what do you think of...

[PAJenn]

PA's opening clinics? I am a 3rd yr PA student (planning to get my MPH) and Im very much interested in public health and would like to eventually open a clinic. I know that as a PA we need a supervising physician and that is why im looking for advice. Do you think MDs would be willing to work for my clinic? I can imagine that it would be an uncomfortable situation trying to juggle opposing roles. The MD is my superior in the medical field but I would be his/her superior in the business aspect. But if it is looked at from a business perspective I would be nothing but an office manager right? What do you all think? Any ideas or suggestions as to how to go about this?

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[deleted6669]

if you want to be an office manager you don't need a pa education for that.......
anyway, it is doable. I have 3 friends(pa's) who opened a clinic and hired a retired doc to be their supervisor of record. he comes in 1 day/week to sign charts and carries a pager for consults (they never call him and he never sees pts). so, yes a pa can open a clinic. currently they have only 3 clinicians but if they wanted they could hire a doc who was not their supervisor as extra help on an employee basis.

 

[PAJenn]

thanks for your input! Having a retired doc is a wonderful idea, I never thought of that...
but just for the record Im in this to become a PA, i absolutely love the profession as well as medicine. I was just using the office manager comparison to explain that just because I owned the clinic did not mean I was trying to be above the M.D. But anyway, further down the line of my career as a PA Id like to open a clinic to give better healthcare for less fortunate people.

 

[deleted6669]

your best bet would be to try a rural or inner city location without an md practice nearby-e

 

[CVPA]

I have a problem with this. Although I can understand this kind of a set-up in a rural setting where there otherwise may not be any healthcare, in most other settings it seems to me that this is an inappropriate way to practice medicine as a PA. It is not the way that PAs were intended to practice nor is it the way that the current laws expect PAs to practice. PAs are called PArtners In Medicine because we practice in tandem with physicians. When we work with each other, we compliment each other and that, I believe, is the safest and most effective way in which to practice medicine as a PA. Using retired docs who don't see patients and only sign charts is, in my opinion, a way to circumvent the laws to provide a better financial reward and/or practice with complete autonomy. This, I feel, borders unethical behavior.

Beyond the moral issues associated with this type of set-up, one must also consider the possible ramifications that it may have on the PA profession itself. In my opinion, this type of arrangement only hurts the acceptance, development, and growth of our profession. One of the biggest complaints that physicians have about our profession is that PAs replace physicians. We continually argue that is not the case and that we practice in tandem with them. This kind of practice, however, goes completely against our rebuttal and provides fuel for their argument while at the same time breeds further resentment towards our profession.

Eugene Stead never intended for PAs to practice medicine with complete autonomy. If you want complete autonomy, go to medical school. If you want greater financial rewards, choose another profession that will allow that, but don't compromise the integrity of the profession by finding and utilizing loopholes that allow one to practice in such a way.

 

[timerick]

(CVPA, you may have missed the point. There's no lack of physician supervision in this scenario. It's simply that the PA's are hiring the supervising physician to work in their clinic, rather than a physician hiring the PA's.)

 

[PAJenn]

thank you timerick...
and actually if you take a look around, I can only speak for my experience, most of the time physicians are merely even around to sign charts and many charts go unsigned! Being a PA does not mean we need a doctor on our tail 24/7 it means we need a doctor in close reach that we can contact if we stumble on a difficult situation. As a matter of fact NYSSPA is actually working on changing the chart sign off rule. I would love to see a setting in which the physician actually sees every single patient that the PA sees....its impossible if that was the case then PAs would not be time efficient because instead of cutting time down they would just be doubling the time needed for each patient.

And I think a clinic in an underserved area is a wonderful role for a PA, primary care medicine is exactly what Eugene Stead wanted for PAs. Im not looking for more money or for autonomy cause if i did then i would have went to med school like you said. Im looking to give better care and better patient education to those people out there who are either not getting any or not getting enough. And in my opinion that is what a PA should be doing.

Replacing physicians is not an option obviously, without physicians we as PAs would not be who we are. And if you took that message with you from my post I apologize because that is not my intetion. Im not trying to redesign the entire profession with one clinic owned by a PA.

I dont think there are any ethical boundaries being crossed. Unless of course it is unethical to want to help people...

 

[CVPA]

Allow me to clarify my previous post as it seems necessary to do so.

First of all, I certainly do not have a problem with PA owned clinics that employ physicians to supervise PAs, nor do I believe that physicians need to be ?on our tails 24/7?. On that we appear to agree. My problem is with the scenario that EMEDPA?s friend is in where a retired doc comes in and signs charts and never sees patients. That is not supervision, that is a rubber ?MD? stamp designed to circumvent the laws. Those kinds of scenarios are counterproductive to our profession and breed resentment amongst physicians. More importantly, its just not good medicine. Along those lines, let me ask you this:

Which of the following two scenarios do you think is best for patient care, and I want you to be absolutely honest with yourself on this answer: Scenario A) A physician and PA see 15 patients each throughout the day in the same office. The PA consults the physician on 4 of the 15 patients and subsequently adjusts the plan on 2 of the 4 patients. Scenario B) A PA sees 15 patients by him/herself throughout the day and then at the end of the week, a doc comes in and reviews the charts and signs off on them.

Secondly, I did not infer from your post that you think PAs are replacing physicians. What I said was that physicians often make that accusation of PAs and that clinics that employ retired docs as rubber ?MD? stamps, strengthen their argument to that effect. If, however, a retired doc is available for ?supervision?, meaning they are available for consultations and are available as a resource for the practicing PA throughout the day, that is completely different.

Finally, I also agree that in underserved areas PA run clinics are necessary and in fact I stated that in the second line of my original post.

Look, this is just my opinion and in no way do I think that I am beyond reproach or that I am sitting in some ivory tower judging others. We all have to do what we are comfortable with and we have to be able to look ourselves in the mirror each day and know that we are providing the best care possible to our patients. I would not feel comfortable owning a clinic that uses a retired doc to stamp his/her name on the charts at the end of the week or month. If you are comfortable with that, more power to you.

Good luck to you in your career.

 

[deleted6669]

a little clarification. the 3 pa's who own this clinic are all former vietnam medics and have between them > 90 yrs as pa's. they only see routine fp and urgent care and refer a lot of stuff out to specialists who then report back with tx plans. also they are the only practice in the area so it's them or nothing. also they don't do ob.

 

[PAJenn]

of course it is a better scenario with the doc on call and i would not feel comfortable not having a doc in reach to consult...sorry if i attacked you or got the wrong idea...but there are PAs out there who have years and years of experience and may feel comfortable doing so, many PAs were docs in other countries and may also feel comfortable not that i am saying it is right or wrong...ultimately it comes down to how well the patient is taken care of...

but thanks for your input, i love listening to other peoples ideas and what not...and i do not in any way judge u or anyone else for that matter...

 

[CVPA]

No problem. This is the place to come and discuss ideas and you should continue to do so, especially given that you are just entering the profession. Sometimes they can get a bit heated, however, I associate that with passion of beliefs rather than reactive hostility.

I would be interested to have this discussion with you in a few years after you have had a chance to practice for a while. You may have the same opinion, then again you may be surprised how it changes with clinical experiences.

Again, good luck.

 

[Serge718]

I would say that it is possible to have a clinic as a PA, but i don't really understand why a doctor would agree to such an arrangement.

I see 2 big problems.

1) Having a PA's running the clinic is a definate risk for the MD. Should something go wrong he/she may lose his/her license to practice medicine. Now don't get me wrong, i'm not saying that MD's make less mistakes then PA's. It's just that the MD may find himself in a situation where things are more or less out of his/her hands.

2) Why work for a PA when you can open an office and have a PA work for you. This way you make the most money for doing the same job. (and no it's not all about money, but for the same job, you might as well be making the most)

I guess if you are a retired Dr. and you will make money for showing up once a week, then it's not a bad deal. But i'm sure many people would be skeptical of such an arrangement.

 

[deleted6669]

my 3 pa friends who run the clinic in question each have their own malpractice policy plus they bought one for the doc. their rates are pretty low because they don't do ob and the doc does zero procedures.also they refer anything high risk to a specialist. their practice is mostly basic fp on healthy folks and stable elderly and some urgent care for migrant farmworkers. it must work, they have been in business for over 15 years and have never been sued.

 

[PAJenn]

serge that was my exact reasoning, i was afraid that docs wouldnt want to work for a PA because they can just have the PA work for them...but there are many medical offices out there that arent run by doctors and instead are run by business me/women, as a matter of fact all the offices Ive worked at were run that way. I know that this will definitely be a big challenge for me, but Ill take the risk as it is a dream of mine. I appreciate your comments and Im glad that someone was thikning hte same way I am...but when it comes down to your statement about the PA messing up, the doc is still ultimately in charge of me and my health care practice, I am simply in charge of the business aspect of the clinic so Im not sure where that scenario would fit in the same "mistakes" could occur whether a PA was running the clinic a business woman/man or an MD... Im hoping that there will be Mds out there who dont want to get involved with all the business and will work for me for a good cause...

 

[cecilia]

Hi,

I am also thinking about the possibility of openning my own place. At least, work at a clinic or hospital part time and my own office part time until things get more stable. I don't know..I am not sure yet. I will be graduating in June. I guess I have to contact the state PA organization to get more info.

 

[MD2b20004]

sorry but from what i am reading no offense to anyone or not attacking anyone is that some on this post want to upgrade their role from PA to MD, as if they always wanted to be an MD and all what an MD can do but dont want to go thru med school, almost like a wanna be MD, to be honest as a patient i will be scared and reluctant to get seen in a clinic run purely by all PAs, for i feel more secure with the education and knowledge of an MD, if you guys want to take on the role of an MD go to med school, dont try to substitute your insecurities and ambitions to want to be "like an MD' without putting in the dues.

Again i am not trying to attack anyone, just a reality check, you guys are PAs, not MDs, want to run your own clinics or act like MDs , then go do your time in med school.

 

[me109cito]

These people are dreaming. Hire MD's to work for P.A's?
Be serious. Your job as a P.A is to work under a physician's supervision not the other way around. Without the physician looking over you, you are nothing. I agree with the above poster, stop trying to be "physician-like" if you want independence then go to med school.

 

[deleted6669]

it's certainly not the norm, but there are lots of solo pa practices all over the country, especially in rural areas. a recent survey in north carolina found 15% of the care in that state delivered by such practices........

 

[MrBob]

Personally I think it is a dangerous thing for a PA right out of school to consider this, unless he.she has a "hired physician" working on site with them. It takes a LOT of experience and exposure to medicine to consider running ones own clinic not only from the business aspect but from the MEDICAL CARE aspect (which to me is the most important factor in this)

This ain't Hardee's....................

 

[PainDr]

I agree with the previous posters. New PA grads have no business opening their own practices. They're just too green. As a 3rd yr resident, I'm 11 years into my education (not counting 2 years in grad school) and I still feel pretty darn green. The problem with new grads is that they only know what they've been taught, which is actually VERY LITTLE! Believe me, you may think you know alot of medicine, but relatively speaking you've barely scratched the surface!

I know what some of you are thinking...how do I know what your knowledge base is? Well, I know because I've worked with LOTS of PA students and grads. Functionally speaking, a new PA grad is somewhat comparable to a 3rd yr med student after 3-4 clinical rotations (although it is very rare to find a new PA with a comparable knowledge base). Older, more seasoned PAs are a different story. In general, they're much more knowledgeable and seem to know and respect their boundries. So to all you new grads...do the right thing...get some experience before you bite off more than you can chew!

 

[deleted6669]

agree with above....solo practice is not the place for a new grad...give it 5-10 years than think about it again.....
it would be best to have a first job with lots of available supervision then over time work yourself into jobs with more autonomy and less direct supervison as your comfort level allows. when you reach the point at which you never ask your supervisor questions and only deal with consultants you are ready for a solo job.

 

[JSNYMD]

If you want to work in a solo practice you should go to med school. I'm tired of people trying to take an easy way out and cut every corner possible so that they can pretend to be something they are not. You say that they only see small stuff...problem is when the big stuff presents as the small stuff. Being a Vietnam medic only gives you one aspect of medicine, not an aspect that would make one a goof fp.

 

[deleted6669]

15+ years in practice without a lawsuit or bad outcome should show that they know when to refer out " big stuff...."

 

[MrBob]

"If you want to work in a solo practice you should go to med school. I'm tired of people trying to take an easy way out and cut every corner possible so that they can pretend to be something they are not. You say that they only see small stuff...problem is when the big stuff presents as the small stuff. Being a Vietnam medic only gives you one aspect of medicine, not an aspect that would make one a goof fp."


I work in a solo practice.....as a PA......many of us do because you guys will not go the community and work......"it's too small"....."I wouldn't want to raise my family here"....."Hell....this is in the boondocks"........Come up with the reasons.

Most of us are just trying to fill a nich and help out somewhere....aren't interested in being you. YOU would be damned surprised how many PA's are damned capable of being MD's...there's no secret to what you do you know.

All that aside...most of us are just trying to do an honest job in a place no one else would dare come and work

I have stated my position regarding PA's and owning practicies. Ya know, really it isn't the PA that looks odd owning his/her own practice...it's the doc who goes to work for them....and I know a BUNCH of docs who are employed by the financially most successful PA in southeastern NC. the guy owns a HUGE medical complex, works as a PA in HIS business (doesn't pass himself off as anything else) administrates this HUGELY successfull operation and employes about 5 docs and PA's along with a large staff.....in a large NC city........

 

[CVPA]

It seems as though everytime a PA discusses an activity on this forum that is also performed by physicians, there are always a couple of yahoos who turn around and call them "MD Wannabes" or "people trying to take the easy way out". Practicing medicine as a PA is not any more taking the easy way out than it is to become a Speech Pathologist or Clinical Psychologist. They are just different professions. As long as the PA is functioning within the scope of practice outlined by their respective state laws, he or she is not acting like anything other than what they are.....PAs. If you don't like it, thats just too bad. The reality is that there are PAs who own their own practices and employ MDs and even though I have concerns about them (which I voiced earlier) the fact is they are doing it LEGALLY. Just because they have the entrepreneurial ambition to set-up such an arrangement does not make them an MD-Wannabe. Get it straight.

 

[MrBob]

Well put CV...........

 

[MacGyver]

Originally posted by emedpa
hired a retired doc to be their supervisor of record. he comes in 1 day/week to sign charts and carries a pager for consults (they never call him and he never sees pts).

I'd like to speak to this "doctor" so I can tell him to his face that he's incompetent and guilty of borderline medical malpractice.

I hope a patient sues the **** out of him and sends him back into retirement.

 

[MacGyver]

Originally posted by timerick
(CVPA, you may have missed the point. There's no lack of physician supervision in this scenario. It's simply that the PA's are hiring the supervising physician to work in their clinic, rather than a physician hiring the PA's.)

OK, he said the guy comes in 1 day a week and NEVER sees patients. For a "doctor" to sign off charts based on that kind of exposure is ridiculous. Its unethical and a very poor way to practice medicine.

I'd guess that this clinic has an avg of probably 10 patients a day so thats 50 patients a week minimum. I bet the supervising doc signs charts for about an hour and goes home, giving him a review time of less than 1 min per chart. Thats an absolute joke, further substantiated by the fact that he NEVER sees patients accoring to the other poster. I find it incredibly hard to believe that out of 50 patients per week minimum, that NONE of them needs to be seen by an MD.

Like I said, that doc is going to get hammered in a lawsuit eventually. He wont just lose money, he'll lose his license and never be able to practice medicine again. I guess he doesnt care since he was already retired to begin with.

 

[MacGyver]

Originally posted by emedpa
15+ years in practice without a lawsuit or bad outcome should show that they know when to refer out " big stuff...."

Never had a bad outcome in 15 years? Bull****.

 

[PACtoDOC]

I think many of you show your inexperience in medicine when you question why a PA would not be qualified to run a medical clinic. If you visit and examine closely most medical offices, you will on usually not a physician, PA, nurse, or accountant running the office. Normally the office manager is either a medical assistant who has worked their way up, an LVN under the same circumstances, or in the best scenarios a BBS graduate or Master's in Business or Healthcare Admin. Any PA who is attempting to run a clinic is doing so because they either are highly qualified to do such, or are desiring to have more of a say in the everyday functions of a clinic. There is no reason that a PA cannot own and run a medical office, but I do feel it is a serious conflict of interest in having this same PA work under a physician that they hire. For this to work, I think there would have to be a detailed contract approved by an attorney that specifically states that the PA's role as a "boss" would be completely separate from their role as clinician. The doctor would need to feel comfortable that the person they report to in a business sense is not capable of exercising any authority over them while in the clinician role. I think this would be very hard to pull off without some sort of animosity developing. My guess is that in the future there will actually be some sort of law against this very arrangement like there already is in the legal world. A paralegal cannot be a partner nor own a law firm, although I know this is not the best of analogies. Bottom line...if you are a PA trying to run a clinic and be an entrepreneur, then you probably have an ethical obligation to not work for the doctor you employ. I just see too many bad things coming from this. I cannot believe that I am even near to agreeing with a troll like MacGyver!!

 

[deleted6669]

mac, they actually see about 40 pts/day. those that need further eval get a REFERAL (ever heard of those) to a specialist. they have an entire network of md consultants who are happy to see their pts.....

 

[NonTradMed]

If there was enough MD supevision, and no one goes beyond their scope or practice, it would not be a legal problem....but I have to admit it would be strange for an MD to override the professional decision of his BOSS....sounds like a relationship fraught with professional dangers.

OTH, the example one poster cited (where the PAs hired a retired doctor)....it would probably work at a professional level, but I question the type of care they are providing their patients with.

Obviously, the PAs are providing care in a place most MDs would not venture, but they really should have a closer relationship with MD, it does sound like they are hiring an MD to rubber stamp the charts.

I guess the situation outlined by the OP is doable, but there are legal and ethical issues that need to be resolved before they can make it happen. Good luck on whatever you choose to do.

 

[MrBob]

Thank you PAC.....I would have liked to have said that the way you did........Owning and practicing can be two very different things.

I now work in a clinic OWNED by two nurses....they have NO responsibility in the day to day MEDICAL care in the clinic..that is the job of me and my supervisor....but they DO understand coding, billing and insurance headaches and they manage that..theyhave a company that does consultant work reviewing charts for medicare accuaracy and they are HOT when it comes to getting your $$ from the insurance companies that like to drag their feet. THis scenerio could work well for anyone who understands business as long as they are not trying to provide INEXPERIENCED medical care also....make sense? anyone wanna rent my nurses? (LOL)

 

[PAJenn]

thanks PACtoDoc thats what ive said throughout this whole post that the PA would simply be the office manager...too many people are heating up this post and making things up...I NEVER SAID I WANTED TO BE AN MD! I dont know where people get this idea, I simply want to bring quality healthcare to an underserved area. Im not looking for independence or autonomy Im looking to help people! I dont get what the big deal is...I agree with PACtoDoc the only thing i was worried about was the doc feeling uncomfortable and the boundaries and such since I would be the MD's boss in the business aspect so thats where my worries came in...and thank you too Mrbob...It seems to me that MD's are afraid of what PA's are capable of....
I also never planned on graduating and opening a practice, I obviously would not have the skills to do things on my own, but even so, the MD is still my superior and still there to check my decisions Im not running this thing on my own, because then I would not be a PA!

and another thing is all this garbage of the FAST TRACK to medicine or the easy way out...last time i checked PA school was in no way easy! its med school cut down to 1 year and residency cut down to another year...if i wanted to be a doc i would have went to med school, I didnt so i obviously found something worthwhile in the PA profession and I am very comfortable with my boundaries and in no way do I want to compromise them....like i said so many times, Im just the owner of the clinic, im not trying to be an MD you dont have to "act like an MD" or be an MD to open a clinic, many clinics are owned by health care professionals and business men and women, wow what a shocker!!!!

...but thank you all for your input cause it has shown me even more how horrible the animosity is between healthcare professionals we should be supporting each other and giving credit to others who are trying to reach out, not bashing people and assuming that we are trying to be something we are not, have faith that we are all called healthcare professionals for a reason, because we are professional and I think most of us out there know our boundaries and if there is a minute population that dont, then consider that they do until otherwise proven dont go assuming that everyone is out there to have their cake and eat it too...

 

[MrBob]

Well Jenn...that being said....GO GIRL......

If you recognize a community that needs healthcare and no one has had the foresight or guts to go help them...do it. Good luck girl!!

btw...come visit us on physicianassociate.com

(I have promoted this forum on that one for those who might be interested)

 

[sambo]

Originally posted by PAJenn

...last time i checked PA school was in no way easy! its med school cut down to 1 year and residency cut down to another year


I hope to GOD that you aren't trying to say that 1 year of PA school and a year of "residency" equals four years of medical school and a 3-4 year residency. You've just discredited any post you make from here on out.

 

[CVPA]

I KNEW IT!!! I KNEW IT!!! I KNEW IT!!! When I read that sentence in PAJenn's post, I knew that some gunner was going to take issue with it. Take it easy Sambo, I am not even the poster and I can tell you that is not what she meant.

Unbelievable.......

 

[PACtoDOC]

CVPA,

I am sorry to disagree with you and agree with Sambo, but her comments were pretty off the mark. It is just not right to assume or believe that PA school is truly any rendition of medical school. The pathophysiology alone in medical school is so in depth and painful that to cut it down at all is simply impossible. You just cannot learn everything in 2 years, much less four. Medical school in one year?? I hardly think so. Residency in one year? I again hardly think so. I have watched the transition that my best friends have made over the first 2 years of medical school and I cannot express how proud I am of them. I am stunned at how much material these guys have to digest without having any background in it at all, and even now nearing the end of year 2, I see many of these classmates to be way past where I was even at the end of PA school. There is a method to the madness here, and it obviously works. These guys in my class are phenomenol, and I cannot even put myself anywhere near their league. I stay close grade wise but I literally consider my background as cheating in a way. If I had to learn all this material this fast, I would probably be significantly more on edge than I already am (and that is pretty on edge!!) So no offense to Jenn, but comments like that are not going to go over well anywhere near anyone who has had to sit painfully through medical school.

 

[CVPA]

Matt:

I agree with everything that you said and I think if anyone is qualified to comment on this it is you, for you have been on both sides of the fence. I just inferred a different meaning from Jenn's post. To me, she was saying that PA school is med school and residency cut-down, period. No where, however, did I read where she said that they were equal......at least that was my take on it.

I have got to say, my friend, the last time that you and I spoke you were singing a very different tune about topics like these. Its interesting how experiences change your perspective.

 

[PACtoDOC]

No kidding CVPA. This damn medical school is like the worst long run your football coach made you do after the worst loss of the year. PA school is more like the fast run to the top of the stadium, where you know how long it is going to take you, you know you will get to walk down as soon as you get there, and you know the pain will only last so long. Here, just when I feel I am doing well, the next system starts and the pain starts all over again. With the exception of pathophysiology, nothing we learn here is in any more detail than PA school, but there is more overall material per subject. Its a lot like Chineese water torture!! What makes medical school different is that it lasts longer, and exponentially there are inherently longer non-academic side effects of such a long haul. Being in school all the time makes you very run down both physically and emotionally. And then knowing that your true future is at least 5-6 years away still is very dissatisfying at times. Ask even the smartest doctor you know
(usually some Plastics or Ophtho doc) what she/he would have done if 2nd year lasted just one day longer. Most will tell you that they would have been looking for the Bell Tower to take aim at some innocent bystanders!! All I can say is that there are some seriously different things about medical school that PA school just cannot simulate. I used to be one of those PA students who told all my family and friends that PA school was "mini med school", but I now know how wrong I was. I mean the tests aren't really any harder, and the people no smarter. It is just a journey that you can't understand without taking it. Even if you put a 10 year veteran physician back in medical school, they would still suffer the same as everyone. They might have to study less, but they still take the same arduous journey once again. It is the ultimate right off passage and it is why you see so many physicians get defensive of their experiences. So don't get me wrong, as you will meet many a "dumb as a box of rocks" doctor out there, but just remember that they somehow had the courage and dedication to make it that far (even though they still may be stupid!!). Its like Navy Seals. These guys are not usually the strongest, or the fastest, or the smartest. But they are the endurers, and they walk the average line very well in all aspects of their training. So even though a sniper might outshoot them, and a diver might outswim them, and a runner might outrun them, no one will ever out survive them. I am a firm believer that almost any average person can make it through medical school, but not just any average person chooses to.

 

[sambo]

Originally posted by CVPA
I KNEW IT!!! I KNEW IT!!! I KNEW IT!!! When I read that sentence in PAJenn's post, I knew that some gunner was going to take issue with it. Take it easy Sambo, I am not even the poster and I can tell you that is not what she meant.

Unbelievable.......

CVPA,

I assure you that I am not a gunner, but I do take offense when anyone tries to downplay the hell that we medical students endure for seven years.

If I took the statement out of context, then I apologize. However, it seemed pretty clear to me what she was trying to say.

 

[CVPA]

Matt:

Well said, kudos.

Sambo:

If I were a medical student, I too would take offense if that was what she was saying. I don't think that is what she meant, but whatever. Only she knows what she meant.

It just seems like medical students, and sometimes even residents, spend more time perusing and monitoring the PA forum for indiscrepancies and opportunities to pounce than they do on their medical studies. I am not saying that is necessarily you, its just that type of thing is a continuous annoying theme here. For this reason, I got away from this forum for the past year and half and so now that I have returned, I am a bit sensitive to that kind of thing. I do, however, enjoy many of the discussions and debates.

 

[PACtoDOC]

And hey CV, if it is any consolation, I think you made a well informed decision to stay a father, husband, and well paid PA!! Sometimes I wonder if I made the right decision. And if I had not had some odd financial resources to make life not all that much different for my family, I probably would have stayed a PA. And yes, I agree that there are too many medical students and residents that wander the halls here at the PA forum looking to show everyone how smart they are. I don't think Sambo meant to be that way, and I also think Jenn would have rephrased her comments had she taken the time to put a few periods into the dissertation as well!!! LOL. She was obviously in a hurry. And like I said, a doctor is no smarter a person than a PA. They just are veterans of a different and longer war!

 

[CVPA]

Its funny that you say that because as I recall, you too are a family man. I was going to email you and ask how that aspect is working out for you.

 

[PACtoDOC]

I am actually closer to my family than ever before since I rarely if ever go to class. But that is all about to change in year 3 coming up in June. Rotations aren't an option unfortunately!! But my kids and wife have adjusted very well to medical school life and the "downsizing". Let me know if you want to work for a PA friendly doc in about 300 years, when I should just be completing my education!! LOL. By then you and all the other PA's of my generation will be retired and sipping Pina Coladas on some beach!

 

[MrBob]

" By then you and all the other PA's of my generation will be retired and sipping Pina Coladas on some beach!"


(LOL).......I know I will!!...or out riding my Harley with no where to report to the next morning

 

[CVPA]

Glad to hear things are going well. During my application process, I felt like things might not go as well for me on the family side. I just pushed those fears into the back of my mind and pressed on with the application process. My wife had already endured 8-years of schooling with me and so the idea of another 7 (4-Med, 3-Res) did not sit well with her, but she didn't want to stand in my way and so she agreed with reservations. In the long run and in all fairness to her and the kids, I just couldn't ask her to do another 7. As it turned out, it was the best decision I ever made and things have since truly opened up for me on the professional side.

Funny how things have a tendancy to work themselves out if you just listen to your gut.

 

[PACtoDOC]

If I were to listen to my gut these days I would likely have to test my EAC's for H-Pylori!! Its tough on an old guy (32) to hang with all these young kids in terms of lifestyle adjustments. They can live on 4 hours sleep, but not me. The stress is really a big factor even when you make great grades. But I only have until May 1st (2 months and 2 weeks away!!!) before I am done with all the didactics forever! I am not worried about boards in the slightest, and in fact plan to use the month off for travelling and relaxing...with a few study hours in there Anyway, CV and Bob, check out my next post on physicianassociate.com and chime in with some advice if you have any. Thx.

Matt

 

[PAJenn]

i put this in the wrong forum by accident..

"(basically we cover 1/2 of what you'd cover in first year and just about everything you'd cover in second year, and we only have one year of rotations instead of two)"

this is exactly wat i was trying to say this whole forum is just competition like i said before, this is not a tournament for who is better than anyone else...if you ask anyone what PA school is like, they will tell you it is med school crammed into 1 year I was in no way saying that we learn just as much and I was not degrading any medical students, everyone needs to take a breather and stop looking for reasons to light flames...Of course PAs dont learn all the pathophys we learn the bare minimun to get us through...so calm down med students I wasnt putting you down or saying anything derogatory...I hear every single day from all my faculty that we need to deal with our workload because we are pretty much cutting trimming and cramming med school into 2 years...

Im not saying that PAs education is equivalent to an MD, im just trying to show how intense our education is, and it really is medical school cut down trimmed and crammed into 2 years, but in no way equivalent....no one is taking away your expertise and your great knowledge, I respect Drs for all their education and i am in no way trying to compete or say that PAs are the equivalent because if they were then who would go to med school?! There are obvious educational differences thats what separates us everyone just breathe in and out and let it go!

 

[DRGIGGLES]

a few words from a lurker...

it occured to me while reading this thread and reflecting on my own experiences, that the difference between PAs and docs boils down to the old horses vs zebras analogy.

it seems that PAs (and NPs too i suppose) basically get taught the horses. they are well qualified to diagnose and treat them and for a great deal of primary care medicine that's sufficient. seen in that light, i'd say it would be fair to characterize PA school as a stripped down version of med school. it's med school stripped of the zebras.

med students, on the other hand, get taught the horses and the zebras too. this explains the difference pac noted in his pathology course. (btw pac, i think you will find this difference will play itself out in clinicals as well. i did...read on.)

several times already, i've blown the basic diagnosis of a horse in front of an attending only to be pulled aside by the PA who's taught it to me again. (does that scare you? it scares me. stuff two years worth of zebra into your head and you'll see how hard it is sometimes to actually recognize a horse. i'm a lot better now though then when i started. promise.) on the other hand, on a number of occasions, i have managed to come up with zebras which the PAs/NPs on the case did not. and a small number of those were actually worked up on. yay...$30,000 per year in tuition not totally blown.

for better or worse, i've also had attendings assign me cases because, "the PAs aren't taught about this". (that's an honest quote and similar statements have been made to me on more than one rotation.) these same docs employ PAs and have good relationships with them so I can only assume those statements were not made out of malice. as a previous poster pointed out, the attendings simply expect us to have a wider knowledge base. correctly so in my opnion, since as docs we will ultimately have more responsibilities.

now whether or not most docs actually do have a wider knowledge base is another story... i could comment on that for ages.

but i won't. instead, i'll retreat into the shadows.
-drgiggles