Is anyone ready to listen yet?

[Timon]

One has much higher academic and clinical standards, but anemic legislative power...the other seems to wield incredible power in the political realm, yet has pathetic education standards. Whichever group is able to fix the Achilles heel first will likely destroy the other. Imagine PAs with the political power of nurses. Imagine NPs with the rigorous education standards and training of PAs.

 

And that's why you apply to a dual program like the one at UC Davis if you're a RN. You can get the best of both worlds since you get both licenses.

[physasst]

And that's why you apply to a dual program like the one at UC Davis if you're a RN. You can get the best of both worlds since you get both licenses.

 

I'm pretty sure the UC Davis program is closing. Or, rather, they will no longer be offering a dual track.

[EMEDPA]

I'm pretty sure the UC Davis program is closing. Or, rather, they will no longer be offering a dual track.

that is my understanding as well.

...on the subject of doctorates for PAs, I don't want us to get stuck with the doctorate as the entry level degree but would like to see an expansion of optional doctorates for those wanting to do admin, research, teaching, etc. Also I would welcome an expansion of pa to md/do programs for those who wish to go that route but I would design them in such a way that pa does not become a shortcut to these programs for instance require a min 5 yrs practice as a pa before application.

it's my understanding that there are a few programs(don't know names) looking at starting new entry level doctorate programs. I don't think this is a good idea.

I would not be opposed to residencies granting doctorates in association with universities for those who complete a residency and do a research project(like the army/baylor model).

if such an option were available in the civilian world I might have gone that route instead of my current DHSc pathway..

[JoePino]

southern>northern

eastern/central valley >coastal

 

Meaning that SoCal, and eastern and central California have preference for PAs?

[EMEDPA]

Meaning that SoCal, and eastern and central California have preference for PAs?

yup. lots of pa jobs in the central valleyand more in socal than norcal.

[Justeco]

I know it's a bit farfetched but why not support a PA to DNP bridge? A PA doctorate without the benefit of full autonomy seems pretty pointless.

[chickitabanana]

I know it's a bit farfetched but why not support a PA to DNP bridge? A PA doctorate without the benefit of full autonomy seems pretty pointless.

 

Why would you want to become a DNP if you're a PA? Anyone applying to either PA or MSN/DNP programs should know the difference between the two professions. Just because they're both mid-levels doesn't mean they're the same thing and interchangeable. A PA is trained in the medical model and NP in the nursing model. If you want to further your education/training/opportunities in the medical model you go the MD/DO bridge route. If you want to do the same in the nursing model you go for DNP.

 

I like EMEDPA's idea of PA to MD/DO bridge (without starting from square one) and requiring a certain number of years of practice before applying. Any PA that wants to become an MD/DO shouldn't have to start from the beginning at the same level as college grads entering med school. Step exams would still probably be required for licensing reasons, but repeating certain lectures, rotations, H&P class, etc. seems like it'd be a waste of time.

 

And, True Anomaly: I know they're allowed to be called doctors the second they have the diploma in their hand, even before they start residency. The overall point I was trying to make is that the rigorous path that MDs/DOs go through is much tougher than a DNP, PT, PharmD, etc. program. Thus, medical doctors earn the title of "doctor" so others who haven't sacrificed as much time, money, sanity, etc. shouldn't think they're at an equal level and deserve the same title. Just my opinion, though.

[MedicalRN]

Why would you want to become a DNP if you're a PA? Anyone applying to either PA or MSN/DNP programs should know the difference between the two professions. Just because they're both mid-levels doesn't mean they're the same thing and interchangeable. A PA is trained in the medical model and NP in the nursing model. If you want to further your education/training/opportunities in the medical model you go the MD/DO bridge route. If you want to do the same in the nursing model you go for DNP.

 

I like EMEDPA's idea of PA to MD/DO bridge (without starting from square one) and requiring a certain number of years of practice before applying. Any PA that wants to become an MD/DO shouldn't have to start from the beginning at the same level as college grads entering med school. Step exams would still probably be required for licensing reasons, but repeating certain lectures, rotations, H&P class, etc. seems like it'd be a waste of time.

 

And, True Anomaly: I know they're allowed to be called doctors the second they have the diploma in their hand, even before they start residency. The overall point I was trying to make is that the rigorous path that MDs/DOs go through is much tougher than a DNP, PT, PharmD, etc. program. Thus, medical doctors earn the title of "doctor" so others who haven't sacrificed as much time, money, sanity, etc. shouldn't think they're at an equal level and deserve the same title. Just my opinion, though.

 

 

I find this argument line to be a little bizarre - you're essentially saying that because one particular field has a difficult path to becoming a "doctor", that no other field should be allowed to use the title. I'm sure there are certain types of chemistry and physics degrees that require just as much if not more work to receive a terminal degree, does that mean a physician should not call themselves a doctor when in an academic setting? Would that be misleading since it is not a PhD?

 

A DNP is a doctorate degree in nursing. A doctor of any field is entitled to use the title doctor - it is not trademarked by physicians and I believe your comments are offensive to countless "doctors" in every field. In one paragraph you essentially shrugged of the years of research, time, and money that PhDs, DNPs, PharmDs, etc. put in to become the master of their subject.

[physasst]

I find this argument line to be a little bizarre - you're essentially saying that because one particular field has a difficult path to becoming a "doctor", that no other field should be allowed to use the title. I'm sure there are certain types of chemistry and physics degrees that require just as much if not more work to receive a terminal degree, does that mean a physician should not call themselves a doctor when in an academic setting? Would that be misleading since it is not a PhD?

 

A DNP is a doctorate degree in nursing. A doctor of any field is entitled to use the title doctor - it is not trademarked by physicians and I believe your comments are offensive to countless "doctors" in every field. In one paragraph you essentially shrugged of the years of research, time, and money that PhDs, DNPs, PharmDs, etc. put in to become the master of their subject.

 

I actually agree with this. I work with literally dozens of MD/PhDs in research circles. I've asked many of them just out of curiosity which was harder, their MD? Or their PhD? As someone with a doctorate, I've always been curious.

 

ALL of them, with the exception of one, stated without hesitation that the PhD was harder. The one exception was trying to be diplomatic and said that they were about equal, but just different.

 

The others.....at least 20 that I've asked, all voted the PhD as the harder of the 2 degrees. In fact, the majority of them snorted, and had this rather incredulous look like...."are you friggin serious?" One of them I remember was dismissive and said that there was no comparison, and it was a ridiculous question as the PhD was much more difficult.

 

Anecdotal yes, but interesting....

 

I would also add that the MD or DO is not considered equivalent to a PhD, ScD, etc. The MD or DO is considered a "first professions" degree by the US Department of Education, and this confers the highest degree within a given profession.....others would include DC, DPM, DDS, JD, OD, etc.etc.etc...It is considered the highest degree one can earn for the practice of medicine. Just as a JD is the highest degree one can earn for the practice of law.

 

EDIT- BTW, I don't use the title "Doctor" in front of patients, one, because there is an institutional policy the precludes any non-physician to use that title....(Psychologists and Podiatrists are exempted), and two, EVEN IF there weren't this policy, I don't think that it is appropriate to do. Patients, for right or for wrong, for better or worse, understand and equate the title doctor with a physician during a clinical encounter.

 

NOW, in the non clinical realm, I do use the title, but not very often. It still sounds weird when someone calls me "Dr.".

[ventana]

I know it's a bit farfetched but why not support a PA to DNP bridge? A PA doctorate without the benefit of full autonomy seems pretty pointless.

 

 

 

This is an idea that I would support - sorry but the AAPA and the whole name of our profession is going to hold us down in the long run...

 

their is nothing like having the highly experienced qualified PAs all jumping ship to the DNP to get the attention of the AAPA

 

Honestly, the ability to practice independently and direct bill - neither of which a PA will ever be able to do in the current setting, BUT DNP already can do in many states, is a HUGE benefit.

 

The other option is a PA--> MD bridge, but I view it is totally stupid at age 44 to consider giving up 3 years of income (3lecom+3residency) >$600,000 lost income, plus >50,000 lost retirement, plus >200,000 in loans - TO DO THE SAME JOB I DO NOW!

 

I don't need all the "extra specialty knowledge" that this 6 year path ends up giving, what I need is an advanced path into an MD or DO program or residency or some other way for independent practice. I have no issue with having to have a collaboration agreement for the first 5 or 10 years of practice, but I am not sure what benefit it is to me in later stages of my career (10-30 years of practice) NO BODY practices alone in our system, we are all part of a team!

 

 

no, autonomy is earned through clinical excellence, not high level of degree.

in the pa vs. np world a doctorate of any kind means some HR person who knows nothing about either will not say "well, the pa does not have a doctorate and the np does". that is nowhere near my primary reason for doing the doctorate but it's on the list.

I would stack my DHSc in terms of units and requirements against any DNP program. there are many ms trained rn's in my program and when I asked them why they are doing DHSC and not DNP they said the DNP was more like 40 units of a management ms level degree vs. our >60 units of learning about biostats, epidemiology, global health issues, research methodology, medical writing for publication, etc

 

 

I would put ANY PA degree (even my AAS) up against the DNP and feel it would come out on top for the actual education.... BUT the reality is that a "doctor" is going to always come out on top...... it is just advertising and advertising works......

 

If you doubt this fact, go into a MacDonald and by a big mac, then take a photo of it, and compare to the pictures on the TV Ads, wholly crap they are not even close to the same, but the advertising works and people buy a big mac (not for health benefits here!) Seriously, a name is HUGE and we are stuck with a pretty crappy one...

 

 

 

 

 

all these people are "doctors" MD DO PhD, ScD, DC, DPM, DDS, OD DNP, PsyD, DPT ..... is it really "breaking new ground" to have a DPA? I think not, we (our leaders) don't have the balls to stand up for us

[physasst]

Also, remember, this was all discussed back in 09. We had a summit at the AAPA to discuss this VERY topic, a clinical doctorate for PAs

 

So, to say that the AAPA is just ignoring this is simply not true. You may not like the conclusions, but this was reached by consensus after voting with many PA attendees.

 

http://www.aapa.org/uploadedFiles/content/Common/Files/padoctoralarticle.pdf

[chickitabanana]

I'm sure there are certain types of chemistry and physics degrees that require just as much if not more work to receive a terminal degree, does that mean a physician should not call themselves a doctor when in an academic setting? Would that be misleading since it is not a PhD?

 

A DNP is a doctorate degree in nursing. A doctor of any field is entitled to use the title doctor - it is not trademarked by physicians and I believe your comments are offensive to countless "doctors" in every field.

 

Okay, I guess you and physasst didn't take the time to read my first post on an earlier page in this thread so I will repeat myself here. If an academic introduces him/herself as "Dr. Smith" in a college lecture hall, it is obvious that he/she is a professor. (Unless, they're lecturing in a medical/nursing school -- then it could be either a PhD or a MD.) Yes, technically, an academic can introduce him/herself as "Dr. Smith" in a hospital setting, but it will rarely be the case he/she does this while wearing a long white coat, stethoscope around neck, holding a chart with lab results in it. Patients often don't even know what an NP and PA are, so introducing yourself as "Dr. Jones, your nurse practitioner" is misleading. Patients most likely disregard the "NP" part because they either stopped listening after "doctor," or don't know what an NP is and rather than ask and look foolish they just go with it since the person said they were a doctor. If a PT comes in to a patients room to work with them and introduces themselves as "Doctor Green" the patient assumes it's their physician. Haven't you ever heard patients remark on how large medical teams are during rounds? Depending on the institution there are attendings, fellows, residents, healthcare professional students, the nurse manager, the nurse(s), a pharmacist, etc. If you add in 5 people calling themselves "doctor" to the patient -- they will get REALLY confused and probably wonder why they have so many doctors treating them. You all need to remember that we understand the healthcare system much better than a layperson who has never gone to MD/PA/NP etc. school, so while you may think it's no big deal, it is misleading to the patient. The same way it's misleading for PAs to not correct them when the patient calls them "doctor." When someone asks a DNP what they went to school for what do they say? I would assume many of them say they went to graduate school to become an NP, not that they went to become a Doctor.

 

In one paragraph you essentially shrugged of the years of research, time, and money that PhDs, DNPs, PharmDs, etc. put in to become the master of their subject.

 

My father went to Cornell for his PhD so, believe me, I am well aware of the time, money, research, etc. that PhDs put in to master their subject. Also, two of my good friends each graduated with their PhD in different subjects over the past couple of years so I know what they went through. My Master's thesis advisor was a PhD and I always addressed him as "Dr. ___" despite the fact that he signed his e-mails with only his first name or initials. I have absolutely no problem calling people with PhDs "doctor" and do have a lot of respect for the amount of time they put in to their schooling.

 

If you want to argue this point -- then what about PAs? We should demand that patients refer to us by more than just our first name given all the time, money, research we put in. I have a Master's degree -- therefore, I should be called "Master _____" by those around me. I certainly shouldn't just be called by my first name the way someone with only a Bachelor's (or, GASP!) no degree is! Not after all the extra work I did to become what I am. Why doesn't anyone feel the need to demand our use of the title Master (or address us by it)? I am entitled to use it, after all, and my achievement should be acknowledged by everyone around me. I see you're still registered as pre-PA, so you haven't yet been through the 2-3 years of rigorous study of PA school firsthand. I would argue that the intense course of study that we undergo in 2-3 years and the time, money, research we do is equivalent to some "doctor" programs like PT and PharmD school. I met some UCONN PharmD students on one of my rotations at the VA and they were actually shocked to hear just how demanding PA school was. More than one medical student at my school also commented on how hard the PA program was joking that "I wouldn't be able to do what you guys do." Most PT schools are three years and the pharmacy school at URI has a 6 year PharmD program from high school. So, they essentially went to undergrad for 4 years and then did two "post-bacc" years as PharmD. Sounds a little like what we do as PAs. Sounds a little like Quinnipiac's 6 year PA school entry course from high school. And, FWIW, Cornell PA students not only have to write a master's thesis, they also have to stand up and defend (it in a similar fashion to PhDs.) So, in essence, I find your comments to be somewhat offensive to PAs. You're basically implying that what we went through is cake compared to some of the other "doctor" fields which is why we don't get to use the title and that PTs, PharmDs, etc. should be allowed to call themselves "doctor" since it was clearly 100x harder than anything an "assistant" did.

[marvi1kd]

The term "doctor" should be abolished! PAs will be PAs...NPs will be NPs and Physicians will be Physicians. Nobody should own the term! Go LeBron!

[Guest Paula]

@chickitbanana: So you want to be called: Master Chickitbanana? I have not heard of anyone wanting to be addressed with the "Master" title. We have discussed in this forum and other forums how to address PAs. Some like PA Jones, Ms. Jones, PA, or Jay Jones, PA. I would go for PA Jones. But in my practice my patients just call me Paula. Or doc, and I still correct them every time, with the statement....call me Paula, I'm not a doctor. Is does get tiring, tho.

[drholmes]

"...I don't use the title "Doctor" in front of patients, one, because there is an institutional policy the precludes any non-physician to use that title....(Psychologists and Podiatrists are exempted), and two, EVEN IF there weren't this policy, I don't think that it is appropriate to do. Patients, for right or for wrong, for better or worse, understand and equate the title doctor with a physician during a clinical encounter.

 

NOW, in the non clinical realm, I do use the title, but not very often. It still sounds weird when someone calls me "Dr."."

 

Thank you physasst! I really love this sentiment! It is my firm belief that as a profession PAs get this! The trick (and underlying concern) for a lot of us is that many - thankfully, not all - of our NP colleagues are just convinced that they much better than physicians. Therefore those, so self-affected do not get it. Also, Nurses will always outnumber us and it is concerning when they get all of the administrative or chief clinical appointments just because of the "D". Additionally, hospitals and political circles are dominated by the Nursing profession and the Nurses will circle the wagons and protect there own - just like we are doing.

 

I'm unsure any move by "the powers that be" will fix this dilemma. Nor do I think any of us really want third parties over-regulating how our clinical perspectives should behave. The only way to combat these issues is with the chops we bring to work every day. If enough of us do this consistently over-time, our practice of medicine will be satisfying and individually we shouldn't have to deal with much of this. I am not suggestion a bury-my-head in the sand approach either. Fight hard for your place at the table, by all means. Then, the regulators will have to publicly justify why this or that policy was promoted over another.

[chickitabanana]

@chickitbanana: So you want to be called: Master Chickitbanana? I have not heard of anyone wanting to be addressed with the "Master" title. We have discussed in this forum and other forums how to address PAs. Some like PA Jones, Ms. Jones, PA, or Jay Jones, PA. I would go for PA Jones. But in my practice my patients just call me Paula. Or doc, and I still correct them every time, with the statement....call me Paula, I'm not a doctor. Is does get tiring, tho.

 

Why not? The argument by those above is that "anyone who earns a doctorate level degree is entitled to use the term 'doctor' when referring to him/herself". So, using that exact same logic everyone with a master's degree should be entitled to use the term "master." Right? After all, we did master a subject. No, I wouldn't ever ask my patients address me as "Master chickitabanana." Referring to me by my first name is fine. PA Jones would be fine, too, but seeing as how the majority of the population can't say "physician assistant" without adding that stupid possessive 's I think it'd be a mouthful to address all PAs as "Physician Assistant Jones." I was just trying to make a point that those who agree anyone with a doctorate degree can be called "doctor" should also argue that anyone with a master's degree should be allowed to refer to him/herself as "master," without question, since we earned our title as well.

 

And, yes, I have seen people refer to themselves as Master. Just last summer I was at a friend's wedding and more than one person was listed as "Master John E. Smith" on the seating chart. So, apparently it does happen.

[EMEDPA]

I like the military convention, PA last name. I work with a few ex-military PAs and they all answer the phone/introduce themselves, etc as PA smith.

makes sense to me.

Dr. smith

PA smith

Nurse Jones

 

voila.

[PAS2014]

I agree with EMEDPA. I wonder why that's not standard...

[Guest Paula]

I thought the term Master could be used as the counter to the term Miss. So in the old days Master Smith referred to a boy and Miss Smith referred to a girl. That has gone by the wayside, I think.

 

Interesting concept though. If someone called me Master Paula I would think of myself as a benevolent dictator...or at least that's what my husband says.

[pglaser01]

I'd be ok with someone calling me Master if it was followed by Shredder

[pglaser01]

Or Splinter really...take your pick

[Timon]

I'd be ok with someone calling me Master if it was followed by Shredder

 

Quoted for awesomeness.

[Guest Paula]

I'd be ok with someone calling me Master if it was followed by Shredder

 

a little levity lightens the load! Ha Ha!

[Justeco]

Why would you want to become a DNP if you're a PA? Anyone applying to either PA or MSN/DNP programs should know the difference between the two professions. Just because they're both mid-levels doesn't mean they're the same thing and interchangeable. A PA is trained in the medical model and NP in the nursing model. If you want to further your education/training/opportunities in the medical model you go the MD/DO bridge route. If you want to do the same in the nursing model you go for DNP.

 

The distinction between the nursing model and the medical model is more legal and technical than practical. My NP and my PA will treat my sinus infection the same way... It may be nice to talk up the medical model over the nursing model in public but in practice they're pretty much the same.

[PAS2014]

i'd be ok with someone calling me master if it was followed by shredder

 

yyyyeeeeeessssss!!!!!!!!!!!!!!