Nurse Practitioner take-over = PA profession death?

[bradt9881]

I know its a whole lot of work. I just question charging the students for the "fluff" that's all.

It wasn't fluff in my program. Nothing fluffy about hem/onc, peds, emergency med, endocrine, etc. And despite taking those 26 semester hours for my last summer of didactic training, I was charged the same full time rate as any other grad student at my school.

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[fab4fan]

No, your point seems to be that "routine" patient issues are simply not worth your time, that they're beneath you. You know, those "BS patients" that you've now mentioned in two separate posts.

Exactly.

 

[PSYCHNP]

It wasn't fluff in my program. Nothing fluffy about hem/onc, peds, emergency med, endocrine, etc. And despite taking those 26 semester hours for my last summer of didactic training, I was charged the same full time rate as any other grad student at my school.

Did you have to pay for each credit hour like peple in most institutions must of your 29-30 credit semesters?

 

[PSYCHNP]

Nurses have far superior lobbying ability than physicians currently...and they are the queen bees of the healthcare bureaucracy.

While physicians were busy saving lives, BIG NURSING took over healthcare. Unfortunate, really.

Many surgeons have the foolish idea that they are immune to the coming tsunami of nursing takeover. They are very mistaken..Derms are already being attacked heavily, and they have been fighting back.

My question is since your training is so inferior to that of a physicians, why do you continue to demand equality in practice rights and income? Seems awfully ignorant and arrogant to believe that your 600 clinical hours and online NP = 10,000's and a hard-fought, top-academic MD. I can't imagine how "great" the clinical "judgement" of noctors who believe such drivel must be.

First of all personally it's hard for me, a lowly nurse, to have full respect for someone who makes less money than me (a resident). But I will entertain your debate. If you are having a difficult time as a FP MD competing step your game up and find another specialty like the top doctors I see on TV (i.e. surgeons etc.). Or is that going to be too much work for someone so superior intellectually? If you can't stand the heat get out the kitchen!!

 

[deleted87716]

First of all personally it's hard for me, a lowly nurse, to have full respect for someone who makes less money than me (a resident). But I will entertain your debate. If you are having a difficult time as a FP MD competing step your game up and find another specialty like the top doctors I see on TV (i.e. surgeons etc.). Or is that going to be too much work for someone so superior intellectually? If you can't stand the heat get out the kitchen!!

Coastie isn't an FP.

And...do you seriously think that TV doctors are "top docs...?" I sure hope not.

 

[PSYCHNP]

Coastie isn't an FP.

And...do you seriously think that TV doctors are "top docs...?" I sure hope not.

It seems to me some of you MDs want extraordinary results for ordinary performance. You want to be praised so much for standing around a clinic all day. Let's face it PAs and NPs are doing a lot of that work these days. That's the reality of the situation. And yes I do consider the docs on Discovery Channel performing surgery and enlightening the world top docs. What are you and coastie doing with all your great training? Let's not get it twisted, in America money still talks. The beauty of this great country is that it is still a capatalistic, competition driven society. Competition you all seem to be scared of.

 

[bradt9881]

Did you have to pay for each credit hour like peple in most institutions must of your 29-30 credit semesters?

No, it was a set flat rate of $8750 per semester if you must ask. That rate applied no matter how many semester hours were taken.

 

[bradt9881]

First of all personally it's hard for me, a lowly nurse, to have full respect for someone who makes less money than me (a resident). But I will entertain your debate. If you are having a difficult time as a FP MD competing step your game up and find another specialty like the top doctors I see on TV (i.e. surgeons etc.). Or is that going to be too much work for someone so superior intellectually? If you can't stand the heat get out the kitchen!!

It's a sad day if we have to tie respect for an individual to their annual income and not what they have accomplished....

 

[deleted87716]

It seems to me some of you MDs want extraordinary results for ordinary performance. You want to be praised so much for standing around a clinic all day. Let's face it PAs and NPs are doing a lot of that work these days. That's the reality of the situation. And yes I do consider the docs on Discovery Channel performing surgery and enlightening the world top docs. What are you and coastie doing with all your great training? Let's not get it twisted, in America money still talks. The beauty of this great country is that it is still a capatalistic, competition driven society. Competition you all seem to be scared of.

It has nothing to do with "competition." It has to do with protecting the public from people who don't know what they don't know.

 

[jwk]

I never said that anyone was beneath me. Those are your words. But yes, after my years in health care I do not have much patience for people that come in and take my time, energy, and focus away from a patient that actually requires it. If that some how makes me a bad person, then so be it. You can try to paint me however you like but that does not change the truth of the situation. You are an AA, correct? So all the pts you see need to be there as they are about to have surgery. That is not always the case for people that come into the ER and/or are admitted to my hospital.

When I have to leave my post op CABG pt that also has a IABP in and is getting dialysis to go deal with a woman that complained of chest pain because she needs a xanax, yes, it bothers me.

So you would prefer to save your efforts only for those patients who truly need you, not for those who might need you but aren't quite sure, which is why they present in the first place? No need to reply - you've already proven my point.

 

[PrinceVersed]

So you would prefer to save your efforts only for those patients who truly need you, not for those who might need you but aren't quite sure, which is why they present in the first place? No need to reply - you've already proven my point.

Wow. It must be nice to live in such a clear cut world where everyone has good, wholesome intentions. Maybe one day I can step out of reality and into your dream existence.

It is truly sad that I am the ONLY member that has ever seen a patient that didn't need to be in the hospital/clinic. Maybe I should move somewhere where the caring efforts of providers like you have been able to completely eradicate the drug seekers and hypochondriacs. If I could only care as much as you guys...sigh..

 

[fab4fan]

Well, gee. I guess I should have apologized to my doc for having a whopping sinus infection instead of something more worthy of her time like, say, a glioblastoma.

 

[BLKPA2MD]

First of all personally it's hard for me, a lowly nurse, to have full respect for someone who makes less money than me (a resident). But I will entertain your debate. If you are having a difficult time as a FP MD competing step your game up and find another specialty like the top doctors I see on TV (i.e. surgeons etc.). Or is that going to be too much work for someone so superior intellectually? If you can't stand the heat get out the kitchen!!

...woow! You should reconsider your decision. They say respect is reciprocal!

 

[PrinceVersed]

Well, gee. I guess I should have apologized to my doc for having a whopping sinus infection instead of something more worthy of her time like, say, a glioblastoma.

I never said you needed to apologized or that you were in someway invalid. Only that you don't need a MD of 30years to treat your sinus infection. A NP or PA would do the job just fine. Though, with yours and your compatriots obvious lack of common sense, maybe seeing a MD would be more beneficial.

 

[fab4fan]

I never said you needed to apologized or that you were in someway invalid. Only that you don't need a MD of 30years to treat your sinus infection. A NP or PA would do the job just fine. Though, with your and your compatriots obvious lack of common sense, maybe seeing a MD would be more beneficial.

Lucky for me, I don't have to make that choice. If I want to see a physician (which is my right as a patient), I get to see a physician. I don't think you are the one who gets that. Not all physicians function in your world, where only certain diagnoses are "worthy" of their time and attention. FWIW, suppose my run of the mill sinus infection had been something more complex? Thanks just the same, but I'm not going to trust a mid-level to make the right call.

 

[PrinceVersed]

Lucky for me, I don't have to make that choice. If I want to see a physician (which is my right as a patient), I get to see a physician. I don't think you are the one who gets that. Not all physicians function in your world, where only certain diagnoses are "worthy" of their time and attention. FWIW, suppose my run of the mill sinus infection had been something more complex? Thanks just the same, but I'm not going to trust a mid-level to make the right call.

I never said you had to. I never advocated NP/PA to be forced onto anyone. Only stated that a MD does not NEED to see every patient, though, they are more than welcome to. NP/PA is a viable option for less acutely sick patients. I'm sorry that everyone on this board thinks that they are walking around with some crazy mystery diagnosis but I just don't see it as the case. If you have a UTI, have had a UTI before, and know you have a UTI now, do you really need to go see a doctor (and please don't give me some BS about needing to see a MD because the UTI is reoccurring)? Could not a NP/PA treat you? Could it be something more nefarious? Sure it COULD. We COULD all start flying around, but the odds of that are pretty low too.

If the NP sees you and doesn't know what is going on, they will ask a doctor. When that doctor sees you and doesn't know what is going on, he will consult another doctor. No ones medical knowledge is complete, not even your doctors.

 

[atcpt1]

I know the program is intensive and you cannot work. Most medical programs are like that like RN, PT, MD, OT, dentistry, chiropractor, audiology, and podiatry. Did I leave one out? Just try them. Here are two semesters from UF's pharmacy program. I am sure it is rigorous and you can't work too, but they only have to pay for 34 credits, as opposed to maybe 60. Not to mention their total program is 134 credits spread out over a period of 4 years and they are awarded a PharmD degree. Keiser's PA program is "138 credit hours" completed in 6 semesters and they are awarded a master's degree. Furthermore, I believe being a Pharmacist is more prestigious and more respected in our society than being a PA. Like I said earlier I believe institutions may be misleading the students with an abundance of "credit hours".

Course # Name Credits
PHA 5451 Clinical Biochemistry 4
PHA 5100 Dosage Forms I 3
PHA 5433 Fundamentals of Medicinal Chemistry 1
PHA 5560C Physiological Basis of Disease I 5
PHA 5727 Intro to Pharmacists, Pharmaceuticals, 3
And the Health Care System
PHA 5941C IPPE I 1
17
[FONT=Times New Roman,Times New Roman][FONT=Times New Roman,Times New Roman]Spring Semester ..
PHA 5101 Dosage Forms II 2
PHA 5436 Structure and Function of Nucleotides: Basis for Therapy 2
PHA 5515 Basic Principles of Pharmacology 1
PHA 5561C Physiological Basis of Disease II 5
MCB 5252 Microbiological and Immunological Basis for Therapy 4
PHA 5781 Pharmacotherapy I 2
PHA 5942C IPPE II 1
17

I have no clue who you are or if you are even a healthcare professional

but I went to PT school and worked 20 plus hours a week adn full time during a lot of the breaks from school.
My brother went to pharm school and worked a similar amount
My wife (at least now she's my wife) is a nurse and worked full-time as a CNA while earning her degree

I can't work in PA school. Not even comparible . It's just harder and faster. And I also pay a flat rate per quarter ($8900) regardless of number of credits. the program is essentially a flat rate. It's not about money....it's a darn good education all things considering

And I do believe it's fair to compare it to medical school. PA school is based on the way physicians were trained during WWII, but obviously modernized. Further, it is modeled after medical school. A PA is the next closest thing to a physician in training.

The way I see it is that a PA is much like a resident their whole career...always learning...always supervised.


In PA school I will complete about 1800 classroom hours and 2400 clinical hours over 28 months over 108 weeks of classes

In undergrad, I was in class approximately 8 months a year when you factor in breaks and summer. Plus I spent about 15 hrs a week in class

@ 4.3 weeks/month * 8 * 4 = 2064 hours in a 4 year undergraduate degree.

Thee is over 4000 hours of training in PA school in 2.33 years.

IMO, i'm earning the credits

Strangely enough, PSYCHNP....you seem somewhat unstable..ironically.
First you report that NP is the same as PA, .....then you can't compare PA to MD and how MD is the gold standard....now your talking sh*% about family docs as being something less than ortho,derm...ect...

Get some help....even if you have to see a PSYCH-NP

All kidding aside....best of luck getting into school.

 

[fab4fan]

I never said you had to. I never advocated NP/PA to be forced onto anyone. Only stated that a MD does not NEED to see every patient, though, they are more than welcome to. NP/PA is a viable option for less acutely sick patients. I'm sorry that everyone on this board thinks that they are walking around with some crazy mystery diagnosis but I just don't see it as the case. If you have a UTI, have had a UTI before, and know you have a UTI now, do you really need to go see a doctor (and please don't give me some BS about needing to see a MD because the UTI is reoccurring)? Could not a NP/PA treat you? Could it be something more nefarious? Sure it COULD. We COULD all start flying around, but the odds of that are pretty low too.

If the NP sees you and doesn't know what is going on, they will ask a doctor. When that doctor sees you and doesn't know what is going on, he will consult another doctor. No ones medical knowledge is complete, not even your doctors.

I never said I thought I had some "mystery diagnosis." Just that I'm fortunate to have a doc who isn't "oh so bored" with her patients. May you be lucky enough to get into a practice where you only see zebras and don't have to deal with cases beneath your abilities.

And yeah, if something is recurring, maybe it should be looked at more closely, not just treated in a perfunctory manner. Treating people for "recurring UTI" when they in fact have bladder CA comes to mind right away. You can't keep giving someone Bactrim DS forever and expect that to go away.

 

[deleted87716]

If the NP sees you and doesn't know what is going on, they will ask a doctor.

Trouble is, they may not know that they don't know what's going on.

 

[PSYCHNP]

I have no clue who you are or if you are even a healthcare professional

but I went to PT school and worked 20 plus hours a week adn full time during a lot of the breaks from school.
My brother went to pharm school and worked a similar amount
My wife (at least now she's my wife) is a nurse and worked full-time as a CNA while earning her degree

I can't work in PA school. Not even comparible . It's just harder and faster. And I also pay a flat rate per quarter ($8900) regardless of number of credits. the program is essentially a flat rate. It's not about money....it's a darn good education all things considering

And I do believe it's fair to compare it to medical school. PA school is based on the way physicians were trained during WWII, but obviously modernized. Further, it is modeled after medical school. A PA is the next closest thing to a physician in training.

The way I see it is that a PA is much like a resident their whole career...always learning...always supervised.


In PA school I will complete about 1800 classroom hours and 2400 clinical hours over 28 months over 108 weeks of classes

In undergrad, I was in class approximately 8 months a year when you factor in breaks and summer. Plus I spent about 15 hrs a week in class

@ 4.3 weeks/month * 8 * 4 = 2064 hours in a 4 year undergraduate degree.

Thee is over 4000 hours of training in PA school in 2.33 years.

IMO, i'm earning the credits

Strangely enough, PSYCHNP....you seem somewhat unstable..ironically.
First you report that NP is the same as PA, .....then you can't compare PA to MD and how MD is the gold standard....now your talking sh*% about family docs as being something less than ortho,derm...ect...

Get some help....even if you have to see a PSYCH-NP

All kidding aside....best of luck getting into school.

I think you are experiencing delusions of grandeur regarding your chosen profession. Let's start with the pre-reqs. At Keiser University they are as follows for PA:
College Math or higher (3 semester credit hours)
• English - Minimum of 3 hours in English Composition
(6 semester credit hours)
• Humanities (3 semester credit hours)
• General Biology or Zoology with laboratory (4 semester credit hours)
• Microbiology with laboratory (4 semester credit hours)
• Biochemistry or Organic Chemistry (3 semester credit hours)
• Social Sciences (3 semester credit hours)
• Human Anatomy & Physiology with laboratory (8 semester credit hours)
• Genetics (3 semester credit hours)
• Behavioral Sciences (6 semester credit hours)

PT, pharmacy, chiropractor, podiatry just to name a few healthcare professions have more similar requirements to MDs. Where is the physics with labs? The chemistry requirements are also lacking as compared with MDs. Just one math class? Give me a break.

I have read a post stating that the assessment class you all take is harder than that of an MD. How can you even say that when MDs are assessing patients as residents and attendings etc. Snap out of it and please wake up.

As far as your relatives are concerned they may be gifted students to go to Pharmacy school and work full time. The folks I know who went to pharmacy school studied 6-8 hours per day. You go to a Pharmacy thread and tell them that as a PA you studied and learned more than them, they will get a good laugh. What you are experiencing in PA school is not uncommon to all other healthcare professions so get off of your high horse.

If the program is so great why don't people regard PAs as real doctors. You are a "midlevel" provider. Your salary is competitive with SLP, PSYD, LCSW, PT, OT, RN, ARNP ect. You are not a rocket scientist (in terms of intellect) nor are you a trader on wallstreet (in terms of compensation), if you are why are you just a PA student.

If the PA program is so rigorous why didn't you just go to MD or DO school to begin with and get it over. PA is not even as prestigious as podiatry or pharmacy (which you claim is easier). I think you all get my point by now. I was overseas trying to explain to a young lady what a PA was and she kept referring to it as a "doctor's assistant". The professors in your schools keep telling you all that you are learning as much as doctors but in two years time. I don't know why they keep feeding you folks with these falsehoods. That's like trying to be a professional bodybuilder in two years. The human mind does not work like that. Some things just take time. Anyhow keep taking your 138 credit hours for a master's degree which specializes in everything, I am tired of orienting you to reality.

 

[Dwindlin]

Trouble is, they may not know that they don't know what's going on.

I, like fab4fan, insist on seeing my doc when I have to go.

 

[PrinceVersed]

Trouble is, they may not know that they don't know what's going on.

Isn't that the risk of all general practitioners? Is a GP as likely to pick up on certain problems as a neuro, nephro, or cardio? Probably not. But hopefully the GP has been trained well enough to know when they don't know or when something seems off. Hopefully, the NP/PA has been trained well enough to know when they don't know or when something seems off.

What it comes down to is whether or not you trust that. I personally do. And as someone who sees two different doctors at least 3x a year, and has so for many years, 97% of the time there is NO reason for them to waste their time on my visit. A NP/PA could just as easily ask, "So, is there anything I can do for you? No? Ok, well see you in 3 months".

 

[fab4fan]

Isn't that the risk of all general practitioners? Is a GP as likely to pick up on certain problems as a neuro, nephro, or cardio? Probably not. But hopefully the GP has been trained well enough to know when they don't know or when something seems off. Hopefully, the NP/PA has been trained well enough to know when they don't know or when something seems off.

What it comes down to is whether or not you trust that. I personally do. And as someone who sees two different doctors at least 3x a year, and has so for many years, 97% of the time there is NO reason for them to waste their time on my visit. A NP/PA could just as easily ask, "So, is there anything I can do for you? No? Ok, well see you in 3 months".

So why do you waste their time when your complaints could easily be handled by a mid-level? If you don't have anything going on for an NP/PA to do, why do you even show up at an office at all? You'd be wasting the mid-level's time.

 

[sideways]

First of all personally it's hard for me, a lowly nurse, to have full respect for someone who makes less money than me (a resident). But I will entertain your debate. If you are having a difficult time as a FP MD competing step your game up and find another specialty like the top doctors I see on TV (i.e. surgeons etc.). Or is that going to be too much work for someone so superior intellectually? If you can't stand the heat get out the kitchen!!

I think you should start seeing the PSYCHMD that's supervising you.

 

[pianoman511]

Isn't that the risk of all general practitioners? Is a GP as likely to pick up on certain problems as a neuro, nephro, or cardio? Probably not. But hopefully the GP has been trained well enough to know when they don't know or when something seems off. Hopefully, the NP/PA has been trained well enough to know when they don't know or when something seems off.

What it comes down to is whether or not you trust that. I personally do. And as someone who sees two different doctors at least 3x a year, and has so for many years, 97% of the time there is NO reason for them to waste their time on my visit. A NP/PA could just as easily ask, "So, is there anything I can do for you? No? Ok, well see you in 3 months".

Unfortunately, that attitude is perpetuating the current opinion that midlevels can do the same job as primary care physicians. This is also the opinion that many in politics have as well because they see cost-savings in this measure. The problem is that once you embrace this ideology, then (as we have already started to see with NPs), the argument becomes "if I am doing the same job and you told me that I am equivalent, I should have the equivalent pay" and that cost-saving measure becomes moot.

Again, regarding your point about recognizing when something is off, I refer to my earlier post. The ability to recognize an abnormal finding on physical exam does not just require the knowledge of what normal is, but what abnormal can indicate. A broad differential is required, and to say that a physician's differential is the same as someone with less knowledge and training is frankly wrong. Unfortunately, our overloaded system of primary care has perpetuated the myth that primary care physicians cannot manage chronic conditions and referral to specialists is necessary. The reality is that our current system rewards physicians for quantity, and it is not economically feasible for PCPs to manage many of the conditions that they refer out. Does every diabetic need to be sent to an endocrinologist ? No.... Does every patient with CAD, HTN need to be sent to a cardiologist ? No... Is a PCP more able to manage those conditions than a mid-level practitioner ? Yes.

 

[atcpt1]

I think you are experiencing delusions of grandeur regarding your chosen profession. Let's start with the pre-reqs. At Keiser University they are as follows for PA:
College Math or higher (3 semester credit hours)
• English - Minimum of 3 hours in English Composition
(6 semester credit hours)
• Humanities (3 semester credit hours)
• General Biology or Zoology with laboratory (4 semester credit hours)
• Microbiology with laboratory (4 semester credit hours)
• Biochemistry or Organic Chemistry (3 semester credit hours)
• Social Sciences (3 semester credit hours)
• Human Anatomy & Physiology with laboratory (8 semester credit hours)
• Genetics (3 semester credit hours)
• Behavioral Sciences (6 semester credit hours)

PT, pharmacy, chiropractor, podiatry just to name a few healthcare professions have more similar requirements to MDs. Where is the physics with labs. The chemistry requirements are also lacking as compared with MDs. Just one math class? Give me a break.

I have read a post stating that the assessment class you all take is harder than that of an MD. How can you even say that when MDs are assessing patients as residents and attendings etc. Snap out of it and please wake up.

As far as your relatives are concerned thay may be gifted students to go to Pharmacy school and work full time. The folks I know who went to pharmacy school studied 6-8 hours per day. You go to a Pharmacy thread and tell them that as a PA you studied and learned more than them, they will get a good laugh. What you are experiencing in PA school is not uncommon to all other healthcare professions so get off of your high horse.

If the program is so great why don't people regard PAs as real doctors. You are a "midlevel" provider. Your salary is competitive with SLP, PSYD, LCSW, PT, OT, RN, ARNP ect. You are not a rocket scientist (in terms of intellect) nor are you a trader on wallstreet (in terms of compensation), if you are why are you just a PA student.

If the PA program is so rigorous why didn't you just go to MD or DO school to begin with and get it over. PA is not even as prestigious as podiatry or pharmacy (which you claim is easier). I think you all get my point by now. I was overseas trying to explain to a young lady what a PA was and she kept referring to it as a "doctor's assistant". The professors in your schools keep telling you all that you are learning as much as doctors but in two years time. I don't know why they keeping feeding you folks with these falsehoods. That's like trying to be a professional bodybuilder in two years. The human mind does not work like that. Some things just take time. Anyhow keep taking your 138 credit hours for a master's degree which specializes in everything, I am tired of orienting you to reality.

LOL

Get some help

Great bodybuilding metaphor......that was brilliant...you know "how the mind doesn't work that way" LOL

And yes. THe PA is a mid level provider....and the pharmacist - really isn't a real provider. Great source of information for certain things, but they just do what they're told by real providers.....sorry (I do respect them)....but less medical training than a PA

Further, I provided you with facts. Hours in class...ect....

There is no comparison

PA's = 111 actual weeks of fulltime education
MD's = 155 actual weeks of full-time education

With the exception of DPM's and DMD/DDS

Everybody else is less.

Sorry. Facts!

 

[PSYCHNP]

LOL

Get some help

Great bodybuilding metaphor......that was brilliant...you know "how the mind doesn't work that way" LOL

And yes. THe PA is a mid level provider....and the pharmacist - really isn't a real provider. Great source of information for certain things, but they just do what they're told by real providers.....sorry (I do respect them)....but less medical training than a PA

Further, I provided you with facts. Hours in class...ect....

There is no comparison

PA's = 111 actual weeks of fulltime education
MD's = 155 actual weeks of full-time education

With the exception of DPM's and DMD/DDS

Everybody else is less.

Sorry. Facts!

I don't know where you are getting your facts from, but pharmacists practice the science of pharmacy. That is their body of knowledge. Go around and ask which profession is more respected and people will tell you pharmacy. They make more money, their profession is world renown, their professional program is a 4-5 year clinical doctorate (which is why they are more highly educated), and they are regarded more highly in professional circles. The field of Pharmacy has its own body of knowledge and the tradition (I believe PAs use the medical model not their own body of knowledge based on their own research). Ask mothers out there who they would prefer their daughter to marry a PA or Pharmacist. You can use that test as a barometer.

Optometrists are another group of healthcare professionals that garner more respect than PAs. Their program is rigorous and science based. The history of optometry can be traced back to the early studies on optics and image formation by the eye. The origins of optometric science date back a few thousand years BC. They even make more money than PAs.

Psychologists with a PHD are highly respected (like DR. Phil on TV). Their program is not science based. Even though they don't always make the big bucks their profession is world renown and has the tradition.

Even a business minded LPN with his or her own successful business can garner more respect than a PA. I can go on and on. Please don't let your ego blind you from the truth. As a PA student don't believe the hype your professors are selling you. Let's not have delusions of grandeur. Everybody else is not less let's not be narrow minded.

I guess all those "fluff" leadership classes in nursing school do come in handy. OOPs I shouldn't have typed that. lol.

 

[Narnian]

Please remind me to bow and scrape if I ever have the privilege of having you as my physician. I hope my illness will be worthy of your awesomeness.

I like what Kung Fu Panda said

"There is no charge for Awesomeness... or atractiveness!" LOL

 

[Narnian]

Ask mothers out there who they would prefer their daughter to marry a PA or Pharmacist. You can use that test as a barometer.

I think you need to go back to leadership school and learn some better comparitive analogies.

Also on that whole prestigeous kick...

Go around and ask which profession is more respected and people will tell you pharmacy.
Optometrists are another group of healthcare professionals that garner more respect than PAs.
Psychologists with a PHD are highly respected (like DR. Phil on TV).

Seriously??? Are you really comparing Pharmacy, Dr. Phil, and Optometry with PA's?

Well whether or not PA's are world renown, or world respected, or make "Big Bucks" does not matter given the feild that they work in. You come in my hospital and collapse on the floor and need emergent care... I'll just go grab the Pharmacist, Dr. Phil and an Optometrist and let them treat you, then after (If you can survive this encounter!) you can tell them how much more you respect them than PA's. I'll be in the breakroom writing letters to Santa about how I want more respect and recognition for christmas! ( because thats really what I got into healthcare for) *Sarcasm*

Healthcare is a team effort and PA's, NP's, Nurses, Docs, RT, PT, OT, Pharm-D etc. all work together. And we are supposed to look out for one another!

 

[delano2000]

LOL

Get some help

Great bodybuilding metaphor......that was brilliant...you know "how the mind doesn't work that way" LOL

And yes. THe PA is a mid level provider....and the pharmacist - really isn't a real provider. Great source of information for certain things, but they just do what they're told by real providers.....sorry (I do respect them)....but less medical training than a PA

Further, I provided you with facts. Hours in class...ect....

There is no comparison

PA's = 111 actual weeks of fulltime education
MD's = 155 actual weeks of full-time education

With the exception of DPM's and DMD/DDS

Everybody else is less.

Sorry. Facts!

Are you completely sure about that?

 

[Dr Oops]

I don't know where you are getting your facts from, but pharmacists practice the science of pharmacy. That is their body of knowledge. Go around and ask which profession is more respected and people will tell you pharmacy. They make more money, their profession is world renown, their professional program is a 4-5 year clinical doctorate (which is why they are more highly educated), and they are regarded more highly in professional circles. The field of Pharmacy has its own body of knowledge and the tradition (I believe PAs use the medical model not their own body of knowledge based on their own research). Ask mothers out there who they would prefer their daughter to marry a PA or Pharmacist. You can use that test as a barometer.

Optometrists are another group of healthcare professionals that garner more respect than PAs. Their program is rigorous and science based. The history of optometry can be traced back to the early studies on optics and image formation by the eye. The origins of optometric science date back a few thousand years BC. They even make more money than PAs.

Psychologists with a PHD are highly respected (like DR. Phil on TV). Their program is not science based. Even though they don't always make the big bucks their profession is world renown and has the tradition.

Even a business minded LPN with his or her own successful business can garner more respect than a PA. I can go on and on. Please don't let your ego blind you from the truth. As a PA student don't believe the hype your professors are selling you. Let's not have delusions of grandeur. Everybody else is not less let's not be narrow minded.

I guess all those "fluff" leadership classes in nursing school do come in handy. OOPs I shouldn't have typed that. lol.

Too bad you dont have a course on witty internet responses.

 

[deleted87716]

Isn't that the risk of all general practitioners?

That's a straw man. Nobody knows everything.

Frankly, generalists are more qualified to evaluate a patient with undifferentiated complaints than specialists. Is your chest pain cardiac, GI, pulmonary, musculoskeletal, or somatic? Which specialist would you choose to evaluate your chest pain first?

It's an illogical fallacy that patients will always self-triage themselves to the appropriately-skilled provider depending on the actual (not imagined) severity of their underlying problem(s).

Hopefully, the NP/PA has been trained well enough to know when they don't know or when something seems off.

I have no reason to believe that the paltry clinical hours in the average NP program provide adequate preparation to properly evaluate undifferentiated patients in an unsupervised setting.

as someone who sees two different doctors at least 3x a year, and has so for many years, 97% of the time there is NO reason for them to waste their time on my visit. A NP/PA could just as easily ask, "So, is there anything I can do for you? No? Ok, well see you in 3 months".

N=1. No statistics classes yet...?

 

[PSYCHNP]

I think you need to go back to leadership school and learn some better comparitive analogies.

Also on that whole prestigeous kick...


Seriously??? Are you really comparing Pharmacy, Dr. Phil, and Optometry with PA's?

Well whether or not PA's are world renown, or world respected, or make "Big Bucks" does not matter given the feild that they work in. You come in my hospital and collapse on the floor and need emergent care... I'll just go grab the Pharmacist, Dr. Phil and an Optometrist and let them treat you, then after (If you can survive this encounter!) you can tell them how much more you respect them than PA's. I'll be in the breakroom writing letters to Santa about how I want more respect and recognition for christmas! ( because thats really what I got into healthcare for) *Sarcasm*

Healthcare is a team effort and PA's, NP's, Nurses, Docs, RT, PT, OT, Pharm-D etc. all work together. And we are supposed to look out for one another!

Good luck with those letters. I don't think they will help.

 

[fab4fan]

I like what Kung Fu Panda said

"There is no charge for Awesomeness... or atractiveness!" LOL

BWAH!

+20

 

[PSYCHNP]

LOL

Get some help

Great bodybuilding metaphor......that was brilliant...you know "how the mind doesn't work that way" LOL

And yes. THe PA is a mid level provider....and the pharmacist - really isn't a real provider. Great source of information for certain things, but they just do what they're told by real providers.....sorry (I do respect them)....but less medical training than a PA

Further, I provided you with facts. Hours in class...ect....

There is no comparison

PA's = 111 actual weeks of fulltime education
MD's = 155 actual weeks of full-time education

With the exception of DPM's and DMD/DDS

Everybody else is less.

Sorry. Facts!

This post goes out to all of you healthcare professionals who are "less"!

Can any of you shed some light on some of the various nonclinical and clinical leadership roles healthcare professionals/providers can embark on? I know in a previous post Emedpa described a PA who went on to work with or become the Surgeon General of the United States. What type of education is best suited for this (An additional MBA, Law degree etc.) formal or nonformal? In corporate business circles an IVY League MBA (i.e. form Harvard/Princeton) is priceless. Does the same hold true for hospital administation/management positions? For example, I know an ER RN who went on to get her Masters degree in Administration and Financial Leadership from FAU and another who earned her law degree. Suppose they got their degrees from Harvard, what opportunities might they have?

What about ownership of one of the following businesses: staffing/employment entity, clinic, private practice, nursing/rehabilitation facility, pharmacy, healthcare facilities (skilled or unskilled), consultation business, educational/training center. How can one (as a healthcare professional/provider) better prepare him or herself for such leadership positions?

Last but not least Academia related leadership positions can be elaborated on.

If anyone (and I mean anyone MD, PA, RN, ARNP, OT, SLP. PharmD, PTA, COTA, LPN, CNA) can expand on any one of these issues. I believe it can enlighten us all, particularly atcpt1.

My point here is that there are people out there making strides and doing big things in healthcare other than PAs.

I guess those "fluff" leadership nursing classes do come in handy afterall. OOPs I shouldn't have typed that.

 

[atcpt1]

This post goes out to all of you healthcare professionals who are "less"!

Can any of you shed some light on some of the various nonclinical and clinical leadership roles healthcare professionals/providers can embark on? I know in a previous post Emedpa described a PA who went on to work with or become the Surgeon General of the United States. Our first lady worked as Vice President for Community and External Affairs for University of Chicago Hospitals (a $273,618 position).

What type of education is best suited for this (An additional MBA, Law degree etc.) formal or nonformal? In corporate business circles an IVY League MBA (i.e. form Harvard/Princeton) is priceless. Does the same hold true for hospital administation positions? For example, I know an ICU RN who went on to get her Masters degree in Administration and Financial Leadership from FAU and another who went on to get her law degree. Suppose they got their degrees from Harvard, what kinds of opportunities might they have?

What about ownership of one of the following businesses: staffing/employment entity, clinic, nursing/rehabilitation center, pharmacy, residential facility (skilled or unskilled), consultation business, educational/training center. How can one (as a healthcare professional) better prepare him or herself for such leadership positions?

Last but not least Academia related leadership positions can be elaborated on.

If anyone (and I mean anyone MD, PA, RN, ARNP, OT, SLP. PharmD, PTA, OTA, LPN, CNA) can expand on any one of these issues I believe it can enlighten us all, particularly atcpt1.

I guess those "fluff" leadership nursing classes do come in handy afterall. OOPs I shouldn't have typed that.

Great....then go be a nurse manager or something, but stop trying to practice medicine independently with such a diluted education.

To tell you the truth - I don't even know what you're saying. What you write is incoherent at times....seems like lots of racing thoughts going through your head....and logic is clearly lost on you.

Anyhow, before finding this site, I never would have had such silly discussions. This is really dumb stuff....and strangely, I find it fun to talk about - and I'm beginning to think it's a reflection of my lack of intelligence....

I provided some data.....feel free to dispute it with data.

Qualitatively, I think I know one thing....people are respected on who they are....a cool nurse rules...likewise for any other professional. When a person is good at what they do....they get respect regardless of their degree....I have great respect for RPh and OD's...it's a great profession for people who like it.



(PS. I would love to hear about the composition of hours for RPh or OD programs....maybe I'll learn something new)

 

[PSYCHNP]

Great....then go be a nurse manager or something, but stop trying to practice medicine independently with such a diluted education.


If all you can do is diagnose and treat an illness (with the help of a supervising MD) after getting your "138 credit hours" of education, you are paying so much for, you are getting ripped off. I would demand a refund from my educational institution. I guess that's why DNPs and PharmDs are being awarded clinical doctorates.

 

[atcpt1]

Good luck with those letters. I don't think they will help.

Again, I don't know what you're saying with your comments, but I just wanted to provide you with another fact that I can back up

PA's are supervised by attending physicians (much like residents)

SCOPE OF PRACTICE DEFINED:
"The physician assistants scope of practice shall be limited to that delegated to the physician assistant by the supervising physician and for which the physician assistant is qualified by education, training and experience. At no time shall the practice of the physician assistant exceed the normal scope of the supervising physician's practice."

As a PA, you have the scope of practice that is similar or equal to your supervising MD. As a person who respects the training of a physician....PA’s seem to get a lot of respect by law makers and their physician supervisors.

PA's do indeed workup complex trauma/emergency situations/critical patients. They practice medicine. There are two professions that practice medicine in healthcare....PA's and MD/DO's. That's why is fair to compare their differences and similarities.

And to touch on another point:

I believe there are two real “doctorate” degrees….MD/DO and PhD – the rest is all degree creep

PA’s could easily justify awarding a clinical doctorate when you compare it to clinical doctorates in pharm, PT, OT ect
But it wouldn’t make sense for the PA profession. The doctorate degree in medicine is the MD/DO. PA is the master’s degree in medicine.
Further, PA schools (like MD/DO) don’t care about the degree awarded…It’s the education they care about. PA school isn’t degree based like other professions
It’s competency based education.

If you’re a pedagological purist, you’ll appreciate this fact

 

[atcpt1]

Don't worry I am sure he will still have a job. PA programs are very thorough and they can work in any subspecialty. I don't see PAs as competition at all. It would be foolish, like crabs in a barrel. I read your link and it does not state that NPs will be 100% interchangeable with doctors. Furthermore, I don't know one nurse that thinks he or she is superior to MDs. I do know pharmacists going around calling themselves doctors though. If you as a pharmacist want to prescribe why don't you go to the dual pharmacy/NP program in Hawaii and take the needed physical assessment classes etc. I don't see why you are so concerned with PAs or NPs when you would be making more than both of them (about $60/hr for standing on your feet in a cold store behind a counter all day), off of the prescriptions that they write.

Read above
and re-read all the other garbage you have written

At least you made a little bit of sense in the above post!

This is why people are questioning your maturity....or even sanity.

Hopefully you're just really young....and thus immature....that is the best we can hope for.

 

[PSYCHNP]

Again, I don't know what you're saying with your comments, but I just wanted to provide you with another fact that I can back up

PA's are supervised by attending physicians (much like residents)

SCOPE OF PRACTICE DEFINED:
"The physician assistants scope of practice shall be limited to that delegated to the physician assistant by the supervising physician and for which the physician assistant is qualified by education, training and experience. At no time shall the practice of the physician assistant exceed the normal scope of the supervising physician's practice."

As a PA, you have the scope of practice that is similar or equal to your supervising MD. As a person who respects the training of a physician....PA's seem to get a lot of respect by law makers and their physician supervisors.

PA's do indeed workup complex trauma/emergency situations/critical patients. They practice medicine. There are two professions that practice medicine in healthcare....PA's and MD/DO's. That's why is fair to compare their differences and similarities.

And to touch on another point:

I believe there are two real "doctorate" degrees….MD/DO and PhD – the rest is all degree creep

PA's could easily justify awarding a clinical doctorate when you compare it to clinical doctorates in pharm, PT, OT ect
But it wouldn't make sense for the PA profession. The doctorate degree in medicine is the MD/DO. PA is the master's degree in medicine.
Further, PA schools (like MD/DO) don't care about the degree awarded…It's the education they care about. PA school isn't degree based like other professions
It's competency based education.

If you're a pedagological purist, you'll appreciate this fact

First of all, that response was to a post made by Narnian. It is important to read a passage in its entirety ( I know they taught you that in PA school).

Anyhow PA is not the master's degree in medicine. Can you support that statement with relevant literature from the NCCPA or other credentialing body?

If you truly believe that PA schools do not care about the degree they award I think you are being naive. Why did they go up to the masters level then? I bet they will soon be following the trend like PT etc. Trust me the educational institutions love money. Just look on the threads on SDN and see how much tuition some of the students owe ($100,000-$200,000 not uncommon). The only thing I see keeping your profession from awarding clinical doctorates are the MDs. They like the fact that PAs are in a subservient position. Anyhow, I have some other work to do, hope you open your eyes and recognize what is really going on out there.

You seem like a pretty intelligent person, if you have the time, money, and resources why don't you just go all the way and become an MD, DO, dentist, or pharmacist? If you are a young student, I think the extra time and investment are well worth it. Remember, my friend, there are few things that are staightforward or "black and white" in this world.

 

[delano2000]

Read above
and re-read all the other garbage you have written

At least you made a little bit of sense in the above post!

This is why people are questioning your maturity....or even sanity.

Hopefully you're just really young....and thus immature....that is the best we can hope for.

I read the quote and I can definitely see why you think that user's posts are incoherent.

 

[youngdoc8205]

I gotta agree with blue dog, PCPs (MD/DO) are MUCH, MUCH better at at diagnosis of undifferentiated pt complaints then independent mid-levels or the specialists.

My evidence if purely anecdotal, based on N=1 (me), but here are several examples

when I was in rads: the PCPs were the ones who ordered the most appropriate images, and not only that they had the highest percentage of being correct,
whereas the cardiologists would order cardiac MRI and perfusion studies on patients who had dyspnea and no sign of cardiac disease
the pulmonologists would order VQ scans on people with CHF exacerbations and the midlevels would order MRI for every headache and my personal favorite: an abdominal film of a pregnant teenager with constipation after doing a "thorough" physical exam with a finding of abdominal distention

 

[atcpt1]

The only thing I see keeping your profession from awarding clinical doctorates are the MDs. They like the fact that PAs are in a subservient position.

The "doctor" degree is meaningless to the PA profession. The degree that's awarded shouldn't influence the ability to practice independently. It's the content of the education that matters. Regardless of what PA's are awarded, they should be supervised unless they complete an educational program comparable to medical school and a residency....supervised by an attending.

With the complexity of the patients that PA's treat, they want a solid education and the supervision of that attending physician. They understand teams and holistic multi-disiplinary care. They want to continually learn, become better practitioners, ect....not walk around with a phony doctor badge citing there declaration of independance.

When they want to advance there education and training, they go to medical school. The PA education is raw, content based, medical training. The scope of practice of a PA is to broad to practice independently (without going to medical school and residency).

The MD-PA team is a simple formula for high quality and effective patient care.

I also appreciate Blue dogs comments:

"Frankly, generalists are more qualified to evaluate a patient with undifferentiated complaints than specialists. Is your chest pain cardiac, GI, pulmonary, musculoskeletal, or somatic? Which specialist would you choose to evaluate your chest pain first?

It's an illogical fallacy that patients will always self-triage themselves to the appropriately-skilled provider depending on the actual (not imagined) severity of their underlying problem(s) - Blue dog."

The generalist education and training is so important and why nobody but a generalist or supervised midlevel should see patients independently. And also why direct access for non-medical providers (non MD/DO/PA) should not exist! Evaluation,treatment, and triage by the generalist is the most cost effective and safe patient care model.

 

[fab4fan]

As a mere diploma nurse, I find PSYCHNP's posts embarrassing to the nursing profession. Please don't get the impression that all nurses think this way based on her posts. Many of us are quite normal (or almost normal ).

 

[Denatured]

As a mere diploma nurse, I find PSYCHNP's posts embarrassing to the nursing profession. Please don't get the impression that all nurses think this way based on her posts. Many of us are quite normal (or almost normal ).

On one hand logic tells me he/she is not even an NP because she arguments her points so poorly that she must be an impersonator making for easy prey. Unfortunately, my gut tells me he/she is completely serious.

 

[Narnian]

I guess that's why DNPs and PharmDs are being awarded clinical doctorates.

I would get your facts straight before you post... PA's in the military can earn a clinical doctorate. They do not call themselves "Doctor"

Tell me this! When will there be a bridge program for DNP's or Pharm-D's to gain a MEDICAL Doctorate? You know! That is that thing that actually allows you to call yourself "Doctor" in a medical setting!

There is already one for PA's at LECOM...

http://www.lecom.edu/index.php/leco...d-physician-assistant-pathway/76/0/1919/18477

and there will be more. It was Dr. Eugene Stead's original Idea for PA's

 

[BLKPA2MD]

As a mere diploma nurse, I find PSYCHNP's posts embarrassing to the nursing profession. Please don't get the impression that all nurses think this way based on her posts. Many of us are quite normal (or almost normal ).

 

[PSYCHNP]

I would get your facts straight before you post... PA's in the military can earn a clinical doctorate. They do not call themselves "Doctor"

Tell me this! When will there be a bridge program for DNP's or Pharm-D's to gain a MEDICAL Doctorate? You know! That is that thing that actually allows you to call yourself "Doctor" in a medical setting!

There is already one for PA's at LECOM...

http://www.lecom.edu/index.php/leco...d-physician-assistant-pathway/76/0/1919/18477

and there will be more. It was Dr. Eugene Stead's original Idea for PA's

Narnian I respect your post very much. You see, Advanced Practice Nurses do not want to be doctors. If they did they would go to MD/DO school. That is why we don't study under the Medical Model and we have our own body of knowledge backed by evidence based research.

I just fear for all my pre-medical students who spend so much money on their tuitions. Money is scarce these days. We are now in an economic depression. Reimbursement for healthcare services have become unpredictable. I was reading the newspaper this morning (something us well rounded professionals do) when I found out that you could now get a 3 bedroom home for $95,000 in some parts of this country. Would you want to spend that type of money in a field of endeavor mired in stagnation, opression, and exploitation when student loan debt is the most difficult type to deal with (way worse than auto, home, or credit card debt)?

Allow me to elaborate on this. Webster's dictionary (2000) defines subservient as "useful in an inferior capacity, subordinate." I bet besides all the barriers of the name itself ("physician assistant"), getting your work signed off, having to be watched all the time, lack of OD/MD bridge programs (just one and who can get into it anyway), there are more "hidden" surprises.

Why do PAs have to take the Physician Assistant National Recertification exam, I believe every six years, and MDs don't? I am not talking about CEUs but a full fledge exam. I know some of you out there are saying that's just making us better clinicians. But, look at the inconvenience it will be to stop your busy schedules working in the ER, taking on family problems ect. to study for, then take this exam. Why should PAs have to prepare for such an exam while the MDs, who impose it, are out on their yachts on a Sunday afternoon with the money they made from PA labor in their private practices?

What happens when you are up in age and went to school years prior and have to take an exam in which you have no control over the content. What do you do if you fail, go work at Wal Mart as a door greeter?

MDs are drinking from the fountain of youth without sharing a drop of water with PAs.

I am sorry if the truth hurts, but I will not rest until I tell it. Then again, maybe I will take a break from this, I am getting tired of all of the bickering.

 

[deleted6669]

I bet besides all the barriers of the name itself ("physician assistant"), getting your work signed off, having to be watched all the time, lack of OD/MD bridge programs (just one and who can get into it anyway), there are more "hidden" surprises.
Why do PAs have to take the Physician Assistant National Recertification exam, I believe every six years, and MDs don't? I am not talking about CEUs but a full fledge exam. are up in age and went to school years prior and have to take an exam in which you have no control over the content. What do you do if you fail, go work at Wal Mart as a door greeter?

a few clarifications:
yes, our name sucks, we're working on that.
"getting work signed off" isn't as involved as you might think. most states do not require 100% chart review. many require 5-10% within 1 month so it's not like most of us are presenting every pt.
we aren't. we aren't "being watched all the time". in fact many of us are not being"watched" at all as there is no physician present while we work. the majority of my shifts I work alone. my sponsoring physician reviews my charts at a later time and gets back to me with feedback. I always can call for consults as needed.
there is 1 bridge now. there will be more. count on it.
most docs do have to retake their specialty exams to stay credentialed. for family medicine docs every 7 yrs, for em every 10 yrs, I think it's 5 for peds and IM, etc
the recert exam is a good idea. it keeps your knowledge base sharp. it's not a secret what material is on it and the fail rate is very low because folks study for it(not very hard after you have done it a few times-my last recert exam I spent 1 hr studying for and scored at the 99% level. my next one I will probably take cold).I frequently have a pa student with me( 12/yr) so I review the material constantly in order to teach it effectively.

 

[PSYCHNP]

a few clarifications:
yes, our name sucks, we're working on that.
"getting work signed off" isn't as involved as you might think. most states do not require 100% chart review. many require 5-10% within 1 month so it's not like most of us are presenting every pt.
we aren't. we aren't "being watched all the time". in fact many of us are not being"watched" at all as there is no physician present while we work. the majority of my shifts I work alone. my sponsoring physician reviews my charts at a later time and gets back to me with feedback. I always can call for consults as needed.
there is 1 bridge now. there will be more. count on it.
most docs do have to retake their specialty exams to stay credentialed. for family medicine docs every 7 yrs, for em every 10 yrs, I think it's 5 for peds and IM, etc
the recert exam is a good idea. it keeps your knowledge base sharp. it's not a secret what material is on it and the fail rate is very low because folks study for it(not very hard after you have done it a few times-my last recert exam I spent 1 hr studying for and scored at the 99% level. my next one I will probably take cold).I frequently have a pa student with me( 12/yr) so I review the material constantly in order to teach it effectively.

Thanks for the timely response Emedpa. You are definitely a leader and a role model in your field. It is true that in the last decade many of the MD certification bodies have required recertification examinations for those entering the given field of endeavor.

I also read some of your posts in other threads. It seems as if you are advocating for bridge programs for your colleagues. Good work.

I know the content of such an exam comes easy to you. As I said earlier you are truly a "gifted clinician". I just fear for the PAs out there who have to be controlled and manipulated by credentialing institutions/entities controlled by MDs. Suppose there becomes a glut of PAs? I bet the Medical Boards will raise the requirements of PAs. They could manipulate the testing requirements just to keep your numbers down.