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As per regional stats on nrmp website.
where can we find this information?
Only because I am lazy and do not want to do the leg work, this ever happen before?
This is easy to explain. Training spot expansion is not occurring due to lack of funding from government sources, and hospitals are coping by increasing the number of NPs, PAs, and CRNAs they are hiring.
http://www.youtube.com/watch?v=xxQB1R8AF4A
This is easy to explain. Training spot expansion is not occurring due to lack of funding from government sources, and hospitals are coping by increasing the number of NPs, PAs, and CRNAs they are hiring.
http://www.youtube.com/watch?v=xxQB1R8AF4A
don't know man, 1688 spots....maybe we should calm down with the expansion for awhile...half the programs I interviewed at are expanding, lets not expand ourselves out of a livlihood.
don't know man, 1688 spots....maybe we should calm down with the expansion for awhile...half the programs I interviewed at are expanding, lets not expand ourselves out of a livlihood.
Two questions 1. what does it mean that there were no unfilled positions? Obviously it does not mean that EM is as competitive as derm or ortho. Does it just then mean that it's popular?
2. Am I the only person that doesn't give a $hit about whether mid-level practitioners work in the ED? Do I really want to be seeing all the most boring urgent-care plus level patients and reporting to an attending the rest of my life? No! Their jobs are fundamentally different from mine. And if these fine ladies and gentleman will see the boring patients, so that I can see more interesting crap--welcome aboard! I think turf wars make sense when you're fighting over the same turf. The low-acuity ED patient is turf that I will readily cede.
Clearly you haven't worked with enough PAs that aren't up to snuff.... but yet you're responsible for.
I'll cede the turf... then let them shoulder the liability, too.
At the residency programs in my area, PAs staff the pods right beside residents--they don't see resus cases, but they'll see high-acuity stuff like NSTEMIs, possible stroke (outside TPA window), abdominal pain, etc.Two questions 1. what does it mean that there were no unfilled positions? Obviously it does not mean that EM is as competitive as derm or ortho. Does it just then mean that it's popular?
2. Am I the only person that doesn't give a $hit about whether mid-level practitioners work in the ED? Do I really want to be seeing all the most boring urgent-care plus level patients and reporting to an attending the rest of my life? No! Their jobs are fundamentally different from mine. And if these fine ladies and gentleman will see the boring patients, so that I can see more interesting crap--welcome aboard! I think turf wars make sense when you're fighting over the same turf. The low-acuity ED patient is turf that I will readily cede.
Two questions 1. what does it mean that there were no unfilled positions? Obviously it does not mean that EM is as competitive as derm or ortho. Does it just then mean that it's popular?
2. Am I the only person that doesn't give a $hit about whether mid-level practitioners work in the ED? Do I really want to be seeing all the most boring urgent-care plus level patients and reporting to an attending the rest of my life? No! Their jobs are fundamentally different from mine. And if these fine ladies and gentleman will see the boring patients, so that I can see more interesting crap--welcome aboard! I think turf wars make sense when you're fighting over the same turf. The low-acuity ED patient is turf that I will readily cede.
You assume that mid-levels will be restricted to boring lower acuity patients. This assumes that hospital administrators and contract holding MDs can be trusted to maintain the higher quality and safety provided by board certified EM specialists even though they can make much more money with lower cost providers.
With the growth of risk based ACOs and the priority of reducing cost of care, I would not bet a lot of money on that assumption. Imagine instead an ED with a medical director, available by phone for tough cases that the PA is too weak to handle. In this ED of the future, PAs provide *all* the ED care including resuscitation. There are already plenty of EDs where the PAs see all levels of acuity without direct supervision. If the PA run ED becomes standard, the market for BC EM is already more than saturated.
Be afraid. Be very, very, afraid.
Clearly you haven't worked with enough PAs that aren't up to snuff.... but yet you're responsible for.
I'll cede the turf... then let them shoulder the liability, too.
Oh, and interns are all up to snuff on July 1st? Pssshhhh.
I don't buy it. I think being super afraid of changes in healthcare, whether it's the inclusion of mid-level practitioners, or new technology, or women becoming physicians in larger numbers, or whatever, is a mistake. Will board certified EM docs have to innovate to set themselves apart? Probably. Maybe doing more administrative work, or research (in academic jobs), or involving themselves in various oversight activities. But I really don't think that being "very, very afraid" of PAs or NPs is going to accomplish anything at all. Nobody argues that a Trauma PA is the same thing as a trauma surgeon. We have a responsibility to perhaps set stronger parameters as a field for what are appropriate tasks for PAs or NPs to handle--something that I think is well worth a lot of EP advocacy. But I refuse to feel threatened by mid-level pracitioners as a matter of principle.
We can agree on the point that there should be better oversight so that EPs are not left holding the bag when less educated/experienced individuals are running the show. As for the rest of it--if you took individual quotes out of context for any group, you'd come up with dumb crap. In fact, taking board certified emergency physicians' comments out of context and laughing about how stupid they are is called "Medicine Rounds" at my institution. Hardly proof positive of any particular deficiencies.
This is easy to explain. Training spot expansion is not occurring due to lack of funding from government sources, and hospitals are coping by increasing the number of NPs, PAs, and CRNAs they are hiring.
http://www.youtube.com/watch?v=xxQB1R8AF4A
Yeah... wasn't this supposed to be about how there were no unfilled positions in the match this year...? I was surprised to see it and very thankful I didn't have to SOAP. EM is great, more peeps are interested in it and as mentioned above, the applicant pool continues to grow without an real expansion in spots. That's probably part of the explanation, but I'm sure there's more.
Friday can't come quickly enough
I was just informed that the correct nomenclature for NPs, PAs, and midwives is "Advanced Practice Providers."
They do not feel they are "midlevel" anymore.
Also, there's a push from PAs to be known as "Physician Associates." They do not assist physicians. They associate with them.
I've also met a few nurses who wish to be called, "Clinicians."
Welcome to SDN.
How many children with ADHD does it take to change a lightbulb ? ....
... wanna ride bikes ?
Single patient encounter last week:
PA to patient: "we get the exact same education as doctor's, we just do it in less time. otherwise, we're exactly the same"
DO to patient: "DO's have a much better understanding of how the body works than MD's. MD's focus more on drugs and surgery"
Patient: "That's what I thought I heard on internet, just making sure"
Per the zero unfilled EM spots. Pretty much expect that to be the norm from here on out for EM and a lot of other specialties. Increased interest in EM as it is often viewed as a lifestyle specialty (??), more students, same number of training spots. Easy math.
For some reason your tales seem very tall on both aspects....ancedotes....
For some reason your tales seem very tall on both aspects....ancedotes....
Yes, it was an anecdote. Good diagnostic skills.
Oddly enough, I've heard remarkably similar things out of the mouths of the DO/PA/NP squads in my neck of the woods.
You will see... oh, you will see...
Single patient encounter last week:
DO to patient: "DO's have a much better understanding of how the body works than MD's. MD's focus more on drugs and surgery"
Patient: "That's what I thought I heard on internet, just making sure"
Oddly enough, I've heard remarkably similar things out of the mouths of the DO/PA/NP squads in my neck of the woods.
You will see... oh, you will see...
This drives me nuts, too. Let me be clear: I have no issues with DOs at all. I was trained by and work alongside many DOs. They're great. Period. Period.
What does kill me is that the public at large likes to believe that while MDs are just soulless scientists that like "drugs and surgery" (oddly enough, I *have* heard that exact same phrase uttered to compare MD/DO before), that DOs like to understand the white magic of "how the body works as a whole" (whatever that means). It really does boil down to that. The public likes to use words like "holistic", "natural", and other terms that make them feel fuzzy... and if you're the master of things that are fuzzy and warm, then you're somehow more "in tune to"... whatever... and are thus more capable of ... whatever.
Medicine is, needs to be, and should be based on logic, reason, and objective fact. What the public wants is... white magic, because "science is hard".
Medicine is, needs to be, and should be based on logic, reason, and objective fact. What the public wants is... white magic, because "science is hard".
I was just informed that the correct nomenclature for NPs, PAs, and midwives is "Advanced Practice Providers."
They do not feel they are "midlevel" anymore.
Also, there's a push from PAs to be known as "Physician Associates." They do not assist physicians. They associate with them.
I've also met a few nurses who wish to be called, "Clinicians."
Paraphrasing from my favorite You tube video:
All of the above titles are akin to a polished turd. It's still a turd.
And quite calling yourself "clinician", or physician associate, or whatever the hell you want to be called to disguise the fact you're not a ****ing doctor.
Oddly enough, I've heard remarkably similar things out of the mouths of the DO/PA/NP squads in my neck of the woods.
You will see... oh, you will see...
Waaiiiiittttt. This is totally different.
I have trained beside and work with lots of D.O.s. I don't notice any tangible difference between our training/skill/ability. Any differences reflect our commitment to our careers, not our base degree.
This is *FAR* different from the debate of the place that NPs and PAs are trying to assume.
NPs and PAs are trying to grab ca$h after two extra years of nursing, want to be called doctor, and mostly are constantly agitating for more and more underserved autonomy.
D.O.s are doctors. They deserve to be called Dr. xxxx in my opinion.
i agree w/ the PA remarks... i am glad that my large, democratic, multistate group keeps MLP's in the fast track areas only and requires MD supervision of all MLP cases... and yes, calls them MLP's
i too have heard some real zingers from PA/NP's... and had to clean up some awful messes. i really wish the concept of "PA residency" would spread more, to at least put new grads on a better ground before they're working just semi-supervised in a place like an ED where you can and will see ANYTHING