Military creates new "doctoral" residency program for PAs

[Tired]

Many of the programs require a lot of the same classes, if not all of the same classes, as medical school.

At some point the allied health professions will realize that very little of our education comes from medical school. If anything, our classes prepare us for our real education.

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[alpha62]

Pointless argument.

I work with some PA's in the Emergency Room and let me tell ya, they all want to be doctors and every one of them were pre-med but didn't have the academic ability to get into medical school (applied and didn't get in). They all b!tch about how the state I am in won't give them independent prescription rights and they always act like they know just as much as the MD's (one of them insisted the respiratory tech to use nebs because the patient was wheezing - yeah he had CHF exacerbation, genius). We MD and MD students are "nice" to the PA's mostly because we should be - it would be immature to be mean to people we work with but deep inside, most of us know you want our turf and the ones we love to be with and respect are few and far between.

I know my n=only a few but that's what I know.

Hilary Clinton wants your " turf " Keep investing in a Medical Degree. When you're sucked into the socialist system this baby boomer generation is about ready to drop on us, you'd better hope they pass a $200,000 student loan forgiveness package along with it.

 

[funkless]

At some point the allied health professions will realize that very little of our education comes from medical school. If anything, our classes prepare us for our real education.

Speak for yourself. I can diagnose and treat any medicine-service patient you put in front of me.

 

[MacGyver]

Speak for yourself. I can diagnose and treat any medicine-service patient you put in front of me.

Sounds like somebody is ready to join the House MD team.

 

[OTD]

This is somewhat confusing to me. A great deal of the PA programs I have looked at - and the one at my school - are just as difficult to get into as medical school, with the added requirement that one have hands on medical experience. Many of the programs require a lot of the same classes, if not all of the same classes, as medical school. Most of the undergrads I know want to go to PA school because they don't want to take on the years of education, but for the most part they are academically able.

Actually no, they are not the same in competitiveness, not even close.

The class requirements the same? Not on your life. You can get into PA school with a 4.0 after 2 years of undergrad. You can't get into med school with that and yes med school requires some hands on medical experience as well. That's not even counting the difference in level of difficulty in the classes after you are in school.

PA school is competitive but it's not even close to getting into medical school. You're talking the difference in playing College football and Pro football.

 

[ForbiddenComma]

Speak for yourself. I can diagnose and treat any medicine-service patient you put in front of me.

 

[funkless]

Sounds like somebody is ready to join the House MD team.

Did I mention I can run a four-minute mile and speak every language known to man?

(Hope you didn't take that first post without its sarcasm.)

 

[DocNusum]

On one hand we have med students (most haven't even memorized a complete ROS, completed a H&P, sutured a laceration, or done a Pap... yet) without the knowledge of medicine in a non-academic setting ringing the alarm bells...

What happened here... did a PA student on your rotation "out-pimp" you...??? Did the PA-C at the hospital demonstrate a command of medical priciples that illuminated your inexperience...???
What's the source of the hate...???

On the other hand we have PA-Cs that sharpshoot other professions (NPs/DNPs) every chance they get... but get their "panties in a bunch" when the PA profession is questioned...

I find it hilarious to read some of these posts by PAs (who have nothing but negativity towards NPs and the DNP degree) defending this DscPA degree... or any percieved need of a profession to direct itself without interference from outside (AMA/MD/DO/NP) organizations with their own personal/professional agenda...

Its also interesting that a person currently in school (in ANY field!!!)seeking a doctorate would discount the need for one (in ANY field!!!)... or that this person would be assinine enough to even have an opinion on the validity of anothers educational process...

It appears to me that the med students here are basically saying: The concept of "mid-levels" should be abolished or at least limited in their educational pursuits to a Masters degree (No doctorates!!!). It is ok for those "mid-levels" to be "doctors little helper" but if they start THINKING on their own and try to direct their profession... then its time to shut them down.. and the PAs are saying: PAs should be allowed to get doctorates (Limited to Health Science, or Ed, or any other "traditional" doctorate but NO PA specific doctorates), but NPs should not be allowed to develop a nursing specific doctorate.

Its ALL really silly when you step back... and look at the fact that all this distills down to one profession attempting to dictate the growth and direction of another equally viable, valuable and valid profession

DocNusum

btw... The patient just wants someone to take care of them...

 

[OTD]

one profession attempting to dictate the growth and direction of another equally viable, valuable and valid profession

DocNusum

btw... The patient just wants someone to take care of them...

While this PC jargon sounds good it's not accurate.

There is one person who's @$$ is on the line and that is the one in charge of the "health care team". That's the doctor. They are not equally viable, valuable or valid nor equally liable. That's just life.

 

[mig26x]

LOL at the thought that getting into PA school is the same in term of competitiveness as med school!! wow!!

 

[Tired]

On one hand we have med students (most haven't even memorized a complete ROS, completed a H&P, sutured a laceration, or done a Pap... yet) without the knowledge of medicine in a non-academic setting ringing the alarm bells...

What happened here... did a PA student on your rotation "out-pimp" you...??? Did the PA-C at the hospital demonstrate a command of medical priciples that illuminated your inexperience...???
What's the source of the hate...???

On the other hand we have PA-Cs that sharpshoot other professions (NPs/DNPs) every chance they get... but get their "panties in a bunch" when the PA profession is questioned...

I find it hilarious to read some of these posts by PAs (who have nothing but negativity towards NPs and the DNP degree) defending this DscPA degree... or any percieved need of a profession to direct itself without interference from outside (AMA/MD/DO/NP) organizations with their own personal/professional agenda...

Its also interesting that a person currently in school (in ANY field!!!)seeking a doctorate would discount the need for one (in ANY field!!!)... or that this person would be assinine enough to even have an opinion on the validity of anothers educational process...

It appears to me that the med students here are basically saying: The concept of "mid-levels" should be abolished or at least limited in their educational pursuits to a Masters degree (No doctorates!!!). It is ok for those "mid-levels" to be "doctors little helper" but if they start THINKING on their own and try to direct their profession... then its time to shut them down.. and the PAs are saying: PAs should be allowed to get doctorates (Limited to Health Science, or Ed, or any other "traditional" doctorate but NO PA specific doctorates), but NPs should not be allowed to develop a nursing specific doctorate.

Its ALL really silly when you step back... and look at the fact that all this distills down to one profession attempting to dictate the growth and direction of another equally viable, valuable and valid profession

DocNusum

btw... The patient just wants someone to take care of them...

Wait, just read your sig. Are you corpsman, or a real doctor?

 

[DocNusum]

While this PC jargon sounds good it's not accurate.

There is one person who's @$$ is on the line and that is the one in charge of the "health care team". That's the doctor. They are not equally viable, valuable or valid nor equally liable. That's just life.

WRONG...!!!

EVERY person on this "team" has a license and livelyhood to lose...
If the "mid-level" gets burnt (name in the NPDB)... this results in being considered "non-employable"... the physician is still employable... but their insurance premium simply increases.

Also

They are not equally viable, valuable or valid nor equally liable.

This is sheer STUPIDITY...
If everyone else (RNs, PTs, RTs, RTTs, Lab Techs, Phelbs, CNAs, CSTs, Dieticians, etc) on the "healthcare team" left the hospital and clinics everywhere... except the physicians... ALL OF THE PATIENTS WOULD DIE... silly.

The care we give is supposed to be "patient centered"... NOT physician centric...

 

[DocNusum]

Wait, just read your sig. Are you corpsman, or a real doctor?

What is a "real doctor"...???
DocNusum, FNP, PA-C
Former 91b2p
Beeotch!!!

20 years in clinical medicine

 

[MacGyver]

What is a "real doctor"...???
DocNusum, FNP, PA-C
Former 91b2p
Beeotch!!!

20 years in clinical medicine

DocNusaince obviously believes that working in a clinical sector is the same thing as completing residency and having competency to work as a full fledged MD. According to that logic, RNs with 20 years experience should get an MD automatically.

 

[MacGyver]

This is sheer STUPIDITY...
If everyone else (RNs, PTs, RTs, RTTs, Lab Techs, Phelbs, CNAs, CSTs, Dieticians, etc) on the "healthcare team" left the hospital and clinics everywhere... except the physicians... ALL OF THE PATIENTS WOULD DIE... silly.

The care we give is supposed to be "patient centered"... NOT physician centric...

Oh please. If all those people left today, doctors could fill their jobs A LOT easier tahn if the docs all left the hospital and all the techs had to fill in. There was a time in american healthcare when doctors did most of those allied health jobs as well.

The only reason we dont do them now is because we make a lot more money doing other stuff. Its not because we couldnt do it.

 

[MacGyver]

On one hand we have med students (most haven't even memorized a complete ROS, completed a H&P, sutured a laceration, or done a Pap... yet) without the knowledge of medicine in a non-academic setting ringing the alarm bells...

What happened here... did a PA student on your rotation "out-pimp" you...??? Did the PA-C at the hospital demonstrate a command of medical priciples that illuminated your inexperience...???
What's the source of the hate...???

On the other hand we have PA-Cs that sharpshoot other professions (NPs/DNPs) every chance they get... but get their "panties in a bunch" when the PA profession is questioned...

I find it hilarious to read some of these posts by PAs (who have nothing but negativity towards NPs and the DNP degree) defending this DscPA degree... or any percieved need of a profession to direct itself without interference from outside (AMA/MD/DO/NP) organizations with their own personal/professional agenda...

Its also interesting that a person currently in school (in ANY field!!!)seeking a doctorate would discount the need for one (in ANY field!!!)... or that this person would be assinine enough to even have an opinion on the validity of anothers educational process...

It appears to me that the med students here are basically saying: The concept of "mid-levels" should be abolished or at least limited in their educational pursuits to a Masters degree (No doctorates!!!). It is ok for those "mid-levels" to be "doctors little helper" but if they start THINKING on their own and try to direct their profession... then its time to shut them down.. and the PAs are saying: PAs should be allowed to get doctorates (Limited to Health Science, or Ed, or any other "traditional" doctorate but NO PA specific doctorates), but NPs should not be allowed to develop a nursing specific doctorate.

Its ALL really silly when you step back... and look at the fact that all this distills down to one profession attempting to dictate the growth and direction of another equally viable, valuable and valid profession

DocNusum

btw... The patient just wants someone to take care of them...

Dont be fooled by this joker. He posts under the name CONTRARIAN at the PA forums. He thinks PAs are equivalents to MDs right now with no extra training. Here's one of his posts from that board:

Excluding residency (basically a new jOB for PA-C new grads)... 3 semesters of science (then 3 semesters of clinical with VACATION BREAKS and the last year is mostly about the "match"...) is all that MDs/DOs get in their training...

If U.S physician schools decided tomorrow (they can do this since the "fairy" magically made their training a doctorate)... to REQUIRE that USMLE core science classes be completed BEFORE being admitted (like a few other countries) MD/DO school would only be 3 SEMESTERS...!!!!!

He wants us to believe that a PA who works in a job for a while is the same thing as completing an MD residency program! What a joke!

Seriously for those MDs on this board who think these PAs are "good guys" and willing to work under us, pleaes go read their comments on the PA forums. Thats where their true colors come out, and just about all of them think they are equivalent to MDs already.

 

[alpha62]

You all are kidding yourselves..... You all work for Nurses and some welfare-to-work clown in a cubicle at the insurance company. Your egos (both MD and PA) are what they're counting on to screw yourselves with.

I'm a PA and I don't really care what anybody thinks and nobody should assume they know what I think . I take my check and I go home. I've got a life and family, the job and work is a four letter word I put up with.

 

[ForbiddenComma]

This is sheer STUPIDITY...
If everyone else (RNs, PTs, RTs, RTTs, Lab Techs, Phelbs, CNAs, CSTs, Dieticians, etc) on the "healthcare team" left the hospital and clinics everywhere... except the physicians... ALL OF THE PATIENTS WOULD DIE... silly.

And if the janitors went on strike, the hospital would be screwed. Probably a lot more screwed than if the NPs went on strike, or the RTs, or (lol) the Dieticians.

Perhaps that means we should require a Doctorate of Custodial Engineering from now on?

What's that? You think that would be silly? What kind of elitist, arrogant pig are you, denying the growth of an equally valid profession?

 

[OTD]

WRONG...!!!

EVERY person on this "team" has a license and livelyhood to lose...
If the "mid-level" gets burnt (name in the NPDB)... this results in being considered "non-employable"... the physician is still employable... but their insurance premium simply increases.

Also



This is sheer STUPIDITY...
If everyone else (RNs, PTs, RTs, RTTs, Lab Techs, Phelbs, CNAs, CSTs, Dieticians, etc) on the "healthcare team" left the hospital and clinics everywhere... except the physicians... ALL OF THE PATIENTS WOULD DIE... silly.

The care we give is supposed to be "patient centered"... NOT physician centric...

No, you would be the one that is wrong. The one that takes the fall is the boss, that would be the doctor. The rest would say "I was just following orders" or "I was depending on the doctor to understand the gravity of the situation". The only time anyone below a doctor has to worry about anything is if they do something WITHOUT an order or something completely asinine like unplugging the vent to sweep up.

As for the patients dying, not true. I can start my own IV's and give my own meds, do it all the time. The nurses can't start central lines or take out gallbladders. I can do my own burr hole, the neurosurgery PA who is very good at neurosurgery wouldn't be able to perform a DPL or XLap. I can write my own abx for community aquired pneumonia, the NP won't be able to treat an empyema but I can.

Sorry just as in every other thing we are not equal just because we happen to be good people and upstanding human beings. If the tables were turned I couldn't fix my car, I don't have the skill set. In that setting the trained mechanic would be much more important than me, who can do a pretty good job of a tuneup/timeing etc but really knowing what I am doing and actually fixing a significant problem is out and I would have to yield to the experts.

We are all human beings with different skill sets. The only thing we are equal in is being human, there are varying degrees of importance/validity/need/ and liability/responsibility depending on the job we do/skill sets we possess. That's just life.

 

[DocNusum]

OTD... thats cool.. I agree with most (>90%) of what you wrote..
But my 3 million/6 million malpractice insurance... and actual malpractice cases say otherwise in that 10%.

Where we disagree is that the physician carries all the responsibility. Everyone with a license to "practice medicine" will be held to the "standard of care."

Now if you are saying that the physician carries more liability because now this physician will be held liable for the acts or ommissions of Two providers (Physician and Mid-level) versus one (Physician or Midlevel)... then we agree.

Physician's action/inaction results in poor outcome... Physician is liable, Hospital may be liable, Mid-level NOT liable
Mid-Level's action/inaction results in poor outcome... Physician is liable, Hospital may be liable, Mid-level is liable

 

[OTD]

Good points and it appears we do agree.

 

[Tired]

What is a "real doctor"...???
DocNusum, FNP, PA-C

Not you.

 

[beasleys]

I'm a PA and I don't really care what anybody thinks and nobody should assume they know what I think . I take my check and I go home. I've got a life and family, the job and work is a four letter word I put up with.

Maybe that is the biggest difference between you and a doctor, yes? More than the title? Is your attitude?

 

[DocNusum]

Not you.

DocNusum wants to warn you about Kool-Aid:

1. There are many varieties of Kool-Aid.
2. Not all Kool-Aid is Kool-Aid.
3. Don't drink the Kool-Aid unless it was made by your mom.
4. If you are really, really thirsty or you don't trust your mom, go ahead and drink the Kool-Aid, but don't be surprised if you end up really ****ing high, diabetic, or dead.

http://en.wikipedia.org/wiki/Kool-Aid

DocNusum

btw... The patient just wants someone to take care of them...
__________________
"Doc" is the name called in the middle of the night when the tracers are hot and you catch one...
"Doc" is the name called in the middle of the night when the chute malfunctions, or you do a bogus PLF....
"Doc" is the name called when the "jimmy" don't look/feel quite right...
"Doc" is the title "Given" to the person you want standing right next to you should any of the above occur...

"Doc" in Nusum was Given... earned!
20 years "takin care of People"

 

[ForbiddenComma]

btw... The patient just wants someone to take care of them...

Well... actually, they want someone good to take care of them... I know, details, details.

 

[Blade28]

Hey everyone, just a quick reminder to keep discussion and conversation civil in here. The "MD/DO vs. PA" topic is a hotly-debated one, and one that often degenerates into flamewars, so let's all try to maintain professionalism.

Thanks.

 

[DocNusum]

Well... actually, they want someone good to take care of them... I know, details, details.

How would you know the "details, details, details"...???
At this point in your "training"... you have NO idea what its like to "care" for patients.
If you had any shred of "integrity"... you would admit that... its been less than a year since you memorized what S/P NQWMI and ROS is... and what they mean...

What your inexperience denies you is... the FACT that the general/lay public has NO conception of the "Standard of Care," nor the "Gold Standard" in/of medicine. "Good" to them... is simply a fast, non-complicated cure with the least amount of iatrogenic effects, mis-steps, and delay... and is derived from the least amount of effort on their part. The fact that there are numerous high dollar jury awards for "frivolous" $hit happens law-suits against MDs/DOs, and RARELY PAs and NPs bears this out...

What your young "idyllic," inexperienced, egotistical mind doesn't get is...
Regardless of how much WE (MDs/DOs/PAs/NPs)... as "providers" fight about what YOU perceive as asserting YOUR "dominance" and YOUR turf...

The Gen Pop just wants someone to take care of them...

The patient could care less about the rest of the BS.

Grow up kid... and stay away from the kool-aid...

DocNusum

 

[DocNusum]

Dont be fooled by this joker. He posts under the name CONTRARIAN at the PA forums. He thinks PAs are equivalents to MDs right now with no extra training. Here's one of his posts from that board:

Excluding residency (basically a new jOB for PA-C new grads)... 3 semesters of science (then 3 semesters of clinical with VACATION BREAKS and the last year is mostly about the "match"...) is all that MDs/DOs get in their training...

If U.S physician schools decided tomorrow (they can do this since the "fairy" magically made their training a doctorate)... to REQUIRE that USMLE core science classes be completed BEFORE being admitted (like a few other countries) MD/DO school would only be 3 SEMESTERS...!!!!!

He wants us to believe that a PA who works in a job for a while is the same thing as completing an MD residency program! What a joke!

Seriously for those MDs on this board who think these PAs are "good guys" and willing to work under us, pleaes go read their comments on the PA forums. Thats where their true colors come out, and just about all of them think they are equivalent to MDs already.

Your "intellectual integrity" is lacking...
Why did YOU edit/exclude this part of YOUR quote:

To be clear...

I AM NOT discounting the MD/DO preparational process...
I'm just "questioning"... Why it seems to be the ONLY one we accept at "face value"...

Here is the ENTIRE post...(contextual)...

Are we "keeping up with the Jones'...
Why do we care what the Nurses are doing...???

Why NOT focus this concern on our profession...???

Why not "clean our house" before we get fixated on others...???

Excluding residency (basically a new jOB for PA-C new grads)... 3 semesters of science (then 3 semesters of clinical with VACATION BREAKS and the last year is mostly about the "match"...) is all that MDs/DOs get in their training...

If U.S physician schools decided tomorrow (they can do this since the "fairy" magically made their training a doctorate)... to REQUIRE that USMLE core science classes be completed BEFORE being admitted (like a few other countries) MD/DO school would only be 3 SEMESTERS...!!!!!

To be clear...

I AM NOT discounting the MD/DO preparational process...
I'm just "questioning"... Why it seems to be the ONLY one we accept at "face value"...

This post was simply me questioning the practice of ONLY accepting the U.S. system as valid...

 

[Frijolero]

snip

What your inexperience denies you is... the FACT that the general/lay public has NO conception of the "Standard of Care," nor the "Gold Standard" in/of medicine. "Good" to them... is simply a fast, non-complicated cure with the least amount of iatrogenic effects, mis-steps, and delay... and is derived from the least amount of effort on their part. The fact that there are numerous high dollar jury awards for "frivolous" $hit happens law-suits against MDs/DOs, and RARELY PAs and NPs bears this out...

sniiiiip

DocNusum

Man, that is some fantastic logic. Remember this?

Physician's action/inaction results in poor outcome... Physician is liable, Hospital may be liable, Mid-level NOT liable
Mid-Level's action/inaction results in poor outcome... Physician is liable, Hospital may be liable, Mid-level is liable

Physicians get sued more often because they have more responsibility, period. Responsibility that includes the mistakes of mid-levels in addition to their own. Nothing is "born out" by that fact.

 

[MacGyver]

If I have to listen to one more PA come out with the tired mantra of "look at us, we want to help MDs, we're not competitors, we dont want independence" I'm going to throw up.

Its very simple guys. Go over to physicianassistantforum.com and read what they are talking about behind closed doors that they dont want MDs to know about. You will find literally dozens of posts about eventually becoming independent, PAs are equal to MDs, etc.

And lookie here, some of our very own SDN PAs are saying very different things on the PA forum that they are lying about on here. Here's a couple of examples:

http://www.physicianassistantforum.com/forums/showthread.php?t=12964&page=3

What this means is that we need to focus our efforts in two areas. One is to make our employment as painless as possible. Loosening supervision rules.....
David Carpenter, PA-C

Perception is more important than reality (in the eyes of the public). NPs at this time in history have an upper hand on PAs. In the next decade, PAs will clearly be considered as a tier beneath NPs . . . unless we wake up. Some laws (like the Family Medical Act) state that now (saying that PAs can be supervised by an MD, DO or NP). Over and over you read job descriptions, other descriptions that talk about NPs have "independence" and "masters" degree and PAs being "dependent" and a "college degree is not required."

This is a public image problem and not a problem of our training (often I think we are better trained . . . but it's not going to matter in decade).

The nurses have been aggressive in promoting their profession, not taking crap from anyone while the PA leadership has often had their heads in the sand.

I hope that it changes. We need, 1) name change, 2) masters required and 3) seek some form of independence. It is not that independence would make us better PAs or really be that practical for most, but it would communicate to the public (including hospitals, doctors and patients) that we are NOT inferior products.

So, we can scratch our heads over a 3 semester NP program, but they eat our shorts in the end if we don't take come courageous changes. But may PAs will be satisfied being on a lower tier. I'm not sure why.

I detect an undercurrent here, thought, that the specialty PA seeing the patient is inferior care, when reading " Offering the patient a choice of "MD A vs MD B" is PROFOUNDLY DIFFERENT than offering the patient a choice of "PA vs MD" which is why I said its not an apt comparison."

I don't see why the comparison is so inappropriate. I will grant that it is difficult in a political climate like Contrarian's....but let's not make the leap that the PA has less to offer than the physician. If you look at a practice like Mike Jones' (Headache specialist, frequent poster here), it's clear that the PA has as much if not more to offer than physicians in a similar discipline.

There's a misplaced sensibility of the patient's part if they are arranged to see a specialist and they cry foul over seeing a PA in the practice, which sells us all short as PAs.....

And Mike Jones is an example, not commonplace, but demonstrative of the abilities of specialty PAs. I don't want to misquote him but he has stated in the past that there have been multiple pt encounters where he had more to offer than his neurology counterparts.

Read that line very carefully. AndersenPA, the poster who made that statement, is claiming that a PA working in neurology is EQUIVALENT to a full blown board certified MD neurologist.

You can spend all day finding quotes just like these, entire threads devoted to the subject of PAs being equal to MDs and how they deserve to be independent because they are scared of the DNPs.

I'll say this again, because very few people on this board seem to understand this.

Fundamental Truth #1 of Midlevel/Allied Health Personnel:

EVERY SINGLE MIDLEVEL/ALLIED HEALTH PROVIDER GROUP THAT HAS EVER EXISTED IN AMERICAN MEDICINE HAS SOUGHT TO GAIN INDEPENDENT PRACTICE. NOT JUST SOME OF THEM, OR HALF OF THEM. EVERY SINGLE ****ING ONE OF THEM.


Fundamental Truth #2 of Midlevel/Allied Health Personnel:

THERE HAS NEVER EXISTED A MIDLEVEL/ALLIED HEALTH GROUP THAT HAS NOT TRIED AND BEEN SUCCESSFUL TO VARYING DEGREES IN GETTING INDEPENDENCE.

Think about that very carefully and please try to refute it, because you cant. Then go over to the PA forums and browse some of their topics. They come over here as sheeps in wolves clothing.

 

[mig26x]

I will never hire a PA or RN to help with my job, I know they are trying to get independence from MD's. In the hospital where I work there's one PA that treat interns and residents like 1st year medical students and then when she's in trouble she expect us to help her. She even talked back to a 2nd year resident because she wasnt doing what the PA told her, guess what, the PA was wrong with the management of the patient!! LOL.

 

[anonodoc]

You were very detailed and descriptive on what you mean here and it helps. But your own argument backfires. Look, if the Army wanted to provide a means to promote PAs, they'd just...promote PAs. To say that the Army cannot decide to promote a PA because the PA doesn't have an advanced degree, which the Army requires for promotion is really silly. Really.

You have obviously never served in the military if you think simple reason applies. When it comes to promotions in ALL fields academic degrees mean everything. The PA's really can't compete in their promotion group as successfully, because the combat service officers who are making those decisions don't know a thing about the medical field. They look and see "oh, CPT so-and-so has a doctorate, but CPT otherperson doesn't, and they consider that accordingly. Bottom line is with out the degree the PA is disadvantaged. And no, I'm not a PA, I'm an MD who has been in the military.

And by the way, don't look now but military PAs have acted pretty damn independently for a long time now, and many of them are better "docs" than some MDs I know. Hell, Navy independent duty corpsman having been acting independently (hence the name) for decades. And the medical world has not ground to a halt, physicians still have jobs. I don't want the PAs job, and if in the civililan world calling them doc brought more in to do the scut work admissions, and frees me of that chore, then all the better.

Continue your rants. They are groundless, but amusing.

 

[Tired]

You have obviously never served in the military if you think simple reason applies. When it comes to promotions in ALL fields academic degrees mean everything. The PA's really can't compete in their promotion group as successfully, because the combat service officers who are making those decisions don't know a thing about the medical field. They look and see "oh, CPT so-and-so has a doctorate, but CPT otherperson doesn't, and they consider that accordingly. Bottom line is with out the degree the PA is disadvantaged. And no, I'm not a PA, I'm an MD who has been in the military.

If that's true, then you of all people should know that the promotion boards for the MSCs are not exclusively composed of line officers. The "ignorance of degrees" is silly. There are PAs on those boards.

If anything, the PAs are at a disadvantage simply because they are lumped in with every other MSC out there, rather than having their own cops. It's not a degree issue, it's a numbers issue.

 

[core0]

If that's true, then you of all people should know that the promotion boards for the MSCs are not exclusively composed of line officers. The "ignorance of degrees" is silly. There are PAs on those boards.

If anything, the PAs are at a disadvantage simply because they are lumped in with every other MSC out there, rather than having their own cops. It's not a degree issue, it's a numbers issue.

The problem is that of the three other specialties the PAs are competing with, two (OT and PT) are graduating at the doctorate level. This puts PAs at a competitive disadvantage with those specialties. The PA doctorate not only puts PAs on an equal footing but designates certain PAs for fast track similar to going to Naval Post Grad.

David Carpenter, PA-C

 

[Tired]

The problem is that of the three other specialties the PAs are competing with, two (OT and PT) are graduating at the doctorate level. This puts PAs at a competitive disadvantage with those specialties. The PA doctorate not only puts PAs on an equal footing but designates certain PAs for fast track similar to going to Naval Post Grad.

You really think that a doctorate is going to change the proportions of PAs vs Optometrists selected for the next rank? Unlikely in my mind. There are still only so many billets for PAs in a given rank range.

 

[anonodoc]

If that's true, then you of all people should know that the promotion boards for the MSCs are not exclusively composed of line officers. The "ignorance of degrees" is silly. There are PAs on those boards.

If anything, the PAs are at a disadvantage simply because they are lumped in with every other MSC out there, rather than having their own cops. It's not a degree issue, it's a numbers issue.

Unless something has changed PAs are not in the medical service corps group. They are in a fairly small group. And while they are certainly not only line officers, and there MIGHT be PAs sitting the board (there are not always representatives from each specialty on a particular board), each member of the board reviews the officer's record separately, and gives it a ranking, COMPLETELY INDEPENDENTLY of the other members of the board. They are not allowed to speak about the candidates. So even if one PA was sitting the board (and there certainly would not be more than one) the majority of the board is those with little understanding of the subtleties we are discussing. Unless you've sat a board you know not of what you speak.

 

[MacGyver]

I don't want the PAs job, and if in the civililan world calling them doc brought more in to do the scut work admissions, and frees me of that chore, then all the better.
.

Oh right, because the PAs with the same title as you will be perfectly happy with doing nothing but your scutwork.

Is that what the "Navy independent corpsmen" do?

 

[Tired]

Unless something has changed PAs are not in the medical service corps group. They are in a fairly small group. And while they are certainly not only line officers, and there MIGHT be PAs sitting the board (there are not always representatives from each specialty on a particular board), each member of the board reviews the officer's record separately, and gives it a ranking, COMPLETELY INDEPENDENTLY of the other members of the board. They are not allowed to speak about the candidates. So even if one PA was sitting the board (and there certainly would not be more than one) the majority of the board is those with little understanding of the subtleties we are discussing. Unless you've sat a board you know not of what you speak.

In the Navy, PAs are definetely MSC (and as far as I know, always have been), so your last line made me laugh.

Regardless of the ranking system, there still exists a discrete number of billets for PAs that must be filled by people at a certain rank. Therefore the number of promotions has to be relatively static based on those billets. Doctorate or no, they still need so many O2-O3 PAs to go here, O4-O5 PAs to go there, etc.

 

[core0]

In the Navy, PAs are definetely MSC (and as far as I know, always have been), so your last line made me laugh.

Regardless of the ranking system, there still exists a discrete number of billets for PAs that must be filled by people at a certain rank. Therefore the number of promotions has to be relatively static based on those billets. Doctorate or no, they still need so many O2-O3 PAs to go here, O4-O5 PAs to go there, etc.

The issue is more above the O4-O5 level. To be considered for any post grad residency you have to have at least 4-7 years of active duty time. The initial selectees at least are O3-O4 with a fair amount of combat time. Within the MSC there are a lot of billets that PAs could fill but haven't because of the current operational tempo. A doctorate makes them more competitive for these billets (or slots in the army) especially the joint command slots that are necessary for promotion above O6.

David Carpenter, PA-C

 

[anonodoc]

In the Navy, PAs are definetely MSC (and as far as I know, always have been), so your last line made me laugh.

In the Army, they're not MSC. You still don't know what you're talking about

 

[DiveMD]

This is somewhat confusing to me. A great deal of the PA programs I have looked at - and the one at my school - are just as difficult to get into as medical school, with the added requirement that one have hands on medical experience. Many of the programs require a lot of the same classes, if not all of the same classes, as medical school. Most of the undergrads I know want to go to PA school because they don't want to take on the years of education, but for the most part they are academically able.

Are the quality of the applicants and the scope of the education similar as well? NO! Minimum requirements are just that...minimum. Admission is not guaranteed unless you outperform the majority of the applicants. And trust me my friend; you’ll need more than the minimum requirements if you want to be accepted in med school.

 

[NMMI76]

The problem is that obviously there is a lot of MD bias in the "discussion" of this topic. MD's really do not deserve the "god-like" status that society has bestowed on them - too many are not competent and too many others prostitute themselves. Over the years, some of the best care that I have received has been from PAs and NP's - AND the instances of the worst care I have received has been from MD's (But to be thorough - I have also know some very exceptional MD's too). By the time I realized that I wanted to do Primary Care I had finished my BS and MA in another field and was serving as an MS officer in the Army. When I got out I didn't have the chance to go back to school - until last year. If I had more time and if most medical schools didn't have a bias against older students, I might be working toward getting in to medical school - but PA School or an NP program are better choices for me. Some years back, I predicted that PA's would eventually escalate their academic credentials to a Doctorate - like the NP's where then working towards. And like NP's - why shouldn't they be allowed to practice independently? Its a matter of preparation and competence - and on the whole, I have seen more incompetent physicians than PA's or NP's; mostly because they have the common sense to stay within their scope - whereas the physicians have been told soooo often that they are omnipotent by their PR machine, that they foolishly believe their own hype and extend themselves beyond what they know are their own limitations - and its their patients who end up paying the bill for the physicians' huberous. PA's and NP's are essential nowdays because most phsyicians don't want to do primary care - they want the big bucks from being specialists - the rates for specialists get inflated even though there is surplus of specialists - and a severe shortage of primary care; meanwhile there isn't enough primary care providers.

 

[NMMI76]

DScPAS ????? Frankly - at the Masters level and now the Doctoral level - "PA Studies" is really a ridiculous degree title - and it isn't even standardized, some schools give out other titles for the Masters degree of PA's. The PA's should get organized towards standardizing the degree name - particularly for Doctorates!!! AND BTW - "Doctor" as I'm sure most of you know is an ACADEMIC title so if an NP or a PA recieves an academic degree that is a doctorate - then they are entitled to be addressed as "Dr" and if the MDs get bent out of shape over it - the that is just too too bad because they do NOT own the title. Other healthcare providers with doctoral degrees are called "Dr" - but check their nametag and the it the DEGREE listed behind their name - so people are actually smart enough to know that there is a difference - the OD isn't going to treat something that isn't part of Optometry; and the PsyD isn't going to treat something outside of psychotherapy or counseling, nor the DPM isn't going to operate on somethinng other than their foot; and the DDS or DMD is going to mostly work on their teeth - although some do more and are the best for intricate Maxillofacial surgery. These specialists stay inside their scope - but as I said earlier, its the MDs who abuse their position. Legally they have set things up so that only their degree and a state license to "practice medicine" is required - but that doesn't mean that they actually have the skills; I know of people who were screwed over by expert opinions" from MDs representing themselves as a particular type of specialist, but they can legally call themselves that even if they have had no specialist training in the field, nor have done the appropriate residency, let alone that they do not have a board certification in that field. For example - someone who had to submit to an "independent medical exam" for a disabling injury; the MD (FMG in this one case . . . . with a Moscow accent so thick it was unintelligable) represented himself as both a Neurologist and Rheumatoloigst (as required by the insurance company's rules) yet he obviously didn't know what he was doing - it was later discovered that he had no training in either, no certification in either field - the only board certification he held was as an allergist . . . . now you tell me what specific training he had involving intricate neurological and rheumatological disesases that qualified an allergist to render an "expert opinion" which coincidentally supported the exact position held by the workers comp insurance company . . . . and which denied benefits to the injured worker . . . . what it actually was constituted Medical Fraud !!!!! But getting back to the universal MD's position that only MD's are really qualified to call themselves "Dr" and that it takes an MD to practice medicine (most DO's aren't that egotistical) Let us compare . . . . despite the idiocy of their government's socialized medicine system, British physicians in general are superbly trained . . . . what degree to they hold????? well, most have an MB (or BM) which is a Medical Baccalaureate - a Bachelor's degree !!!!!! In the British Commonwealth, the first medical degree is a bachelors, the MD / Medical Doctorate is an advanced research and teaching degree (and where being addressed as "Mr" instead of "Dr" is a higher title . . . but that's like a flashlight is a "torch" - a car trunk is a "boot" and a cigarette is a "***" . . . . and an MB is called doctor because of centuries of language that equated doctor with physician - other academic doctorates were called "Professor" . . . . . . . So, if the person treating me is called "Dr" and the initals after their name are DNP or DNSc or DScPA (or let me suggest to the PAs that they use DScPM for Doctor of Science in Medical Practice or DscM for Doctor of Science in Medicine or even DScP for Doctor of Science Physician - because if they have a doctoral degree and are independent, then they aren't Physican Assistants any longer - they are physicians of a very particular type !!!!!!) And if the MDE's don't like that - they maybe they can get their professional society (re: "union" or "trade guild" to loosen up those artifical restrictions on Medical Schools that keep them from increasing enrollments - since keeping the population of physicians low, increases demand and surprisingly results in higher wages/profits for the physicians that there are . . . . . . Imagine that!

 

[Kubed]

.... Can't... follow... insane... ramblings....

....must lay down....

 

[NMMI76]

Oh and I see some other med student "self-appoijnted expert" is talking out of his rectal orifice about which branch PAs must only be assigned to in the various Armed Forces - because of a sigle obsevation limited to how just one service does it . . . . . Well, the Medical Department of each service is organized how each service finds it most efficient for that service - specialties other than the "big three" Physicians-Nurses-Dentists are herded together into organizations designed originally by . . . . .. the Physicians, that guarantee a "lesser stature" to anyone not a physician . . . . . But on the immediate case of PAs :
in Navy they are MSC or Medical Service Corps (the Navy only has 4 medical branches - MC, NC, DC for the "big three" and everything else is in the MSC); in the Air Force, PAs are BSC or Biomedical Science Corps; and in the Army they are AMSC or Army Medical Specialist Corps, AMSC is not to be confused with MSC or Medical Service Corps - although the organization is not totally logical - the MSC has two arms, 67-series which is administrative support specialties and the 68-series which are "allied health sciences" although that doesn't include the "allied health sciences" which are specifically in the AMSC - which besides PAs are Occupational Therapists, Dieticians, Physical Therapists - all described as "hands-on treatment specialties . . . which doesn't really hold as a "standard" since Podiatrists defintely fit that definition but they are 68-series in the Medical Service Corps, along with Optometrists, Pharmcists, Psychologists, Social Workers . . . all of the 68-series specialties provide direct treatment . . . . but then who ever accused the Army of being logical . . . in fact, the first non-military trained PA's accepted by the Army (1979) were initially Warrant Officers but their Medical Department Officers Basic Branch Qualification course was not with AMSC officers but with MSC officers . . . . . I'm not certain how the Coast Guard handles their PAs and NPs - which are the only medical officers who can actually be Coast Guard - all others, physicians, nurses (other than NPs), pharm, etc. who provide services to the Coast Guard are actually USPHS officers on loan to the Coast Guard . . . . and of course the one in charge is physcian from PHS. . . . . . Frankly, I think the USCG would be better off having their own - or getting their medical officers loaned from the Navy instead of PHS . . . . because the PHS is not a military organization - while technically a Uniformed Service that is not the same as being an Armed Force . . . . . besides - the PHS is top-heavy with hippies and the like - even though the great number from the hey-dey draft-dodgers has retired, their mentality lives on in the organization and whom they subsequently selected to fill their ranks . . . . if you're not an ultra-liberal you don't stand a chance of passing your pre-commission background investigation and actually being "commissioned" While they may like to pretned that they are military - they way PHS manages its officers its more like being a civilian employee with a uniform . . . .

 

[NMMI76]

Well Kubed - I'm sorry that you can't follow along - maybe I should truncate things into itty-bitty bit-sized pieces for you. OR given the graphic for your "Avatar" (the molecular diagram of Sildenafil citrate) maybe you've taken a bit too much of your Rx and there isn't enough blood left to adequately supply your CNS . . . . . its being diverted and your BP is dangerously low . . . which explains why you're fatigued and need to lay down.

The point is simple - The list of course pre-reqs for PAs is essentially the same as for applying to Med-School and PA training follows the Med-School model . . . . Getting into a PA program is about as hard as getting in to Med School.

A critical observation though - both PA school and NP programs both state a selection preference that they want candidates who will "dedicate themselves to providing care to underserved populations" . . . but just "reliable" is that? How many of their graduates are actually out there working in truly "underserved" communities? Be honest - the overwhelming majority are looking after their careers and seeking out the best practice opportunities and also the best salaries (so they can pay-off the huge debt from their training program. . . .) Its fairly hypocritical (but say that out loud and you don't get into the program; or if you're in the proigram they find a way to wash you out) Its like their dedication to "diversity" - but try being a male attempting to get into a good NP program - even with more male applicants, the "selectees" are still overwhelmingly female - and not always the "best" academically; diversity seems to really be a code-word for something else and only token males manage to get in (not just NP programs, but any nursing school - males are a discriminated minority) We are supposed to be past such things - societally speaking! Oh but Kubed - your Med-School bias is showing . . . . . . .

 

[Faebinder]

Oh and I see some other med student "self-appoijnted expert" is talking out of his rectal orifice about which branch PAs must only be assigned to in the various Armed Forces - because of a sigle obsevation limited to how just one service does it . . . . . Well, the Medical Department of each service is organized how each service finds it most efficient for that service - specialties other than the "big three" Physicians-Nurses-Dentists are herded together into organizations designed originally by . . . . .. the Physicians, that guarantee a "lesser stature" to anyone not a physician . . . . . But on the immediate case of PAs :
in Navy they are MSC or Medical Service Corps (the Navy only has 4 medical branches - MC, NC, DC for the "big three" and everything else is in the MSC); in the Air Force, PAs are BSC or Biomedical Science Corps; and in the Army they are AMSC or Army Medical Specialist Corps, AMSC is not to be confused with MSC or Medical Service Corps - although the organization is not totally logical - the MSC has two arms, 67-series which is administrative support specialties and the 68-series which are "allied health sciences" although that doesn't include the "allied health sciences" which are specifically in the AMSC - which besides PAs are Occupational Therapists, Dieticians, Physical Therapists - all described as "hands-on treatment specialties . . . which doesn't really hold as a "standard" since Podiatrists defintely fit that definition but they are 68-series in the Medical Service Corps, along with Optometrists, Pharmcists, Psychologists, Social Workers . . . all of the 68-series specialties provide direct treatment . . . . but then who ever accused the Army of being logical . . . in fact, the first non-military trained PA's accepted by the Army (1979) were initially Warrant Officers but their Medical Department Officers Basic Branch Qualification course was not with AMSC officers but with MSC officers . . . . . I'm not certain how the Coast Guard handles their PAs and NPs - which are the only medical officers who can actually be Coast Guard - all others, physicians, nurses (other than NPs), pharm, etc. who provide services to the Coast Guard are actually USPHS officers on loan to the Coast Guard . . . . and of course the one in charge is physcian from PHS. . . . . . Frankly, I think the USCG would be better off having their own - or getting their medical officers loaned from the Navy instead of PHS . . . . because the PHS is not a military organization - while technically a Uniformed Service that is not the same as being an Armed Force . . . . . besides - the PHS is top-heavy with hippies and the like - even though the great number from the hey-dey draft-dodgers has retired, their mentality lives on in the organization and whom they subsequently selected to fill their ranks . . . . if you're not an ultra-liberal you don't stand a chance of passing your pre-commission background investigation and actually being "commissioned" While they may like to pretned that they are military - they way PHS manages its officers its more like being a civilian employee with a uniform . . . .

I'm the last person to comment on spelling and grammar but could you please utilize paragraphs and maintain points together? Your rambling is insufferable and the scattered way you write does not help prove your point (which is completely unclear).

 

[Kubed]

Well Kubed - I'm sorry that you can't follow along - maybe I should truncate things into itty-bitty bit-sized pieces for you. OR given the graphic for your "Avatar" (the molecular diagram of Sildenafil citrate) maybe you've taken a bit too much of your Rx and there isn't enough blood left to adequately supply your CNS . . . . . its being diverted and your BP is dangerously low . . . which explains why you're fatigued and need to lay down.

...

I, along with my alleged "avatar" thank you for the attempt at paragraphs in your 4th post. As always, itty-bitty-bit-sized pieces are much appreciated.

...
Oh but Kubed - your Med-School bias is showing . . . . . . .

We've never even met, but I'm blushing at the compliment! Thanks!

 

[MacGyver]

And if the MDE's don't like that - they maybe they can get their professional society (re: "union" or "trade guild" to loosen up those artifical restrictions on Medical Schools that keep them from increasing enrollments - since keeping the population of physicians low, increases demand and surprisingly results in higher wages/profits for the physicians that there are . . . . . . Imagine that!

Explain this to me genius. NYC has the highest doctor/patient ratio in the world. Explain to me why they also have some of hte highest healthcare costs per capita in the world?

Healthcare is not a free market. More docs does NOT produce lower healthcare costs.

 

[Castro Viejo]

AND BTW - "Doctor" as I'm sure most of you know is an ACADEMIC title so if an NP or a PA recieves an academic degree that is a doctorate - then they are entitled to be addressed as "Dr" and if the MDs get bent out of shape over it - the that is just too too bad because they do NOT own the title.

Uhm, they do in a healthcare setting when a patient is involved. Most states reserve "Doctor" to mean a physician and disallow other doctoral degree holders to be addressed as "Doctor" in a a patient care setting. Sorry. So all those nurses with PhDs are still just "Nurse Jane" or "Nurse Bob," and are never to be addressed as "Doctor."

But if it makes you happy, you can be an ultimate tool belt and make reservations at the local Burger King with your DrScPAS degree and have them address you as "Dr. NMM176" if it makes you feel any better.

Here's a tip: You should probably do a little more reading before coming onto SDN and attempting to spread your gospel.

the OD isn't going to treat something that isn't part of Optometry; and the PsyD isn't going to treat something outside of psychotherapy or counseling, nor the DPM isn't going to operate on somethinng other than their foot;

Hmmm... Wrong, wrong, and surprise, wrong.

Optometrists are attempting to gain operating privileges in areas traditionally awarded to Ophthalmologists. So, whose to say at the moment, what "isn't a part of Optometry?"

Clinical Pscyhologists, for years, have been fighting for the right to prescribe psychotropic medications just as a Psychiatrist would.

In my little corner of the world, a certain podiatrist is doing varicose vein "surgery" on the side.

And if the MDE's don't like that - they maybe they can get their professional society (re: "union" or "trade guild" to loosen up those artifical restrictions on Medical Schools that keep them from increasing enrollments - since keeping the population of physicians low, increases demand and surprisingly results in higher wages/profits for the physicians that there are . . . . . . Imagine that!

Hmmm... Sounds like someone got rejected from medical school one too many times. Good luck, sir, as I'm sure that chip on your shoulder will certainly become quite entertaining to many of your fellow PAs and supervising MDs in the future.