PAs (Physician Assistants) who think they are physicians!

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Ackj said:
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.
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some states require both the pa and the md name on the rx, some do not.
pa's have their own dea's in the vast majority of states, with unrestricted sch 2 in most of these.

emedpa
pa who doesn't think he's a doc...
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there have been pa residencies for over 30 yrs. see www.appap.org
none of these leads to independent practice but a better understanding of a specialty.
pa students do surgical rotations in school just like ms3's. this should not be news to anyone.same hrs(mine was > 100 hrs/week), same pt loads, am rounds, etc so bitching about it is not surprising.
most of my md and rn colleagues call me by my first name to my face and mr emedpa in front of pts.
some pa's with military backgrounds are used to "pa smith" so they continue to use that in the civilian world as well when they introduce themselves, answer phones, etc.
I wish this was done universally. it would go a long way to getting rid of a lot of confusion that currently exists. I always introduce myself to pts and consultants as emedpa, one of the emergency medicine pa's.
if a pharmacist gave me crap about being a pa on the phone I would just send my pts elsewhere....plenty of pharmacists are happy to honor my scripts...
 
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so how do you guys feel about folks who do a dual degree pa/pharmd program? I think there are 5 or 6 of these now....
 
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emedpa said:
so how do you guys feel about folks who do a dual degree pa/pharmd program? I think there are 5 or 6 of these now....
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I see very few reasons why one would want to do a dual PA/PharmD... There are very few places where someone will be doing the job of both a PA and a Pharmacist, and I can't think of any niche markets that would be looking for that particular combination.
 
b1234 said:
I see very few reasons why one would want to do a dual PA/PharmD... There are very few places where someone will be doing the job of both a PA and a Pharmacist, and I can't think of any niche markets that would be looking for that particular combination.
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"clinical pharmacist" comes to mind...
 
May I ask which schools/programs offer these dual degrees? I would be interested in researching more about this :)
 
emedpa said:
there have been pa residencies for over 30 yrs. see www.appap.org
none of these leads to independent practice but a better understanding of a specialty.
pa students do surgical rotations in school just like ms3's. this should not be news to anyone.same hrs(mine was > 100 hrs/week), same pt loads, am rounds, etc so bitching about it is not surprising.
most of my md and rn colleagues call me by my first name to my face and mr emedpa in front of pts.
some pa's with military backgrounds are used to "pa smith" so they continue to use that in the civilian world as well when they introduce themselves, answer phones, etc.
I wish this was done universally. it would go a long way to getting rid of a lot of confusion that currently exists. I always introduce myself to pts and consultants as emedpa, one of the emergency medicine pa's.
if a pharmacist gave me crap about being a pa on the phone I would just send my pts elsewhere....plenty of pharmacists are happy to honor my scripts...
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Thanks for the clarification..I wasn't exactly aware as I really havent researched the field. But it seems to be endorsing the same exact point I am trying to make. Why create a profession called "physician assistant", who goes through pretty much the same rigor in training as a medical student, just like you said. What are the limitations? What is the difference? All I'm saying is I feel like the original intent was to provide basic primary care in areas of shortage of physicians.....and looks like we have far swayed from that........30 years u said?
 
At least 30 yrs...the first pa class graduated in 1967 and the first residency in surgery was soon thereafter. there are over 150 pa programs now and residencies in many specialty fields. these residencies don't train one to replace a doc but to be a better pa. for example a lot of the pa surgical residencies devote a lot of time to care of the surgical pt outside of the o.r. the residency trained pa allows the doc to spend more time operating and less time rounding, admitting pts, and doing discharge h+p's, etc
the em pa residencies train pa's in many skills that are good to have for any emergency clinician; ultrasound, management of trauma, care of the critical pt, difficult airway procedures, etc
I for one would be in favor of mandatory pa residencies in all fields outside of primary care( as that is the focus of pa school itself).
I've visited friends doing pa residencies.these are not cakewalks. they are 80-100+ hrs/week
for 1-2 yrs, carrying a pager all the time, 5 am rounds, etc
the pa surgical residency I am most familiar with is this one which graduated its first class in 1976. pa's are the only surgical housestaff here so there is no competition from md residents:
http://www.norwalkhospital.org/common.aspx?id=2559

from the website:
The importance of the PA's role at Norwalk Hospital cannot be understated. Physician assistants constitute the entire surgical house staff, taking an active role in the assessment, management and daily care of patients. The PAs provide 24-hour coverage including night and weekend on-call hours, staffing the hospital floors, the OR and the ICU.
 
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b1234 said:
I see very few reasons why one would want to do a dual PA/PharmD... There are very few places where someone will be doing the job of both a PA and a Pharmacist, and I can't think of any niche markets that would be looking for that particular combination.
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I don't believe that you can have both of your licenses active at one time because it would constitute a clear conflict interest much the same way that you can have your medical and pharmacy degree active at one time. However, with that being said... I can see how it would benefit someone with a PharmD to have a more in-depth medical background when dealing with patients especially if you want to do something more hands on. I don't necessarily think that it would be able to replace the traditional pharmacy residency if you want to be clinical pharmacist but rather supplement.

Good luck all. ;)
 
PharMed2016 said:
I don't believe that you can have both of your licenses active at one time because it would constitute a clear conflict interest much the same way that you can have your medical and pharmacy degree active at one time. However, with that being said... I can see how it would benefit someone with a PharmD to have a more in-depth medical background when dealing with patients especially if you want to do something more hands on. I don't necessarily think that it would be able to replace the traditional pharmacy residency if you want to be clinical pharmacist but rather supplement.

Good luck all. ;)
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Citation? I'm not aware of any restriction on holding dual licenses, but perhaps this is accurate. I'd think as long as you weren't writing your own scripts and filling/checking them yourself without review by another professional, it shouldn't be a problem.
 
PharMed2016 said:
I don't believe that you can have both of your licenses active at one time because it would constitute a clear conflict interest much the same way that you can have your medical and pharmacy degree active at one time. However, with that being said... I can see how it would benefit someone with a PharmD to have a more in-depth medical background when dealing with patients especially if you want to do something more hands on. I don't necessarily think that it would be able to replace the traditional pharmacy residency if you want to be clinical pharmacist but rather supplement.

Good luck all. ;)
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Why would you not be able to hold active both licenses? Why would they have combined programs? I know a PA/Pharm.D with active licenses.
 
Narnian said:
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.
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I know what you're talking about...it's part of one of those safety things and paternalism/not questioning the MD. Damn it, I read this article too now I can't remember it. This is gonna drive me nuts.
 
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I had a classmate at my former school who was a PA completing a PharmD. He was doing it to qualify to be faculty in PA programs because some kind of doctorate was required. That was my understanding anyway.

I think you can be dually licensed.
 
dual licensure md/pharmd or pa/pharmd are not a problem as long as you don't write scripts and then direct pts to fill them at a place you have an interest in.
if dual licensure was not allowed there would be no dual cert programs.
( I believe there are np/pharmd programs as well).
 
Today, once again, I tried to clarify an order with no frequency on a clonidine, the nurse told me, "The doctor wrote it went home and here's her number : XXX-XXX-XXXX". I called her and found out that she's the Physician Assistant of an attending doctor in house. I am just surprised that the RN called that PA as "Doctor" and she doesn't even correct it...lol...And what more funnier is that the RN didn't even know the difference between PA vs. MD and call everyone who writes orders as "Doctor", except pharmacists...and we're the ones who have a doctorate degree!!!!
 
And, as you are all well aware, all rx errors are made by pa's and never by physicians.....
stop being a troll and trying to make something out of nothing....
 
emedpa said:
And, as you are all well aware, all rx errors are made by pa's and never by physicians.....
stop being a troll and trying to make something out of nothing....
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I am not saying all pas are making errors and physicians aren't!!! In fact, I do respect PAs and I know a lot of good PAs. One of the PA that I used to work with at our hospital was really good. All his orders were very clear. I rarely had to call him to verify anything because he knows his shiett pretty darn well.

And no, I am not a troll....I just wanna whine a bit...for fun...
 
All4MyDaughter said:
Citation? I'm not aware of any restriction on holding dual licenses, but perhaps this is accurate. I'd think as long as you weren't writing your own scripts and filling/checking them yourself without review by another professional, it shouldn't be a problem.
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Nah, not a citation. I remember a year or so back that I had a question regarding dual licenses for a MD.DO/PharmD and was told that you couldn't have both licenses active due to the conflict of interest. That shouldn't prevent you from using the knowledge and applying it to your practice though. Maybe I was misinformed. :laugh:
 
rxforlife2004 said:
And no, I am not a troll....I just wanna whine a bit...for fun...
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ok
providers, don't you hate it when pharmacists call you every time you write septra ds 2 tabs bid x 10 days for mrsa because they are unaware that it is the recommended dose in some areas with partial resistance to standard dose septra? you would think after the 10th or 20th script from a variety of providers that they would be aware it is an acceptable dosing strategy.
 
RX CARE said:
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.......:confused:
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its kind of unfair to limit a profession to just one side (primary care), thats like saying all pharmacists should just work retail

of course there are bad PAs, there are bad apples in every batch

i used to talk all the time with the PAs Id see in the hospital on my rotations, the ones who did orthapedics: did pretty much all the pre op, post op work, and were first assist on surgery (depending on the resident situation), and they raked in 100k+ ...and of course, all responsibility still falls on the surgeon, not a bad gig at all!!!
 
emedpa said:
ok
providers, don't you hate it when pharmacists call you every time you write septra ds 2 tabs bid x 10 days for mrsa because they are unaware that it is the recommended dose in some areas with partial resistance to standard dose septra? you would think after the 10th or 20th script from a variety of providers that they would be aware it is an acceptable dosing strategy.
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Yeah, but this is the pharmacy forum. It's ok for pharmacists to vent about each other and about other professions in here, but it's not cool for people to come to this forum and criticize pharmacy or pharmacists.
 
Carboxide said:
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.
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Seriously...
 
rxforlife2004 said:
Today, once again, I tried to clarify an order with no frequency on a clonidine, the nurse told me, "The doctor wrote it went home and here's her number : XXX-XXX-XXXX". I called her and found out that she's the Physician Assistant of an attending doctor in house. I am just surprised that the RN called that PA as "Doctor" and she doesn't even correct it...lol...And what more funnier is that the RN didn't even know the difference between PA vs. MD and call everyone who writes orders as "Doctor", except pharmacists...and we're the ones who have a doctorate degree!!!!
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I guess i never really cared what a PA or NP called themselves. All I ever cared about was getting my question answered. Nowadays, all I care about is service and the bottomline...Not whether a PA calls themselves doctor or not...This is just me though...
 
Doctor M said:
I guess i never really cared what a PA or NP called themselves. All I ever cared about was getting my question answered. Nowadays, all I care about is service and the bottomline...Not whether a PA calls themselves doctor or not...This is just me though...
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This. When I call my OBGYN office to make an appointment, they always ask me "What doctor do you see?" I answer them, "I see Beth," not, "I see Beth but SHE'S NOT A DOCTOR SHE'S A NURSE MIDWIFE?" I've heard the office staff tell patient's "your doctor is Beth." It is not a big deal. Should Beth run around the office all day reminding the staff that she isn't a doctor? Should we make fun of Beth if she doesn't and claim she's trying to pretend to be a doctor?

Why are we even worried about these things? It's silly, IMO.
 
emedpa said:
ok
providers, don't you hate it when pharmacists call you every time you write septra ds 2 tabs bid x 10 days for mrsa because they are unaware that it is the recommended dose in some areas with partial resistance to standard dose septra? you would think after the 10th or 20th script from a variety of providers that they would be aware it is an acceptable dosing strategy.
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Why not have all the ******* prescribers write a quick note on the prescription for an outside the norm dosing? You want to give someone Levaquin 4 times a day? Good for you. Then write a quick note on the script that says "Dosing QID for XYZ infection per new guidelines." Case closed, no phone call everybody happy. I do a quick Google search and maybe learn something new. If you think I have the time to call every time some idiot writes an illegible prescription or writes for some off the wall dose you are sadly mistaken. In fact I detest calling to clarify a presciption because it takes forever and I end up getting someone whos names is Candy or Leticia the receptionist telling me it is okay.

For God's sake you would be amazed at what a little communication or fore thought on your part could accomplish to save us all alot of time.

(Yes, I am quite aware of the MRSA guidelines that calls for Bactrim DS 2 BID.)
 
emedpa said:
some states require both the pa and the md name on the rx, some do not.
pa's have their own dea's in the vast majority of states, with unrestricted sch 2 in most of these.

emedpa
pa who doesn't think he's a doc...
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Texas is one of those states that requires both names on the prescription. For those of you practicing in Texas tell me why in the hell do half the NP's and PA's write scripts that do not include thier supervising physicians name?
 
All4MyDaughter said:
This. When I call my OBGYN office to make an appointment, they always ask me "What doctor do you see?" I answer them, "I see Beth," not, "I see Beth but SHE'S NOT A DOCTOR SHE'S A NURSE MIDWIFE?" I've heard the office staff tell patient's "your doctor is Beth." It is not a big deal. Should Beth run around the office all day reminding the staff that she isn't a doctor? Should we make fun of Beth if she doesn't and claim she's trying to pretend to be a doctor?

Why are we even worried about these things? It's silly, IMO.
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agreed...who cares...beth or dr beth or midwife beth...either way, its beth! I just dont care...No one calls me Dr. Mazariegos, its Carlos...Yes, i have a PharmD, but it means little for what I do now.
 
BestDoctorEver said:
[/B]
Seriously...
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Seriously. Of course, you're talking to a person who had to get surgery because a PA (who introduced himself as Doctor) didn't set a bone correctly OR splint it correctly. In fact, he didn't set it at all.

When the surgeon saw the x-rays from the ER, the FIRST thing out of his mouth (less than 10 seconds after holding them up to the light) was "Why didn't he set the bone? It's clearly a centimeter off."

The PA at the ER: "Well, the bone looks completely in position and doesn't need to be set..."
 
I am pretty sure it was a lot easier and faster route to get a PA degree back in college. It doesn't have to be a master degree. I Know a program with bachelor degree. I still remember a friend of mine, whose grades were worse than mine and did not even have to take hard classes( such as O-Chem..), already got her bachelor of PA and practiced while I was still in 1st year of pharmacy school. But again, I knew I didn't like to touch patients, so whatever...
 
sensing lots of inferiority complex here

thought all health care professionals were supposed to get along :love:
 
Carboxide said:
Seriously. Of course, you're talking to a person who had to get surgery because a PA (who introduced himself as Doctor) didn't set a bone correctly OR splint it correctly. In fact, he didn't set it at all.

When the surgeon saw the x-rays from the ER, the FIRST thing out of his mouth (less than 10 seconds after holding them up to the light) was "Why didn't he set the bone? It's clearly a centimeter off."

The PA at the ER: "Well, the bone looks completely in position and doesn't need to be set..."
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For God sake..You are going to be a pharmacist; stop making generalization about a whole profession based on what one individual did.
 
Seriously, some people on here spend too much time worrying about how other people are addressed. I bet you all go to the zoo on the weekend and smack every kid upside the head who refers to a tiger as a cat. Get over yourselves.
 
MountainPharmD said:
Texas is one of those states that requires both names on the prescription. For those of you practicing in Texas tell me why in the hell do half the NP's and PA's write scripts that do not include thier supervising physicians name?
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it should be printed right on the rx,.
when I worked in ca(which requires both) my rx pad said :
emedpa, pa-c
j. smith, md
 
BestDoctorEver said:
For God sake..You are going to be a pharmacist; stop making generalization about a whole profession based on what one individual did.
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thanks .
I appreciate the vast majority of the pharmacists I work with(including 1 who works in the ed with us as a consultant) but like anyone I have horror stories about mistakes made by a pharmacist( or md, or do, or rn, rt, pa, paramedic, nutritionist, surgeon, etc) that resulted in a poor pt outcome.
 
All4MyDaughter said:
Yeah, but this is the pharmacy forum. It's ok for pharmacists to vent about each other and about other professions in here, but it's not cool for people to come to this forum and criticize pharmacy or pharmacists.
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I'm sure if I started a thread called "pharmd's who think they are clinicians" berating pharmd's based on 1 poor experience in the clinicians forum that it would be shut down within 5 minutes.
I wouldn't be involved in this thread if it wasn't degrading to pa's.
 
I sense the ignorance towards PAs off the charts here...

I find it absolutely ridiculous that a healthcare professional like a Pharm.D would deliberately call frequently for orders written by a PA; that's honestly something I've never heard before and I sense if you are doing this, you may rather try to look for the problem in yourself. I can't understand how insecure a person would have to be to do that. Also, it's not the PAs that represent themselves as MD/DO's, although rather its the nurse practitioners that claim they are physicians. I've shadowed a few PAs and learnt that they're quite good at what they do. Personally, the two I shadowed were smart as a whip, and I thought they were quite competent. I just couldn't see myself doing that for my life, dealing with 30-40 patients a day, 5 days a week. Definitely would rather learn about drugs and their interactions then clinical medicine, but hey, that's just me.

Pharm.D, PA, MD, DO,..... I can make a list right now about the PA who had no bedside manners, the pharmacist who gave the wrong dosage, the MD who left a scar on my face, the DO who misdiagnosed me...etc...etc...etc

The point is that every profession will have both sides of the spectrum. No profession is to gain from talking down about another profession. Be a professional; most people posting here are pharmacists or pharmacy students, if not for yourself, atleast live up to the name of your profession.
 
emedpa said:
I'm sure if I started a thread called "pharmd's who think they are clinicians" berating pharmd's based on 1 poor experience in the clinicians forum that it would be shut down within 5 minutes.
I wouldn't be involved in this thread if it wasn't degrading to pa's.
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I agree that this thread is pretty ignorant. I demonstrated WAY upthread that it was created under questionable purposes and stated my opinion that the thread was likely started just to stir up stuff. I think it's pathetic, honestly.

HOWEVER... what I stated to you above is the official policy of this web site. So start that thread in the Clinicians' forum if you must. As long as it's otherwise free of TOS violations, it will likely stay open. Check out the thread in the dental forum called "Pissed at Pharmacist." It was never closed. If you want more clarification, please send me a PM.
 
WVUPharm2007 said:
Same reason people buy BMWs...they just want to be better than other people...or whatever...
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I for one in NO way believe I am better than anyone else. I drive a BMW because I love the car...It doesnt make me feel "special"...then again i may be an exception...:shrug:
 
Doctor M said:
I for one in NO way believe I am better than anyone else. I drive a BMW because I love the car...It doesnt make me feel "special"...then again i may be an exception...:shrug:
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Sure...whatever... DOCTOR! You know that car makes you feel like The Man. You can, however, demonstrate your humility by purchasing a BMW for ME. That will help me feel better about myself! :D
 
WVUPharm2007 said:
Same reason people buy BMWs...they just want to be better than other people...or whatever...
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You need to drive an M5 and get back to me. I hated being a mechanic who worked on BMWs all the time, because they're a ***** and a half to work on. But they are absolutely one of the greatest driving cars all around.

But because I would be fixing the car myself, there's no way I would own one. And I understand your point about the elitist douches. Most of the idiots who came in our shop with BMWs were just status-seekers (trophy wives, small penis syndrome men, etc.)
 
Doctor M said:
I for one in NO way believe I am better than anyone else. I drive a BMW because I love the car...It doesnt make me feel "special"...then again i may be an exception...:shrug:
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They said on Top Gear a few years ago that in order to own a BMW, you need to have an ******* personality. Now it's more of *******s buy Audis. Personally, I can't stand the low-20s to mid-20 year olds who drive the Infiniti G35s and G37s. I see that car way too much on the road. Makes me like that I picked the Volkswagen CC. When I first bought it, I'd see another one maybe once a week. Now it's like once a day.
 
psh...whatever...all you BMW haters! no small penis syndrome here or any type of syndrome. I just love the car...i dont race it, i'm not a dick on the road...Just love the car...
 
audi > bmw frankly, there is no reason to buy a lux car in a down economy anyways, you just make yourself a target for the desperate
 
Doctor M said:
psh...whatever...all you BMW haters! no small penis syndrome here or any type of syndrome. I just love the car...i dont race it, i'm not a dick on the road...Just love the car...
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I didn't say ALL, I said most. If you can afford for someone else to fix it, why not? They're absolutely brilliant pieces of engineering. If I bought a euro car, it would be a BMW.

In terms of the ****tyness of major european cars (how often they break/CEL), here's the breakdown in my experience:

1. Jaguar. If you have one, I'm sorry. I can tell you stories that would spin your head.
2. VW/Audi <-----total pieces of crap. I've never met a VW that I liked, and the Audi is it's more refined (read: more sensors that will break) brother.
3. Land Rover
4. Volvo
5. Mercedes
6. BMW/Mini

I know there are others, but the ones I see most often are there. Keep in mind this is from a mechanical perspective. While you may love flying around in your Audi R8, I'm the one who has to diagnose your perma-check engine light. Thusly, I hate it.

EDIT: Ha, I said "breakdown"...no pun intended.
 
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