to wear a white coat.

Alternatively, we could just wear white coats that drag the ground 2 feet behind us. This would also work as it would literally trip up those who are walking behind us and trying to follow in our footsteps.

Died🤣

 

[Mr Roboto]

It's pretty clear why these midlevels are attempting to encroach on our field and think they can. Let me reference you to myth 6:

"A shorter coat signifies a healthcare provider is in training. When PA students complete their education, they begin their practice with a longer white coat—equal to that of any other clinician. "

It's clear where they are getting their power from. It's the long white coat. I know any of the resident or highers here can attest to that feeling the first day when you walk into the hospital with a long white coat, some nurse looks at you and says, "Good Morning, Dr. Juan 😉," the patients are finally happy to have you walk into their room, and when you call someone for a consult they don't hang up the phone on you after saying, "tell your goddamn resident to call me next time you ****ing *****" (amazingly, the power of the white coat transcends over phone lines).

We gotta cut their coats short. We need an outward symbol of their subservience. This is the only option if we hope to not be drowned in a melting pot of white cotton-polyester blended fabrics, where MDs come out as nothing more than another piece of the puzzle: no more or less important than the PAs, nurses, NPs, case managers, pharmacists, social workers, nutritionists, x-ray techs, or whoever the hell else wants to wear a white coat.

Alternatively, we could just wear white coats that drag the ground 2 feet behind us. This would also work as it would literally trip up those who are walking behind us and trying to follow in our footsteps.

The hospital system I worked at had nursing students rotating, and part of their official uniform was a long white coat. Confusing as hell.

 

[Psai]

The hospital system I worked at had nursing students rotating, and part of their official uniform was a long white coat. Confusing as hell.

It's an insidious attempt to blur the lines. But once people know who you are, it doesn't matter what you wear.

 

[NotYou20]

"93% of patients who recently saw a pa agreed that pas are a trusted healthcare provider"

...According to a survey conducted" behalf of the aapa

Funny how that works

 

[gwarm01]

I don't trust anyone whose coat isn't at least knee-length.

 

[NaOH]

Alternatively, we could just wear white coats that drag the ground 2 feet behind us. This would also work as it would literally trip up those who are walking behind us and trying to follow in our footsteps.

2 feet, hell, you need one a few yards long - then you can have a couple of students tagging along to adjust it whenever you stop.


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[Psai]

2 feet, hell, you need one a few yards long - then you can have a couple of students tagging along to adjust it whenever you stop.


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this is me

 

[MrChance2]

In most hospitals I've been in you can recognise the attendings because they aren't wearing a silly white coat. I think no white coat is the new white coat.

 

[NaOH]

You can tell the physicians in our hospital because they all wear the same hospital-issued OR scrubs. But honestly, they suck - I'd rather have my Carhartt's with a dozen pockets.

 

[Obnoxious Dad]

You ignored the second half of my post quite expertly. I'll say it again - legislatures rarely override the internal workings of the BOM. You think they will do differently, prove it. Show me where they've stepped in and overridden the BOM before.

I didn't ignore your post. I disagreed with it.

Legislatures, and not nursing boards, in the last 20 years have given advanced practice nurses much greater authority to prescribe and practice independently. (At the US Congressional level this is going on right now with CRNAs at the VA.) This has occurred over the loud and lavishly financed objections of physicians. Just because physician assistants are CURRENTLY under the jurisdiction of medical boards, doesn't mean that legislatures can't move their licensure and regulation to independent boards that don't serve the interests of physicians.

In 1960 5% of the GDP was devoted to health care and now it's 18%. People are getting buried by these costs and they are sick of it. Many Americans think physicians are motivated solely by greed and some of them KNOW that the medical, pharmacy, nursing and dental professions are guilds that do their best to protect their turf and keep competition out.

Physicians need to know that they must prove on a practical level that they have skills that are worthy of higher pay. Physicians who don't understand that are just whistling past the graveyard.

 

[VA Hopeful Dr]

I didn't ignore your post. I disagreed with it.

Legislatures, and not nursing boards, in the last 20 years have given advanced practice nurses much greater authority to prescribe and practice independently. (At the US Congressional level this is going on right now with CRNAs at the VA.) This has occurred over the loud and lavishly financed objections of physicians. Just because physician assistants are CURRENTLY under the jurisdiction of medical boards, doesn't mean that legislatures can't move their licensure and regulation to independent boards that don't serve the interests of physicians.

In 1960 5% of the GDP was devoted to health care and now it's 18%. People are getting buried by these costs and they are sick of it. Many Americans think physicians are motivated solely by greed and some of them KNOW that the medical, pharmacy, nursing and dental professions are guilds that do their best to protect their turf and keep competition out.

Physicians need to know that they must prove on a practical level that they have skills that are worthy of higher pay. Physicians who don't understand that are just whistling past the graveyard.

Nursing scope is an issues between the medical board and the nursing board so of course the legislature steps in. Find me examples of the legislature stepping in for an intrenal board matter then we'll talk.