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What do you want PAFT to focus on in the next 3 years?


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Plus remember it takes 12 years to churn out 1 board-certified pediatrician or family medicine physican versus 3 years for a IM/FP physician assistant or specialist. So the workforce-development economics do not support entrenched brick n mortar allopathic/osteopathic/mid-level practitioner education.

Dude, do you even math?

 

4 years undergrad + 4 years med school + 3 year residency = 11 years for a physician.

 

4 years undergrad + 2.5 years PA school = 6.5 years for a non-residency trained PA, assuming all HCE can be done during undergrad.

 

So, rather than 4:1, the ratio is more like 3:2.

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Never say Never!

Healthcare is 20% of our national GDP. This horse has been way outta the barn long before you and I were postgrads.

 

You don't need a face-to-face lecture neccessarily to read and interpret histopathology slides and understand the physiology of the RAAS. The online version permits greater immersion and repeat study to become expert. So there are clear benefits to an online and/or hybrid PA education model in additional to brick n mortar.

 

I eat dinner 3x monthly with 45 year old MDs. They are seriously contemplating or actively retiring from practice. These are the young ones....who are still young enough to pivot to another profession before they get too old. They are totally dismayed and burnt out from the never-break even educational debt, long-hours without seeing family, negative payscale, malpractice, etc... That's just the tip of the iceberg.

 

Who is going to fill the clinical void between those physicians 60+ retiring and those 40+ retiring. Plus remember it takes 12 years to churn out 1 board-certified pediatrician or family medicine physican versus 3 years for a IM/FP physician assistant or specialist. So the workforce-development economics do not support entrenched brick n mortar allopathic/osteopathic/mid-level practitioner education.

 

We can all stand on ceremony about the good ol days of MD/PA classroom-based academia. But the WORLD IS FLAT and nearly 9 billion humans will need healthcare services over the next century. Who's gonna meet that demand....how are we going to rapidly meet that demand....

 

All it takes is for 1 or 2 simultaneous natural disasters, infectious disease outbreaks or terrorists attacks on "any soil" to Code Black an already fractured domestic or international healthcare system.

 

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3 years for PA vs 12 for physician? I stopped reading after that kind of math.

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ICMNTV--

 

I actually don't think we need very more PA schools. If you were to double the number of PA students to meet this so called "demand" where are they going to do their training? Who precepts all of these students?

 

I am already seeing PA jobs drying up in major metropolitan areas. There are plenty of jobs in "small town America" but not many of the 25 year old PAs w/ minimal HCE want to serve these communities. They also need several years of adequate supervision before working in a community on their own.

 

The lack of primary care providers is a trickle down effect from MD/DOs pursuing higher paying specialties. The same goes for the 25 year old PA students I have seen from local schools.

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PAFT already approached DWB/MSF about their no PA stance and their board sent back a letter clarifying their use of NPs. when they use NPs they only use them as RNs, they are not using them as practicing clinicians. They are willing to use PAs who possess an MPH in a logistical support role doing planning, epidemiology, etc. They get enough applications from residency trained/boarded docs that they reject most of those apps so have no need for PAs/NPs to work as clinicians.

Thanks so much EMED!  I feel like I've seen enough other orgs that take PAs, that there are still options.  A colleague of mine actually created her own clinic in Ethiopia that she travels to twice a year.  (If anyone ever wants the info, PM me and I'll send you the link!)

 

On a side note - are you still in the Nova program?  I haven't been on the forum in awhile but recall you were doing the DHSc.  I'm ~1/3 of the way through the ATSU program for DHSc in Global Health. :)

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I am also very old in this business and can tell you that producing an online PA opens the door for an IDIOT provider to be produced - one who has no interpersonal skills or can't function with other humans but can do fine online. 

 

 

Totally agree!

 

We've learned this, too, from the online NP programs.  In my practice alone, we've had to let go of 3 in the past year who had either "direct-entry" training (IE: they didn't practice as nurses first) or did the online-NP programs.  This is just anecdotal, and I am NOT bashing NPs (some of my closest friends and most knowledgeable colleagues are NPs), but I am saying that we need to maintain a training method we can be proud of.  

 

And beyond that, adding more PA programs before giving us a greater scope of practice may really be shooting ourselves in the foot.  We could end up with a lot of new grads working for lower pay, willing to do work that doesn't fully utilize their skills and knowledge.  If we allow for collaboration or even independent practice (for those who have expensive experience), then suddenly we have a potentially great solution to our healthcare - and especially our primary care - crisis.

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To the oldies :0)

I am finding your anti-online education reasoning hard to follow.  Just to be crystal I am referring only to an online year-1 didactic phase with a traditional face-to-face, clinical preceptorship/elective year-2.

 

I too am an oldie who was educated and allied-trained in the the mid-80's. Back then we took K-type MC basic science and shelf exams. You had to know your subject matter 4 different ways (A-True, B-False, C-True, D-False, E-None of the above) or a combination thereof. We took our core classes that way then went into the clinics. Mind you, the professors back then were ol''school attending physicians and many floor nurses, who learned and practiced the "art" of medicine since the late 60's.  They understood social-medicine in the context of acute and chronic disease, they understood multiculturalism and poverty in the context of public health disparities and infectious disease pandemics (e.g, Kaposi's Sarcoma and Crack-related GSWs circa 1978-1985).  We practiced Woodstock medicine where white, black, asian and latin HCPs listened to the same music, understood each other's communities and related to other's health issues. Those preceptors could spot a natural and they could spot a bookworm. You washed out if you couldn't hold your own even if you scored A's on your exam.

 

I have watched for the past 35 years medical schools and more recently PA schools churn out, 3.8 GPA, 29 MCAT scoring premeds getting an automatic admit to medical school (now PA school) because they knew how to game the application,testing, and interview system.  More so because the interviewers all look and sound alike. Yes, they go further to score above the 90 percentile in their USMLEs too. But when they get into the clinics, they can't hold steady a tongue depressor let alone perform a basic H&P on Abuela Sanchez or understand why Lil' Tyshawn is a monthly ER readmit for his sickle cell crisis or asthma.

 

So how you are technically educated in your didactic year has < 20% correlation of how you will succeed as a 2nd year or postgrad PA.  How you succeed or how you are perceived as a mid-level clinician has about 80% correlation to how your family raised you, what foods they cooked, what schools you attended, and what interpersonal values you osmosed in your community as a child, teen, and post-secondary student.  I will even go as far to include your age, marital and parental status as HUGE correlations to how you will succeed as a clinician.

###

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I cannot agree with anything you said, ICMNTV.

Online education is not going to promote communication skills or appropriate level PAs on any front.

High GPA folks do not necessarily know how to find their way out of a paper bag - with a flashlight.

 

High GPA and "scores" do not a person make.

Some folks with those high GPAs are socially dysfunctional with zero common sense or street sense.

 

Give me someone with good average grades and an amazing bedside manner and THAT person will make an awesome PA.

 

So, I will continue to counter that one cannot quantify a person by grades, marks and metrics. 

 

I will still support that a student should be in a brick and mortar classroom with us old PA educators getting eye to eye contact and checking for their ability to communicate, assimilate, grow and respond to situations and others. Hmmm, that is exactly what I do in a clinic every single day................................ for years on end.

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I think we are in agreement on 98%.  

 

My support for online education is based on finding a recruiting and workforce development solution to the shortage of brick n-mortar slots/seats.  And more recently, a solution the rabid dysfunctional admissions schemes bypassing those very same candidates that you and I are both in agreement on.  Over the past 5 years I have datamined the admissions profiles of two dozen-plus programs from Southern Florida to New Hampshire and Texas to Illinois.  I can count on 4 hands the numbers of Latino, Black, Native American students and graduates over the past half decade that have been admitted and graduated. The recent NCCPA data bolsters my argument.  Candidates with average and/or above average grades and a keen sense of community, definately make GREAT MDs/PAs. They are being bypassed for admissions.  AAMC data has always known that URM medical doctors >90% of the time return to their home communities to practice, many of these rural and urban federally designated HPSAs.  The art of medicine is 70% listening and humanism and 30% science-medicine. 

 

Lastly, this online concept isn't that foreign or damaging of a trend. Think back to the early 90's where allopathic medical schools challenged their traditional 150-student sized auditorium education model with small group-sized Problem-Based Learning (PBL). I recall the push back. Several schools also experimented with 5-year medical school tracks with the first 2 years spread over 3 years (3:2 education), and way back in the 70's a few schools experimented with and still today have accelerated 6-7 year BS/MD programs.  All of these programs were postulated to rectify perceived problems with then medical education admissions, retention and lack of humanism in their graduates.

### 

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To the oldies :0)

I am finding your anti-online education reasoning hard to follow. Just to be crystal I am referring only to an online year-1 didactic phase with a traditional face-to-face, clinical preceptorship/elective year-2.

 

I too am an oldie who was educated and allied-trained in the the mid-80's. Back then we took K-type MC basic science and shelf exams. You had to know your subject matter 4 different ways (A-True, B-False, C-True, D-False, E-None of the above) or a combination thereof. We took our core classes that way then went into the clinics. Mind you, the professors back then were ol''school attending physicians and many floor nurses, who learned and practiced the "art" of medicine since the late 60's. They understood social-medicine in the context of acute and chronic disease, they understood multiculturalism and poverty in the context of public health disparities and infectious disease pandemics (e.g, Kaposi's Sarcoma and Crack-related GSWs circa 1978-1985). We practiced Woodstock medicine where white, black, asian and latin HCPs listened to the same music, understood each other's communities and related to other's health issues. Those preceptors could spot a natural and they could spot a bookworm. You washed out if you couldn't hold your own even if you scored A's on your exam.

 

I have watched for the past 35 years medical schools and more recently PA schools churn out, 3.8 GPA, 29 MCAT scoring premeds getting an automatic admit to medical school (now PA school) because they knew how to game the application,testing, and interview system. More so because the interviewers all look and sound alike. Yes, they go further to score above the 90 percentile in their USMLEs too. But when they get into the clinics, they can't hold steady a tongue depressor let alone perform a basic H&P on Abuela Sanchez or understand why Lil' Tyshawn is a monthly ER readmit for his sickle cell crisis or asthma.

 

So how you are technically educated in your didactic year has < 20% correlation of how you will succeed as a 2nd year or postgrad PA. How you succeed or how you are perceived as a mid-level clinician has about 80% correlation to how your family raised you, what foods they cooked, what schools you attended, and what interpersonal values you osmosed in your community as a child, teen, and post-secondary student. I will even go as far to include your age, marital and parental status as HUGE correlations to how you will succeed as a clinician.

###

First off, I'm not an oldie. I am under the age of 30 (even though I have been in medicine for 10 years as I was a firefighter/paramedic at 19 years old).

 

I appreciate your knowledge and wisdom you bring to the table. I agree that minorities have often been overlooked in this profession. I graduated in a class where 5 of 35 would have been considered minorities. It is definitely something that existing PA programs need to work on. I have seen several PA programs (NYC/LA/Chicago) that are overwhelmingly admitting excellent students from all backgrounds and ethnicities.

 

Regarding online education: I am ok with 1st year didactic education being primarily online or learned at your own convenience. Most med schools have <50% attendance at most lectures and students watch them on their own. Students learn from several sources nowadays and no one is arguing that. I do think it is ridiculous that most PA schools have such hardcore attendance policies.

 

What you were arguing is that online education for PAs would increase the amount of students a program could then admit. Yale had a plan to increase their online program up to 300 students per class. That is extremely troubling as most PA schools have a hard time finding rotations for their students. There are very little incentives to precept students nowadays because there is no financial gain and providers deal with the added pressure of full patient schedules and administrators breathing down your neck. It may not be a problem in your area but I know it is a problem in several areas around the country.

 

More students ---->>> oversaturation. It's already happening whether you have realized it or not. It's still region specific, but salaries are leveling off and the quality of new jobs for new grads has gotten drastically worse (they are being taken advantage of because they are desperate).

 

Just look at J.Ds, PharmDs, and in some areas DPTs now. Most DNP schools already have their students set up their own rotations with little oversight as to the quality. We would be entering a grey area where we are diluting the quality of the training that PAs have had in the past.

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  • 1 month later...
Guest Paula

Approach the ARC-PA to standardize the degree designation for PAs to be Master of Medical Science degree.  NOT MPAS.

 

(This is not my original idea and came from Febrifuge on another thread).  Kudos to Feb. 

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I agree with most of the posts on here, especially rev's :) !

 

As a student, and relatively new to the field. My #1 sounds silly, especially for it to be "#1" (which rev and many other talked about) , but I'd like to share my story.

 

Title - PA be associated with Physician Associate

Perception is EVERYTHING. I know it sounds silly, and it really is not an issue for experienced individuals within health care (cause they know better!). But for most of the general public, and politicians you bet it is because most are not intimately knowledgable about the healthcare field.

 

I was a first hand account of this misconception and fell victim of what a PA actually is. My assumption about their education, what they do, and are capable of doing, limited them (us!). I had been around medicine throughout high school and undergrad (Primary Care and Ortho clinics with only MDs). I naturally had heard about PAs. I asked what does it stand for and what do they do... Physician Assistant. I instantly thought of CNA (Certified Nursing Assistant) , MA (Medical Assistant), ST (Surgical Tech/Assistant). "So ok, what do they do" ... I usually got a very abridged explanations saying they work under a physician in treating conditions. "Ohh, ok... interesting I don't think I want to do that", because I was thinking it was like a more advanced/specialized MA, or a CNA but for physicians. If you had asked me then, "Do you want a PA to read your MRI to diagnose your ACL tear?"  I would have been pretty confident and been like... "uhhh, no?". Silly I know! But I had never directly worked with one (or knew one)! It wasn't until graduate school (~23, and ~8 years being around medicine and education) did i get a proper understanding. I caught up with an old orthopedic surgeon I worked under (who had left the practice, and gotten a PA in his new practice), and i finally understood the full breadth what their education was, what they do, and can do. Wow... how could I be that naive, and had so many misconceptions! I think it came down to my initial perception, and meaning behind and the word Assistant. It altered my professional opinion (deciding to go into the another career at the time) and my personal opinion of them (wanting them to take care of me as a provider). If it affected me, and I am almost certain it plays a role to the general public, and by extension policy makers.

 

Personally, I would like the Title of PA to be associated with Physician Associate. Cause often time, the next logical question for someone who hasn't been around many PAs, "what does that stand for". Simply "PA", would still have people refer back to "Physician Assistant". So ideally, i think we should have the definition be Associate. So the AAPA, would stand for American Academy of Physician Associates.  This would be for "definition" sake and people can still refer to us as PAs, but when they would search on google... they would be reminded of proper nomenclature.

 

Companies and individuals spend huge amounts of money on "Brand identity", perception, advertising, and first impressions (think apple store, and apple packaging). I know there are other, more critical issues, but i think those would fall into place with less resistance if there were a change. If perception to the public, politicians, and government were different, then those outside healthcare would have a better gauge of what we do and wouldn't be easily confused with other similarly titled position!

 

Its a sad thing to admit, but that is why I would like to change :)

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I agree with most of the posts on here, especially rev's :) !

 

As a student, and relatively new to the field. My #1 sounds silly, especially for it to be "#1" (which rev and many other talked about) , but I'd like to share my story.

 

Title - PA be associated with Physician Associate

Perception is EVERYTHING. I know it sounds silly, and it really is not an issue for experienced individuals within health care (cause they know better!). But for most of the general public, and politicians you bet it is because most are not intimately knowledgable about the healthcare field.

 

I was a first hand account of this misconception and fell victim of what a PA actually is. My assumption about their education, what they do, and are capable of doing, limited them (us!). I had been around medicine throughout high school and undergrad (Primary Care and Ortho clinics with only MDs). I naturealyl had heard about PAs. I asked what does it stand for and what do they do... Physician Assistant. I instantly thought of CNA (Certified Nursing Assistant) , MA (Medical Assistant), ST (Surgical Tech/Assistant). "So ok, what do they do" ... I usually got a very abridged explanations saying they work under a physician in treating conditions. "Ohh, ok... interesting I don't think I want to do that", because I was thinking it was like a more advanced/specialized MA, or a CNA but for physicians. If you had asked me then, "Do you want a PA to read your MRI to diagnose your ACL tear?"  I would have been pretty confident and been like... "uhhh, no?". Silly I know! But I had never directly worked with one (or knew one)! It wasn't until did until graduate school (~23, and ~8 years being around medicine and education) did i get a proper understanding. I caught up with an old orthopedic surgeon I worked under (who had left the practice, and gotten a PA in his new practice), and i finally understood the full breadth what their education was, what they do, and can do. Wow... how could I be that naive, and had so many misconceptions! I think it came down to my initial perception, and meaning behind and the word Assistant. It altered my professional opinion (deciding to go into the career) and personal opinion of them (wanting them to take care of me as a provider).

 

Personally, I would like the Title of PA to be associated with Physician Associate. Cause often, the next logical question for someone who hasn't been around many PAs, "what does that stand for". Simply "PA", would still have people refer back to "Physician Assistant", so ideally we should have a new definition be Associate. So the AAPA, would stand for American Academy of Physician Associates.  This would be for "definition" sake and people can still refer to us as PAs, but when they would search on google... they would be reminded of proper nomenclature.

 

Companies and individuals spend huge amounts of money on "Brand identity", perception, advertising, and first impressions (think apple store, and apple packaging). I know there are other, more critical issues, but i think those would fall into place with less resistance if there were a change. If perception to the public, politicians, and government were different, then those outside healthcare would have a better gauge of what we do and wouldn't be easily confused with other similarly titled position!

 

Its a sad thing to admit, but that is why I would like to change :)

Its not sad at all to admit. I think the majority of people on the forum are for a change in our name from Physician Assistant to Physician Associate. I only wish it would have happened before FPAR, I think it would have made it easier to pass bills through state legislature and get the public to understand that we don't just take your weight, height, and blood pressure.

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