how do PA's interact with docs? how are they different from nurse practioners?

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MrBob

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I'm not sure I understand the question...would you elaborate....?
 

hawkeyes

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oldman, I've seen you on the premed site as well. My boss likes to hire PA's rather than NP's becuase they are more similar in thinking. In the clinical workplace, they function similarly, both "midlevel providers." However, PA training is from the medical model (same as med school, though much abbreviated), while NP's are generally nurses with lots of experience and their training is an extension of what they have learned in their work as a nurse. I have heard another doc say that he finds it easier to work with PA's becuase while the NP and PA may both get to the same point (diagnosis, treatment, management) eventually, the PA takes a route more similar to that of a physician. My boss said that its becuase they have the same bad habits as physicians and so it is easier to work with and understand one. Hope that helps. I'm a PA.
 

Emedpa

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The clinical hours are also vastly different. a typical p.a. program has over 2200 hrs of clinical time while most np programs are in the 300-700 hr range. pa rotations are often based on 3rd and 4th year med student rotations lasting 5-12 weeks . I teach both pa and np students in my ED. the pa's are here for 4-6 weeks depending on the program and the np students are only required to do 40 hrs, so about the time they have figured out the computer system they are gone.
 

Freeeedom!

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I would hire a Physicians Assistant over a NP. Preferably one with a masters degree and a few years clinical experience. As a Physician, I have a good idea what the clinical rotations were like for a PA...but not for a NP. I also have a good idea of their academic experience...and their title alone seems to represent a less adversarial (sp?) relationship.

But the most important aspect is a friendly person who understands his/her role in the department.
 

hawkeyes

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Emedpa - where are you going to med school? Will you continue to work as a PA while in school? I ask becuase I am in the same position and would really like to work... but most people tell me that it would be much too hard. Your thoughts?
 

Freeeedom!

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In most programs, it is HIGHLY frowned upon to work in any allied health or nursing profession DURING school. We were EXPLICITLY told not to work in health care (fear of practicing medicine without a license).
 

Bandit

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In would agree withn freedom that allied health persons should not work while in med school. That being said, PA might be a bit different. I get 65$/hr per diem and would be hard pressed to avoid the quick 500 bucks for a day. The "fear of practicing medicine" I think is a non-issue with PA`s.

PS: There is no "s" or "`S" after the physician.
 

Emedpa

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hawkeyes-I am not yet in an md/do program, however, I will probably continue to work a shift a week or so while in school. this is completely legal as long as you have your own dea number, supervising physician, and state scope of practice(as I currently do in 2 states). hope that helps-e
 

hawkeyes

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Thanks all. Freeeedom, why was it an issue for the PA in your class to work as a PA? Practicing medicine is exactly what PA's do. Bandit, wow, you make a whole lot of money. WOWOWOW! My goodness. How does one find a per diem job? How do you go about finding an agency? Any help would be much appreciated! Emedpa, good luck with wherever you end up going! Thanks!
 
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Freedom specifically, and all,

You are completely wrong. I respect the vast majority of what you say on this forum most of the time, but you are dead wrong here. How can you express the desires of faculty or policy-makers at schools other than yours? You have attended one of about 200 medical schools in this country, so don't try to be the expert on this issue please. An allied health professional with or without a license is legally able to and should work if they desire. Allow me to go down the list. Natalie Bell at Howard is a respiratory therapist who has worked while attending medical school. Dave Kelley is a Kirksville student who is a respiratory therapist as well. TCOM has a PA who is a second year student, and he works weekly. I am a PA, and I may or may not work while going to school. God forbid, you think because I take a few more classes that I can't be trusted with this "extra" knowledge" not to cross the line between a PA and a physician? This is totally hilarious and I am sitting here bewildered how you can say such a thing. And Bandit, you, why are you saying allied health people should not work while in medical school? So I guess paralegals should not while in law school, and I guess an engineer who has only a BS degree should not work as an engineer while getting his/her Master's, right? Now don't get pissed off here Dr. Freedom, but you brought this one on yourself. I really do respect most of what you say on this forum as I said, but you are not even in the ballpark at this baseball game.

Matt
 

Bandit

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Matt, I meant to say that I can certainly understand the logic behind not allowing allied health to work while in med school. While this "logic" might not be allpicable to most, it can be seen as a protection of the patient. Perhaps a misguided PT in med school might "overlook" something or an eager OT "dismissing" something based on their incomplete medical knowledge. Not a good idea. This is ceratinly not a knock on PT/OT and most likely does not pertain to the great majority, but as with any profession, there are strong and weak.
I excluded PA`s from this because we are not just taught how to practice medicine -- but how to evaluate boundries. Knowing when to test those boundries and when to recognize them is essential as a PA. That being said, working a fastrac some Sunday morning for cash should be fine for a PA. I cant stress this enough---you dont need four more years to dx allergic rhinitis!!!
 

hawkeyes

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Got some passionate people here, I see. That's good. Thanks for the feedback. Can't wait to hear from Freeedom.
 

Freeeedom!

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Well, this isn't really a big deal...why all the fuss PAC? Work don't work, whatever. They told us not to...they frowned upon it.

If one thing can be said about some of the PA's on this website...you surely think you guys are great. Granted, I come off passionate, but sh!t do you guys sound arrogant.
Maybe I am just tired but, if it isn't some DPT calling themselves "doctor" it is a PA saying they practice "medicine". Whatever people. If practicing medicine is diagnosing and treating allergic rhinitis...then my mom was a doctor 35 years ago.
For the time being, I am gonna concentrate on me. I know that I graduated from medical school. I CAN say that I practice medicine. I am A PHYSICIAN. You guys can fight over what ever abstract bullsh!t you want to...but I am tired of this arrogance, I am tired of debating. I would love for all the PA's, NP's, DPT's, CRNA's to fight it out in a big boxing ring to decide "who deserves to be the king of mid-level care" or "who is more 'like' a doctor".
Sometimes reading this website is just plain depressing.
 

Bandit

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Freedom my friend, you must be tired. The arrogance is in the form of young medical students -- not the PA`s. "I am a Physician" -- well your majesty, you are no more physician than I. Not at least untill you grad. (or have you since you started posting?) Even then it will take you a few years to aquire the clinical skills I have had for years now. Never forget that Doctors are made in residency, not med school. You have consistantly bashed others in mid-level roles and quite frankly are testing the limits of my friendship. To imply that DPT`s calling themselves "doc" is anything like PA`s prqacticing medicine is nuts. I have a license to practice medicine (albeit with some restrictions) but listen pal -- I have a license to practice medicine.
I fear that dispite some of your past posts, you do hold contempt for mid-level providers and for some reason deny the respect they deserve. Whatever man, I wont be drawn back into that debate with you. This forum does indeed get depressing, but it is due to people constantly bashing others -- be it professions/politics/or any other BS about "me vs. you" You can have all that crap. Anyone here want to discuss a reasonable sane topic? Start a new thread. Freedom -- get some sleep or stop posting. Thanx -- friend.

edit: I dont know to be angry or disappointed in you freedom. Sometimes you show enlightenment--others astonishing immaturity.
 

hawkeyes

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why do you even bother posting, Freedom? I posted a sincere question, with no pretenses of making myself appear to be able to "practice medicine" when indeed I am not so "qualified" as you. I received help from other SDN'ers and thank them. You, ...don't even deserve so much of a rebuttal. You think that the scope of PA practice is limited to allergic rhinitis? You are so ignorant. <img border="0" alt="[Wowie]" title="" src="graemlins/wowie.gif" /> And I am SO sad that you are a "physician."
 

CVPA

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Freedom:

I couldn't help but smile when I read your characterization of PAs as arrogant because of our belief that we practice medicine. I smiled because from a historical perspective, your posts have screamed of arrogance to the Nth degree. This kind or irony and hypocrisy, therefore, amuses me. I am sure there have been PA postings that were arrogant as there were physician/medical student postings which were arrogant. These are individually determined, not professionally.

News flash, Freedom, whether you like this fact or not, PAs do practice medicine. The difference between PAs and physicians is that we do not practice autonomous medicine. This is a factual definition, my misinformed friend, not conjecture on our part. Below is the definition of PAs according to the AAPA (American Academy of Physician Assistants) and the AMA, respectively.

AAPA DEFINITION:

•••quote:•••Physician assistants are health care professionals licensed to practice medicine with physician supervision. PAs employed by the federal government are credentialed to practice. As part of their comprehensive responsibilities, PAs conduct physical exams, diagnose and treat illnesses, order and interpret tests, counsel on preventive health care, assist in surgery, and in most states can write prescriptions.••••AMA DEFINITION:

•••quote:•••The physician assistant is academically and clinically prepared to practice medicine with the direction and responsible supervision of a doctor of medicine or osteopathy. The physician-PA team relationship is fundamental to the PA profession and enhances the delivery of high-quality health care. Within the physician-PA relationship, PAs make clinical decisions and provide a broad range of diagnostic, therapeutic, preventive, and health maintenance services. The clinical role of PAs includes primary and specialty care in medical and surgical practice settings. PA practice is centered on patient care and may include educational, research, and administrative activities.••••Nothing abstract about that, eh?

You are right about one thing, you do need to concentrate on yourself. Your obsession with PAs is not healthy, doctor.
 
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Freeeedom!

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ALL OF YOU ARE TERRIBLY ARROGANT! not PA's in general...just you.

Hawkeyes, you didn't even read the context of the reply...don't be *****ic.

Bandit...once again you are insulting and jump off the handle at the drop of a hat. You take the cake as the most arrogant person I have EVER debated. I am testing your friendship?? What is that...a threat? Give it up, dude, I have never said I was better than you ( all i have said is that I finished 4 years of medical school}...but you insist that you have some sort of 'magical' clinical skill that I don't posess...with what? I am sure you do your job well...but you always EXPECT an insult...you seem to be SO DEFENSIVE and Frustrated!
You want so badly to be taken seriously. It bites you in the ass that NO MATTER HOW GOOD YOU ARE, you will never be the final decision maker. It eats you up that when someone calls you "doctor" you HAVE to correct them. Even if you DO by definition practice non-autonomous medicine...if you say "well, I have been practicing medicine for X years"...people will won't take that comment seriously...it won't even stand up in a court of law! (practicing medicine without a license is a LEGAL definition...defined on a case to case basis and interpreted as such...that was my point earlier).
It sticks in your craw, that your title has the word ASSISTANT in it. It really bugs you doesn't it? I can see through it...that is why I call you arrogant.

"I would hire a Physicians Assistant over a NP. Preferably one with a masters degree and a few years clinical experience. As a Physician, I have a good idea what the clinical rotations were like for a PA...but not for a NP. I also have a good idea of their academic experience...and their title alone seems to represent a less adversarial (sp?) relationship.

But the most important aspect is a friendly person who understands his/her role in the department."

this was a compliment that I gave earlier on this board...I meant it then. But you people take the cake. Absolutely take the cake. Arrogant and frustrated.
 

hawkeyes

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yeah I sure did read the context of your reply. And I read it again to be sure that I got it right.. I did. relax! don't know why you keep coming back for more.... <img border="0" alt="[Laughy]" title="" src="graemlins/laughy.gif" />
 

PACmatthew

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Freedom, please relax. Bandit I can guarantee you is not frustrated being a PA, or he would have done something about it years ago. He's already changed professions twice. You have to see this from the really big picture from which your television does not receive such reception. The reception I speak of is above your understanding yet because your are just now becoming an intern. You simply have no idea, or a limited perspective by which to reply with. I can absolutely guarantee you that if you are going to be doing ER, you will see the value of PA's, and you will see that they do practice medicine. God knows it is ambiguous to have the title assistant in your title, but PA's still practice medicine. And I hate to break the news to you, but PA's have the final word all the time about patient care. And having the final word in medicine is by definition practicing medicine. There are cases where docs see each and every patient after the PA, but I would venture to say that 95% of patients nationwide that see PA's leave without ever seeing a physician. If you want to call someone frustrated, then call me frustrated Freedom. I will admit that I am frustrated being a PA, but I am in the minority. Just don't think that because you will be an intern soon that you have now been blessed with some sort of vision that enables you to have more experience than a PA like Bandit who probably has more gray hair than you and I have underarm hair. He is experienced and his opinion is to be valued. In a few short years, you and I will have the same title, but we will not think the same way. You see, as an intern I will know that the only thing less senior to me will be the custodion, and I will already know the value of a PA. You are about to be an intern, but a physician nontheless, so please do not make a final decision as to what you think a PA is capable of until you complete your journey. That is all I ask. Stand back just a few feet and be a little less abrupt in the way you approach people. And one last point of information, a PA is a Physician Assistant, not a Physician's Assistant. It is a fact, not to rag on you, but just a fact. Please use the title correctly because those who have it earned it. Good luck in residency, and you are still on my cool list though you probably don't care. Later dude.

Matt Messa, EMT-P, MPAS, PA-C
1LT, US Army Reserve, 65D
 

Ponyboy

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I agree with you, Freeedom. There are some arrogant personalities around here.

"And I hate to break the news to you, but PA's have the final word all the time about patient care. And having the final word in medicine is by definition practicing medicine." Now, hold on a sec. If a PA has random chart reviews or random patient re-examinations by a supervising physician (or any type of quality control mechanism, like there should be), they are being supervised. If the supervising MD decides that the PA isn't doing what he wants to be done with the patient, the MD gets the final word in patient care.

"Just don't think that because you will be an intern soon that you have now been blessed with some sort of vision that enables you to have more experience than a PA like Bandit who probably has more gray hair than you and I have underarm hair. He is experienced and his opinion is to be valued." While experience is an excellent tool to have, a preceptor of mine has always stated that patient care cannot be based on experience alone because once you are outside the realm of your experience, you are lost. A broad based didactic education is as necessary (if not more so) as experience to handle the complicated and rare illnesses that may come your way.
 

CVPA

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Freedom:

First of all, I find the degree of your rantings astounding. So much so that with the amount of exclamation marks and capitalized words, one might suggest that it is you who is the frustrated and defensive one. But then again, I am no psychiatrist, so what the hell do I know, right?

Secondly, arrogance as I understand it, is not defined by one who is defensive, frustrated, or expects insults as you so ineptly described Bandit. Arrogance, as described by Webster, is defined as ?proud contempt of others?. Gee, I wonder who fits that definition.

Are some of us guilty of being defensive at times? Absolutely, and why not? My god, Freedom, look at the history of your postings. Do you really lack the insight to see why some of us might ?jump off the handle at the drop of a hat?? You feel that you debate; many including myself would say that you incite. I am not so sure that you do this out of your self-purported passion as much as you do it out of some pathologic need for self-inflation.

Are some of us frustrated? Again, absolutely. Our profession continues to have to define ourselves repeatedly to people. We are still relatively young and thus defining who we are is, for now, a reality of being a PA. That doesn?t take away from what we do as clinicians or in our professional satisfaction. It does lend itself to a certain degree of frustration that for most of us, including Bandit, has nothing to do with being the final decision maker or correcting people who call us doctor or even having the word ?assistant? in our title. Those are your malignant projections which, in my opinion, reflect a certain insecurity in you that would prevent you from ever having the confidence to be a PA. That?s right, I said confidence. You see, Freedom, most successful PAs are confident, not arrogant. Confidence is necessary in order to focus on the important things in our profession such as the quality of care delivered to our patients and not on the stupid superfluous things like not being the doctor or not being the one who makes the final decision. The sooner you come to understand this, the sooner you will understand why people get incensed by your words.
 
G

G3

I would have to say that this thread has provided me a fantastic opportunity to practice restraint, and observe my own defensive tendencies. Believe me, it has been difficult, :mad: :p

thankfully there those here who express what I feel in a more eloquent, rational manner than I could.
 

Bandit

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Fredom,
"I am testing your friendship?? What is that...a threat?" You feel threatened by this, and I am the one who is threatened? I am the one with insecurity? I am the one that is concerned with the opinion of others? I am the arrogant name caller? Boy oh boy. Clearly I have misjudged you. You dont need to be a psychiatrist to understand your projections. Your very screen name "Freedom" screams a story in itself. I must say that for you to get the interpretation you did out of my post (a fairly friendly post at that) you really need some time to eat/sleep/and examine yourself. Take care man.
 

MrBob

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Freeeeeedom.......how are ya Bud?...I been gone a while....gotten a little touchy here haven't you?
It amazes me how you guys just attack each other like you want to fight or something. If you were in a bar sharing a beer would you interact this way? Why don't you make yer point and stop getting personal?

Now ya can tell me to F*&K off if ya wanna..but to the real young students, it sets a bad example......

I should keep my nose outta this but it simply took a very good question and made it into a flame war.

BTW...Congrats on your graduation, I 'm sure you and your parents are proud of you. If you will grace us occasionally with your wisdom we will be all the better for it. (Sorry I couldn't help that..) This IS a PA forum and we would appreciate a little courtesy here. PErhaps you can start a "I was once a medical student but now I'm God" forum...then you guys could break each others arms patting yourselves on the back.

Finally....I make FINAL decisions 8 hours a day, 5 days a week, thank you very much, and am the ONLY provider many people in my community see for their health care...sort of unnerves you doesn't it?.....

Give us all a break, will you? You aren't the first person to graduate from medical school, you know.
Good Day........
 

Freeeedom!

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Well nancy, I just cant seem to wait. Either I get an address (probobly a fake) or a restraining order (because you are a ***). I dont think I want to let this drop??? Hm,mmm? I suspect you have very few friends. Any of them will do too ***.

These are some of the kind words sent to me from a PA named "smedley" not long ago via personal message. Excuse me if I get a bit touchy when people get threatening!
There is more if you would like to see them...so if someone wishes to discuss "sending a message to the younger kids"...I am not the problem.
I have tired of this. I feel so damned blessed to have gone through and achieved what I have. I have entered a fraternity of brothers and sisters of which I have the utmost respect...I do not see being a physician as a job (like EVERY PA I HAVE EVER WORKED WITH), I see it as a privilege, the privilege of carrying on a tradition which has lasted for centuries. I have gone through each hoop, I have EARNED the right to do what I do, each right of passage. I will not let anyone cheapen or threaten me or the profession I have entered.

Should you get your head out of your ass, we shall talk as adults. Untill then it would be my pleasure to pound you like the *** that you are. Really dingus, I will pay for the trip. Just say when and where. IT IS ON ME!!!!! NO EXCUSES!!!!!!!!

Wow, more nice words...you guys have zero right to lecture ME on conduct...ZERO RIGHT!!!

By the way, websters new world defines arrogant as :full of or due to pride; haughty
and Haughty : showing great pride for oneself and conceit for others
 

CVPA

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Freedom:

OK, so let me see if I have this right. You post a couple of inappropriate messages that were privately sent to you last year (I remember the incident) and that somehow makes all of us, who had nothing to do with that, unqualified to comment on your conduct? Well Freedom, with sound logic like that, how can any of us refute what you say?

Hey by the way, thanks for the additional definition of arrogance. It qualified my assertion about you nicely.
 
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MrBob

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Freeedom.....
You have a right to be upset by the personal messages and they are surely uncalled for. They are a reflection of someone elses ignorance and childishness. It would be difficult for me not to seek such an ass out and teach him/her some manners. I, for one, apologize if one of my "collegues" came up with such a personal reply and turn my back on such an dingus.

Now as for being privileged....I think we each consider ourselves as such. I will be interested in seeing how "privileged" you still feel in 10 or 15 years when the wonder wears off and you have had..................heck.....never mind.I feel myself sinking into that little hole you must be in. I often wonder if somewhere in medical school they don't teach some of you guys how much more important you are than the rest of society. Every day I see docs who refuse to complete charts in a timely fashion, talk down to the ancillary staff, exhibit the arrogance and haughtiness you describe and are unpunished or overlooked because "...they are important to this hospital". Thier arrogance is nauseating. I have seen a senior vascular resident make a pass at my wife ( a nurse at the time) and when he heard my description of "breaking his knuckles with a ball peen hammer" he got the idea.

You know...the farther down you are on the scale of importance in medicine, the bigger you are as a pain in the ass...the more important you think you are.....the more you think you know. Graduate med students don't have the corner on intelligence or manners.
Sorry that you.......Hell, why am I apologizing? You come to OUR forum and slam PA's.....I for one am absolutley for opinions and sharing comments and ideas but I have reached my limit with your comments about Physicians Assistants....level of education....capabilities...comparing to MD's/DO's......it really seems to matter only to you. The rest of us just plain don't like someone coming into our home and being rude.....

'nuff said

Gotta little outta hand didn't I?........sorry

Bob

Bob
 

Bandit

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wow, those are pretty tough quotes. "Well nancy, I just cant seem to wait" -- what was he/she waiting for? Not the point however. Just checking in to read more of this dribble. It is wens. and I have worked 42 hours already this week and have not even seen a physician yet. Hmmm, no final decisions here! Guys, lets give ole freedom here a break -- I too have felt the demands of sleep deprivation!! (either that or I really am wrong -- just young I supose)

PS: did someone say that those quotes were from a year ago? I would love to read that thread. Where might I find it? Please tell me that freedom has not SAVED it!!?? All this time??
 

Freeeedom!

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No it wasn't from a year ago!
I saved it because to threaten someone via internet, phone messages, or in person is against the law...why would I erase evidence? If someone said they were going to come and find you and beat you...would you shrug your shoulders and say "hmmmm, no biggee". We live in a time when less has been said and forgotten, and wammo...we got a body in the woods. If you guys were married (perhaps you are), and this guy found you and called your home and your wife picked up...knowing these threats existed over SEVERAL days...what would you do? Dismiss them??

As for not seeing a doc in several days...not my license...there are lawyers waiting for a chance at that cash cow. And I highly think bragging about unethical practices such as that (you are violating the law correct?) is not anything to be proud of. Because you are by yourself hardly justifies independent practice...and needs no reply.
 

CVPA

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Oh, give me a break. There is no way that Smedley could have found out who you are and where you live based on a made up name that you use on SDN. You don't even post your email address so he couldn't have tracked that even if he wanted or had the ability to. Plus, Smedley was all talk. He was just another PA who was pissed off by your usual antagonistic and condescending "I'm the chosen one, because I am a medical student" mantra. Yes, he went off the deep end and took it way too far, so don't think for a moment that I codone his actions. Take a valium and relax, Skippy, I doubt hes coming after you.

You know, it got me thinking a bit about that ugliness that went down last year (as in 2001). You would think that someone like yourself, who obviously took him seriously, would have stopped, stepped back and looked at how you may have contributed to that situation. Did you ever do that, Freedom? Did you ever think that maybe, just maybe, you had something to do with that situation getting out of hand and that maybe you might want to change the way you interact with people on this website?

Naaaaaa.....what was I thinking?
 

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What a strange response CVPA...
Hmmmm, this is a goofy message board. If anyone gets so ENRAGED that they threaten someone with violence...you are saying it isn't THEIR fault? What?? This character had some obvious problems and to blame FREEDOM for speaking his mind and not backing off...is ridiculous.
Any threat should be taken seriously...any threat. ESPECIALLY if they given repeatedly via private email.
My friend, a few years ago ON THIS SITE, my password was stolen (how, I don't know) and my displayed name was on all sorts of silly comments.

Who is being naive? Would you rather take a threat seriously or not?

Personally, I also feel very lucky and priviliged to be called "doctor". It has been a long time coming and still a long road ahead...I too was a PT prior to med school, and instead of lobbying to expand my practice rights, I went to med school. Bandit has said some pretty goofy things over time, don't blame freedom for calling him out. And I would hope threats would never be used to tell people to "back off"...but if that is how you work CVPA...
 

MrBob

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I think the comments sent to Freedom were complertely out of line no matter what the intention or insinuation. I am squarley on his side about this issue. I wnated to make that clear. It embarrasses me to think one of our own would resort to such low settings. Such an individual,in my opinion, should be banned from the site. Who are our moderators????How does one become one? This is supposed to be a professional group of people and we should carry ourselves in such a manner no matter how much we disagree.

I disagree with much of Freedoms presentation and attitude, but this is an open forum and all should be entitled to their opinions without fear of reprisal.

I wanted to go on record about this subject.
 

CVPA

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Clown Guy:

Do you have some sort of sort of reading disorder? I suggested that maybe Freedom CONTRIBUTED to the situation. How you translate that into me asserting that Smedley was faultless, is beyond me. What I am saying is that it takes two to tango on a discussion board. I remember those series of posts and Freedom made some threats too, after Smedley initiated it. They were not to the same extent as Smedley, I'll give Freedom that, but he did contribute to the escalation. To say that he was just "speaking his mind", is a total downplay and misrepresentation of what happened.

I also said that I don't codone what Smedley did and, like Mr. Bob, I want to make the point painfuly clear that what Smedley did was completely wrong and his being banned was just. I am only suggesting that Freedom do a little self examination as to HOW it happened. IF he does and decides it was all Smedley and he was just an innocent bystander expressing is opinions, then fine. On the contrary, if he decides that he may have contributed to the escalation, then maybe it will serve him on a personal level.

By the way Clown Guy, I am so happy that you feel "priviliged" to be called a doctor. Maybe someday, doctor, you'll even learn to spell like one. :D
 

rdennisjr

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MrBob:

Just FYI - the poster who is being discused was banned from SDN once the moderators were made aware of the situation.

Dennis
 

Emedpa

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freeedom - in most states bandit is working well within the law. the standard in most states is that an md/do review a percentage of charts within 1-4 weeks. in oregon the requirement is 10% of charts within 30 days. there is actually no requirement in any state that I know of that says a physician must see any of a pa's pts. it just works out that we tend to consult on the tough cases and they sometimes give the pt a second exam in addition to offering advice .I work side by side with board certified ER docs every shift. I probably talk to them about 2-3 pts a shift out of 30, of which they actually re-examine 1. many experienced rural pa's(like mr bob or bandit I imagine) simply send their charts off to their supervising md/do who reviews them without ever coming to the practice. a good supervising physician will give feedback to their pa and tell them" you need to order a ct to follow this up, or you forgot that this 50 year old guy needs a DRE at his yearly physical", etc. hopefully, the pa then goes back and remedies their oversight by ordering the needed test or consult, etc.
the whole pa/physician interaction does not work if the md/do is unwilling to offer constructive criticism and feedback. this is not meant to flame anyone or to imply that pa's can or should work independently of supervision, be it on site or indirectly as described above. let's all stop bickering shall we. everyone has something positive to offer here. " why can't we all just... get along"-E
 

Freeeedom!

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CVPA, you really have no idea how the whole personal message situation went down...I suggest you "hush" at this point. It really wasn't fun, and after reflection of the FIRST PM, I began to be a little alarmed. The second frightened me.
Unfortunately, the moderator of this board did not proceed with the appropriate action quick enough and I went to the "head honcho".
This is neither here nor there.

First, I would like to say sorry for upsetting many of you. I have really come to like Mr. Bob, and I think (from this small venue) he is a really nice human being and I would be lucky if I could ever call him "friend".
Secondly, please do not misinterpret my pride and honor for my profession...I feel truly lucky to be welcomed into the brotherhood/sisterhood of physicians. I hope you all accept my apology and I wish you all a wonderful and fulfilling career.

Take care.
Capt. Freedom
 

CVPA

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Capt. Freedom:

When a man can apologize in the middle of a flame war, it says a lot for his character. It appears I have underestimated yours. Kudos.

I certainly did not mean to make light of your incident. Smedley emailed me a couple of times after the incident and I can tell you that he genuinely felt bad about it and apologized to me for letting himself get out of line. Hopefully, he apologized to you. I can also tell you that you never were in any real danger, although you had no way of knowing that. Anyway, as you said this really is neither here nor there.

Good luck to you and your career.
 

Bandit

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"(you are violating the law correct?)" wow, you really are misinformed as to the practice of PA`s. I simply have to laugh at this point.

As for your last post, I knew you just needed some sleep.

Noone here condones violence in any form.
 

PACmatthew

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Well I gotta tell you, I have come to like all you guys a lot. I look forward to reading what each of you has to say even when it pisses me off. We do all have many things in common and let me help jog everyone's memories what these things are.

1) We all want to see patients get great healthcare.

2) We are all Americans and Americans really need to stick together these days.

3) If the the world doesn't cool down soon, we just might find ourselves working side by side in a Canvas tent soon, in a place far away from here.

Then there won't be any of this foolish pride and rhetoric. Hell, I don't even think it would take a war to get us all to like each other, I think it would be as simple as us all getting together face to face and sharing some beers. If one could measure the level of testosterone one secretes while sitting at a keyboard I would wager to say that it is significantly different than face to face meetings. This stupid screen takes the humanistic side of communication away and we all become a screennames.

Does anyone remember how they felt when they saw the Trade Towers burning on live TV? Do you recall how everyone was really nice to each other for a few weeks after that? I recall even longer traffic jams in my neighborhood because people were actually overpolite at the four way stop, allowing everyone to go before them. Though I hated to see the tragic event unfold, I felt like it brought most people back to a place where they valued life and those around them. Now, in the wake of new threats against our country, many of us have fallen right back into the same old habits of being less than caring about our actions and attitudes.

Let me step up and be the second to say that I hope I can be a little more reasonable in my replies. I can't promise that I will be able to do this on the chiropractic posts, but I will even try there.

God bless all you guys, even HappyClown.

Later.

Matt
 

MrBob

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Freedom............

We are friends......no doubt about it...we just disagree occasionally. Hell, I disagree with my wife often and LOVE her. (I just get "cut off" if I do it too often, LOL)

I really would like to know you better and help you overcome some of your understandable anxieties about PA's and the percieved risk to your license. I firmly believe that one day you will meet one , partner up with him/her and have a better understanding of our role in a liberal PA state.

Until then...................

Buy your next cold one and I'll owe you the$$ for it.
 

oldman

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wow, my original post seems to have set off some fireworks! sorry to get you guys all riled up. hopefully you'll all make peace even if you agree to disagree.

thanks for the info about the comparison of Nurse Practioners to Physician Assistants.
 

JasonDO

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I really don't understand what all the arguing is about. Docs and PAs work together in a team effort to provide care for the patient. There are holes in everybody's knowledge. Nobody is all knowing or has all the answers. Medicine is a life long learning process where every health care worker has a role in treating the patient.

Even if the aforementioned patient is a drunk alcoholic who woke you up at 3:34 AM because he started vomitting blood...lol
 
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