Physicians Assistants?

I don't want "works in conjunction with." I want the real deal.

I want a doctor. I want him trained in the best schools, with access to the best technology and I'd like some experience, too. When it comes to my health and my body (or that of those I love), I don't play. No second best, thank you very much.
 
I have been going to the same PA for years. She does my physicals and will sit for as long as I need her to comfort me or explain any medical situations or just plain female things that might be going on with me. She has always ordered tests for me and will send me to a doctor or the gyno 90% of the time if she doesn't think she can treat something. I feel very safe with her judgements.


Also, to the poster who has a PA story of the person being misdiagnosed with a broken nose in ER......well I was misdiagnosed years ago by a "real" ER doctor who said I just had a mild concussion after my auto accident when in fact the next morning another doctor viewed the same X-rays and saw my neck was broke in 3 spots which required major surgery.
 
I think it really depends on the P.A. I like ours a lot (and I also like our family doctor.) Remember--every graduating class of doctors had 50% who were below average. I'd take a good PA over a poor doctor any day.

I have some experience with a bad doctor/ good PA combination. A few years ago, my daughter had an ear piercing that swelled up and "ate" the ear backing. It was inside her ear lobe! I took her to urgent care since it was the weekend, and asked how it could be removed. The doctor didn't believe me. She felt around and said nope, the ear backing must have been pushed off somewhere--check your house. Well, I knew I was right (I could feel it). I took her in to our PA on Monday and she surgically removed it. So much for my imagination.
 
I use my PA for everything and couldn't be happier! If something really big came up, I know she would get the doctor in on it, anyway. For routine meds, minor illnesses and annual check-ups, I am very happy to go to my PA!
 

With the current reimbursement rates for family practitioners and general medicine docs, expect to see more and more PAs and NPs. The reality is that the reimbursement for services just isn't there. It's a lot cheaper to put an NP or PA in the role of doing an initial screen and diagnosis with the MD pulled in as needed.

Also, you can expect your doctor visiting you in the hospital to become a thing of the past soon. Hospitalists are the wave of the future.
 
I guess it's the same everywhere: you can have both good AND bad "real deal" doctors and the same goes for PA's and NP's.

Our office has only NP's, no drs., and I love it. They are very careful and intelligent and are able to spend a bit more time per patient. The dr. that used to work with us sometimes would continue to attempt to treat a patient instead of sending to a specialist when he should have. Never seen the NP's do that. They are very cautious and meticulous. There is very little they can't do health-wise....they can't sign adoption papers or your death certificate! Other than that, they do everything the dr. can do. It's a great practice.
 
Hospitalists are the wave of the future.

::yes:: there are several on staff at the medical clinic I visit.

And as far as wanting "the best" when it comes to medical care....I agree. I would imagine anyone would if possible. Yesterday I had to do a follow up visit to have B/P checked and get a refill for a maintenance script. A PA could have taken care of this but I was seen by an MD. A "waste" of time and resources in my opinion.
 
Hey there Delilah
I am sure that if you ever did have a PA or NP they wouldn't stay long due to your arrogant attitude and complete lack of respect. There is no need to act so high and mighty. Yes your a physician so we all know you went to school for a long time, that still doesn't mean you haven't screwed up before. I am glad to know PA's/NP's "have their role". And ALL of them have overstepped their expertise. For the record almost all PA programs now are transitioning to Master Programs and some even to Doctorates, so yes you have to have a Bachelor's degree to get in. So for example, I had a 4 yr bachelor's degree, did a 2 and 1/2 year (including summer classes) Master's program, and must be directly supervised for 2 years under a physician. I too had to pass a medical licensure exam which must be repeated every 6 years and log 100 CME hrs every 2 years. So while that may not be what you had to go through, it isn't a weekend lesson. You are probably intimidated that someone else can do a good job other than you. Flame on I am sure you will have some nasty reply.
 
Just wanted to add my 2 cents since I am a PA as well. And by the way it is Physician Assistant not Physician's Assistant, but anyway. The one thing that people should understand is that even if you have a bad experience w/a PA that doesn't mean all will be the same. Not everyone likes the same doctors and just because they don't like one, they typically don't write off the whole profession. I also don't think people realize the amount of training and exposure a lot of PA's have, plus the training they additionally accrue over time. As far as what you pay for it is fine if you only want to see the doctor but typically your insurance is billed 80% for a PA's service versus the doctor. I am sure that there are times when I have missed the right diagnosis on a patient. On the same token I have found plenty of new heart murmurs and a major Autism diagnosis that was missed by my supervising physicians. No one is perfect. What is important is knowing when to research more or ask for additional guidance. I would urge anyone against or for the profession to research more about it because I feel it is commonly misunderstood.


As the wife of a PA-good for you!!!!!!!! :love:
The record needed to be set straight
 
Well, since I am applying to a PA program...I guess my opinion is a bit biased. However, I think that anyone that dismisses PAs or NPs across the board is sorely mistaken about either their skills or the medical field as a whole. Midlevels are the future, and there is nothing wrong with receiving medical care from a PA. In fact, in the office I work in, the PA/NPs do EVERYTHING an MD does except surgical/on call duty (it's an OB/GYN office). I have received care from both PAs and NPs in different settings, and I would not hesitate to return to them. And I'm still alive and well...
 
I've had good ones and bad ones - the same experience I have had with doctors..

However, one thing I find interesting is that nurses will often pick up on things long before the doctor does and when they do, the doctors tend to get very angry and defensive.. What difference does it make "who" picks up on what? The goal is to diagnose and treat the patient properly - not throw a hissy fit over "who" picked up on the signs first..:rolleyes:
 
I work in health care--not as a provider, but as an IT Manager. All things being equal, I would take a PA or NP any day of the week over a physician. The state of health care requires physicians to be money making machines--responsible to squeeze in 40 to 50 'visits' per day. In order for a physician to make their (high) salary and support the practice, they have to employ this money making machine methodology. It means they're spending about five minutes with you and two to three minutes dictating their notes on you.

Mid-levels (PAs and NPs) typically make far less than a physician and are responsible for less indirect cost of the practice and consequently have a much more manageable load (20 or fewer visits per day) and might actually get to spend some time working out your health issues. Mid-levels can often spend a half hour with you or more. They can get to the bottom of issues and give your whole health picture more than a hurried glance.

I also find mid-levels generally less arrogant than physicians (the God complex doesn't run as deep in most mid-levels).

Just my two cents worth...
 
There were several PA's working in the clinic in our old town (rural). A couple of them were good but the rest of the were pretty bad. One in particular gave everyone the 'virus' diagnosis, which in my DS's case was really bilateral pneumonia, close but he almost ended up in the hospital because of that one.

We regularly saw on of the good PA's for routine stuff but anything more then that and we went to a specialist.

I see a NP for my annual check-ups. She is ok but kind of ditsy. I was in about a month ago and while we chatted for a long time she forgot to do some things like a blood draw to check my TSH levels for my thyroid. As I was leaving I remembered and told her and her response was 'you have a thyroid problem'. Um yes, for about 14 years now.
 
As an NP who is working on her doctorate, docs like Deliah make my blood boil.

And if anyone has ever worked in a teaching hospital, you would be flying to the NPs and the PAs!
 
I have taken myself and my kids to see a PA or a NP if we really need to get in and they have an appointment available right away. But, if I have any serious concerns I either wait to see a doctor or I will see th PA or NP and ask to follow-up with a phone call with a doctor. It does stink that they charge you and the insurance company the same amount to see either a PA or NP and a doctor.
 
I'm anxious to know if they are as good as the Dr because tomorrow the NP is doing some biopsy's on nodules and I hope she is good. The Dr wouldn't have been able to see me for 3 months and rheumatologist said too long a wait. Wish me luck:scared1:

NP is not a PA they are worlds apart. NP is about as close as you can get to a dr. PA has a lot less training and I do not think they can prescribe.
 
As an NP who is working on her doctorate, docs like Deliah make my blood boil.

And if anyone has ever worked in a teaching hospital, you would be flying to the NPs and the PAs!

I agree with you to some extent. HOWEVER that being said I think lots of people mix up NP's and PA's. I think in lots of professions where assistants are used the assistant feels that he or she is equal to the professional. NP's are great and so are PA's when they know what they know but are willing to get the doc when they don't know. For a cold etc PA is fine anything more than that give me an NP and a doctor. I always wonder why a PA did not go to school to be at minimum a nurse or even more so why s/he did not go to become an NP.
 
Well, I am a nurse. A regular hospital RN with a Bachelors degree, no advanced degrees of any sort.

Some of my thoughts:
~The amount of schooling someone has doesn't necessarily make them "better" than someone else. I know many physicians who have a lot of very impressive education credentials, who aren't good doctors. Sometimes doctors can get into their "I'm the doctor" mode and miss good insights from ALL members of the medical profession. (This is coming from a hospital nurse in early July who has been dealing with the new influx of interns, all of whom are very quick to remind you that they the "the doctor" with their 10 minutes of experience, so I may be a bit testy right now. ;) )We can all learn from each other if we take the time to listen. Nurses tend to be very unimpressed with MDs who feel the need to recite their credentials. Don't tell me you're a good doctor. Prove it to me.
~MDs, in general, don't like professions that can "horn in" on their turf, for that very reason...they're horning in on their turf, which ultimately means a pay cut. Hence the reason orthopedists don't like chirpractors, many MDs don't like PAs & NPs.
~Ideally, the relationship between a PA or NP and an MD is supposed to be collegial. The MD is ultimately responsible for those who work "under" him/her, so there is concern on the MD's part (and understandably so) that the PA or NP is doing a good job. But that should be the MD's concern about any member of their staff. There does have to be a relationship of trust built, the PA or NP has to know their limits, they have to be able to "check" their ego enough to say "I'm not sure about this, let me speak with the MD". But, quite frankly, I also think a good doctor should kn ow their limts and be able to say "I don't know" and be willing to call in someone who will know, or who might be better equipped with specialty education so that they can figure it out. In my primary MD's office, they have NPs (no PAs). basically, the NP sees you, develops a preliminary diagnosis, usually spends a couple of minutes discussing it witht he MD who gives the final OK for the NPs treatment plan, or the MD may make a change to the treatment plan. Essentially what the NP does in my MD's office is get the patient started, seen, preliminarily diagnosed. The NP takes 12 of the 15 minute office visit and then the MD takes the last 3 minutes to double check. Frees up the MD some, I guess. I have no problem with it because I have always found the NPs in my MD's office to be quite good.

The bottom line is, like in any profession, there are good and bad. There are good and bad doctors, nurses, PAs, NPs, teachers, police officers, politicians (well, actually I'm starting tho think all politicians are bad and self-serving so let's leave them off this list!). And frankly, just because someone misses a diagnosis or misdiagnoses someone, doesn't make them "bad". Healthcare is provided by humans. Humans make mistakes. Believe me when I tell you, most healthcare people don't start their day by saying "Let's see how many people I can make worse today by screwing up".

And delilah, while I'm sure you're a very good doctor and your credentials are quite impressive, the tone of your post was quite condescending.
 
NP is not a PA they are worlds apart. NP is about as close as you can get to a dr. PA has a lot less training and I do not think they can prescribe.

Actually, PAs require a Bachelors degree and 2 additonal years of school and they can prescribe. I tihnk you are confusing PA with some other profession. Perhaps Medical Assistant, which is more of general person in the office who can do EKGs, draw blood, take vital signs etc.
 
I agree with you to some extent. HOWEVER that being said I think lots of people mix up NP's and PA's. I think in lots of professions where assistants are used the assistant feels that he or she is equal to the professional. NP's are great and so are PA's when they know what they know but are willing to get the doc when they don't know. For a cold etc PA is fine anything more than that give me an NP and a doctor. I always wonder why a PA did not go to school to be at minimum a nurse or even more so why s/he did not go to become an NP.

Bella I am not sure you are on target here.
A PA usually has the equivalent to a Masters Degree.
 













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