PAs (Physician Assistants) who think they are physicians!

[rxforlife2004]

I wonder how everyone thinks about PAs who think they are physicians?...I get pretty annoyed sometimes when a PA acts like as if he/she is an actually physician (MD,DO). Case study: I made round on the floor this morning for a PK level adjustment...as I was writing the progress note, a PA came up and asked , "I need the chart for pt..ABC", and "who is the nurse for...?". There were like 2 different MDs sitting there ...at the same time. But the weird thing is I notice that several nurses (especially the foreign trained ones) call this PA as "doctor"...lol....

On the other note, a friend of mine, a PA, also acts as if he's a physician. He posted on his facebook, " SUBJECTIVE:
CC: Vaginal discharge with itching Diff. Dx: vaginitis, STD
HPI: 23 year old white female presents with 5 day history of increasing vaginal discharge with itching. Partner noticed odor while having sex. Has sensation of heaviness in lower abdomen. Has noticed some mild dysuria. Date of last sexual contact 3 days ago, denies pain with intercourse. pMHx: Genital condyloma at age 16, treated with cryosurgery, no surgeries, injuries or hospitalizations ......."

I was like, "WTF?"....and added, "The physician lounge at this hospital is nicer than the one at my old place. The parking is also better well-structured, especially for physicians like us"


I am not jealous or anything but I just feel weird when someone pretends to be someone else...to gain respect and autonomy.

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[WVUPharm2007]

I wonder how everyone thinks about PAs who think they are physicians?...I get pretty annoyed sometimes when a PA acts like as if he/she is an actually physician (MD,DO). Case study: I made round on the floor this morning for a PK level adjustment...as I was writing the progress note, a PA came up and asked , "I need the chart for pt..ABC", and "who is the nurse for...?". There were like 2 different MDs sitting there ...at the same time. But the weird thing is I notice that several nurses (especially the foreign trained ones) call this PA as "doctor"...lol....

On the other note, a friend of mine, a PA, also acts as if he's a physician. He posted on his facebook, " SUBJECTIVE:
CC: Vaginal discharge with itching Diff. Dx: vaginitis, STD
HPI: 23 year old white female presents with 5 day history of increasing vaginal discharge with itching. Partner noticed odor while having sex. Has sensation of heaviness in lower abdomen. Has noticed some mild dysuria. Date of last sexual contact 3 days ago, denies pain with intercourse. pMHx: Genital condyloma at age 16, treated with cryosurgery, no surgeries, injuries or hospitalizations ......."

I was like, "WTF?"....and added, "The physician lounge at this hospital is nicer than the one at my old place. The parking is also better well-structured, especially for physicians like us"


I am not jealous or anything but I just feel weird when someone pretends to be someone else...to gain respect and autonomy.

Who cares. Let them have their whatever the hell it is that makes them feel better about themselves. If they want to live a quasi-lie...let them live a quasi-lie...people give too much of a damn what other people think about themselves...and how other people carry themselves.

But if you want my opinion...

They use Facebook and update their status. Which is enough for me to think the person is a douchebag. And they want to use a bunch of clinical jargon on it so their friends will read their wall and think they are all smart and ****. They also give themselves what they consider to be lofty status. Personally, I'm not impressed by a person that is a physician...but I'd imagine he fancies himself as one and thinks it is a high status "thing"...or whatever. So...yeah...typical modern narcissist. They are rather easy to identify. My advice, stop using Facebook...or at the very least, stop reading everyone's stupid ass status updates...and get less annoying friends.

 

[quartel]

This is really a double-edged sword. I understand that letting other think you are a physician can get you a lot of respect because people have been brainwashed to think MD's are supermen/women but there are obvious consequences to doing this.

In the short run, telling people you are a physician will get people's attention might even get you sex but in the long run it's going to be hellish to keep this lie going.

In any case, approval seeking behavior is something a low-status person does. If a person ever does it to me I give them the standard "wooooow you are by one of the most coolest/interesting people I have ever met" response.

 

[phathead]

Same thing as pharmacists insisting on calling themselves Drs (even though technically it is correct).

Do what I do when people pull crap like this. Crush them with knowledge they would have if they were truly physicians. Let them walk away with their tail between their legs.

 

[IrishHammer]

He posted on his facebook, " SUBJECTIVE:
CC: Vaginal discharge with itching Diff. Dx: vaginitis, STD
HPI: 23 year old white female presents with 5 day history of increasing vaginal discharge with itching. Partner noticed odor while having sex. Has sensation of heaviness in lower abdomen. Has noticed some mild dysuria. Date of last sexual contact 3 days ago, denies pain with intercourse. pMHx: Genital condyloma at age 16, treated with cryosurgery, no surgeries, injuries or hospitalizations ......."

He actually put that up as a status? Doesn't that constitute a massive violation of HIPPA laws?

 

[WVUPharm2007]

He actually put that up as a status? Doesn't that constitute a massive violation of HIPPA laws?

If there are no names...then no.

But, really, how lame do you have to be to do that? "Look at me, I have patients!!!!"

 

[Makati2008]

Sounds like there is some underlying issues with P.A.'s? To the first one if he was only asking for a chart and asking for the nurse he was doing his job. I don't think that is acting like a Physician in any stretch. If he didn't correct the nurse who called him a Doc then shame on him. But to make the comments that you made are no better than the nurses/MD/DO/PA who make comments about PharmD's(I personally respect you all).

As for your "friend"-whom you seem again jealous of/bashing him subtly, it was wrong of him to make those comments online about a patient. Although its not a HIPPA violation but it's very disrespectful. I truly doubt he/she called herself a doc as well due to that being illegal(PA ethics 101) and misrepresentation.

In the end just do the right thing and the PA/MD/DO/PharmDs that cross the line will hang his or herself.

Anyway remember that patient care comes first and you will be fine....

 

[owlegrad]

He actually put that up as a status? Doesn't that constitute a massive violation of HIPPA laws?

I think the magical words are personally identifiable information. Still a terrible idea to post that as your statues but not a HIPAA violation. Really I am sure you have covered this a nauseating number of times by now.

 

[Ackj]

He actually put that up as a status? Doesn't that constitute a massive violation of HIPPA laws?

It's not a violation of HIPAA, but a blatant violation of HIPPA: Hopeless Individuals Posting Physician Announcements.

 

[owlegrad]

It's not a violation of HIPAA, but a blatant violation of HIPPA: Hopeless Individuals Posting Physician Announcements.

 

[All4MyDaughter]

On the other note, a friend of mine, a PA, also acts as if he's a physician. He posted on his facebook, " SUBJECTIVE:
CC: Vaginal discharge with itching Diff. Dx: vaginitis, STD
HPI: 23 year old white female presents with 5 day history of increasing vaginal discharge with itching. Partner noticed odor while having sex. Has sensation of heaviness in lower abdomen. Has noticed some mild dysuria. Date of last sexual contact 3 days ago, denies pain with intercourse. pMHx: Genital condyloma at age 16, treated with cryosurgery, no surgeries, injuries or hospitalizations ......."

I call BS. Facebook status updates have a character limit, and this is too long to be a real status update.

 

[tungsten87]

If there are no names...then no.

But, really, how lame do you have to be to do that? "Look at me, I have patients!!!!"

that's actually not true. with something like this the patient's name, location, and age may not be disclosed if the patient resides in the state and is over a certain age (I think 70)

however, in this case since the location is not mentioned and the patient is 23 years old it's ok!

 

[DYSF777]

I think this Michigan hospital is pretty clear on what they think of PAs. Here is a write up I found for one of their ad campaigns.

Advertising for its emergency department in the Lapeer Area View and aired on WQUS FM 103.1 radio, the Lapeer Regional Medical Center wrote, "If you want risk, try skydiving. Don't do it with your emergency care....You want to go to Lapeer Regional Medical Center where trauma trained nurses and top ER physicians staff our state of the art emergency department. At Lapeer, you'll be treated by these specialists and not by physicians' assistants."

 

[Tenor CS]

So, out of curiosity, what IS the proper honorific title for a PA?

I went to an ENT's practice, but I always saw his PA, who was excellent and provided me with wonderful care. The word around the campfire was that only patients who actually needed surgery ever got to see the MD.

I was always confused as to what I should call him, since he was not, technically, a doctor.

When I made my appointments on the phone, the office staff just referred to him as Mr. [Lastname].

 

[adma826]

So, out of curiosity, what IS the proper honorific title for a PA?

I went to an ENT's practice, but I always saw his PA, who was excellent and provided me with wonderful care. The word around the campfire was that only patients who actually needed surgery ever got to see the MD.

I was always confused as to what I should call him, since he was not, technically, a doctor.

When I made my appointments on the phone, the office staff just referred to him as Mr. [Lastname].

In the Air Force peds clinic my kids used to use, the active duty Ped was Dr. Pediatrician, and the PA was Col. PA, previously Major PA before her promotion. In Women's Health, the NPs and PAs usually were referred to by rank for making appts but by first name in the intimate setting of the exam room.

 

[confettiflyer]

the lower people are on the totem pole, the more they like to "nudge forward" and try to impress people.

the biggest problem prescribers we had in retail were PA's... in fact, all of the yelling we got came from PA's. Oh, one day we found out mid call he was a PA....one of our outgoing interns unleashed a fury through the phone and belittled the guy. He never called back.

the problem orders in the hospital come from residents. we don't really have an attitude issue at my workplace but we love love LOVE our attendings. they come in, lay the smack down, and love us in the pharmacy.

 

[rxforlife2004]

the lower people are on the totem pole, the more they like to "nudge forward" and try to impress people.

the biggest problem prescribers we had in retail were PA's... in fact, all of the yelling we got came from PA's.

Did the PA actually yell at you? I wouldn't take this...Remember, you are a professional and a Pharm.D. Education wise, you are at the same (if not above) level as a PA. So don't ever let them cross the line. You can even hang up on an MD too if they have bad attitudes...

 

[tkim]

So, out of curiosity, what IS the proper honorific title for a PA?

"Mr." or "Mz."

 

[IrishHammer]

"Mr." or "Mz."

If they start to get an ego, just go with "Not Dr. So-And-So". It's every bit as accurate as calling them Mr. or Mrs. and it helps keep their ego in line. Do it right in stride too, it stings more that way.

 

[tkim]

If they start to get an ego, just go with "Not Dr. So-And-So". It's every bit as accurate as calling them Mr. or Mrs. and it helps keep their ego in line. Do it right in stride too, it stings more that way.

I wasn't trying to be sarcastic, it is really the title they should be addressed by.

 

[Sparda29]

I call BS. Facebook status updates have a character limit, and this is too long to be a real status update.

Maybe it was in the notes section?

 

[IrishHammer]

Maybe it was in the notes section?

He misunderstood. He thought it was the SOAP Notes section.

 

[Carboxide]

I wasn't trying to be sarcastic, it is really the title they should be addressed by.

Disagree. PAs have a master's degree. They should be called by their first name.

A PA who either calls himself doctor or allows other people to should be brought up to the...the person in charge of PAs. Because they perform the same duties as physicians, they are seriously allowing for misrepresentation of education.

Personally, I don't think they're qualified at all.

 

[IrishHammer]

Disagree. PAs have a master's degree. They should be called by their first name.

A PA who either calls himself doctor or allows other people to should be brought up to the...the person in charge of PAs. Because they perform the same duties as physicians, they are seriously allowing for misrepresentation of education.

Personally, I don't think they're qualified at all.

So we should call them "Master"? One could see how that would be better than "Doctor" in keeping them from getting a big head.

 

[owlegrad]

Disagree. PAs have a master's degree. They should be called by their first name.

A PA who either calls himself doctor or allows other people to should be brought up to the...the person in charge of PAs. Because they perform the same duties as physicians, they are seriously allowing for misrepresentation of education.

Personally, I don't think they're qualified at all.

Huh? When do you use Mr. and Ms. then? I mean I assume you use Dr. for graduate level degree holders, so anyone below that gets called by thier first name?

No one here is saying they should be called doctors. I think the point is that it is polite to call someone Mr. or Ms. until you have their permission to do otherwise. Just because they "only" have a masters doesn't give you permission to be rude.

 

[Ackj]

the lower people are on the totem pole, the more they like to "nudge forward" and try to impress people.

the biggest problem prescribers we had in retail were PA's... in fact, all of the yelling we got came from PA's. Oh, one day we found out mid call he was a PA....one of our outgoing interns unleashed a fury through the phone and belittled the guy. He never called back.

the problem orders in the hospital come from residents. we don't really have an attitude issue at my workplace but we love love LOVE our attendings. they come in, lay the smack down, and love us in the pharmacy.

One of my pharmacists likes to have me call up PAs to clarify an rx and then ask who their supervising physician is. There's nothing like that to remind them who's autonomous and who isn't.

 

[Carboxide]

Huh? When do you use Mr. and Ms. then? I mean I assume you use Dr. for graduate level degree holders, so anyone below that gets called by thier first name?

No one here is saying they should be called doctors. I think the point is that it is polite to call someone Mr. or Ms. until you have their permission to do otherwise. Just because they "only" have a masters doesn't give you permission to be rude.

Well, you don't call the nurse "Mr" or "Mz", do you? What's the difference?

 

[owlegrad]

Well, you don't call the nurse "Mr" or "Mz", do you? What's the difference?

I call people by however they introduce themselves to me. If they include their last name I use Mr or Ms, unless they indicate otherwise. If I haven't been introduced I don't use their name at all. It's pretty simple really - just call people by whatever they ask to be called by and don't assume you are on a first name basis from the start. It's basic courtesy.

Maybe I am still too young? I can't imagine just going around calling people by their first name unless I have been told that's alright. Seems rude. Of course once you know someone using their first name should be natural, but then you are doing it because you are familiar with them.

I can't imagine using someone's first name as a way to bring them down a peg or show dominance.

 

[All4MyDaughter]

If they start to get an ego, just go with "Not Dr. So-And-So". It's every bit as accurate as calling them Mr. or Mrs. and it helps keep their ego in line. Do it right in stride too, it stings more that way.

Really hoping this is a joke.

One of my pharmacists likes to have me call up PAs to clarify an rx and then ask who their supervising physician is. There's nothing like that to remind them who's autonomous and who isn't.

Please explain how this advances the profession of pharmacy and promotes patient care. There is nothing wrong with calling to verify a script, and in some circumstances, you do need to know the name of the supervising MD/DO but that's to meet a legal requirement, not to "subtly" remind the PA that they can't practice independently. If your pharmacist truly likes to play these little ego games, he needs better hobbies. Or to grow up.

I can't imagine using someone's first name as a way to bring them down a peg or show dominance.

Exactly. The crap in this thread is embarassing. If we, as pharmacists and pharmacy students, really have such a terrible inferiority complex that we need to resort to these tactics to make us feel good about ourselves, then that's pretty pathetic.

So regarding what to call PAs/ARNPs/CNMs, etc. At my last clinical site, I took my cue from my preceptors when addressing the physicians and NPs in situations AWAY from patients (like in treatment team or at lunch). Some of them were Dr. Smith (doctor) or Ms. Jones (NP) some of them were Tom or Rita. People will usually let you know what to call them either directly or indirectly. I'd go with more formal initially. It's polite. You'll never go wrong by referring to someone with their title and last name and letting THEM tell you they'd prefer something less formal.

 

[BMBiology]

On the other note, a friend of mine, a PA, also acts as if he's a physician. He posted on his facebook, " SUBJECTIVE:
CC: Vaginal discharge with itching Diff. Dx: vaginitis, STD
HPI: 23 year old white female presents with 5 day history of increasing vaginal discharge with itching. Partner noticed odor while having sex. Has sensation of heaviness in lower abdomen. Has noticed some mild dysuria. Date of last sexual contact 3 days ago, denies pain with intercourse. pMHx: Genital condyloma at age 16, treated with cryosurgery, no surgeries, injuries or hospitalizations ......."

I was like, "WTF?"....and added, "The physician lounge at this hospital is nicer than the one at my old place. The parking is also better well-structured, especially for physicians like us"

I also question this supposedly facebook post. This case is identical (word by word) to an example soap note from a nursing school posted online:

http://www2.kumc.edu/instruction/nursing/nrsg811/soap_note_example.htm

 

[All4MyDaughter]

I also question this supposedly facebook post. This case is identical (word by word) to an example soap note from a nursing school posted online:

http://www2.kumc.edu/instruction/nursing/nrsg811/soap_note_example.htm

I think the whole purpose of this thread was **** stirring, and people have responded and really not made themselves look good... WTG pharmacy forum...

 

[Sparda29]

I also question this supposedly facebook post. This case is identical (word by word) to an example soap note from a nursing school posted online:

http://www2.kumc.edu/instruction/nursing/nrsg811/soap_note_example.htm

 

[rxforlife2004]

I think the whole purpose of this thread was **** stirring, and people have responded and really not made themselves look good... WTG pharmacy forum...

yup yup...that's the whole point of my existence here....to stir up and fight.
No, but really, my friend is a PA and he posted something like that on facebook...to show off "I'm a PA....I'm seeing patients....I'm busy... I have power".

 

[Ackj]

Really hoping this is a joke.



Please explain how this advances the profession of pharmacy and promotes patient care. There is nothing wrong with calling to verify a script, and in some circumstances, you do need to know the name of the supervising MD/DO but that's to meet a legal requirement, not to "subtly" remind the PA that they can't practice independently. If your pharmacist truly likes to play these little ego games, he needs better hobbies. Or to grow up.

Lighten up, this thread is about hotshot PAs who are trying to pass themselves off as physicians. Were you previously a downtrodden PA? Are you going to force others to call you Dr. when you get your pharmD? How does calling another practitioner Mr. or Ms. tangibly improve patient care and/or advance the profession?

 

[All4MyDaughter]

Lighten up, this thread is about hotshot PAs who are trying to pass themselves off as physicians. Were you previously a downtrodden PA? Are you going to force others to call you Dr. when you get your pharmD? How does calling another practitioner Mr. or Ms. tangibly improve patient care and/or advance the profession?

LOL. This thread was started under questionable pretenses to make fun of the members of another profession. Good job taking the bait. I've never been a PA. I generally answer to my first name and prefer that to Mrs. A4MD or Ms. A4MD. To answer your final question, addressing another practitioner politely and appropriately is a simple matter of respect and professional courtesy. It's not that difficult.

 

[spacecowgirl]

There are d-bags in every profession. Obviously.

 

[owlegrad]

LOL. This thread was started under questionable pretenses to make fun of the members of another profession. Good job taking the bait. I've never been a PA. I generally answer to my first name and prefer that to Mrs. A4MD or Ms. A4MD. To answer your final question, addressing another practitioner politely and appropriately is a simple matter of respect and professional courtesy. It's not that difficult.

So what you are saying (and stop me if I am wrong) is that you show others respect EVEN when you haven't walked a mile in their shoes? Sorry I just don't get you sometimes. Are you saying that you don't have to have been a PA in order to treat them with basic common courtesy?

You understand that because of all that extra schooling (1-2 years?) you will be superior to them in every way, right? No need to address them by name at all, "grunt" or "lackey" should do just fine. If they should attempt to make eye contact stare them down until they are appropriately submissive. If this doesn't work smack them on the nose with a rolled up news paper. They will learn eventually.

 

[confettiflyer]

Did the PA actually yell at you? I wouldn't take this...Remember, you are a professional and a Pharm.D. Education wise, you are at the same (if not above) level as a PA. So don't ever let them cross the line. You can even hang up on an MD too if they have bad attitudes...

oh we do...and they didn't yell at me, they yelled at my pharmacist and she just hung up. called back, got the intern, and when she found out he was a PA (from the script scan)....she unleashed the greatest verbal beatdown i have ever heard at CVS. something about personal insecurities and his inability to attain an MD and attempting to make up for it by yelling at college students at the corner drug store when he really reports to a physician like the nurses and medical assistants he works with.

but yeah isolated case, we have PA/NP's in the hospital and they've been around long enough to know not to pull crap like that/put in weird orders.

 

[quartel]

I'd have some level of sympathy. I'd imagine it would be like working as a tech or intern at a pharmacy for 20-something years, you know the job very well but you are lacking some years of schooling. No matter how long you work you will never achieve the same level of salary or respect as the person working above you. After 5 or so years of being asked by others what you do, it might become tempting or easier to just lie. It's like how my Japanese friend let's call him Tetsuo just tells others his name is John because after 20 years, it's just easier to get by this way.

Obviously a person that makes up stuff like this is a bit sad but it tells us a lot about the kind of society we live in. We live in a society where your job defines your status and how you ought to be treated. It shows me that people generally give respect to those in power and less respect for those that don't have it. I personally try (keyword: try) to evaluate the character of the human being and treat them accordingly to that. It's just sad that most people use existing power differentials to bully people, it's really sad and shows how savage we are.

 

[DYSF777]

On a side note I had a PA friend of mine exclaim on his facebook status that he was thrilled to be done with surgery...2 years of schooling and they are cutting people open?

 

[rxforlife2004]

On a side note I had a PA friend of mine exclaim on his facebook status that he was thrilled to be done with surgery...2 years of schooling and they are cutting people open?

yup...they do have PA surgeons!

 

[DYSF777]

yup...they do have PA surgeons!

I know they can suture but to actually perform a surgery with 26 months of schooling and an internship is impressive. What the hell was I thinking not going into that field.

 

[rxlea]

 

[rxforlife2004]

I know they can suture but to actually perform a surgery with 26 months of schooling and an internship is impressive. What the hell was I thinking not going into that field.

http://www.aaspa.com/
http://money.cnn.com/magazines/moneymag/bestjobs/2009/snapshots/2.html

 

[SHC1984]

I know they can suture but to actually perform a surgery with 26 months of schooling and an internship is impressive. What the hell was I thinking not going into that field.

The PA most likely just assisted the surgeon while the SURGEON performed surgery.

I think people that aren't MDs but expect to be treated like an MD or want to do MD's work are funny. If someone wants to be treated like an MD or wants to do a MD's job then just go to MEDICAL SCHOOL. Why go to PA school, dental school or pharmacy school if you rather be a MD. People don't make any sense.

 

[Podmeister]

At the hospital, the staff usually refer to the PA by his or her first name.

When I first got on staff, I would inquire about such individuals floating around the nursing stations, and the nurses usually replied,
"Oh, that's so and so, the PA for Dr. so and so.."

 

[Narnian]

Did the PA actually yell at you? I wouldn't take this...Remember, you are a professional and a Pharm.D. Education wise, you are at the same (if not above) level as a PA. So don't ever let them cross the line. You can even hang up on an MD too if they have bad attitudes...

I think there is some kind of code now that you can call when there is anyone being unprofessional. Like yelling and banging charts like an ape. I have seen Doctors yell at nurses before and thought there needs to be something that can be done. I think it is called a code white coat or something. Maybe code Jackass would be a more fitting name. They have some friendly weightlifting gentlemen escort the Doctor or clinician out of that situation, by force if necessary. Has anyone ever heard of this??? It was a recent article I read about 8 months ago.

 

[type b pharmD]

cardiothoracic practice I was a patient of had PA's do all vein harvesting for cabgs. sseems like a technical skill that anyone could learn given time and practice.

 

[owlegrad]

I think there is some kind of code now that you can call when there is anyone being unprofessional. Like yelling and banging charts like an ape. I have seen Doctors yell at nurses before and thought there needs to be something that can be done. I think it is called a code white coat or something. Maybe code Jackass would be a more fitting name. They have some friendly weightlifting gentlemen escort the Doctor or clinician out of that situation, by force if necessary. Has anyone ever heard of this??? It was a recent article I read about 8 months ago.

At my hospital it is code Show (get it, cause they are show...). Calling Dr. Show to blah, blah. We also have Dr. Armstrong if force will be required. Calling Dr. Armstrong to yada, yada. Clever, eh? We have never used them though. Dr. Armstrong is for patients only (can't use force on personal or visitors), but Dr. Show can be used for anyone that is acting up.

 

[RX CARE]

When I did my cardiology rotation, there was a PA who was always hanging around with the cardiac surgeon, and scrubbed in at every surgery. She was quite attractive. The weird thing is, he also had a surgical resident and a fellow at the same time. So I wonder what the PA's role was, and if it is really a necessity.
Honestly, I feel like the PA profession came about due to the shortage of primary care physicians and/or the workload that the existing ones experienced because of the shortage. I do not understand why PA's need to specialize...I feel like they should be restricted to primary care. That's why we are having a consistent issue with primary care shortages, because at some point, the professions that were designed to help out decide to push for specialization. The same thing seems to be happening with NP's too. Looks like they are on a path to PA residencies too....which is really redundant imo...that really should be medical school.

On the other hand, one can argue that pharmacy went through those phases, but I think at the end of the day, pharmacy really is interested in the drugs; it's just that the drugs are heavily intertwined with what everyone else does. Maybe I'm wrong....was just thinking out loud with this PA stuff.......