Bad PA press from a PA herself

[chickitabanana]

Not sure who has seen this article but it was posted by a friend on facebook. I feel it's somewhat insulting and also disheartening that a PA would disrespect her profession by conveying that 1. there's a limit to how much PAs can/are able to learn and 2. that PAs are not trained to think critically and only are capable of following algorithims. Articles like this don't help our profession get the respect it deserves. It's a constant battle for us to educate the public on what a PA is/does/how they're trained/what they can and cannot do. I'm really disappointed to read this (and more dissapointed to see the number of people who "liked" it.)

 

http://www.kevinmd.com/blog/2014/10/pa-md-appreciation-physician-education.html

[jmj11]

I think her motive became clear that she is now a medical student. Medical students usually go through a socialization process where they enter (in their minds) a new and higher caste of society. To do so, you have to dis-the lower classes.  SDN is full of such thinly veiled attempts.  

 

Years ago I remember two NPs - turn MDs writing articles (can't remember where this was published). In the first one, the NP-MD was really dis-ing her prior profession as poorly trained idiots. Then the second NP-MD said the opposite. She said that after being in practice for 10 years a NP, she felt that Medical School added nothing but the letters after her name.  

 

I didn't see the details about this PA but had she practiced before going to medical school?  Was she a medical school wannabee all along?

[DiggySRNA]

So PAs & NPs don't respect the training physicians get...huh? Even Physicians who are specialized HIT a glass ceiling, knowledge wise. I am pretty sure a cardiothoracic MD cannot accurately diagnose and treat a patient needing orthopedics attention. Yeah...that's why the FP MD I shadowed processed referrals everyday. Of course MDs have more in depth of knowledge (7-8 more years of training), But c'mon, don't belittle other professions. 

 

According to her: "All I ask is that PAs and ARNPs alike, respect MDs/DOs for the depth of their training." What about the reciprocal? I can tell  that she will not be collaborating with PAs or NPs anytime soon lmao. "I could treat anything in an algorithm but if a patient with a new disease or a complex path came in, I did not have the tools to solve the problem."  That's why you have a collaborating/supervising physician to consult when guidance is needed...who is she going to consult when she's a physician?...referral to a specialist anyone? :'D.

 

To each his own. Not everyone is fit to be a PA and she took a seat from a potential lifelong PA.

[mrwhite]

This article is a laugh, simply pandering to the MD crowd. Grasping at thin straws, trying to hold on to some perception of authority from yester-year, all the while being swallowed whole by nurse practitioners.

[PACdan]

So she barely practiced as a PA (two years) AND she isn't even done with med school yet.

 

Maybe she should hold off on the haughty doctor attitude until she actually is one. I agree with above; sounds like she always wanted the MD title for psychosocial reasons and now, not even all the way through medical school, she's putting out ill-informed opinion pieces like this.

 

It's a true shame.

 

[PACdan]

On a related note, KevinMD tends to be an exercise in physician masturbatory writing.

Some people have raised the pertinent counterpoints in the comments section, but the prevailing winds are mostly against anything non-Doc there.

[SoCalPA]

What a waste of a PA school seat!!!  As a pre-pa with no desire to become a physician this makes me sick to my stomach!!

[Sassy27]

She seems to have intentionally left out what specific "specialty" she practiced in. The academic instruction I worked at in NY - the PAs in complex fields like internal medicine, hematology/oncology, transplant and even ER are expected to perform and have the knowledge equal to the physicians. In fact if we demonstrated incompetency even in minimal levels - there would be consequences. Now this type of intense environment isn't for everyone (it wasn't for me) but there are certainly people who thrive in such places. Her attitude may have been drastically different have been thrown into such an environment as opposed to the one she was in.

 

Having said that - the PAs in the department where I worked usually took many, many years to master the material we were required to know. Even the very best and brightest PAs I worked with could not master what we were doing even after 5years+ in some situations. My suspect is that the "specialty" she worked where she hit a "ceiling" was probably not very difficult (surgical specialty of some sort, fast track - these are only guesses) , only required her to memorize a few specific algorithms, and relied heavily on the MDs to be the brains of the operation.

 

In short - it's not fair to generalize her seemingly "easy" job and equate it with the PA profession as a whole. She obviously has no clue what some PAs are expected to know at some positions and institutions.

[ventana]

time line

 

Grad PA school

 

two years later start med school

 

This means that she likely was unhappy as a PA the moment she stepped out in to practice

[Guest Paula]

She was a medical school wanna be from the start and got derailed and chose PA school.  Kevin MD sure likes her blog and her responses are interesting from all the comments posted.  At two years of practice I hit the glass ceiling of sore throats and UTI's too.

[Guest Paula]

P.S. She references some of the PA blogs and sites so I believe she is writing about us. 

[db_pavnp]

Sounds like a personal issue.  Maybe it should have stayed on Facebook.

[RichardLPeeA]

I personally don't have a problem with someone going from PA --> MD / DO.  But the profession was good to her for 2 years, and there is no reason for her to bad mouth it. 

 

She was a medical school wanna be from the start and got derailed and chose PA school.  Kevin MD sure likes her blog and her responses are interesting from all the comments posted.  At two years of practice I hit the glass ceiling of sore throats and UTI's too.

First sentence:  "My journey in medicine began as a young child: I was the typical kid who knew I wanted to a be a doctor" 

 

 

So she barely practiced as a PA (two years) AND she isn't even done with med school yet. Maybe she should hold off on the haughty doctor attitude until she actually is one. I agree with above; sounds like she always wanted the MD title for psychosocial reasons and now, not even all the way through medical school, she's putting out ill-informed opinion pieces like this. It's a true shame.

But... But... But... I learned the entire Kreb's cycle and can recite it by heart! 

 

That means that my decision to treat that strep throat with amoxicillin is more deeply grounded in the basic sciences than your decision to treat with amoxicillin based on your cook book medicine algorithm.

[SoCalPA]

I personally don't have a problem with someone going from PA --> MD / DO.  But the profession was good to her for 2 years, and there is no reason for her to bad mouth it. 

Neither do i except if you are gonna go through at least 2 years of pre-reqs, 2 yrs training to be a PA, only work 2 years and then go to medical school. It's quite possible that this person deprived someone of a seat at a PA program. Likely someone who really wants to be a PA, has done enough research, and applied ample amount of critical thinking to know what they want to do as a career.  I mean two years after graduating? Really?

[whoRyou]

Neither do i except if you are gonna go through at least 2 years of pre-reqs, 2 yrs training to be a PA, only work 2 years and then go to medical school. It's quite possible that this person deprived someone of a seat at a PA program. Likely someone who really wants to be a PA, has done enough research, and applied ample amount of critical thinking to know what they want to do as a career.  I mean two years after graduating? Really?

 

 

... she took a seat from a potential lifelong PA.

 

 

What a waste of a PA school seat!!!  As a pre-pa with no desire to become a physician this makes me sick to my stomach!!

 

Me too ...

[PACdan]

Likely someone who really wants to be a PA, has done enough research, and applied ample amount of critical thinking to know what they want to do as a career. I mean two years after graduating? Really?

If we ever see more expedient bridge programs pop-up, I posit you'd see some new grad PAs try to apply right after their graduation.

 

Sadly I'm convinced that a small number of students "settle" for PA school each year. Some will get over it and some will carry that chip on their shoulders. Being a physician has benefits (and a few drawbacks), but some people want it for all the wrong reasons.

 

I doubt this PA maxed out her options after two years of practice and more likely she just had the opportunity to get what she couldn't before...but always wanted: doctor title. It reads like an elaborate excuse. Instead of being humble about it, she's writing a PA bashing article before ever being in practice as a physician. That smacks of sour grapes.

:(

 

[SocialMedicine]

Who knows    perhaps we can blame her PA school ?  I have witnessed some of these programs offering students little mentorship and not so stellar clinical education experience. It is hard to overcome those obstacles. 

[db_pavnp]

I feel one has to desperately miscalculate a number issues to accidentally become a PA for as few as 6 months before submitting med school apps.  I am not so sure I trust someone who was unable to challenge themselves with an MMS for more than six months and immediately figured the solution was to throw down even more school.  There is a psychology concept which suggests that individuals who are the worst at particular tasks are also the ones most likely to wildly overestimate their competence.  To think you have reached a "pinnacle" of anything in six months suggests either delusion or a complete inability to discover unknown topics and commit to self-education when there isn't a grade involved.  This is an attitude towards work and life that I do not understand, nor care to.

[primadonna22274]

In a rush between admissions and I don't have time to read all the replies above, but my gut reaction is the whole article reads a bit like sucking up.

Look, if you haven't been through med school AND PA school (and few of us have), your perception of either of those pathways is skewed. I agree with her that the information dumped on us in M1-2 is vast--much more so than in PA didactics. M3-4 is going to work and reading often (but not constantly), shelf exams and more board exams. I felt like I learned very little in my combined M3/4 year and rested on my laurels a little bit (hey, I needed a break). Started intern year in July and this is where the REAL physician learning begins! Christin has no concept of this yet because she hasn't done it yet. It sounds like she is a highly motivated student and I can extrapolate she will do well, but her PERSPECTIVE is incomplete at best. And so is mine--I'm not an attending yet. I do have 14 years of PA practice to her 2 though.

Sounds like she's one of those who should have just gone to med school to begin with. And this is fine. I should have gone too--I feel no shame in admitting that. But it sounds as though, like me, she didn't have any mentors who encouraged her to become a physician. I certainly didn't. I didn't know that I could do the work until I was doing it. and I'm sure most of us have had the experience of realizing gee, these docs aren't any smarter than me, they just did something I didn't do--and herein lies the hierarchy.

If you don't like your life, change it. --my mantra, YMMV

[primadonna22274]

And what the heck? Show of hands--who here practices algorithms?! Last I heard we practice MEDICINE. Which requires knowledge, understanding and thought.

Unfair jibe better suited to some other advance practitioners who actually do practice algorithmically (which I think is an arguable point but whatev.)

[ventana]

In a rush between admissions and I don't have time to read all the replies above, but my gut reaction is the whole article reads a bit like sucking up.

Look, if you haven't been through med school AND PA school (and few of us have), your perception of either of those pathways is skewed. I agree with her that the information dumped on us in M1-2 is vast--much more so than in PA didactics. M3-4 is going to work and reading often (but not constantly), shelf exams and more board exams. I felt like I learned very little in my combined M3/4 year and rested on my laurels a little bit (hey, I needed a break). Started intern year in July and this is where the REAL physician learning begins! Christin has no concept of this yet because she hasn't done it yet. It sounds like she is a highly motivated student and I can extrapolate she will do well, but her PERSPECTIVE is incomplete at best. And so is mine--I'm not an attending yet. I do have 14 years of PA practice to her 2 though.

Sounds like she's one of those who should have just gone to med school to begin with. And this is fine. I should have gone too--I feel no shame in admitting that. But it sounds as though, like me, she didn't have any mentors who encouraged her to become a physician. I certainly didn't. I didn't know that I could do the work until I was doing it. and I'm sure most of us have had the experience of realizing gee, these docs aren't any smarter than me, they just did something I didn't do--and herein lies the hierarchy.

If you don't like your life, change it. --my mantra, YMMV

 

 

the voice of reason - well said

 

I for one know that MS1-2 is far more detailed then PAS-1 - and would never contest this statement

 

and the TRUE feet on the ground learning is when you start to work - rather it be as an intern, resident, or PA-C - to discount the PA profession, which up to this point has relied on OJT, when you have only been a PA for a few months/years clearly shows a lack of understanding of the PA profession.

 

Strange that in so many ways she has good insight, but on the bigger issue she misses it.  

 

Prima - once again you are the voice of reason....   we need more of you!!

[Guest Paula]

I have never practiced algorithmically but I do have problems spelling it. 

[gbrothers98]

I read the article. Seems like someone's personality disorder is shining through.

I also love algorithms. Nothing like a clear decisionmaking point to clarify a patient's condition. BTW, most algorithms I use come from physician publications and lectures given by physicians. Since I am not their primary audience, seems there are many physicians that take a likeing to algorithms too. Likely they went to a different, lesser medical school than the article author.

GB PA-C

[cbrsmurf]

I suspect she just failed to get into med school her first (or 2nd, 3rd) try and 'settled' for PA school.  She started med school after 2 years of being a PA.  This probably meant she immediately (re-) took the MCAT and go her references together in her first year of practice, applied to med school, got accepted around the time of finishing her 1st year of being a PA.  Worked her 2nd year as PA and became a student when the academic year started.  Reached a ceiling in her knowledge?  Oh, please.  

 

She must have spent her first year learning how to rub the brown gunk on her nose her first year as a PA, because she's pretty damn good at it now.

[Hawkfish]

Tried to attempt some critical discussion of that blog, but it was never posted.  Meh.

 

Dennis