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http://www.jaapa.com/issues/j20081101/articles/sounding1108.htm
fter more than 3 decades as a proud member of the PA profession, and as one who has focused on patient care exclusively during that entire time, I feel able to speak with some clarity about what has always been the most sensitive of subjects: our professions titlephysician assistant. And as I get ever closer to that age of Medicare eligibility, I feel able to face the inevitable firestorm that always seems to rain down on those of us who feel that this is an issue yet to be happily resolved. The specter of the clinical doctorate has come to the fore, and now its time. Not time to discuss who we are or what were made of, where we came from, and what we are capa-ble ofour physician mentors and our patients pretty much know all that. We need now to discuss a title that will at last reflect the reality of where we fit into the scheme of health care delivery here and increasingly around the world. And physician assistant aint it!
Maybe in the early 1970s, PAs mostly assisted their physician employers, supervisors, and mentors directly, by extending their eyes, ears, and hands. And maybe in the early days of every new PAs career, he or she is truly an assistant. But time marches on, and the medical world and health care delivery have evolved. We have evolved with them. Our title has not. It no longer is a helpful descriptive of our role.
Tell the military PA, crouching in the sand, sticking a chest tube into a colleague wounded by an IED (improvised explosive device), that he or she is an assistant. Explain to the family of a hospital emergency department patient that their daughters gaping laceration is being repaired by a physician assistantthat no doctor is on duty just then. Listen anonymously, as I have, to a patient telling his friend that yes, his shoulder had been dislocated during the game, but the orthopedic surgeon sent in his assistant to reduce it. She did a great job, though. Even after 30-plus years, I still occasionally encounter the returning patient who looks at my name badge and says incredulously, Youre still an assistant? You should have graduated to a full MD by now! And I launch into the explanation I learned by rote during my first weeks of PA school. It was a good one then, but now it feels like Im trying to convince myself.
So, what is the answer to this dilemma? How should we deal with it?
Some would say that we just need to do a better job of public education: if we explain ourselves to enough people often enough, using the right media, patients will come to understand that were not physicians. But will they really, especially in the era of the paper chase?
Many PAs have doctorates: a hard-earned and well-deserved PhD or DSc, EdD, DrPH, DPsy, DPT, or PharmD. Some even have an ND, or perhaps a DC. They are doctors, although they are not physicians. They practice as PAs. Should they be called doctor?
There are always those in our own profession who will predictably fire back with. If you want to be called doctor, go to medical school! (I didnt and still dont.) Okay, I get it. But how about a title that more accurately describes what we actually do? Or where we fit in? Is a title like that such a stretch?
I think not but, I hasten to add, Im not sure what that title should be. I do know that it shouldnt contain the word assistant. Perhaps associate physician, sort of like an associate professor. Or physician associate, as in one who works in association with a physician while not actually being one.
And who gets to decide the title, even if we find one that we can agree on? Is it the individual states? The NCCPA? The AAPA? The NBME?
I have no magic answer. I just know that as more and more of us get doctoratesclinical or otherwiseI never want to hear one of my PA colleagues say to a confused and perhaps scared patient, Yes, I am Dr. X, but I am not a physician. Im a PA, a physician assistant. But, its okay to call me doctor because I am one just not a medical doctor Im a doctor of physician assistant science. And this is my esteemed colleague, Dr. Y, who is a nurse practitioner. No, shes not a physician either, but she is a doctor of nursing science, so you may refer to her as doctor if you wish. How may we help you today? JAAPA
fter more than 3 decades as a proud member of the PA profession, and as one who has focused on patient care exclusively during that entire time, I feel able to speak with some clarity about what has always been the most sensitive of subjects: our professions titlephysician assistant. And as I get ever closer to that age of Medicare eligibility, I feel able to face the inevitable firestorm that always seems to rain down on those of us who feel that this is an issue yet to be happily resolved. The specter of the clinical doctorate has come to the fore, and now its time. Not time to discuss who we are or what were made of, where we came from, and what we are capa-ble ofour physician mentors and our patients pretty much know all that. We need now to discuss a title that will at last reflect the reality of where we fit into the scheme of health care delivery here and increasingly around the world. And physician assistant aint it!
Maybe in the early 1970s, PAs mostly assisted their physician employers, supervisors, and mentors directly, by extending their eyes, ears, and hands. And maybe in the early days of every new PAs career, he or she is truly an assistant. But time marches on, and the medical world and health care delivery have evolved. We have evolved with them. Our title has not. It no longer is a helpful descriptive of our role.
Tell the military PA, crouching in the sand, sticking a chest tube into a colleague wounded by an IED (improvised explosive device), that he or she is an assistant. Explain to the family of a hospital emergency department patient that their daughters gaping laceration is being repaired by a physician assistantthat no doctor is on duty just then. Listen anonymously, as I have, to a patient telling his friend that yes, his shoulder had been dislocated during the game, but the orthopedic surgeon sent in his assistant to reduce it. She did a great job, though. Even after 30-plus years, I still occasionally encounter the returning patient who looks at my name badge and says incredulously, Youre still an assistant? You should have graduated to a full MD by now! And I launch into the explanation I learned by rote during my first weeks of PA school. It was a good one then, but now it feels like Im trying to convince myself.
So, what is the answer to this dilemma? How should we deal with it?
Some would say that we just need to do a better job of public education: if we explain ourselves to enough people often enough, using the right media, patients will come to understand that were not physicians. But will they really, especially in the era of the paper chase?
Many PAs have doctorates: a hard-earned and well-deserved PhD or DSc, EdD, DrPH, DPsy, DPT, or PharmD. Some even have an ND, or perhaps a DC. They are doctors, although they are not physicians. They practice as PAs. Should they be called doctor?
There are always those in our own profession who will predictably fire back with. If you want to be called doctor, go to medical school! (I didnt and still dont.) Okay, I get it. But how about a title that more accurately describes what we actually do? Or where we fit in? Is a title like that such a stretch?
I think not but, I hasten to add, Im not sure what that title should be. I do know that it shouldnt contain the word assistant. Perhaps associate physician, sort of like an associate professor. Or physician associate, as in one who works in association with a physician while not actually being one.
And who gets to decide the title, even if we find one that we can agree on? Is it the individual states? The NCCPA? The AAPA? The NBME?
I have no magic answer. I just know that as more and more of us get doctoratesclinical or otherwiseI never want to hear one of my PA colleagues say to a confused and perhaps scared patient, Yes, I am Dr. X, but I am not a physician. Im a PA, a physician assistant. But, its okay to call me doctor because I am one just not a medical doctor Im a doctor of physician assistant science. And this is my esteemed colleague, Dr. Y, who is a nurse practitioner. No, shes not a physician either, but she is a doctor of nursing science, so you may refer to her as doctor if you wish. How may we help you today? JAAPA