IOM supports removing scope of practice restrictions from Nurses

[danielmd06]

yup, for the last 23 yrs(see my signature).
I work level 1 and 2 trauma ctrs as well as rural/critical access and underserved/solo positions.
at my solo night gig we staff pa's 24/7 and docs on day shift only. the day doc reviews all charts from the past 24 hrs. newer grads work day shift with a doc there while those of us with > 10 yrs experience tend to migrate to the night shifts. we always have a doc available for consults and have transfer agreements with a regional facility for trauma/cva/acs/etc transfers. a lot of our sicker pts are stabilize and ship( I saw 18 on night shift last night and transfered 7).

Did see your signature but didn't want to assume.

I do know of (and work alongside) such people as yourself. So I'm familiar with this concept. I was thinking of the other poster's question in terms of this volume of "remote" work really increasing dramatically.

I hate to think that doctors could just be sitting around in an office all day on a cell phone/computer *supervising* a veritable army of PA's and not actually getting out in the trenches and seeing patients themselves...

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[deleted6669]

I hate to think that doctors could just be sitting around in an office all day on a cell phone/computer *supervising* a veritable army of PA's and not actually getting out in the trenches and seeing patients themselves...

at least at our facility all the docs work on the day shifts but have nights off.
state laws limit the # of pa's a doc can supervise. that # is usually no more than 4 and some states have limits of 1 or 2.
we staff this particular facility with a group of 4 docs(days) and 15 pa's (days and nights).
we have used this model for the last 15 years( I have been there for 10 of those).

 

[mig26x]

Im still waiting on an answer from the IOM (not that Im expecting one) in respect to see if they will let their family members be treated/diagnose by a nurse the next time they are admitted to the hospital. Because if you open the flood gates now there's no closing them. Next thing you will see nurses running the ICU.

 

[badasshairday]

\ Next thing you will see nurses running the ICU.

They seem like they do at the VA already..... What is up with VA ICU nurses? I just don't get it. The Medicine teams have patients in the ICU, but the freakin nurses don't listen.

 

[princekc]

I hate to think that doctors could just be sitting around in an office all day on a cell phone/computer *supervising* a veritable army of PA's and not actually getting out in the trenches and seeing patients themselves...

Hard to believe but it's true. This is becoming more frequent particularly in IM/FM & Urgent care setting.

 

[princekc]

we staff this particular facility with a group of 4 docs(days) and 15 pa's (days and nights).
we have used this model for the last 15 years( I have been there for 10 of those).

....$$$$ I smell it!

When PAs are adequately utilized = millions $$$ in generated revenue.

As now an exp PA, I constantly feel that I'm making my boss richer thus the desire to further......

 

[altap]

I applaud emedpa for practicing in rural America. But it is for the best interest of patients that a physician whether a resident or an attending should always be present whenever a PA or NP or a grp. of PA or NP is working. IMHO, what he is doing constitutes practicing medicine independently.

 

[zenman]

I applaud emedpa for practicing in rural America. But it is for the best interest of patients that a physician whether a resident or an attending should always be present whenever a PA or NP or a grp. of PA or NP is working. IMHO, what he is doing constitutes practicing medicine independently.

I think he answered this in post #152, "this is not "independent practice" as there is always a mechanism for stat consult and oversight. where I work now I have access to physician referals/consults/rads overreads, etc."

 

[altap]

Consult? Even attendings consult other attendings. Oversight? He works at the ER solo and a physician reviews the charts from the past 24 hrs? Common now. 5 years of experience as a PA and you can now practice medicine independently? Today it's 5 or 10 years. How about tomorrow? This is a dangerous road that physicians don't want to go. We are talking about the health of a nation here not the housing industry or textile industry. I'm going to say it again, it is for the best interest of the public that a physician whether a resident or an attending should always be present whenever a PA or NP or a grp of PA or NP, notwithstanding their experience, is working. No ifs or buts.

 

[zenman]

Consult? Even attendings consult other attendings. Oversight? He works at the ER solo and a physician reviews the charts from the past 24 hrs? Common now. 5 years of experience as a PA and you can now practice medicine independently? Today it's 5 or 10 years. How about tomorrow? This is a dangerous road that physicians don't want to go. We are talking about the health of a nation here not the housing industry or textile industry. I'm going to say it again, it is for the best interest of the public that a physician whether a resident or an attending should always be present whenever a PA or NP or a grp of PA or NP, notwithstanding their experience, is working. No ifs or buts.

I must point out that the current health of the nation is screwed up due to multiple factors, one probably being a lack of nads for one group of providers.

 

[BLKPA2MD]

Consult? Even attendings consult other attendings. Oversight? He works at the ER solo and a physician reviews the charts from the past 24 hrs? Common now. 5 years of experience as a PA and you can now practice medicine independently? Today it's 5 or 10 years. How about tomorrow? This is a dangerous road that physicians don't want to go. We are talking about the health of a nation here not the housing industry or textile industry. I'm going to say it again, it is for the best interest of the public that a physician whether a resident or an attending should always be present whenever a PA or NP or a grp of PA or NP, notwithstanding their experience, is working. No ifs or buts.

...practically speaking, it's impossible especially if the PA is experienced. Not cost effective! There's no such thing as independent practice as far as I'm concern. It's team work! No PA or MD/DO practice independently techically speaking.

 

[deleted6669]

it is for the best interest of the public that a physician whether a resident or an attending should always be present whenever a PA or NP or a grp of PA or NP, notwithstanding their experience, is working. No ifs or buts.

I train fp residents in emergency medicine as part of my job. it wouldn't really be appropriate(or legal) for them to be supervising me. I've seen over 100,000 emergency pts in my career with the full spectrum of complaints. no fp resident even comes close to that. frankly I would be insulted(and quit any job) that had an fp resident supervising me.
a licensed/boarded doc? no problem. actually one of my attendings for a while was a guy I trained.
the small facility that I work at uses fp(not em) docs.
unless a pa is running every single pt by the doc there is no difference between doc present on site and next day review. couldn't someone be sent home inappropriately with a doc in the next room just as easily as if they were not there at all? and if you have the doc see every pt you don't need the pa at all.
sure, a lot of the reason they use pa's 24/7 vs docs is cost savings( 30/hr extra for fp doc vs pa) but over the 15 yrs we have used this model we have had more significant QA/M+M issues with pts seen by the fp docs than those seen by the em pa's.

 

[BLKPA2MD]

I train fp residents in emergency medicine as part of my job. it wouldn't really be appropriate(or legal) for them to be supervising me. I've seen over 100,000 emergency pts in my career with the full spectrum of complaints. no fp resident even comes close to that. frankly I would be insulted(and quit any job) that had an fp resident supervising me.
a licensed/boarded doc? no problem. actually one of my attendings for a while was a guy I trained.
the small facility that I work at uses fp(not em) docs.
unless a pa is running every single pt by the doc there is no difference between doc present on site and next day review. couldn't someone be sent home inappropriately with a doc in the next room just as easily as if they were not there at all? and if you have the doc see every pt you don't need the pa at all.
sure, a lot of the reason they use pa's 24/7 vs docs is cost savings( 30/hr extra for fp doc vs pa) but over the 15 yrs we have used this model we have had more significant QA/M+M issues with pts seen by the fp docs than those seen by the em pa's.

....right on time bro!

 

[deleted87716]

I must point out that the current health of the nation is screwed up due to multiple factors, one probably being a lack of nads for one group of providers.

The fallacy in the whole "blame the doctors" argument is the assumption that doctors were ever in control of healthcare in the first place.

 

[zenman]

The fallacy in the whole "blame the doctors" argument is the assumption that doctors were ever in control of healthcare in the first place.

Doctors have never been powerful in politics....why is that?

 

[zenman]

Again, I don't think anyone here is inferring that they are hesitant to a nurse doing a nurses job. Apprehension comes from someone not trained as a full physician making the decisions as such.

A full physician failed to say one single thing about drug action, SE's or to schedule any follow-up labs on a family member discharged on fluoxetine and carbamazepine. I had to do it. They were readmitted last night. Maybe the full physician will do better this time. Just saying....

 

[deleted87716]

Doctors have never been powerful in politics....why is that?

Most of us are too busy taking care of patients.

 

[jwk]

Doctors have never been powerful in politics....why is that?

Burying their heads in the sand.....and assuming someone else will do it for them. Fortunately, some are waking up to that fact.

 

[Charles_Carmichael]

A full physician failed to say one single thing about drug action, SE's or to schedule any follow-up labs on a family member discharged on fluoxetine and carbamazepine. I had to do it. They were readmitted last night. Maybe the full physician will do better this time. Just saying....

Nice n = 1 example! If a full-fledged attending, with a minimum of 7 years of rigorous medical training, is capable of making mistakes like that, do you really think that the average NP/DNP, who has less than 10% of the training physicians receive, is less likely or more likely to make such errors?

 

[zenman]

Most of us are too busy taking care of patients.

Watch this:

One nurse can take care of say, 5-7 patients. One nurse manager, supervising 7 nurses, can take care of 35-49 patients.

So a few doctors need to break away from the exam table and start "managing" at the political level if you want any change.

I'll be dead before that happens though.

 

[rmsgolfer]

A full physician failed to say one single thing about drug action, SE's or to schedule any follow-up labs on a family member discharged on fluoxetine and carbamazepine. I had to do it. They were readmitted last night. Maybe the full physician will do better this time. Just saying....

You had to do what? Speak to the patient? My apologies but I don't see how this translates to nurses and nursing programs having the knowledge to make medical decisions anywhere near the level a trained physician holds. Absolutely, the doc should have been on the ball and educated the patient further and followed through with proper steps, no one would argue that. People make mistakes, thats why a solid TEAM effort is needed in healthcare, and as in any case a TEAM works best when it's members fill the niche their education and training prepared them for.

Your post points more toward an example of where a physician should have done more to educate the patient, it in no way explains why nurses should make medical decisions.

 

[danielmd06]

Watch this:

One nurse can take care of say, 5-7 patients. One nurse manager, supervising 7 nurses, can take care of 35-49 patients.

So a few doctors need to break away from the exam table and start "managing" at the political level if you want any change.

I'll be dead before that happens though.

Hey..."watch" this:

When you make sweeping judgements about large groups of people you look silly. Whether it's regarding careers, financial situations, race, gender, or whatever. Pick a topic...you still look silly.

Whether you want to admit it or not, most physicians are far, far too busy taking care of patients to become "politically active." Even if you think this concept is a joke. For the second time in this thread...I'll tell you people that Blue Dog is speaking truth. Just follow a couple of average family physcians for a week...you'll find it far more stressful (and busier) than 99.99% of nurse managers' jobs. The fact that you don't realize this illuminates the extent of your knowledge (or lack thereof) regarding this subject matter.

Making inflammatory comments that challenge how much doctors are working will not further anyone's arguments on this topic and only encourage others to cease taking you seriously.

 

[deleted87716]

So a few doctors need to break away from the exam table and start "managing" at the political level if you want any change.

Already happening.

 

[VA Hopeful Dr]

A full physician failed to say one single thing about drug action, SE's or to schedule any follow-up labs on a family member discharged on fluoxetine and carbamazepine. I had to do it. They were readmitted last night. Maybe the full physician will do better this time. Just saying....

How can you be sure that the doctor didn't say anything about action and side effects? C'mon man, we've all seen patients who forget what we tell them 5 minutes later or who change their answers to questions between one person and another.

Now, about the discharge without f/u labs. Does the patient have a PCP? Was said patient told to f/u with said PCP within 1 week? If a patient has a PCP (and isn't a newborn), I have no problem having the PCP set up any outpatient labs that need to get done, assuming it doesn't need to get done in 2-3 days.

 

[zenman]

Hey..."watch" this:

When you make sweeping judgements about large groups of people you look silly. Whether it's regarding careers, financial situations, race, gender, or whatever. Pick a topic...you still look silly.

Whether you want to admit it or not, most physicians are far, far too busy taking care of patients to become "politically active." Even if you think this concept is a joke. For the second time in this thread...I'll tell you people that Blue Dog is speaking truth. Just follow a couple of average family physcians for a week...you'll find it far more stressful (and busier) than 99.99% of nurse managers' jobs. The fact that you don't realize this illuminates the extent of your knowledge (or lack thereof) regarding this subject matter.

Making inflammatory comments that challenge how much doctors are working will not further anyone's arguments on this topic and only encourage others to cease taking you seriously.

I don't look silly at all. You don't get it and probably never will, especially since you think I was making an inflammatory statement. The fact that most doctors don't have time is just an excuse. Yes, it's great you're taking care of patients and I applaud you for that. It's also one reason physicians have been run over by others and all they do is complain and go take care of their patients, with the exception of a few in politics trying to make a difference for their profession. I'm just giving you free advice. Do what you want with it.

 

[zenman]

How can you be sure that the doctor didn't say anything about action and side effects? C'mon man, we've all seen patients who forget what we tell them 5 minutes later or who change their answers to questions between one person and another.

Both parents and adolescent patient came away knowing about as much as they did upon admission

Now, about the discharge without f/u labs. Does the patient have a PCP? Was said patient told to f/u with said PCP within 1 week? If a patient has a PCP (and isn't a newborn), I have no problem having the PCP set up any outpatient labs that need to get done, assuming it doesn't need to get done in 2-3 days.

No f/u directions given re labs, drug interactions, etc...

It happens all the time...

 

[danielmd06]

I don't look silly at all. You don't get it and probably never will, especially since you think I was making an inflammatory statement. The fact that most doctors don't have time is just an excuse.

(1) In your opinion you don't look silly at all...but you were making a swift, single, judgement about a very large group of people. Sorry, but people who make sweeping assertions about large groups of people look silly by making such comments. You take people one at a time...as you find them. But we can agree to disagree. No problem. Just don't kid yourself into thinking you've discovered some great cosmic truth about nurses and doctors.

(2) What makes you so sure "I don't get it and probably never will?" The fact that I think you made a silly, sweeping, assertion?

(3) How are your comments not inflammatory when you're basically insinuating that most doctors are less busy than an average nurse manager? You cite numbers of patients that a nurse is overseeing (supervising, really in your latter example) when residents cover that many for 24 hour calls day-in and day-out all the time? My own service would crest 80 patients on some holidays and weekends. When was the last time that nurse manager pulled a 30 hour shift? Come one. Fair is fair. Doctors are working harder on average.

(4) It may be an excuse for you...but not everyone is lying about their work load to politely excuse themselves from politics.

 

[zenman]

(1) In your opinion you don't look silly at all...but you were making a swift, single, judgement about a very large group of people. Sorry, but people who make sweeping assertions about large groups of people look silly by making such comments. You take people one at a time...as you find them. But we can agree to disagree. No problem. Just don't kid yourself into thinking you've discovered some great cosmic truth about nurses and doctors.

I'll make this sweeping generalization that we probably all agree on. A large group of people called nurses are very powerful in politics. A large group called physicians are less powerful. What I trying to say is one group here on SDN, for the most part, are just complaining. Who's leading this pack?

(2) What makes you so sure "I don't get it and probably never will?" The fact that I think you made a silly, sweeping, assertion?

Maybe you'll get it here in a second.

(3) How are your comments not inflammatory when you're basically insinuating that most doctors are less busy than an average nurse manager? You cite numbers of patients that a nurse is overseeing (supervising, really in your latter example) when residents cover that many for 24 hour calls day-in and day-out all the time? My own service would crest 80 patients on some holidays and weekends. When was the last time that nurse manager pulled a 30 hour shift? Come one. Fair is fair. Doctors are working harder on average.

Watch this:

One nurse can take care of say, 5-7 patients. One nurse manager, supervising 7 nurses, can take care of 35-49 patients.

So a few doctors need to break away from the exam table and start "managing" at the political level if you want any change.

I'll be dead before that happens though.

This had nothing to do with workload. Maybe it can explain it another way. You can only take care of so many patients by yourself. You can take care of many more patients by delegation. You are still taking care of patients whether you are taking care of 8 patients by yourself or taking care of 100 by delegating their care.

So, physicians who are too busy to go into politics can only see so many patients by themselves, but may take care of 1,000s if they say, kick DNPs to the curb...if you think they are providing inadequate care and harming patients..

(4) It may be an excuse for you...but not everyone is lying about their work load to politely excuse themselves from politics.

Hopefully this is now answered. If not, talk to Blue Dog. By the way, I hate politics and do not want to have anything to do with it except vote. I can afford to lie back though because of the powerful nursing lobby. Many years ago, I did take one of the most powerful senators in Mississippi to lunch to discuss some health care issues, but that's been it.

Now that I'm going to make myself useful and start working, I'll be weaning myself off public forums. Don't want patients tracking me down.

 

[danielmd06]

I'll make this sweeping generalization that we probably all agree on. A large group of people called nurses are very powerful in politics. A large group called physicians are less powerful. What I trying to say is one group here on SDN, for the most part, are just complaining. Who's leading this pack?


A generalization about two lobbies and their relative strengths is very different than making a sweeping comment about an entire group of people (physicians) and their work ethic. Do you really not see the difference? Do you really not see how that might be construed as inflammatory? If not, then I really don't know what else to add. I guess "You don't get it and probably never will."

I'm certainly not leading a pack of complainers. I'm not leading anything, and I'm not complaining. I'm defending physicians and how we're perceived. Isn't that what you're implying more physicians should do?

You can take care of many more patients by delegation. You are still taking care of patients whether you are taking care of 8 patients by yourself or taking care of 100 by delegating their care.

Sure. But is delegation really better for the patient? Why not increase the numbers of doctors and refuse to sacrifice quality of care for vulnerable patients?

So, physicians who are too busy to go into politics can only see so many patients by themselves, but may take care of 1,000s if they say, kick DNPs to the curb...if you think they are providing inadequate care and harming patients..

You're misunderstanding me. I don't think nurse practicioners are providing inadequate care or harming patients...as long as they are supervised. They are trained to be supervised after all, right? How is holding true to that vision "kicking them to the curb?" As I said before, if you want to work in a supervised capacity, do advanced nursing or be a physician's assistant. If you want to work in an unsupervised capacity, go to medical school.

And I'm not interested in for advocating a system that decreases my work load if it potentially harms patients...no matter how much time it gives me to dedicate to politics.

I can afford to lie back though because of the powerful nursing lobby.

Just because nurses have a lobby doesn't mean these entities will do what's right for the majority of patients. They'll just do what's right for the best interests of some of the people they represent...like oil companies and tobacco companies. I'm advocating for the patients here, the nursing lobby is only advocating for a sub-section of the nursing force.

One thing we agree on is that I do think more physicians should get involved in politics.

 

[altap]

It's funny to say the least that emedpa is claiming to be training residents. It could be true, because the word "training" could be interpreted differently depending upon someone's point of view. As I said I applaud emedpa (or any healthcare worker) for working in rural America but if I were a patient I still would like to be seen by a physician (resident or attending).

 

[altap]

IMHO, physicians as a grp and individually should get more involved in politics. Politics determines every aspect of our (physicians and patients) lives.

 

[altap]

I forgot to reply to emedpa's assertion that it would be inappropriate or illegal for a resident physician to be supervising a PA. From what I know (correct me if I'm wrong), a PA is a midlevel, so how could it be illegal or inappropriate for a moonlighting resident physician to be supervising a midlevel?

 

[deleted6669]

I forgot to reply to emedpa's assertion that it would be inappropriate or illegal for a resident physician to be supervising a PA. From what I know (correct me if I'm wrong), a PA is a midlevel, so how could it be illegal or inappropriate for a moonlighting resident physician to be supervising a midlevel?

there are legal requirements in place for what a supervisor must do/be.
for starters they need to be board certified physicians in good standing with their state medical board...which a resident by definition is not as they have not yet completed their training.
at my last job I was a formal preceptor of record for fp residents in em. I wrote their eval, my sp was the residency director and he assigned all the interns a 1 month em rotation with me or one of the other pa's which focused on em procedures but included other issues as well. at my current job it's more informal but it's still teaching (mostly procedural). the interns are assigned to an area of the ed staffed by a pa and they run cases by us and we precept them on procedures. I still sign their charts but the formal eval is written by one of the docs after getting input from us(as they often have minimal interaction with the resident)..

 

[zenman]

I'll make this sweeping generalization that we probably all agree on. A large group of people called nurses are very powerful in politics. A large group called physicians are less powerful. What I trying to say is one group here on SDN, for the most part, are just complaining. Who's leading this pack?


A generalization about two lobbies and their relative strengths is very different than making a sweeping comment about an entire group of people (physicians) and their work ethic. Do you really not see the difference? Do you really not see how that might be construed as inflammatory? If not, then I really don't know what else to add. I guess "You don't get it and probably never will."

I'm certainly not leading a pack of complainers. I'm not leading anything, and I'm not complaining. I'm defending physicians and how we're perceived. Isn't that what you're implying more physicians should do?

Yes, yes, yes. I was never talking about work load, work ethics, etc.

You can take care of many more patients by delegation. You are still taking care of patients whether you are taking care of 8 patients by yourself or taking care of 100 by delegating their care.

Sure. But is delegation really better for the patient? Why not increase the numbers of doctors and refuse to sacrifice quality of care for vulnerable patients?

I merely provided an example of how one can take care of more patients if they feel they are not getting adequate care...change the health care arena.

One thing we agree on is that I do think more physicians should get involved in politics.

Now you have it

Now I can go...

 

[Instatewaiter]

I don't look silly at all. You don't get it and probably never will, especially since you think I was making an inflammatory statement. The fact that most doctors don't have time is just an excuse. Yes, it's great you're taking care of patients and I applaud you for that. It's also one reason physicians have been run over by others and all they do is complain and go take care of their patients, with the exception of a few in politics trying to make a difference for their profession. I'm just giving you free advice. Do what you want with it.

The fact that most doctors don't have time is an excuse? You are insinuating that nurses work equally hard? What are you smoking? I am not trying to be argumentative but just based on hours, docs on average work nearly 2x as many hours.

At my hospital, the nurses work 3 twelve hour shifts per week. That's 36 hours a week... I mean hell, 6 days ago I worked a call where I worked more hours straight than the nurses do in a week.

there are legal requirements in place for what a supervisor must do/be.
for starters they need to be board certified physicians in good standing with their state medical board...which a resident by definition is not as they have not yet completed their training.
at my last job I was a formal preceptor of record for fp residents in em. I wrote their eval, my sp was the residency director and he assigned all the interns a 1 month em rotation with me or one of the other pa's which focused on em procedures but included other issues as well. at my current job it's more informal but it's still teaching (mostly procedural). the interns are assigned to an area of the ed staffed by a pa and they run cases by us and we precept them on procedures. I still sign their charts but the formal eval is written by one of the docs after getting input from us(as they often have minimal interaction with the resident)..

First off, an intern is NOT the same as a resident.

If a resident has taken step 3, they would be eligible for being board certified... otherwise they wouldn't be allowed to moonlight. Almost every moonlighting location requires you to be board certified (at least here in Va/Md but perhaps it is different in the sticks). So again, you were supervising interns which i don't find anything wrong with, especailly if they are not EM interns.

 

[zenman]

The fact that most doctors don't have time is an excuse? You are insinuating that nurses work equally hard? What are you smoking? I am not trying to be argumentative but just based on hours, docs on average work nearly 2x as many hours.

At my hospital, the nurses work 3 twelve hour shifts per week. That's 36 hours a week... I mean hell, 6 days ago I worked a call where I worked more hours straight than the nurses do in a week.

I guess your sleep deprived brain is why you don't realize I'm in no way talking about work hours or ethics, only that one group is politically powerful and the other isn't. Don't worry about it.

 

[princekc]

The fact that most doctors don't have time is an excuse? You are insinuating that nurses work equally hard? What are you smoking? I am not trying to be argumentative but just based on hours, docs on average work nearly 2x as many hours.

At my hospital, the nurses work 3 twelve hour shifts per week. That's 36 hours a week... I mean hell, 6 days ago I worked a call where I worked more hours straight than the nurses do in a week.



First off, an intern is NOT the same as a resident.

If a resident has taken step 3, they would be eligible for being board certified... otherwise they wouldn't be allowed to moonlight. Almost every moonlighting location requires you to be board certified (at least here in Va/Md but perhaps it is different in the sticks). So again, you were supervising interns which i don't find anything wrong with, especailly if they are not EM interns.

...In reference to emedpa post..what he meant is that to provide supervision, an MD/DO must complete a residency training, be board certified, State license & in good standing etc etc....

And yes, a resident can't supervise a PA (legally speaking). Furthermore, an experienced ER-PA often time supervised intern & resident and sign-off their chart if necessary.

 

[altap]

IMHO, a PA or any midlevel just lacks the foundation to be training any intern or resident (this is not to put down any profession). Why? Because a midlevel didn't go to med. school. The better educated should be training the lesser educated, not the other way around.

 

[princekc]

IMHO, a PA or any midlevel just lacks the foundation to be training any intern or resident (this is not to put down any profession). Why? Because a midlevel didn't go to med. school. The better educated should be training the lesser educated, not the other way around.

....A PA assist in the training process of an intern/resident. Does that make you feel better now?

 

[bradt9881]

It's funny how worked up people like Altap get when they find out a PA might be teaching something of value to a medical student/intern/resident. God forbid they might learn something useful!

 

[VA Hopeful Dr]

It's funny how worked up people like Altap get when they find out a PA might be teaching something of value to a medical student/intern/resident. God forbid they might learn something useful!

Its not that we think y'all don't have things to teach us. Heck, emedpa knows more about EM than I likely ever will. I think its more of the mindset that doctors should be teaching doctors.

That said, most of my fellow residents don't mind learning from PAs. Since y'all are more frequently in specialty practices us family residents actually can learn a fair bit from you.

 

[prairiedog]

It's funny to say the least that emedpa is claiming to be training residents. It could be true, because the word "training" could be interpreted differently depending upon someone's point of view. As I said I applaud emedpa (or any healthcare worker) for working in rural America but if I were a patient I still would like to be seen by a physician (resident or attending).

Not me, give me the provider of 25 years in the ED versus the FP MD who is picking up hours on the side. No brainer!

 

[TTPHUS]

PAs are cool, NPs suck

Now on to the point at hand. What can we do about these nurses trying to be doctors? I hate to just sit here and do nothing...

+ 1 .
Who usually hires NPs ? Well that would be a start . Additionally , you can :

1.You can contact your elected officials . Most of them have an online form where you can express your concern .
2.Write to as many state medical boards as possible .
3.Express your concern to AMA
4.Write an op/ed piece in your local paper .
5.Make a youtube video
6.Make a webpage specfically for this issue .
7.Raise awareness with local amsa groups .

This nonsense has to stop .