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Medical Doctor vs. Physicians' Assistant

 
 
Reply Tue 18 Jul, 2006 06:13 pm
What is the difference between an MD and a PA? PA's act like they should be respected like MD's, but I'm not sure I understand why. Are there any PA's on the board that can shed some light to the subject?

How long do PA's go to college?
Do PA's have malpractice insurance?
Why won't some insurance companies pay for a medical visit with a PA?

Any thoughts would be greatly appreciated.
 
cjhsa
 
  0  
Reply Tue 18 Jul, 2006 06:17 pm
I'll only see a PA to get prescriptions renewed. They aren't doctors (at least not yet), and typically are used to take a load off the doctor, seeing patients with less complicated problems, like sprains and sore throats.
EmilyGreen
 
  1  
Reply Tue 18 Jul, 2006 06:47 pm
The PA's I've met seemed to be quite sensitive about the fact that they don't get the respect the MD's get - I'm not understanding why. Most people seem to do what you do and just see them for the simple things. I'm hoping someone will share more info.

Thanks for your input. Smile
0 Replies
 
cjhsa
 
  -2  
Reply Tue 18 Jul, 2006 06:49 pm
Put another way, if you took you car to the mechanic, would you want the receptionist to do the work?
EmilyGreen
 
  0  
Reply Tue 18 Jul, 2006 07:07 pm
True, I wouldn't want the receptionist to do the work.

A while back, before PA's were so common, I got them mixed up with the Nurse Practitioners.
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ossobuco
 
  0  
Reply Tue 18 Jul, 2006 07:26 pm
There is a big difference in training and experience. PA's work under the purview of md's and see their foibles. They may be as bright but not have had the wherewithal in terms of access to schooling in the first place to qualify to get in to med school, the money to make it through even if they had scholarship help, or the sticktoitiveness to survive. It is a long haul, and post md training is also a long haul. I was a premed once, long ago, and don't resent the people that made it through. Though I have sympathy for people with doctorates in science who roll eyes at m.d.'s re getting batting eyes from the populace. Though batting eyes from the populace as a mode of obeisance has changed a bit.

My cousin's son was in PA training, and hurt his back, is doing something else now. He would have known a lot, and is a competent fellow; he was a paramedic earlier. Still, there is usually a knowledge difference in broad terms. However, in some specific situation, some may know more than a beginning intern.

A long time friend who I first met as an intern - now a retired chief of emergency who passed boards in psychiatry as well as ER medicine, if I remember correctly - said they were all saved in their rotation through cardiology when they were newly out of med school by the cardio ICU nurse. Not that there weren't residents and others above them, but that the nurse was the one who saved their respective asses, got them equilibrated fast.
ossobuco
 
  1  
Reply Tue 18 Jul, 2006 07:32 pm
Well, Registered Nurses often have good training, and the Nurse Practioners I've known were well regarded RN's before their NP training. My cousin's son, for example, knew much less than my nurse friend about medicine.

Well, this is all anecdotal. I'll leave it for people in the fields to talk about.
Different aspects of medicine have different competences, and respect to all from me for their savvy.
0 Replies
 
Noddy24
 
  1  
Reply Wed 19 Jul, 2006 08:39 am
For donkey's years people have complained that doctors don't spend enough time with them.

The PA's can handle the explanations of medicine--talking, listening responses to the FAQ's.

I can read pamphlets and do research on the Internet--a lot of people can't PA's are essential if these people are going to be informed patients.
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EmilyGreen
 
  1  
Reply Wed 19 Jul, 2006 04:15 pm
ossobucco, how long is PA school? Do they not have to have a pre-med degree?
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ossobuco
 
  0  
Reply Wed 19 Jul, 2006 04:17 pm
I don't know, why don't you look it up on google? I doubt you have to have a premed degree to do that.
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EmilyGreen
 
  1  
Reply Thu 20 Jul, 2006 03:45 pm
I see that so many times on the duscussion forums "Just google it"... when I, or the authors of other threads, want more than a definition.
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ossobuco
 
  1  
Reply Thu 20 Jul, 2006 03:53 pm
Perhaps a Physician's Assistant will see this question and help you then.
0 Replies
 
sozobe
 
  0  
Reply Thu 20 Jul, 2006 04:01 pm
I'm virtually certain "no" on the pre-med degree. I have a friend who is a PA. She graduated from college with some sort of a landscaping degree, then took a few weeks' worth of classes and became a PA. The impression I have from her stories is that the more narrow the specialty and the more experienced the PA, the more valuable he/she is. My friend works in a very narrow specialty and is very experienced and is seen as worth her weight in gold (and gets a pretty hefty salary, if not doctor-level).

I think that a new PA or one who is expected to know a lot (as in, a broad spectrum) would be clearly inferior to a doctor.
EmilyGreen
 
  0  
Reply Sun 23 Jul, 2006 05:40 am
Hmmm, I'm developing the opinion that the PA position shouldn't even exist.
Phoenix32890
 
  0  
Reply Sun 23 Jul, 2006 07:51 am
http://www.bls.gov/oco/ocos081.htm

My understanding is that originally the PA occupation was created to serve in inner city and rural clinics, where there were not sufficient phycisians to serve the population. The first PAs were former army medics, who wanted to use their medical experience in private life, but did not want, or were unable to go through, full medical training to become a physician.

PAs have expanded to be found in many setting. Often a busy physician's office will employ a PA to deal with the less critical cases, and routine checkups, supposedly under the supervision of the doctor. One doctor's office that I went to would shift you to the PA if you needed an immediate appointment, and the doctor did not have an opening. I remember one instance that the PA,(who was really terrific in terms of dealing with patients) felt that she did not have the expertise to deal with my problem, so she called the doctor in after she had examined me.

PAs can prescribe, but are limited in what that can prescribe. (I am not completely sure, but I don't think that they can prescribe narcotics, and other more "serious" medications.
Phoenix32890
 
  1  
Reply Sun 23 Jul, 2006 07:54 am
EmilyGreen wrote:
Hmmm, I'm developing the opinion that the PA position shouldn't even exist.


I disagree. In some areas, a PA can be a very valuable medical adjunct. They have the time to sit and really listen to the patients, a luxury that has become just about obsolete in the medical world of today. The important thing is that the PA needs to understand his/her limitations, and not bite off more than they can chew.
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EmilyGreen
 
  1  
Reply Sun 23 Jul, 2006 03:12 pm
Well, if you had a PA that was very well aware of his/her limitations, then I'm sure you'd be comfortable seeing one - but are you comfortable paying the same amount for the visit as you would with the MD?

I've had 3 really horrid experiences with PA's, and I've grown very curious about their medical/education background.
0 Replies
 
Phoenix32890
 
  2  
Reply Sun 23 Jul, 2006 03:29 pm
From the link in my earlier post:


Quote:
All States require that PAs complete an accredited, formal education program and pass a National exam to obtain a license. PA programs usually last at least 2 years and are full time. Most programs are in schools of allied health, academic health centers, medical schools, or 4-year colleges; a few are in community colleges, the military, or hospitals. Many accredited PA programs have clinical teaching affiliations with medical schools.

In 2005, more than 135 education programs for physician assistants were accredited or provisionally accredited by the American Academy of Physician Assistants. More than 90 of these programs offered the option of a master's degree, and the rest offered either a bachelor's degree or an associate degree. Most applicants to PA educational programs already have a bachelor's degree.

Admission requirements vary, but many programs require 2 years of college and some work experience in the health care field. Students should take courses in biology, English, chemistry, mathematics, psychology, and the social sciences. Many PAs have prior experience as registered nurses, while others come from varied backgrounds, including military corpsman/medics and allied health occupations such as respiratory therapists, physical therapists, and emergency medical technicians and paramedics.

PA education includes classroom instruction in biochemistry, pathology, human anatomy, physiology, microbiology, clinical pharmacology, clinical medicine, geriatric and home health care, disease prevention, and medical ethics. Students obtain supervised clinical training in several areas, including family medicine, internal medicine, surgery, prenatal care and gynecology, geriatrics, emergency medicine, psychiatry, and pediatrics. Sometimes, PA students serve one or more of these "rotations" under the supervision of a physician who is seeking to hire a PA. The rotations often lead to permanent employment.

All States and the District of Columbia have legislation governing the qualifications or practice of physician assistants. All jurisdictions require physician assistants to pass the Physician Assistant National Certifying Examination, administered by the National Commission on Certification of Physician Assistants (NCCPA) and open only to graduates of accredited PA education programs. Only those successfully completing the examination may use the credential "Physician Assistant-Certified." In order to remain certified, PAs must complete 100 hours of continuing medical education every 2 years. Every 6 years, they must pass a recertification examination or complete an alternative program combining learning experiences and a take-home examination.

Some PAs pursue additional education in a specialty such as surgery, neonatology, or emergency medicine. PA postgraduate educational programs are available in areas such as internal medicine, rural primary care, emergency medicine, surgery, pediatrics, neonatology, and occupational medicine. Candidates must be graduates of an accredited program and be certified by the NCCPA.

Physician assistants need leadership skills, self-confidence, and emotional stability. They must be willing to continue studying throughout their career to keep up with medical advances.

As they attain greater clinical knowledge and experience, PAs can advance to added responsibilities and higher earnings. However, by the very nature of the profession, clinically practicing PAs always are supervised by physicians.
0 Replies
 
EmilyGreen
 
  0  
Reply Sun 23 Jul, 2006 06:15 pm
Wow, nursing school is harder than that. I always felt so sorry for the nursing students at my university, because they had hard classes and had to have excellent grades - then again, I was glad that nurses had to learn to work that hard, ha ha.

Well, Phoenix, thank you for the info - I realise now why some doctors don't hire them at all, seeing them as a liability. If they know their limitations, I'm sure they are extremely helpful - but the PA culture in my area teaches them to argue with the MD's and expect to be treated like they ARE MD's. I'm glad to know they aren't like that everywhere.
sozobe
 
  0  
Reply Sun 23 Jul, 2006 06:22 pm
I wonder if the requirements for PA's changed at some point recently? I won't swear by "a few weeks," but I think what this person told me was a lot less than two years -- all I'm certain of is that my reaction was, "that's all???"
 

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