Why are there so many PA's?

[darktooth]

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Is it...

1 - Because of the national physician shortage, hospitals are forced to hire more mid-level providers to handle the workload?

or

2 - Hospitals discovered that rather than paying 5 physicans at 250k a piece, they can hire 1 physician to oversee 4 PA's at 60k a piece?


one of these is good for us, one is not. what do you think?

 

[Winged Scapula]

PAs are not as productive as physicians. It would take more than 4 PAs to do the work of 4 physicians. The same has been identified with other mid-levels; they are not as efficient, order more tests and see fewer patients in the same time frame as a physician. But yes, they are cheaper (but PAs generally make more than $60K, at least in surgical fields, ours are approaching and in some cases, exceeding 100K).

 

[darktooth]

I know they're not as efficient, but is that something hospitals actually consider? Or do hospitals not care as long as they save money in the end, and they don't get sued too often?

From what I've seen at the hospitals in my city, seems like hospitals are trying to save a buck by hiring more mid levels and keeping a few physicians around to oversee the mid levels, make sure they don't screw up, legal reasons, etc...

 

[Beargryllz]

There aren't as many PAs as there are physicians. In fact, it isn't even close

 

[darktooth]

There aren't as many PAs as there are physicians. In fact, it isn't even close

We're not talking about sheer #'s. We're talking about PA's working in positions that physicians could fill.
the past 2 times ive been to the ER ive seen a PA. when my uncle went to the ER last month, he saw a PA. Why is this (especially since they are so few in overall numbers)

 

[TheWeeIceMan]

They are building an army to fight the NPs/CRNAs.

 

[Flamen04]

We're not talking about sheer #'s. We're talking about PA's working in positions that physicians could fill.
the past 2 times ive been to the ER ive seen a PA. when my uncle went to the ER last month, he saw a PA. Why is this (especially since they are so few in overall numbers)

So you're making a generalization based off TWO ER visits? Are you a medical student? If so, I'll speak in terms you should understand: Your small study does not have the necessary POWER to back such claims. Get a better beta brahhh

 

[KinasePro]

I love working with PA's/NP's on the wards. They're basically MS-3's frozen in training with limitless patience for doing all the scut work.

 

[Anastomoses]

I love working with PA's/NP's on the wards. They're basically MS-3's frozen in training with limitless patience for doing all the scut work.

Isn't M1 and M2 what differentiates a doctor from a nurse?

 

[deleted500612]

I love working with PA's/NP's on the wards. They're basically MS-3's frozen in training with limitless patience for doing all the scut work.

I would say a NP is more like the opposite of an MS3 when it comes to skill set. They wont even have close to the amount of theoretical/background medical knowledge, but will have far better clinical and practical skills.

 

[KinasePro]

Isn't M1 and M2 what differentiates a doctor from a nurse?

I would say a NP is more like the opposite of an MS3 when it comes to skill set. They wont even have close to the amount of theoretical/background medical knowledge, but will have far better clinical and practical skills.

Knowledge from M1 and M2 comes out in decision making, building differentials, taking board exams etc... I've done practice board questions with PA's/NP's and their material is a joke compared to how we're tested. Their hard questions are the 95%ers from UWorld. But that being said, you can't really tell the difference between them and us when, for example, your team is admitting it's 12th CHF exacerbation in as many days. They'll be accustomed to the standard management plans and a few of the nuanced ones as well. The difference though is that they only really know what they see, and their knowledge base is clearly limited -- which is exactly how an average MS-3 is on the wards. Practically speaking, they're like a medical student sentenced to purgatory in MS-3 for their entire career. They're pretty familiar with common medical problems. But they've never heard of mayer-rokitansky-kuster-hauser syndrome, and generally don't offer differentials. They are responsible for a metric sh1t ton of scut work though, which makes them far more valuable than a typical MS-3.

 

[notbobtrustme]

So you're making a generalization based off TWO ER visits? Are you a medical student? If so, I'll speak in terms you should understand: Your small study does not have the necessary POWER to back such claims. Get a better beta brahhh

this post is high yield for the boards

 

[notbobtrustme]

Isn't M1 and M2 what differentiates a doctor from a nurse?

Residency is what differentiates a doctor from a nurse.

 

[darktooth]

No one addresses the question directly because its uncomfortable. We're spending a good chunk of our lives to become physicians and mid levels are popping up everywhere now that hospitals are discovering they can use them to provide adequate care with a much lower payroll.

 

[evilbooyaa]

No one addresses the question directly because its uncomfortable. We're spending a good chunk of our lives to become physicians and mid levels are popping up everywhere now that hospitals are discovering they can use them to provide adequate care with a much lower payroll.

Guess you didn't read any of the other posts in this thread.

 

[Darth Doc]

We're not talking about sheer #'s. We're talking about PA's working in positions that physicians could fill.
the past 2 times ive been to the ER ive seen a PA. when my uncle went to the ER last month, he saw a PA. Why is this (especially since they are so few in overall numbers)

Sounds like you got fast-tracked for a non-life threatening issue. In the hospitals I've worked at the MDs got the urgents off the ambulance and other items the nursing staff triaged as MD appropriate and the PAs got the suturing, abdominal pain, headaches, etc.

Why PA's in the ER? Because in general, we like procedures and ER pays better than family practice and doesn't have any call and the urgent issues are fun. Kind of like why a med student might choose ER over FP residency. If you're doing all the scut work, pick scut work you enjoy. I believe the recent studies on PA specialty practice still show us overwhelmingly in FP, then in ER and surgery specialties.

Why do hospitals hire PAs? Because we are cost effective at what we do, but we do have limits. Why would an MD want to see another ankle sprain in the ER? I'm pretty sure the MD would prefer to drain the pericardial sac or otherwise save a life. (Which is why I'm off to med school with y'all.)