taking orders from young doctor.

[kent100s78]

Well im the one that started this thread and never expected the thread to get to this level. this thread was intended to discuss not to insult either proffesion.We all know that PA's and Doctors are both important and crucial to the field of medicine.

The reason I asked the question is cause I am a 25 year old student who has 2 more years left in his undergrad. degree. I always had a deep interest in medicine and had dreams of being a MD or DO but do to sickness and immaturity I never had a chance to complete my education.

Now that I am healthy and motivated I become recently skeptical about medical school due to my age of 25 , I assume I would begin med. school by the time im 28 and would'nt be finished by 32 and thought I might be too old plus being married for 2 years makes it alot more difficult; That is when I learned of PA programs and it sounded quit interesting to me. Able to practice medicine, persrcibe med's, and some place own a prctice.

The only issue I had is to be honest, taking orders from a young intern or resident. How would I feel? Being 45 and then being over-ruled by some-one young enough to be my son/daughter.Please don't take me wrong, I understand that no PA is at the same level of any Doctor.Anyone that thinks diffrent think of this. the avg. PA school is altogether 4 years if you do a combined masters program 5 years. On the other hand doctors do 4 + 4= 8years of education and im not sure but about 3000 hrs. of clinicals before they begin a demanding 4 year residency program.

If I do decide to become a PA and no matter how i feel at 45 when the time comes "THE DOCTOR IS THE DOCTOR" and I must do as they say.I just hope the PA proffesion is not considered as a Nurse or loose power to the Nurse that is all I worry about.

If I can't be number one, I don't mind being in second, but nothing less.

---

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[JSNYMD]

Actually you'll be lower than second. You have the attending, then any residents on the team, then you.

 

[kent100s78]

Well I meant second to the Doctor.The attending and the Resident are both Doctors I assume.

 

[Febrifuge]

The reason I asked the question is cause I am a 25 year old student who has 2 more years left in his undergrad. degree... recently skeptical about medical school due to my age of 25 , I assume I would begin med. school by the time im 28 and would'nt be finished by 32 and thought I might be too old... How would I feel? Being 45 and then being over-ruled by some-one young enough to be my son/daughter.

Well, I dunno... I'm 33 now, and as part of my career change I'm working as a tech in the ED. If I somehow get my prereqs done at lightspeed, I could maybe start med school in Fall 2006. I'd turn 40 around the time I start residency.

At that time, I figure I could be a little jealous of the 26-year-old PA who has more experience and confidence than I do, and wonder why the %$#& I went through all that school... especially when the PA's shift is over and s/he goes home to the sort of life I'm waaaayyyy behind on starting for myself.

On the other hand, five years later, my residency will be done. My life will get a lot better, and I will already have been doing the coolest job on the planet for several years (if you count my ED tech gig and the clinical part of med school). Meanwhile, the PA will be doing the coolest job on the planet in a manner that is functionally, in terms of the team, a whole lot like a perpetual resident (...assuming things work there and then like they do in the ED I know today).

In a way, the choice is almost easier being a non-trad. If I think there's a significant chance that maybe PA wouldn't push all my buttons, or as many as MD/DO would, my choice is between the time it takes to do the med school route, or the time it takes to earn PA, work PA, and then go back.

Know thyself, is all I can tell anybody. I know several MDs who say they would go PA, if they had it to do again. And a few PAs who say they'd go MD/DO.

 

[lalee]

Originally posted by Febrifuge

Know thyself, is all I can tell anybody. I know several MDs who say they would go PA, if they had it to do again. And a few PAs who say they'd go MD/DO.

Yep, the grass is always greener! It's up to the individual to decide which side is better for him/her. No matter which you choose, you'll ALWAYS have a boss to answer to...can't escape that!

 

[jeffdowjones]

Feb-couldn't have said it any better myself. I'm 32 and i'm going the PA route with no regrets. i personally know 2 R3s who openly said to me they wish they went the PA route. i thought long and hard about being a doc too, because like Porsche says, "there is no substitute"!!. for me it was all about priorities. not to mention i'm a crazy adhd case who can't imagine staying in the same thing for the rest of my career (being a PA lets you change disciplines as i'm sure you know)!!! yikes!! so what the heck-i get to be a glorified resident for the rest of my life =)... it is so true about the grass-usually you come to find out it's not as green on the other side as you think!! =) best of luck to you in achieving your dreams-peace jd

oh, and gasman-you're a jackass.

 

[profunda]

a PA is not a resident. PAs are not doctors. no nurse or pharmacist in their right mind would ask a PA permission or advice on any matter relating to a patient, but would a resident. PAs assist residents. PAs are assistants of doctors, no less, no more. know your role.

Originally posted by jeffdowjones
Feb-couldn't have said it any better myself. I'm 32 and i'm going the PA route with no regrets. i personally know 2 R3s who openly said to me they wish they went the PA route. i thought long and hard about being a doc too, because like Porsche says, "there is no substitute"!!. for me it was all about priorities. not to mention i'm a crazy adhd case who can't imagine staying in the same thing for the rest of my career (being a PA lets you change disciplines as i'm sure you know)!!! yikes!! so what the heck-i get to be a glorified resident for the rest of my life =)... it is so true about the grass-usually you come to find out it's not as green on the other side as you think!! =) best of luck to you in achieving your dreams-peace jd

oh, and gasman-you're a jackass.

 

[lalee]

Originally posted by profunda
no nurse or pharmacist in their right mind would ask a PA permission or advice on any matter relating to a patient

Oh really? I guess all the PAs I've worked with just had all the ancillary staff just toying with them...you might want to look into this...I think you'll find that you're mistaken.

 

[Febrifuge]

Originally posted by profunda
a PA is not a resident. PAs are not doctors. no nurse or pharmacist in their right mind would ask a PA permission or advice on any matter relating to a patient, but would a resident. PAs assist residents. PAs are assistants of doctors, no less, no more. know your role.

Mmmm, snarky! Are you sure you're not thinking of 'Medical Assistants?' Because PA's are not what you're describing.

Thanks for looking out for me, but I know the roles. I know the roles because I work in the Emergency Dept of a Level One Trauma Center that has several excellent PA's. Where is it you work, where you have both PA's and residents? I don't think I caught that part.

What I said was that functionally, in terms of the care team as a whole, a PA is much like a resident. And I'm standing by that, because both PA's and residents function independently, under the review and supervision of staff physicians. Both order medications and interventions, and both do procedures. At the hospital where I work, PA's do everything that residents do. They are often the 'PMP' (Primary Care Provider) of record for a patient's case.

And yes - the RNs follow PA orders, and consult with them for instructions just like they do for residents. There are only two things residents do that PA's dont: since we're a teaching hospital, an R3 will run trauma cases in the trauma room. And since they're permanent staff, the PA's don't have to leave after they finish their three years, like residents do. A PA is not the assistant to a physician, any more than a resident is just an 'apprentice' to a staff doc.

Residents check with PA's for advice, and vice versa. Each will hand off patients to the other when necessary. I saw an arterial bleed hand wound a few days ago. The resident did the initial survey and stopped the bleeding, then a PA took over and administered drugs and did the sewing. I asked if he (the PA) needed an assistant, because that's my role. He said thanks, he was cool, I should check back in a bit. And I left him to tend to his patient.

 

[rdennisjr]

While the debate in this thread has been rehashed many many times, it's time to do it again obviously. Just remember, differences of opinion are fine, argument is fine. Name calling, personal attacks, acting like a child is not.

This is the one and only warning everyone gets. Please remember to play nice with others.

Thanks

Dennis

 

[Febrifuge]

Indeed, rd-- and I'm sorry to have risen (dropped?) to the bait. Saying that someone should "know (their) role" strikes me as a bit of a slap in the face. Much like "know your place." The implications are... uncool.

Your sig says you're a PA in emergency med. Could you talk about your spot on the care team, as it's defined in your workplace?

 

[Teufelhunden]

Originally posted by Febrifuge
A PA is not the assistant to a physician, any more than a resident is just an 'apprentice' to a staff doc.

Interesting...a "Physician Assistant is not the assistant to the physician.

Hmmmm....

 

[rdennisjr]

Obviously what you do as a PA is going to be very dependent on not just your training, but the state and federal laws that govern what we can do, insurance policies, and your relation with either your supervising physician or the group you work in.

Generally, I have few limitations on what I can do. I can run codes, I can do chest tubes, lumbar punctures, etc. Generally however, that is not my role - although my ability to step into that role on a moments notice is a critical part of my position. We function in a side-by-side role in our ER which has a variety of players - Staff Attendings, residents of several programs, interns, M3/M4 students, EMT-P students, PA-students. In general I take what appears to be the less significant patients to allow our residents a chance to get the training they need. However, I certainly pick up several of the more challanging ones per shift. Any ortho, MVA, fever of any age, chest-pain, etc is fair game, and I like to grab a few per shift just to keep my skills sharp. We are expected to do our own procedures including suturing, LP's, pelvics, etc. We do our own consults to the appropriate service, own wet-reads of films, etc

In my other position in a smaller town I am the only in-house provider with physician back-up in town as needed. Responsibilities are similar, but I get everything. Not that big of a deal however, as anyone that is going to need advanced cardiac care or is a major trauma is a basic work-up, stabilization, and prep for air evac to the major centers about 30 miles away.

As you can see - what you do varies widely. In a surgery position I turned down my job would have been the obvious clinical work-ups, H&P's, patient prep, opening and disection to the spine, assist in the hardward placement, then close on my own.

Hope that helps to some degree

Dennis

 

[Febrifuge]

Originally posted by Teufelhunden
Interesting...a "Physician Assistant is not the assistant to the physician.

Hmmmm....

Naturally, this is confusing to anyone with a grasp of the English language, so I don't blame anyone for pointing out the absurdity behind the fact that the title does not match the functional desccription. I'm one of the troublemakers who would like to see the job called 'Phsycian Associate' because that's a lot more in line with the reality.

PAs assist doctors in the same sense that doctors assist other doctors. Check out rdennisjr's list of tasks there. If the PA weren't around, this is all stuff that would be done by a doctor. Not me as an EMT/tech, not even an RN usually. A PA is a medical professional who works on a team that includes a physician. In some places, that 'team' is more a case of the doc reviewing charts once a week, and the PA is assistant to nobody but his/her patients.

 

[profunda]

The next in line who would take a job like this is probably a nurse practitioner, then a regular RN can probably do the job, and then if not, a 4th yr med student might volunteer to do it.

Where am I? A UC medical center surgery dept. I see the PA asking the resident questions, and the resident does surgeries while the PAs is doing what a RN can do, except RNs dont because they have other things to attend to. PAs dont do their own surgical procedures like residents do. PAs are not pharmacists, or residents, or doctors. PAs know more clinical aspects of medicine than most med students just because med students have been trained thus far mostly in the mechanistic basics of sciences. These basics are taught because when med students become doctors, they are expected to understand new pathologies, therapies and their complications, and derive new therapeutic procedures. However, the competence of med students, residents, doctors, and pharmacists is greater than a PA's. Dont kid yourselves because someday all med students/ residents become doctors based on their slow progressive scientific and clinical training, and all PAs remain PAs based on rudimentary clinical experience.

Originally posted by Febrifuge
Naturally, this is confusing to anyone with a grasp of the English language, so I don't blame anyone for pointing out the absurdity behind the fact that the title does not match the functional desccription. I'm one of the troublemakers who would like to see the job called 'Phsycian Associate' because that's a lot more in line with the reality.

PAs assist doctors in the same sense that doctors assist other doctors. Check out rdennisjr's list of tasks there. If the PA weren't around, this is all stuff that would be done by a doctor. Not me as an EMT/tech, not even an RN usually. A PA is a medical professional who works on a team that includes a physician. In some places, that 'team' is more a case of the doc reviewing charts once a week, and the PA is assistant to nobody but his/her patients.

 

[profunda]

Know your role = know your place in society

 

[Febrifuge]

Fair enough, but the roles on any particular care team are going to be defined by the institution where the work is being done. It's not so simple as saying task x always requires an MD, while a resident can do y and a PA can do z, everywhere and all the time.

There can be, and often is, a lot of overlap. So there is no one singular 'role in society' for any of the levels of training we've talked about. I'm sure if we cared to look hard enough, we could find an experienced MD happily doing something 'rudimentary' and a PA doing something 'advanced,' and both working within their scope of practice.

 

[deleted6669]

That's funny, because when residents(interns) are assigned to me as their preceptor in the e.r., they answer to me....and they all know their place.....

 

[Teufelhunden]

Yeah, sorry dude...gotta call you on this one.

My preceptor was going to be out of the office one day, and I asked if I could come in and work with his PA instead. His answer? No. Because PAs are not authorized to teach/train medical students.

So I highly doubt PAs are training interns and residents somewhere.

 

[deleted6669]

I wasn't kidding. I work in a facility with an unopposed fp residency. all the interns spend a month with the em pa's on a procedures rotation. we get them up to speed on suturing, fracture reduction, ingrown toenails, fb removal from the eye, control of epistaxis, slit lamp exams, regional blocks, etc....
it is a very friendly set up. we treat each other with respect as colleagues. when they are senior residents we present cases to them occassionally. why is it so hard for you to believe that in the real world new docs can learn something from seasoned pa's?
in reality, pa's and docs respect each other. everyone has their comfort level, and people ( whether pa or md) refer on the stuff that they are not comfortable with. I can't help but notice that most of the bitching on this thread is from premeds and ms1/ms2's. in the real world we actually all can get along and do our jobs without stepping on each other toes.
ps: tefelhunden, you may be correct about the situation in ohio. the pa laws in ohio are among the worst in the nation. they are only 1 of 2 remaining states that do not allow pa's prescriptive priviledges so it is entirely possible that they restrict pa's as preceptors also. peace

 

[bgreet]

I think baggywrinkle is the most insightful poster that has currently responded to this thread. There are numerous incompetent physicians, and there are numerous incompetent pa's I think instead of bashing one or the other it may be most prudent to make sure you do not become one of these incompetent people. Unfortunately it seems that a lot of you have already begun on the trail of degredation.

 

[profunda]

It makes no sense that you know so much more than residents, but you want to go to med school. If PAs like you know so much, why would you need that?

Originally posted by emedpa
I wasn't kidding. I work in a facility with an unopposed fp residency. all the interns spend a month with the em pa's on a procedures rotation. we get them up to speed on suturing, fracture reduction, ingrown toenails, fb removal from the eye, control of epistaxis, slit lamp exams, regional blocks, etc....
it is a very friendly set up. we treat each other with respect as colleagues. when they are senior residents we present cases to them occassionally. why is it so hard for you to believe that in the real world new docs can learn something from seasoned pa's?
in reality, pa's and docs respect each other. everyone has their comfort level, and people ( whether pa or md) refer on the stuff that they are not comfortable with. I can't help but notice that most of the bitching on this thread is from premeds and ms1/ms2's. in the real world we actually all can get along and do our jobs without stepping on each other toes.
ps: tefelhunden, you may be correct about the situation in ohio. the pa laws in ohio are among the worst in the nation. they are only 1 of 2 remaining states that do not allow pa's prescriptive priviledges so it is entirely possible that they restrict pa's as preceptors also. peace

 

[deleted6669]

I have much better procedural skills than most residents but there is more to medicine than procedures. I don't have the same high risk ob or icu experience as an md for instance. going to med school will make me a more well rounded provider outside of the field of emergency medicine..


I dont understand why ppl take sdn so personally; it's a computer screen of a bunch of strangers discussing issues. Who cares if anyone judges anything on it, would it make any difference in your life? Chill out.
PROFUNDA: I found this elsewhere and it applies equally here...

 

[profunda]

Not taking anything personally. Just find it amusing to find a doc wanna be PA talking down residents/docs and up the PA profession.

 

[lalee]

Originally posted by profunda
Not taking anything personally. Just find it amusing to find a doc wanna be PA talking down residents/docs and up the PA profession.

Are you even registering what has been stated in the posts? No one has been "talking down" residents/docs! People are just posting their experiences/observations, but you want to make personal strikes against others that don't share YOUR point of view. Get used to the diversity my friend and embrace it....you might actually learn something!

 

[jeffdowjones]

Originally posted by bgreet
I think baggywrinkle is the most insightful poster that has currently responded to this thread. There are numerous incompetent physicians, and there are numerous incompetent pa's I think instead of bashing one or the other it may be most prudent to make sure you do not become one of these incompetent people. Unfortunately it seems that a lot of you have already begun on the trail of degredation.

"can't we all just get along??" =) you are EXACTLY right, bgreet. i apologize for my last post if i caused any duress, i was just giving my 2 cents. anybody who reads the sdn threads regularly already knows who the insecure trolls are, so far be it for me (or any of us!) to throw myself into the mix and descend to their level. For the record-i too work at a level 1 trauma facility with a ton of residents. The only degree of separation between the residents and PA's is seen in the fast track area, which the PA's staff solely. In addition, the 'usual' things can be seen as well: residents handle traumas, etc. and that makes sense b/c they're future attendings. however, if PAs are in the main ed area, a casual observer wouldn't see a difference: PAs consult with attendings just like the residents do, and the more experienced PAs, like the experienced residents, will even approach the attending with the same intent, as in "this is what i'm going to do for this patient..." PAs consult with residents and vice versa, but both will present to an attending. i've never seen a PA present to a resident for a final decision on the course of treatment. there isn't a doubt in my mind that docs are more knowledgeable in their chosen field-it makes common sense-they have more schooling and training. my best friends are two attendings. but it doesn't mean a doc may necessarily be smarter than a PA with an equal amount of experience. where i work i see mutual respect among ALL the professions. i'm only a lowly PA student, but i am already acutely aware of the scope of my limitations, and i'm okay with that. docs deserve to do what they do because they trained for it.

 

[PACtoDOC]

Wow, what a jacked up thread. The only person on here with the experience to back up their comments is EMEDPA. Gas-man, and especially Profunda, you guys are just plain clueless. I have decided to bring my expertise in this area to the thread because I have the unique capability of speaking to you as not only a PA, but a medical student soon-to-be physician.

First, Profunda. I think you do not read clearly, because you have twice misquoted EMEDPA. He stated that in Florida a few years back, the state decided to be the first state to allow FMG's to practice as PA's if they passed the PA boards. He is correct in stating that 6% passed. Why should this surprise you, because the majority of FMG's also do not pass the USMLE, a very similar exam. Then you seemed surprised to hear that a select class of PA's all passed the FP boards (old copy of the exam). This is the bread and butter of PA education. When I studied for my PA boards, I used the FP board review book because it is basically the same info, just at a higher level. So don't be surprised that a PA could pass the FP boards. We are not talking about the internal med boards!

Gas-Man and Profunda both. If you think that PA's should not be staffing rural ED's and providing the only care in rural areas, then stay yourselves in the city. But the majority of our country lives outside major metropolitan areas, and if we could get enough docs to go there we would never have created the PA profession to begin with. And truth be told, PA's are taught what they need to know as clinicians to be competent in these places solo. Do you really think that what separates a physician's and a PA's education is somehow a wealth of knowledge that makes docs so much more capable of practicing medicine? Wrong if you do think this. Medical education is more rigorous in an often useless obscure way. I will go on record to say that PA school is a direct reflection of medical school, without all the glare. And the one thing I don't think anyone can honestly proove one way or the other is whether or not this "glare" represents knowledge that is crucial for practicing medicine. Most of what you read in Robbin's (the bible of 2nd year pathology), is not even going to still be in your cortex when you start practicing. Its cool to know that a left atrial myxoma is a benign cardiac neoplasm that presents like hypertrophic cardiomyopathy, and its neat to say that I can recognize rapidly progressive crescentic glomerulonephritis under the microspcope, but the truth is that even know I now know these things, I still use the basic pieces of knowledge I obtained as a PA to practice medicine. I work for a couple different groups right now, an EM group and an urgent care group, and the physicians and I joke around that I am going to somehow be transformed the day I graduate to practicing like a physician instead of a PA. Very few of them even remember this "glare" of knowledge when I quiz them at work. They laugh and tell me that most of medical school was memorization that they dumped before residency. Residency is what really makes a doctor, and PA's basically do a residency by working with doctors for many years!

And which one of you prions was it that said that a PA coud not pass the USMLE? Hec dude, I passed step one my first year in medical school. At the end of first year, our school participated in the nationwide administration of the GSBS exam, which is a 3 year old USMLE that is given at the end of first year to show you how you compare nationwide to other medical students ( and to scare you into starting to study for step ONE early!). The average nationwide was about 51%. I scored a 70% which would have given me a passing USLME step one score of about 210 or so. I can tell you that none of what I learned in first year was really relevant to that exam because it was all pharm, patho, and clinical scenarios/treatment. The basic science questions on that exam were nearly impossible for a first year to answer because they were disguised in typical USMLE clinical scenarios for which a first year has virtually no chance of understanding. So don't say a PA could not pass the boards. And just wait till June when I take the real deal after having had such an awesome refresher this year on pharm and patho. I'll officially go on record to challenge Gas-Mans's board scores if he is really a physician or student. If you come within 20 points of my USMLE score I will eat your shoes!!

Bottom line, if you don't like PA's, then don't hire one and don't do your residency where they use them. As for me though, I plan to find two military trained PA's with many years under their belts to come be my PARTNERS in the rural area. Yes, I said partners, because that is what they will be. And yes, I will pad my income while also giving them an unbelievable chance to create their own clientelle and make a great living.

Oh yes, one last thing, Profunda can be a disguise to actually mean superficial and not worthy of its name. Just look at the profunda femoris artery.

 

[profunda]

PACtoDoc, you have your opinion, and you one of thousands of PA are not representative of all PAs. You passed MCAT and got in med school, so you are probably one of the smarter PAs and not an average one. All I know is, when I am a doc, I will be doing research and coming up with new cutting edge cardio procedures based on my knowledge of CO = SV x HR, the angiotensin pathway, and the process/histology of atherosclerosis, reading new england and other journals to keep myself posted on new findings while the PAs are just doing procedures that can be trained in a year. I dont use robbins is a crappy book.

 

[profunda]

This is stupid I am going to discuss in the preallo forum about this exact topic. Everyone on here responding is just a PA who wants some credit for something they dont deserve. See ya I'm outtie.

 

[PACtoDOC]

Profunda,

Prior to applying to your cardiovascular fellowship, kindly be sure and brush up on your English language skills. Reading your sentences, I can only imagine what it is like to be dyslexic. FYI, nothing you mentioned about the Starling Principle, atherosclerotic heart disease, or the renin-angiotensin pathway makes you stand out as some kind of cardiovascular research scholar. You would have impressed me if you had stated you would be hoping to do research on the presence of myeloperoxidase enyzme elevations surrounding acute coronary events. The things you mentioned just show that you have taken an undergraduate level physiology class. Good luck on the ESL portion of your fellowship interview, and happy trolling. Damn guys, why did it take the rest of you so long to write something to get rid of Profunda??

 

[profunda]

It's more than what a PA knows.

Thank you for trying to put me down. Communicates to me you are a just bitter person and that your previous arguments should not be considered at all. Probably because you wasted half your life being a PA. You label me a troll because I am the rest of the 99% of pop who thinks the 2 year "training" and clinical experience does not make a PA an expert health care provider.

And yes I was an ESL. At least try to be mature, non-racist, and jealous of my diversity.

Originally posted by PACtoDOC
Profunda,

Prior to applying to your cardiovascular fellowship, kindly be sure and brush up on your English language skills. Reading your sentences, I can only imagine what it is like to be dyslexic. FYI, nothing you mentioned about the Starling Principle, atherosclerotic heart disease, or the renin-angiotensin pathway makes you stand out as some kind of cardiovascular research scholar. You would have impressed me if you had stated you would be hoping to do research on the presence of myeloperoxidase enyzme elevations surrounding acute coronary events. The things you mentioned just show that you have taken an undergraduate level physiology class. Good luck on the ESL portion of your fellowship interview, and happy trolling. Damn guys, why did it take the rest of you so long to write something to get rid of Profunda??

 

[deleted6669]

profunda- you disappoint me. didn't you just promise to go hang out in pre-allo instead of coming back here to condescend to us lowly pa's....

 

[PACtoDOC]

Profunda,

Appreciate this diversity from a Hispanic, PA, soon-to-be doctor, and bilingual life wasting person. Me la pela!! No quiero hablar con tigo mas. Necesitas comprar una maestra de Engles prima vez! I made my first half million as a PA, which is how I can afford to go to med school, travel, relax on weekends, and do med school the easy way (if you can say there is an easy way!). I am just over 30, so don't try and act like you are something special. And I dare to challenge you and say that your English is more like an ETL than an ESL......English as a third language. I hope your second language is better than your third. But I suppose being fluent in ignorance shouldn't count as a second language anyway!!.

There won't be any further responses from me to you. You are now relagated to the likes of MacGyver! As Tony Soprano would say, "He's dead to me".!!

 

[deleted6669]

matt- don't bother...
you and I were running codes in a ditch on the side of the road when he was learning to pee without a diaper.....

 

[profunda]

By the time I'm that age, I would've accomplished more than that dirt. Took you up to 30 yrs old to earn a meager half mil. I'm sorry you had to be such an old med student with that kind of cheap change in your pocket.

The spelling is Ingles. Obviously Spanish is your second language. And actually english IS my third language (however, I never took your comment about my english seriously, this isnt an literature contest i never meant to use my proper grammar).

You're still not changing any perception that PAs know nothing compared to doctors, even though you are striving with all your energy to do so. i mean, i remember everything from all my brs and notes, and it's not my fault med students/residents like you have a prob retaining info.

emedpa, I come back whenever someone like pactodoc shows he needs a little more annoyance.

Originally posted by PACtoDOC
Profunda,

Appreciate this diversity from a Hispanic, PA, soon-to-be doctor, and bilingual life wasting person. Me la pela!! No quiero hablar con tigo mas. Necesitas comprar una maestra de Engles prima vez! I made my first half million as a PA, which is how I can afford to go to med school, travel, relax on weekends, and do med school the easy way (if you can say there is an easy way!). I am just over 30, so don't try and act like you are something special. And I dare to challenge you and say that your English is more like an ETL than an ESL......English as a third language. I hope your second language is better than your third. But I suppose being fluent in ignorance shouldn't count as a second language anyway!!.

There won't be any further responses from me to you. You are now relagated to the likes of MacGyver! As Tony Soprano would say, "He's dead to me".!!

 

[profunda]

yeah and i'm on my road to becoming a famous doctor while you are still diggin your ditch. how sad.

Originally posted by emedpa
matt- don't bother...
you and I were running codes in a ditch on the side of the road when he was learning to pee without a diaper.....

 

[deleted6669]

profunda...
matt and I used to be 911 paramedics in busy trauma systems. "running a code" as you will someday learn, means being the decision maker in a cardiac arrest situation. a "cardiac arrest" as you hopefully will learn in your cardiology fellowship is a fairly intense medical situation requiring a cool head and an excellent grasp of emergency medicine principles. go away and stay away profunda. this is the pa forum you are not welcome here.

 

[Teufelhunden]

This paramedic-hype always kills me. Take any GED-holder, send 'em through community college paramedic program and they think they're freaking trauma surgeons. You could train a monkey to follow the ACLS algorithim. Paramedics are technicians, nothing more.

It's funny, we had a few "Ricky Rescue" former-paramedics in my med school class who swore they were freaking cardiologists. Didn't take them too long to realize they didn't know sh|t once we started med-school-level CV physiology.

Anyway, I know lots of paramedics...hell, my wife went through paramedic school when she was in the Navy -- almost aced the National Board exam -- and she'll be the first to admit that she doesn't know sh|t.

I normally don't "pull rank" on this forum, but MAN am I getting sick of people who havn't spent Day-1 in med school acting like they're freaking attendings.

You can have all the initials you want after your name...you can be a former nurse and PA...have a PhD...write a freaking book on ACLS....but until you get to med school, you're just a premed.

In other words, when you finally get to med school, you and the 21 y/o w/ no health care experience whatsoever are on EXACTLY the same level.

 

[deleted6669]

...UNTIL CLINICALS WHEN THEY CAN ALL EAT MY DUST....

 

[PACtoDOC]

Hey Teufel, if you bothered to read the previous few posts you would see that I am a PA who IS halfway through med school. Don't talk to me about how meaningless it is to run a code, just because you married some squid med drop out. I too was a corpsman you freaking jar head and I spent 4 years taking care of your kind. Show some freaking respect if you expect to get some. Your stupid little globe and anchor means nothing to me on this forum, but the one tattooed on my left bicep does. And there is no national board exam for paramedics. There is a national registry test that is pretty difficult. You cannot teach a monkey how to perform an ACLS algorithm; you can only teach them how to memorize them. Its altogether different when you are the one actually running the show. Why don't you and Profunda see who has the least favorable chance of becoming a cardiologist, preferably in a loing discussion on another forum. You are like many med students I know who are clueless and arrogant.

 

[tkim]

I would ask all participants to cool it down, please.

 

[profunda]

I am not arrogant. I consider myself an insignificant person, but that's at least "something." I cant be arrogant when I'm claiming to be greater than "nothing," which is a PA.

You are only 0.01% (rounded up) of non-PAs who think PAs are something. No matter what you and emedpa believe and try to convince of others, 99.99% of the population think PAs are nothing. It's funny to see how PAs in this forum think they know so much. You seriously should know that behind your backs, all the med students and residents and patients and nurses think you are just a PA, while you are thinking how valuable you think you are.

Originally posted by PACtoDOC
Hey Teufel, if you bothered to read the previous few posts you would see that I am a PA who IS halfway through med school. Don't talk to me about how meaningless it is to run a code, just because you married some squid med drop out. I too was a corpsman you freaking jar head and I spent 4 years taking care of your kind. Show some freaking respect if you expect to get some. Your stupid little globe and anchor means nothing to me on this forum, but the one tattooed on my left bicep does. And there is no national board exam for paramedics. There is a national registry test that is pretty difficult. You cannot teach a monkey how to perform an ACLS algorithm; you can only teach them how to memorize them. Its altogether different when you are the one actually running the show. Why don't you and Profunda see who has the least favorable chance of becoming a cardiologist, preferably in a loing discussion on another forum. You are like many med students I know who are clueless and arrogant.

 

[somebody]

Wow--I am absolutely amazed at the arrogance displayed here.

I am an MSII, and when I go to my preceptor in a small community ER, I often will tag along with one of the PAs. I have learned a lot from him. Does he know as much about medicine as the doc? No, but he sure as hell knows a lot more about clinical medicine than I do. And when he does need help with something, he asks my preceptor, or whichever other attending physician is on at that time.

I take every opportunity I can to learn something--I don't care if it's from the doctor, the PA, or the nurse, or whatever--If I don't know it, I want someone who does to teach me. I'm more worried about learning how to be a good doctor than I am about where I rank among the staff.

PAs (and NPs) fill a very important need in our society--without them, many, many more people would be without basic healthcare. They have a role that is different from doctors, but important nonetheless, and most of them understand their role and work within it well.

 

[Teufelhunden]

Originally posted by PACtoDOC
Your stupid little globe and anchor means nothing to me on this forum

I guess if you never went through 13 weeks at Parris Island, it wouldn't

Originally posted by PACtoDOC
You are like many med students I know who are clueless and arrogant.

Yeah, you're right...totally clueless...I don't know how I got this far

Listen, I'm not one to get into silly little flame wars online. I vented about paramedic premeds in general, and you chose to take it personally, and responded with personal attacks. I don't believe in attacking people personally online. Why? Because I don't know any of you. For all I know, you could be a good guy that I might get along with just fine in the "real" world.

It's sad that people can't disagree on topics w/o resorting to ad hominem retorts.

 

[deleted6669]

this thread has gone way off course and just become a bash- the- other- guy symposium. let's just end it here and try to respect each other the next time around. peace-e

 

[fab4fan]

And yes - the RNs follow PA orders, and consult with them for instructions

I wish I could say I've had a good experience working with PA's, but I haven't. The three settings I worked in that utilized PA's made me afraid...very afraid.

It was so bad at one place that I refused to accept any orders from the PA...I ran everything he ordered (other than Tylenol) past the MD. The PA got on my case about it, but I had my license to protect, and in my state, nurses aren't under the same "obligation" (for lack of a better word) to follow PA orders...we can if we choose to, but they don't carry the same weight as an order from a doc.

I found the PA's to be nastier to nurses, too; very dismissive and condescending. They were the last people I would have gone to for questions regarding pt. care.

In a way, I wish I could have had a good experience working with a PA. It's hard to be objective when you have only a negative frame of reference.

Anyway, a nurse's responsibility in handling a PA's orders may vary from state to state.

 

[fab4fan]

Under a physcian's supervision of course

Kind of...as a hospice nurse, they pretty much let me do my own thing.

 

[fab4fan]

Cute, very cute.

 

[timerick]

Originally posted by fab4fan
....Anyway, a nurse's responsibility in handling a PA's orders may vary from state to state.

Your employer may have a say in that as well. They may not want to have the medical staff and the nursing staff going in opposite directions... not good for patient care.

 

[fab4fan]

That's true, but ultimately, I have to protect my license...that may not be an employer's priority. If I follow through with orders that are problematic, I have to answer to the BON for it.

If a facility wants to use a provider who isn't safe, that's their decision. It's my legal, ethical, and professional responsibility to question/refuse to carry out unsafe orders, no matter who writes them.

That is why I ran all the orders that particular PA wrote past the attending. I value my license too much to risk it for anyone, doc, PA, NP...