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Is that pool as good and dedicated as the earlier pool? Did Christie introduce herself as an MD? But he is thriving as a Kaiser cardiac case manager and making a good income. Fact: PAs are a Masters level program of education, with no formal post graduate process that can favorably compare to a medical doctor”s. We will have to agree to disagree. I don’t have the answers but wanted to open the discussion. Medical school = physician. 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. 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. I am not familiar with your written work and after reading this I won’t be in the future. PAs do not practice medicine based on the needs of insurance companies, I am one so I know. 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. What I see with PA's are people who either don't have the brains or drive but want to be doctors. To imply you'll see an MD when you won't is not okay, it is dishonest. Secondly, I would again urge you to do some self reflection. NP training is online and this allows the student to work, would this be considered full time? Good luck to you. I should also note that there are PA residencies for those interested in specific fields of medicine, e.g. Again, this is a fact about NP education not a commentary about superiority or inferiority. ). Many say? Never would I want to cheapen the sweat equity of MDs. It seems like Christie Kidd was intentionally trying to mislead the public as to her degree and qualifications. Transparency is the major point. I picked one instance because it is a story and readers relate to stories. But it has been happening in some states. I understand where you are coming from, feeling concerned regarding the education differences between MD/DO and PA/NP. 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. Shorter track= physician helper. Have any patients of hers come forward who were unhappy with her care and were misled about her credentials? Mention to your patient that in addition to receiving a board certification, NPs undergo peer review of their skills, and, like physicians, are required to continuously complete education and training to stay up-to-date on shifting trends in medicine. Thank you for your comments. The training physicians receive is tantamount to making sure the patient is getting “good” care-evidence based. You need to take your health (OHIP) card with you. MD/DOs are regulated, which is appropriate, why aren’t mid-levels being regulated by specialty training when they are practicing independently? 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. 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. You will have to take that up with the authors of that piece. A board-certified plastic surgeon is supervising “skin specialist” Christie Kidd, PA-C, not a dermatologist. As a new NP, I find myself running into this frequently. 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. The years of education required for obtaining a PA degree are considerably fewer than that of an MD. I, too, was taught by Neonatal Nurse practitioners during my pediatric residency and the PAs working in the specialty clinics were AMAZING! It’s all about truth in representation and I can’t think of a place where this is more important than medicine! This can be complicated in actual daily practice but it doesn’t change our responsibility to be clear about who we are and correct patients when they are confused about credentials. You can request to see me instead of the MDs. I absolutely agree that people can get great healthcare from people who are not MDs. There is a place for PAs and NPs in healthcare. 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. Physician Assistants are not "want-to-be" doctors. See the above. That is what this post is really about. I have had a long bedside RN career in many areas of nursing, I have physicians already asking if I want to partner with them. If the MD tells people what he or she wants and defines the role they want their PA to take then we are a good team. Please do not lump us together the education and practice are not the same; As I said, I’m happy with my PA, and apparently are most other people. I think your comments are very fair. ” I don’t think we can make generalized statements about the quality of current PA and NP graduates ”. Absolutely nailed it. In two years of writing experience, no one has ever gone after me personally as two of the commenters did here. Before you slay all of us for being unethical, uneducated, clinicians, you should do some actual research. She practices in Washington state.” Are you telling me that you did not write that with the intent of putting down other clinicians who are not “ACTUALLY” MD’s. 6. Discuss the consequences of denial. This should upset all of you who love being a PA. Why would one want to perpetrate a fraud? 5. In practice PAs are being given virtually identical roles and responsibilities. Think of the electrician that has the certifications necessary to do the electrical work on a new home or remodel. Medicine needs to recognize a PA with ten year’s experience is able to do many things with more autonomy than a … This article is about a PA gone rogue. If you agree the title is unnecessarily inflammatory of the PA profession then you should be as frustrated or upset as many of my colleagues here. Note, I do not say that midlevels are inferior, but the role of midlevels is different than that of physicians. A hospital might use non-M.D.’s for the same reason and a physician might use them to increase his income by increasing the number of patients being seen. Truth in advertising is the definition of informed consent, and is the duty of all physicians and other assistant healthcare workers to clearly delineate their roles so that the patient has a clear understanding of the extent of the training and knowledge base of the clinicians they are seeing. Everyone wants to claim to be “equal to a physician” (and many on this comment thread proudly state they are “better than”) but no one wants to put in the work. http://www.changehealth.today. What you do and what a physician does are NOT identical. Hello Doctor, Search or browse RateMDs for trusted reviews & ratings on doctors & healthcare facilities. Right now it seems too many responders are in a defensive position rather open to debate on policy considerations. PA’s are a valuable member of the team but I agree their training does not approach that of a board certified dermatologist. What are your thoughts on DNPs who open their own clinics and refer to themselves are Dr. SoandSo? I would love to have read a piece talking about the dangers of misrepresentation but you used that idea as a front for your opinion about PAs. I never see the PA's at my hospital working weekends, evenings, or holidays. I dont understand why so many mid level providers are upset by this post. But as a reader and interested inhabitant of the peanut gallery, perhaps I can suggest a bit of clarification. I will get extended time with patients, and the flexibility to change specialties- keeping the career fresh and interesting- while having diagnostic and prescription capabilities.' As a physician in California who has supervised NPs and PAs, this topic is truly an important one. ; all of these accomplishments didn’t happen by osmosis. So unfortunately, while you may be the ethical one out there, many aren’t. Thank you for reading and commenting. Honesty, trust, and transparency are ideals essential to the medical profession. This post about misrepresentation clearly has you upset. The original title was Honest, Trust, and Transparency. You can search b… Things have changed and not all PAs and PA students have a military background, however patient care experience is STILL a requirement. Patients have preferred me to some MDs, because the MDs are “other”, even if they were born in the US. In many areas of medicine PAs are put into the exact same roles as MDs, same clinic rooms, same MAs, same facilities, same roles and responsibilities. Interestingly enough, that augmented education is about 1,000 clinical hours. And if one admits that what she has done is wrong, then do not justify or minimize her behavior. There are no derogatory statements about ANY profession being made. Increasingly, the legislatures of certain States have approved amendments to their professional licensing regulations to permit independent practice for mid-level practitioners. PAs are able to specialize in any field they wish to and you make it seem as if PAs are all acting in this manner. 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? The average length of a PA program is two years; the first year is similar to the first half of physician training, while the second year is comparable to a physician residency. Her google business page used to read dermatologist. Many times I get a call at 2am from a physician who has been up all night trying to figure out why a patient is not responding to care as they should. Physicians have training in many areas, they do rotations in all aspects of health care then pick a specialty and do a fellowship. ... You can't get an appointment when you need to see your doctor. Many of us, for instance, are fortunate enough to work with fabulous supervising physicians who teach, tutor and encourage our growth as clinicians. 7 “An NP is an independent practitioner with some states requiring physician oversight. I do not use these terrible MDs as examples for what is wrong with MDs as a whole, including their sometimes abysmal bedside manner. As I’ve said previously, if I wanted to be a physician I would have gone to medical school. We're the original doctor ratings site with over 2 million reviews. Lets break it down: On her clinic website, his name and biography is still prominently displayed as one of two practicing physician’s, the other is the author. Employment for medical doctors is projected to grow 14% in the next 10 years, which is … I don’t know why this always turns into an us vs. them, ego vs. ego, or PAs vs. Drs. I went to the doctors with my girlfriend cause she had a boil that needed to have an incision and i tried to watch the whole procedure and i ended up having a vasovagal episode ( passed out). What a great article! But blatant lying is despicable. Medicine is not just about spending time with patients and being caring, it is about correct differential diagnosis and using evidence based medicine for testing and treatment. I have never met, or personally witnessed, a PA trying to pass themselves off as a physician. By the time a PA graduates, they are well versed in medicine and have accumulated an abundance of experience at the patient’s bedside. Aside from everything else discussed here, taking the medical advice of a Kardashian/Jenner is a recipe for disaster. The issue here is transparency. emergency medicine, psychology etc. Maybe a loved one in remission for cancer starts losing weight or re-experiencing symptoms. While you may never read another thing I write because this piece angered you to such a great extent… you might like this one, https://www.kevinmd.com/blog/2017/10/physicians-deserve-mercy-silentnomore.html. All the best to you in the future. Below are some tips, and even a few additional resources you can hang around the clinical areas to help ease these tense patient management situations. Further discourse makes no sense. They don’t realize he had 15 years post secondary education to go out into practice and passed pediatric and endocrine boards. I doubt it. NP’s will meet their maker when they start getting sued for their stupidity. It may well not be a doctor: ... what type of medical provider would they want to see. The truth is, you may not always need a traditional physician — and may have a difficult time finding one. Ohh..My. Toggle navigation Menu. Surely you could have made your point in a more eloquent and sophisticated way, don’t you think? My claim is that I am a good PA that can out diagnose and give better care because I learned how over eight years of practicing and studying and caring. If patients prefer to see a PA who is working under the supervision of a doctor, that’s great. Any example that undermines the trust of these folks in a notable way should be identified and examined in an effort to do better. However with the proliferation of NP programs, newly graduated nurses are starting programs with no nursing experience, and from what I have experienced working with some of these nurses is that they have no interest in patient care as a nurse, only in getting there NP degree as fast as possible. The unsupported, inflammatory, statements that you made in your opinion post is staggering for someone who attended an institution that educates a variety of medical professionals and always instills a collaborative spirit. 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. Do not assume that the person you are communicating with has no experience. They were receptive to my leadership and there was no sense of competition, just teamwork. I think what myself and other PAs are trying to point out is that the piece very much is demeaning to PAs as a whole and in actual practice there are many more important factors that distinguish a PA from an MD rather than their training. Patients don’t want unethical healthcare providers even if they are nice. Who would ever even ask that statement? However, I think you should also consider the individual. Absolutely it is a problem if a PA misrepresents themselves as a Physician. Next time, my car’s fuel pump goes out, ill try to look for the nice guy instead of a mechanic. Look, her bio previously read that she graduated from the USC School of Medicine. Your last sentence is: “Niran Al-Agba, MD is ACTUALLY a physician. Using the information above it looks like NPs have potentially 6-9 years of training. I do think years of education are important, most of all, being transparent about our years of education is vital. Physicians are held accountable for the health and safety of the patients we serve. 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. Going into my freshman year at the University of Georgia, I declared myself a biology major, with an eager intent of going into some area of healthcare. Both Democrats and Republicans are responsible. He is an avid reader and a mediocre golfer. Suddenly, a person with less expertise and perhaps too little expertise is the one throwing the electrical wires all throughout the house leaving live wires exposed, ungrounded outlets, etc. Thank you for your feedback. It is truly unethical and immoral to do so. NPs collaborate with physians for the best care if the patient. Be proud and represent one’s own field with dignity. Thank you for giving credit to your PA who sounds awesome! And you think it is a good idea to go backwards? I think it is dangerous to say “PAs are able to specialize in any field they wish to” when states are granting independent practice rights. I am at a loss for words. im not scared of blood or anything gory, i just pass out for no reason. The only difference mentioned is that the years of education to become certified are fewer for a PA than an MD. On the other hand, “when you get sick, it’s easier to have a doctor you know and can trust.” A primary care physician treats you with your medical and family history in mind. E-mail us a copy of your piece in the body of your email or as a Google Doc. Somewhere in that blurred line trouble is brewing. One doesn’t like to think about such problems occurring in their home so I doubt one would like to think about that when their health is involved. 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). When to see a doctor There is not always an obvious cause of lower back pain, and it often gets better on its own. Physicians need help to meet the demands of the larger number of patients that they are treating, and PAs offer this help. What Kind of Doctor to See For Back Pain. The insurer, whether you realize it or not, substantially influences how physicians practice. Depending on the study, Doctors rank #1 to #6 in best paying jobs in the the US. PAs are measured all the time, it is incredibly difficult to get into a quality accredited PA program, many say it is harder than med school. Thanks. I hope you will agree with me that most NPs do not want to be physicians, if we did we would go to med school. Doctor and PA salaries vary widely depending on the state as well as the healthcare setting. So, where is Ms. Kidd? They don't want to put the time into training or into the practice of medicine. You might also take a more straightforward path by asking “Why don’t you want to see the doctor?” 5. More importantly patients thank you! I have experienced white privilege on a daily basis. Finally, as for updating my website being “truth in advertising”, my father passed away at the end of October, and to be honest (which I am to a fault), I have not decided what to do regarding the website. Patients have a right to know who they are seeing and what their provider’s credentials are. The prescribing doctor has a legal right to reduce or change the medication if deemed it is not needed or another medication that may be less harmful can be prescribed. Great questions Allan, as usual. 11. Signup | Login Claim Doctor Profile Claim Doctor Profile. Please do not insinuate otherwise. If you don’t want a defensive attitude you might want to stop using insulting questions and statements. PA school was very challenging. My decision to become a physician assistant did not come easily or without much deliberation. Thank you. Save my name, email, and website in this browser for the next time I comment. This article pointed to a state medical board spokesperson who clearly does not recognize differences in specialties, a physician supervising a PA in a specialty in which he himself is not boarded, a PA misrepresenting herself, and layers of the press, misunderstanding the training of a myriad of professionals. ” it is incredibly difficult to get into a quality accredited PA program, many say it is harder than med school.”. Problem: Who You See and What You Get”. It all does beg the question as to why I really valued my 10 years of medical education (2 years extra during medical school for M.S. As a bedside nurse and NP student I see the knowledge physicians have. In short, there are providers from every field who excel and those who just get by. Your email address will not be published. If you really care about patient safety then you would know what I mean. In fact, I often read that “the nursing model treats the whole patient, while the medical model just focuses on the pathophysiology of disease”. Please take some time to actually look into the profession rather than bashing it, using a few instances as something to make your point. It is about teamwork and collaboration. Hard to argue patient preference on this situation. Yes, for hundreds of years medicine was more of an apprenticeship than a formal didactic education. This is an example of the Republican plan to let market forces bring down the cost of medical care. But he recognizes the difference between our training and respects that. All the programs I know of state on their websites that it is not feasible for the student to work during their program due the intensive time requirement. At the tender age of 21, she inaccurately referred to Ms. Kidd as her “life-changing dermatologist.” Cosmopolitan continues the charade, publishing an article on the Jenner family “dermatologist.”. According to Title 16, California Code of Regulations sections 1399.540 through 1399.546, a PA in “independent” practice is limited to the scope of his/her supervising physician by law. In many areas of medicine it is nearly impossible to tell a PA and a Physician apart. I think patients deserve transparency. This is learned in Medical School and Residency/Fellowship. So every time I write an article about ONE specific mid-level provider who is unethical, various readers try to put me in the box of saying ALL mid-level providers are bad. Couldn’t have said it better. 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. I can understand why so many people want to … This point must be a joke. A PA is a physician assistant. Is a healthcare provider a doctor, a nurse, a PA or an NP? So I am not bitter nor do I feel undervalued as a PA but referring to PAs as “playing doctor” and inferring that without close MD oversight we are not as good or competent as MDs is not the reality that I work in every day. If we did so then why would we not also measure the quality of MD graduates? “Vitriol” is a very strong word to use when I’m simply asking for you to advocate supporting an open dialogue, and understand how your article title, while not your own, may shut that down. Most importantly we are being placed in roles where we are doing exactly the same thing as Doctors. I never see the PA's at my hospital working weekends, evenings, or holidays. What I see with PA's are people who either don't have the brains or drive but want to be doctors. Provide Emotional Personal Protective Equipment (PPE) for Physicians Facing Psychological Trauma From the COVID-19 Crisis, We Need to Fix COVID-Damaged Care Sites and Give the Country Better Care and Universal Coverage in the Process. We can pin a lot of things on Trump but this isn’t one of them. We can’t simply talk about blurred lines rather we need to talk about what suddenly precipitated these blurred lines and whether or not the patient should be provided choice over their own bodies. The problem that this article is addressing is a PA who is misrepresenting herself as a board certified dermatologist, which she is NOT. I would encourage you consider the tone of your words here and what they are intended to imply. Your email address will not be published. This was in response to initial planning around “full practice authority” (essentially what NPs have in many states). Dr. Al-Agba, you waded into this by publishing this article being critical of a profession that you have to work alongside. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4730953/. Your article and your responses to me and others reeks of narcissism. 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. Furthermore, by signing off your article stating you are “actually a physician”, you further drive home the concept that PAs are somehow out there broadly misreprenting themselves clinically, or are practicing routinely outside their scope. 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. YES, PA’ s should make sure that their patients know that they are seeing a PA, just like they should be informed that they are seeing a MD, DO, NP, RN, RT, PsyD, etc. Patients sometimes don’t know what to call PAs and they often want to be polite. Columns. Yes, it would have benefited our profession to actually prominently display herself as a PA, being clearly very good at what she does. I used to hear that quite a bit. © Copyright 2020 Barton Associates All Rights Reserved, continuing medical education (CME) requirements, Nurse Practitioner Scope of Practice Laws, Physician Assistant Scope of Practice Laws. 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 is not unheard of that doctors will "fire" a patient. You seem focused on making this about denigrating large groups: related to ethnic or foreign background. What you have written is excellent commentary. The AMA did a study recently showing that about 70 percent of patients if not more, had no idea who they were seeing. My questions neither favor the physician or the extender. She must know the shock wave she has sent through her profession…does California have a law against false advertising? This is such a timely well written article! Sometimes we try any idea. I could offer a lot of “brutally honest” statistics of the positive impact of PAs in many fields in healthcare but instead I will just share my anecdotal experience as a PA practicing in Geriatrics now for 8 years. Most physicians are eager to hire a PA, as we provide the same quality preventative care, but for much less cost than it would be to hire a physician. . PAs are "done with school" and will never "be a doctor". Got it? Thank you for this piece. PAs practice and prescribe medications in all 50 states and the District of Columbia ; A PA is a nationally certified and state-licensed medical professional. 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). Suddenly the needs of the patient seem to melt away. This is a common problem in society and not just the medical profession. While you may feel this piece was demeaning, it was truly not intended that way. Christie Kidd”, as the “go-to MD practicing in Beverly Hills.”, The article shared how Ms. Kidd treats the Kardashian-Jenner family, “helping them to look luminous in their no-make-up selfies.”, While most of us cannot grasp the distress caused by not appearing luminous in no-makeup-selfies, this is significantly concerning for Kendall Jenner. Well, maybe not. Now at least clinical hours are required” . I know this is a long comment, but I will not apologize for it. These prerequisites are intended to verify that each candidate has the base knowledge necessary to succeed before adding the clinical skill set needed to practice medicine.
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