PA limitation compared to MD

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Makati2008 said:
Personally respect
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what? pa's are not universally respected based on their training, experience, and demonstrated competence?
hard to believe.....:)
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duckie99 said:
4. There is no guarantee that a PA who does this will match.
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From what I understand, osteopathic residencies aren't particularly competitive. The chance of a former PA not matching, providing they did well in school, seems like it would be very low (unless they want to match into one of the most competitive specialties like derm).
 
CityLights said:
From what I understand, osteopathic residencies aren't particularly competitive. The chance of a former PA not matching, providing they did well in school, seems like it would be very low (unless they want to match into one of the most competitive specialties like derm).
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yup. if I went back I would aim for a full scope unopposed fp residency....you can do almost anything with that.
 
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NotAsking4Much said:
So much PA bashing...I don't get why people just can't accept they fit a much needed niche in health care. I guess people are just protective of their professional territory.

I must say...PA is a great profession. 60-80k starting salary, can be equally as "rewarding" as any provider, good lifestyle, good job security. I think it's a great field for anyone who wants to be part of healthcare but may be turned off by the obligatory time to jump through all the hoops. Obviously, there are limitations but just saying...
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There was no PA bashing in this post, I clarified that a person is able to work without being Board Certified right out of GME training. The other part of the post was to say that PAs train, get hired and basically start at the bottom of the food chain until they get enough on the job training to be called fully proficient. There definitely is a ceiling for how high PAs can go in administration vs. physicians as well as scope of practice. Mid-levels that overstep cause a great deal of their own problems. Management usually is split between RNs and physicians in most organizations, and if you're looking for a cushy job with very high salary, that's where to go. PAs usually don't get to that point.

Salary-wise, 2-5 years out of PA school can easily get you to the 90k+ range, but creeps up slowly from there. Any physician in ANY field should at least be at about 200k+ 2-5 years out of training. If not, they don't have an attorney helping with their contracts, have poor business sense or complain year after year about their EMR or staff slowing them down without addressing it. Yes, I've talked to FP, IM and Peds doctors that say that they don't know what the problem is when a doctor complains about making X per year and they say they make almost double that because they make good decisions on the issues mentioned above.
 
Blue Dog said:
Actually, there are plenty of folks arguing that FM residency should be four years, not three. Anyone who thinks primary care is easy either hasn't done it, or isn't any good at it.
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So what do they have to say to the PAs such as the one above who are claiming that 80-90% of an FM docs job can be done by a PA with 0 residency? Simply false? Or does that extra 10-20% of knowledge/skill really take 4 extra years?
 
rog411 said:
So what do they have to say to the PAs such as the one above who are claiming that 80-90% of an FM docs job can be done by a PA with 0 residency? Simply false? Or does that extra 10-20% of knowledge/skill really take 4 extra years?
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I think the best people to talk to are the PA's doing the LECOM bridge program. They've commented in several threads before, and the take-away I got from them was "you don't know what you don't know, I have learned soooo much since I went to med school that I didn't know as a PA." I'm sure you could track the threads down.
 
Forgive me. I haven't read this thread in its entirety. But here are my two cents:

What's your main objective here, emedpa? It is clear to me that you, like many of us, defend your career choices with emotion and vigor. Good for you that you're a PA! But recognize that your continued banter on this thread shows your insecurity.

It is likely that you've worked very hard in your life to be a PA. It is likely that you are competent and good at what you do. It is likely that you earn a good living and have been able to realize some of your financial goals and dreams because of the dollar that you make. Given that, how would YOU like it if someone with significantly LESS training than YOU were to begin to tell anyone who would listen that THEY can do YOUR job just as well? How would you like it if this person went to a "school" that required less rigor than your PA school, and these schools were popping up all around the country? Suppose for another moment that politicians believed that a solution to the healthcare crisis was to train more "pseudo-midlevels" so that they can "help" the current midlevels do their job? And suppose further that you had to work alongside this person everyday. How do you think you'd handle it?

It is clear to me that patient care is best delivered in a team model. This is most significantly true in an acute care setting. In this scenario, I hope for experienced nurses, PAs, NPs, perfusionists, RTs... whoever. I just want to take care of the patient and I welcome anyone's input when things aren't going well. But for a team to be effective, each member needs to know their role and accept it. When subordinates try to usurp their superiors--or convey an attitude that "they know better"--then team chemistry suffers and ultimately, patient care is diminished.

I respect and welcome those midlevels who wish to join my team and my cause, to help me take care of sick patients. However, don't for a minute think you can take my job or do my job. I (we), too, have worked very hard to achieve my (our) professional status. I (We), too, have bills to pay and financial goals to try and achieve. Medicine is my (our) calling and my (our) living, and I (we) will defend it fiercely.

To you, midlevel emedpa, I say stay within yourself. And I will, too. Then, things will be alright.
 
Textbookversion said:
I think the best people to talk to are the PA's doing the LECOM bridge program. They've commented in several threads before, and the take-away I got from them was "you don't know what you don't know, I have learned soooo much since I went to med school that I didn't know as a PA." I'm sure you could track the threads down.
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I think this is a major point that needs to be quoted again. Sure the H&P class is something a PA can do already and just add to their skills in this with what they learn from formal classes. But the fact that former PAs have said that after making the full transition to transition to a physician with residency and everything else they have the opportunity to know what they didn't know before.
 
Blue Dog said:
They know better.
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If only they would put their knowledge to use in shaping healthcare policy and checking the uncontrolled proliferation and scope expansion of midlevels rather than making MDs lives more difficult :-/
 
rog411 said:
so what do they have to say to the pas such as the one above who are claiming that 80-90% of an fm docs job can be done by a pa with 0 residency? Simply false? Or does that extra 10-20% of knowledge/skill really take 4 extra years?
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reread what i wrote. 80-90% of outpatient/clinic practice. Not inpatient practice
 
bud12345 said:
, how would you like it if someone with significantly less training than you were to begin to tell anyone who would listen that they can do your job just as well? How would you like it if this person went to a "school" that required less rigor than your pa school, and these schools were popping up all around the country? Suppose for another moment that politicians believed that a solution to the healthcare crisis was to train more "pseudo-midlevels" so that they can "help" the current midlevels do their job? And suppose further that you had to work alongside this person everyday. How do you think you'd handle it?

.
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you mean np's?.....:)
I think they should be regulated like pa's and have to have a physician of record who oversees their work....
 
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emedpa said:
you mean np's?.....:)
I think they should be regulated like pa's and have to have a physician of record who oversees their work....
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i agree 10000%. emedpa i think instead of arguing wth the MDs you should put your efforts into straightening out the NPs!!
 
rog411 said:
i agree 10000%. emedpa i think instead of arguing wth the MDs you should put your efforts into straightening out the NPs!!
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docs need to take a side. you can work with us and support us or compete with the np's who you have zero influence over.....
 
emedpa said:
docs need to take a side. you can work with us and support us or compete with the np's who you have zero influence over.....
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i can't speak for others but as a doc i will definitely support PAs over NPs
 
I don't know why anyone would hire an NP over a PA. You could drive a truck through the fluff filled holes in their curriculum. I think it takes the same amount of clinical hours to become an NP in most states as it does to become a paramedic.
 
xenotype said:
I don't know why anyone would hire an NP over a PA. You could drive a truck through the fluff filled holes in their curriculum. I think it takes the same amount of clinical hours to become an NP in most states as it does to become a paramedic.
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Yup and now they have a doctorate program with more fluff so they can confuse people into thinking they know more!

It's the docs themselves that give NPs the power by hiring them and using them.
 
Next post. didn't realize I could embed.
 
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[YOUTUBE]http://www.youtube.com/watch?v=57yjSmX4Wlw[/YOUTUBE]
 
emedpa said:
a typical day in the life of a PA:
http://www.youtube.com/watch?v=asgVIVV8H6U
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Emedpa, I've been reading your posts quite a bit lately, and I'm curious about how you ended up as an ER PA. It sounds like you really take your job seriously and do a good job, but it also seems like the fact that you don't get respect from random people who don't understand the system bothers you.

I'm assuming you ended up in medicine in a round-about way (i.e. already had a family and couldn't go back to school for 4 years), and if you'd known in high school you wanted to be in medicine you'd be an MD right now.
 
sjdsn135 said:
Emedpa, I've been reading your posts quite a bit lately, and I'm curious about how you ended up as an ER PA. It sounds like you really take your job seriously and do a good job, but it also seems like the fact that you don't get respect from random people who don't understand the system bothers you.
I'm assuming you ended up in medicine in a round-about way (i.e. already had a family and couldn't go back to school for 4 years), and if you'd known in high school you wanted to be in medicine you'd be an MD right now.
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emt in high school
er tech through college 26 hrs/week during school yr while taking 20 units/term and 60 hrs/week summers.
ba#1 medical anthro
paramedic school right after college
5 yrs as a medic in L.A. & philadelphia (the city of brotherly shove, hated that place)
pa school (bs#2)
ms clinical emergency medicine
post masters cert in adv. clinical studies in em and fp
grad certificate global health
currently 1/2 way through a 4 yr global health doctorate
(back story-my dad was the kind of doc who couldn't handle being a doc and raising a family. I have no memory of him before age 13. I didn't want to be that kind of father. I figured out too late I could have held it together and been a good doc and father. I also had an inappropriate fear of o-chem in college. never took it. pa just seemed to make sense down the line for a paramedic with a prior bs level degree. when I finally started getting it together and went back to take prereqs my wife lost her job, we had a kid, etc, etc. life happens....opportunity cost now > 1 million dollars for me to go back to school....)
 
emedpa said:
emt in high school
er tech through college 26 hrs/week during school yr while taking 20 units/term and 60 hrs/week summers.
ba#1 medical anthro
paramedic school right after college
5 yrs as a medic in L.A. & philadelphia (the city of brotherly shove, hated that place)
pa school (bs#2)
ms clinical emergency medicine
post masters cert in adv. clinical studies in em and fp
grad certificate global health
currently 1/2 way through a 4 yr global health doctorate
(back story-my dad was the kind of doc who couldn't handle being a doc and raising a family. I have no memory of him before age 13. I didn't want to be that kind of father. I figured out too late I could have held it together and been a good doc and father. I also had an inappropriate fear of o-chem in college. never took it. pa just seemed to make sense down the line for a paramedic with a prior bs level degree. when I finally started getting it together and went back to take prereqs my wife lost her job, we had a kid, etc, etc. life happens....opportunity cost now > 1 million dollars for me to go back to school....)
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I'm sorry to hear it didn't quite turn out the way you had wanted, but it sounds like you did the best you could with your circumstances.

I still think your dad deserves a lot of respect for sacrificing his family life to be the best clinician he could be (whether he could have balanced better is a different issue). I think that's why a lot of med students and MD/DO's are defensive about this issue, because they made a sacrifice and want to be respected for that sacrifice over people who chose not to. It's not that they don't think a PA is capable of being a great clinician if they really want to.
 
I want to become a physician, but my kids will always be number one.

I know a bunch of doctor's kids and pastor's wives. It's pretty tough for them too.
 
emedpa said:
emt in high school
er tech through college 26 hrs/week during school yr while taking 20 units/term and 60 hrs/week summers.
ba#1 medical anthro
paramedic school right after college
5 yrs as a medic in L.A. & philadelphia (the city of brotherly shove, hated that place)
pa school (bs#2)
ms clinical emergency medicine
post masters cert in adv. clinical studies in em and fp
grad certificate global health
currently 1/2 way through a 4 yr global health doctorate
(back story-my dad was the kind of doc who couldn't handle being a doc and raising a family. I have no memory of him before age 13. I didn't want to be that kind of father. I figured out too late I could have held it together and been a good doc and father. I also had an inappropriate fear of o-chem in college. never took it. pa just seemed to make sense down the line for a paramedic with a prior bs level degree. when I finally started getting it together and went back to take prereqs my wife lost her job, we had a kid, etc, etc. life happens....opportunity cost now > 1 million dollars for me to go back to school....)
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So I am now contemplating whether I want to go forward with DO school or move in the PA direction. I am nontrad. (29), have a child, husband, house, etc. I have spent a lot of time with different doctors and they all agree that if my ultimate goal is to open my own underserved clinic for women (paying a physician as a consultant, of course) I should just become a PA and save myself the seven years of med school, debt, and residency agony. I have never really cared about the "Dr." title. Based on your posts, it sounds like you would disagree with me? Is it that bad as a PA?

I worry as a doctor I won't have enough time to continue building my non-profit corporation designed to help underprivileged women. I also worry about time with my son/family. I have seen the damage absentee parenting can cause and it's not pretty. I can imagine that you would agree...you can't make up for lost years and life is so short. I would love your opinion.
 
Wilf said:
I would be very angry if I went to the ER and only a PA was there to see patients. I don't know what patient population you are dealing with but most middle class and upper class patients would not put up with that level of care.
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This one of the main reasons PAs don't get respect! {Rodney Dangerfield style} [EM already said this]

But the great ones like EM deserve respect , end of story! Ill return...:sleep:


My deeper thoughts on PA limitation compared to MD:

1)The MD gets to make "big" decisions.

2)By definition PA is a physician dependent position..(The docs should not see PAs as threats compared to NPs who may pose some threat..

3)Say what you want but "hands on experience" is a big frickin deal in this medical debacle.
(Taking some time,cordial bedside manner, (not being in a frenzy) and overall Oslerian clinical experience, a PA may out do a doc in certain instances depending on specialty)


[Even in this case the sophisticated PA can't run around bragging, he must be humble and/or bite his tongue] {Knowing that sometimes human beings sometimes feel insecure} Unfortunately the young ones may not know this..Overall its the art of medicine!- limitation or no limitation
Just keeping it real....

4) If a lawyer or liar does not want to talk to the PA its ok. Its already written in stone that he is a douche..

By the way Im not saying that EM is bragging..:)
 
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Emedpa, you are quite painful honestly. always posting BS and defending your PAs to no end. It is true torture to read the things you write. it's as if you live just to argue over the equality of a PA to an MD. Never have been, could be, or will be (or DESERVE to be) equal. go away.
 
billybob746 said:
Emedpa, you are quite painful honestly. always posting BS and defending your PAs to no end. It is true torture to read the things you write. it's as if you live just to argue over the equality of a PA to an MD. Never have been, could be, or will be (or DESERVE to be) equal. go away.
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Learn to grammar better if you're going to be this condescending. Right or wrong, it's just irritating to witness.

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You lost me at "painful honestly".

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painful, honestly. hope that makes you feel better about yourself
 
It was for your benefit broski ;)

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billybob746 said:
Emedpa, you are quite painful honestly. always posting BS and defending your PAs to no end. It is true torture to read the things you write. it's as if you live just to argue over the equality of a PA to an MD. Never have been, could be, or will be (or DESERVE to be) equal. go away.
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Grow up.
It always amazes me how people like yourself act all brave on an Internet forum and yet they are the most timid people ever when you meet them in real life.....
 
It is hard for me to believe a PA with an AS degree (which some PA-Cs have) can function as good or better than MD/DO even in fp. I think AAPA should standardize these PA programs just like MD/DO.
 
Temperature101 said:
It is hard for me to believe a PA with an AS degree (which some PA-Cs have) can function as good or better than MD/DO even in fp. I think AAPA should standardize these PA programs just like MD/DO.
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they put out a "recommendation" a few years ago that every program grant an ms. most do. the others are being phased out....
 
emedpa said:
they put out a "recommendation" a few years ago that every program grant an ms. most do. the others are being phased out....
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Great...Not that I am against PA...I am a RN who would choose to do PA over NP with no problem. I think these NP programs have so much flaws.
 
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