Why is the A in PA stand for assistant?

[hospPA]

Um, what would prefer, Para-medical, like paralegal? A PA is not a primary health care professional, but a subservient, dependent health care professional that is regulated and controlled by MDs and DOs. You assist doctors. That's your job as a PA, not to practice medicine.

Also, not all PAs have 6 years of schooling -- most have 2 years at best. If you want to be independent health care professionals, go to medical school.

Wow, I am so clear on this now. Thanks much. 20 years old, premed. Thanks for commenting based on your wealth of experience in the field. I consider myself honored to have read you very thoughtful post.


Pat

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[Happy613]

PACtoDOC,

A great post! since I am avoiding studying I will toss in my thoughts on the matter......

PA is a demanding carreer that is a great option for those seeking to go into healthcare. The bigger issue here is really how society views the profession of medicine in general. Doctors tend to get more respect than they deserve, there is a cultural aura that surrounds anyone who is a physician. It impresses people, and many people enjoy that recognition. I can't say that I am not guilty of this from time to time.

I never considered PA school, soley because I felt that I had the type of personality that would not do well with somone who would always be my superior. Its not as alturistic as I should be, but I was being honest to myself about what I could or could not deal with.

Is it right that the docotor who couldn't get into med school and went to some far off forieghn school (b4 anyone goes crazy I am not talking about established schools like SGU, Ross, or Saba, or the like that consistently place students in solid residencies....but the other ones whos names i don't even know ) is considered more intelligent by society than the PA who went to Duke? Or anybody else for that matter?

Its silly, but unfortunatley people make snap decisions based on labels and preformed preceptions. Personally I think we assighn way to much to the value a degree holds, and it often leads us to incorrect judgements about people.

I think PA's shouldn't be called assistant, it is demeaning. And it doesn't reflect the time commitment and depth of knowledge they have. Plus lets be honest, most do very little "assisting" anyway. Three years post-grad in other proffesions makes you a lawyer, gets you an mba or qualifies you to be a professional engineer (or at least begins to). Associate might not be the right term....but something else.

In the end if this bothers you as much as it did me, you really should go to med school. I hope I havent offended anyone, and maybe as I progress in my medical education I will see things differently

 

[deleted6669]

Awesome Post Happy

 

[Anubis84]

Wow, I am so clear on this now. Thanks much. 20 years old, premed. Thanks for commenting based on your wealth of experience in the field. I consider myself honored to have read you very thoughtful post.


Pat

Yeah, that's mature...bash me cuz of my age and major. Thanks!

 

[Anubis84]

PACtoDOC,

A great post! since I am avoiding studying I will toss in my thoughts on the matter......

PA is a demanding carreer that is a great option for those seeking to go into healthcare. The bigger issue here is really how society views the profession of medicine in general. Doctors tend to get more respect than they deserve, there is a cultural aura that surrounds anyone who is a physician. It impresses people, and many people enjoy that recognition. I can't say that I am not guilty of this from time to time.

I never considered PA school, soley because I felt that I had the type of personality that would not do well with somone who would always be my superior. Its not as alturistic as I should be, but I was being honest to myself about what I could or could not deal with.

Is it right that the docotor who couldn't get into med school and went to some far off forieghn school (b4 anyone goes crazy I am not talking about established schools like SGU, Ross, or Saba, or the like that consistently place students in solid residencies....but the other ones whos names i don't even know ) is considered more intelligent by society than the PA who went to Duke? Or anybody else for that matter?

Its silly, but unfortunatley people make snap decisions based on labels and preformed preceptions. Personally I think we assighn way to much to the value a degree holds, and it often leads us to incorrect judgements about people.

I think PA's shouldn't be called assistant, it is demeaning. And it doesn't reflect the time commitment and depth of knowledge they have. Plus lets be honest, most do very little "assisting" anyway. Three years post-grad in other proffesions makes you a lawyer, gets you an mba or qualifies you to be a professional engineer (or at least begins to). Associate might not be the right term....but something else.

In the end if this bothers you as much as it did me, you really should go to med school. I hope I havent offended anyone, and maybe as I progress in my medical education I will see things differently

Good post. I think the FMG from India or Pakistan or wherever, who has less skill and competence (possibly) than most PAs even from non-prestigious state schools, are still "doctors" and perceived as superior. What gets me is that a lot of FMG with undergrad medical degrees (MBBS= bachelor of medicine) of only 6 years in length, or less in some cases, plus a residency, are considered superior to master's level PAs. I think it's like you said, Americans put a strong value on being a physician regardless of that physician's training. Doctors who graduate last in their medical school class are still DOCTORS, whereas the top of the line PAs are just....well, PAs. It's a sad commentary on the prestige of titles and degrees.

I think this is why so many other health professions have looked to medicine and used its education and training as a model to improve their own. In the 50s and 60s, optometrists received BS and Masters degrees, now they are "doctors" of optoemtry. Pharmacists had five-year BS degrees, now they "doctors" of pharmacy. Chiropractors, podiatrists, and veterinarians use the doctor title. Now audiologists are converting to AuD ("doctor" of audiology) degrees and so are PTs who are now getting Doctor of Physical Therapy degrees (DPT). I think this trend is based on self-preservation (insurance reimbursement, respect, autonomy, independence from medicine) as well as professional recognition. PTs, pharmacists, and audiologists are now saying "Hey, look at me, I'm a doctor too!" Not sure if this right or wrong, but those other professions seem to get more recognition and respect based on:

1) The title of their degree (doctor vs. masters/bachelors)
2) Their professional designation (optometrist, clinical pharmacist, etc. vs. physician ASSISTANT).
3) Strength of professional organizations

I mean, when you compare the occupational designation optometrist to physician assistant, one is deemed an independent profession whereas the other is deemed to be a subordinate inferior job, not profession. It's sad, but true. The weird part is, in the case of PTs, they will have 3 year clinical doctorates (post BA/BS) or 4 year professional doctorates post 2 years of college, and will be "doctors", but they are less autonomous than PAs in most states. In fact, in Michigan, a PA can Rx PT w/o MD/DO approval, within reason.

I think that's what the problem with the public is. So maybe PAs could lobby for:
1) A less demeaning name
2) A standard degree program (some schools offer associates programs, others bachelors programs, and many masters programs -- there is no standardization like the MD/DO or JD or PharmD). If all PA programs offered the same degree and had the same requirements and curriculum, perhaps there would be less confusion?
3) more autonomy

Those 3 things served the NPs well in their quest for enhanced professional powers. Maybe the PAs could use some of those ideas in their quest for advancement.

I've also read various things about the PAs becoming the future Primary Care health care providers, while the MDs and DOs become the specialists. Not sure what that means, but it might end FP/GP and IM. Doubt it though.

 

[hospPA]

Yeah, that's mature...bash me cuz of my age and major. Thanks!

Your right, I'm sorry. I should have said that those are some very strong comments from someone who has not lived what he or she is talking about. I took offense to your post and responded. I will try to be more diplomatic next time. Nothing wrong with being premed and 20. I wish I were 20 again! Wait, no I don't

Good luck in your pursuit of higher education,

Pat

 

[Anubis84]

Your right, I'm sorry. I should have said that those are some very strong comments from someone who has not lived what he or she is talking about. I took offense to your post and responded. I will try to be more diplomatic next time. Nothing wrong with being premed and 20. I wish I were 20 again! Wait, no I don't

Good luck in your pursuit of higher education,

Pat

I never meant to offend you. I was just asking a question. Please accept my apology and re-read what I first posted. I didn't mean it to be disrespectful.

Jared

 

[WMUPAS]

[/QUOTE]Can I get an Amen..??? A hallejuah? Allrighty... everyones hand in the center...on three.....go team, ready...... 1..2..3...GO TEAM [/QUOTE]

Amen! Hallelujuah!

 

[WMUPAS]

Like I said in an earlier post, I don't care about letters or titles. Dad does just fine! For those of you more concerned....how about medical clinician (MC)?

Oh...it is soooooo close. If you can't accept that, well then, I would think about another career.

Frankly, as a PAS in a couple of months, I would let the licensed PAs figure the title out. I'm happy with plain ol' PA...or "hey you," "*$#%khead," etc. You get the point...I just want to improve my patients outcome.

 

[sunnyjohn]

Like I said in an earlier post, I don't care about letters or titles. Dad does just fine! For those of you more concerned....how about medical clinician (MC)?

Oh...it is soooooo close. If you can't accept that, well then, I would think about another career.

Frankly, as a PAS in a couple of months, I would let the licensed PAs figure the title out. I'm happy with plain ol' PA...or "hey you," "*$#%khead," etc. You get the point...I just want to improve my patients outcome.

Main Entry: cli·ni·cian
Pronunciation: kli-'ni-sh&n
Function: noun
1 : a person qualified in the clinical practice of medicine, psychiatry, or psychology as distinguished from one specializing in laboratory or research techniques or in theory
2 : a person who conducts a clinic


Main Entry: med·i·cal
Pronunciation: 'me-di-k&l
Function: adjective
Etymology: French or Late Latin; French médical, from Late Latin medicalis, from Latin medicus physician, from mederi to remedy, heal; akin to Avestan vI-mad- healer, Greek medesthai to be mindful of -- more at METE
1 : of, relating to, or concerned with physicians or the practice of medicine
2 : requiring or devoted to medical treatment
- med·i·cal·ly /-k(&-)lE/ adverb


I like medical clinician MC better than *$#%khead!

 

[WMUPAS]

What ever happened to jezzielin, the original poster? She stirred up a great discussion and then booked off.

 

[EMDrMoe]

Without reading the entire thread (or getting involved with mudslinging), I understand the job title frustration...Athletic Trainer. Hmmmm, how does that describe what we do? I always had people asking "oh, who do you train?" and how can I blame them?

Okay, now to go back and read the rest of the thread instead of studying...

 

[adamdowannabe]

Medical clinician seems to be the dictionary definitive!

And it's an acronym, so the PA could then sign their name

MC. Yadda Yaddayad


And then upon introducing onesself in a clinical setting, you can grab your opthalmoscope, put it in front of your mouth, wave the other hand in the air back and forth and say..


Yo Yo Yo YO!...... My name is MC Yaddayad, so just wave your hands in the Ayer...wave em like ya just don't cayer.... Now tell me ma'am/sir what brings ya in, what's ailing ya Oh-Yayer!

 

[sunnyjohn]

Medical clinician seems to be the dictionary definitive!

And it's an acronym, so the PA could then sign their name

MC. Yadda Yaddayad


And then upon introducing onesself in a clinical setting, you can grab your opthalmoscope, put it in front of your mouth, wave the other hand in the air back and forth and say..


Yo Yo Yo YO!...... My name is MC Yaddayad, so just wave your hands in the Ayer...wave em like ya just don't cayer.... Now tell me ma'am/sir what brings ya in, what's ailing ya Oh-Yayer!

Hardee har har har

 

[Jengirl18]

LOL...that just made my day.

 

[liverotcod]

Would "Physician Asswiper" be an improvement? Or just sort of a lateral move?

 

[LukeWhite]

Medical clinician seems to be the dictionary definitive!

And it's an acronym, so the PA could then sign their name

MC. Yadda Yaddayad


And then upon introducing onesself in a clinical setting, you can grab your opthalmoscope, put it in front of your mouth, wave the other hand in the air back and forth and say..


Yo Yo Yo YO!...... My name is MC Yaddayad, so just wave your hands in the Ayer...wave em like ya just don't cayer.... Now tell me ma'am/sir what brings ya in, what's ailing ya Oh-Yayer!

Heh.

Re the title, medical clinician seems problematic in that it doesn't uniquely define the job. Pretty much *everyone* in the field is a medical clinician.

The problem with redefining the PA name is that PA's were, for lack of a better word, invented to be very competent assistants to physicians even though now many do much more. It's hard to imagine a med system in the US that would tolerate practice without any physician oversight (even if in some cases that would perhaps be fine). Thus, unless a health profession has existed for a long time concurrently with physicians (like nurses), it will be hard to put into a play a title that does away either with the relationship to physicians or the fact that the relationship is necessarily (though sometimes nominally) hierarchical.

Personally, I think Physician Extender is a more accurate title, and I have trouble thinking of others, besides the current PA, that improve the title's accuracy. But again, PE runs into the problem of everyone having to change their business cards.

 

[50960]

How about physician appendage.....

 

[adamdowannabe]

business cards only cost 50 dollars for 1000,

I made the mistake of spending 90 bucks to jump up to 2000 when I became a massage therapist.... I left stacks of them at every conceivable location, hoping to build an instant clientele.....

Anyone want to spend 50 bucks for 1000 business cards with my name on them? I think I actually have 1500 in a box somewhere

Everyone mentions the whole idea of changing a business card, when we all know it's COOL to get to design a new one, sit down with a graphic artist and spend 500 dollars just designing something,

Who remembers the scene from "an american psycho" when all these blue suits were comparing their cards, all of them pretty identical.... that was a riot!

 

[surgpa]

You don't even KNOW the people on this forum. You have no idea what they've been through and sacrificed, you have no idea of how they are with their patients and colleagues. Grow up Jezzelin. The first thing you learn in med school is not to jump to conclusions quickly, because things are not always how they appear. People on this thread have tried to educate you and maybe if you don't like the attitudes you are seeing, med school is not for you. Med students are intelligent, highly competitive, and often (unfortunately) arrogant people. Part of this is because our entire lives, we are always competing against one another, for med school admission, then residency, then fellowship, the list goes on. And, the truth is, people are still in awe of doctors, and you are told over and over again how much you've accomplished. Some people take this too seriously and it goes to their heads.

This is the reality of becoming a physician. And, as you're seeing, the claws come out when people try to downgrade what physicians do or to compare them to ancillary staff members with less education and training. If you end up going to med school, you will understand this perspective after everything you go through. Trust me.

I've been a PA for 25 years now. I think all of this is getting a bit ridiculous. I have always been fine with being an "assistant" (although "associate" is more appropriate) because I did not go off to med school. Could I have done this? Probably, but for one reason or another the PA profession was a better fit.

Having said that, I admire many of my friends who are MDs. They worked just as hard as I did, albeit for a longer period to get where they are. That is "their" system and PAs are in another paradigm of training. Sure, I trained with med students, went to many of their lectures as well, but I did not put in all the time to get the MD. Simple enough.

I did see some talk about the "bridge" program to complete an MD program. I'm sure that would be a good option for PAs who want to go on to that. Dr. Stead actually wrote a lengthy paper on just that topic.

The problem as I see them are that we tend to get wrapped up in names, symbols and all of the other trappings that are secondary to why I presume we are all here for: patients. If you enjoy taking care of patients regardless of your "level", then you're in the right spot. If you complain about those pesky people who want your help and you have a desire to do something else. Do so.

Sometimes we lose sight of our real life from all the distractions around us.

Mike

 

[50960]

Good points, Texas!

 

[CircleTheDrain]

I was thinking that Medical Practioner MP would be a good name

Medical Practioner as opposed to the Nurse Practioner as PAs follow the medical model while NPs follow the nursing model.

but if you wanted to keep the PA...how about Physician Alternate?

 

[toughlife]

I have worked in emergency medicine for 18 yrs now, many of these as a pa. I currently work for a busy trauma ctr( >100k pts/yr)that uses a large contingent of pa's. we see almost anything that comes in the door with the exception of obvious mi's (they get screened by an em doc and go to cath lab), multisystem trauma(trauma team sees them), obvious new cva's( md screen and stroke team eval).we are well paid and appreciated by the md group. we are partners in the em group and receive production bonuses.The group uses over a dozen pa's most of whom had prior experience as military or civilain medics. we don't hire new grads. minimum qualification to get your interview: acls/atls/pals, 5 yrs experience as an em pa, great letters of rec from previous em job, and requirement to work on call for a yr before full time status so the group can check you out. it is a great gig.I also work solo a few times a month in a slower facility seeing whatever comes in the door
and that is a blast as well.
for more info on pa's in em see our professional society's webpage, www.sempa.org

This is pretty much what I visualize in a setting where PA/NPs work. Docs handling complicated issues while everything else being handled by midlevels.

 

[toughlife]

I'd say a PA falls somewhere along the lines of a 3rd year resident. I'd laugh if a med student or an intern tried to get all "hierarchy" on a PA, and the PA would probably laugh too, in their face.

Are you for serious??? An R3, at least the ones I have worked with, are MUCH more knowledgeable than a PA. At my school, an R3 pretty much runs the MICU with two R1s and a med student with attending oversight. I doubt that a PA could do that. I go to a "top 7" allopath school and the R3s would pretty much mop the floor with your face in terms of knowledge. At best you are at a 4th year-intern level, if anything; and this is with years of experience as a PA.

 

[toughlife]

That's just great. A modicum of ignorance is all it takes to deconstruct several messages worth of progress. That is absolutely ridiculous. Second year residents manage emergency rooms throughout the United States. There's virtually no comparison. Talk about apples and oranges ? You're seriously suggesting that a physician assistant, with one year of clinical background, can compete with a senior level resident physician ? Ah, the train of thought gets derailed once again.

Though the previous post matters little in the scheme of things, it is attitudes like that which render medical students both incredulous and hostile. The likening of a newly graduated PA to a third year resident (if that is indeed your contention) indicates that you have virtually no understanding of a physician's training. In most cases, senior level residents (at least in EM) have completed more critical care, trauma anesthesia, radiology, neuro and pedi EM that a recently graduated PA can even dream about. Physician assistants who complete even ONE year of post grad EM training often tell me (granted, anecdotal evidence at best) that they are far more prepared from an additional year of post graduate schooling. Residency is designed to temper the knowledge base of the graduated physician with some much needed experience... A resident completing two years of 80 hour average work weeks has more than doubled the time that an average PA student spends in clinical rotations.

Interns and students frequently don't possess the experience necessary to formulate mature clinical judgements. The difference that a year of physician level responsibility makes, however, is hard to underestimate. I apologize if I have taken your remarks out of context. As you've seen, there are many PAs on this forum who have spent 18+ years in emergency medicine.. (no naming names). These individuals have seen it, done it, intubated it, and resuscitated it. Their experience gives them a rather unique and informed perspective on patient care and medical decision making. Judging from your post, it does not seem that you're one of these seasoned providers. My comments are in response to your apparent comparison between a PA (recent grad) and a third year resident.

One thing you forgot to mention is that a PA's clinical year is like a med student's third year not like an R1 year. So even if the PA has done a clinical year, it does not qualify him/her to be even compared to an R1.

 

[governator]

love this PA vs Docs debate. Which only exist in internet forums. I'm a DO about to start ER residency, have an ortho PA sister (2 yrs removed from school). All i want to say is that we all know what we're getting into when we apply/accepted to Med or PA school. We've all done our research about lifestyles, income and even titles. So why does it bother people when their title says Physician Assistant? It was PA before you start PA school, PA when you're in PA school and PA after you graduated. Should be proud of it.

PA is a great profession, my sister is loving it. Just want to give a heads up to people that are worried about length of schooling/tuition, Miami Dade Community College's PA program (in FL) accept High school graduates (their program is an associate degree). (you'll save 4 yrs of undergrad tuition) and YES, their graduate are equal to any other PA program graduates (Bachelors or Masters).

 

[50960]

Miami Dade Community College's PA program (in FL) accept High school graduates (their program is an associate degree). (you'll save 4 yrs of undergrad tuition) and YES, their graduate are equal to any other PA program graduates (Bachelors or Masters).

this is scarey...

 

[durban]

I went to medical school after two years as a PA. From my own personal experience, Type B is right - there is no comparison between the PA and medical school, although there is tremendous variation amongst PA programs. I have met recent PA grads from some programs whose knowledge blew me away. My program was weak. And Type B is right about the assistant designation also. Any other designation is not only inaccurate but will add fuel to the paranoia about midevels' encroachment on MDs' scope of practice. The term "assistant" in no way detracts from the appreciation or respect doctors have for PA's.
Now THAT SAID, Type B's assertion that he's addressing only the "assistant" issue is not true. If you read his posts, he makes some very gratuitous, snide digs at PA's. Dr's who do this are insecure themselves about the advancing role of midlevels and probably bitter about the attendant reimbursement issues. That's speculation, but what is not speculation is that if you are on the fence about PA vs. med school, go to med school. If you're a PA having doubts about whether you can put up with his kind of pomposity and insecurity, go ahead and bite the bullet and go to med school. I'll be finished next year and I can honestly say it has been worth it partly due to knowing I will not have to deal with MD's like this.

 

[hospitalistpac]

Miami Dade Community College's PA program (in FL) accept High school graduates (their program is an associate degree). (you'll save 4 yrs of undergrad tuition) and YES, their graduate are equal to any other PA program graduates (Bachelors or Masters).

this is scarey...

ok I could hardly believe but I looked into. I knew there were some programs that still offered associates. I looked into it and in order to be accepted you have to to 30 college credits in life sciences and general arts and have considerable health care experience. The actual PA program is 24 mos just like most. People with a BS or MS apply to this as well because the tuition is reasonable.
I personally don't know why anyone go to a PA school that did not grant an advanced degree though. I think these AS programs are getting phased out. I hope.

 

[deleted6669]

this type of program is being phased out as the profession is converting gradually to a masters degree at the entry level.
community college programs are the exception, not the rule in pa education.
community college grads may be equal in that they can take the cert exam but unless they had prior experience/training they are not "equal" to grads of other programs and people who hire pa's(say me) know the difference.

 

[adamdowannabe]

Yes, scary indeed.

One of the only reasons the quicky medical education of PA is feasible, is because of the previous healthcare/life experience of the current PA applicant and littany of pre-req courses that may or may not even be required by medical school. (the A&P just to get people up to speed as to the basics of how the body works etc.....)

I am already weary of the 21-22 year olds getting their MSPAS in the 3+2 (undergrad/professional years) model. and being dropped off at clinic to practice medicine. With a Masters degree!

Heck if medical school didn't have residency I would be scared that these 25-26 year old new MD's just don't have the life experience to know what dealing with people involves.

 

[governator]

i think the only difference, if it does exist, between an associate or master degree PA graduate is getting the first job as a PA and i have yet met a PA graduate that struggles getting a job (although i know nothing about the hiring process of a PA, i'll take emedpa's word on this). Why would this Associate program scary? you're learning the same stuff as any other PA programs, you take the same board exam, you're licensed the same way, AND you get paid the same salary after graduation. If you're an aspiring future PA, wouldn't you rather be 21-23 yr old graduate, working than 27-29 yr old graduate, working with more student loans? I mean you're gonna be judged by your performance and not your degree anyway.

 

[adamdowannabe]

i guess the point I was trying to make, was about the maturity of a 21 year old. I know when I was 21 I thought I knew some stuff about life, but did I? then at 23 I had my first professional career in an "I'm the boss" role, and it was THEN that I thought I new something, now getting closer to 30 I realize I don't really know much or have very much experience. It's not the clinical skills and knowledge that the 21 year old lacks, it's everything else that comes with age and experience that they lack. Thats what makes it scary, how they relate to people, if they have built any sort of inner person to rely on in the tough career of medicine, all the things you don't learn in school.

I have an aquaintance who is 21 and about to start a Psi-D degree, she is good at school, but lacking in "everything else" so, in 3 years, at age 24 will she be ready to be a clinical counselor? I highly doubt it. She hasn't moved out of her parents house, she hasn't lived any life, I am not sure reality has been forced upon her.

Same thing goes for the really young med students, getting an MD at age 24-25 does not make someone ready to be put in the position of being a good physician, I think the residency is what makes young people grow up so quickly. It's not that these people aren't properly educated, they are just so young.

How many "older people" realized every few year through out the twenties and early thirties how little you really knew back when you were 21, 22, 23, 25....26, Now, think about how at that age you thought you knew it all? Young people don't realize how little they know, until they get out of the age.

 

[deleted6669]

"It's not the clinical skills and knowledge that the 21 year old lacks...."

yes it is. the whole comcept of the pa is that it is meant to be a second career building upon a prior base as a medic, r.t., rn, etc and not as a stand alone 1st career. when I went through pa school everyone in my class of 80 had at least 3+ years in another medical career. as you may or may not recall the original concept of pa school was to start with seasoned military medics and build on the base. we lost that somewhere along the way and it shows in the students who show up clueless on rotations now......

 

[JAMMAN]

This might sound bad and I know that PAs assist doctors, but it just irritates me that going to college for 4 years, then PA school for 2 - I would work so hard to be called assistant. It should be associate or something... any thoughts or other ideas for what 'A' can stand for?

The A stands for assistant.

 

[lawguil]

Yes, scary indeed.

One of the only reasons the quicky medical education of PA is feasible, is because of the previous healthcare/life experience of the current PA applicant and littany of pre-req courses that may or may not even be required by medical school. (the A&P just to get people up to speed as to the basics of how the body works etc.....)

I am already weary of the 21-22 year olds getting their MSPAS in the 3+2 (undergrad/professional years) model. and being dropped off at clinic to practice medicine. With a Masters degree!

Heck if medical school didn't have residency I would be scared that these 25-26 year old new MD's just don't have the life experience to know what dealing with people involves.

Aren't these 25-26 year old residents practicing medicine? Just because you're a resident doesn't mean you don't "practice". I understand supervision, however, supervision for a "young" PA should be similar and how the supervising physician uses the PA should be tailored to the needs and experience of the PA 22 or 40 yoa.

I understand that history of the PA profession (having prior medical experience) and think it is an awesome structure. I wonder if the need for the PA's has grown so much and so many colleges now have a program that they have to open the admissions criteria a little more to meet demand and fill classes. ( I have no idea). Surely when a PA student shows up with no previous clinical experience they struggle or feel uncomfortable, but how do they adapt and how are they when they leave the clinical rotation? I suspect that 1 full year of didactics and 1 full year of rotations could make a competent practitioner out of somebody without experience.?? The person with experience would be just that far ahead/ potentially. My experience with PT and Athletic training student is that they either get or they don't.

 

[deleted6669]

You are the assistant to someone who also went to college for 4 years....then med school for 4...then residency for 3-5 more and maybe another 1-2 for fellowship...for perspective...

2 years after college = physician assistant
7-11 years after college = physician

I do see your point but lots(most) of pa's have more than 2 yrs post college, they also have prior training and experience.
take me for example:
5 yrs emt
university of ca bs degree with heavy sci concentration
1 yr paramedic praogram
5 yrs as paramedic
3 yr pa program
1 yr postgrad masters(em)

so I have 5 yrs post bs for 9 yrs total education. granted not 7+ post bs like an md but not just an associates degree either.....

 

[nev]

This is probably out of topic....but do PAs specialized in surgery actually perform surgeries?

Thanks
Nev

 

[deleted6669]

This is probably out of topic....but do PAs specialized in surgery actually perform surgeries?

Thanks
Nev

they 1st assist and do as much as their supervisors allow. for some that means" hold retractors" for others that means" you(pa) do the surgery and I (md) will 1st assist you". pa's can not open up shop as solo surgeons but lots of surgical pa's have done major procedures with their docs walking them through it initially then just assisting later.I have several friends who have done skin to skin appendectomies, etc while their supervising md's watch.
some outpt surgical ctrs use solo surgical pa's for any procedure less than 20 min long that does not require general anesthesia. for instance fb removals and abscess drainage under fluoro,derm procedures, prostate biopsies, etc

 

[adamdowannabe]

"It's not the clinical skills and knowledge that the 21 year old lacks...."

yes it is. the whole comcept of the pa is that it is meant to be a second career building upon a prior base as a medic, r.t., rn, etc and not as a stand alone 1st career. when I went through pa school everyone in my class of 80 had at least 3+ years in another medical career. as you may or may not recall the original concept of pa school was to start with seasoned military medics and build on the base. we lost that somewhere along the way and it shows in the students who show up clueless on rotations now......

Emed, don't forget a 17 year old can become an EMT and rapidly become a paramedic, and spend a few years doign that, and at 21 they might have three years of clinical experience and skills, but in the whole scheme of life, they are still just 21 years old. We all know, at 21 most people think they know everything there is to know about life, but besides all the medic skills, what does a 21 year old REALLY understand about the world? I guess I am bringing up the whole wisdom issue, as a separate thought to the clinical experience issue.

 

[adamdowannabe]

My previous health experience is on the low end of things (1,500 hours or so) plus a few years as a clinical massage therapist. I know when I first got my start in clinical settings (in athletic training) I was aprehensive about hurting people. Doing orthopedic evals can be downright brutal to a patient. Timid hands, associated with a timid mentality, it took me 6 months to become comfortable with my abilities; I guess thats how long it took me to realize, I would probably mess up, but thats how people learn. So, yes, I understand the importance of having previous hands on before getting thrown into PA clinicals, or else the PA-S is going to spend 15 months afraid to do anything more then watch. (which makes it almost a total waste)

The same thing exists in medical roations too, some med students are just too scared to try things, their preceptors let them get away with it, 12 weeks with minimal activity. mostly observation.

It's a two fold issue though. The mal prepared student, coupled with preceptors who get irritated by the students mal-preparation. maybe the PA preceptor needs to lay it down.... see one, practice one with instruction, then do one! And, if the rotating students can't get over it, they need to suck it up or take a hike. Tough love attitude? Military attitude?

Did you order the code red? You're GOD DAMN right I did!

 

[sweetpeamd09]

After seeing his/her posts in several threads I completely second that motion!

This thread has rapidly degenerated into garbage. I dont know why everyone has to argue about the same thing over and over again. Does anyone here really care about what Typebmed says (whatever his name is)? Does/should typeb really care about what anyone here says? The answer should be NO to both questions. After many years of writing in forums I have found it is best to just ignore posts/threads that really aggravate you. Its just not worth your time.

 

[PACtoDOC]

Emed, don't forget a 17 year old can become an EMT and rapidly become a paramedic, and spend a few years doign that, and at 21 they might have three years of clinical experience and skills, but in the whole scheme of life, they are still just 21 years old. We all know, at 21 most people think they know everything there is to know about life, but besides all the medic skills, what does a 21 year old REALLY understand about the world? I guess I am bringing up the whole wisdom issue, as a separate thought to the clinical experience issue.

At 18 I received some of most high speed medical training possible for a non-trauma surgeon. I was a Navy Corpsman with a high speed Marine unit. If you don't know what that means, do a google search. By 19 I had combat medical experience that most physicians will not receive in a lifetime of waiting and hoping. By 21 I had a civilian paramedic certification to go with it, and by 24 I was accepted to PA school. I don't think many people enter PA school at age 24 with this much experience, and yet I feel I was still not mature enough to practice medicine. So the age thing makes sense even from the perspective that someone could be highly qualified medically speaking. And what is scary is that there were lots of people in my PA class younger than me with no experience at all. If the profession had been smart, they would have required all PA's to be 2nd career medical professionals with a minimum of several thousand hours of experience. But now any pre-med who can't do well on the MCAT applies to PA school, and thus the pool is tainted forever.

 

[governator]

have to disagree with the whole age thing. I understand that a 21 yr old might be at a disadvantage compare to a 40 yr old on things that has no formal teachings...... things like marriage, dealing with money, etc. But we're talking about a profession with formal teaching. How is it a 21 yr old PA graduate 'not as good as' a 40 yr old PA graduate. The patients presented are the same, symptoms are the same, treatments are the same (generally). Are you talking about handling stress? or other issue?

 

[adamdowannabe]

I think it has to do with the maturity of dealing with medical issues, depending on the specialty, can a 21-22 year old really be wisened enough to tackle difficult medical issues (ethically and positional).

As an extreme example, a 21 year old male, acting in a position of medical provider for 16 year old pregnant or sexually active teenager who needs care.

Obviously there is more to it then that, also relating to how a patient views such a young persons abilities. obvioulsy it is stereoptypical issue, but the dynamic exists. One that might hinder the ability for quality medical care.

I keep thinking about the recurring MADTV sketch involving the bubbly young blond girl as a ditzy physician, and how young (really young) members of the medical community (21 year old PA's) might be met with apprehension, and also might not have the personal growth to deal with complicated issues.


Thanks for the understanding PACtoDOC

 

[50960]

I agree! Experience on top of training makes a sound practitioner. Training can make a competent practitioner, but without experience and maturity one will only be competent. It takes time to be good at what you were once trained to do. Basic neuroscience and thousands of years of philosophy prove this to be true!
I have learned a whole lot more in the years I have been practicing that I ever did in school, and that knowledge has changed how I KNOW and understand what I did learn in school.

 

[PACtoDOC]

I agree! Experience on top of training makes a sound practitioner. Training can make a competent practitioner, but without experience and maturity one will only be competent. It takes time to be good at what you were once trained to do. Basic neuroscience and thousands of years of philosophy prove this to be true!
I have learned a whole lot more in the years I have been practicing that I ever did in school, and that knowledge has changed how I KNOW and understand what I did learn in school.

Wow, I am on the same page with Psisci!! One more comment. About 35% of medical visits are actually psychosomatic issues bubbling up, and without life experience, I can't see a 21 year old equipped to handle them.

 

[RAMPA]

By 21 I had a civilian paramedic certification to go with it, and by 24 I was accepted to PA school. I don't think many people enter PA school at age 24 with this much experience, and yet I feel I was still not mature enough to practice medicine. So the age thing makes sense even from the perspective that someone could be highly qualified medically speaking. And what is scary is that there were lots of people in my PA class younger than me with no experience at all. If the profession had been smart, they would have required all PA's to be 2nd career medical professionals with a minimum of several thousand hours of experience. But now any pre-med who can't do well on the MCAT applies to PA school, and thus the pool is tainted forever.

i totally agree with you. ask me my age...c'mon i dare ya...ok here it is I am 20 yrs YOUNG! i could start PA school next fall and finish and only be 22. I WOULD MAKE A GREAT PA RIGHT! I AM A MONITOR TECH AND UNIT CLERK AND HAVE 2 YRS EXPERIENCE SO THATS ENOUGH FOR SOME PA SCHOOLS![/sarcasm off] i know that i would not feel right handling some cases. i could be qualified, but whos going to listen to a pimple faced 22 yr old who just moved out of home? kinda like those verizon commericials! i would refuse to see a young PA. even though thats what i want to do. how am i gonna confide in someone 2 yrs my elder??? no way. this is not the way to go for the PA profession.

if an MD sees that i did undergrad straight thru PA school and knows that ive never had a real job, he'd probably pay me crap. b/c i dont know how to deal with pts (not ideally at least) and i need the money, plus i have no background in medicine.

now what if i had 3-4 yrs experience as a Resptech at a busy hospital was around 30 yrs old and applied to work for a Cardiologist. would i have the upper hand? YES. both moneywise and "lifewise".

why do MD's have residencies, same reason PA's should have previous medical experience. and as EMEDPA said folding sheets at the hospital or following Dr Uncle should not count.

 

[governator]

i guess age does matter for a lot of you guys when it comes to medicine. I personally feel that a 21 yr old is an adult and with proper training should be able to perform his/her duties. If a young aspiring future PA asks me for an advice, i'm going to tell him/her to attend the school now if possible rather than waiting for couple extra years. Is there 21-24 yr old PA grads out there that would like to comment on this?

 

[Happy613]

Well I'm not a pa student, but i am at the younger age of the spectrum. I am 25. When I graduate med school I will be 27. The youngest person in my class (7 year ba/md program) will be 24 when they graduate.

I agree totally that when in your twenties there are just certian experiences you haven't had yet and it affects how you see things. I think this is why many med schools are accepting older students. Some of my classmates are in there 40's and on their 2nd carreers, their realworld knowledge will be invaluable to them. The way I approach it is that I simply acknowledge that I am really green at this and have very little experience outside of academic settings. I think the key is for younger people in the health care field to realize this and temper their behavior.

I think the requirment at many PA programs for substantial previous clinical worrk would be beneficial to the medical school model; however impractical given the length of medical education in general.