medical vs surgical

[Bumbl3b33]

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I had a question for all you guys choosing specialties.

Do you guys ever try to like surgery more as a hedge against mid-level encroachment? I guess what I mean is that it's much harder for NP's/PA's to be the ones doing surgery, where as every medical field (GI, FP, IM...etc) has turf wars going on with mid-levels. Do you guys take this into consideration when deciding on med vs surg? If you choose or are planning to choose medical, how do you reconcile with this?

Thanks

 

[seelee]

Personally, I would rather deal with the whole mid level thing than the ****fest that is Surgery.

 

[D elegans]

personally, i would rather deal with the whole mid level thing than the ****fest that is surgery.

+1

 

[dsoz]

I thought that PAs could do surgery. I am probably wrong about that.

 

[Winged Scapula]

I thought that PAs could do surgery. I am probably wrong about that.

A PA can assist with an operation but a licensed surgeon is required to be present for the "critical portion" of the procedure. They are not doing the case.

 

[Bumbl3b33]

Personally, I would rather deal with the whole mid level thing than the ****fest that is Surgery.

Can you shed some light as to what you mean by this comment?

 

[theseeker4]

A PA can assist with an operation but a licensed surgeon is required to be present for the "critical portion" of the procedure. They are not doing the case.

What does "required to be present" mean legally? Are there laws to prevent a surgeon from overseeing mid levels who are the actual ones doing the physical work in the same way that physicians in other fields "oversee" mid levels in other areas? Curious if there is any actual legal difference between surgery and everything else, or if mid levels simply haven't been able to edge their way into surgery yet.

 

[peteB]

maybe the medical doctors should start encroaching on the surgeons' territory by starting to more and more procedures? 🙂

 

[theseeker4]

maybe the medical doctors should start encroaching on the surgeons' territory by starting to more and more procedures? 🙂

I see what you did there 😀

 

[seelee]

Can you shed some light as to what you mean by this comment?

As I said; "personal preference".

I find that surgeons have a miserable existence. They are beaten and mistreated in residency, they work ungodly hours, and worse the believe that it is all necessary.

I would personally prefer to deal with CRNA issues than submit to that.

On the other hand. I don't think that encroachment is such a big deal. There is a physician shortage and physician extenders help make up the difference. I know of no MD who has been unable to find a job due to encroachment.

Our role will change though. We will transition to more of an oversight and management role.

 

[SpecterGT260]

What does "required to be present" mean legally? Are there laws to prevent a surgeon from overseeing mid levels who are the actual ones doing the physical work in the same way that physicians in other fields "oversee" mid levels in other areas? Curious if there is any actual legal difference between surgery and everything else, or if mid levels simply haven't been able to edge their way into surgery yet.

PAs are not doing much within the surgical suite. Closing is common. Mayby opening. Supportive procedures. It is not like the medicine relationship where PAs take their own cases and need to be signed off by a doctor. Podiatrists have more surgical scope than PAs.

From what I understand insurance will not cover complications of surgery performed by PAs. The doctor needs to be the one performing the surgery.

 

[Slack3r]

A PA can assist with an operation but a licensed surgeon is required to be present for the "critical portion" of the procedure. They are not doing the case.

Yet.

 

[SpecterGT260]

Yet.

there are MANY hurdles before that happens. As I said earlier, it isnt the same as them working under doctors within the clinic. They are not performing their own surgeries with a physician checking in on them.

 

[yuiness]

PAs are not doing much within the surgical suite. Closing is common. Mayby opening. Supportive procedures. It is not like the medicine relationship where PAs take their own cases and need to be signed off by a doctor. Podiatrists have more surgical scope than PAs.

This. I don't know how universal this is, but surgical attendings at my institution are required to dictate that they were present and scrubbed for the entire duration of their procedures and that there were no overlapping procedures.