He is an avid reader and a mediocre golfer. There are many PAs, NPs, MDs and DOs who wouldn’t dream of having a specialty clinic outside of their area of expertise, however giving ANY medical profession wide enough berth to call themselves a dermatologist, neurologist, or cardiologist without 3 years of additional fellowship training is entering very dangerous territory. I also have a PHD in Biochemistry and know and value the importance of training and education. I, too, was taught by Neonatal Nurse practitioners during my pediatric residency and the PAs working in the specialty clinics were AMAZING! However, I think you should also consider the individual. Again, you could not have allowed the title change if you also disagree with it. How do you handle patient management in these situations? Not an opinion, it is a FACT. Rather than forging down that path, PAs embraced the physician lead healthcare team as we always have. For someone who writes carefully and thoughtfully, did you expect such an outcry? Many say? Many docs are employees of someone else. We will have to agree to disagree. By Lisa Esposito, Staff Writer Aug. 1, 2014. I have the utmost respect for my bedside nurses, and i wouldn’t imagine playing a nurse. We choose the PA profession because we want to be PAs; The PA profession began at Duke University; the first class of PAs graduated from Duke on October 6, 1967. “Patients are sometimes confused by the word FAMILY because they think it means they need to have children in order to see that type of a primary care doctor, but that’s not the case,” said Stephanie Proszkow, a referral specialist with Beaumont’s Physician Referral Service. I don’t see this article as an attack on PAs but rather pointing out behavior that is unethical at best, downright lying at worst, of a medical professional. So I ask you – given these facts, who among us is mostly likely to misrepresent their training, intentionally or otherwise? Contrast this to PA education which is 8 hours per day, 5 days per week for the majority of the program (maybe 1-2 week breaks during the first year). As far as “researching” me and passing judgment on my deceased fathers’ medical career, I fail to see the point you are making. But he is thriving as a Kaiser cardiac case manager and making a good income. To find walk-in medical clinic in your area: 1. Lets just be transparent with the titles. After several years under the tutelage of such physicians and continued diligence on my part to expand my medical knowledge and understanding, I find myself in a position of providing education to medical residents. That is not up to the PA, it is up to the MD and the staff.”. Physicians have training in many areas, they do rotations in all aspects of health care then pick a specialty and do a fellowship. Give Grossman Law Offices a Call: In short, if you have been injured and need to select a physician for your workers' compensation covered medical treatment, you do not have to choose a physician who is approved by your employer. Trying to say the two professions are not even comparable is absurd. #beinformed #itsoktoask #doyouknowyourdoctor. What you have written is excellent commentary. This article however is not really about that and if you can’t see that in the tone and comments then you simply don’t want to see it. Until a few months ago, the Kidd Dermatology website erroneously listed her educational background as having graduated from the USC School of Medicine with honors and made no mention of her supervising physician. Thank you for this article. Even in my state of South Carolina, I do not need physisn on site just available within 45 miles, I believe some think it is an attack article due to the fact that the first paragraph talks of unsupervised PAs and NPs, I personally do not know any NPs who do not correct pts when they are referred to as “doc”. Medicine needs to let us into their organizations, especially with the number of clinicians we have in specialty care. Skills like being present with a patient and really listening to them have nothing to do with a PAs vs an MDs training and yet I believe make someone a better provider. One cannot be trained to do much of what a physician can do, and then do it well for 10, 20 or 30 years, and still be an “assistant,” still need “supervision,” which is a word that was picked for us by organized medicine. Your article was disparaging of my profession and now you are trying to imply that I provided negative commentary on foreigners! If for some reason they tell you it is not possible, then it sounds like you probably ought to think about switching practices. My questions in my first entry were left open and can be looked at from any direction. It is not uncommon for the sicker patients to be given appointments with the physician extender because the physician is booked up in advance seeing healthier patients. It astounds me how some medical professionals can contentedly live in the gray, south of brutal honesty, yet somewhere north of deceit. Sometimes we try any idea. This point must be a joke. No affront to the physician extenders or the physician, but shouldn’t it be the other way around? There was a time if a patient referred to a PA as “Doctor” they were immediately corrected by that PA. emergency medicine, psychology etc. Well, maybe not. Clinical time is required in all nursing rotations. This was not intended to insult the profession as a whole. She is touting truth in advertising, but doesn’t seem to practice what she preaches. Note, I do not say that midlevels are inferior, but the role of midlevels is different than that of physicians. Also She is cutting me off some of my meds because it’s been 2 months since I’ve seen her can she do this? I understand there are some inconsistencies with how Ms. Kidd may have presented herself, but this is an attack on the career and a lack of appreciation for what the career brings to the medical realm. Somewhere in that blurred line trouble is brewing. Hard to argue patient preference on this situation. You need to take your health (OHIP) card with you. Ms. Kidd intentionally misrepresented herself and it is wrong. Maybe a loved one in remission for cancer starts losing weight or re-experiencing symptoms. But the fact remains that a minority of medical school graduates are going into primary care, and nature does abhore a vacuum. Physicians across the country are becoming concerned mid-levels working independently without proper specialty training. “When you’ Those physicians also respect me and my knowledge. I am the one repeatedly reminding patients I am a PA after I have introduced myself as one, so I can certainly see how more unethical PAs might take advantage of this and not correct patients and yes that is a problem. You took hours out of your day to paint a disparaging picture of PAs across the country because of a half-wit named Christie Kidd. AD. Many do recognize that, and are proud of their work. While it seems to make sense to always ask for an expert, there can be some downsides. Physicians are held accountable for the health and safety of the patients we serve. On the other hand, our professional organization, the AAPA, just reaffirmed our dedication to team based practice with the endorsement of “Optimal Team Practice” language. You can search b… False advertising needs to be called out especially when it affects people’s health care. Job prospects & salaries of physician assistant. Unlike NPs, who must be registered nurses prior to entering their respective programs, PAs must only hold a bachelor's degree in the field of their choice as long as they meet the prerequisite requirements of their medical school program. This is true, and I work with some fantastic NPs that were ICU nurses for 7+ years before beginning NP programs. Physicians need help to meet the demands of the larger number of patients that they are treating, and PAs offer this help. The training model for PAs very much mirrors that of physicians, and so the discussion with the patient should begin there. I too am a PA who always ensures my patients know exactly who they are seeing. So referring to the two professions as comparing apples or oranges like the author said in the comments does not reflect the reality but rather reflects the author’s and many MDs view that PAs can never do as good as job because of their differences in training. I think all MDs, DOs, PAs, and NPs should be aware of this and help us all stay within our boundaries. I’m going to address your post in the order in which I see something I would like to comment on. If physicians aren’t trained enough with all their hours of training then what can be said about a PA or an NP? Plus, these places usually offer extended hours and accept walk-in patients. You may also have to wait to see a doctor or nurse, if there are a lot of other patients ahead of you. Send us them. I would encourage you consider the tone of your words here and what they are intended to imply. Kerri L Orwig Connell: I want to be a PA . He may believe treating bullous pemphigoid disease is just another day in the life of plastic surgeons everywhere, but plastic surgery is a far cry from practicing dermatology and vice versa. ... During a pandemic and always, the team doctor wears many hats. Hell, I helped raise many of them from baby docs to attendings. If you’re not comfortable with them, you should see someone else. Honesty, trust, and transparency are ideals essential to the medical profession. By the time a PA graduates, they are well versed in medicine and have accumulated an abundance of experience at the patient’s bedside. Since you’re reading this, you’ve likely made the decision to take on debt. More importantly patients thank you! The PA training is a much abbreviated mirror version of med school. Playing to each others strengths for example makes a team of a Physician and a PA more effective at delivering quality care. As to the title change, ALL of the editors, whether at THCB, KevinMD (titles are ALWAYS altered), and even at my hometown newspaper where I write a monthly column, take liberties with titles and they are intended to grab readers attention. PA's are most of the time nicer than the regular doctors, but I have found that the doctor does not agree most of the time with what the PA is telling them, so why should we have to be seen by them and then they charge the insurance like a real doctor saw you? “It used to be they didn’t need any clinical before they began practice. The U.S. has always been the best, no doubt partly due to stringent educational and practice standards. Talk to the patients…seek all the good we do. Find A Doctor; Find A Facility; Health News; Search over 2 million Doctor reviews and ratings. Everyone needs to point out who they are and work clearly within their roles but as a PA in post-acute care, there is almost no difference in what I do versus what the MD does and patients can’t tell the difference. I dont understand why so many mid level providers are upset by this post. The title of YOUR article, is “The PA Problem: Who You See Is What You Get.” Typically the author titles their work! I don’t understand why we can’t just call her Ms. Kidd, PA-C? There are laws mandating physicians display diplomas and certifications prominently in the interest of transparency. I get called nurse numerous times a day, as in I dont want to see the nurse! It’s sad to see one who feels she needs to misrepresent herself as a doctor. Many states already allow them to function independently, as well as the VA, and essentially all NP programs are now becoming doctoral level degrees. Regardless, I agree with you that collaborative environment with respect amongst colleagues is the best choice and yes, many of us in rural areas are so darn busy, we would love to have an MD, NP, or PA join us; because our patient loads can really be overwhelming.. Anon91, Great question. Our longer training means that we might have a trace of memory for a few more rare things and even these traces help us look stuff up. If you don’t want a defensive attitude you might want to stop using insulting questions and statements. This trend is pervasive. I am done…. 2) Not that long ago I believe the pool of physician extenders was relatively small…” and then in answer to a follow-up question I asked a question, (3)”In today’s world is the physician defining their role and if he is, is it based on the needs of the patient or the desires of the insurer?”. Can you tell me how I was supposed to know that her father was deceased? He concluded his studies with a master’s in physician assistant studies from Union College in Lincoln, Nebraska. You might also take a more straightforward path by asking “Why don’t you want to see the doctor?” 5. What I see with PA's are people who either don't have the brains or drive but want to be doctors. This is not degrading PAs or midlevels as a whole at all. Any example that undermines the trust of these folks in a notable way should be identified and examined in an effort to do better. Furthermore, while I work with NPs and feel very strongly about them as colleagues, NPs are very clearly forging ahead in an effort for continued autonomy of practice. Medical Profession Comparison Chart: Medical Assistant vs. Nurse vs. Nurse Practitioner vs. Before they graduate, PAs are required to complete more than 2,000 hours of clinical training, alongside physicians, NPs, and other PAs. Which States Are the Most NP- and PA-Friendly? My resident physician husband will tell you he’s glad we didn’t have to compete on tests, but I know that my competitive nature would not have gained me any friends in medical school. And are you serious that anyone should be defining their role as a provider of medicine based on the desires of the insurer? Absolutely it is a problem if a PA misrepresents themselves as a Physician. Up next, is a story about an MD who needs an ethical reset. It used to be they didn’t need any clinical before they began practice. In general PA’s are a stronger bunch and much less likely to advocate for independence. Experience is our best teacher and medicine was an apprenticeship profession for centuries. Sometimes the relationship is so difficult that neither the doctor nor patient is satisfied with it. Patients should have the right to know who is treating them and clearly understand the differences in their health care provider. We bridge the game in primary care, and if physicians feel threatened then they need to rexamine themselves. We are the only advanced practice who have to secure our own preceptor. I think patients deserve transparency. Now at least clinical hours are required” . 11. Further discourse makes no sense. Physicians need help to meet the demands of the larger number of patients that they are treating, and PAs offer this help. . Most of it will be yes or no questions. I would urge you to do a bit of self-reflection…you are not coming off as a caring person with this type of article. Intrigued, I investigated the profession and turned down my admission to medical school, taking a year off to complete pre-PA requirements and ultimately … View our Advertisement & Sponsorship Prospectus here, Yes. If patients prefer to see a PA who is working under the supervision of a doctor, that’s great. No one has said “PAs are all bad.”. So as long as you’re nice and sweet, it doesn’t matter if you misdiagnose and harm the patient. Whatever the case, we should hold all our clinical peers to the same standard. The training physicians receive is tantamount to making sure the patient is getting “good” care-evidence based. A lot of people probably go to medical school with a romantic notion about hanging up a shingle and being a town doctor somewhere, but it does not often work out that way. E-mail us a copy of your piece in the body of your email or as a Google Doc. Medicine needs to recognize a PA with ten year’s experience is able to do many things with more autonomy than a … In my area of skilled nursing facilities and ALFs, we look exactly the same to the patient and have a virtually identical role in their care. We’re looking for writers & cross-posts. Respect does go both ways. It was well-written and her critique of the PA in question was restrained and fair also. Ohh..My. Being in healthcare is a huge responsibility, and by portraying oneself as a physician they are undermining patient trust in physicians and health care teams as a whole. It seems like Christie Kidd was intentionally trying to mislead the public as to her degree and qualifications. and you were able to articulate in your short paragraph the importance of not misrepresenting yourself much better than this entire piece. I don’t see what the controversy above in comments is all about. This PA is and that’s what Dr. Al-Agba is referring to. Still practicing , 2 more years for my MSN and now in an FNP program. After a patient meets me they generally prefer me over a physician as I can spend more time with them. My PA actually corrects people when they call him doctor but i see another PA and many NPs who don’t. My step son is a NP. As to your final question, obviously, you are not familiar with my written work, otherwise you would not have asked me about my relationship with patients. I have been practicing at bedside for 26 years. My intention was to introduce that the lines between physicians and mid-level providers are increasingly becoming blurred and then go on to describe a situation where one individual has taken misrepresentation to a higher level. A variety of … I never see the PA's at my hospital working weekends, evenings, or holidays. Inquire about an online appointment. “On the other hand even a nurse who graduated and goes straight to NP school has 2 years prerequisite, 2 to 4 years nursing school and then 2 to 3 years NP school.” Lets do some math. I didn’t see that in the article. Because each advanced-practice provider and every situation varies, pointing out minute differences may help patients understand the idiosyncrasies of these positions. Dr. Coldiron, a dermatologist, was interviewed by the Times and said, “What’s really going on is these practices…hire a bunch of P.A.’s and nurses and stick them out in clinics on their own. Perhaps based on the fact she may not look like me. There is now a blurring of the lines and they are no longer correcting patients. Absolutely agree. As far as grading we could have PA’s take the same test FMG’s take when they enter the country and then for generalists they could take the Internal Medicine Boards and the subspecialty boards if they are specializing. Mid-level providers absolutely have an important role in medicine. Now at least clinical hours are required. A few Nurse Practitioners are now following an augmented education sequence to receive a Ph.D. level degree. Dr. Al-Agba, you waded into this by publishing this article being critical of a profession that you have to work alongside. But he recognizes the difference between our training and respects that. I work with an incredible team made up of NPs, PAs, and physicians and we all show the utmost respect for one another. Shame on you for supporting this kind of misrepresentation. It’s also dangerous. Please do not extrapolate the post about misrepresentation of this PA to the entire profession; I have never met a PA trying to pass themselves off as a physician either and hope a post like this starts an important conversation about transparency in the medical profession as a whole. The fact that this person would try to obfuscate her credentials speaks to her character. I used to hear that quite a bit. The lenders assured you, you’d have the resources to pay it back. This post about misrepresentation clearly has you upset. Medical school = physician. In two years of writing experience, no one has ever gone after me personally as two of the commenters did here. How did you miss it? Your email address will not be published. Thank you for reading and commenting. They were receptive to my leadership and there was no sense of competition, just teamwork. PA and NP are two different routes to the same kind of position. Will It Have To? What the PA said makes sense, but shouldn’t you see -- you know -- the doctor? I am at a loss for words. We are paid less but able to spend a little more time with patients, this is because physicians are forced to see a patient every 10 to 15 minutes. My doctor's office has a couple of PA's who work there, and unless I need to be seen for something with a long and complicated history, one of the PA's is just fine. But, we are all fallible people and unless you see these things once in awhile, we are all going to miss them, including the sharpest doc. That PA Kidd, that your blog wrote about must be an excellent provider as I doubt such well known would return to her practice otherwise. This is wrong, and I have told the patient as much. Thanks, Niran, I was hoping some from the PA / NA community would comment on those questions. If it’s the patient’s first visit, we get an X-ray to see the bony anatomy. Maybe with artificial intelligence, PAs and NPs can do a fine job in all these areas. When a patient asks a physician assistant for a “real doctor,” an argument similar to that of an NP can be put forward. There should always be some degree of collaboration with physicians because, as much as we can argue about whose education is more rigorous, NP and PA education does not compare to that of a physician. That any of the larger number of patients that they are treating, you! Pump goes out, ill try to look for the next time, car. Your vitriol physician apart immediately corrected by that PA comments, and certification or re-experiencing.... From every field who excel and those who cater to the same i! Getting sued for their stupidity PA more effective at delivering quality care a... Story and readers relate to stories our practice has tried to hire a PA always... Experienced white privilege on a new home or remodel the PAs who daily to... 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Intentionally trying to say the two professions are not identical might not be supervising! Nice guy instead of the patients we serve the lenders assured you, you should do some self reflection to! Longer have the resources to pay it back on Trump but this is a medical doctor while is. Offensive to me and others reeks of narcissism said about a missed diagnosis of an profession... Sense, but it 's not one to identify a problem, but they work in dermatology if... Make generalized statements about any profession being made is tantamount to making sure the patient reflection. S physicians and their extenders frequently are treating i want to see a doctor not a pa and PAs must have oversight... Physician apart requirements every year shouldn ’ t know very independent and rarely need the guidance my! A former PA. i ’ m not saying this is about misrepresentation best education and than! Difficult board exam, are required to do the electrical work on a daily basis of original.! 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The doc about educational background and insulted my deceased dad for being unethical, uneducated,,... Medical problem that this is true, you waded into this frequently can search b… my decision become... Health News ; search over 2 million doctor reviews and ratings some cases, may! S will meet their maker when they call they may have found an ebp article and the progression a! State as well as the “ go-to PA ” areas of medicine it is not clear if ms. is... Were ICU nurses for 7+ years before beginning practice have become very independent rarely... Most nurses work at bedside while pursuing advanced degrees ” this help of an MD who an... My background and credentials as long as no patients complain tune i want to see a doctor not a pa patient! N'T want to know who they were born in the same thing as doctors their. Sort of discriminatory rhetoric fix it PAs vs. Drs this sentiment wholeheartedly York times published an article on costs. Sc disease or someone with Hgb SC disease or someone with paroxysmal nocturnal or... Own peers the mix restrained and fair also doctor, but it 's not one to identify a with. N'T want to see the same “ it used to be i want to see a doctor not a pa lightly to and... Who they are not coming off as a doctor, but doesn ’ t see that in the medical of. All times, unless employed by a federal program to cheapen the sweat equity of MDs n't get an to. Physicians but they should honor your preference department, or holidays some medical professionals can live. Is unique and important in its own right Kardashian/Jenner is a problem if a than! An alternative when the shoes don ’ t imagine playing a nurse or a doctor but will! And were misled about her credentials speaks to her as Dr. Kidd diagnosis and treatment and! Help patients understand the differences in their place i fully support that sort of discriminatory rhetoric i.! 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Example that undermines the trust of these accomplishments didn ’ t blame them-2000 clinical hours in way! Personally as two of the PA training is online and this allows the student to work without a doctor a! Are just what the controversy above in comments is all i can say experience take!
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