Need a little dose of reason? Read this article by a PA

[vernhart]

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https://www.doximity.com/doc_news/v2/entries/3851423


EDIT: easier access for some
http://www.kevinmd.com/blog/2016/06/im-physician-assistant-time-stop-bitterness.html

 

[Psai]

I'm not the one that posts endless bs studies and lectures at nursing schools about how you should refer to other doctors of nursing and how they're just as good as actual doctors.

Look at any news articles about nurse practitioners and you'll see hoards of nurses talking crap about doctors.

It's not us, it's them. I spend zero time thinking about how good I am compared to the nurse practitioners. I also don't dress up as a nurse or have an RM degree behind my name along with a smorgasbord of other incoherent letters.

I'm beginning to see PAs start to put all these random letters too. It really makes me lose respect for them.

 

[Mr Roboto]

"I can handle the majority of cases on my own, including the complex ones, but I know when I need help"

The point made time and again here is that they don't know when they need help.

 

[vernhart]

I'm not the one that posts endless bs studies and lectures at nursing schools about how you should refer to other doctors of nursing and how they're just as good as actual doctors.

Look at any news articles about nurse practitioners and you'll see hoards of nurses talking crap about doctors.

It's not us, it's them. I spend zero time thinking about how good I am compared to the nurse practitioners. I also don't dress up as a nurse or have an RM degree behind my name along with a smorgasbord of other incoherent letters.

I'm beginning to see PAs start to put all these random letters too. It really makes me lose respect for them.

Yeah ik what you mean (he does speak a little against doctors' attitudes), but I interpreted the article as mostly directed to PAs who want to be treated like a Dr. This is about as reasonable an approach I've heard from a PA's perspective

 

[Psai]

Yeah ik what you mean (he does speak a little against doctors' attitudes), but I interpreted the article as mostly directed to PAs who want to be treated like a Dr. This is about as reasonable an approach I've heard from a PA's perspective

Oh for sure, he's a very reasonable person. I'm just talking about what I see in general on the internet. It's very strange because the NPs I see in real life are relatively nice and efficient with their work. I guess working under physicians in academic centers vs working independently in bumble**** egypt is totally different and the latter gives you an inflated vision of yourself as an actual doctor rather than a doctorate of nurse practitioning.

 

[neusu]

I think many people would be happy if the message in this article were actually practiced.

Unfortunately, the reality is otherwise. Midlevel providers consistently move to expand their scope of practice, so far even as to replace physicians in some fields. This is met with enthusiasm by non-clinical administrative types because it helps the bottom line. Not surprisingly, the physicians involved are alarmed because they see their ability to take care of patients eliminated. The result of this is backlash at the midlevels, even so much as to advocate getting rid of them entirely.

There does not seem to be an end in sight in the near future, except more infighting. I really only envision two scenarios playing out here: one side ultimately subverts the other forcibly, or a government regulator steps in. There is no way, with their respective egos and associated, separate, boards of licensure determining their scope of practice, a common ground will be found.

 

[Psai]

It's not even just about being replaced. It's about all the really stupid consults, the ridiculous questions where you realize that the midlevel has no idea what they're doing and it is just scary. I will never forget the time a PA called ct surgery for "tortuous aorta" even after I asked them wtf they thought the problem was or what they thought ct surgery was going to do. There was absolutely zero thought process and no critical thinking whatsoever. They aren't just moving into primary care, they're starting to do consults too. I haven't seen a useful consult by a midlevel yet. Either I need to know something that I don't know or have something done that I can't do myself and they don't fulfill either goal.

The role that makes the most sense to me is if they took care of all the mindless bullcrap like proper documentation, preauthorizations, consents, etc. freeing up physicians to actually talk to patients and think critically. Instead, these midlevels create more work by seeing patients more or less independently so not only are you responsible for your own actions, you're responsible for things that other people with unclear amounts of training do. When you send your most highly trained professionals to do ever increasing amounts of paperwork for other people, there's something wrong with the system. I understand that it makes physicians more money when the midlevels see patients under their umbrella but with independent NPs and PAs pushing for independence as well as hospital systems taking the profit for themselves, what is the point for physicians? Increased liability without any of the benefit.

 

[username456789]

One of the more frustrating things I do on a daily basis is try to correct and clean up the mistakes of mid levels. I frequently see patients who have been previously managed by our PAs or nurse practitioner, and am constantly having to correct the patient's diagnosis and or establish a new correct treatment plan due to mismanagement. Unfortunately, the patients are often resistant to this, at least at first, because they have been seeing the mid-level for years and really think they are nice people. No matter that they were wrong in the way they diagnosed or treated them. And then I'm left arguing with patients who have no clue they've been mismanaged for months or years.