New Doctor of Physician Assistant Medicine Program

[Acromion]

You would think so. Powerful lobbying within the system. We are out numbered. You finds them everywhere (HR & in administration etc).

 

I agreed that "Nursing degree creep means more nurses in influential position." That's exactly my point. We are falling behind here. Others had done it (PharmD, DPT, and DNP). What the heck are we waiting for? I rest my case.

 

If all your friends jumped off a bridge, would you do it too? Let's be honest, do you really need a doctorate to fill prescriptions at a Rite Aid? Or teach old ladies how to use a walker? Or prescribe z-packs for the sniffles? 

 

Everyone else in the whole world is talking about how to make education cheaper, more efficient, and more relevant to the needs of our healthcare system. And yet here we are talking about adding another pointless boondoggle to our profession. I think the PA's have found the right formula. I got in and out of grad school (albeit with a lot of debt and less hair on my head) and straight into a high paying job. In this economy, that's practically a miracle. The NP's aren't fooling anyone who matters with their cargo cult doctorate. They will probably capture a large share of the primary care market, especially among medicaid patients and other patients with crappy insurance. But they are simply not equipped to take care of really sick patients and they will feed lots of referrals to specialists and thusly the PA's working for them. That will just be the reality in our lopsided, specialty centered health care system.

 

I don't understand the panic.  There are still plenty of opportunities for experienced PAs. In fact, most MDs I know prefer to work with PAs, not NPs. Every day, my email box is full of opportunities.  Sure, they may not be in the location we want or near family.  I still can't find a decent opportunity in my native Cleveland but that's OK.  There are plenty of places in the country that are looking for us.  Right now, I am doing locums until I figure out where I want my last permanent job to be.  And believe me, there is a plethora of work in this venue as well. Oh, by the way, every single locums assignment I have completed has resulted in a permanent job offer.

 

I am totally against Dsc or other doctorate unless the individual pursues it for the sake of education.  If I do *any*  further degree it will be a bridge program to MD. But hey, if you guys want to go in debt, be my guest.  One only needs to look at all of the 22 year olds coming out of school up to their eyeballs in debt to think twice about more schooling.  Tuition ain't cheap, and I, for one, will not be a party to degree creep.  Fortunately, it is highly unlikely I will need to.  There are a lot of sick patients out there, and regardless of whether you like Obama or the ACA, the net result will be more customers.  How many, remains to be seen.  From my experience, some people will not seek medical care even if they have the best insurance.

 

Please people, chill out and take heart.  I believe that we are in the catbird seat as a profession.  I am not a Pollyanna by any means.  But I think the future is far rosier that what has been painted on this forum.

 

Agreed.

 

I may be biased because I went to school and work in a very PA friendly state (Michigan), but everyone here including doctors and the lay public knows what PA's are and have a ton of respect for them. NP's 

[cinntsp]

The NP's aren't fooling anyone who matters with their cargo cult doctorate. 

 

...except for the two parties that matter most: the public and state/national legislative bodies.

[LIPPER]

^^ Fighting it. Not going to happen. I've being a PA for 7+ yrs & the DNP almost 4+ yrs or less (total yrs as an MLP). Guess the folks forcing that I reports to the DNP? The nonclinical folks who only sees or hears the words doctorate (DNP).Hence, I'm for a push for doctorate in PA w/ DHSc an option. Not a big fan for a bridge program but won't strike it down either. May or may not pursue bridge program in the future. IMHO. The bridge program erode the core foundation of the entire profession and disrupt the integrity of the PA profession. We've got to stay as PAs and fight for a better scope of practice.

I wonder how JCAHO would respond to a informants inquiry ?

 

 

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[True Anomaly]

KMD- if you're actually having to report to a DNP in regards to medical decisions, then why aren't you contacting your state medical board or the state nursing board, or even JCAHO as LIPPER pointed out?  You're not powerless.  A DNP supervising your medical care in any way is illegal and no hospital wants to be violating an obvious legal statute as that, no matter how much it may seem like you are at their mercy.

[KMD16]

^^ I do not report and will not report to a DNP. What I said was that I'm being told to report to one which I bluntly refused. Hope this clears things up.

[SocialMedicine]

the profession does not mature w a bridge program it allows the successful and able PAs to become MD's, an the PA profession immature. Someone competent like primadonna goes on to do the MD while someone who could not succees in a bridge program or gain admission stays as a PA. Now my PA degree is worth less. 

[KMD16]

a bridge program would not "erode" our profession, it would strengthen it and strengthen the MD profession. It is the only logical course for the profession to mature

Explain how a bridge program " would strengthen it and strengthen the MD profession" and how " it is the only logical course for the profession to mature"

 

 

 

[True Anomaly]

^^ I do not report and will not report to a DNP. What I said was that I'm being told to report to one which I bluntly refused. Hope this clears things up.

 

Good to hear

[Guest JMPA]

the profession does not mature w a bridge program it allows the successful and able PAs to become MD's, an the PA profession immature. Someone competent like primadonna goes on to do the MD while someone who could not succees in a bridge program or gain admission stays as a PA. Now my PA degree is worth less. 

noooooooooo PA is not worth less but rather worth more. It allows the opportunity for those whom which to bridge to MD with out having to waste time with retaking classes. A true bridge from the PA profession to MD strengthens the PA profession by reflecting the strong medical backround necessary for independent medical practice. It in no way weakens the PA "degree". In my opinion a PHD is useless for independent clinical practice and only good for teaching or research. Lets not try to replace MD with silly meaningless doctorates like the NPs are doing, we have the necessary backround, allow a bridge for those whom choose it. Of course the bridge should require a standard time of practice as  a PA first to ensure competence.

[LIPPER]

^^ I do not report and will not report to a DNP. What I said was that I'm being told to report to one which I bluntly refused. Hope this clears things up.

Fly me to Hawaii? ;)

 

 

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[EMEDPA]

the profession does not mature w a bridge program it allows the successful and able PAs to become MD's, an the PA profession immature. Someone competent like primadonna goes on to do the MD while someone who could not succees in a bridge program or gain admission stays as a PA. Now my PA degree is worth less. 

your pa degree was always worth less. Mine too. The list of things a doc can offer a practice that a pa can not is not insignificant.

[Woody85]

the profession does not mature w a bridge program it allows the successful and able PAs to become MD's, an the PA profession immature. Someone competent like primadonna goes on to do the MD while someone who could not succees in a bridge program or gain admission stays as a PA. Now my PA degree is worth less.

Are high school teachers worthless because they are not phd professors?

 

Whether you like it or not a PA has a master's in medicine. The terminal degree for medicine is an MD. Create the bridge, you don't have to cross it.

[Joelseff]

Worth Less vs worthless....

 

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[whoRyou]

Worth Less vs worthless....

 

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Good eye/statement/question ...

[whoRyou]

Forgive me if this has been posted already (I have NOT read ALL 15 pages of this post). Found an interesting study and it is very apropos to the topic The Doctorate Pipeline In Physician Assistant Education It is to note that when it was published - 2006 then look at the first sentence ... 

 

This study examined the intentions and motivations of PA faculty regarding the pursuit of doctoral education in 2003. Variables

assessed included the characteristics of faculty and the educational programs they were pursuing, including type of program and degree

awarded, delivery methods, and presence or absence of institutional support. Projections were made based on the anticipated dates of

graduation.

This is something that has been considered for quite sometime. I wonder why nothing has been done? Why so slow? I guess politics and egos get in the way as usual

[KMD16]

^^ I looked at the publication very quickly. Will read it again. Must say that it was an excellent work.

 

However, the sample size was small. Furthermore, the research/publication is dated 2006 which's almost eight years ago. Eight years is a very long time, particularly, given the recent landscape in healthcare.

 

I wonder what would be the endpoint result if the sample size are expanded or follow-up repeat survey on subjects.

[Wes797]

^^ I looked at the publication very quickly. Will read it again. Must say that it was an excellent work. However, the sample size was small. Furthermore, the research/publication is dated 2006 which's almost eight years ago. Eight years is a very long time, particularly, given the recent landscape in healthcare. I wonder what would be the endpoint result if the sample size are expanded or follow-up repeat survey on subjects.

 

This study looked at the motivations of PA Faculty to pursue a doctorate or PhD for teaching/leadership purposes.  Not a clinical doctorate which you are pushing for.

[whoRyou]

^^ I looked at the publication very quickly. Will read it again. Must say that it was an excellent work. However, the sample size was small. Furthermore, the research/publication is dated 2006 which's almost eight years ago. Eight years is a very long time, particularly, given the recent landscape in healthcare. I wonder what would be the endpoint result if the sample size are expanded or follow-up repeat survey on subjects.

Good question ... I wonder too. I guess time will only tell

PS I also noticed the sample size was quite small like you said. It's too bad it could have possibly turned some heads and might have made history and all this discussion we are having now could be a moot point.

 

This study looked at the motivations of PA Faculty to pursue a doctorate or PhD for teaching/leadership purposes.  Not a clinical doctorate which you are pushing for.

True, but I still think the study was a head of its time considering how long ago it was published. Sometimes it feels like (research) science/medicine goes at snail's pace

[SocialMedicine]

lame response EMED   .... a PA degree is not WORTH LESS if you measure worth in terms different than full practice ownership/basic science knowledge/residency experience etc..... Many on this board have significant autonomy 6 figure salary versatility in professional experiences and have 0 regrets ..... No need to depress people with your own definition of worth,  

[EMEDPA]

lame response EMED   .... a PA degree is not WORTH LESS if you measure worth in terms different than full practice ownership/basic science knowledge/residency experience etc..... Many on this board have significant autonomy 6 figure salary versatility in professional experiences and have 0 regrets ..... No need to depress people with your own definition of worth,  

ask a practice owner if they would prefer an autonomous FP physician for 180 k/yr who can bill medicare at 100% and require no supervision or a pa who makes 90K, bills at 85% and requires a doc to cosign their notes.....also the doc can do house calls, refer to p.t., order home health, etc , all under their own license...

I understand the value  a pa brings to a practice, unfortunately they need a doc to have that value while an np in many states does not.the reason we are losing the primary care battle to the nps is that we legally require a physician supervisor and many nps do not. doesn't matter if docs think we are better if they think we are more trouble to work with. in specialty medicine it doesn't matter, there is always a doc around for the most part. that is why we are winning the specialty market battle. they know we are better there and the extra supervision is less of an issue because hospitals generally require nps have their notes signed as well. .

[Acromion]

Explain how a bridge program " would strengthen it and strengthen the MD profession" and how " it is the only logical course for the profession to mature"

 

By creating a bridge program instead of a separate doctorate, you are basically acknowledging and affirming the fact that the PA degree is essentially a master's degree in medicine, and that PA's practice in essentially the same profession as doctors, albeit at a lower level of formal education. I don't think we should do what the nurses have done and carve out a separate clinical doctorate, thereby creating a separate silo for our profession to mature into. There's already a great deal of overlap between PA and MD/DO education since many PA's are educated at med schools and are taught by MD's and DO's in their didactics and clinicals. A bridge program would be the best way for PA's to get an advanced degree without creating a rift between the two professions.

 

PA's could be more efficiently and quickly trained to be primary care doctors than students coming out of college with zero health care experience. 

And that is where our healthcare system is truly lacking, isn't it? It wouldn't be hard to do. Make a bridge program that graduates PA -> MD/DO and give them a guaranteed spot in a primary care residency. Many first year med school classes could be taken mostly online (the med students I talked to rarely went to class and watched all their lectures online), so that a PA could feasibly work part time while taking certain med school courses. Our medical education system is so antiquated and costly. It will have to change at some point, and I think PA's could be right at the forefront of that change.

 

the profession does not mature w a bridge program it allows the successful and able PAs to become MD's, an the PA profession immature. Someone competent like primadonna goes on to do the MD while someone who could not succees in a bridge program or gain admission stays as a PA. Now my PA degree is worth less. 

 

But don't you think it's only fair to give motivated PA's like primmadonna a place to go, so they don't have to bang their heads against a glass ceiling their entire career? I don't think the bridge program would weaken or brain drain profession in the least. I think a minority of PA's will choose to do a bridge program, and those that do would be well positioned as PA educators having experienced both professions. Having talked to a couple PA's who went on to MD/DO, they were highly respected and valued among their peers in both professions.

[Acromion]

Are high school teachers worthless because they are not phd professors?

 

Whether you like it or not a PA has a master's in medicine. The terminal degree for medicine is an MD. Create the bridge, you don't have to cross it.

 

Couldn't have said it better myself!