Can a PA become board certified?

[Angry Birds]

Like docs who have MD, PhD on theirs?

The DHSc is a common degree in the UK. The first program in the US opened in 2003 and several others have followed. Several holders of the DHSc have gone on to become deans of colleges, provosts, etc. The recent Assistant surgeon general (#2 in chain of command) at the US Public health service was a PA and holder of the DHSc degree.

See, this is misleading. Just as one cannot equate PA/NP with MD, so too can one not equate a DHSc to a PhD. I say this as someone who is currently starting a PhD program.

According to google, here is what a DHSc is:

"The Doctor of Health Science (D.H.S. or D.H.Sc.) is a post-professional academic degree for those who intend to pursue or advance a professional practice career in Health Arts and Sciences, and Health Care Delivery Systems, to include clinical practice, education, administration, and research."

The PhD, on the other hand, is a terminal research degree. The taught component of a PhD is equivalent to a master's, and it is the original research part--which takes, on average, at least three years--that earns one a PhD.

In other words, there is a monumental difference between a DHSc and a PhD--the former is a post-professional degree, and the PhD is a research degree. They are completely different. Just like PA is completely different than MD.

And the fact that you mentioned "several holders of the DHSc have gone on to become deans of colleges, provosts, etc." is also very misleading. The DHSc degree is specifically designed for such people. It is, sorry to say, often simply a fluff degree. It is just like people claim to have gone to Harvard Business School but who didn't get into or complete the prestigious MBA program but instead did a post-professional course such as the OPM (Owner/President Management) program, which is part of the HBS executive education program. That's like this guy here who claims that he "got into HBS" with a 1.8 GPA:

There is nothing essentially wrong with your degrees, but it is when faulty comparisons are made with higher degrees that the problem arises..

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[EMDOC17]

This thread was hard to read. From what I have seen/heard/read the PCA/CNA does the job of the LPN but gets paid less. The LPN does the same thing as the RN but gets paid less. The RN does the same thing as the PA/NP does but gets paid less. The PA/NP does the same thing as the MD/DO but gets paid less. So by all this the PCA/CNA does the exact same thing as the MD/DO does.

We will never get over the fighting between physicians and midlevels. Advocate on a political level but treat with respect in real life. In a day in the pit we are a part of the same team, except for the surgeons they are douches, (kidding).

 

[emnotsureanymore]

at a good PA program PA2=MS3. at my program we were scheduled interchangeably.

I am a PA. I am also a med student. PA2 in no way equals MS3 by any stretch. Sorry. I feel like physicians do not have a very good grasp on PA education and PAs do not have a very good grasp on physician education. The only people qualified to make these assessments are those who have actually done both. And there are many of us. You will never hear a PA who goes to med school say anything like PA2=MS3.

Also, why does your signature tag say 30 years in emergency medicine? Have you been practicing as an EM PA for 30 years? If you are including your experiences in EMS, that is not practicing emergency medicine or any kind of medicine. Physicians and PAs practice medicine, but the T in EMT-P stands for... technician. I hope this is not another disingenuous advertisement of credentials, as you have much to offer and generally represent PAs in a positive light. I would hate to see that be completely discredited

 

[deleted6669]

I am a PA. I am also a med student. PA2 in no way equals MS3 by any stretch. Sorry. I feel like physicians do not have a very good grasp on PA education and PAs do not have a very good grasp on physician education. The only people qualified to make these assessments are those who have actually done both. And there are many of us. You will never hear a PA who goes to med school say anything like PA2=MS3.

Also, why does your signature tag say 30 years in emergency medicine? Have you been practicing as an EM PA for 30 years? If you are including your experiences in EMS, that is not practicing emergency medicine or any kind of medicine. Physicians and PAs practice medicine, but the T in EMT-P stands for... technician. I hope this is not another disingenuous advertisement of credentials, as you have much to offer and generally represent PAs in a positive light. I would hate to see that be completely discredited

I've been an em pa for 20 years and was previously a paramedic for 10 years, thus "30 years working in emergency medicine". I don't know what your pa program was like, but at my pa program(at a major medical school 24 years ago) PA2 and MS3 students were scheduled interchangeably for rotations; same call, same rounding responsibilities, same pt load, etc. I spent 100 hrs/week on surgery, etc. and was required to do everything the ms3s did.
maybe I should have said, MY 2nd year pa school experience was equivalent to that of MS3s at my school, as that would have been more accurate. I have heard the same from many colleagues, but I can not speak to every pa program and every rotation.

 

[deleted6669]

See, this is misleading. Just as one cannot equate PA/NP with MD, so too can one not equate a DHSc to a PhD. I say this as someone who is currently starting a PhD program.
It is, sorry to say, often simply a fluff degree. ..

it really depends on the program. I know folks with PhD after their names who got them from diploma mill types of schools with 1/2 the effort and credit load of my DHSc.
we don't need to have a pissing contest about doctoral degrees. there are lots of types and each has their own unique requirements. Is an EdD better than a DHEd, etc?
I looked at DrPH programs as well as PhD programs which required fewer credits than the program I ended up completing.
I did significant research in a developing nation over the course of 12 separate trips over 4 years and developed a project which will likely change the way a disease is treated. As I mentioned above, this was not an inconsequential endeavor.

 

[MSmentor018]

it really depends on the program. I know folks with PhD after their names who got them from diploma mill types of schools with 1/2 the effort and credit load of my DHSc.
we don't need to have a pissing contest about doctoral degrees. there are lots of types and each has their own unique requirements. Is an EdD better than a DHEd, etc?
I looked at DrPH programs as well as PhD programs which required fewer credits than the program I ended up completing.
I did significant research in a developing nation over the course of 12 separate trips over 4 years and developed a project which will likely change the way a disease is treated. As I mentioned above, this was not an inconsequential endeavor.

what does the phd/dhsc or really any doctrate level degree provide in medicine? regardless of any added alphabet soup, clinically you work based on your state license.

 

[emnotsureanymore]

I've been an em pa for 20 years and was previously a paramedic for 10 years, thus "30 years working in emergency medicine". I don't know what your pa program was like, but at my pa program(at a major medical school 24 years ago) PA2 and MS3 students were scheduled interchangeably for rotations; same call, same rounding responsibilities, same pt load, etc. I spent 100 hrs/week on surgery, etc. and was required to do everything the ms3s did.
maybe I should have said, MY 2nd year pa school experience was equivalent to that of MS3s at my school, as that would have been more accurate. I have heard the same from many colleagues, but I can not speak to every pa program and every rotation.

My PA program was the same as far as a comparative schedule to med students in the clinical year. med student/PA student rotations are probably even more similar now then they were when you went to school because clinical education is crap these days, especially for DO students. Its honestly more about the education that comes before and comes after rotations. I'm really not trying to be elitist here, trust me. I'm a DO student, so not exactly the cream of the crop... just trying to share some perspective as one who has experienced both educational models.

 

[Gither]

I've been an em pa for 20 years and was previously a paramedic for 10 years, thus "30 years working in emergency medicine". I don't know what your pa program was like, but at my pa program(at a major medical school 24 years ago) PA2 and MS3 students were scheduled interchangeably for rotations; same call, same rounding responsibilities, same pt load, etc. I spent 100 hrs/week on surgery, etc. and was required to do everything the ms3s did.
maybe I should have said, MY 2nd year pa school experience was equivalent to that of MS3s at my school, as that would have been more accurate. I have heard the same from many colleagues, but I can not speak to every pa program and every rotation.

I'm assuming you meant equivalence in time frame of training and not fund of knowledge.

When I was a third year med student I rotated with second year PA students during surgery. None of us actually knew what the hell we were doing lol. But at the same time, none of us actually thought we were equivalent in depth of knowledge. Although I never went to PA school, common sense just told me

PA1 does not equal M1+M2
PA2 does not equal M3
PA first year out in practice does not equal M1+M2+M3+M4+intern year.

You can't just skip full academic years of med school and claim equivalence. As a senior EM resident, I still feel like a clueless fool often. I'm sure I'll be even more scared, nervous, and insecure as a first year attending even after board certification. I honestly don't know how all these mid levels are always so confident in themselves with less training. I'm almost done and would never say half the things they claim.


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[deleted6669]

My PA program was the same as far as a comparative schedule to med students in the clinical year. med student/PA student rotations are probably even more similar now then they were when you went to school because clinical education is crap these days, especially for DO students. Its honestly more about the education that comes before and comes after rotations. I'm really not trying to be elitist here, trust me. I'm a DO student, so not exactly the cream of the crop... just trying to share some perspective as one who has experienced both educational models.

fair enough. best of luck in your studies.

 

[Angry Birds]

I've been an em pa for 20 years and was previously a paramedic for 10 years, thus "30 years working in emergency medicine".

It is this sort of language that comes across as misleading. You constantly equate and conflate education and training that is clearly not equivalent.

Exhibit A:

I don't know what your pa program was like, but at my pa program(at a major medical school 24 years ago) PA2 and MS3 students were scheduled interchangeably for rotations; same call, same rounding responsibilities, same pt load, etc. I spent 100 hrs/week on surgery, etc. and was required to do everything the ms3s did.
maybe I should have said, MY 2nd year pa school experience was equivalent to that of MS3s at my school, as that would have been more accurate. I have heard the same from many colleagues, but I can not speak to every pa program and every rotation.

Exhibit B:

it really depends on the program. I know folks with PhD after their names who got them from diploma mill types of schools with 1/2 the effort and credit load of my DHSc.
we don't need to have a pissing contest about doctoral degrees. there are lots of types and each has their own unique requirements. Is an EdD better than a DHEd, etc?
I looked at DrPH programs as well as PhD programs which required fewer credits than the program I ended up completing.
I did significant research in a developing nation over the course of 12 separate trips over 4 years and developed a project which will likely change the way a disease is treated. As I mentioned above, this was not an inconsequential endeavor.

I'm not stating that your work was inconsequential. Rather, I am stating that you cannot equate your degree to a PhD, which is substantially different, for the reasons I listed in my previous post.

Your point about a diploma mill is a red herring. It goes without saying that a degree, whether an MD or a PhD, is useless if it comes from a diploma mill.

 

[Fox800]

I've been an em pa for 20 years and was previously a paramedic for 10 years, thus "30 years working in emergency medicine". I don't know what your pa program was like, but at my pa program(at a major medical school 24 years ago) PA2 and MS3 students were scheduled interchangeably for rotations; same call, same rounding responsibilities, same pt load, etc. I spent 100 hrs/week on surgery, etc. and was required to do everything the ms3s did.
maybe I should have said, MY 2nd year pa school experience was equivalent to that of MS3s at my school, as that would have been more accurate. I have heard the same from many colleagues, but I can not speak to every pa program and every rotation.

So you're claiming one third of your career experience from your time as a paramedic? That is disingenuous. Sorry, it's not the same. I was a paramedic before I went to medical school and still maintain my credentials.

I graduated with classmates that were nurses, paramedics, and even a PA before attending medical school. I am confident that none of them would claim their years of prior work experience as equivalent to working as a physician when discussing tenure and years on the job. Even the PA-turned-physician, and that is a way closer association than comparing a paramedic to a PA. For the record, I went to a state medical school that also had a PA program. PA2 was definitely NOT equivalent to my MS3 year in terms of hours worked. Let's not forget that this was while all of the medical students were studying for Step 2.

I wouldn't graduate from an emergency medicine residency program and go around telling people that I had "five years of experience in emergency medicine" right out of the gate. That would be a load of BS. You wouldn't tell employers that when you applied for a job.

That plus your "GlobalDoc" tag line...c'mon. It's this culture of blurring the lines that is one of my major gripes with mid-level providers. We aren't interchangeable. I have a feeling that you work at an ER that gives you so much free reign because it's such a crappy place to work that they cannot regularly retain board-certified emergency physicians to staff the place.

 

[throckmortonDO]

Look I get it, it's an ego thing. However, that's the job you went to school for and chose/qualified for. If you wanted "more" (whatever that means to you) then you should go to medical school and complete residency/fellowship training. It's that simple. I was in a similar spot prior to medical school, and I did exactly that. I can tell you the training before, in no way compared to medical school. Not even in the slightest.

I see arrogant 'midlevels' all the time. or is it 'providers' ? whatever corporate-invented moniker it is these days.
I don't get it. I'm still scared I don't know enough and am going to make a mistake and hurt someone, even now as an attending.

If you want to be independent, by all means, please have it. I don't really want to sign your charts for that patient I never saw or assume your liability. Please have your independent practice rights. The lawyers of america thank you in advance.

 

[StandOrFall]

Time for some wisdom from a long-lost, and hilarious, wise man. There was a very similar discussion going on nearly a decade ago.

https://goo.gl/vWisRm (Really great discussion in the comments…PB’s wit on full display)

https://goo.gl/M18zmV

https://goo.gl/hxizdt (check out the 9th comment)

 

[Fox800]

The Dunning-Kruger effect is real.

Time for some wisdom from a long-lost, and hilarious, wise man. There was a very similar discussion going on nearly a decade ago.

https://goo.gl/vWisRm (Really great discussion in the comments…PB’s wit on full display)

https://goo.gl/M18zmV

https://goo.gl/hxizdt (check out the 9th comment)

"Not a day goes by where I don’t come against the limits of my knowledge and I have been hard at it for almost six years. And I still have two more years of training before I can practice independently of skilled supervision. If you think that some guy straight out of a two-year masters program is equal to the task then God love you, you’re a true man of the people, but you are crazier than a ****house rat."

That's effing amazing. Thank you for sharing.

 

[StandOrFall]

The Dunning-Kruger effect is real.


"Not a day goes by where I don’t come against the limits of my knowledge and I have been hard at it for almost six years. And I still have two more years of training before I can practice independently of skilled supervision. If you think that some guy straight out of a two-year masters program is equal to the task then God love you, you’re a true man of the people, but you are crazier than a ****house rat."

That's effing amazing. Thank you for sharing.

I still look back at Panda Bear's blog from time to time – he was such an amazing writer...and frigging hilarious. Wherever he is now, I hope he's well.

 

[filhodeinferno]

I've been an em pa for 20 years and was previously a paramedic for 10 years, thus "30 years working in emergency medicine". I don't know what your pa program was like, but at my pa program(at a major medical school 24 years ago) PA2 and MS3 students were scheduled interchangeably for rotations; same call, same rounding responsibilities, same pt load, etc. I spent 100 hrs/week on surgery, etc. and was required to do everything the ms3s did.
maybe I should have said, MY 2nd year pa school experience was equivalent to that of MS3s at my school, as that would have been more accurate. I have heard the same from many colleagues, but I can not speak to every pa program and every rotation.

Medical students are expendable and by and large useless in the hospital, so you aren't impressing most of us with this PA2=MS3 comparison, misguided as it is. They are equal in the hospital because they are both useless as far as what work they actually do. They both have different training and knowledge bases, though.

 

[doctalaughs]

If a school has a year designed exactly the same that is made for 2nd year PAs or 3rd year med students, that is a school I wouldn't want to attend and would think quite poorly of it. Because med students SHOULD be receiving a different depth of training based on the fact they have done 2 years of more in- depth basic underpinnigs than the PA.


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[da8s0859q]

I still look back at Panda Bear's blog from time to time – he was such an amazing writer...and frigging hilarious. Wherever he is now, I hope he's well.

Amen. Panda Bear, come back sometime.

 

[Apollyon]

Amen. Panda Bear, come back sometime.

Brother is long gone - vapor, ghost, history, the whole shebang.

 

[da8s0859q]

Brother is long gone - vapor, ghost, history, the whole shebang.

I know it. Too bad, eh? Wishful thinking.

 

[SpacemanSpifff]

I've been an em pa for 20 years and was previously a paramedic for 10 years, thus "30 years working in emergency medicine". I don't know what your pa program was like, but at my pa program(at a major medical school 24 years ago) PA2 and MS3 students were scheduled interchangeably for rotations; same call, same rounding responsibilities, same pt load, etc. I spent 100 hrs/week on surgery, etc. and was required to do everything the ms3s did.
maybe I should have said, MY 2nd year pa school experience was equivalent to that of MS3s at my school, as that would have been more accurate. I have heard the same from many colleagues, but I can not speak to every pa program and every rotation.

Would you say that you were being trained with the same goal in mind?

 

[deleted6669]

Would you say that you were being trained with the same goal in mind?

YES. most of my preceptors didn't care if someone was a pa or med student. we were there to learn medicine. One of my evals (emergency medicine in fact) said among other things " worth his weight in 4th yr medical students...I wish (emedpa) was a medical student as I would offer him a spot in our residency program next year". you may think I am lying and that this is BS. it isn't.

 

[racerwad]

YES. most of my preceptors didn't care if someone was a pa or med student. we were there to learn medicine. One of my evals (emergency medicine in fact) said among other things " worth his weight in 4th yr medical students...I wish (emedpa) was a medical student as I would offer him a spot in our residency program next year". you may think I am lying and that this is BS. it isn't.

I think what the person you were replying to was getting at were the goals and abilities of the programs, in general, rather than your own abilities. I don't think anyone is discounting the work you have put into becoming a PA, nor the efforts you have put in to further yourself professionally. The issue is the blurring of the lines, the "everyone is a provider" nonsense, etc, that PA and NP groups are promoting (and many physicians are accepting) that is driving myself and some of my colleagues crazy.

 

[deleted6669]

I think what the person you were replying to was getting at were the goals and abilities of the programs, in general, rather than your own abilities. I don't think anyone is discounting the work you have put into becoming a PA, nor the efforts you have put in to further yourself professionally. The issue is the blurring of the lines, the "everyone is a provider" nonsense, etc, that PA and NP groups are promoting (and many physicians are accepting) that is driving myself and some of my colleagues crazy.

I respect the work EM physicians put into their medschool and training. I fully understand that the ideal provider to staff an emergency dept is a residency trained and boarded EM physician. The kind of facilities I work at can not attract and retain these folks. If any of you want to see 12 patients in 24 hrs for 75/hr you are welcome to apply for my job. The family physicians who work there on the rare days we don't have PA coverage only make 90/hr and in all honesty, most of them are not as well suited for the position as a good em pa. I wouldn't want to go work in a primary care clinic. That is what FP physicians are good at. many of them are out of their depth when it comes to critically ill crashing patients and defer to me when someone like that arrives at shift change.

 

[Fox800]

I think what the person you were replying to was getting at were the goals and abilities of the programs, in general, rather than your own abilities. I don't think anyone is discounting the work you have put into becoming a PA, nor the efforts you have put in to further yourself professionally. The issue is the blurring of the lines, the "everyone is a provider" nonsense, etc, that PA and NP groups are promoting (and many physicians are accepting) that is driving myself and some of my colleagues crazy.

There is an incredible, undeniable, tangible difference in education and experience between board-certified emergency physicians and a PA or NP. Midlevel interest groups would have you completely discount the extra years of medical school and residency training, long hours, and hard work - and they tell the public that there is no difference, that were are completely interchangeable, and that NPs and PAs are just as good (and in some ways better).

It's disgusting.

 

[deleted6669]

There is an incredible, undeniable, tangible difference in education and experience between board-certified emergency physicians and a PA or NP. Midlevel interest groups would have you believe that there is no difference, that were are completely interchangeable, and that NPs and PAs are just as good (and in some ways better) than board-certified physicians.

It's disgusting.

that is not my belief. see my post above( #124).
EM Physician>>>>Senior EM PA>>>>>typical FP physician working in the ED

 

[Fox800]

that is not my belief. see my post above( #124).
EM Physician>>>>Senior EM PA>>>>>typical FP physician working in the ED

I understand your personal beliefs. However, national PA and NP interest groups are pushing the idea of PA or NP (with any amount of experience) = board-certified emergency physician.

Each time there's a push at the state-level for increasing mid-level independence, I die a little inside.

I'm just a little sick of 25 year old BSNs shooting through their NP programs and coming out the other side with overconfidence, and brand-new PAs thinking that they're hot stuff.

Midlevels working for specialty groups that do the same narrow scope of things over and over again, picking out mistakes that residents make when they rotate on their service for one month, just to feel smart (look how that doctor didn't know xyz or how we do xyz here, what an idiot!)

One of our new PAs was trying to talk down to me when we first met because she's worked for a year at an urgent care center. Yeah, OK. Neat.

 

[deleted6669]

FWIW the EMPA national body (sempa) is closely aligned with acep and committed to working with em physicians.

 

[Fox800]

FWIW the EMPA national body (sempa) is closely aligned with acep and committed to working with em physicians.

That's nice. What about the AAPA's push for full practice authority and responsibility?

"The Task Force believes AAPA should adopt policy to do four things:
• Emphasize our profession’s continued commitment to team-based practice (this is pure lip service/feel-good language).
• Support the elimination of provisions in laws and regulations that require a PA to have and/or report a supervisory, collaborating or other specific relationship with a physician in order to practice.
• Advocate for the establishment of autonomous state boards, with a voting membership comprised of a majority PAs, to license, regulate, and discipline PAs (we want to do the same job as physicians but not have to be overseen by those pesky docs - just like the NPs have done).
• Ensure that PAs are eligible to be reimbursed directly by public and private insurance."

http://news-center.aapa.org/wp-content/uploads/sites/2/2016/12/FAQ-Final_12_15.pdf

Full Practice Authority and Responsibility - AAPA News Center: NCCPA’s PANRE Proposal

 

[deleted6669]

That's nice. What about the AAPA's push for full practice authority and responsibility?

that is more about competition with NPs. right now PAs are losing jobs to NPs because physicians don't WANT to supervise or sign notes. after FPAR passes(and it will) the relationship between PAs and docs shouldn't change. what will change is that the docs won't feel liable for the work done by PAs. FPAR doesn't stop a pa from getting a consult or practicing team-based medicine. in fact the new title for fpar as of last week is "optimal team practice".

 

[Fox800]

that is more about competition with NPs. right now PAs are losing jobs to NPs because physicians don't WANT to supervise or sign notes. after FPAR passes(and it will) the relationship between PAs and docs shouldn't change. what will change is that the docs won't feel liable for the work done by PAs. FPAR doesn't stop a pa from getting a consult or practicing team-based medicine. in fact the new title for fpar as of last week is "optimal team practice".

There is no way you can read their policy suggestions and suggest that "the relationship between PAs and docs shouldn't change". It TOTALLY FREAKING CHANGES. So much so that you want to morph into the role of a physician, not be regulated by state medical boards, and do your own billing. Tell me how that isn't completely, fundamentally changing the relationship between physicians and PAs.

And the argument of "NPs slipped through the cracks so we should be on an even playing field because jobs!"...give me a break.

"Optimal team practice" as defined by mid-level providers. It's optimal because we say so. -AAPA

 

[deleted6669]

we had to do something. we were losing jobs to NPs because PHYSICIANS were preferentially hiring them. the best em job for pa/np in my town is an np only shop because of this. I met with the director of the ED there who said he personally prefers PAs and our training , but none of the docs in the group want to sign their notes, so they staff with NPs instead.

 

[WilcoWorld]

we had to do something. we were losing jobs to NPs because PHYSICIANS were preferentially hiring them. the best em job for pa/np in my town is an np only shop because of this. I met with the director of the ED there who said he personally prefers PAs and our training , but none of the docs in the group want to sign their notes, so they staff with NPs instead.

That is penny-wise and pound-foolish.

 

[deleted6669]

That is penny-wise and pound-foolish.

yup, this despite a statement from the president of acep that PAs are the non-physician provider of choice in emergency medicine.

 

[Makati2008]

we had to do something. we were losing jobs to NPs because PHYSICIANS were preferentially hiring them. the best em job for pa/np in my town is an np only shop because of this. I met with the director of the ED there who said he personally prefers PAs and our training , but none of the docs in the group want to sign their notes, so they staff with NPs instead.

Agreed. There are plenty of jobs that I applied to as a PA that only preferred NPs which was depressing.


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[MSmentor018]

we had to do something. we were losing jobs to NPs because PHYSICIANS were preferentially hiring them. the best em job for pa/np in my town is an np only shop because of this. I met with the director of the ED there who said he personally prefers PAs and our training , but none of the docs in the group want to sign their notes, so they staff with NPs instead.

whoa hang on. so you're saying we don't have to sign NP charts?? is this a state dep rule? I have to sign all the charts on the shift. so if no one is signing the np charts, who does the lawyer sue and who is ultimately responsible when a pt goes down the tubes ?

 

[deleted6669]

whoa hang on. so you're saying we don't have to sign NP charts?? is this a state dep rule? I have to sign all the charts on the shift. so if no one is signing the np charts, who does the lawyer sue and who is ultimately responsible when a pt goes down the tubes ?

in an outpt setting most NP charts in the 23-24 "independent np states" are not signed by a physician. inpt settings can set their own rules.

 

[doctalaughs]

in an outpt setting most NP charts in the 23-24 "independent np states" are not signed by a physician. inpt settings can set their own rules.

The point about competing with NPs is a nice way to distract people from the obvious aims. If thats the only issue why try to separate from the board of medicine?

I would be fine not co-signing a midlevel's notes and not taking the liability. However, that's not how it pans out in real life. Look at the CRNA vs anesthesiologist mess. Those docs still get sued all the time even with the CRNAs practicing under a separate license. Because when things go south the person with the highest level of training gets dragged in to clean up the mess. At least the way things are, we have some small measure of control in how patients are being worked up and treated as a "supervisor" instead of zero say.

Midlevels want complete independence and control over their scope of practice, terms of employment, license discipline etc..... until they cant handle something or get in over their heads. Sorry- cant have it both ways.


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[sum dude]

Depends on the individual PA, their training and experience, and the needs of their community. while most EM PAs do low acuity work(and there is certainly a place for that), PAs with a desire to see sicker patients who get additional training beyond what is available in PA school can find places that will utilize their skills. typically these are very rural or undesirable areas that can not attract/afford/retain an EM boarded physician. A good em pa is a better fit for a rural ED than your avg FP physician. After 30 years working in emergency medicine, I now work exclusively single coverage, rural, critical access hospitals seeing every patient and performing every procedure. high acuity and low volume is a lot more fun than high volume and low acuity.

Disagree w/ that, there's lots of good FP's out there who grandfathered in. I'd take an experienced FP over a solid PA every time. While I'd commend a PA for going to an EM PA residency, PA schooling and training does not equal MD/DO schooling/training. There will never be a PA to MD training, otherwise no one would go to medical school (which is 4 yrs, BTW, compared to 2 years). Residencies are 16,000 hours of training. Despite whatever KoolAid the NP's are drinking, PA/NP training does not equal physician training and boarding. See Dunning-Kruger Effect

 

[SpacemanSpifff]

YES. most of my preceptors didn't care if someone was a pa or med student. we were there to learn medicine. One of my evals (emergency medicine in fact) said among other things " worth his weight in 4th yr medical students...I wish (emedpa) was a medical student as I would offer him a spot in our residency program next year". you may think I am lying and that this is BS. it isn't.

I believe you. I hope you don't think my questions equate to questioning your clinical acumen or value. You've obviously put a lot of work into your career and have excelled. Regardless of your personal experience, the standard PA education is not equivalent to standard medical education in the US, because, as you noted, the baseline expectations are different between our fields. I have no issue with qualified individuals, PA or NP, working in the ED and filling gaps in underserved areas that need help because that's just the reality of the current situation.
Personally, I judge individuals based on their performance, not the letters after their name. That said, I hold different professionals to different standards because that's the way healthcare teams work.

 

[Medic2PA-C]

More integration into MD boards and associations is needed, not less. It is hoped the ACEP would create a pathway for PAs to become educated and certified in emergency medicine and obtain a credential directly from the ACEP. This clearly would be different from ACEP board certification for physicians but it would embed PAs into the physician-lead team even further.

 

[MedicaMagus]

More integration into MD boards and associations is needed, not less. It is hoped the ACEP would create a pathway for PAs to become educated and certified in emergency medicine and obtain a credential directly from the ACEP. This clearly would be different from ACEP board certification for physicians but it would embed PAs into the physician-lead team even further.

Isn't this the appeal of being a PA? You don't need to be certified in any field. You have the ability to move from specialty to specialty. If you want to be certified in a specialty, why not go to medical school and complete a residency? I just find it confusing that you would want certification/recognition from ACEP/ABEM when that's not what the profession was intended to achieve in the first place.

 

[racerwad]

More integration into MD boards and associations is needed, not less. It is hoped the ACEP would create a pathway for PAs to become educated and certified in emergency medicine and obtain a credential directly from the ACEP. This clearly would be different from ACEP board certification for physicians but it would embed PAs into the physician-lead team even further.

To what end? This seems like continued scope-creep and "everyone is a provider." Taking the boards and being board certified is for physicians and part of its value is based upon the effort it takes to become board certified. Watering it down weakens this value for all involved.

Also, ACEP does not board certify anyone. They are our professional organization to which interested members can join. The American Board of Emergency Medicine (part of the American Board of Medical Specialties) is who grants board certification.

 

[NeuroPA]

There is actually only one Pa-D.O. bridge program available in the United States and it cuts the first year of med school off.

 

[Overthehorizen]

Emed gets upset when posters spar with him here but he runs his own site where he and his moderator friends squelch any criticism of the PA profession. When you see posts by Eme, boatswain, rev ronin, oldpa, Paula and others, you should realize the profit handsomely from pumping the stock of the PA profession because they are with the AAPA, NCCPA or a. PA program. Go to embeds site and you will be instantly banned for criticizing the PA profession with legitimate issues.

 

[Siggy]

Apologies for anyone who put off by my ideas. I am new to the medical field...

Can a first responder take a few courses, get a couple of years of experience, and just take the NREMT exam and become an EMT without taking an EMT course?

Can an EMT take a few extra courses, get a couple of years experience, and just take the NREMT-P exam and become a paramedic without actually taking a paramedic course?

I mean... why not? The line between a first responder and a paramedic is blurred as it is and they practically do the same thing? Why would you be against more education and the first responder advancing their education?

 

[Boatswain2PA]

Would you say that you were being trained with the same goal in mind?

Med school and PA school do NOT train with the same goal in mind. Med school provides an incredibly broad base for the new physician to stand on to prepare them for residency, where they get increasingly more autonomy until they are at the very top of their profession. PA school provides a narrower base of medicine, but should prepare them to be able to practice and, within limitations, see patients on day one. Slight difference, but with big impacts.

There is an incredible, undeniable, tangible difference in education and experience between board-certified emergency physicians and a PA or NP. Midlevel interest groups would have you completely discount the extra years of medical school and residency training, long hours, and hard work - and they tell the public that there is no difference, that were are completely interchangeable, and that NPs and PAs are just as good (and in some ways better).

It's disgusting.

Just remember the "interest groups" you are referring to are a vocal minority of PAs. Most PAs don't have a clue about the politics of the AAPA, and many of us disagree with them.

Disagree w/ that, there's lots of good FP's out there who grandfathered in. I'd take an experienced FP over a solid PA every time. While I'd commend a PA for going to an EM PA residency, PA schooling and training does not equal MD/DO schooling/training. There will never be a PA to MD training, otherwise no one would go to medical school (which is 4 yrs, BTW, compared to 2 years). Residencies are 16,000 hours of training. Despite whatever KoolAid the NP's are drinking, PA/NP training does not equal physician training and boarding. See Dunning-Kruger Effect

Yes, lots of good FPs who grandfathered into ABEM. But I would rather have an experienced EM PA taking care of my critically ill kid in the ED than a FP who hasn't stepped foot in the ED since residency. The FPs specialize in FP and all of the stuff involved with that. Many haven't intubated, managed sepsis/trauma/DKA/etc, or started a central line in years, or have the faintest idea of how to use an ultrasound. Meanwhile that is what some EM PAs do.

 

[Fox800]

Just remember the "interest groups" you are referring to are a vocal minority of PAs. Most PAs don't have a clue about the politics of the AAPA, and many of us disagree with them.

Sure thing. They're only your national lobbying body.

 

[Boatswain2PA]

Sure thing. They're only your national lobbying body.

Just like the AMA is yours. What percentage of physicians are members of the AMA? The AAPA also has very low membership rates, I have never been a member.

 

[Fox800]

Just like the AMA is yours. What percentage of physicians are members of the AMA? The AAPA also has very low membership rates, I have never been a member.

Doesn't matter. They represent you, and they're stirring up a s#@t pot. They're who the public looks to when they try to figure out what the PA profession is up to.