Interesting! What a PA makes....Parade Magazine

[SupergreenMnM]

Let's face it: A PA is a different career than a physician, but I really don't know how a PA can claim they don't want the job of a physician when what they do is so similar. .

About as similar as a paramedic and a doctor, or a CNA and an RN. Yes they are both in health care but they practice at very different levels.

I believe the reason a person would go to PA school is simply a matter of time (2 yrs v. 4 yrs + residency). I think if a student said to me that they didn't want to be a physician or the job of a doctor, but a PA instead, I might have some questions about what they new of the PA profession.

They SHOULD be going in because they want the job of a PA, if they haven't done their research and figured out what that is they are sorely unprepared. As I've said before, anyone going to PA school because they think it will be "just like a MD" or "almost the same as what the MD does" will be sorely disappointed.

I also think it would be natural for a PA to want more autonomy as they developed their skills and is usually delegated once the supervising physician feels comfortable with the PA. At least that's my understanding.

I agree with this, its natural. That said experience only gets you so much w/o formal training and education. The skills they are developing and improving are their PA skills, not skills they never learned by not doing medical school and residency, so the MD that works with them will become more comfortable with their competence as a PA, not by allowing them to do things outside their scope.

I also think it's fairly natural and common in any profession to lobby and develop support for higher salaries. I think PA's make a comfortable living (you describe it as bragging), but also may be able to make the case that they are worth more than they are paid from the business perspective of healthcare.

Agree with the first but not the second, I think most people in the healthcare industry are paid about what they should be, with the exception perhaps of familiy med/general IM/peds, and the possibility of some nursing midlevels being overpaid because they fill the spot of a more skilled provider that the locality can't afford.

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[lawguil]

So wait, now you are saying a PA is the same job as a physician?Also, I often question the motives behind some of your posts, as I have debated with you before and you often claim things aout many things you have no experience with.
I am not putting down PAs at all, some are really great. BUT they are not MD/DOs, and when going into the field they really need to decide...do I want to be a doctor, then go to medical school; if not, then go to PA school. It is their choice. I am going to defend my future profession just like anyone else, so I don't know what to say about that. If someone wants an MD/DOs job, they should pick up and go to medical school.

No! I clearly said that they are similar. I think it's reasonable to beleive that the average PA would find the profession of a MD/DO appealing and might even pursue it if they were a competitive candidate or could make the sacrafice. How as a PA could they want to go to PA school and also say they don't have an interest in medicine! The fact is they both practice medicine! A physician assistant is the extension of the physician.

Although PA's don't learn material to the depth of a physician or have equivalent clinical educations, the material that they do study is similar and the jobs that they perform on a daily basis is similar.

My words exactly were:
"I think if a student said to me that they didn't want to be a physician or the job of a doctor, but a PA instead, I might have some questions about what they new of the PA profession. "

I clearly recognize the differences, however, I don't think that you are recognizing the similarities of the two DIFFERENT professions.

It amazes me how people in any health related vocation like to inflate how educated they think they are!

So No, I WAS NEVER SAYING THAT A PA IS THE SAME JOB AS A PHYSICAIN.

I'm certainly not in a position to say that and most certainly, you're not in a position to say that I said it!

 

[Noeljan]

No! I clearly said that they are similar. I think it's reasonable to beleive that the average PA would find the profession of a MD/DO appealing and might even pursue it if they were a competitive candidate or could make the sacrafice. How as a PA could they want to go to PA school and also say they don't have an interest in medicine! The fact is they both practice medicine! A physician assistant is the extension of the physician.

Although PA's don't learn material to the depth of a physician or have equivalent clinical educations, the material that they do study is similar and the jobs that they perform on a daily basis is similar.

My words exactly were:
"I think if a student said to me that they didn't want to be a physician or the job of a doctor, but a PA instead, I might have some questions about what they new of the PA profession. "

I clearly recognize the differences, however, I don't think that you are recognizing the similarities of the two DIFFERENT professions.

It amazes me how people in any health related vocation like to inflate how educated they think they are!

So No, I WAS NEVER SAYING THAT A PA IS THE SAME JOB AS A PHYSICAIN.

I'm certainly not in a position to say that and most certainly, you're not in a position to say that I said it!

 

[lawguil]

About as similar as a paramedic and a doctor, or a CNA and an RN. Yes they are both in health care but they practice at very different levels.


They SHOULD be going in because they want the job of a PA, if they haven't done their research and figured out what that is they are sorely unprepared. As I've said before, anyone going to PA school because they think it will be "just like a MD" or "almost the same as what the MD does" will be sorely disappointed.

Perhaps you can explain your response in more detail. I don't understand the analogy you have made.

It appears to me (perhaps I am wrong) that you are inflating the difference b/t a physician and a PA.

In most states, PA's practice with general supervision from the physician. The supervision typically consists of chart review x number of times a year. As I understand it, PA's are scheduled with patients who have new complaints and/or continuing care and evaluate, diagnose, treat, refer and/or consult as needed. Is this really drastically different than the job of a physician.
As I understand it, MD's case loads may consist of the more interesting and complex cases. Physicians are also more likely to be business owners and thus have business like responsibilities. Also, the physician represents the final decision maker for his patients and the patients that his extenders see.

I'm not convinced that the disparity b/t the two are that different. Neither does the physician who is sitting beside me right now and I'm not a PA so he doesn't have to sugar coat his opinion of the PA profession. Also, he wants to me to let you know that if he were to do it over again today, he would go to PA school instead of DO.

 

[SupergreenMnM]

Perhaps you can explain your response in more detail. I don't understand the analogy you have made.

It appears to me (perhaps I am wrong) that you are inflating the difference b/t a physician and a PA.

In most states, PA's practice with general supervision from the physician. The supervision typically consists of chart review x number of times a year. As I understand it, PA's are scheduled with patients who have new complaints and/or continuing care and evaluate, diagnose, treat, refer and/or consult as needed. Is this really drastically different than the job of a physician.
As I understand it, MD's case loads may consist of the more interesting and complex cases. Physicians are also more likely to be business owners and thus have business like responsibilities. Also, the physician represents the final decision maker for his patients and the patients that his extenders see.

I'm not convinced that the disparity b/t the two are that different. Neither does the physician who is sitting beside me right now and I'm not a PA so he doesn't have to sugar coat his opinion of the PA profession. Also, he wants to me to let you know that if he were to do it over again today, he would go to PA school instead of DO.

I think you are making a comparision between a PA and a family medicine doctor (or more accurately, the old general practitioner). There is a VAST difference between what a PA does, and say the typical radiation oncologist, the typical trauma surgeon, the typical neurologist, the typical vascular surgeon, etc etc. As to how similar to PAs job is to the general practitioner I think that largely depends on the GP, as to where he is and what he does...if he chooses to only do a limited number of things thats his choice but to compare the scope of practice of a PA to an MD shows a misunderstanding of the PA scope of practice.

I'm sorry your friend does not enjoy his career choice. I know others who have been in medicine for decades and feel just the opposite...I guess it just depends on what you want out of your career. I have no bias one way or the other either as my original training is as a PhD, but I also know many PAs and understand the limitations of their scope of practice. We actually have a PA in the class of '10 that is getting his MD simply because he wants to practice at a higher level.

 

[lawguil]

I think you are making a comparison between a PA and a family medicine doctor (or more accurately, the old general practitioner). There is a VAST difference between what a PA does, and say the typical radiation oncologist, the typical trauma surgeon, the typical neurologist, the typical vascular surgeon, etc etc. As to how similar to PAs job is to the general practitioner I think that largely depends on the GP, as to where he is and what he does...if he chooses to only do a limited number of things that’s his choice but to compare the scope of practice of a PA to an MD shows a misunderstanding of the PA scope of practice.

I'm sorry your friend does not enjoy his career choice. I have been in medicine for decades and feel just the opposite...I guess it just depends on what you want out of your career. I have no bias one way or the other either as my original training is as a PhD, but I also know many PAs and understand the limitations of their scope of practice. We actually have a PA in the class of '10 that is getting his MD simply because he wants to practice at a higher level.

Your point is well taken and also valid in my opinion. Clearly, PA's don't perform surgery and thus can't be compared in that respect. Thus, the difference is vast. I would say that the pre and post operative care is often handled by the PA or as a collaborative effort b/t the PA and MD, but I agree in the specialty area's, the practice is different.

However, my opinion still stands that in the primary care specialties, the job is similar.

My friend is a family physician and he doesn't seem to think there is a big difference b/t what he does and what the PA in his practice does. He is our team physician. His practice is very broad and he says that the PA he used to supervise mirrored what he did in practice including procedures and complexity of patients.

I'm an associate professor in an exercise science department at a competitive college in the NE. I'm also part of a committee of pre-professional advisors and also serve as a per-diem athletic trainer in our athletics department. Obviously, I can't speak with the experience that you seemingly have. I do interact with medical school programs, physicians, and attend conferences and continuing education workshops for advisors. Accurate or in-accurate the general consensus that has been exacted on me is that a PA is probably the closest thing to a physician (MD/DO). Even more so than a DDS/DMD or DPM. It isn't uncommon now for pre-professional advisors to group MD/DO/PA together when speaking about careers in medicine. Again, it appears from my perspective, that medical schools and even the AMA, consider these three different professions to be very similar. Also, as I understand it, the AAPA is hell bent on maintaining the profession of a PA as a dependant practitioner. Again, as my disclosure, my vision doesn't extend beyond pre-professional advising.

 

[lawguil]

Your point is well taken and also valid in my opinion. Clearly, PA's don't perform surgery and thus can't be compared in that respect. Thus, the difference is vast. I would say that the pre and post operative care is often handled by the PA or as a collaborative effort b/t the PA and MD, but I agree in the specialty area's, the practice is different.

However, my opinion still stands that in the primary care specialties, the job is similar.

My friend is a family physician and he doesn't seem to think there is a big difference b/t what he does and what the PA in his practice does. He is our team physician. His practice is very broad and he says that the PA he used to supervise mirrored what he did in practice including procedures and complexity of patients.

I'm an associate professor in an exercise science department at a competitive college in the NE. I'm also part of a committee of pre-professional advisors and also serve as a per-diem athletic trainer in our athletics department. Obviously, I can't speak with the experience that you seemingly have. I do interact with medical school programs, physicians, and attend conferences and continuing education workshops for advisors. Accurate or in-accurate the general consensus that has been exacted on me is that a PA is probably the closest thing to a physician (MD/DO). Even more so than a DDS/DMD or DPM. It isn't uncommon now for pre-professional advisors to group MD/DO/PA together when speaking about careers in medicine. Again, it appears from my perspective, that medical schools and even the AMA, consider these three different professions to be very similar. Also, as I understand it, the AAPA is hell bent on maintaining the profession of a PA as a dependant practitioner. Again, as my disclosure, my vision doesn't extend beyond pre-professional advising.

I think this scenario is worth considering as well.

I know a physician assistant who has several supervising physicians and practices in a wide range of specialties. I would say that his scope is quite broad. He works in the ER/Urgent care, ortho 2 x week and multi specialty surgical assisting. As an outsider, to me, this would be an interesting and stimulating career. Also consider this same PA use to work in family medicine for several years and worked in oncology his 1st year out of college. His knowledge is considerable and is certainly respected by me.

Clearly you can make the case that he doesn't have the depth of education in any one specialty, but I say that about physicians all the time. I'm very research oriented and I’m not typically impressed by anyone's depth of knowledge in healthcare. They're trained as practitioners, not scholars.

 

[Noeljan]

I think this scenario is worth considering as well.

I know a physician assistant who has several supervising physicians and practices in a wide range of specialties. I would say that his scope is quite broad. He works in the ER/Urgent care, ortho 2 x week and multi specialty surgical assisting. As an outsider, to me, this would be an interesting and stimulating career. Also consider this same PA use to work in family medicine for several years and worked in oncology his 1st year out of college. His knowledge is considerable and is certainly respected by me.

Clearly you can make the case that he doesn't have the depth of education in any one specialty, but I say that about physicians all the time. I'm very research oriented and I’m not typically impressed by anyone's depth of knowledge in healthcare. They're trained as practitioners, not scholars.

Actually, specialist physicians do just that, they specialize in a specific area, often in many specialties having done research/published. I guess physicians can say that about you then, you don't have the depth or knowledge to do their job, obviously most wont have that to do yours.

 

[lawguil]

I think the word assistant is used to denote that its a mid level position, while associate implies a professional equal. That said I agree with the part about the 's, though for the very hot PA I know I really really wish it was a 's.

Associate does not imply equal in the context that it would be used as in the title physician associate! By definition, it clearly defines a subordinate role!

http://dictionary.reference.com/browse/associate
11. a person who is admitted to a subordinate degree of membership in an association or institution: an associate of the Royal Academy.
–adjective 12. connected, joined, or related, esp. as a companion or colleague; having equal or nearly equal responsibility: an associate partner.
13. having subordinate status; without full rights and privileges: an associate member.
14. allied; concomitant.

http://www.wordreference.com/definition/associate
C adjective
1 associate(a)

having partial rights and privileges or subordinate status; "an associate member"; "an associate professor"


L.

 

[lawguil]

Actually, specialist physicians do just that, they specialize in a specific area, often in many specialties having done research/published. I guess physicians can say that about you then, you don't have the depth or knowledge to do their job, obviously most wont have that to do yours.

Other than the MD's/DO's who underwent a MSTP, they aren't widely known for the scholarly achievements or for quality research.

"Actually, specialist physicians do just that, they specialize in a specific area"

To practice in a specific area is more accurate! Hardly scholarly!

 

[Noeljan]

Other than the MD's/DO's who underwent a MSTP, they aren't widely known for the scholarly achievements or for quality research.

"Actually, specialist physicians do just that, they specialize in a specific area"

To practice in a specific area is more accurate! Hardly scholarly!

Ok you win,
physicians have no significant scholarly achievements. PA's are MD/DO equal and should make more money. MD/DO are nothing more than robotic clinicians, with lackluster educational achievements. If you are an MD/DO with education before med school it doesn't count, however for people like you for some reason it does, and in fact makes you that much more qualified to comment and designate about careers you have no idea about (ps having people sitting next to you who are docs dont count). Oh I forgot, it is also up to you to designate what a real degree is (I remember debating with you about NP education a while back, you claimed NPs were uneducated idiots basically and I defended them. You also claimed they didn't go to graduate school or something like that).
Oh another PS this is not an English lesson, and quoting online dictionaries don't help. You were never a nurse, CNA, NP, PA or MD/DO but yet you often claim supreme authority on all of them, based on personal interactions, lol. Then when someone else claims something based on experience you have a heart attack (I remember you saying you didn't like NPs based on a personal interaction with like two NPs)
whateva you are being silly.

 

[lawguil]

Ok you win,
physicians have no significant scholarly achievements. PA's are MD/DO equal and should make more money. MD/DO are nothing more than robotic clinicians, with lackluster educational achievements. If you are an MD/DO with education before med school it doesn't count, however for people like you for some reason it does, and in fact makes you that much more qualified to comment and designate about careers you have no idea about (ps having people sitting next to you who are docs dont count). Oh I forgot, it is also up to you to designate what a real degree is (I remember debating with you about NP education a while back, you claimed NPs were uneducated idiots basically and I defended them. You also claimed they didn't go to graduate school or something like that).
Oh another PS this is not an English lesson, and quoting online dictionaries don't help. You were never a nurse, CNA, NP, PA or MD/DO but yet you often claim supreme authority on all of them, based on personal interactions, lol. Then when someone else claims something based on experience you have a heart attack (I remember you saying you didn't like NPs based on a personal interaction with like two NPs)
whateva you are being silly.

This may be your finest post yet.... it lacks composure, substance, authority or any trace of intellect. You've managed to elude it all. A fine piece indeed. L.

 

[Noeljan]

This may be your finest post yet.... it lacks composure, substance, authority or any trace of intellect. You've managed to elude it all. A fine piece indeed. L.

haha whatever you say buddy, you make me laugh

 

[deleted87716]

Remember, guys...the ad hominem attack usually means that you're losing the argument. Don't be a loser.

 

[SupergreenMnM]

Remember, guys...the ad hominem attack usually means that you're losing the argument. Don't be a loser.

SupergreenMnM runs outa the thread to avoid getting any dirt on the prestine candy shell.

Actually, my response will have to wait a bit till I'm done with the mountain of reading that was dumped on my desk this afternoon.

 

[Beau Geste]

"Whose assistant are you? The physician's."

uh, no
I don't belong to them.
I work with them. I can work without them present. in fact I can work without ever seeing them at all. we have to have a relationship that offers minimal oversight via chart review or other means(in my state this relationship is refered to as "sponsorship" ).
I never "assist" as I don't work in the o.r.
it's the current name of our profession and one of the problems with the profession.
physician associte works much better but as david said only 3 programs that I know of give this title(his two and stanford) and only 1 state uses the title frequently(ct).

why is this such a difficult concept for people?
's=possessive which is very insulting. might as well say doctor's little helper.
it's the difference between a medical assistant and a clinician with a graduate degree and in most cases 8- 10 yrs of post high school education when you consider prior medical training+ bs+pa school.

associate will never work as long as you require legal supervision. Seriously, you need to get over this hang-up.

 

[Beau Geste]

Maybe we should get back to the original topic of the thread --- if lawguil and MnM want to bicker they can PM each other.

 

[lawguil]

associate will never work as long as you require legal supervision. Seriously, you need to get over this hang-up.

Why does "associate" have anything to do with legal supervision?

Should we call respitory therapists, physical therapists, and the like "physician assistant" because they might require legal supervision from a physician?

You do understand that assistant and associate are synonyms.
The meanings are nearly identical.

http://thesaurus.reference.com/search?q=assistant&start=11

I agree that PA's don't do much "assisting" to the physician. They are subordinate or recieve general supervision from a physician(s). There is a difference in my opinion.

 

[Beau Geste]

The only definition I'm concerned with is the scope of practice. The bottom line is that PAs are not equal in job duty to physicians. Yes, it's a different job, but the position of PA was created due to lack of physician primary care. So the PA position is unique in that it is intricately tied to the Physician, but will never overtake the Physician in scope of practice. There are PAs that have relative autonomy as far as minimal consultation and chart signing, but it is always the Physician's butt on the line as a supervising body when a PA screws up.

Even if a PA has the opportunity to buy into a partnership, it does not make the scope of practice equal. It just means they have a legal stance to profit from the business as a whole, not just from the work they do.

This thread is not about your hang-ups about the semantics of your title. If you're really that concerned about it, complain to your governing body. It won't do much good here except to release steam and get in a bickerfest with people from other professions. SDN is really trying to keep threads from going off topic (although I confess to taking bait now and then) and most importantly, keeping threads from being closed. All members have the right to post legitimate questions, and it's great when threads can build from many different perspectives adding to the topic. It's not great when threads degenerate because of the same-old arguments replayed over and over.

But, if you wanted to create a thread about how other PAs feel about the title "Physician Assistant", be my guest. But also keep in mind others might respond in ways you don't like and it will be moderated, as all the threads are (thanks to KentW ).

I hope you realize I have a lot of respect for PAs. I prefer to call a spade a spade though and not make more of what is really there. I've been in your situation with job title and even been somewhat harassed by other SLPs because I refer to our profession as "speech therapist" sometimes because it's less of a mouthful than "speech-language pathologist". I'm not really worried about semantics - I've got way more to worry about than that, like doing my job the best I can.

 

[deleted6669]

for what it's worth the original name of the profession was physician's associate and it got changed to physician's assistant to appease the ama who felt threatened.later the 's was officially dropped.
http://www.pahx.org/artifacts/registryArtifacts.htm
I never refer to myself as a physician assistant but as an "emergency medicine pa". after 40 yrs pts should now what a pa is.....they have figured out np which has been around for less time after all......
your scope of practice arguement is very weak.
a lot of pa's do in fact have the same scope of practice as the majority of the docs they work with. this is true in almost all primary care and em practices. we are sponsored or supervised depending on the state by a single md/do, not all docs in the practice. unless I am sitting next to my sp(which happens maybe 4 times/yr) the doc sitting next to me has no more authority over me than I do over them. they don't review my charts and have no say in how I practice. my actual sp has told me in the past that he does not believe senior pa's should need chart review. it is only done in our practice to decrease malpractice rates(they give us a better rate if docs sign some charts) as it is not a state requirement. my sp does not even read my charts, he just stamps them. if I ever have a question he has to pull the chart and read it for the 1st time.
in subspecialty medicine and surgical practices there is more of a difference.
I am scheduled interchangeably with docs where I work. if they are sick I cover them. if I am out they cover me. same pt load and expectations. our shifts are filled by whoever has availability not by provider type. pa's cover 24/7 with a single doc on day shift only to do admin work. if that doc is sick a pa can fill that shift. sure the docs know a lot more cell biology and embryology than I do but when it comes down to it we treat pts exactly the same way. the senior docs know more than I do about em and I know more than some of the junior docs who are fresh out of fp residency.
I find it interesting that you believe a crna can match the experience of an md anesthesiologist over time as you have stated elsewhere but you refuse to allow pa's the same courtesy of learning skills on the job over time. maybe some of that crna/np political bs is rubbing off on you so that you suddenly think a pa's graduate degree isn't worth the same as graduate degrees earned by other non-md health care professionals......hmmmmm.....
unless you are a pa you really have no place commenting on our title. how would you like it if we also started refering to slp's as "speech aides" or "swallowing coaches" or "rehab techs"? doesn't really reflect your level of experience, does it.....please as a common courtesy respect us by using our title appropriately and understanding why the the 's concept is incorrect.

see this other current thread on the same topic:
http://forums.studentdoctor.net/showthread.php?t=393607

 

[Beau Geste]

I find it interesting that you believe a crna can match the experience of an md anesthesiologist over time as you have stated elsewhere but you refuse to allow pa's the same courtesy of learning skills on the job over time. maybe some of that crna/np political bs is rubbing off on you so that you suddenly think a pa's graduate degree isn't worth the same as graduate degrees earned by other non-md health care professionals......hmmmmm.....
unless you are a pa you really have no place commenting on our title.

Wow. As far as the CRNA issue, if you've read my other posts, you know there's one in my family. And I've shadowed him for at least 20 years in the OR. Not only that, but you generalized my exact feelings on CRNA vs. MD. Oh, and I've also got an FP MD in my family that has a PA on staff, and I've been shadowing her for 10 years off and on and I've seen firsthand what a PA can and can't handle based on training + knowledge. Yes, in some aspects they do the same thing, but there are other situations where a CRNA or PA or NP is just not enough to do the job a physician does. Sorry you don't like it, but go to med school if you want full medicine privelages. I've said that in the past, and I'll keep saying.

Your argument that I'm not a PA so I can't comment on the title is extremely weak. You're not a physician - does that mean you can't comment on physician topics?

how would you like it if we also started refering to slp's as "speech aides" or "swallowing coaches" or "rehab techs"? doesn't really reflect your level of experience, does it.....please as a common courtesy respect us by using our title appropriately and understanding why the the 's concept is incorrect.

SLPs wouldn't be referred to as speech aides. When it comes to speech and language, SLPs are the "doctor" and speech aides are the "PAs" so to speak. There's a definite line drawn in the scope of practice (aides can't perform assessments, do treatment plans, modify plans, or do swallowing therapy for starters) and, well, at least for our profession, we feel it's necessary to actually supervise our speech aides (each aide must be supervised for each on-going client or about one work week per month in Early Intervention in IL), and the law agrees with us in the states where speech aides are allowed to practice. Rehab techs aren't allowed to treat speech/language patients. Besides, it says on my business card and my treatment notes who I am, and since I own the business people generally don't mistake me for an aide.

But, this conversation has inspired me to think about hiring one or two.... What they ARE allowed to do I can hire out for 1/4 the cost it would to have me do the therapy

So, your analogy is a bit off and maybe you should do your homework before you think you can get me riled up about someone mistaking an SLP for a "speech aide". I would probably correct someone, but I wouldn't get my panties in a bunch about it.

 

[Beau Geste]

Also emedpa,

if there's anything else I failed to address that you would like addressed, please let me know. Your text is extremely hard to read without indentation, capitalization, and consistent punctuation.

I thought I would let you know that I tend to skim over your text because of that.

 

[deleted6669]

"I hope you realize I have a lot of respect for PAs.
I prefer to call a spade a spade though "

me too. you can't stand the idea of anyone else practicing medicine at a high level who is not a physician. get over it. lots of us run practices and staff e.d.'s without ever seeing physicians at all. we do the same things in the same order as the docs who work there on other days. that would be "the same scope of practice".
no we are not physicians. a quick look at our nametags and an introduction as a pa should make that clear.
you don't like or respect pa's. don't pretend that you do.

"I've also got an FP MD in my family that has a PA on staff, and I've been shadowing her for 10 years off and on and I've seen firsthand what a PA can and can't handle based on training + knowledge. "

you know the limitations of 1 pa in 1 clinical setting. guess what? maybe some of us are smarter or more invested in ongoing clinical education that your 1 pa contact......we are not all pa robots, there is some variability out there in experience and competency, just like among physicians or any other group of professionals.
I frequently exceed my cme allowance in order to better myself as an emergency medicine clinician. this year I will spend a few thousand dollars out of pocket for courses not required by my work but which I feel will help me serve my pt population better. most of these by the way are "physician level courses" in critical care, trauma, advanced airway management, etc and guess what? I always end up scoring in the top 10% of each of these courses when exam time comes around.

"I would probably correct someone, but I wouldn't get my panties in a bunch about it."
you would if you got called a swallowing coach regularly and asked when you were going to be "a real swallowing doctor".

 

[PhysioMan]

Also emedpa,

if there's anything else I failed to address that you would like addressed, please let me know. Your text is extremely hard to read without indentation, capitalization, and consistent punctuation.

I thought I would let you know that I tend to skim over your text because of that.

If this thread is too much for you feel free to throw in your hand. Besides, I believe you missed a few credentials in your profile...Oh wait, you're not a Physician either...

 

[Chronic Student]

This is just my (obviously not up to her standards) PA opinion.

Just let her say what she is going to say.

It is very obvious from her posts that she is anti-PA, no matter what she professes in her posts and the hate shines right through.

In fact, she is the major reason that I rarely post here anymore.

-Mike

 

[Beau Geste]

20 years of shadowing a CRNA, and 10 years of shadowing a PA? WTF?

Maybe it's time to do something else.

May dad is a CRNA and my mother is an FP MD. I've always had an interest in medicine, since I was little and they were and are great about letting me shadow (now when I visit)

 

[Beau Geste]

me too. you can't stand the idea of anyone else practicing medicine at a high level who is not a physician.

you are right about this. I guess I'm just old fashioned.

you don't like or respect pa's. don't pretend that you do.

that's your opinion. I know that I do. I've been seen by PAs for primay care stuff and totally fine with it. I wouldn't want one doing my cancer surgery when it was done though.

you know the limitations of 1 pa in 1 clinical setting. guess what? maybe some of us are smarter or more invested in ongoing clinical education that your 1 pa contact......we are not all pa robots, there is some variability out there in experience and competency, just like among physicians or any other group of professionals.

That's refreshing to hear.

"I would probably correct someone, but I wouldn't get my panties in a bunch about it."
you would if you got called a swallowing coach regularly and asked when you were going to be "a real swallowing doctor".

that's highly unlikely. I work in early intervention and there's not typically a swallowing case. If there is, it's pretty severe and I shy away from it because I don't feel comfortable handling those cases.

I don't think SLPs should do swallowing therapy anyway.

Are there "real swallowing doctors?"

 

[Beau Geste]

If this thread is too much for you feel free to throw in your hand. Besides, I believe you missed a few credentials in your profile...Oh wait, you're not a Physician either...

Hopefully I will be in about 5 years....

And this forum is not exclusive to PAs, despite what you believe.

 

[Beau Geste]

This is just my (obviously not up to her standards) PA opinion.

Just let her say what she is going to say.

It is very obvious from her posts that she is anti-PA, no matter what she professes in her posts and the hate shines right through.

In fact, she is the major reason that I rarely post here anymore.

-Mike

Exactly what have I said that's so anti-PA that you don't post here anymore? The fact that I have issues with what PAs should/should not practice? I have also written lots of good things about PAs but the attack squad seems to have overlooked them.

There are only a handful of threads I participate in this forum and you're telling me I ran you out??? You must have VERY thin skin.

And I thought you had finally made up your mind to become a CRNA or is that some other Mike?

Blah. I have an orgo exam to get to.

 

[Beau Geste]

20 years of shadowing a CRNA, and 10 years of shadowing a PA? WTF?

Maybe it's time to do something else.

Didn't you get thrown out of the Gas forums???

 

[Noeljan]

Exactly what have I said that's so anti-PA that you don't post here anymore? The fact that I have issues with what PAs should/should not practice? I have also written lots of good things about PAs but the attack squad seems to have overlooked them.

There are only a handful of threads I participate in this forum and you're telling me I ran you out??? You must have VERY thin skin.

And I thought you had finally made up your mind to become a CRNA or is that some other Mike?

Blah. I have an orgo exam to get to.

I agree with Megboo
Saying that PA's are not doctors, nor should they be given the same practicing rights, is not the same thing as being anti something. I am going to be a physician and I think PAs are great for certain things less malignant, but that is where I think the line should be drawn. The problem comes in when PAs think they should somehow be on the same professional level as the MD/DO. That is not right, or fair, and basically a slap in the face to physicians IMO to think otherwise. Like I said before, if you want to be a PA great, go to PA school. If you want to be a doctor, go to medical school.
Ok off to my last exam of graduate school ever in oncology and I couldn't sleep!!!! wish me luck

 

[lawguil]

First, Megpoo decides to express her opinion about the title of the PA (associate v. assistant)

"associate will never work as long as you require legal supervision."

Then proceeds with another convoluted answer with additional contradictions.

The only definition I'm concerned with is the scope of practice. .

This thread is not about your hang-ups about the semantics of your title.

I'm not really worried about semantics - I've got way more to worry about than that, like doing my job the best I can.

Naturally, rules and concepts only apply to others in other professions. I do have to admit, 30 years of combined shadowing experience in medicine is a mighty long time. Personally, whenever I've shadowed anybody, I usually get the gist of it in a fairly brief period of time. Hell wasn't there a day when physicians were trained on the job like a journeyman. Megpoo, you should probably be given a license to practice medicine…Gosh!

 

[Beau Geste]

First, Megpoo decides to express her opinion about the title of the PA (associate v. assistant)

"associate will never work as long as you require legal supervision."

Then proceeds with another convoluted answer with additional contradictions.




Naturally, rules and concepts only apply to others in other professions. I do have to admit, 30 years of combined shadowing experience in medicine is a mighty long time. Personally, whenever I've shadowed anybody, I usually get the gist of it in a fairly brief period of time. Hell wasn’t there a day when physicians were trained on the job like a journeyman. Megpoo, you should probably be given a license to practice medicine…Gosh!

So you're trying to lend credibility to yourself with personal attacks, now? Megpoo? Seriously? At least I have the decency to address what others bring up and not call names.

Have you even read my posts about why I have shadowed as much as I have? Because the medical field is fascinating to me and I've always wanted to pursue it. Unfortunately I wasn't able to do it when I was a traditional undergrad - cancer treatment sorta took priority in my life and I chose a field less demanding at the time. But that never stopped me from wanting to shadow and learn as much as I can.

There was nothing convoluted about my answer. My point was that being called an associate would probably not happen with MDs/DOs having to provide legal supervision. It implies equal standing as far as medical practice. Obviously others agree with me, otherwise PA wouldn't equal Physician Assistant.

My point about the scope of practice is that as far as I'm personally concerned, a PA could be called flaftryioners as long as they don't overstep their scope. As I've said before, I've got no hang-ups about seeing a primary care PA. How is that anti-PA?

 

[deleted6669]

"As I've said before, I've got no hang-ups about seeing a primary care PA. How is that anti-PA?"

because only about 1/2 of us work in primary care.
the rest of us find specialty medicine more interesting and have found a place there along with physicians. some of us work side by side with specialty docs and others work in specialty areas with very little oversight after extra training and years in practice learning the ropes from more experienced docs and pa's.
there are lots of additional educational avenues out there for pa's to gain specialty experience from residencies in almost every specialty-including oncology- ( see www.appap.org) to attendance at most physician level conferences and cme courses, including procedural medicine courses.
many specialty pa's focus on only 1 aspect of a specialty and know it inside out. the local health dept HIV expert around here is a midlevel provider. the premier headache clinic here is run by a pa who only does h/a medicine. neurologists refer their difficult h/a pts to this clinic.
several trauma and critical care residencies for pa's now exist that train pa's to run icu's and manage the sickest pts in the hospital. they take 1st call, they put in the chest tubes, a-lines, adjust vent parameters, etc without consulting with physicians until end of shift at sign out.
aside from running a surgery in the o.r. for the entire case there isn't much that a pa in this day and age can't legally be trained to do. pretty much any outpt procedure is up for grabs; treadmills, colonoscopy, colposcopy, fracture reduction, any derm procedure including mohs procedures, etc
sorry if you don't like it. it's happening now and will continue despite your personal feelings on the matter. don't trust pa's? don't hire one. let everyone else make the big bucks and have more vacation time while you see every pt in your practice by yourself at every visit and take call continuously by yourself.
but wait, I'm getting ahead of myself. you still need to pass the mcat and get into school.....

 

[Beau Geste]

but wait, I'm getting ahead of myself. you still need to pass the mcat and get into school.....

As you should know, there's no "passing" score on the MCAT. If my GRE scores are any indicator, I'll rock it. Thanks!

 

[Beau Geste]

sorry if you don't like it. it's happening now and will continue despite your personal feelings on the matter. don't trust pa's? don't hire one. let everyone else make the big bucks and have more vacation time while you see every pt in your practice by yourself at every visit and take call continuously by yourself.

You're right, I don't like how some PAs want to do away with a physician altogether, or at least talk like that's how they feel. And that's the vibe I get from a lot of the veteran PA posters here. You may perceive me as being anti-PA, but I also perceive you as anti-MD/DO.

I most certainly would hire a PA, but I don't know what field I'm going into yet! Let me "pass" my MCAT and get into med school first!

 

[deleted6669]

although there is no official "pass" score on the mcat there are ranges that are generally considered adequate to gain matriculation to medschool( I'm speaking of md here-there are a lot more variables in the DO process) and ranges that are not.
I think we can both agree that all else being equal(gpa, ec's, etc) 35 is a good score and 15 is not.
28+ gives one a reasonable chance of getting in somewhere and <20 pretty much sinks you unless you ran a clinic for orphans in a thrid world country for 10 years.
I wish you the best of luck on your mcat(honestly) and hope you gain an appreciation of what pa's can do for a primary care or specialty practice while in school. we are not the captain of the ship but work well as executive officers.
peace-e

 

[Beau Geste]

although there is no official "pass" score on the mcat there are ranges that are generally considered adequate to gain matriculation to medschool( I'm speaking of md here-there are a lot more variables in the DO process) and ranges that are not.
I think we can both agree that all else being equal(gpa, ec's, etc) 35 is a good score and 15 is not.
28+ gives one a reasonable chance of getting in somewhere and <20 pretty much sinks you unless you ran a clinic for orphans in a thrid world country for 10 years.
I wish you the best of luck on your mcat(honestly) and hope you gain an appreciation of what pa's can do for a primary care or specialty practice while in school. we are not the captain of the ship but work well as executive officers.
peace-e

Yeah, I'm pretty neurotic about the MCAT right now since it's less than a month away now. No one wants to bomb it, and being a non-trad it's especially important to do well.

My views on healthcare have changed already with the experience I've had and when I get to work side-by-side with PAs I may view things differently.

 

[Beau Geste]

Have you even read my posts about why I have shadowed as much as I have? Because the medical field is fascinating to me and I've always wanted to pursue it. Unfortunately I wasn't able to do it when I was a traditional undergrad - cancer treatment sorta took priority in my life and I chose a field less demanding at the time. But that never stopped me from wanting to shadow and learn as much as I can.

May dad is a CRNA and my mother is an FP MD. I've always had an interest in medicine, since I was little and they were and are great about letting me shadow (now when I visit)

Tired - These are my posts in response to the amount of shadowing I've done. I take it you haven't read all the posts in this thread.

 

[lawguil]

So you're trying to lend credibility to yourself with personal attacks, now? Megpoo? Seriously? At least I have the decency to address what others bring up and not call names.

Have you even read my posts about why I have shadowed as much as I have? Because the medical field is fascinating to me and I've always wanted to pursue it. Unfortunately I wasn't able to do it when I was a traditional undergrad - cancer treatment sorta took priority in my life and I chose a field less demanding at the time. But that never stopped me from wanting to shadow and learn as much as I can.

There was nothing convoluted about my answer. My point was that being called an associate would probably not happen with MDs/DOs having to provide legal supervision. It implies equal standing as far as medical practice. Obviously others agree with me, otherwise PA wouldn't equal Physician Assistant.
My point about the scope of practice is that as far as I'm personally concerned, a PA could be called flaftryioners as long as they don't overstep their scope. As I've said before, I've got no hang-ups about seeing a primary care PA. How is that anti-PA?

I honestly didn't intend to right "megpoo". In fact I really don't understand why it would be name calling as I don't know what the "Megpoo" would mean anyway. My apologies for the typo.

Also, associate physician vs. physician would NOT imply equal standings. It's quite the contrary. The name implies that the associate would be subordinate to the physician. It's similar to the assistant professor v. associate professor v. professor.

L.

 

[Chronic Student]

Originally posted by megboo:

Exactly what have I said that's so anti-PA that you don't post here anymore? The fact that I have issues with what PAs should/should not practice? I have also written lots of good things about PAs but the attack squad seems to have overlooked them.

There are only a handful of threads I participate in this forum and you're telling me I ran you out??? You must have VERY thin skin.

And I thought you had finally made up your mind to become a CRNA or is that some other Mike?

Blah. I have an orgo exam to get to.

Here are some quotes:

1. "Wow. As far as the CRNA issue, if you've read my other posts, you know there's one in my family. And I've shadowed him for at least 20 years in the OR. Not only that, but you generalized my exact feelings on CRNA vs. MD. Oh, and I've also got an FP MD in my family that has a PA on staff, and I've been shadowing her for 10 years off and on and I've seen firsthand what a PA can and can't handle based on training + knowledge. Yes, in some aspects they do the same thing, but there are other situations where a CRNA or PA or NP is just not enough to do the job a physician does. Sorry you don't like it, but go to med school if you want full medicine privelages. I've said that in the past, and I'll keep saying.

Your argument that I'm not a PA so I can't comment on the title is extremely weak. You're not a physician - does that mean you can't comment on physician topics?"

First off, in this post you seem to be genralizing the capabilities of all PA's based on one interaction. You also seem to be implying that all PA's want to do everything a doctor does. I know I sure don't! I agree with you about being able to comment on being a PA, even though you are not one. However, you have to admit that there are certain things that have more meaning when you're in a profession. For instance, when I was an EMT and people would call me an ambulance driver. Did they mean something bad by it? Probably not, but it was irritating.

2. "I'm not really worried about semantics - I've got way more to worry about than that, like doing my job the best I can."

You say that you don't care about semantics. However, you had a pretty strong reaction to physician associate vs. physician assistant and seem to think that it is trying to imply that we are equal to physicians. That is simply not true and it was one of the very first titles the PA profession used.

3. "associate will never work as long as you require legal supervision. Seriously, you need to get over this hang-up."

That seems a very definitive statement and just who is being antagonistic telling others to get over their hang-ups and at the same time you complain about others bickering.

4. "That's like me arguing over whether to call me a speech-language pathologist or a speech therapist. Either way, I still do the same damn job!"

Once again, using the word damn and an exclamation point seem unneccesary argumentative. Something you have dinged me for before.

5. "Sorry, but I agree with the bill. If you want to prescribe and perform complex procedures, go to med school."

It sounds to me like you think that PAs are not capable of grasping pharmacology. I take that as anti-PA, because it sound like you don't think PA are capable of grasping pharmacology and/or their limitations.

6. "Because NPs and PAs don't have enough training and didactic background to prescribe across the board. Even allowing NPs and PAs to begin prescribing antibiotics and such leads to issues of what can/can't they prescribe and the boundary lines wear thin, and eventually someone will get hurt by a well-meaning NP or PA."

There are many clinicians (MD's, PA's and NP's) who make Rx mistakes, it is not limited to the mid-level. In fact, if you write enough prescriptions you are going to make a mistake. I am very aware of my limitations and am extremely careful about writing prescriptions. The drugs that I write for the most, I know a lot about. If there is any question, than I will ask my SP or get on the phone with a pharmacist.

7. "So PAs in NY can prescribe all kinds of meds? And diagnose?"

You make broad, sweeping generalizations about what you think PA's can and can't do. However, it seems as if you don't know a lot about them. PA's diagnose and prescribe in most every state, if not all of them. In fact most can prescribe scheduled medications (III-V) and there are a number of states that allow them to prescribe schedule II.

8. "I don't mind prescriptions for birth control pills or similar drugs done by PAs, but they should not be prescribing serious medications. Now, just what are serious medications? Well, that would take a lot of sitting down with a Desk Reference and Drug journal to sort through, and since I haven't been to med school and spent +/- 4 years in a residency, I don't know much about medication and side effects and just what kind of training is necessary to be dealing out certain prescriptions."

Once again, you claim to know a lot about PA's and you think that we should not be allowed to prescribe serious medications. OCP's can be very serious medications, which goes to show that you don't have a very good grasp of pharmacology and are probably not the best person to comment on our ability to prescribe.

9. "I don't disagree with you there. It just makes me uncomfortable that PAs in most states can prescribe all meds after only a year of internship.

Overstepping boundaries for me is related to the, Hi I'm Dr. so and so, your PA. I should have been more clear.

If a PA is following their scope then I can't complain about that. I can have issues with the scope, though."

I have never personally heard a PA refer to themselves as a doctor. Does it happen, I'm sure it does. However, most of us go to great pains to explain to patients that we are not MD's and that requires us to educate our patients a lot. Additionally, in my state (Texas) we have to wear a name badge stating that I'm a PA and it is also on my labcoat and I always introduce myself as a Physician assistant. You make it sound like we are all trying to pass ourselves off as doctors and I assure you it is quite the opposite and I'm all for prosecuting people who do try and pass themselves off as an MD.

10. "I'm sure after making it through med school (keeping fingers crossed), I will work with many PAs, and I won't have a problem with that. I just want to be able to do my job without the question in the back of my head of "If PAs can do all this stuff, what's the point of doctors?"

Sounds to me like you have some insecurities about being a doctor and you are projecting those onto the PA profession, as it is an easy target.

11. "I think in this case it was a particularly inept NP, not an inept profession."

This is one of the ones that really gets me. This was a case of an inept practicioner and you defend the profession. However, you seem to generalize about PA's as a profession and ascribe it to us all and not just some bad apples.

12. "Absolutely, but they were not created to replace physicians.'

This is the post where I really began to think you had it in for PA's. Once again, I don't think anyone stated that they were created to replace physicians and you responded to me that you were just making a statement. My question is, where did you get this idea from? Did a PA tell you they wanted to replace a doctor or do you just get this idea from some of the things posted on this forum.

13. "Responded more to the title of the post. Don't fret over it. There's no hidden agenda in my post. Just a comment."

You say in this post that you don't have a hidden agenda, but I'm really not sure. Additionally, how would you take it if someone told you not to fret over SLP's wanting to replace doctors when you did not think that was the case. You might get upset at a generalization about your profession.

14. "Please specify to whom you are talking to.......

And try not to use euphemisms like "I'm not saying you're smoking crack, BUT..." - you're highly unlikely to have a "friendly" debate and have others stop bashing PAs if you use that kind of rhetoric to argue with.

Sorry to sound so harsh, but I'm sick of everyong complaining that they are sick of everyone bashing them, and then they bash right back."

You can be pretty harsh in some of your posts and say that you are sick of bashing, but you seem to do that to PA's a lot. It just strikes me as hypocritical. Especially when you tell me to quote whom I'm refering to in my posts, but don't do the same in yours.

15. "grow up and get a life" was directed generally at posters who continually rip on the subject. To imply someone is smoking crack is a little more harsh and personal, and as a forum advisor, I'd rather stop personal attacks from the get-go rather than have threads spiral out of control.

Next time use the quote feature included in each post and people won't have trouble figuring out who you are "directly" responding to.

You admitted you had a knee-jerk reaction. Try to keep a thicker skin, especially in this forum.'

Still, telling someone to grow-up and get a life is pretty harsh, especially from someone who is an advisor. Maybe better handled through PM's. This is another one of those instances where I think you're being hypocritical. Once again, you did not use the quote feature either. Thanks for telling me to have a thicker skin, I appreciate your persoanl attack and unsolicited advice.

16. "I didn't think it was funny, and I'm not getting into a pissing contest with you. The end."

That is your personal opinion and you participated in the pissing contest and when you did not like someone calling you out, you simply decided to call it quits. So much for allowing people their say.

This is a sampling of why I get the idea that you are anti-PA and most of your so-called praise for PA's is with qualifications or right after you've said something less than flattering about them.

You also implied that I was part of the attack squad which sounds a lot like bashing.

Additionally, I've worked in the OR for a long time and my skin is pretty thick. However, your general disdain and condescending attitude are something that I would prefer not to have to deal with on any sort of a regular basis. Therefore, I choose not to post here too much or even read a lot of the threads.

BTW, I don't seem to be the only one who thinks that you are anti-PA.

Must be some other Mike that had mentioned being a CRNA, there are lots of us. I'm very happy being a PA and have no desire to be a CRNA. BTW, what does that have to do with anything?

Overall, there is not any one thing that you have posted that convinces me you're anti-PA, it is all of your postings in-toto and it may be that the tone of your posts comes across as overly harsh to me. I may be the only person to feel that way and I fully admit it and I also know that you are probably very different in-person than your posts make you appear.

I also have issues with people having very dogmatic attitudes about others and their professions when they don't have a really good grasp of the issues they so vehemently comment on, such as your PA's should not prescribe when you don't have a very good grounding in pharmacology yourself. I try to keep an open mind until I have a lot of info. For instance, I would never comment on SLP issues, because I don't really have a good grasp of the intracacies of the profession.

Anyway, you wanted to know why I thought you were anti-PA and those posts is where I get the idea. Perhaps I'm wrong and I'm enough of an adult and a professional to admit I might be wrong.

Sorry, for the long post everyone.

-Mike

 

[njbmd]

Stu Jones, 37
Physician’s assistant
Franklin, Tenn.
$109,000


http://www.parade.com/money/slideshows/salary-survey/salary-survey07.html

You folks got wayyyy off topic so I will bring back the original post as a little reminder. Kudos to the dude above who has honed his skills and makes a nice salary for using those skills.

Bottom line, if you do your job well, you can make a good salary and perhaps do something that you like.

Let's stay on topic and stay professional(and cordial), as after all, we all are professional here. There are plenty of folks out there who will read this forum looking for information. Let's give them some good info like the above and stay on topic.

 

[Beau Geste]

Ugh. Forget it. I originally had something else in this post but I agree with the mods that we need to get back on track of the OP's question.

 

[deleted6669]

ok, back on topic.....don't know why the 1st poster was impressed. that is a pretty avg salary for an experienced ortho pa.....when you consider 84,396 to be the avg pa salary across the board and 90k for everyone in ortho( new grads and experienced) then his salary is pretty much avg for an ortho pa a few yrs out of school. now if he made 200k that would be newsworthy.....gotta work in ct surgery 60-80 hrs/week and be residency trained to make that as a pa.....

 

[ChandutheMagici]

As you should know, there's no "passing" score on the MCAT. If my GRE scores are any indicator, I'll rock it. Thanks!

Hi. Sorry if this is off subject and I don't mean to discourage you, but these tests aren't even close in comparison. I've taken them both and the GRE was significantly easier than the MCAT. Regardless, let's get back to PA's and how much they make.

Chandu

 

[Beau Geste]

Hi. Sorry if this is off subject and I don't mean to discourage you, but these tests aren't even close in comparison. I've taken them both and the GRE was significantly easier than the MCAT. Regardless, let's get back to PA's and how much they make.

Chandu

Yes, this is off topic. You can PM me if you need to tell me something "off-topic".

 

[NDESTRUKT]

So who's better? NP or PA?

The answer is: the mid level that will work hard and does a good job. I'd much rather have an NP that is easy going, good attitude, knows what they can and cannot do well than a PA with an ego that "I'm as good as an MD but I'm not". The situation also applies vice versa.

Wait, this wasn't the OP's original reason for starting this thread was it? haha

If I offended anyone with my benign statement, oops - my bad (and your loss).

 

[ChandutheMagici]

Yes, this is off topic. You can PM me if you need to tell me something "off-topic".

So you're kinda mean, huh? Good luck to you and I hope you do well on the test.

Chandu

 

[Kajukenbo]

"I think it's reasonable to beleive that the average PA would find the profession of a MD/DO appealing and might even pursue it if they were a competitive candidate" lawguil

So, even you agree that all PA's may not be a competitive candidate for MD/DO. You contradict yourself a lot throughout these forums.

 

[deleted6669]

"I think it's reasonable to beleive that the average PA would find the profession of a MD/DO appealing and might even pursue it if they were a competitive candidate" lawguil

So, even you agree that all PA's may not be a competitive candidate for MD/DO. You contradict yourself a lot throughout these forums.

of course this is true that not all candidates are competitive for md/do. it's also true that many medstudents would not be competitive at certain pa programs.....there are several medstudents here at sdn who had md/do as their fallback after not getting into pa.....