Sad for her, sad for her profession, and sad for her patience. There is a lot of talk about autonomy, but not much to really go around. My doctor's office has a couple of PA's who work there, and unless I need to be seen for something with a long and complicated history, one of the PA's is just fine. Most CME programs are attended by all three types of professionals, ensuring that NPs and PAs are not only trained similarly to physicians, but that they continue their education alongside them as well. “It used to be they didn’t need any clinical before they began practice. Hard to argue patient preference on this situation. So, when a patient questions a NP’s medical expertise, the conversation should begin with the education involved to become one: “I was a registered nurse once, and still am one at heart, but I furthered my education and received an advanced degree to learn the practice and administration of medicine. Therefore it is up to you to prove the scenario you prefer. We choose the PA profession because we want to be PAs; The PA profession began at Duke University; the first class of PAs graduated from Duke on October 6, 1967. A magazine referring to her as the “go-to MD” is not an inconsistency, it is a lie. I went to the doctors with my girlfriend cause she had a boil that needed to have an incision and i tried to watch the whole procedure and i ended up having a vasovagal episode ( passed out). I agree that my response was somewhat harsh; however, as a PA, I am probably a bit more sensitive to the sensational statements that are being made by some physicians regarding my profession. I have written many times about the importance of team dynamics and collaboration in healthcare. As a bedside nurse and NP student I see the knowledge physicians have. Niran Al-Agba, MD is actually a physician. I also have a PHD in Biochemistry and know and value the importance of training and education. A variety of … 3. Yes. I hope so. From the front desk staff to the highly trained specialist, everyone should know the importance of the key role each of those individuals play in good patient care. So as long as you’re nice and sweet, it doesn’t matter if you misdiagnose and harm the patient. Still practicing , 2 more years for my MSN and now in an FNP program. In my opinion, the gist of the article is a failure to be truthful in advertising one’s title, education and practice. At the tender age of 21, she inaccurately referred to Ms. Kidd as her “life-changing dermatologist.” Cosmopolitan continues the charade, publishing an article on the Jenner family “dermatologist.”. In this infographic, we explore facts and figures behind the American addiction epidemic, what you can do to keep helping, and how Barton can guide you through next ste... Are you an NP or PA who has fielded patient requests to see a “real doctor”? Medicine needs to recognize a PA with ten year’s experience is able to do many things with more autonomy than a … Ah thank you. Things have changed and not all PAs and PA students have a military background, however patient care experience is STILL a requirement. I have no knowledge of your father or his death. In practice PAs are being given virtually identical roles and responsibilities. There is now a blurring of the lines and they are no longer correcting patients. Finally, as for updating my website being “truth in advertising”, my father passed away at the end of October, and to be honest (which I am to a fault), I have not decided what to do regarding the website. Thank you for making it clear this is very personal for you and no matter what, I cannot assuage your vitriol. Being in healthcare is a huge responsibility, and by portraying oneself as a physician they are undermining patient trust in physicians and health care teams as a whole. The insurer, whether you realize it or not, substantially influences how physicians practice. We are providing the exact same care in many areas of medicine so statements like “Horses are “like” Zebras, but they are far from being the same.” is very insulting. By Lisa Esposito, Staff Writer Aug. 1, 2014, at 9:55 a.m. Mor Here is an example: https://medicine.uiowa.edu/pa/education/prospective-students/course-requirements . Can you tell me how I was supposed to know that her father was deceased? “In addition most nurses work at bedside while pursuing advanced degrees”. During several years of “Blogging,” I have never seen such a fuss. Do not assume that the person you are communicating with has no experience. You should see their faces when they find out I am an Irish Catholic… Click To Tweet 15. Right now it seems too many responders are in a defensive position rather open to debate on policy considerations. However with the proliferation of NP programs, newly graduated nurses are starting programs with no nursing experience, and from what I have experienced working with some of these nurses is that they have no interest in patient care as a nurse, only in getting there NP degree as fast as possible. They don't want to put the time into training or into the practice of medicine. Why pick one instance, from a day time talk show, no-less, to target PA’s? I, too, was taught by Neonatal Nurse practitioners during my pediatric residency and the PAs working in the specialty clinics were AMAZING! We are paid less but able to spend a little more time with patients, this is because physicians are forced to see a patient every 10 to 15 minutes. Would we really accept a mid-level practitioner as representing adequate Primary Healthcare for a child with disabilities or for an adult on five or more medications taken at least once a day? While it seems to make sense to always ask for an expert, there can be some downsides. AD. Mid-level providers absolutely have an important role in medicine. They were receptive to my leadership and there was no sense of competition, just teamwork. Yes, you should have the right to see whichever doctor you prefer. This article is about a PA gone rogue. Physicians made these events happen to the betterment of mankind. It may require you to wait a little longer to get an appointment with the doctor, but they should honor your preference. This difference tends to be of little consequence, as the majority of NPs practice in outpatient primary care. Thanks. I agree PAs must have doctor oversight at all times, unless employed by a federal program. He’s not out trying to make himself a media star or allowing himself to be mischaracterized. Many say? How did you miss it? I have not seen such a fuss before either, but it is interesting in that much in the way of dialogue may be generated. In essence, I feel the appropriate way to utilize PAs is for Physicians to take the lead in defining their role which may be unique to the Physician or environment they work. I don’t think we can make generalized statements about the quality of current PA and NP graduates but certainly the more we have the greater the variety. It may well not be a doctor: ... what type of medical provider would they want to see. If your primary-care MD is usually missing in action, and you want to see someone with an equivalent level of training and experience, consider a DO (Doctor of Osteopathic Medicine). This point must be a joke. Thank you for your comments. This is CLEARLY a PA problem as there has never been an unscrupulous or fraudulent physician. As a physician, the insecurity by PA’s here is astonishing. Good luck to you. On the other hand, “when you get sick, it’s easier to have a doctor you know and can trust.” A primary care physician treats you with your medical and family history in mind. You can request to see me instead of the MDs. Let us not presume to somehow extrapolate this information to reflect a larger statement about PAs and PA practice. If you do this well then the collaboration can dramatically improve the quality of care patients receive, if you demean the role as this article did then the collaboration suffers. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4730953/. Does being a helper mean you do not provide quality care? I get called nurse numerous times a day, as in I dont want to see the nurse! Dr. Al-Agba, you should not throw stones in a glass house. Your email address will not be published. Its sounds like an ego issue. im not scared of blood or anything gory, i just pass out for no reason. At that time, my mother was hospitalized and she told me about her physician assistant (PA) who was the one who spent time and developed a relationship with her. The website of the plastic surgeon states, “Trust only a Board-Certified Plastic Surgeon;” which in my opinion, seems astonishingly tongue-in-cheek. This is not what it was about! Not to mention it is not clear if Ms. Kidd is the driving force behind all the misrepresentation. PAs require 100 hours CME every 2 years and must recertify thru examination every 10 years (this was recently revised from 6 years to be more consistent with our physician colleagues). My intention was to introduce that the lines between physicians and mid-level providers are increasingly becoming blurred and then go on to describe a situation where one individual has taken misrepresentation to a higher level. I don’t understand why we can’t just call her Ms. Kidd, PA-C? Look online to find a walk-in medical clinic in your area. PA-S speaking here. Lets break it down: PAs do not practice medicine based on the needs of insurance companies, I am one so I know. What a great article! The fact that this person would try to obfuscate her credentials speaks to her character. Your email address will not be published. Unlike NPs, who must be registered nurses prior to entering their respective programs, PAs must only hold a bachelor's degree in the field of their choice as long as they meet the prerequisite requirements of their medical school program. I will say the PA I go to is great at diagnosis and treatment. Over 20 years I have become very independent and rarely need the guidance of my supervising Physician. Of course there are good and bad MD’s, DO’s, NP’s and PA’s. I think that approach is terribly unethical. Unfortunately when I express my concern about this to NPs, the response is usually that nurse has a doctorate and has a right to themselves doctor. In our area other providers know my name and associate me with excellent care….there are always “bad apples,” and I have meet some physcians that I am truly shocked how they even made it through medical school. I support the PA profession as long as it stays on our team. Depending on the study, Doctors rank #1 to #6 in best paying jobs in the the US. You walk into the exam room or emergency department, or you are making the rounds for a physician. Two to 4 years of nursing school is comparable to the required 4 year degree of all PA programs. My posts have had no negative racial or anti immigrant connotation and for you to imply otherwise is more telling of you. A person who portrays themselves as a physician, but who is not is falsely advertising themselves as someone who has training and credentials that they do not have. If all professionals do not insist on the honesty and transparency called for in this article, we ALL… our boards, physicians, PA and the press will continue to erode the public trust. Great questions Allan, as usual. Intrigued, I investigated the profession and turned down my admission to medical school, taking a year off to complete pre-PA requirements and ultimately … Ad coms will want to know that you have considered what these other professions have to offer, and they want to see if you know what medicine is all about. I have a similar problem, i want to be a doctor but everytime i see blood i pass out. If physicians aren’t trained enough with all their hours of training then what can be said about a PA or an NP? The word assistant is a misnomer. If it was simply the years of education then the rest of the civilized world would be duplicating our system when in fact the length of education for Physicians in the rest of the world is much shorter. That is understandable and you are entitled to feel that way. Its a licensure issue and not a payor quality of care problem, right? Thank you for the constructive criticism on this piece. Great ideas for improving the health care system. You are seeing what you want to see, rather than the original intention of this post which is calling out misrepresentation. It is confusing, even to those of us who work within the medical industry. No evidence is given. The training model for PAs very much mirrors that of physicians, and so the discussion with the patient should begin there. A comparison of what it takes to get in (GPA, MCAT, GRE scores, prerequisite coursework, and clinical experience), years of training and time in school, job duties, cost of education, average salary, job satisfaction, divorce, and burnout rates all compiled into this (very shareable) image. Magazines make erroneous statements all the time. The search for truth, left unattended, is no longer an alternative when the choral ending occurs. I've started to think about how I could pull myself out of this slump. Transparency is the major point. PA and NP are two different routes to the same kind of position. Midlevels are not equal to physicians!! After a patient meets me they generally prefer me over a physician as I can spend more time with them. Some want to return from ... “If a doctor has been out for a while, they are not. I have always taken on the role of being an extension of their practice style and done so with very little guidance from them. If you were concerned about how this would be viewed, by the PA’s at large, you should have rethought several of your statements, which exudes disdain for non-physician medical providers. You may feel I am intentionally being dishonest and that is your prerogative, in reality, I am grieving a huge loss of my father, business partner, colleague, friend, and mentor — all at the same time. Ok, got it! Absolutely agree. What you do and what a physician does are NOT identical. But blatant lying is despicable. To bring this closer to home, in an attempt to help you see the err of your ways, let me tel you a personal story. You and your doctor must be able to work together as a team to treat your disorder. Our longer training means that we might have a trace of memory for a few more rare things and even these traces help us look stuff up. There are laws mandating physicians display diplomas and certifications prominently in the interest of transparency. If you want to be involved in all the complicated patients then you must say so, if you want to only be doing new admissions and regulatory visits in nursing facilities and have the PA do most of the care during their stay then you must define that as directly and clearly as you can. 11. While PAs are a valuable member of a treatment team, their training does not approach that of a board certified dermatologist (8 versus 2 years of post college training). However, that does not change the fact that each role is unique and important in its own right. It’s incredibly important for patients to know who they are seeing and what that persons training is. see my comment above. One’s understanding of the pathophysiology of disease and pharmacological management must be solid. Christie Kidd”, as the “go-to MD practicing in Beverly Hills.”, The article shared how Ms. Kidd treats the Kardashian-Jenner family, “helping them to look luminous in their no-make-up selfies.”, While most of us cannot grasp the distress caused by not appearing luminous in no-makeup-selfies, this is significantly concerning for Kendall Jenner. My training emphasized treating the whole patient, not just disease. A PA is entering into a dangerous territory with regards to safety of patient care by misrepresenting their training and certification. What on earth is wrong with being a PA? “Vitriol” is a very strong word to use when I’m simply asking for you to advocate supporting an open dialogue, and understand how your article title, while not your own, may shut that down. I used to hear that quite a bit. PAs are "done with school" and will never "be a doctor". A patient utters the words you dread hearing: “I want to see a real doctor, not an assistant.” In some rural areas, a physician assistant or nurse practitioner may be the only medical provider for miles, so a “real doctor” may not be around. The AMA did a study recently showing that about 70 percent of patients if not more, had no idea who they were seeing. As the number of PAs is growing rapidly and lines of roles and responsibilities are being blurred, it is not only important for PAs to represent themselves correctly but I also ask that Physicians be more proactive in defining the PA role. I find her knowledgeable but also see her as a mentor in my life for many reasons. Why is it ok to mislead a patient about educational background and credentials as long as no patients complain? While it seems to make sense to always ask for an expert, there can be some downsides. ... You can't get an appointment when you need to see your doctor. I will ask the question again of all the PA’s who have commented: Why is Ms. Kidd allowing herself to be labeled as the “go-to MD” instead of the “go-to PA”? No one has said “PAs are all bad.”. If it’s the patient’s first visit, we get an X-ray to see the bony anatomy. Think of the electrician that has the certifications necessary to do the electrical work on a new home or remodel. Who would ever even ask that statement? Further more, I don’t recall that any of the national ‘health system’ certification processes have ventured into this problem. That is not up to the PA, it is up to the MD and the staff.”. Furthermore, NPs have no ongoing certification maintenance requirements outside of CMEs (75-150 hours) and clinical hours (1000 in their field of practice) per 5 years. 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