Emedpa and physasst, I'm not an expert on this, but I think working solo or working without any supervision from a physician is a violation of the rules governing PAs. Last time I checked, to supervise means to watch over/oversee someone (to make sure that what he is doing is correct) . So why would any org or any grp do any study or any comparative analysis comparing PAs who are supervised by physicians to PAs working solo?
You are correct, you are not an expert.
pa's may legally work without a physician present as long as they are available by phone. this is called "distant supervision " and is completely legal in most states.
I'm working alone right now. have seen 18 pts so far tonight and have not spoken to a physician once.
3 good friends of mine work solo in the aleutians. their supervising physician is 6 hrs away by plane. yes, this is completely legal. they stabilize and transfer anyone who needs care they can not provide. they give tpa to MI's. they intubate, run codes, put in central lines and chest tubes, they reduce fxs and hang pressors, etc
we don't need hand holding and folks double checking everything we do. folks who work solo are not new grads. most of us are former military or civilian medics and have worked as pa's with direct physician supervision for yrs prior to ever working solo.we seek consults when we need them. we have been doing this job and doing it well for for > 40 yrs in places that physicians don't want to go.....when there is room for improvement in our practice our physician colleagues let us know. it's a mentoring relationship built on trust and mutual respect.every procedure we do we have to get credentialed for, just like our physician colleagues. pa's are often compared to "lifetime residents". a 3rd yr em resident can moonlight in a rural er without his attending present even though he is not yet a boarded em doc( and yes, I understand the difference between a 3rd yr em resident and a pa). a specialty pa knows more about their specialty than the vast majority of physicians who do not practice that specialty.
ALTAP, it's time for you to stop commenting about pa issues in this and all other pa threads. you obviously have no idea whatsoever what you are talking about. I know you wish you could work as a pa since you are a nurse who is an fmg who hasn't matched. you can't and you won't be able to. EVER.
your best bet is to reapply to do the thing you were trained to do, attend a physician residency. I do wish you good luck in that endeavor.
PS HERE IS AN EXAMPLE OF SUCH A JOB. TOOK ME LESS THAN 2 MIN TO FIND....
Mayo Regional Hospital is a 25 bed CAH in Dover-Foxcroft, Maine, just 35 miles north of Bangor. We see approximately 12,000 patients annually in our level III ED, without large seasonal variation. We staff the department full-time with a single qualified EM provider at either the physician or mid-level. Our day shift is from 0700 through 1900, the night shift is from 1800 through 0700. Full-time providers work three shifts weekly.
Although much of what we see in the ED could be managed in an office setting, the providers need to have the critical recognition skills for those who are acutely ill and require hospitalization, as well as be able to implement independently those life-saving skills (intubation, ACLS, thrombolysis) that can be essential to resuscitation. We are only 40 miles from Eastern Maine Medical Center, a tertiary care facility in Bangor. We transfer cases to them that we can't safely handle here (i.e. multiple trauma, complicated orthopedics, severe sepsis, and STEMi patients after thrombolysis) and are able to do that either by ground or air transport. The ED has telemedicine capacity with them for all of their trauma surgeons, pediatric ICU physicians, and Neurology for telestroke consultation.
Qualifications for this position include, but are not limited to:
-PA-C with at least two (2) years of experience in EM in environments that stress the independent nature of practice.
-Physician backup for mid-level providers is not on site and may be as much as 30 minutes from the hospital.
-Successful mid-level candidates need to demonstrate (through experience, certifications, and reference verifications) their ability to independently manage critical patients for the initial phases of acute illness, including advanced airway management and thrombolysis for acute ischemic events.
-Benefits include group health and dental, 403(b) retirement program with employer match, educational loan payback eligibility, and a generous paid time off program.
