Yep, Healthcare is in trouble...

[H_Caulfield]

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Tried to make an appointment to have my physical and vaccinations (starting med school in September), and was informed (by three different offices) that a PA would be seeing me. What is it that primary care doctors do anymore, if it's not to see patients? 😡

 

[MoxieDO]

lucky you got to a PA. My university overbooks their clinics and I was stuck seeing the RN with an upper respiratory track infection. I ended up overdosing on the medications she was giving me....not fun. Finally got in to see the doctor when I got worse (due to overdose) and got my medications in order. There is a definite need for more primary care docs everywhere.

 

[clowden]

I don't think it's a lack of primary care docs that we're seeing. It's more like there is not enough money to pay highly trained attendings when PA's and RN's are cheaper to a program and CAN do the job. PA's and RN's don't have as much training as an MD or DO, but sure are less expensive to staff.

 

[BAM!]

Tried to make an appointment to have my physical and vaccinations (starting med school in September), and was informed (by three different offices) that a PA would be seeing me. What is it that primary care doctors do anymore, if it's not to see patients? 😡

You have it completely backwards.

PA's and RN's are only helping healthcare. They take a load off of overworked doctors, especially when all you need is something so simple as a physical and some vaccinations. If you're posting on these boards, odds are you're young, healthy, and don't need to see a doctor.

PA's are relatively new, so people don't know about them, but they went through academic years and rotation years at PA school just like med students. They often don't get the respect they deserve from close-minded people like you who don't know what they're talking about.

Open your eyes. PA's are not ruining healthcare. They are helping healthcare.

Also, do they rest of the world a favor, don't make sweeping statements about things that you don't know anything about. If you do, one day, you'll be a doctor, people will listen to you, and the world will be dumber.

 

[BAM!]

...and it figures the OP's screenname is holden caulfield.

 

[LJDHC05]

Wait until a PA/RN/therapist puts Clowden in his/her place on July 1 of clinical rotations. As a son of a RT, don't piss the nursing/technical staff off or they'll make your life a living hell and see to it that your rotations are MISERABLE. PA's are some of the most approachable/helpful people in a clinical setting and can be your best friend.

I tried to book an apt with my PCP and she's booked solid until september, so I've got a Nurse Practicioner doing my physical...which is cool with me.

 

[willow18]

PA's are relatively new, so people don't know about them, but they went through academic years and rotation years at PA school just like med students. They often don't get the respect they deserve from close-minded people like you who don't know what they're talking about.

More like academic year and rotation year.

I do agree that they deserve respect, as does any human being, no matter what profession he/she is involved in.

 

[McMD]

Ok, maybe I'm crazy...but when I make call the doc's appointment...I specifically ASK for the PA...she is so nice and when I handed her the documentation that she had to fill out and it said the school I will be attending, she was so excited for me!! I haven't seen my actual PCP since I was maybe 10 years old, and I've been going to the same doc's office since I was 4....I specifically ask for the PA that works there!!

 

[MacGyver]

lucky you got to a PA. My university overbooks their clinics and I was stuck seeing the RN with an upper respiratory track infection. I ended up overdosing on the medications she was giving me....not fun. Finally got in to see the doctor when I got worse (due to overdose) and got my medications in order. There is a definite need for more primary care docs everywhere.

Please tell me you are joking. ARe you telling me its LEGAL for RNs to script drugs now? I hope you had an NP and not an RN

 

[SanDiegoSOD]

Tried to make an appointment to have my physical and vaccinations (starting med school in September), and was informed (by three different offices) that a PA would be seeing me. What is it that primary care doctors do anymore, if it's not to see patients? 😡

Do you really think you need someone with 7+ years of medical education to squeeze your balls and push a needle effectively? Unless you have a history of complex disease, a PA should be trained to more than adequately perform a simple physical.

 

[clowden]

hey hey hey guys...I never said anything knocking the capabilites of a PA or LNP or RN. The only thing I said is that MD's and DO's have more training...do they not? I agree that PA's and LPN's can be and are great care providers. I worked in an interventional nephrology clinic as a surgical tech for a year and it was basically run by a PA. When the PA was gone and the actual MD's had to take over it was terrible because the PA was by far better at doing just about everything. Also, I absolutely LOVED the nurses I worked with, they were the glue linking everything together.

The point I was trying to make in passing (I guess I should have made myself more clear) is that why would you pay a highly trained attending physician if you can pay an RN, LNP, or PA significantly less money for the same care when dealing with a lot of patients. They are certainly capable of treating them.

I was trying to disagree with H_Caulfield who said "What is it that primary care doctors do anymore, if it's not to see patients?" This statement implies that PCP's are lazy and don't care about patients. In some specialties across the nation, mostly in Family Medicine the physicians are being overworked and the programs are relying more and more on PA's, RN's and LNP's and this is why you are seeing someone like that when you're getting a flippin vaccination or have acute bronchitis (which I get every winter and is NOT as big a deal as kidney failure which is probably more like what the physician is busy treating). As the head of a hospital would you rather stock more PA's RN's or LNP's whose eduaction and salary costs less and who are just about as competent as doctors for most medical problems or a physican who you have to pay six figures and whose education costs the program tons of money...think about it.

Y'all read WAY more into my post than I had said. Trust me I have been humbled time and time again, and will respect and lean on anyone I consider to be more knowledgeable than me (which will be pretty much everyone for the next 4 years). You got me all wrong...all wrong.

 

[LJDHC05]

My bad clowden...I know that I'm gonna piss off the nursing staff within the first week of my rotations just based on the fact that I'll know nothing at all and be thrust into the middle of their unit. Didn't mean to jump on you...

 

[skypilot]

In some specialties across the nation, mostly in Family Medicine the physicians are being overworked and the programs are relying more and more on PA's, RN's and LNP's and this is why you are seeing someone like that when you're getting a flippin vaccination or have acute bronchitis (which I get every winter and is NOT as big a deal as kidney failure which is probably more like what the physician is busy treating). As the head of a hospital would you rather stock more PA's RN's or LNP's whose eduaction and salary costs less and who are just about as competent as doctors for most medical problems or a physican who you have to pay six figures and whose education costs the program tons of money...think about it.

Well the FPs are overworked because the med schools are not producing enough of them. Someone had to step in and fill the void and it is the NPs and PAs.

But I hope they enforce high quality standards on all the NP programs because I would hate to see lawsuits from failure to diagnose. I'd rather pay an extra $100 each time I visit the doc than have a practitioner who misses something.

Having said that my interactions with NPs have been great. Many of them have had 20 years of experience and spend a lot more time with you than the docs.

 

[TBforme]

.

 

[clowden]

It's all good...should have been more clear. I had just got finished reading this other message board about medical programs running inefficiently and tried to make a thoughtful statement without giving it much thought.
🙂

PA's, LNP's, RN's, MD's and DO's can all coexist more than happily, I was just reading about these programs, however, that have all of the above running around with their heads cut off doing all the same work and not working with eachother very well. I think with different kinds of health care provider's entering the fray the roles of each are kind of clouded which can make for some resentment and problems in the workplace. If everyone knows their role and works together as a team and respects each other and their unique role then it is a pretty amazing and efficient thing to see. Perhaps the medical field should do a better job of defining and establishing those roles.

 

[MacGyver]

Perhaps the medical field should do a better job of defining and establishing those roles.

I agree thats what needs to be done. However, there is this historical artifact whereby doctors and nursing boards are totally separate. That gives teh nurses a foothold to invade MD turf any way they want to.

Nursing boards should be abolished, and instead one "healthcare" board for each state should be founded. This helathcare board would control scope of practice for EVERYBODY in the healthcare profession, including doctors, dentists, physical therapists, chiropractors, RNs, LPNs, NPs, PAs, pharmacists, etc. Of course this board should have reps from all fields but MDs should have most of the say.

This will never fly though, because nurses and the others are happier using their own boards to write their own scope of practice any way they see fit.

 

[RobHan]

http://cfm.mc.duke.edu/News.htm

I don't think it's a lack of primary care docs that we're seeing. It's more like there is not enough money to pay highly trained attendings when PA's and RN's are cheaper to a program and CAN do the job. PA's and RN's don't have as much training as an MD or DO, but sure are less expensive to staff.

 

[BAM!]

More like academic year and rotation year.

I do agree that they deserve respect, as does any human being, no matter what profession he/she is involved in.

not all PA masters programs are 2 years. Lots are 2.5-3 years, thus yearS

 

[BAM!]

i personally will not go to a PCP if they have NPs/PAs working for them. i believe that the person most qualified to treat me is a doctor. there is no shortage of doctors. there are just plently of doctors who are quite happy to boost their pay by having PAs work with them, or hospitals/clinics who would also like to increase their profits.

now at the beginning of 4th year, i realize that you can never know too much and i want the person that knows the most taking care of me. even common symptoms/problems can be something rare or serious. there are few things more important than your health, and i do not think it is elitist to demand the most for yourself.

Firstly, there is a shortage of doctors. Why do you think doctors are so overworked? Because there are so damn many of them?

Secondly, realize that experience is much more important than credentials. Your sense of entitlement is elitist, especially when you, a healthy med student in your twenties, draw doctors away from 60 year old patients who have complicated problems and need professionals with more training in that area. Your close-minded views are a perfect example of why health care is so far behind other countries.

 

[TBforme]

.

 

[Taurus]

not all PA masters programs are 2 years. Lots are 2.5-3 years, thus yearS

"The average PA program curriculum runs approximately 26 months." This is from PA national association.

http://www.aapa.org/geninfo1.html

 

[latinfridley]

"The average PA program curriculum runs approximately 26 months." This is from PA national association.

http://www.aapa.org/geninfo1.html

BCM's PA program is ~30 months

 

[MoxieDO]

Please tell me you are joking. ARe you telling me its LEGAL for RNs to script drugs now? I hope you had an NP and not an RN

oppps, sorry the title escaped me, but it was in fact a NP. Wow this thread has exploded. The fact is there is a shortage of docs and unfortunately some (like myself) are restricted by health plans etc to only go to a certain place (like my univ. clinic where it is free by my insurance) where it is not always easy to get in to see a doc due to the overwhelming number of patients. PAs and NPs exist to help relieve some of the strain on doctors regarding simple or frivolous cases, but by no means are they replacement for docs, especially in regards to serious illnesses. I have a very long, well documented history of asthma, allergies, bronchitis, etc. and should have either seen the doc or the NP should have noted all meds I was taking before prescribing new ones. It was a mistake anyone could make, but this is more a result of ppl trying to rush through patients because they are overloaded with so many of them.

 

[BAM!]

"The average PA program curriculum runs approximately 26 months." This is from PA national association.

http://www.aapa.org/geninfo1.html

well not to be too picky, but 26 months is still years. I guess I was being silly and calling 1.5 years years. I admit it, my fault, I was being too technical.

 

[BAM!]

as for the other guy,

I see your point, you want to access to the best health care possible. I'm sorry if I came down too hard on you with my views, maybe I should tone it down a little (just trying to make these threads more interesting).

However, I still think your mindset is fundamentally rooted with elitist views. You stated that you wouldn't even go to a practice that employed NPs/PAs, for fear of having to see the one of them I presume. You're writing off the entire practice for this reason? You can still see the doctors working there, you know. Keep in mind, the context of this thread - physicals and vaccinations. NPs and PAs have essentially the same training for H&Ps and vaccinations as doctors. They can handle it.

If you were in your mid twenties and healthy, it's not efficient or considerate. It doesn't make sense to necessitate 7 years of medical training for a physical and vaccinations. Clear and simple. But you got me, my guess was wrong, and you're older.

As for the shortage of physicians, obviously this depends on where you live. but yes, there is a shortage.

Yes, credentials are important to beauracracies. Experience is important in real life. I won't patronize you, as you're old enough to know this by now. But it's important to remember.

 

[SeventhSon]

Wait until a PA/RN/therapist puts Clowden in his/her place on July 1 of clinical rotations. As a son of a RT, don't piss the nursing/technical staff off or they'll make your life a living hell and see to it that your rotations are MISERABLE. PA's are some of the most approachable/helpful people in a clinical setting and can be your best friend.

I tried to book an apt with my PCP and she's booked solid until september, so I've got a Nurse Practicioner doing my physical...which is cool with me.

did you read his post carefully? He never said anything disparaging about RNs or PAs

who are you to wave your finger you must have been high...

oh by the way OP... yes you had one isolated incident where you couldnt see your PCP. The healthcare system must suck. Jeez.

 

[homeboy]

My Dad's a PA, and he pretty much ran the ER in the small rural town I grew up in. He persuaded me not to go PA because he said it's frustrating doing 85-90% of the same thing as a primary care doc but getting paid 1/3 as much.
Not that money is the be-all and end-all, but I think that's an important psychological aspect, and it would be very frustrating.

As it is now, PAs fucntion as FPs in a primary care setting, particularly in rural parts of the country, and it's a more efficient appropriation of health care dollars to hire 1 or 2 docs and some PAs than staff an ER or clinic full of FPs.
I can understand that as frustrating from the FPs point of view (other people encroaching upon their territory), but the PA profession is one solution in the cost problem of health care today.

It's a symbiotic relationship.