Medical Doctor vs. Physicians' Assistant

My first reaction was to ask "Well, why don't you?". Now, I see the rational. Phoenix has done it for you.

In any case, I've had outstanding luck with Physician's Assistants. Before finding my present Physician, I dropped two doctors when they lost their PAs. They seemed to be either unqualified, uncaring, or just too honked up on themselves to listen to their patients. I've never had insurance problems with them, probably because I've never known a PA in his or her own practice. All billing is done through the doctor's office.

I don't think that a PA can have his own practice. I do believe that the deal is that he is working under the aegis of an MD. I think that when he bills an insurance company, the billing is under the physician's name.

The rationale was not that I was hoping someone would "do it for me", its that a definition was not all I wanted. I know requirements differ all over the country and I've only had a limited experience with PA's, leaving me very curious about the whole MD/PA/NP situation. Discussion forums are for just that, discussion. I asked more in my original post than "What's the definition of a PA?"

Yes. The link from seemed a great deal more than a definition, but maybe that's just me.

I don't think you understand this board. Many thousands sign up and many less sort of hang in and try to answer questions.



Some of those who hang in are pretty smart and some of us aren't -- and how can you tell, re one question or another.



Most of us would like to help and often do if we see a question we can reply on.

Being excoriated for trying to help, well, hell, please take a kite and aim at the moon.

If you want to just talk, come on back.

ossobucco, who are you talking to? Me or Roger?

I think she was definitely talking to Roger.

Ah, thought so.

Not Roger.

:wink:

Yesterday I had a very satisfactory office visit with the PA who works with the surgeon who will do my biopsy/mastectomy next month. She explained what I had to have explained, stopped explaining when I indicated that I understood and paused frequently to see whether I wanted to vent.

Noddy, were you charged the same price for seeing the PA as you would seeing an MD?

I haven't seen the bills yet. The surgeon popped for a "Howdy Do", but the bulk of my time was spent with the PA.

Judging from our insurance statements, neither Medicare nor our Blue Shield plan object to paying for PA sessions.

Most surgeons I know are doctors of few words and gifted hands. They don't have bedside manners--they have OR expertise. This is my second go-round with breast cancer and I was very happy to deal with a woman who could give me advice about what-to-wear for maximum comfort after a mastectomy.

From the PA's point of view, I was a person, not simply a cancerous breast.

I have been looking into this program. There are only 3 schools that offer the program and it is quite competitive. They are higher and in charge of nurses. However, they never can open their own practice due to being a P.A. like Nurses can. You need to have about 7 pre-requisite courses (i.e. AP, Microbiology, Stats, etc.) and a bachelor's to get into the program, then it is two years as in 24 months with no breaks. That is taking 7 classes a semester. Therefore, I suggest that rather than competing, we should praise those who go through all of that to provide us health care. Everyone deserves the same respect, why would you treat anyone less b/c of their position. That is just ignorant.

actually PA school is a lot harder than nursing school. Nurses just have to take the basic anaomy and basic biology...while to actually get into PA school you have to take the biology majors science courses which are more difficult...Most PA programs are master's degrees now...to get in a four year degree is not technically required but its almost impossible without one. The 2 year program once you get in is equal to the first two years of medical school. The "study part" of the program. In medical school you second two years are clinicals...but PA's are trained under the doctor for their clinical experience.

Emily,

You are misinformed my dear. First let's begin by stating simple facts.
MD's, DO's are doctors- plain and simple. They go to college, then attend medical school, go through residency and then in some instances through fellowships. NP's go to nursing school and complete post nursing courses in order to obtain a Master's degree and now in some instances a Ph.D. PA's now in most settings must have a Bachelor's degree upon entering PA school and train utilizing the basic medical school principles. Most PA's now leave with a Master's degree and yes some leave with Ph.D's. PA school is NOT nursing school. It is much more intense and much more directed at learning anatomy, pathophysiology, principles of clinical medicine, how to diagnose and treat illness, addiction etc. Nursing school does not encompass much of this.
We all have a place in medicine despite what egotistical, self absorbed others who are in health care may think. It is unfortunate that you had "3 horrid" experiences with PA's. I would like to know your definition of "horrid". I'm sure we have all had bad experiences with all levels of health care starting with the receptionist, the MA, the PA, the NP and the holier than thou doctor.
PA's, NP's fill a gap that is growing even wider in todays medical world. If you don't want to see a PA or NP then don't. You have a choice, open your mouth and say so. Most midlevel practitioners are quite capable of dealing with the normal complaints. Simply put A+B should equal C. If it doesn't then it is time to see someone with more advanced training. Get your facts straight before you start spouting off about a profession that has been created by a shortfall of physicians, lack of health care in poor areas etc. It is sad to read your comments- and when you start speaking of a subject without much knowledge, do a little research- before you start putting down a decent profession. PA's are NOT doctors, nor should they pretend to be. They are midlevel practitioners with basic medical knowledge to start. Once they have been in their respective fields for long enough you can sure bet most of them can handle just about any situation. Ask any PA serving in the military right now. Who do you think is taking care of our men and women that are fighting in a senseless war? That's correct, A PA. Not many NP's or MD/DO's out there on the front lines sacrificing their lives for their country. Get your facts straight. Matter of fact go to aapa.org. You will learn all about the PA profession and the good that most PA's bring to our underserved populations.

Whoa!

I wish we had dem here!!!!!

I'd go for it.


I had thought there was a pretty long and demanding qualification demanded....longer than nursing, but shorter than medicine????

(Or what I did.......but nemmind...)

Edit:

Some info

(ONLY 2 YEARS POST GRAD???? %$$#@#@ &&%$%$ !!!!!!)

http://www.bls.gov/oco/ocos081.htm


http://www.opm.gov/Qualifications/standards/IORs/gs0600/0603.HTM



http://www.aapa.org/gandp/statelaw.html



http://www.calstate.edu/HRAdm/Classification/R02/Physician_Assistant.pdf


http://www.dsd.state.md.us/comar/10/10.32.03.04.htm


http://www.bop.gov/jobs/job_descriptions/physician_assistant.jsp


http://www.google.com/search?client=opera&rls=en-GB&q=physician+assistant+%2B+qualifications&sourceid=opera&ie=utf-8&oe=utf-8

I have provided a list of classes and diagnoses I made as a second year PA STUDENT. It has been a wonderful experience. And please remember, I have seen many clinicians who were great in Chem and Calc stink when they have to do CPR for 45 minutes, then the patient dies - so much for the sprains and sore throats comments (although strep can infect the kidneys and knees - name someone who told you that before?)

My goal as a student was to become a PA not an MD. Many good students (some IVY league) failed out of PA school. We lost 4 students our first semester and gained 6 from the class before. The standards are not easier than other medical programs (40 out of 500 were accepted to our program) We have up to 9 full classes a semester - while starting rotations within the first 5 months.

I have made many clinical calls as a student that other clinicians have missed. Some have been life saving. We all work together for the benefit of the patient. The MD's and PA preceptors have been wonderful.

Our classes are taught by PA's and MD's. The PA profession started in the military when field medics/surgeons who were not m.d.'s returned home with skill surpassing that of a usual medical professional.

Last week I worked in neurosurgery clipping the spinous process from a pt. who needed a laminectomy. Scroll down to see the procedures I have done.

Advanced Clinical Skills
Applied Therapeutics I (PAST-610-01)
Applied Therapeutics II (PAST-640-01)
Cardiovascular Diseases (PAST-601-01)
Clinical Diagnostic Procedures 550.01-550.03 Lab
Clinical Diagnostic Procedures 550.02
Clinical Nutrition (PAST-624-01)
Clinical Problem Solving I (PAST-605-02)
Clinical Problem Solving II (PAST-635-04)
Dermatology (PAST-680-01)
Diagnostic Imaging (PAST-650-01)
Gastrointestinal Diseases (PAST-631-01)
History Taking
Intro to Clinical Practice I (PAST-615-01)
Intro to Clinical Practice II (PAST-641-01)
Pharmacology
Neuro/Hematology/Oncology (PAST-661-01)
Obstetrics and Gynecology (PAST-620-01)
Orthopedics (PAST-603-01)
Pathophysiology
Public Health and Comm Med
Pulmonary&Infectious Diseases (PAST-602-01)
Renal/Genitourinary Diseases (PAST-632-01)
Surgery (PAST-645-01)

The worst diagnosis is the one you do not know about or make- so it is very challenging.

O.R. / E.R. Procedures:

Proximal humeral arthroplasty
Sphincterotomy + fissurectomy
Incision and drainage of cyst
Suturing - both hand and instrument ties
Stapling
Gluing
Colostomy takedown (no more bag for the pt!)
Indirect inguinal hernia repair
Umbilical hernia repair
Injections, I.M., I.V.
Blood draws

Diagnoses:

Emesis secondary to concussion - missed by all but me on physical exam. Pt did not know about massive hematoma on back of skull

Ludwig's angina! my best call to date

Simple arrythmias by diagnosed by pulse, verified by 12 lead EKG

Various murmurs mostly 2/6 systolic

Brain cancer... glioblastoma multiforme (pt was romberg + on physical exam - a lost skill)

Non ST elevation MI (heart attack w/o EKG findings)

Cardiac Ischemia (obese female NIDDM, presenting in church to me with emesis and vague numbness - heart attack until proven otherwise). Family was happy!

Chronic Venous Insufficiency - easy pick-up, hard to treat

I really don't think Emily will amount to anything. I just received an offer to design a mouthpiece with acceleromators for concussion research.

I want to get working as soon as possible, because most physicians need my assistance...

Ask an "health care professional" about digital clubbing next time and see what they say.

Many PA's I have worked with are in the Special Forces. One treated cushings in a Ranger who went to 3 MD's. Unacceptable!