Medical Doctor vs. Physicians' Assistant

PA, why see one? Is it that PA dont want the responsibility of a Dr. like paying Medical Malpractice insurance? Or is it that they are not willing to go to school long enough to be a Dr? Or what is it? I dont care to see a PA and will not untill i am forced to do so. I think that will come soon enough! Dr.s need to be carefull what they ask for, PA will end up taking there jobs. Like cases of Family Med Dr. colds, sore throat, and the Doctors will be forced into a Specialty and Family med will be a PA job. Dr.s like this now, but becarefull!

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

This link will give you a lot of information about the position.



I remember, years ago, that P.A.s were utilized mostly in rural areas or inner cities, where there were not enough M.D.s. Over the years though, this has changed, at least in my area. Almost every specialist group that I or my husband see has a P.A. These professionals are utilized for more routine care, follow-up, etc.

As a group, I find that they offer a patient more time, and have the ability to sit and LISTEN to the patient, a luxury that eludes many doctors today.

One thing that bothers me is that although they are professionals, P.A.s are invariably introduced and greeted by their first names, as opposed to M.D.s, who are called by Dr. so-and-so.

"Hi! My name is Tiffany and I'll be your medical practicioner today. Isn't that swell?"

I was a medical secretary once, ages ago. Usually this type of position works like hell and is paid secretary's wages. Now, they are required to attend, yes, classes for a few months. They assist doctors by such things as giving shots, drawing blood, giving EKG's, assisting in Office procedures such as removing moles, warts, stitches,etc., lots of etc. In those days we were simply "trained."We were the "physician's assistant.

A physician's assistant now is generally a nurse who has had additional training. You would have to call one of the many (everywhere) colleges that offer these types of medical courses.

Careful about some of those (few or several months) colleges. Some doctors may not recognize them as credit. Some colleges or universities may not either
You can also take short courses in any kind of ex-ray, MRI, etc. Again, check out the accreditation of those schools.

I am very suprised that in this day in age people are so ignorant. Physician assistants are licensed medical professionals that are fully educated and trained in the medical module, which is the same module as physicians are trained, they are also credentialed by the state they practice in to evaluate, diagnose, treat and prescribe medications. I am a PA and yes I did complete my premed degree and afterwards attended 2 years of PA school, which was very rigorous and not easy, the main difference between PA and MD school is that it is accelerated into a 2 year program instead of 4, and a residency is not completed, but when it comes down to it...you are learning Medicine, which is the same material all practicing providers need to learn, including physicians and NPs and your first few years on the job experience are pretty much like your residency program. In fact, after finishing school and starting work in my field, I felt I had more experience, especially in procedural skills than 1st year residents in my field. Please do your research and maybe try asking someone who actually knows about this profession before downgrading an entire profession. After all, you may find a PA or NP to be taking care of your mother one day.....

On the job training, eh?

Again, its always the nurse who saves someones assets, least paid, most experienced certaintly blessed with common sense and most abused by the system on a whole...sadworld.

physicians assistants go to school for two years to get their masters degree. Its very much like a nurse getting their masters in nursing. The difference is that PA's can assist with surgeries and are a type specific where nurses with masters degrees can go on to do more work behind the scene in a desk.
I have my BS in health sciences and I am now looking into PA graduate schools. What caught my attention of PA's is that you can work in the surgery room and assist with the surgeries. Not to mention, they make more than BRN's or Nurse Practitioners (depending on their specific field)

I am a Physician assistant, currently working in Vascular medicine. PA's are trained to practice medicine in the same medical model of MD's, with the main difference being the lenght of study. MD's attend a 4 year college and then undergo 4 years of medical school, of which 2 years are dedicated to the classroom and 2 years for preceptorships and rotations. PA's also must have a degree from a 4 year college and then undergo 2 years of medical school, of which 1 years is dedicated to the classroom and 1 year is preceptorships and rotations. Unlike medical school, which has the summers off, PA school is yearlong. After medical school , MD's then go on to internships to specialize in their prospective fields. these internships can last anywhere from 3- 7 years depending on the specialty. PA's can also go on to internship after training with most programs lasting 16-24 months. Internships are not required for PA's, however, and most PA's begin practicing after school.
What do we do? We see patients in the office or hospital or clinic or wherever an MD sees patients and in the same way. We examine, diagnosis, order studies and treat. We see patients alone and do not need a physician to see a patient after us. We are reimbursed by Medicare, and insurance companies the same way an MD is, but at 75% the reimbursement of an MD. We must have a NPI or National Provider Index as well as a state board of medicine certificate to practice. We must also have a DEA number in order to write medications. We can write almost all the meds a doctor can except class I narcotics, which most MD's do not write for anyway.
Just like MD's there are PA's that practice surgery, although unlike an MD, we do not do surgery alone, we only assist in surgery.
All PA's must have malpractice insurance with a coverage equal to the specialty for which they are employed.
We cannot practice independently. We must practice with a MD. There are even practices that are owed by PA's that employ MD's, and the PA practices with the MD's. But a PA cannot decide to open a practice on their own.
Hope this helps

I am currently studying to be a PA, and I have to finish my Bachelor's degree first, then complete my Master's in PA. It is a total of about 5 years, with clinical rotations in the final years. I know this is an old thread, but just FYI.

There is the real story and make sure you have your information correct before you begin to tear down a good career and deny yourself the opportunity to obtain good healthcare.
I am in PA school. I had to have a biology degree and go through the GRE exams. I had to take about 20 pre-requisite courses that were in the hard science and psychology field. None of these grades could be below a 3.5 grade average. 700 people applied to be in my program and only 45 were selected. I will be taking 4 semester of courses then attending clinical rotations just like those that MDs attend.
The best healthcare providers I have ever seen have been PAs. They are compassionate caring people who have to deal with a lot of silly misconceptions. Often these people worked in fields prior such as EMTs, paramedics and nurses.
The healthcare profession is about the team of people that work with you. Don't under-mind someones knowledge just because you did not have your facts straight. PA has been one of the top growing professions in the country. So there you go.

Sure. Two of the three PAs I've seen have been excellent. Just don't convince yourself that you've got the same qualifications as an MD that's finished residency.

Maybe my problem is that I know too much about medicine. I reentry saw a p.a., who, although he was very nice, and did listen, he made two mistakes.

I had a lump on my arm which he diagnosed as a cyst. He gave me a shot of cortisone, which did nothing. (He told me that the lump would go away in three days) I went to my dermatologist, who diagnosed it as a benign lipoma, and, due to my instance, had it biopsied, just to make sure.

I came to the aforementioned p.a. with bronchitis. He gave me a 10 day course of antibiotics. The bronchitis just was not resolving quickly enough. After I finished the drug, I discovered that I had an infection from a bad tooth. Although the bronchitis was a bit better, it was still there after My dentist gave me another antibiotic. In 2 days the bronchitis was gone.

If I had not followed up with another doctor, I could have had a lot of grief.

In these days, I think that it is very important that a patient needs to become very knowledgable about his body.

That's what I was thinking of. The last time I saw a PA, it was for an irritated and essentially blind eye. He prescribed antibiotic eye drops and and oral antibiotic. Four days later, I took it to the urgent care centerl. Their doctor made an emergency appoint with my eye doctor, who did laser surgery the same day. Within two weeks, my glaucoma had sufficiently recovered that I could read street signs if they weren't too far away.

Total, and apparantly permanent recovery.

Rog- Your story is the sort of thing which really bothers me. You were sophisticated enough to seek other help. Someone else might have ended up with a major league problem.

Yes they can!
I just returned from 2 diferent ERs seeing only a PAC.
Both offered hydro codeine

I love my PA, He is every bit a Doctor to me, matter of fact i see much more compassion in him then i see in MD. I took my paperwork to a lawyer for SSI, what ignorant fool this lawyer was said he's not a MD and told me to find a real MD then come back.......

I am currently a PA student and was not aware of the ignorance surrounding the profession. I can pretty much guarantee you, that the last 5-10 times you went to the "doctors", you saw a PA not an actual doctor. PA students attend the medical school with the doctors for some classes, are trained to handle emergencies and can specialize in their chosen field. The rotations completed after PA school are done with third year medical students. PA's can diagnose diseases, treat symptoms and write prescriptions. One does not go to PA school because they weren't smart enough to get into medical school either. I got into 3 PA programs and two medical schools. I chose to go to PA school rather than med school because I want to have a closer relationship with my patients and being a PA will allow me to do that.

No the requirements have not changed- most PA programs are about 28 months.

One thing that no one has mentioned is that PA must have have college degree, most often a pre-med degree, and then they are required to spend at least a year working with direct patient care in a medical facility. The application requires that those who apply to PA school have previous medical experience. With this in mind, most PA's have nursing or pharmaceutical experience before they start PA school. That is more than I can say for nursing school or medical school.

People sometimes tend to confuse PAs (physician assistants) with MAs (medical assistants)- this may be the issue with the person claiming they became a PA in 3 weeks (with few exceptions that require military training or specific health target curriculums) a bachelor's degree with science, mathematical, etc. fulfillment is required, and it is advanced, graduate level work. Being accepted by a PA program is extremely competitive. Most PA programs receive 1, 000 - 3,000 applications each year but accept only 30 - 50 students a year. I'll let you do the math. The requirements of PA programs have changed somewhat over the years, however, becoming a PA has NEVER only required 3 "weeks" of training. Go to the NCCPA for more information as to the history of this field and current requirements. PA programs have numerous requirements to be nationally accredited, which is what is required to allow graduates to sit for PA certification- like medical students they have didactic requirements, as well as clinical requirements. In many schools they simply complete certain courses with medical students, and take additional classes of their own at the same time (i.e. because PA programs are typically of shorter total length than medical school). The majority of PA programs are now Master's level and as such require a 4 year bachelor's degree, AND completion of a 2 - 3 YEAR PA program with numerous requirements. Many programs offer a Master's of Medical Science in PA studies rather than simply a Master's in PA studies. This is the case with my program which offers the Master of Medical Science in PA studies- so I took anatomy with the medical students, and as part of my PA program I completed graduate level biochemistry, physiology, etc. This is similar to friends I have in other PA programs. We study with the med students, and have many of the same instructors, etc. We go to cadaver lab and have workshops and standardized patient exams. I am in the midst of completing my clinical training as a PA student and on my previous rotation I worked 70 - 80 hours a week, and it was NOT administrative work. My program is similar to many others requiring clinical rotations in primary care, inpatient and outpatient internal medicine, surgery, emergency medicine, inpatient and outpatient pediatrics, geriatrics, gynecology and obstetrics, psychiatry, etc, etc. During my rotations I report to the same upper level resident and attending physician as the interns (i.e. 1st year MDs) and the medical students. And the skills I am expected to develop and perform in terms of patient interviewing, physical examination, documentation of initial and progress notes, diagnosis, assessment and treatment plan development are absolutely no different than theirs. While administrative work keeps a very small percentage of PAs busy, most do not go through the rigor of PA school to become glorified secretaries. I already had a Master's degree prior to entering PA school and I can tell you that PA programs are not an "average" master's level program. In addition to passing an accredited PA program, which requires a minimum B average, passage of an intense National Certification exam is required. Additionally, PAs must re-test/pass a national exam every 6 years to maintain certification. Please also note that laws vary by state and with PA experience and the physician(s) a PA works with, however, in most states the "supervising" physician is not physically supervising. Another difference between MDs/DOs and PAs is that while residency and fellowship type opportunities are newly emerging for the PA field, these have been a cornerstone of medical training. To address a comment posted, clearly a new PA who has just graduated will likely have less responsibility than a PA with 10 years of experience, however, it is incorrect to state unanimously that PAs deal with less difficult patients. That may well be the case in certain examples, but it depends greatly upon a PAs experience and relationship and training with the doctor that he/she works with. I know PAs who work at the ER- they manage acute coronary syndrome, and handle ectopic pregnancy, and trauma- they have been practicing for years, have gained the respect, confidence, and trust of the physicians they work for, and as such function in that capacity because that is the autonomy granted to them at the discretion the physicians they work for. As a PA gains experience he/she earns more autonomy, under the judgment of the physician he/she chooses to work with. And in fact, many individuals interpret the "supervision" by a physician incorrectly. In many cases the "supervision," as required by law, has nothing to do with hands-on supervision. In most states the physician need not even be present at the facility. As someone mentioned prior, a PA must know his/her limitations- period. The same is true of a good doctor. And in his/her early career, it's likely that a PA will encounter limitations and it is the responsibility of the PA to then obtain the assistance of the physician.- Just as a physician might seek help from another specialty when something exceeds his/her expertise. Additionally, while many PAs work in primary care, they also serve in numerous fields in addition to primary care, including cardiothoracic surgery, neurosurgery, ortho, neurology, dermatology, geriatrics, pediatrics, etc. Like any field and profession, there will be both good examples and poor examples of individuals in a profession. My experience has shown that "good" physicians employ "good" PAs. In other words, if a physician is "good," he /she will either hire or train a PA to function in a similar capacity and he/she too will perform with excellence. To those of you who have had negative experiences with PAs, I am sorry that this was the case. One of my PA mentors is particularly wonderful and once told me this- if someone goes to a new doctor and has a bad experience, they will just find another doctor, but if they see a bad PA, they may never be willing to see one again. And I can understand why, give that, as illustrated on this discussion board, people often do not know the medical training and requirements that PAs go through. Being given the authority and honor to practice medicine by diagnosing and managing illness and having the ability to prescribe medications (typically not controlled-2 substances) is a privilege that comes with much effort, I assure you. Additionally, in terms of education and training, NPs have additional education required for being an RN that allows them to practice-- they follow a nursing model. PAs follow a medical model of education and training. To answer another question on the post, PAs do not independently carry malpractice insurance- they are typically carried under the insurance of the physician(s) they work with. One additional item I would like to address is that the vast majority of PAs choose to go to PA school for various reasons that do not involve rejection from medical school. Depending upon why and how someone wants to practice medicine can have a lot to do with their personal choice. Believe it or not, PAs have often been accepted to medical school and choose to go to PA school. Like most of my classmates, for example, I loved the fact that as a PA I would be able to work in more than one specialty if I chose to- I would have that option. I also like the fact that this field puts a very high priority in serving in rural populations that might not otherwise receive access to care. I also liked that I could practice in an outpatient clinic and not have to worry about being a business owner as well as a physician- I don't want the burden of running a business and owning my own practice. I just want to help people and provide them with care. It's not to say that being a PA is better or worse than being a doctor- it's to say that while there is significant overlap in daily duties, there are factors that do differentiate the two, and those factors often help inform one's choice. PAs and physicians are not generally in conflict with each other- PAs exist due to the need and demand of physicians and patients. Should either of those cease to exist, the field would not prosper as it has. Demand continues, increasingly on the rise. I hope you find this information helpful. I am posting it because the field is relatively new and prior to someone introducing it to me, I was unaware of its existence. Once I researched it more and shadowed some PAs, MDs, and NPs, I decided this was the correct choice for me. The PA field was also voted the #2 job in America for 2011 I believe, in terms of job satisfaction, etc. And thus far, based upon my clinical experiences, I am very happy with my choice. It is humbling and rewarding to serve patients in this capacity.