convulsed Posted November 19, 2014 Share Posted November 19, 2014 Just read this from the ACEP Facebook page :http://www.nbcnewyork.com/investigations/Urgent-Care-Center-New-Jersey-New-York-Connecticut-Physician-Assistant-Doctor-Regulation-283103481.html Link to comment Share on other sites More sharing options...
akdEM Posted November 19, 2014 Share Posted November 19, 2014 I'd like to know more detail about how that guy actually presented and what they think an urgent care MD would have done differently... If he wasn't in any kind of acute distress, I can't imagine it would have changed much. I would imagine the PA said, see your primary and exercise... but who knows. Maybe they missed some kind of obvious warning sign. Joint pain in a 39 year old wouldn't really have me thinking heart attack. Sad story though... I think the overall message of the story might have some merit. The urgent care industry is booming, and regulations probably are a little lacking. To pin it on PAs or NPs is, of course, short sighted. But we've all heard stories of people showing up at urgent care centers with atypical ACS sxs or early signs of stroke, so they need to be held to a very high standard of care. That said, I think PAs and NPs is perfectly suited for urgent care settings. Link to comment Share on other sites More sharing options...
andersenpa Posted November 19, 2014 Share Posted November 19, 2014 No medical details, can't determine a thing about this "Joint pain" was his complaint shoulder pain presenting as a coronary? or knee pain form being overweight? anything is possible one thing we've all learned in this profession is how easily we are made to be the scapegoat if there is a complication Link to comment Share on other sites More sharing options...
SocialMedicine Posted November 19, 2014 Share Posted November 19, 2014 Poor journalism. This should be responded to. Link to comment Share on other sites More sharing options...
andersenpa Posted November 19, 2014 Share Posted November 19, 2014 Ms. Cheng, I am a PA (Physician Assistant), and recently saw the video of your report on the PA malpractice suit in Wading River, NY. A few comments and corrections to you story: 1. The correct title of the profession is “Physician Assistant”, not “Physician’s Assistant” (the plaintiff attorney got it wrong as well). While this may appear to be a minor detail, it is a nomenclature issue that our profession worked hard to change. PAs are licensed professionals who practice medicine. The possessive in “Physician’s” denotes ownership by the physician, which is not the case. Most PAs practice with physicians where both are employees of a larger health system. 2. The practice model of PAs using remote supervision (the physician not required to be on site) is not unique or new. It is commonplace across the country, with a track record of excellent outcomes. You can research the malpractice data to see that PAs have a lower malpractice rate than physicians. You report that the “I-Team” has learned of this practice model, and to my read, present it as if it is a hidden danger to patients. This is far from the truth. PAs provide high level medical care in the US and internationally, to the same standard as our physician colleagues. It is a fair approach to look at health care delivery systems- in this case, Urgent Care- and evaluate if they are held to the same standard as hospitals or outpatient medical offices. As a PA, I don’t appreciate an insinuation that the credential (PA) or practice model (remote supervision) of a health care provider as being the cause of a poor patient outcome when none of the medical facts of the case are known or presented. We know nothing of the link between the patient’s outcome and what care was provided. This story borders on sensationalism. As our health care system modernizes, we see a growth in provider ranks (PAs and Nurse Practitioners being the most common physician alternatives). PAs have been around for 50 years, and it is based on our track record of excellence that we have been able to broaden access to care by functioning in remote supervision models. Whether it is a suburban Urgent Care or rural family practice, PAs can be found as the “one and only” medical provider around. They have the data to show that they are doing a great job at it. We must be wary of denigrating professions without all the facts at hand. Respectfully, Matthew Andersen, PA-C Seattle, WA Link to comment Share on other sites More sharing options...
KMD16 Posted November 19, 2014 Share Posted November 19, 2014 Total BS! Sad there was a loss. Thanks Matt for your letter. I will do the same. Link to comment Share on other sites More sharing options...
SocialMedicine Posted November 19, 2014 Share Posted November 19, 2014 who are you writing letters to ? Link to comment Share on other sites More sharing options...
Moderator ventana Posted November 19, 2014 Moderator Share Posted November 19, 2014 total garbage (unless it was left shoulder pain) Not enough information to even form an opinion but it raises questions that are just designed to sell newspapers and sensationalism.... News flash, we can not predict when or even who is going to have an MI more then once I have seen patients pass a stress test, and cardiac work up, to drop dead of a massive MI shortly there after..... it happens this article is just sensationalism at its worst Link to comment Share on other sites More sharing options...
andersenpa Posted November 19, 2014 Share Posted November 19, 2014 who are you writing letters to ? The journalist's email is at the bottom of the linked page Link to comment Share on other sites More sharing options...
andersenpa Posted November 19, 2014 Share Posted November 19, 2014 Her response: Thanks for the note. The intent of the story was to look at urgent care centers and how they are not held to the same standards as hospitals or ambulatory surgery centers. I will consider these comments. Thanks Pei-Sze Cheng WNBC-TV Link to comment Share on other sites More sharing options...
MedicinePower Posted November 19, 2014 Share Posted November 19, 2014 She (and the lawyer) seem to be shocked that PAs practice without a physician standing over their shoulders. I wonder if they realize the level and quality of training a PA has? Link to comment Share on other sites More sharing options...
PACdan Posted November 19, 2014 Share Posted November 19, 2014 The lawyer's just doing his *shocked* act for the camera. "Can you believe there was no real DOCTOR there? Oh my..." He'll do it in court too (if they don't settle), and convince all the nice folk on the jury that it's just appalling that the PA was making medical decisions on her own...regardless of what that law actually says. Link to comment Share on other sites More sharing options...
gbrothers98 Posted November 19, 2014 Share Posted November 19, 2014 Reactionary article on a slow news day. Alarm the public, find someone to blame. Wake up and do it again. Doesn't have to be correct just has to grab attention so that viewers will continue to watch through the advertising break. I doubt in NJ the overwhelming concern will last much into flu season. Everyone will still want their Zpak. G Brothers PA-C Link to comment Share on other sites More sharing options...
cbrsmurf Posted November 19, 2014 Share Posted November 19, 2014 should've gone to the ED CC: Toe pain workup - cardiac enzymes, CXR, stress test, cath lab would've easily caught this Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted November 19, 2014 Moderator Share Posted November 19, 2014 one of my attendings claims to have picked up an MI in fast track with a c/c of nontraumatic L pinky pain. apparently the give away was the terrible comorbidities in the PMH(dm, htm, smoker, etc) and the fact that the pt was diaphoretic in the middle of winter. Link to comment Share on other sites More sharing options...
stellahead Posted November 19, 2014 Share Posted November 19, 2014 Don't count on broadcast news doing a correction. I worked in print journalism for a decade, and never saw our broadcast counterparts held accountable. It's pretty funny that it took hard-nosed reporting to uncover the definition of a "physician's assistant." That's impressive Googling, I mean, investigating. Link to comment Share on other sites More sharing options...
Acebecker Posted November 20, 2014 Share Posted November 20, 2014 one of my attendings claims to have picked up an MI in fast track with a c/c of nontraumatic L pinky pain. apparently the give away was the terrible comorbidities in the PMH(dm, htm, smoker, etc) and the fact that the pt was diaphoretic in the middle of winter. What I find disturbing is that, for pinky pain, a comprehensive medical history is not routine. How many of us have seen the patient for finger pain without getting into a discussion on their diabetes, cholesterol, hypertension? Pretty much everybody here. That your attending caught it was the fluke, most likely. Not the other way around. Now, a patient who appears to be in distress who presents with finger pain, well that should be doable. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted November 20, 2014 Moderator Share Posted November 20, 2014 I'm guessing the med list was something like this which is a dead give away even before seeing the pt: metformin, lantus, lovastatin, asa, lisinopril. add that to a diaphoretic older lady with L sided upper extremity pain and I think most of us would have caught that as well. Link to comment Share on other sites More sharing options...
Timon Posted November 20, 2014 Share Posted November 20, 2014 should've gone to the ED CC: Toe pain workup - cardiac enzymes, CXR, stress test, cath lab would've easily caught this Lol! Link to comment Share on other sites More sharing options...
Recommended Posts
Archived
This topic is now archived and is closed to further replies.