Neurology PA knows as much as neurologist

[exPCM]

Michael Jones
Occupation: Physician assistant
Hometown: Anacortes, Wash.
"I have been a physician assistant (PA) for 28 years. PAs have two years of clinical work, plus a masters' degree in medicine when they complete their program. With time, a PA learns a great deal more about medicine as they practice. By the ten-year mark of practice, most PAs are just as productive, providing the same level of medical care as a family practice physician."

"PAs, however, cannot hold down health care costs in the present situation. The reason is, while they earn half or less of what a physician makes, the law requires each PA to always have a 'supervising physician.' In most cases, especially with an experienced PA, the physician is never consulted because the PA knows as much as they do by that time. However, the physician demands 60% of the PA's earnings to be paid to the practice and the physician takes home (as additional income) at least half of that amount."

"If PAs were allowed more autonomy after they have practiced for a whole decade, they could fill a huge void and really bring down the cost of care. If I didn't have to pay my supervising physician (whom I've never asked a question because I know as much or more than he does) 60 cents of every dollar, I could offer basic office visits for about $40-$45 rather than $75-$100."

"The physicians will always hide behind the concept that 'PAs are dangerous and must be supervised.' Yes, PAs do need to learn from physician supervision during their first years in practice. But it is extraneous after that and adds a huge cost."

http://money.cnn.com/galleries/2009/news/0907/gallery.healthcare_nurses/3.html

Johnny Michael Jones, PA; PAC

Specialty:
Neurology, Physicians Assistant
Location:
1315 E Division St
Mount Vernon, WA 98274
Telephone:
(360) 424-8951
(other locations) (hide other locations)

Location: 2
2979 Squalicum Pkwy, Ste 201
Bellingham, WA 98225
(360) 756-6800
Maps & Directions

Board Certifications:
Unknown, Not Applicable
Education: Education


Patient Reviews

Reviews 1-1 of 1
Johnny Michael Jones, PA; PAC
Jul 29, 2009 anonymous Anonymous

Comment

"This guy is awful. He thinks he's very smart, but he's extremely rude to patients and his knowledge base is pathetic. He misdiagnosed my headaches for years and refused to ask his supervising physician for help. I would never recommend him to anybody."

http://www.revolutionhealth.com/doc...49374/reviews?a=139818&dest_route_type=direct

My comment: It is a good thing the neurologists at the Cascade Neurologic Clinic have this PA who knows as much or more than a neurologist.

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[JasonS]

The comments are just as inane. There are some absolute idiots on that board:

Sue, an NP wants her "fair share."

"we just want pay commensurate with our experience, w/o the over-head 'supervisory' fee having to be thrown in there to make it really out of reach. It would help healthcare reform! And, FYI, as a PA I have nearly 8 years of college, a post-grad capstone in Geriatrics/ Internal Medicine, and 23+ years of experience including more than 2500 clinical hours in my program, & an add'l1500 in my capstone. You MUST be counting sleeping hrs. for your 'doctor' #s!"

I find it amusing that she left out the increased malpractice insurance that she would have to be responsible for The main thrust is that doctors are greedy bastards that are effing up our economy, while the mid-levels are the altruistic knight-in-shining armor that will save us from these money hungry monsters. What a complete f*cking joke.

 

[aaddnl]

Thank you for telling it like it is. Physicians need to stand up for their profession as it seems like everyone these days wants to attack and blame physicians for everything, particularly for problems with the health care system. Most PA's and NP's and other ancillary staff seem to have a big chip on their shoulder and constantly try to criticize doctors and "one up" their physician colleagues, even unprofessionally in front of patients, etc. But what the delusional authors of those statements above dont realize is they aren't as good as they think they are, and two years of postgraduate training is hopelessly inadequate to navigate the complexities of modern medicine and properly evaluate and treat patients independently. Although these "providers" believe they are better than the doctors they work for, the "A" in PA still stands for assistant and the "N" in NP still stands for nurse and there is a reason for both. There are always rare exceptions to the rule, but any time that real responsibility or medical liability is involved they run and hide. And the consults they call are generally ridiculous and demonstrate a major void in knowledge. I certainly have respect for these providers and recognize that they help patients and are invaluable to many practices, but the statements by these particular providers are reckless and ignorant and need to be addressed.

 

[NJWxMan]

These are the same people that become petrified and useless when the real emergency occurs or the proverbial crap hits the fan. Most mid levels talk a great game and can spout all they want about their experience, but they are usually the first to get on the phone when their patient is crashing. Even better, is when the mid level truly screws up management or misses the diagnosis and the supervising physician has to clean up their mess. I've seen my fair share of these situations as a medical student in the past.

 

[ask1288]

PA's are good for doing repetitive stuff, that does not change aka "automatisms" You can train anyone to do that stuff. Perhaps even a monkey. I would posit, you could train a PA to do hernia surgeries all day even without med school training. Maybe even hemicraniectomies. But clinical neurology however is different. We had a very interesting case yesterday and Dr Heilman (father of American behavioral neurolog) who was the attending remarked: "I have practiced neurology for over 50 yrs, and there is not a single day that goes by, when i see something, i have never seen before."

Sure a PA could manage strokes. Maybe even seizures or status, but come the stuff thats in between, the PA will not be able to discern, and perhaps a spinal cord stroke will be treated with steroids coz it was judged to be "transverse myelitis" or vice versa.

PS It is important to realize that it is not because a PA is less smarter, but because they don't have the training for it. PA training is based solely on pattern recognition. A neurologists training is based on mroe than that. localising, thinking outside the box.

my 2 cents

 

[Strokeguy]

Couldn't resist responding to this post. This is the most ridiculous idea I have seen or heard so far. Also a PA may be able to manage the so called 'stroke' beyond any treatable time window - aspirin, echo, mri/mra; look at the radiology report and refer for endarterectomy, start statins/ACE inhibitors. It would be a tragedy for patient care if they were to attempt acute stroke thrombolysis. No matter what their experience, it is outrageous to expect them to know about TCD, CTA, concepts of cerebral perfusion/autoregulation and pros and cons of MRI and CT penumbral imaging and using all this info to treat acute stroke.
Stroke neurologists also manage several pts with complex cerebrovasc dis - multiple vessel stenosis/occlusion, moyamoya, vasculitis and so on that need more skill and training.
There is no other subspeciality in neurology with higher malpractice than 'vascular neuro'.
This 'god send' PA has probably never managed a real neurologic emergency.
Epilepsy is another subspeciality that needs more training. How can you expect this from an experienced PA to gather skills at electrocorticography, vns and several other things. This is absolutely crazy.

 

[bustbones26]

Michael Jones
Occupation: Physician assistant
Hometown: Anacortes, Wash.
"I have been a physician assistant (PA) for 28 years. PAs have two years of clinical work, plus a masters' degree in medicine when they complete their program. With time, a PA learns a great deal more about medicine as they practice. By the ten-year mark of practice, most PAs are just as productive, providing the same level of medical care as a family practice physician."

"PAs, however, cannot hold down health care costs in the present situation. The reason is, while they earn half or less of what a physician makes, the law requires each PA to always have a 'supervising physician.' In most cases, especially with an experienced PA, the physician is never consulted because the PA knows as much as they do by that time. However, the physician demands 60% of the PA's earnings to be paid to the practice and the physician takes home (as additional income) at least half of that amount."

"If PAs were allowed more autonomy after they have practiced for a whole decade, they could fill a huge void and really bring down the cost of care. If I didn't have to pay my supervising physician (whom I've never asked a question because I know as much or more than he does) 60 cents of every dollar, I could offer basic office visits for about $40-$45 rather than $75-$100."

"The physicians will always hide behind the concept that 'PAs are dangerous and must be supervised.' Yes, PAs do need to learn from physician supervision during their first years in practice. But it is extraneous after that and adds a huge cost."

http://money.cnn.com/galleries/2009/news/0907/gallery.healthcare_nurses/3.html

Johnny Michael Jones, PA; PAC

Specialty:
Neurology, Physicians Assistant
Location:
1315 E Division St
Mount Vernon, WA 98274
Telephone:
(360) 424-8951
(other locations) (hide other locations)

Location: 2
2979 Squalicum Pkwy, Ste 201
Bellingham, WA 98225
(360) 756-6800
Maps & Directions

Board Certifications:
Unknown, Not Applicable
Education: Education


Patient Reviews

Reviews 1-1 of 1
Johnny Michael Jones, PA; PAC
Jul 29, 2009 anonymous Anonymous

Comment

"This guy is awful. He thinks he's very smart, but he's extremely rude to patients and his knowledge base is pathetic. He misdiagnosed my headaches for years and refused to ask his supervising physician for help. I would never recommend him to anybody."

http://www.revolutionhealth.com/doc...49374/reviews?a=139818&dest_route_type=direct

My comment: It is a good thing the neurologists at the Cascade Neurologic Clinic have this PA who knows as much or more than a neurologist.

Look, I am not going to bash on you. But this is very simple. If a person wants the autonomy of a physician, then they need to go to medical school and do enough post graduate training to earn a state medical license. Sorry, that is just the way it is and that is NOT going to change!

I would never deny that the academic route to becoming a PA is academically challenging but there are few things becoming a PA does not include, years of residency training for one thing.

Again, let me make it clear! If you want to be a physician, then become a physician. Don't become a physician assistant or nurse practicioner and spend the rest of your career arguing why are just as good as an MD/DO. Plain and simple, in the eyes of the law, you are not!

 

[neurologist]

Hey, don't knock 'em. Apparently they're the answer to all of medicine's problems . . .

http://www.time.com/time/nation/article/0,8599,1914222,00.html?cnn=yes

Sarcasm aside, I have worked with a broad range of midlevels. A few I would not allow to treat my dog. Others are pretty much functioning just a minimal step below that of a physician, and had their lives happened a little bit differently, may well have gone to med school. Most are in the middle -- reasonably competent and aware of their limitations. In general, I have found them an asset rather than a problem.