Pace of PA vs MD/DO Didactic curriculum

[deleted480308]

According to my friend they are with them for the entire M2 year and take the same tests with them for every system which includes the path. Pretty impressive, but I really doubt it is anywhere near the norm of PA programs.

I call Bull$&@$........no way the exams are the same

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[lmn]

Ask the professors that offer the test. They aren't the same tests.

I don't go to the same school... I just put the info out there that there is at least one place that they take classes with and sit for exams at the same time.

Maybe they are watered down, maybe not. Although to me it is weird to make them take the test together if they are taking a different exam and their schedules are exactly the same. In either case, I don't really care, but I think this thread really shows the superiority complex that some med students need to feel over PA's...

My point is that what is expected of them is much lower than what is expected of a physician, so even if they are taking the same classes, they often aren't learning as much of the material. 1 month in PA school is in no way equivalent to 1 month in MD/DO school. That, combined with a lack of residency, makes them a far less competent provider than their physician counterparts, and is exactly why they are midlevels.

At least in this case they are learning exactly the same material as the MD students. We don't know if they are taking the exact same test, but they are getting the exact same lectures and materials at least. So the material is identical. Why do you seem to be projecting such a need for PA students to be learning "inferior" training than you or I? Do you really care that much?

 

[AspiringERMD]

At my school, MD and PA students do all the preclinical years' classes together. I'm not sure if they get the same exams, but we take them in the same room at the same time.

 

[W19]

At my school, MD and PA students do all the preclinical years' classes together. I'm not sure if they get the same exams, but we take them in the same room at the same time.

So they do a 2-year preclinical...

 

[Rajayray2019]

I will say, and worth noting, that PA schools tolerate far less in the way of student failure.
Most medical schools you can fail 1-2 classes, remediate, and if necessary repeat the year. (as long as you fall within the mandated number of years in your state).

PA schools...not so much. they're far less tolerant. below a 3.5? see ya later.

Even though I think that PA school is easier, in both didactic/clinical education, I don't know that I agree with this zero tolerance policy that is so common. I think that the PA students should get a little slack, if the medical students are going to get it.

 

[Mad Jack]

I don't go to the same school... I just put the info out there that there is at least one place that they take classes with and sit for exams at the same time.

Maybe they are watered down, maybe not. Although to me it is weird to make them take the test together if they are taking a different exam and their schedules are exactly the same. In either case, I don't really care, but I think this thread really shows the superiority complex that some med students need to feel over PA's...


At least in this case they are learning exactly the same material as the MD students. We don't know if they are taking the exact same test, but they are getting the exact same lectures and materials at least. So the material is identical. Why do you seem to be projecting such a need for PA students to be learning "inferior" training than you or I? Do you really care that much?

It is the reality. I know of multiple schools where they take some of the same courses as the MDs or DOs and zero where they take the same tests, though they are often tested at the same time. This makes sense, as the USMLE and PANCE test different things in different ways- giving the PAs the same exam as the medical students would be to their detriment.

It isn't important to me that their expected level of knowledge is lower. It is a fact. No PA would pass Step 1 after their preclinical curriculum, guaranteed. That their knowledge and competence is lower is important for the public to know, because, despite what politicians would have them think, board certified physicians are the must qualified clinicians out there. We need to maintain that image at all costs, to protect patients, the health care system, and our future career prospects.

 

[deleted480308]

It is the reality. I know of multiple schools where they take some of the same courses as the MDs or DOs and zero where they take the same tests, though they are often tested at the same time. This makes sense, as the USMLE and PANCE test different things in different ways- giving the PAs the same exam as the medical students would be to their detriment.

It isn't important to me that their expected level of knowledge is lower. It is a fact. No PA would pass Step 1 after their preclinical curriculum, guaranteed. That their knowledge and competence is lower is important for the public to know, because, despite what politicians would have them think, board certified physicians are the must qualified clinicians out there. We need to maintain that image at all costs, to protect patients, the health care system, and our future career prospects.

What is arrogant and sad is for anyone else to pretend they are trained to the degree we are....they are intelligent, useful, and trained.....they are not trained to the degree we are

 

[ACSurgeon]

It is the reality. I know of multiple schools where they take some of the same courses as the MDs or DOs and zero where they take the same tests, though they are often tested at the same time. This makes sense, as the USMLE and PANCE test different things in different ways- giving the PAs the same exam as the medical students would be to their detriment.

It isn't important to me that their expected level of knowledge is lower. It is a fact. No PA would pass Step 1 after their preclinical curriculum, guaranteed. That their knowledge and competence is lower is important for the public to know, because, despite what politicians would have them think, board certified physicians are the must qualified clinicians out there. We need to maintain that image at all costs, to protect patients, the health care system, and our future career prospects.

- while your statement about PAs not being able to pass step 1 MIGHT be true, I'm not sure that such a sweeping generalization is correct. Assuming they spend time with uworld and first aid, I bet some (?many) would pass step 1. I'd be happy to see data showing a 0% pass rate.

- step 1 is a crappy indicator of knowledge and a crappie the indicator of clinical competence. Not sure why we use it as if it's a good standard.

- you're not discussing this topic with the public. You're discussing this with mostly medical students/doctors. These lengthy posts about how inferior PAs are do nothing to educate the public. It seems like they stem from insecurity and wanting to demonstrate superiority.

- if PAs attend the same classes and have be same materials, they might actually reach a similar level of pre-clinical knowledge. The fact is, pre-clinical knowledge is NOT what separates doctors from PAs. It's also not the degree. It's the intense clinical experience over many many years that will never be approximated with on the job learning.

- many doctors have become lazy. They have no desire to go the extra mile, work a little harder, read during their free time etc. Those doctors provide similar services provided by midlevels and ARE at risk of being replaced (to an exten) with PAs and NPs and CRNAs. They are also the same doctors who use the argument of "I'm a doctor so I must be better" rather than demonstrating a unique set of skills, knowledge and work ethic. To avoid a flame war, I won't mention specific disciplines but I think most people here know which specialties have become replaceable by physician extenders. It's in part because of their lobbying lower, but also in part from our laziness to perform to our capacity (and to lobby to a lesser extent)

 

[deleted480308]

- while your statement about PAs not being able to pass step 1 MIGHT be true, I'm not sure that such a sweeping generalization is correct. Assuming they spend time with uworld and first aid, I bet some (?many) would pass step 1. I'd be happy to see data showing a 0% pass rate.

- step 1 is a crappy indicator of knowledge and a crappie the indicator of clinical competence. Not sure why we use it as if it's a good standard.

- you're not discussing this topic with the public. You're discussing this with mostly medical students/doctors. These lengthy posts about how inferior PAs are do nothing to educate the public. It seems like they stem from insecurity and wanting to demonstrate superiority.

- if PAs attend the same classes and have be same materials, they might actually reach a similar level of pre-clinical knowledge. The fact is, pre-clinical knowledge is NOT what separates doctors from PAs. It's also not the degree. It's the intense clinical experience over many many years that will never be approximated with on the job learning.

- many doctors have become lazy. They have no desire to go the extra mile, work a little harder, read during their free time etc. Those doctors provide similar services provided by midlevels and ARE at risk of being replaced (to an exten) with PAs and NPs and CRNAs. They are also the same doctors who use the argument of "I'm a doctor so I must be better" rather than demonstrating a unique set of skills, knowledge and work ethic. To avoid a flame war, I won't mention specific disciplines but I think most people here know which specialties have become replaceable by physician extenders. It's in part because of their lobbying lower, but also in part from our laziness to perform to our capacity (and to lobby to a lesser extent)

Again, BS.....being "replaced" by nonphysicians has nothing to do with effort or skill of physicians and everything to do with the lobbying power (legislative and public opinion) of nonphysicians

 

[ACSurgeon]

Again, BS.....being "replaced" by nonphysicians has nothing to do with effort or skill of physicians and everything to do with the lobbying power (legislative and public opinion) of nonphysicians

And your suggestion? We stomp our feet and proclaim "but we're better because we are doctors?" Oh wait, NPs are "doctors" now too. That won't work. But we do a residency. Nope, PAs and NPs have some residency programs now too. The public is far too ignorant and careless to dig through the details of our more in depth curriculum, harder step and board-certification exams, our intense residency, etc.

I agree that we have to lobby. We also have to emerge as clearly performing higher and being more committed. Most NPs/PAs/CRNAs are not interested in doing more than their 30-40 hrs/week and earning their paycheck. It's just a job to most of them. Our training is so superior that it should be palpable to hospital administrators/the public/legislators etc. This will take more than a tantrum where we get red in the face and insist that we are better.

 

[Mad Jack]

- while your statement about PAs not being able to pass step 1 MIGHT be true, I'm not sure that such a sweeping generalization is correct. Assuming they spend time with uworld and first aid, I bet some (?many) would pass step 1. I'd be happy to see data showing a 0% pass rate.

- step 1 is a crappy indicator of knowledge and a crappie the indicator of clinical competence. Not sure why we use it as if it's a good standard.

- you're not discussing this topic with the public. You're discussing this with mostly medical students/doctors. These lengthy posts about how inferior PAs are do nothing to educate the public. It seems like they stem from insecurity and wanting to demonstrate superiority.

- if PAs attend the same classes and have be same materials, they might actually reach a similar level of pre-clinical knowledge. The fact is, pre-clinical knowledge is NOT what separates doctors from PAs. It's also not the degree. It's the intense clinical experience over many many years that will never be approximated with on the job learning.

- many doctors have become lazy. They have no desire to go the extra mile, work a little harder, read during their free time etc. Those doctors provide similar services provided by midlevels and ARE at risk of being replaced (to an exten) with PAs and NPs and CRNAs. They are also the same doctors who use the argument of "I'm a doctor so I must be better" rather than demonstrating a unique set of skills, knowledge and work ethic. To avoid a flame war, I won't mention specific disciplines but I think most people here know which specialties have become replaceable by physician extenders. It's in part because of their lobbying lower, but also in part from our laziness to perform to our capacity (and to lobby to a lesser extent)

First off, you fight the fight of opinion within your profession in order to have a more unified voice when dealing with the public. Every time I hear a medical student say "their training is just as good as ours" is one time too many. It us in no way equivalent, for many reasons.

Second, there is no PA school where the students take all of MS1 and MS2 with medical students. That is why they wouldn't pass the Steps. There are some where they get a bit of MS2, and very few where they do the majority of MS2 with med students, but they basically skip MS1 and have watered down anatomy and basic science courses. Their fund of knowledge is lower, thus their eventual understanding of cases and literature is lower. You can't say, "but what about the exceptions, the ones that work really hard" when comparing them to us, because in medical school and residency, there is no option for us to not work hard. Their best can barely scrape the abilities of our worst, hardly an accomplishment.

Now, as to the fields where they are making inroads, there have yet to be direct comparisons of unsupervised midlevels taking care of cases in equal acuity to their physician counterparts that show equal outcomes in any field. Anesthesia and primary care studies have, by and large, focused on low acuity or supervised practice. I just hope we get some honest studies in the future and the public wakes up.

 

[ACSurgeon]

First off, you fight the fight of opinion within your profession in order to have a more unified voice when dealing with the public. Every time I hear a medical student say "their training is just as good as ours" is one time too many. It us in no way equivalent, for many reasons.

Second, there is no PA school where the students take all of MS1 and MS2 with medical students. That is why they wouldn't pass the Steps. There are some where they get a bit of MS2, and very few where they do the majority of MS2 with med students, but they basically skip MS1 and have watered down anatomy and basic science courses. Their fund of knowledge is lower, thus their eventual understanding of cases and literature is lower. You can't say, "but what about the exceptions, the ones that work really hard" when comparing them to us, because in medical school and residency, there is no option for us to not work hard. Their best can barely scrape the abilities of our worst, hardly an accomplishment.

Now, as to the fields where they are making inroads, there have yet to be direct comparisons of unsupervised midlevels taking care of cases in equal acuity to their physician counterparts that show equal outcomes in any field. Anesthesia and primary care studies have, by and large, focused on low acuity or supervised practice. I just hope we get some honest studies in the future and the public wakes up.

All good points. I'm not sure any medical student here has said that PAs have a similar fund of knowledge. The original question was about the pace, not the absolute amount of knowledge. There has been a number of threads discussing midlevels vs doctors in the last year, and I still can't recall medical students arguing that any midlevel emerges with equivelant knowledge. Taking the same pathophys course with the same exams is not the same as having the same knowledge.

For as much as we complain about the poor quality of our pre-clinical education (PhDs covering there research instead of anything clinically relevant) we seem to to somehow think this preclinical experience is what differentiates us from the rest. Our first two years certainly make up some of the difference. Our clinical training is what makes us astronomically ahead of the rest.

For most if not all medical students, it is self evident that we are far ahead in knowledge and skills. Anytime a pre-clinical student posts here after arguing with a midlevel student and feeling insecure they come from reassurance rather than because they believe they're receiving similar education to midlevels.

 

[TBV]

But let's be real the chicks are much hotter in PA school

 

[deleted480308]

But let's be real the chicks are much hotter in PA school

You clearly don't attend my school

 

[TBV]

You clearly don't attend my school

You should see some of the towering infernos that attend my schools' affiliate PA school.

 

[Psai]

You should see some of the towering infernos that attend my schools' affiliate PA school.

pics or it didn't happen

pa and nursing students are generally better looking than the med students in my area though
but somehow the attendings are better looking than the midlevels

 

[W19]

pics or it didn't happen

pa and nursing students are generally better looking than the med students in my area though
but somehow the attendings are better looking than the midlevels

Working on the floor as a nurse is not pretty!

 

[TBV]

pics or it didn't happen

pa and nursing students are generally better looking than the med students in my area though
but somehow the attendings are better looking than the midlevels

Thats true there's a smoking hot cardiologist in our hospital SOO hot want to touch the hiney

 

[Psai]

Thats true there's a smoking hot cardiologist in our hospital SOO hot want to touch the hiney

You should let them know. Who knows what might be in store for you in the future?

 

[TBV]

You should let them know. Who knows what might be in store for you in the future?

Perhaps an invite to the office of HR

 

[Mad Jack]

You should let them know. Who knows what might be in store for you in the future?

A restraining order.

 

[AspiringERMD]

So they do a 2-year preclinical...

Ours is 1.5 years for PA and MD students, actually. But yeah, I was surprised at that. Seems like there's hardly a difference at our school. Just fewer (different too? Not sure) clinicals, from what I can tell right now. But again, I don't know if their tests are different.

 

[Yadster101]

Ours is 1.5 years for PA and MD students, actually. But yeah, I was surprised at that. Seems like there's hardly a difference at our school. Just fewer (different too? Not sure) clinicals, from what I can tell right now. But again, I don't know if their tests are different.

which school?

 

[Kaustikos]

You should see some of the towering infernos that attend my schools' affiliate PA school.

/flame suit on

Respiratory therapy students win in our hospitals.
I don't know why or how, but it's like "WTF, you don't belong in a hospital"

 

[Mad Jack]

/flame suit on

Respiratory therapy students win in our hospitals.
I don't know why or how, but it's like "WTF, you don't belong in a hospital"

I didn't become an RT for nothing lol...

 

[lmn]

It is the reality. I know of multiple schools where they take some of the same courses as the MDs or DOs and zero where they take the same tests, though they are often tested at the same time. This makes sense, as the USMLE and PANCE test different things in different ways- giving the PAs the same exam as the medical students would be to their detriment.

It isn't important to me that their expected level of knowledge is lower. It is a fact. No PA would pass Step 1 after their preclinical curriculum, guaranteed. That their knowledge and competence is lower is important for the public to know, because, despite what politicians would have them think, board certified physicians are the must qualified clinicians out there. We need to maintain that image at all costs, to protect patients, the health care system, and our future career prospects.

I don't think it's at all fair to compare PA students attempting Step 1 when they don't have specific study time and a ton of materials that are directly aimed at passing Step 1. Who knows how many MD students would even pass on a first try without special study periods, First Aid, Pathoma, UWorld, Goljan, etc. I don't even have a clue what is on their licensing exam, who knows we could fail their exams if we don't use the targeted study material. Does that make us inferior to them in some way? If they are in the same classes they are literally getting the exact same material as MD students. If you take a Step 1 practice test before any special studying time or material and then one after you prep specially for step, there will be a huge difference. A huge amount of that test is specific information for Step 1 alone and getting used to their specific question style. That doesn't mean you were as "stupid" as a PA student before you started prepping for Step 1 and that you are magically a genius afterwards, you simply learned specific material for that test and how to take that specific test. Hell I have yet to even meet a single attending that hasn't said Step 1 is an archaic test that doesn't really tell us anything, and definitely doesn't transmit to how someone will be as a clinician.

 

[Yadster101]

The preclinical education is not compatable at all. Lol. Ever heard of Step 1? Do you think most PA students could pass that exam after their "grueling" 1 year of accelerated preclinical classes? I bet not.

Recently learned that at UIowa the PAs and the med students have the exact same preclinical classes. If they are passing the same classes then I think Iowa PAs would pass Step 1.

 

[Psai]

Taking the same classes does not mean you're absorbing the same things or end up with the same knowledge. There's a huge gulf of knowledge in between people in my own class despite having gone through exactly the same training. Passing classes is not the same thing as passing step 1. Also, PA schooling is shorter and less involved so I doubt that they are taking the same classes with the same expectations.

I've taken graduate level classes during college with science ph.d. candidates and smoked them but that doesn't make me a ph.d. in biochemistry.

 

[cbrons]

Recently learned that at UIowa the PAs and the med students have the exact same preclinical classes. If they are passing the same classes then I think Iowa PAs would pass Step 1.

You sure their requirements from those classes are the exact same?

 

[Yadster101]

Taking the same classes does not mean you're absorbing the same things or end up with the same knowledge. There's a huge gulf of knowledge in between people in my own class despite having gone through exactly the same training. Passing classes is not the same thing as passing step 1. Also, PA schooling is shorter and less involved so I doubt that they are taking the same classes with the same expectations.

I've taken graduate level classes during college with science ph.d. candidates and smoked them but that doesn't make me a ph.d. in biochemistry.

hmm..well I agree that there will always be a "huge gulf of knowledge" between individuals in a class which is why some ppl end up being competitive for derm while others are forced into FM cuz of low scores. Regardless they are all still doctors.

Passing classes is not the same thing as passing step 1.

Idk about that. The majority of ppl that pass their classes are able to pass step 1. If the PAs are passing the classes why wouldn't they pass step 1?

 

[Yadster101]

You sure their requirements from those classes are the exact same?

All I know is that they take the exact same classes with the same professors.

I don't think they'd give PAs different exams if they share the same lecturer. What would be the justification for that? That PAs simply have less grey matter than the MS1/MS2s..? Lol

 

[cbrons]

All I know is that they take the exact same classes with the same professors.

I don't think they'd give PAs different exams if they share the same lecturer. What would be the justification for that? That PAs simply have less grey matter than the MS1/MS2s..? Lol

They have less they are expected to know since they wont be practicing medicine independently hencr why their training isnt as long or extensive

 

[Yadster101]

They have less they are expected to know since they wont be practicing medicine independently hencr why their training isnt as long or extensive

Ya their training isn't as long but if they taking the exact same class side by side with med students Im pretty sure their preclincal knowledge would be the same...lecture material = exam material. Also if they're attending the same lecture, does the lecturer just stop frequently and say "PAs dont need to know this"?

 

[cbrons]

Ya their training isn't as long but if they taking the exact same class side by side with med students Im pretty sure their preclincal knowledge would be the same...lecture material = exam material. Also if they're attending the same lecture, does the lecturer just stop frequently and say "PAs dont need to know this"?

Ok bud

 

[TBV]

Why are we measuring dicks with PAs again?

 

[W19]

PA is legit guys.... NP is a joke!

 

[Psai]

Ya their training isn't as long but if they taking the exact same class side by side with med students Im pretty sure their preclincal knowledge would be the same...lecture material = exam material. Also if they're attending the same lecture, does the lecturer just stop frequently and say "PAs dont need to know this"?

We take some of the same classes with dental students who are smarter on average than PAs and they still get dumbed down tests compared to ours. They didn't even have to learn pelvic anatomy or go through the legs when we were doing gross. Same lecture material but different expectations and different exams. This is not a dump on dentists or PAs.

Also, during the clinical years there were plenty of times when we rotated with the PA and there were things that they just didn't need to know. There were a lot of things they didn't know. This isn't a dig but the reality of the program. You go to PA school to learn to be a PA, you don't go there to learn to be a doc

We don't need to participate in measuring contests, it's that everyone keeps saying that they're just as good as us. The nurses are going so far as to claim that they're better than we are at our jobs when they just aren't in any way.

 

[W19]

...

 

[princekc]

Wow! Very interesting read for sure!!

 

[TwinsFan]

Sitting in the same lecture is not the same as "taking the same classes." Between lecture, syllabi, outside reading and demonstrating mastery of all of this on exams this makes up a class. If any of these aren't the same then it isn't the same class. Period.

Also, a med student who was helping pa students here (top MD and PA school) said that their hardest questions were our easy ones on exams and for boards studying.

 

[Yadster101]

Sitting in the same lecture is not the same as "taking the same classes." Between lecture, syllabi, outside reading and demonstrating mastery of all of this on exams this makes up a class. If any of these aren't the same then it isn't the same class. Period.

Also, a med student who was helping pa students here (top MD and PA school) said that their hardest questions were our easy ones on exams and for boards studying.

From what I understand the Iowa PAs and MDs have the same syllabus and have to take the same tests.

 

[AlteredScale]

From what I understand the Iowa PAs and MDs have the same syllabus and have to take the same tests.

Hmm, I find it hard to believe that PAs needed to know what signaling molecules help push an embryo towards neural crest formation. That's wayyy too basic science for them. And it's not supposed to be an insult. It's the fact that 1) they don't need to know that and 2) they don't have time to know that stuff when their curriculum requires them to get kicked into clinical rotations so fast.

The reason why medical students are tested on the minutiae is because we are geared to understand the complexity of diseases. The only way to act on the forefront of research is to understand the language and thus, be tested on such material (minutiae).

A PA just needs to know the basics and more importantly the clinical approaches to disease.

That's why I find it hard to believe that PAs and MD students took the same course say in immunology. If they indeed did, then it was a waste of time for the PA students.

 

[TwinsFan]

From what I understand the Iowa PAs and MDs have the same syllabus and have to take the same tests.

We need an Iowa MD and PA student to confirm this. I highly doubt they take all the same classes and course load with all the same tests/syllabi and have the same passing threshold and no outside help (cheat sheet / shortened study sheet to "focus" their studying).

Taking one of the easier MD program classes where the avg is ~90 and only needing a 70 is not the same as taking "all the same classes."

 

[W19]

Maybe the Iowa PA is a 3-year long program... 2-year preclinical and 1 year rotation...

 

[Yadster101]

We need an Iowa MD and PA student to confirm this. I highly doubt they take all the same classes and course load with all the same tests/syllabi and have the same passing threshold and no outside help (cheat sheet / shortened study sheet to "focus" their studying).

Taking one of the easier MD program classes where the avg is ~90 and only needing a 70 is not the same as taking "all the same classes."

Ok so from their website it does seem like the take the same classes (link below). It is odd but if its true I'd think the Iowa PAs could pass step 1.

http://www.medicine.uiowa.edu/pa/curriculum/

http://www.medicine.uiowa.edu/md/The_New_Curriculum/

 

[W19]

It makes sense since Iowa preclinical year is 18 months for MD... The PA program is only 28 months. These PA will be ready to practice medicine after doing rotation for only 10 months... Scary!

 

[deleted480308]

It makes sense since Iowa preclinical year is 18 months for MD... The PA program is only 28 months. These PA will be ready to practice medicine after doing rotation for only 10 months... Scary!

They won't be practicing medicine in the manner that doctors do, they will be PAs. There is a difference

 

[Psai]

It makes sense since Iowa preclinical year is 18 months for MD... The PA program is only 28 months. These PA will be ready to practice medicine after doing rotation for only 10 months... Scary!

That's the whole point. A third year medical student is not prepared to practice medicine. And yet they are sending out people with less experience and knowledge than a third year medical student. Wow.

 

[IlDestriero]

That's the whole point. A third year medical student is not prepared to practice medicine. And yet they are sending out people with less experience and knowledge than a third year medical student. Wow.

This is why the doc in a box with one physician overseeing (blindly signing charts and "audits" for) 4 locations from his own full practice is so scary. It's also frightening that increasing numbers of patients go to these places repeatedly for minor things that are easily treated, fail to follow up with the primary care doctor that they haven't seen in years since they got better, and miss opportunities to get the routine checks and follow up that detect early disease.
That's a real problem, and they are thinking that they saw "the doctor" 3 times in the last 3 years. In reality they saw a NP or PA that only evaluated them for their cut, sore throat, rash, etc. ignoring the other warning signs of problems that they're not looking for at all. One patient I knew had "white coat hypertension" at 3 NP visits over a several years, never followed up with the PCP that they hadn't seen in a decade, and then had a significant stroke. Seems like that significant HTN that everyone ignored should have been treated years ago, and the outcome may have been different. It's not the NPs fault, they probably told him to recheck his BP or follow up, but medically unsophisticated patients don't connect the dots and don't often follow up when their acute problem goes away. I had a kidney stone years ago and still never saw the urologist I was supposed to follow up with as I got better and only had a single stone.

 

[W19]

This is why the doc in a box with one physician overseeing (blindly signing charts and "audits" for) 4 locations from his own full practice is so scary. It's also frightening that increasing numbers of patients go to these places repeatedly for minor things that are easily treated, fail to follow up with the primary care doctor that they haven't seen in years since they got better, and miss opportunities to get the routine checks and follow up that detect early disease.
That's a real problem, and they are thinking that they saw "the doctor" 3 times in the last 3 years. In reality they saw a NP or PA that only evaluated them for their cut, sore throat, rash, etc. ignoring the other warning signs of problems that they're not looking for at all. One patient I knew had "white coat hypertension" at 3 NP visits over a several years, never followed up with the PCP that they hadn't seen in a decade, and then had a significant stroke. Seems like that significant HTN that everyone ignored should have been treated years ago, and the outcome may have been different. It's not the NPs fault, they probably told him to recheck his BP or follow up, but medically unsophisticated patients don't connect the dots and don't often follow up when their acute problem goes away. I had a kidney stone years ago and still never saw the urologist I was supposed to follow up with as I got better and only had a single stone.

I guess that's the new trend... I have been going to the same primary care physician for 7 years now... I only saw her once. She got a couple of offices and staff with PA/NP. It's probably the new way to make money using mid level providers at the expense of patients...