Doctoral Degree for PAs

[burnpac]

I just saw this on the Facebook physician assistants page:

 

http://www.pasfortomorrow.org/Statement-on-Doctoral-Trained-PAs

 

There already is a doctoral degree for PAs. It is called M.D. The absolute last thing that we need to be doing in this time of increased demand and rapid expansion of the profession is to make PA training more expensive and inaccessible.

[cinntsp]

The idea isn't to make the training more expensive or inaccessible, but to award students a degree that is reflective of the work they are already doing in terms of credit hours.  It is up to educators, administrators, and legislators to stem the rising cost of tuition that is happening across the board.

[burnpac]

The idea isn't to make the training more expensive or inaccessible, but to award students a degree that is reflective of the work they are already doing in terms of credit hours.  It is up to educators, administrators, and legislators to stem the rising cost of tuition that is happening across the board.

We will see how that works out for the profession if this takes hold. I'm sure that the altruistic for-profit PA education system will work hard to reduce the economic burden of PA training while awarding a higher degree.... (sarcasm intended  :-)  )

[LT_Oneal_PAC]

I respectfully disagree.

 

If MD was the doctoral degree for PAs, then we should be given credit for the medical education we have. We are not. So if physicians want us to be a separate profession, so be it. Create our own doctorate.

 

Next you say it will make it less accessible. We already have more credit hours and training than many other doctoral health professions. Very little would need to be added to have a doctorate.

 

Lastly, it doesn't have to be mandatory, but many are against having the option at all. Why? I can't logically answer this.

 

 

 

[SoCal_PA]

Pushing programs to be longer will only drive more students to go for the MD. The time commitment is becoming too similar 

[cinntsp]

I'm sure that the altruistic for-profit PA education system will work hard to reduce the economic burden of PA training while awarding a higher degree.... (sarcasm intended  :-)  )

 

I agree with your sentiment, but I don't believe we should thwart our progress as a profession because of the for-profit reality that is higher education.  We need to find ways to keep tuition down.  

[burnpac]

I agree with your sentiment, but I don't believe we should thwart our progress as a profession because of the for-profit reality that is higher education.  We need to find ways to keep tuition down.  

Give me one solid piece of objective evidence that the lack of a doctorate degree is "thwarting" the progress of the profession. One of the strengths of the profession right now is our ability to train nearly 7000 PAs a year after an average of 26 months of training. Demand is at an all time high. What is the problem that proponents are trying to solve with this "solution"?

[ventana]

I just saw this on the Facebook physician assistants page:

 

http://www.pasfortomorrow.org/Statement-on-Doctoral-Trained-PAs

 

There already is a doctoral degree for PAs. It is called M.D. The absolute last thing that we need to be doing in this time of increased demand and rapid expansion of the profession is to make PA training more expensive and inaccessible.

 

 

could not disagree with you any more - you seem to not understand where the profession and health care is going and I know in the past you have tried to defend the AAPA's lack of action which has left PAs behind.....

 

 

It is essential for us to have a clinical doctorate degree - the number of health professions that have this already is staggering and growing (PT, OT, SLP, nursing, and a whole slew of others).  We do not want to be doctors (MD/DO) however we do need to get the respect and recognition we deserve.  Would you rather see a Doctor of NP or an assistant?  This is a a very real issue and one that I truly think needs to get resolved.  Logic is lost to most the general public, and certainly congress and the agencies that are writing policy - if every other profession is getting clinical doctorates we need to as well.  There have been a few cases recently where I was the only one who was NOT at the doctorate level caring for a patient, yet I was the one giving the orders...   patient doing to PT (DPT), wound clinic (DNP) and got home care from another DNP...... 

 

 

I will use myself as an example - 13 years of out PA school, 3 mortgages, one child, and the real cost of me going back to med school approaches a million dollars - in my mid 40's I would be a physician in my mid 50's and how do I possibly pay back the loans at that time.  All I want is to be able to practice at the top of my license and sign the forms and care for the patients in the way I already know how to. I don't want, need and feel the desire to wholesale my life for 7 years to do the EXACT same job I do currently.....

 

 

I am sorry, but in this case I think you opinion is wrong, outdated, and actually harmful to our profession. 

 

I am not sorry if my words are strong - we have got to move forward and stop this silly debate - we should be granting DPA to all our graduates and allowing a bridge program for MS or BS PAs currently

[burnpac]

could not disagree with you any more - you seem to not understand where the profession and health care is going and I know in the past you have tried to defend the AAPA's lack of action which has left PAs behind.....

 

 

It is essential for us to have a clinical doctorate degree - the number of health professions that have this already is staggering and growing (PT, OT, SLP, nursing, and a whole slew of others).  We do not want to be doctors (MD/DO) however we do need to get the respect and recognition we deserve.  Would you rather see a Doctor of NP or an assistant?  This is a a very real issue and one that I truly think needs to get resolved.  Logic is lost to most the general public, and certainly congress and the agencies that are writing policy - if every other profession is getting clinical doctorates we need to as well.  There have been a few cases recently where I was the only one who was NOT at the doctorate level caring for a patient, yet I was the one giving the orders...   patient doing to PT (DPT), wound clinic (DNP) and got home care from another DNP...... 

 

 

I will use myself as an example - 13 years of out PA school, 3 mortgages, one child, and the real cost of me going back to med school approaches a million dollars - in my mid 40's I would be a physician in my mid 50's and how do I possibly pay back the loans at that time.  All I want is to be able to practice at the top of my license and sign the forms and care for the patients in the way I already know how to. I don't want, need and feel the desire to wholesale my life for 7 years to do the EXACT same job I do currently.....

 

 

I am sorry, but in this case I think you opinion is wrong, outdated, and actually harmful to our profession. 

 

I am not sorry if my words are strong - we have got to move forward and stop this silly debate - we should be granting DPA to all our graduates and allowing a bridge program for MS or BS PAs currently

 

1. After 33 years of practice as a PA in 6 specialties, I think that I have at least as good an understanding as to where the profession has been and where it is going as any other PA. You make not like my opinion or perspective, and like me, you are entitled to your opinion. We are discussing the pros and cons here as professional colleagues.

 

2. The best argument you can come up with is essentially everyone one else is doing it so we should too? Again, show me one piece of objective evidence that the lack of a doctorate degree is hindering the profession in any way.

 

3. The debate is not silly. It is important that the profession think through these weighty issues prior to rushing headlong down a path which could have profoundly negative implications for the growth and utility of the profession.

 

4. I don't need to go to medical school to be a highly valued, respected and paid member of my medical team. I certainly don't need a DPA.

[Maynard]

A program director once explained to me that when audiologists changed their title to "doctor" their average income went down as a direct result. Yeah, they got the respect that comes with the "doctor" title, but they also saw their field flooded by people who want the respect that comes with the "doctor" title, and their pay adjusted accordingly.

 

I'm a pre-PA and don't have a strong position on this particular subject, but I think it's worth considering whether a doctorate program would lead to higher tuition plus lower post-grad pay plus more people in the profession for the wrong reasons.

[LT_Oneal_PAC]

A program director once explained to me that when audiologists changed their title to "doctor" their average income went down as a direct result. Yeah, they got the respect that comes with the "doctor" title, but they also saw their field flooded by people who want the respect that comes with the "doctor" title, and their pay adjusted accordingly.

 

I'm a pre-PA and don't have a strong position on this particular subject, but I think it's worth considering whether a doctorate program would lead to higher tuition plus lower post-grad pay plus more people in the profession for the wrong reasons.

They were either mistaken or lied. This report from ASHA shows not only did salaries never drop, but if you look at the table comparing doctorate prepared audiologists vs other, the salary was higher for the doctorate level.

 

http://www.asha.org/uploadedFiles/research/memberdata/06AudSurveyTrendsSalaries.pdf

 

Though it wasn't ever particularly high in the first place.

[EMEDPA]

no one is saying we need to add coursework to go to a DPA or DMS(doctor of medical science, which would be my preference). we need to award folks the degree they have already earned. Dr. Davenport has a very convincing position paper on this, which I wish he would post here.

many masters degrees are 40ish credits post BS. PAs are already doing 100+ credits. they have already earned the degree, they just aren't being given the appropriate degree.

no one else has 200+ college credits and only an MS. it costs nothing to just change the name of the degree.

The "respect differential" with a doctorate is huge. I'm not even done with my DHSc in global health yet and I am being offered positions on the boards of global health organizations as well as opportunities to lead teams overseas, etc based on my future doctoral title. I was offered the medical directorship of a hospital in Ethiopia as well.

"Emedpa, Doctor of global health candidate" gets a lot more respect than "Emedpa, Senior EMPA, 27 years in emergency medicine, and holder of a CAQ in EM."

[Z PA-C]

I would support a doctoral degree granted to PAs if it didn't take longer and didn't cost more than it already does. Our tuition and courseload is already pretty much the same as the DPT students anyway.

EMEDPA beat me to it!

[ventana]

 

 

2. The best argument you can come up with is essentially everyone one else is doing it so we should too? Again, show me one piece of objective evidence that the lack of a doctorate degree is hindering the profession in any way.

 

 

 

4. I don't need to go to medical school to be a highly valued, respected and paid member of my medical team. I certainly don't need a DPA.

 

2- examples - no hitech $$  -cost me personally > $40,000, unable to sign/order hospice, unable to sign/order VNA, not admitted to hospital medical staff - but instead lumped in with allied health, can't sign a death cert - as we are just the doctor's assistant, and the 100's of times that we all have had to explain that we are not an assistant to patients, family, friends, professionals.  Being asked by the state of MASS to get the medical assisting board to okay me opening my own practice (yup really did happen).  Having the ability to own or own practice severely restricted in many states, being linked to a single physician for our license in many states.   These are all issues where having a terminal doctoral degree might well make a HUGE difference in the ability to politically advance OUR career field

 

4 - with the barriers to care as stated above - I can not practice at the top of my license, and I have a very different take and experience set then someone that has not owned their own business.  It is amazing the number of barriers that there are when you doc is not there to just sign, or order things that need to be done.  Might be less important in the specialty fields, but in the PCP world this is critical.  I too do not want to be a doc, but I do want to care for my patients the way they deserve and the way I have been trained to do. I can not do this right now because regulations are preventing me.  I don't want to be a doc, I want to be the best PA for my patients.  If this means I am doctor PA so be it - just take the restrictions away.....

 

 

 

 

 

Overall we are likely in the midst of a once in a lifetime (or longer) change in health care - AAPA has not kept PAs at the front of this change, and these issues are mounting.  Meanwhile the NPs are doing a much better job in the political realm and are actually leaving PAs far behind. I suspect (unless PAFT can get AAPA to act - which there is indications of) the NP will overtake the primary care world, be paid at 100%, get full independence with out restrictions and in general truly step into the role of PCP LONG before (if ever) the PA field does.   

 

 

Again what needs to be understood, and seems to be difficult for some to realize, is that congress and agencies determining policy are people, and as such they form their own opinions with the limited data they have.  This means that if most Allied health is a doctorate level, NPs, OD, Psych, PharmD are all doctorates, we are logically below this and should not be on level playing field.  It only makes sense......  

What does not make sense is to continue to hold onto the old notion that we can keep doing things the same way and expect a different outcome.  

WE are loosing the battle and need to redress and yes "copy" what other fields are doing......  might seem superficial, but why do you think that all these other fields have done it??  BECAUSE IT WORKS - and even if it did not work as well as hoped for, by NOT going along with it we are actually singling out PAs as something less -  "That PA degree must not be worth as much as an DPT - or as hard"   

 

 

Again, we need to step forward as a profession, and as the saying goes, lead, follow or get out of the way.

[burnpac]

no one is saying we need to add coursework to go to a DPA or DMS(doctor of medical science, which would be my preference). we need to award folks the degree they have already earned. Dr. Davenport has a very convincing position paper on this, which I wish he would post here.

many masters degrees are 40ish credits post BS. PAs are already doing 100+ credits. they have already earned the degree, they just aren't being given the appropriate degree.

no one else has 200+ college credits and only an MS. it costs nothing to just change the name of the degree.

The "respect differential" with a doctorate is huge. I'm not even done with my DHSc in global health yet and I am being offered positions on the boards of global health organizations as well as opportunities to lead teams overseas, etc based on my future doctoral title. I was offered the medical directorship of a hospital in Ethiopia as well.

"Emedpa, Doctor of global health candidate" gets a lot more respect than "Emedpa, Senior EMPA, 27 years in emergency medicine, and holder of a CAQ in EM."

I totally get this distinction. However, good luck with getting the diploma business to do this out of the goodness of their hearts. I have found that respect in any professional field is earned, and not bestowed by some letters after my name. I know a lot of folks with doctorates for whom I have little to no respect.

 

 

Sent from my iPad using Tapatalk

[burnpac]

2- examples - no hitech $$  -cost me personally > $40,000, unable to sign/order hospice, unable to sign/order VNA, not admitted to hospital medical staff - but instead lumped in with allied health, can't sign a death cert - as we are just the doctor's assistant, and the 100's of times that we all have had to explain that we are not an assistant to patients, family, friends, professionals.  Being asked by the state of MASS to get the medical assisting board to okay me opening my own practice (yup really did happen).  Having the ability to own or own practice severely restricted in many states, being linked to a single physician for our license in many states.   These are all issues where having a terminal doctoral degree might well make a HUGE difference in the ability to politically advance OUR career field

 

4 - with the barriers to care as stated above - I can not practice at the top of my license, and I have a very different take and experience set then someone that has not owned their own business.  It is amazing the number of barriers that there are when you doc is not there to just sign, or order things that need to be done.  Might be less important in the specialty fields, but in the PCP world this is critical.  I too do not want to be a doc, but I do want to care for my patients the way they deserve and the way I have been trained to do. I can not do this right now because regulations are preventing me.  I don't want to be a doc, I want to be the best PA for my patients.  If this means I am doctor PA so be it - just take the restrictions away.....

 

I get that you believe that there is a cause and effect relationship between a doctorate, and the barriers to full PA practice. You seem to believe that clouds will part and the birds will sing if we would only make doctorates mandatory and the terminal degree of the profession. I don't see this as a logical argument, and I'm still waiting for some, any objective or persuasive evidence that the lack of a doctorate is a barrier to the advancement of the profession. The problems that you cite are legislative challenges that have little to do with our educational status, and everything to do with political power. We are growing in this area, but we have to compete against organized medicine and nursing, and their millions (people and $$$), compared to our 100,000.

 

Our utility as a direct provider of patient care is becoming more recognized as evidenced by the 44 states that improved their practice acts this past year. We have a long way to go as cited by your valid examples of barriers to physician / PA team practice. But it is also true that we have come a long way since the inception of the profession.

 

As a PA who has worked in state and national legislative affairs over three decades, I can tell you that those barriers will only be overcome by hard legislative work at the state and federal level by dedicated and passionate PAs like yourself. Putting DPA on your resume and nametag is not going to impress anyone, least of all the legislature.

 

BTW, I also have my own business as a PA corporation, and work for myself. You and I both agree that we need to remove the barriers to full PA practice at the top of our training and license, we just disagree how to go about it. 

[PACdan]

105 credits in the pipeline and I already have sour grapes that I'll only end up with a Master's degree.

 

It's pretty illogical.

 

[EMEDPA]

105 credits in the pipeline and I already have sour grapes that I'm only gonna end up with a Master's.

 

It's pretty illogical.

There is always a postgrad DrPH or DHSc option. part time. 3-4 years while working full time. I got tired of waiting around for other options like a 2 yr bridge to MD/DO or an em residency that granted a doctorate so jumped into the DHSc. Glad I did. it has been a great experience.

[PACdan]

There is always a postgrad DrPH or DHSc option. part time. 3-4 years while working full time.

That will probably become a necessary reality for me at some point. Unless they grandfather us 100+ credit folks to a DPA at some point... I won't hold my breath.

 

Every single PA teaching at my program was forced to pick up a doctorate to continue in their posts. Is this the norm?

[Will352ns]

Lastly, it doesn't have to be mandatory, but many are against having the option at all. Why? I can't logically answer this.

I think the main reason there is opposition to having the option is that once it gets a foothold and there are more and more doctorate programs, the academia machine will pick up on it and start to offer only that option. Yes, we already have the hours as MS, but that won't stop them from adding more.....at cost.

The road to hell is paved with good intentions. 

 

I would support a doctoral degree granted to PAs if it didn't take longer and didn't cost more than it already does. Our tuition and courseload is already pretty much the same as the DPT students anyway.

 

EMEDPA beat me to it!

^^^^ If this was the case, then yes.  Unfortunately, it doesn't follow the higher education business model.

[SoCalPA]

I just hope the name of the degree will mean something to someone. The MMS (Master of Medical Science) has a very clear meaning to most people outside of the PA field whereas the MPAS pretty much has an internal meaning.  Similarly a DMS could possibly have more meaning than DPA.  You're practicing medicine not practicing PA studies.  Just my two pre-pa cents.  

[True Anomaly]

I can totally buy the argument that changing the profession's name from "Physician Assistant" to "Physician Associate" would over time help public perception of our profession.  

 

I cannot, and never have, buy the argument that creating a clinical doctorate out of thin air for PA's will help our public perception and advancement as a profession.

 

"Doctorate of Physician Assistance" is still the absolute dumbest title I could possibly imagine.

[EMEDPA]

I can totally buy the argument that changing the profession's name from "Physician Assistant" to "Physician Associate" would over time help public perception of our profession.  

 

"Doctorate of Physician Assistance" is still the absolute dumbest title I could possibly imagine.

yup, it's got to be DMS

[LT_Oneal_PAC]

I think the main reason there is opposition to having the option is that once it gets a foothold and there are more and more doctorate programs, the academia machine will pick up on it and start to offer only that option. Yes, we already have the hours as MS, but that won't stop them from adding more.....at cost.

The road to hell is paved with good intentions.

 

^^^^ If this was the case, then yes. Unfortunately, it doesn't follow the higher education business model.

If people want a masters degree then market forces will keep them around.

[RetNavyPAC]

I can totally buy the argument that changing the profession's name from "Physician Assistant" to "Physician Associate" would over time help public perception of our profession.  

 

I cannot, and never have, buy the argument that creating a clinical doctorate out of thin air for PA's will help our public perception and advancement as a profession.

 

"Doctorate of Physician Assistance" is still the absolute dumbest title I could possibly imagine.

 

Yep.  And that's what Lynchburg College's new program is going to offer: a DPAM.

 

DPAM - "Doctorate of Physician Assistant Medicine" 

 

Pbbbffttt!