Physician. Assistant doing surgery alone with Physician over seeing

[Medfieldfuture]

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Does anyone think that if PA's were to take further extensive training in surgery, that they would be able to preform surgery on their own but with an attending physician over seeing?

 

[ram1senk]

I've asked mother this before (been an ortho PA for 20+ years) and she said yes. She would be "incredibly nervous", but has been through the procedures so many countless times that she knows what he does before he does it. Obviously this is just her opinion, and is untestable, but I feel as if I believe her.

 

[The Beyonder]

Does anyone think that if PA's were to take further extensive training in surgery, that they would be able to preform surgery on their own but with an attending physician over seeing?

If an attending has to oversee all of the surgeries, what would be the point of a PA?

 

[JPodel]

If an attending has to oversee all of the surgeries, what would be the point of a PA?

Exactly, if we need a surgeon to look over the surgery, why not just give the surgeon the task and rid the PA? Hospitals will love saving some money.

 

[Mt Kilimanjaro]

Two threads?

Simple surgery is not simple when you cut wide and blood shoots to the ceiling.

 

[Medfieldfuture]

So basically you guys say that a PA, who does basically a "mini med school" is useless in surgery and you would prefer a surgical tech helping a doc and get rid of the PA's? If it were to be like that why not get ride of all the surgical staff and let the surgeon and anesthesiologist do all the work? PA's are a good asset and even a more valuable one of they learn how to preform procedures as well.

 

[JPodel]

No one said that we would prefer surg techs over PA's... We said that it would be inefficient to have a surgeon look over a PA doing a procedure when the surgeon can be doing it by himself...

 

[Mt Kilimanjaro]

Three words:

Know your role.

 

[Medfieldfuture]

Exactly that's why i said in my other thread a 2 year residency. Did you not read correctly? And if you do not like my threads you and just simply not look at them, and as for me being "hubris" I'm not I'm the least hubris person there could possibly be because I am Very aware of what training doctors go through and I'm know GS go through 5 year residencies but I said very small surgeries maybe even just laproscopic surgery

 

[Mt Kilimanjaro]

Exactly that's why i said in my other thread a 2 year residency. Did you not read correctly? And if you do not like my threads you and just simply not look at them, and as for me being "hubris" I'm not I'm the least hubris person there could possibly be because I am Very aware of what training doctors go through and I'm know GS go through 5 year residencies but I said very small surgeries maybe even just laproscopic surgery

Solid effort, troll.

2/10

 

[JPodel]

1. A 2 year residency doesn't compare to the 5+ year residency for surgeons.
2. Doesn't matter how small a surgery is, it is still a surgery and there is a chance of death.
3. I am pretty sure a lot of surgeons would find this offensive as you are basically saying that surgeons go through 5+ years AFTER med school so that PA's can do a 2 year "residency" and be able to "perform" surgery.

 

[Medfieldfuture]

As of now I really think your answers are simply just arrogant and I don't deal with people like so like I said earlier you don't like don't look simple as that, troll

 

[Medfieldfuture]

1. A 2 year residency doesn't compare to the 5+ year residency for surgeons.
2. Doesn't matter how small a surgery is, it is still a surgery and there is a chance of death.
3. I am pretty sure a lot of surgeons would find this offensive as you are basically saying that surgeons go through 5+ years AFTER med school so that PA's can do a 2 year "residency" and be able to "perform" surgery.

I guess in a way you're right maybe I'm looking into something that's at people won't like to see and maybe wot happen but then again it could but thanks for your responses on both threads

 

[JPodel]

Yeah no problem man, it would be interesting to see how this would work out if it did ever happen.

 

[Medfieldfuture]

Well as you can see I would see great hopes for it but hey I'm not a committee to be deciding what happens, but I like the idea but as I can see many people are not for it but oh we'll I just wanted to see what people thought of it, thanks again

 

[Aerus]

Well as you can see I would see great hopes for it but hey I'm not a committee to be deciding what happens, but I like the idea but as I can see many people are not for it but oh we'll I just wanted to see what people thought of it, thanks again

So you decided to ask a question on a public forum, then start raging when people give responses that don't agree with your predetermined answer? 😕

Why make the thread then?

 

[preMedDonut]

Well as you can see I would see great hopes for it but hey I'm not a committee to be deciding what happens, but I like the idea but as I can see many people are not for it but oh we'll I just wanted to see what people thought of it, thanks again

I think I just lost some verbal reasoning points.

 

[pandahunter]

OP just wants people to agree and praise him for his brilliant opinion.

 

[yehhhboiii]

This thread gave me cancer. Now I need a PA to operate on me.

 

[ESzczesniak]

There is nothing magical about surgery. It is a purely technical skill like carpentry and mechanics. The value and education of a surgeon is knowing who to operate on, what surgery to do, what to do if things don't go as planned, and who not to operate on (perhaps most important). The OR itself, while a lot of fun, is nothing special.

 

[JPodel]

There is nothing magical about surgery. It is a purely technical skill like carpentry and mechanics. The value and education of a surgeon is knowing who to operate on, what surgery to do, what to do if things don't go as planned, and who not to operate on (perhaps most important). The OR itself, while a lot of fun, is nothing special.

Okay Mr. Insult.

 

[ESzczesniak]

Okay Mr. Insult.

Sorry if you don't like my answer. I'm a senior surgical resident, so I have some perspective on this. Difficult to say the same for a number of people posting comments who haven't even finished medical school yet, much less surgical training.

 

[DrBowtie]

There is nothing magical about surgery. It is a purely technical skill like carpentry and mechanics. The value and education of a surgeon is knowing who to operate on, what surgery to do, what to do if things don't go as planned, and who not to operate on (perhaps most important). The OR itself, while a lot of fun, is nothing special.

Truth.

 

[mmmcdowe]

There is nothing magical about surgery. It is a purely technical skill like carpentry and mechanics. The value and education of a surgeon is knowing who to operate on, what surgery to do, what to do if things don't go as planned, and who not to operate on (perhaps most important). The OR itself, while a lot of fun, is nothing special.

I definitely agree and could potentially see a scenario similar to anesthesiologists overseeing a bunch of mid levels in each room. There are a few more boundaries to this in surgery such as a different perspective on malpractice risk, a much for hands on role, and also resistance in the field. I don't think that it will happen any time soon.

 

[ESzczesniak]

I definitely agree and could potentially see a scenario similar to anesthesiologists overseeing a bunch of mid levels in each room. There are a few more boundaries to this in surgery such as a different perspective on malpractice risk, a much for hands on role, and also resistance in the field. I don't think that it will happen any time soon.

Similar models are actually in place in some Asian countries, or at least so I am told. I'm not an expert on international medicine, but am to understand that the "surgeon" (the one with the medical degree) has a role more to determine the appropriate surgery and supervise than to do any real surgery.

While PA's are different than residents, you only need to read an operative report from an academic institution to see there is actually some legal precedent for this. The key words to allow for legal billing (particulary Medicare) by the attending are "I was present and scrubbed for all critical portions of this procedure". It doesn't say what those portions are or who did the critical portions.

In community practice, it is indeed common place for PA's to close the surgical wounds. I am not aware of too many that open, but this could be foreseable under the above wording.

I do think there will be much resistance by surgeons. Proportionally, these "simple" surgeries that would be the realm of the PA are where surgeons can really pile on the earnings. I think my numbers are a bit dated, but for instance a total knee arthroplasty surgeon's fee is something like $1400 for about 60 minutes of work (assuming a PA or resident does most positioning and closing as is usually the case) while a revision knee arthroplasty is about $1800 for what is often 4-5 hours of work. Doing complex cases just doesn't pay and if all these simple one's go to PA's, the surgeon's will lose their earning power.

 

[lilwayne]

I think that surgeons should be the only ones doing surgeries.

The reason that surgeons do all of those years of crazy training is not necessarily to do straightforward procedures, but to know what exactly to do when everything goes horribly wrong.

Assuming PA's had some sort of extended training, I have no doubt that it would train them to do straightforward procedures, but when **** goes south they wouldn't know what to do. Just stick to letting the surgeons do the surgeries.

- Young mula baby