taking orders from young doctor.

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kent100s78

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my issue about becoming a PA is taking orders after 15 years of work experiance. how will i feel when im 45 yo taking orders from a 27 yo MD or new resident with an ego. thats my concern about becoming a PA can someone help clarify this for me.

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pa's don't take orders, we write them. nurses take orders. pa's consult as needed. if you get a supervising doc with a different care philosophy, change supervisors or get a new job. you never have to do things that you think are not right. if your supervising doc is hellbent on a certain course of action, sign the patient out to him. then his name is on the chart, not yours.
 
PAs must be supervised by physicians. Of course the situation will arise where the PA will be older than his/her supervising MD (this happens in nursing too). If you want to be the one making the final decisions (in the medical profession), you will have to become a doctor. It is the same situation for dental hygienists, paralegals etc. If this is not acceptable to you, you should seek out the corresponding job which provides greater autonomy (i.e. physician, dentist, lawyer)...
 
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Unfortunately, I've been witness to several situations where the PA has been "overuled" if you will by the doc (ER in these instances). It seemed pretty commonplace for the doc to add on tests that the PA didn't order or to change the script or to switch the patient to a different antibiotic etc.... I just thought it was normal, but apparently, it is not.

I'm sure it is practice dependant.

later
 
there are practices where the pa has to present every case. in that situation the doc has input early on for better or worse. in most pa employment situations the docs never see the majority of the pa's pts unless the pa has a question and presents the patient and asks for advice.
 
Perhaps you prefer not to function as a Physician Assistant then...because as a PA, your role is to be a physician extender, not independent practitioner...regardless of the age of the doctor/attending.
It was the exact reason I left the field of Physical Therapy. While I had immense independence, the final decisions were left up to the doctor. I am happy I made that decision. And while the similarities between PT and a PA is limited, it already sounds as if you have doubts regarding your future (hey you don't see than many 50 year old PA's or PT's)
Clearly, most of the PA's that I have come across work with surgical specialists...they act truly as an assistant in every sense of the word (quite to the benefit of the surgeon)...some are happy, some are miserable. But you must be CONTENT with being in a supervised role. You may ALWAYS be over-ruled, as you are working under the supervising Physician.
I have met with a group of PA students not long ago(May) and it seemed like their "dream jobs" were to work part -time in pain clinics or work assist with ortho surgeons. Each student gave the impression that the job opportunities were shrinking in the midwest (except for surgical specialties) because of the recent surge of PA's and NP's in the market place.
I wish you the best of luck in your career and happy Rosh Hashanah
 
Originally posted by 12R34Y
Unfortunately, I've been witness to several situations where the PA has been "overuled" if you will by the doc (ER in these instances). It seemed pretty commonplace for the doc to add on tests that the PA didn't order or to change the script or to switch the patient to a different antibiotic etc.... I just thought it was normal, but apparently, it is not.

I'm sure it is practice dependant.

later

Why is that unfortunate? The supervising MD decided to modify the workup or therapy as indicated. That is exactly what they are supposed to do!
 
that doesn't mean they were right. often it's a bs change like keflex to dicloxacillin because of a personal preference...
there are times of course when the doc recommends something worthwhile. that is why we consult with them on tough cases.
 
Originally posted by emedpa
that doesn't mean they were right. often it's a bs change like keflex to dicloxacillin because of a personal preference...
there are times of course when the doc recommends something worthwhile. that is why we consult with them on tough cases.

Still though thats besides the point. Yes, sometimes doctors make dumb decisions just like PAs do.

The doc has every right and responsibility to overrule the PA if he/she feels it is appropriate.

I dont understand what the big deal is here.

What are you trying to say? That docs should have their power to overrule PAs trimmed or cut back?

PAs were created to help doctors, not to work on their own.

If you wanted to be an independent practioner, you should have become an MD/DO/NP.
 
Dear emedpa

I would be careful calling a doctor's decision to change something "useless". Did you ask why? Or were you upset that he/she overruled you?

It seems to me that you would like the privilege of patient care without going through medical school, only having to ask the doc for the "difficult" patient. I'll tell you, it is amazing to me how many "simple" cases become difficult very quickly once the history comes out.

I agree with the rest that it is part of the job to take orders from physians. I do hope that you work with docs who respect your role, as well as I hope that you respect theirs.
 
I have great respect for the physicians I work with. for the most part they treat me as a colleague. I work fairly independently and they are ok with that because after > 16 years working in EM they know that I know my limits and when to ask for help. I probably consult on 5-10% of all the pts I see. most are admission quality or strange presentations. often they don't know the answer to my questions and recommend the appropriate consult.
my state defines supervision as 10% chart review per month so for the most part they never see my patients unless I ask them to. I am aware of the difference between a residency trained/boarded physician and myself, which is why I am on the trail to become an md/do in the near future.
 
Having had worked in a small 10 bed ER as an O.N. tech/EMT with only 1 nurse and 1 provider (usually a PA) I know that P.A.'s are a valuable asett to rural emergency health care (and urban health care too I'm sure, I just don't know personally). I'm on my way to becoming a D.O. (hopefully), and want to go into emergency medicine. The PA's that I worked with dealt with everything coming in to the hospital. Once the on-call physician went home for the night it would easily be 15+ minutes before they were there, and that's even if we called them in right away. The PA did everything for every patient when they first arrived. I have a great respect for the PA profession and am looking forward to being able to use their expertise to my advantage when treating patients.
 
Originally posted by kent100s78
my issue about becoming a PA is taking orders after 15 years of work experiance. how will i feel when im 45 yo taking orders from a 27 yo MD or new resident with an ego.
That's interesting. I'll be 25 when I become a resident. I can't imagine ordering around a 45 year old PA. It wouldn't feel right.
 
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I'm new here gas man. remind me again, you and macgyver are the same person, right?
 
The physician-PA team doesn't need to involve anyone ordering anyone around. Supervisors don't have to be bossy, you know. And you may not feel weird if you're supervising people older than you or with more experience than you.
 
I certainly don't mind getting coffee for someone ... they don't even have to be my supervisor. No big deal.

But you sound like you have a real attitude about it. I don't think I'd enjoy having you on my team at all. If you're this way about coffee, what are your attitudes like when it comes to important issues?

Scary to imagine.
 
you seem to have a coffee fetish gas man. I work solo er so there is no doc around to ask for coffee, sorry.....
 
Maybe he should have studied nursing instead.
 
sorry to break this to you gas man but pa's have been working solo in rural er's almost as long as pa's have been around( > 30 years...)
we have an fp md and a surgeon 20 min away available as back up for multicasualty incidents, etc or to consult by phone but we don't call them all that often....
they review all the charts at the end of the week and provide feedback as needed.
and this will piss you off too, our anes dept is composed almost entirely of crna's.....
 
it's a long drive to a "real hospital" in december in northern maine in the snow.....the next few hospitals down the road all have pa/crna's too. you pretty much need to drive to bangor or portland to find a hospital that has a mixed staff.
 
For those of you new around here and haven't dealt with gas man in the past............here is the info.

Most around here realize he isn't actually a doctor. He is a troll and is usually making argumentive statements on most of the other threads as well.

Just ignore him. How many residency trained physicians do we have on this board (real ones) who come onto websites and harass and degrade everyone........NONE that I know of.

Your pre medness shows gas man....give it up. No one believes you are a doctor. this is pre-allo board stuff all the way.


later undergrad boy.
 
" I would take the drive"...
then when you crash and are unresponsive the medics would take you to my er. you would wake up with me starting your central line and putting in your chest tube while a crna manages your airway. when you complain we assume you are hysterical because of a closed head injury or hypoxia. we paralyze you with pavulon, intubate you and admit you to the medicine service after your workup is negative. you wake up in 4 point restraints with a pa hospitalist adjusting your dopaminre drip in the unit.....:D :D :D
 
Originally posted by emtp2pac
" I would take the drive"...
then when you crash and are unresponsive the medics would take you to my er. you would wake up with me starting your central line and putting in your chest tube while a crna manages your airway. when you complain we assume you are hysterical because of a closed head injury or hypoxia. we paralyze you with pavulon, intubate you and admit you to the medicine service after your workup is negative. you wake up in 4 point restraints with a pa hospitalist adjusting your dopaminre drip in the unit.....:D :D :D

Although I don't agree with the trolling Gas_Man, the scenario mentioned above is truly scary to me (not just because of the horrific situation, but because I did not see a true MD/DO throughout the ordeal). I guess I won't be moving to rural Maine anytime soon.
 
I'm sure that post was mostly in jest. I work in a similar situation and the doc would have been called in after the pt was stabilized....you can't blame the guy for taking a cheap shot at gas boy, he had it coming....
 
http://www.ama-assn.org/amednews/2003/11/17/prsd1117.htm

I am not agreeing with Gasman's posts, but....I still believe the OP's question is ridiculous. A PA doesnt even require a bachelors degree. To be admitted to most med schools, you have to be the top of your undergrad institution, plus it is difficult to pass all the exams and 2 boards to graduate in med school, and then do a couple of years of residency to learn the precise mechanisms of bodily functions. Even if the doctor is young and "inexperienced," (I cant see how that can be after all these years of training and residency), he/she still knows much more about underlying complications than some medical terms/observations. A doctor then has to keep renewing licensure by taking more exams and reading at home about the newest therapies, antibacterial resistance, etc that even an inexperienced PA does not normally do.

My opinion is that whether the doctor is inexperienced relative to a PA, he/she still has more medical "training" and "knowledge about the latest therapies/complications," and that the PA should worry about correctly "assist"ing a physician young or old rather than automony because physician assistance is role of a PA.
 
Most PA schools now offer a masters degree. Those that don't, still offer the same masters-quality training.

More than half of med school applicants are accepted. Less than 1/4 of PA school applicants are accepted. (No need to talk about how much easier it is to get into PA school than med school. In most cases, the prerequisites are very similar.) If you want to point out the "easiest" or "quickest" PA schools, we can point out some three-year Caribbean med schools that are easy to get into and whose quality is suspect, too. More fair is to compare an average med school with an average PA school.

My PA school has 18 months of didactic training followed by 12 months of rotation. The med school in town (a very good one) offers 18 months of didactic training (with three month breaks) followed by 24 months of rotations. Their school's medical students and PA students sit through most of the same classes together.

That said, a PA is trained to work with delegated authority of his/her supervising physician. It is the physician who decides what the PA is capable of doing. No matter if the physician is 23 years old and the PA is 72, it doesn't matter. Authority is authority, last time I checked. If you can't work underneath someone younger than you (or female, black, gay, religious, etc.) then you need to do an attitude check and grow up.
 
One must be the biggest idiot for making this statement.

Have you thought about this possibility? If the pool of applicant applying to med school is much more intelligent, diligent, and competent, even if half of this pool gets in, it is still harder to get in med school. If only 1/4 of the applicant gets in, but the applicants who were originally applying were all stupid, how much does getting in PA school prove?

So what there is more or less didactic training? If you know anything, you'd know most med students learn by ditching classes and studying hard outside the classroom.

Carribbean students have a very tough time getting a residency position. They can basically forget about surgery and all surgical subspecialties, derm, emergency med, etc. The only places is maybe ob/gyn, fam practice, peds outside of community hospitals. Still, they have to go through med school + residency, which is a minimum of 7 years. PA school is 3. I am comparing the average PA school with the lowest of med schools (carribean), and med is still tougher.


Originally posted by timerick
Most PA schools now offer a masters degree. Those that don't, still offer the same masters-quality training.

More than half of med school applicants are accepted. Less than 1/4 of PA school applicants are accepted. (No need to talk about how much easier it is to get into PA school than med school. In most cases, the prerequisites are very similar.) If you want to point out the "easiest" or "quickest" PA schools, we can point out some three-year Caribbean med schools that are easy to get into and whose quality is suspect, too. More fair is to compare an average med school with an average PA school.

My PA school has 18 months of didactic training followed by 12 months of rotation. The med school in town (a very good one) offers 18 months of didactic training (with three month breaks) followed by 24 months of rotations. Their school's medical students and PA students sit through most of the same classes together.
 
And who cares about a masters degree? This degree is a joke these days. Any monkey can get into a masters program. Many universities allow you to complete a masters entirely online.
 
I really don't understand why people think it's incredibly easy for PA students to study medicine, and it's incredibly difficult for medical students to study medicine. Whatever PA's study in school, the fact is that they practice very good medicine under physician supervision, as all studies so far have shown. And when foreign MD's in FL were given a chance to practice legally as PA's if they passed the standard PA certifying exam, only 6% passed it. But I'm sure some people on this forum just aren't satisfied with scientific studies, not interested in facts. To them it seems that if you're not an MD, you're a nobody. Sad look at life.
 
Originally posted by timerick
I certainly don't mind getting coffee for someone ... they don't even have to be my supervisor. No big deal.

But you sound like you have a real attitude about it. I don't think I'd enjoy having you on my team at all. If you're this way about coffee, what are your attitudes like when it comes to important issues?

Scary to imagine.

There is one on every hospital staff.

I couldn't help but notice that you hail from New Mexico and Dr PITA is from Chicago. Those places are worlds apart and practice setting is everything. I suspect that Dr PITA will have a hard time keeping competent help.

As to the independence of PA's and NP's let me say it again. Practice setting is everything. I am a pharmacist and tripped into this area by mistake when this thread caught my eye. When I practiced in Durango Colorado there were several mid level practitioners in my area of service who maintained independent offices around the four corners. One NP ran her own office in Farmington and another was the **ONLY** healthcare option in town way up in the San Juan mountains in tiny Silverton.

If you want to practice in the Chicago metro area you might have to tolerate fools like this guy. But if you want to take healthcare to the people where they really need it - out in the places where perfumed princes like Dr PITA would stick out like a sore thumb there is ample opportunity. Is this not the original intent of the P.A. concept? To take healthcare where there currently is none?

I might add, btw, that in Washington State, by setting up practice agreements with multiple docs you can gain a very nice measure of practical autonomy

Cheers
 
Originally posted by profunda
http://www.ama-assn.org/amednews/2003/11/17/prsd1117.htm


My opinion is that whether the doctor is inexperienced relative to a PA, he/she still has more medical "training" and "knowledge about the latest therapies/complications," and that the PA should worry about correctly "assist"ing a physician young or old rather than automony because physician assistance is role of a PA.

Having the knowledge and successful application are two different animals. I have worked in several teaching hospitals and the first year residents - the baby docs - needed very close watching till they figured out which way was up. The entire health care team is shepherding them as in you don't **REALLY** want to do this [insert foolish order] do you DOCTOR? Those who refuse to listen contribute to the national spike in the death rate every July....
 
Timerick, you must be joking. I advise you to stop with these comments because you are only making a fool off yourself (btw, if you ask any PA to pass boards 1,2,or 3, 0% would pass. I'm sure > 50% doctors wouldnt pass a nursing exam, but what does that prove since doctors arent trained on nursing care).

Baggywinkle, I am not referring to first year interns or even residents. I'm talking about doctors who are done with residency.
 
my class took old md fp boards as prep for our boards. guess what? we all passed...
 
You are such a smart guy. There is nothing to really understand. All PAs could've gone to med school but chose to go PA. Now, doctors can do surgeries and angioplasties whereas PAs cannot. PAs assist and follow orders of physicians so go and do it. How hard is that to understand?

It is so believeable that 6% of doctors pass PA boards whereas 100% PAs pass FP boards. Get out of here with your bogus statistics.

Originally posted by timerick
I really don't understand why people think it's incredibly easy for PA students to study medicine, and it's incredibly difficult for medical students to study medicine. Whatever PA's study in school, the fact is that they practice very good medicine under physician supervision, as all studies so far have shown. And when foreign MD's in FL were given a chance to practice legally as PA's if they passed the standard PA certifying exam, only 6% passed it. But I'm sure some people on this forum just aren't satisfied with scientific studies, not interested in facts. To them it seems that if you're not an MD, you're a nobody. Sad look at life.
 
Originally posted by profunda
Baggywinkle, I am not referring to first year interns or even residents. I'm talking about doctors who are done with residency.

Okay, done with residency. Wrong is still wrong. It does not matter how long ago medical school was.

Quick examples where I have personally crossed swords with physicians to the point of refusing to dispense

Pediatric patient garamycin dosed by weight at the absolute upper range without peaks or troughs ordered. Physician was not familiar with the pharmacokinetic concept of monitoring to safeguard against oto/nephrotoxicity. No bloodwork/no drug

Pediatric patient; Tylenol with codeine elixir ordered for pain control in large doses amounting to over a pint per day. Failed to take into account hepatoxicity of acetaminophen max adult dose is 4gms/day documented liver damage above 6gms/day. This doseage amounted to 11.5 GRAMS acetaminophen per day and it was being given at that rate when I intervened.

Calcium CARBONATE ordered for iv admixture in hyperalimentation
This one got a really good laugh

Vibramycin 1gm IVPB q12h. Snap response from physician was "that's what I wrote - that's what I want" This was a ten fold overdose.

All of these orders were from experienced physicians, not residents. Please tell me, should they have been blindly followed?

In most cases you are correct. But occasionally your forty five year old P.A. will have experience which will trump that of a new physician. My heaven, especially the older ones who served as combat medics in vietnam. These guys know trauma in ways rarely seen in domestic medicine. They might know a thing or two
that a peace time physician may see once in a career.
 
It's been a while since I had a conversation like this with people who base their opinions on prejudice rather than on fact. I thought MD's were supposed to be trained in the scientific method. The reasoning in the anti-PA arguments here is so very unscientific. Fortunately, I think most physicians take a more logical view of the PA profession and the way Physician-PA teams are contributing to high quality, cost effective health care in all 50 States.

Anecdotal evidence is not as reliable as statistical sampling. (I could come up with anecdotes about how a physician spent 3.5 minutes with my wife, not even touching her at all, and sent her home for bedrest... when her problem turned out to be an ectopic pregnancy. Or the physician who insisted on treating her amoeba infection for three months, despite negative lab results on any parasites, increasing rectal bleeding, etc. Finally another doctor did a simple digital exam and discovered a large tumor. Unfortunately, by that time, the cancer was stage four.) We can all find examples of individual incompetence and doctors, nurses, techs, etc., that we feel should be retrained or leave the profession. But look at statistics... you'll find that a physician-PA team provides physician-level care, nothing less. Apparently the PA training is sufficient for the job the way it is working right now.
 
baggywinkle, of course this stuff happens. even a lab tech or high school student can find something that a professor said or did incorrectly in the lab. but dont try to emphasize some small incidences out of billions of cases and prove your superiority.

timerick, here's the scientific reasoning. PAs cannot incise cancers, do surgeries, or correctly differentially diagnose biopsies. A doctor can. PAs earn ok income. Doctors earn 10x more. There is no prejudice; you just have to accept this "fact."
 
baggywinkle, perhaps you brought on some points about how you know more than doctors. have you thought about the fact that you are trying to compare yourself with an FP, and even then, you still dont know more than he/she, because you've caught a small mistake but what about the other important things the FP doctor does which is correct diagnosis and educating the patient. of course, let's extend outside of fp. will any doctor/person refer a patient with a severe glaucoma to PA over opthamologist, or stroke to PA over neurologist, or lung cancer to PA over pulmonist/oncologist. you've gotta be kiddin yourself.
 
PROFUNDA-THERE ACTUALLY ARE SPECIALTY PA'S IN ONCOLOGY AND OTHER SPECIALTIESWHO AN FP MD MIGHT REFER TO(INDIRECTLY)! FOR INSTANCE, MD ANDERSON CANCER CTR IN TEXAS HAS A POSTGRAD ONCOLOGY RESIDENCY FOR PA'S.
AN ONCOLOGIST WHO USES A PA WOULD HAVE THEM DO H+P'S AND DEVELOP AN INITIAL CARE PLAN WHICH THEY WOULD THEN REVIEW. CHECK OUT WWW.APPAP.ORG FOR A LIST AND LINKS TO THE PA RESIDENCY PROGRAMS. A SPECIALTY PA KNOWS MUCH MORE ABOUT THEIR SPECIALTY THAN A PHYSICIAN WHO DOES NOT PRACTICE THAT SPECIALTY!!! ALSO YOU ARE WAY OFF ON PA SALARIES. MANY PA'S MAKE > 100K/YR ESPECIALLY IN ER/SURGERY/ORTHO. GRANTED THE DOCS MAKE MORE BUT NOT" 10 X AS MUCH" AS YOU STATED.
Postgraduate Oncology Program
PA Educational Programs
The University of Texas
M.D. Anderson Cancer Center
(713) 792 - 7475
Fax: (713) 792 - 0795
1515 Holcombe Boulevard - Box 043
Houston, Texas 77030 - 4009
www.mdanderson.org


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Length of Program 12 months
Class Size 36925
Starting Date: September 10
(January start date also available)
Ending Date: August

PROGRAM DESCRIPTION AND HISTORY:
The Postgraduate Oncology Program offered by The University of Texas M.D. Anderson Cancer Center (UTMDACC) is dedicated to enhancing the use of Physician Assistants in the field of cancer care. This 12- month clinical program is designed to prepare PAs for a career in medical, surgical and radiation oncology. The program uses a multi-disciplinary approach to adult oncology through hands-on training and supportive supervision. This comprehensive fellowship combines basic academic, technical and judgmental skills into a framework necessary for conducting effective cancer management.

CURRICULUM:
DIDACTIC: The didactic component of the curriculum consists of lectures, multidisciplinary conferences and institutional Grand Rounds. By working at a premier oncology research institution, participants will have the opportunity to become involved in research. At the end of the year, each PA will prepare a manuscript suitable for publication on a relevant oncology topic.

CLINICAL: Throughout the year, PA?s will rotate through more than 12 disciplines receiving hands on training in a variety of settings including, outpatient clinics, inpatient wards, operating rooms and the emergency center. Students will become an integral part of the health care team, under the supervision of attending physicians, and gain the confidence and skills required to become a successful oncologic PA.

Students will have the opportunity to gain skills in indirect laryngoscopy, various surgical procedures, bone marrow aspiration, and biopsy interpretation, management and care of indwelling catheters, administration of chemotherapeutic agents, and management of immunocompromised patients. They will also gain experience in correlating the clinical evaluation of the patient with radiologic, laboratory, and pathologic findings.

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M.D. Anderson Cancer Center is a component of The University of Texas System. The UT System enrolls nearly 150,000 students at the undergraduate, graduate and professional levels. There are nine academic campuses, six health complexes, four medical schools, two dental schools and seven nursing schools.

The UTMDACC is one of the world?s leading comprehensive cancer centers and one of 42 medical institutions located in the Texas Medical Center. MDACC has 469 patient beds, 26 operating rooms and more than 200 medical and surgical faculty. Guided by the mission of excellence in patient care, research, education and prevention, over 400,000 patients have received care at MDACC since 1944.

UTMDACC has employed PAs for greater than 15 years and has a strong history in PA education. More than 80 staff PAs provide care to patients in a wide variety of disciplines, including cancer prevention, radiation, medical and surgical oncology.
 
if PAs are so well off, why do you want to go DO or MD then?
 
PERSONAL SATISFACTION OF KNOWING THAT I AM WORKING TO MY FULL POTENTIAL. THE SCARY THING IS THAT I MAY ACTUALLY END UP MAKING LESS MONEY THAN I CURRENTLY DO AS I AM PLANNING ON GOING FROM SPECIALTY PRACTICE TO FULL SCOPE(RURAL) FP PRIMARY CARE W/ OB, ETC
 
but PA is the full potential. i mean, what potential is there left to do med, since med and PA are the same, or was it that PA is better than med?
 
I never claimed that they were the same, only that outcomes are similar in most clinicaL situations. physicians obviously have a greater general medical knowledge base. An md/ do specialist in any field will know more than a corresponding pa in that field. specialty pa's, however may know more about a topic than a physician who is not a specialist in that field. that was my point...
THIS THREAD CAN NOW DIE.....
 
Originally posted by profunda
baggywinkle, perhaps you brought on some points about how you know more than doctors. have you thought about the fact that you are trying to compare yourself with an FP, and even then, you still dont know more than he/she, because you've caught a small mistake but what about the other important things the FP doctor does which is correct diagnosis and educating the patient. of course, let's extend outside of fp. will any doctor/person refer a patient with a severe glaucoma to PA over opthamologist, or stroke to PA over neurologist, or lung cancer to PA over pulmonist/oncologist. you've gotta be kiddin yourself.

I should point out that I am a pharmacist and not a P.A.

It is not that I know "more" I just know "different" and the only way you will even realize that I am there is when you - the physician (or the P.A.) screws up. We are all human and allowed to make mistakes. This is why the healthcare system is designed in layers. Think of it as a safety net.

The point here being that no one person has complete or exclusive access to to the body of knowledge called medicine.
Everyone has something to contribute to patient care which is the goal - yes? Caring for the sick. This oneupmanship displayed by the pitameister is petty and unproductive. As the executive in charge of treatment, alienating those who are there to support you is counterproductive to your goal. You would be wise to pull your team together by empowerment because we, your healthcare team are here to make you look good by covering your happy white a** when you screw the pooch. In each of the instances cited above a member of the team covered for you when you dropped the ball. Just imagine what your life would be like and how crippled you would be if your support team was no longer there and it was you baby- all you - by your lonesome. All the lab tests, all the procedures, all the medications, all the nursing done by little old you. You've got the knowledge but could you foot the bill.

Do not forget that your power comes only by the rule of law and that laws can be changed. In third world environments where surgery is done with rubber dishwashing gloves and needles are washed and reused the knowledge level of the P.A. would be welcomed with open arms. I might add that many American physicians, spoiled by the level of support they receive and take for granted would be too traumatized to function. I saw this first hand during gulf war one. Critical medical stores such as antibiotics and albumen were rerouted to support the military creating shortages in the civil healthcare system. It was sad and humorous watching the perfumed princes throw tantrums because medicine [a] was unavailable while the ready alternative medicine was sitting on the shelf. Heaven forbid they should be required to put on their thinking cap and get creative. How on earth would they function in a true emergency where the on demand supply system actually broke down on a national basis. Never forget that our healthcare system is only seven days from grinding to a halt.
 
I'm going to be a cardiologist in my own clinic, and I wont care to have a pharmacist or a PA.

Your comments would better be used on the OP, who is the one who need to know his/her role.
 
Originally posted by profunda
I'm going to be a cardiologist in my own clinic, and I wont care to have a pharmacist or a PA.

Your comments would better be used on the OP, who is the one who need to know his/her role.

I am confident that both you and Dr PITA will be fine physicians.
What you do is difficult and demanding. My hat is off to you. Better you than me bud, better you than me.

I presume you will write prescriptions and admit patients to hospital? Rest assured that the rest of us are cheering you on and supporting you even though we may not be physically present in your clinic.

Cheers
 
ok baggywinkle, i agree with you. i think i lost the point of this thread. i probably am agreeing on most issues you bring up and i'm probably more humble and less confrontational in person, but some things that ppl said on here really ticked me off. like the statistics these idiots gave about 6% doctors passing PA boards and 100% PA passing FP boards. I think we diverted from the OP question. I still think it's ridiculous to complain about following orders from young physicians. Maybe they might be more wrong than older physicians, but you still need to follow their orders regardless of age because PAs role is to assist physicians. The OP here seem to have more prob with following orders from a young person, since all doctors occasionally make mistakes and she doesnt have prob with the older doctors doing that but only the young ones.
 
Hopefully your relationship with the older P.A. would be good enough that you could pull him aside for a dialog. Pick his brain, see where he is coming from. Then, if it is necessary to over rule him you should have the professional courtesy to exercise your role as educator and let him know why he has been over ruled. This has nothing to do with medicine this is just good management. Contrast this to the one way, fetch my coffee style portrayed by Dr PITA. He has shut off what might be critical information. Information which would be used against him if his call is wrong when the P.A. is summoned to testify at the malpractice suit against him. Ultimately, as executive in charge it is your call and it should be as informed as you can make it.

Your domain and my domain are similar in this respect. You are not paid for what you know. You are not paid for what you do. You are paid to be responsible when it all heads south. The lawyers will line everyone up and assign percentage responsibility
with monetary awards being distributed by that percentage. So if Dr PITA orders Strychnine IVPB, and I mix it, and the P.A. administers it, we will all hang together for what we should have known according to standards of practice. Not on my watch. Dr PITA's tantrums aside.
 
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