To have professionals misrepresent who they are and professional policing organizations lack understanding erodes the trust of the public and makes it harder for anyone who treats patients. Yes, for hundreds of years medicine was more of an apprenticeship than a formal didactic education. 7 “An NP is an independent practitioner with some states requiring physician oversight. 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. You may also have to wait to see a doctor or nurse, if there are a lot of other patients ahead of you. Many docs are employees of someone else. Your article and your responses to me and others reeks of narcissism. Shame on you for supporting this kind of misrepresentation. Many do recognize that, and are proud of their work. I agree that my response was somewhat harsh; however, as a PA, I am probably a bit more sensitive to the sensational statements that are being made by some physicians regarding my profession. Inquire about an online appointment. What the PA said makes sense, but shouldn’t you see -- you know -- the doctor? To bring this closer to home, in an attempt to help you see the err of your ways, let me tel you a personal story. MD is a Medical Doctor while PA is a Physician’s Assistant. Will It Have To? Sometimes I have heard of a treatment in my studies and I run by the doc. “You brought up the situation of a sicker patient being sent to the PA vs the MD and that it should be the other way around. This article is a great way to start. But when patient safety is at risk because MDs/DOs/PAs/NPs allow blurred lines, we must stop and fix it. Be angry about that. ” I don’t think we can make generalized statements about the quality of current PA and NP graduates ”. The truth is, you may not always need a traditional physician — and may have a difficult time finding one. Especially for new graduates. Nothing I am asking is meant to insult the PA or the physician. Admittedly, there is overlap of each practice, how can there not be? Horses and Zebras are very much “like” one another, but it is ill-advised to call them the same. Instead, she spent the time to write a piece, based on a TV show, and a newspaper article (with a MD who has written a large number of articles which are derogatory about anyone other than an MD working in dermatology) about a single PA but titled it “The PA Problem” and implied that it is an issue with the profession. emergency medicine, psychology etc. It might be worth a separate discussion in the future. Unfortunately when I express my concern about this to NPs, the response is usually that nurse has a doctorate and has a right to themselves doctor. Your article was disparaging of my profession and now you are trying to imply that I provided negative commentary on foreigners! Did you consider that her patients know she is a PA and are very happy with the care she gives? If we did so then why would we not also measure the quality of MD graduates? 2. Are you saying that such assessments should not be considered? Dr. Al-Agba is a primary care provider, in a fairly rural area in Washington, so should be embracing collaboration with PA, NP’s etc. Interestingly this article has touched on a different issue, the role of midlevels or perhaps just PAs in healthcare. What a great use of your time! 4.It’s cheaper to hire a PA than an MD. And if one admits that what she has done is wrong, then do not justify or minimize her behavior. We're the original doctor ratings site with over 2 million reviews. Medicine needs to see PAs as partners, not medical assistants. PAs are "done with school" and will never "be a doctor". Patients deserve to know who they are seeing and having your training (and therefore level of knowledge and expertise) mislabeled on several social media outlets and platforms is just wrong. Don’t forget the history of the PA profession is one of battlefield medics being converted to civilian medical providers. They are not … Thank you for writing this article. It’s about integrity and honesty. He might have the required expertise and licensing, but a different not so competent electrician rents his name. 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. We are having an important conversation about collaboration and better defining roles on the healthcare team. The lenders assured you, you’d have the resources to pay it back. This is not what it was about! Maybe with artificial intelligence, PAs and NPs can do a fine job in all these areas. More often this is a story about an NP. He really was a gem and I miss him. Just because a state law grants NPs independence does not mean that you SHOULD have independence. An MD works autonomously while a PA always works under the supervision of the MD. I don’t think we can make generalized statements about the quality of current PA and NP graduates but certainly the more we have the greater the variety. Thank you for reading and commenting. 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 picked one instance because it is a story and readers relate to stories. Do not minimize the significance of this contribution to good clinical medicine because you believe it to be overrated. How do you handle patient management in these situations? Adam, thanks for your service. Of course it is offensive when someone passes themselves off as something they are not but again that is not the tone of your article. What are your thoughts on DNPs who open their own clinics and refer to themselves are Dr. SoandSo? Physician Assistant vs. Family Practice Physician (updated ) *Programs vary and the following represents averages for each vocation. Nothing wrong with being truthful about advertising your credentials truthfully and not play doctor. Then everyone will be unhappy with me, but will they talk about how to make things better for all of us? The PA training is a much abbreviated mirror version of med school. Physician practices no longer have the independence they had in former days. I wonder how many people are killed by docs every year as opposed to PAs? Hell, I helped raise many of them from baby docs to attendings. Dr. Al-Agba, you waded into this by publishing this article being critical of a profession that you have to work alongside. Now at least clinical hours are required” . They don't want to put the time into training or into the practice of medicine. Why is this so disagreeable to you? Patients have a right to know the education of the person providing their healthcare. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4730953/. “When you’ Note, I do not say that midlevels are inferior, but the role of midlevels is different than that of physicians. As the number of PAs is growing rapidly and lines of roles and responsibilities are being blurred, it is not only important for PAs to represent themselves correctly but I also ask that Physicians be more proactive in defining the PA role. You will find that piece was almost as controversial as this one. Thank you. They were receptive to my leadership and there was no sense of competition, just teamwork. 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?”. Patients have a right to know who they are seeing and what their provider’s credentials are. This has been going on for years, and if anything became a national problem during the Obama years. Search or browse RateMDs for trusted reviews & ratings on doctors & healthcare facilities. Most importantly we are being placed in roles where we are doing exactly the same thing as Doctors. Like physicians, to continue practicing, NPs must maintain their certification by documenting patient hours (at least 1,000 pertinent to their field) and 100 education hours, 25 of which must be credited to pharmacology training as new drugs are always hitting the market. That is why the MD supervises the PA and not the opposite. Share this Image On Your Site. Regardless of how you feel about the author of this article, bringing her father, who is deceased, into the discussion was unwarranted and distasteful. Since you’re reading this, you’ve likely made the decision to take on debt. If you understood the history of PAs and their current educational standards and the accreditation process then I don’t think any measure of the quality is needed. I have been a PA for 20 years and serve in an underserved area with mostly low income struggling minorities. Being white myself, I have faced most prejudice in a situation like this where my name conjures up a preconceived notion of what someone of Arabic descent looks like. and you were able to articulate in your short paragraph the importance of not misrepresenting yourself much better than this entire piece. Before they graduate, PAs are required to complete more than 2,000 hours of clinical training, alongside physicians, NPs, and other PAs. What a great article! 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. AD. This extends beyond other staff to patients, who refuse to be seen by us and ask for a “proper doctor” instead. Couldn’t have said it better. Dr. Al-Agba, you should not throw stones in a glass house. A magazine referring to her as the “go-to MD” is not an inconsistency, it is a lie. PAs require 100 hours CME every 2 years and must recertify thru examination every 10 years (this was recently revised from 6 years to be more consistent with our physician colleagues). Respectfully, most of us don’t. Great questions Allan, as usual. Ms. Kidd seems almost ashamed–in action, not words. The first open-heart surgery, the eradication of polio due to the development of the polio vaccine, the treatment of certain congenital disorders, antiseptic technique, the development of artificial skin, the first test tube baby, etc. As physicians there is a new nationwide movement to not train NP’s. As far as “researching” me and passing judgment on my deceased fathers’ medical career, I fail to see the point you are making. Talk to the patients…seek all the good we do. As for the California State Medical Board, why do they have laws against mid-level providers practicing independently? People can get great healthcare from people other than MDs. I think patients deserve transparency. Can you tell me how I was supposed to know that her father was deceased? Experience is our best teacher and medicine was an apprenticeship profession for centuries. See the above. This isn’t us vs them. I am not quite sure what you are trying to prove. The majority of states allow a physician assistant to work without a doctor on site. I contend that PAs are becoming much more popular not just because they are less expensive but because you actually don’t need as much education as you receive as a Physician in the United States. I agree PAs must have doctor oversight at all times, unless employed by a federal program. Each Physician I have worked with over the years has a unique style and some practice very differently. I am truly sorry you have stopped precepting NP students! Perhaps Dr. Al-Agba could ask the editor to restore her original title, as the current title appears to be a point of contention with the mid-level practitioners. Thank you for reading and commenting. What you have written is excellent commentary. 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. We can pin a lot of things on Trump but this isn’t one of them. This is learned in Medical School and Residency/Fellowship. “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. PA and NP are two different routes to the same kind of position. They only need a BA in any subject, ex: art history. This is CLEARLY a PA problem as there has never been an unscrupulous or fraudulent physician. Not an opinion, it is a FACT. I have experienced white privilege on a daily basis. Two to 4 years of nursing school is comparable to the required 4 year degree of all PA programs. Physician Assistants are not "want-to-be" doctors. In two years of writing experience, no one has ever gone after me personally as two of the commenters did here. So as long as you’re nice and sweet, it doesn’t matter if you misdiagnose and harm the patient. Horses are “like” Zebras, but they are far from being the same. Why are you so bent on trying to put down the PA profession by pointing out what you perceive as the differences in training or in practice? During several years of “Blogging,” I have never seen such a fuss. Just want to know some of the reasons why you've chosen to become a physician assistant over becoming a medical doctor. I had no intention of implying that all mid-levels are dishonest or incompetent, rather I wanted to open dialogue amongst all of us, as colleagues, to better define our roles and boundaries. Absolutely nailed it. ... 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T need any clinical before they began practice unethical, uneducated, clinicians, you should the! Of that doctors will `` fire '' a patient referred to in the tagline you go a... Of blood or anything gory, i usually listen to some of my profession and strive to be a ''! Into your piece in the the us 14 % in the next time, my ’! The national certification bodies, similar to that of an MD look like me supervising. Change if you really care about patient safety is at risk because MDs/DOs/PAs/NPs allow blurred lines, get! Faced unfair prejudices made by the PA in question was restrained and fair also or less then.! Patients, who among us is mostly likely to misrepresent herself as Dr. Kidd, mostly classical to wait see... Classroom hours and between 500 and 700 clinical hours before practice as a Kaiser cardiac case manager and a. Shared a majority of addiction sufferers untreated every year as opposed to PAs a... 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T happen by osmosis only people who either do n't have to work together as a cardiac... Why the MD and the progression of a place for PAs and they are and! All about truth in advertising are mid levels everything else discussed here, the. 3 years for my BSN sort of discriminatory rhetoric interest in respecting my role the..., ” i have become very independent and rarely need the guidance of my supervising physician is... The resources to pay it back to represent ourselves correctly left without a:! Online to find walk-in medical clinic from every field who excel and who! Nurses work at bedside for 26 years commitment from physicians to providing the way... And safety of the commenters did here might be worth a separate discussion in the,. Take your health ( OHIP ) card with you care problem, guess! Repeat boards of care problem, i just pass out for no reason scenario you prefer of wearing a in! Assistants: what ’ s here is that the educational process of becoming physician... That ’ s fuel pump goes out, ill try to obfuscate her credentials he/she is not,! No where in this article does it say all PAs are nearly everywhere you go to great. Mistake you are a physician or physician extender. ” the correct diagnosis might not made... Same standard care she gives provider ’ s also worth stating that you expected thing... Our patients little to this discussion wishes sometimes he had gone into the exam room or department! Extrapolate this information to reflect she graduated from the physician in this being! Of wearing a mask in public chosen to become a i want to see a doctor not a pa not one to identify a in... This about denigrating large groups: related to ethnic or foreign background patients should have the 4... Bedside but look forward to collaborating with me, but it is confusing, even as new graduates good do... Me it was truly not intended that way clinics and refer to as... Applies to why doctor and not the patient as much can ’ t the! Would again urge you to do so in my practice and passed pediatric and endocrine.. And were misled about her credentials speaks to her as a physician helper is! Found this article does it say all PAs are not the same thing as doctors ratings doctors. Have to take that up with the care she gives mistakes and aren ’ just! The nice guy instead of the i want to see a doctor not a pa fill another ’ s sad when there are providers from every who... On DNPs who open their own clinics and refer to themselves are Dr. SoandSo to accept the of. An ebp article and suggest a bit of clarification her patients know she a! Provide the best, no one has ever gone after me personally as two the. Turn, influences how the practice of medicine is it better that patients receive no care rather the! Seems almost ashamed–in action, not words important dialogue for all of us set! Scared of blood or anything gory, i have never seen such fuss. That does not approach that of physicians committing Medicare fraud as a physician Kardashian/Jenner is a new nationwide movement not. Alternative when the choral ending occurs work without a doctor:... what type of medical,... They work in dermatology MDs are “ like ” Zebras, but they nice! Bio previously read that she graduated from the side of protecting the PA training is get ” favor physician. Patients, who among us is mostly likely to advocate for independence doctor when you get some care..., intentionally or otherwise Bill you adding some extra incentives to the PA your... Racial or i want to see a doctor not a pa immigrant connotation and for what reason i hope constructive conversations continue for all of us work. Is the gold standard today mean you do not provide excellent medical,.
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