Medical Doctor vs. Physicians' Assistant

How do you decide though- how are you supposed to know what you want to do. I know want medicine, and I know I don't want to be a nurse. I want to save people and I want to help. Im supposed to choose what I would be happier as--a PA or a doctor and I honestly don't know how I can choose. I've shadowed and researched and I am really at a loss. Any advice?

My experience with PA's has been OK. It is usually faster to see one for the routine hurdles the medical monopoly places in front of us. Some have been quite satisfactory some not so. It is the same with MD's/DO's. My personal preference for handling routine medical care has been nurse practioners (CRNP). They benefit, typically, with caring for customs for a fair number of years before returing for their master'sdegrees and internships. That trait is different than medical practioners (physicians/PA's who essentially "treat" the customers.
The comparison between PA's and nurses stated above is incorrect. the comparisn should be between CRNP's and PA's. Those are the two occupations that perform the same medical extender roles. Their training involves minimally four years of nursing, nursing practice then then the masters in nursing or doctor of nusing practice. Both are authorized to perform the same functions under some type affiliation agreement with a physician.
A key diffeence in most states is that a PA cannot establish an independent practice a CRNP can (must have an affiliation agreement, too. Since PA's are totally regulated by medical boards, care has been taken by physicians to ensure PA's cannot be reimbursed directly; CRNPs who are not entirely controlled by medical boards can and often are reimbursed directly.
There are numerous nurse managed clinics using nearly all CRNP staffs in large cities and poor communities. Since many physicians will not accept those customers, their routine care is handled by CRNPs, RN's and other support staff.
My belief is there is a place for all but much of the basic care does not need the brusk attention of physicians. The critical point for PA's and CRNP's is to know when they need to refer the customer to the physician. My experience with both is that they do.

this is completely wrong. most PA programs are at least 25 months long. it's not about being inferior or superior to a doctor, every part of the medical system serves a different purpose.

Maybe nurses and doctors shouldn't exist, either...

I've been seeing a PA for the past 3 years, she had been the best medico I've ever seen, every diagnosis she has made has been spot on and she has always referred me to an appropriate MD specialist when needed, she listens and hears what I say and respects my opinions and does not hesitate to argue with me. In return I do what she says without question.

HAHAHAHAHA!

Dear Emily,

As I have understood to date, a Physician's Assistant must have a Masters Degree in that specialty. They also must pass an exam to be licensed. I do not know what is required for certification.

I have been treated 3 times by PAs. The 1st 2 turned out well. The last instance was a disaster. I had asthma. The PA at the ER would not give me a script for anything but a rescue inhaler. His reasoning was that I should obtain longer-acting therapy from my regular doctor. Unfortunately, I had just totalled my car and the longer-acting inhaler which keeps me healthy was in the car when it was towed. So it was history. Could not get a refill -- too soon. Mountain cedar hit -- bad asthma. Used the rescue inhaler. Ended up with a life-threatening acute asthma acerbation. 4 ER visits in 24 hours. During the 3rd visit, the PA calledme a "liar" and started a HUGE commotion in the ER. He had overheard me talking to my father 50 miles away. I asked my DAD to call the regular DR in the city (DAllas) to call me in an RX for a corticosteroid since I knew that I was not going to get from the PA in my small town. The PA overheard the conversation w/ my Dad on the phone. He walked in and called me a "LIAR." Then he started yelling at me. After that, he also started accusing me of all kinds of ridiculous and crazy things. I refused to argue w/ him and asked him to leave my treatment room. He pretty much left finally after I started yelling for the nurse and security. He still would not write the script that I needed. Reminder: this was my 3rd trip to ER in one day. 2 hrs later I was back by ambulance after ha ing to walk 2 miles home in the cold w/ nothing but a dress and a sheet in 45 degree rain. He was still at the ER. They put me in a closed room and posted the security guard outside my door. I have contacted an attorney who knows the CEO of the hospital. This PA apparently has done this kind of thing before to others. Yet he continues to work there. I will follow upw/ the attorney and CEO on an informal basis, along w/ the licensing authority, to ensure he cannot hurt other patients again. I will never again take any kind of medical treatment from a PA if I am in an acute or critical medical state. Losing my life to an unprofessional masogenistic irate lunatic with a P.A. license is just not worth it. It is better to wait for a real doctor if in that situation. Hope this helps you. Good Luck [email protected]

I happen to ask a PA in the State of WA the difference between a PA and MD. He told me that basically the short answer is what I quoted from you.

"The physician assistant is prepared, both academically and clinically, to provide health care services under the direction and supervision of a doctor of medicine (MD) or osteopathy (DO). PA functions include performing diagnostic, therapeutic, preventive, and health maintenance services."

"PAs in all 50 states, Washington, D.C., and Guam have prescriptive practice privileges. They may not receive direct third-party (insurance) reimbursement for their services, but their services are billed for through their supervising doctor or employer. Like many other professions, physician assistants are regulated at two different levels. They are licensed at the state level according to specific state laws. Certification is established through a national organization. Requirements for minimal practice standards are consistent across all states."

"Licensure: Laws specific to PA licensure may vary somewhat among the states. However, nearly all states require national certification before licensure."

"All state laws require PAs to have a supervising doctor. This physician does not necessarily have to be onsite at the same location as the PA. Most states allow physician supervision by telephone communication with periodic site visits. Supervising doctors typically review and sign all visits the PA records in the patient's file"
http://www.nlm.nih.gov/medlineplus/ency/article/001935.htm

It is also my understanding the Medical Doctors have at least 4 more years of schooling than a PA.

Nursing school is not that hard. I was a nursing student before I decided to become a doctor. The nursing classes were a joke compared to the depth that the biology/chemistry major course went into. When I was in medical school at least 90% of the students were science majors, not nursing. As for the PA, for the most part they take the same courses for the first year as the medical students. When we started our second year of science, the PAs went on to start their clinical rotations. So to break it down, PAs = 4 year bachelors degree + 2 years master (with 1 year science and 1 year clinical). MD = 4 year bachelors degree + 4 year doctorate (with 2 years in science and 2 years clinical) + residency + possible fellowship.
I chose the doctor route so I would have more control, but there seems to be a lot of PA bashing by people who are ignorant about the profession. They have a lot of schooling and the requirements to get into PA school are pretty much the same as medical school. In fact PA’s applicants need to have more hands-on experience then the medical school applicants and since there are more applicants in the PA program one could say it is harder to get into PA school than medical school.

man yall have it all wrong i mentor with a PA and she deals with everything, yeah they get sore throats and things along those lines but they get anything from that up to things that belong in the emergency room. To be a PA it requires a PHD its four years of undergrad studies and 2 1/2 years of PA school. A PA can prescribe you medicine as well. A PA pretty much does everything for a patient except treat some of their more serious problems and that is when you are referred to a doctor or another specialist. A PA deserves just as much credit if not more than doctors. Doctors just have to know how to fix a problem they dont have to go through the difficulty of trying to diagnose a patient which is much harder than you would think. Dont take information from people unless they have experienced it first hand.

Ya, well I'm not sure where you are getting your information from. I am a physician MD in Arizona. I own a clinic that employes 14 doctors with varying specialties as well as a nurse practitioner. I have had PA's 3 times in the past year work at our facility. All 3 were fired. Their knowledge was questionable at best and all 3 had the attitude that they were the primary healthcare provider......which clearly, they were not. I would be leary to hire anoher PA. I am sure that there are a few good ones out there that know their limitiations, however, the USA is the only country whose healthcare shortage has tried filling it with a diluted shorter education by creating a degree called PA. For the record. A 4 year degree is NOT required, basic sciences and humanities are and the degree isless than 24 months full time. Hope this helps.

Furthermore extremlen69, who do you think diagnoses? Seriously...PA's? Wrong, they are able to however since the dawn of MD's and DO's they have diagnosed and tried to correct their patients problems. Also, yes....they can prescribe under the license of the doctor for where they work. Sceduled narcotics are extremely limited when RX'ed by a PA.

Thank you for posting, neurosurg, I take your point. I'm not by definition against pa's; the only one I do know personally is sharp and very aware of boundary issues, now head of red cross emergency in her metro area (if I remember right), and it is a large area.

Power planning is natural and antagonisms abound, resentment grows. I strongly get being very tough on standards and behavior. I'll extend that to each side, though I've a natural bias to the mds.
Who am I? an old days research tech with opinions, later career.

Welcome to a2k. Stick around.

Not to worry, neurosurg. Nobody was going for the idea of a PA having a PhD as part of the requirement.

I'd prefer she would refer you to doctors, probably at UNM, who could help you.

wait wait wait you have it all wrong! PA's are many times just as qualified as doctors to do their work. to become a PA you must go 4 years undergrad and take the GRE's or MCAT then go to PA school for 2-3 years. before going to PA school tho you must have prior experience in the field after undergrad. "A few weeks" is a gross understatement and belittles the career.

a liability? doctors do not see PA's as liabilities nor is the position of PA any less legitimate than MD/DO. My mom got bitten by a dog and we went to the emergency room where an amazing PA worked like clockwork to put the IV drip, sterilize it, and stitch her up. he also had 5 other patients and was ordering all the nurses around to help him out! for all intensive purposes, PA's are very much like doctors once they get out into the field because they can practically do the same things.

it is disrespectful to say that the PA career is anything less than an MD just because they have a bit less schooling.

To clarify a few points...to get into a PA school you MUST have completed pre-health/med classes. Prerequisites for PA school are very similar to medical school requirements...chemistry classes, biology, physics etc + anatomy and physiology (which is not required by med schools).

The PA is considered a position between the patient and the doctor, the difference between the nurse's responsibilities and a Physician Assistant's duties and autonomy depends on the state where the practice is located.

Hello Emily Green,
Seeing as I am a PA, I am the MOST qualified amongst ALL of those responding to this post to give you accurate information regarding a PA. I've perused through all of the information disseminated on this topic and with some I agree and the rest can be summed to up to comments made out of sheer ignorance(lacking proper information about PA's).

There is a distinction between PA's and MD's that is evident- our schooling. Traditional medical schools are 4 years (some being 3) postbachelors resulting in a Medical Doctorate (MD). PA's are awarded a Master's degree in Medicine upon completion of the 2.5 to 3 year program postbachelors (Some of which now hold Doctorates for PA's). PA's complete 80% of the medical school curriculum and attend schooling year round. Given the smaller number of PA schools nationwide, PA school is quite more competitive for admission than entrance into a medical school. Furthermore, MD's MUST complete a residency within a particular specialty whereas PA's are not required. However, there are a number of PA's that continue onward to complete Residency training as well. I took both the MCAT and the GRE. However, the PA is not a profession of those who "could not make it in medical school" (as referenced by another post). Having graduated from my undergraduate program with a 3.5 GPA with a major of Pre-Med(Biology).

We are two separate professions that tend to a lot of the same roles within a given healthcare setting. The term "assistant" shouldn't not be used to denote a technical job- we are a PROFESSION of its own. In response to the aforementioned post comparing PA's to a "receptionist": PA's a highly skilled providers that are licensed by the same medical boards to credential our medical techniques. We can provide fully competent health care just like your physician. That's why we are used so extensively. No, we're NOT JR. Doctors. We should not be respected as MD's. We should be respected as PA's and no longer compared to that of a physician! A PA's role can vary
from setting to setting.

In an ER setting, us PA's complement the role of the physician because we do the same work as the ER docs there. We're EXPECTED to operate at a high skill level just like an MD or else we're of no use.
PA's can carry a malpractice insurance if desired but most of the time , PA's are covered by the physicians office that he/she might be working for. This is the same way for PA's working at a hospital. That institution pays for it.

I'm not familiar with particular insurance companies not paying for medical visits with a PA. Which insurance company are you referring to?

Finally. Reading this discussion board has been rough.

I am not a PA but I am currently applying and hope to be a PA student shortly!

I have a 4 year undergraduate Bachelor's degree in Molecular Biology with a minor in Psychology. I have taken both the MCAT and the GRE and I am working in clinical research.

To enter PA school you need a 4 year undergrad degree with courses in general chemistry, organic chemistry, biochemistry, biology (A&P, Micro, cell molec) as well as english and psych.

PA school is 115 weeks on average and awards a master's degree while medical school is 150 weeks and awards a doctorate. No REQUIRED residency for PA grads but there is the option.

PAs can do 80% of what a doctor can do. Including prescribing schedule II - V drugs which includes narcotics, and they have their own DEA number! Which means it doesn't depend on their physician.

Yes they have to work with a physician but that doesn't mean the MD/DO has to be on site. They can be in another state in some instances.

I wish people would really try and find out about the profession before they go talking poorly about it. It's laziness and ignorance that I can't stand.

Just on a side note, one of the main reasons I chose to become a PA was the ability to switch specialties without having to go back to school, or to work in more than one specialty at the same time. PAs, like MD/DO, are trained as generalists, so they can choose any specialty they so desire. However, unlike MD/DO, they are not pigeonholed into one area their entire careers. This flexibility was SO appealing to me.

Also, just to clarify, I had a 3.7 gpa and a 31S on the MCAT and a 1330 on the GRE. I had been offered a couple interviews at medical schools when I decided against becoming a doctor. Many times PA students are quite capable of getting into and through medical school, but they choose PA instead for their own personal reasons.

It just depends what a particular person is looking for. I am fine with not being the MD. I know I will be extremely competent and capable in the end and I will contribute greatly to the medical team. Everyone is needed in their specific capacities.