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Misconception about a PA Doctorate


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if you knew nothing about pas and nps and were an hr wonk trying to fill a position and saw an np had a dnp and a pa had an ms you might assume the np was better because of the higher degree. yes, this is about credential creep and keeping up with the joneses but the fact of the matter is some folks just look at highest academic degree and have no idea how pas and nps differ in any other way. we compete against them for jobs. this is whay when they went to an ms we did too. they upped the ante and now we will be forced to as well. also I don't like DPA( DR of assisting makes no sense, we don't study assisting, we study medicine) I like DMS (Doctor of medical science). many pas now get an mms so dms would be a logical progression. 

 

yup, this is how PAs employed by the government work (VA, Army, Navy, etc).  Your GS level (and your associated salary) is based on the highest degree you hold OR the # of years of experience related to the job.  But coming in as a new graduate doctorate trained clinician will give you a higher salary than a new graduate master's trained clinician.  same would be true for a bachelor's level clinician or associate degree clinician... 

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MrEven

 

Yes, Doctorate completion programs for PAs are being created. Also, some new programs are looking at simply giving an appropriate degree for the work done. Need doctorate PAs to get these off the ground. Need to pay the doctorate PA enough to make a career in education worth while.

 

 

A few thoughts

 

This discussion of "physician versus doctor versus doctorate" is late.....  a PT introduced themselves as Dr __________ the other day, by 2020 the APTA wants EVERY new grad PT to be a Doctorate level, I have heard the NP have a deadline of 2015? for the same - 

 

We are being let behind in the political realm and we live in the USA where sound bites and first impressions are sometime all that is needed - 

"You can be treated by Doctor NP Kellogg, or we have a Physician Assistant available to see you....."  what is the lay person going to think? (not what is reality but just what do they think?)

 

As NPs make strides toward independence what is easier - Doctorate level NP wants independence or MS level NP wants independence... lawmakers see less resistance to another doctor being independent.

 

 

Then on a more personal level, I have AAS, BA, MBA, MS and by far my PA degree was LEAPS AND BOUNDS harder then any of these.  And from talking with other professionals (not just PAs) a doctorate level degree seems fitting and in line with what is going on in the world around us

 

And one more example - I have cancelled my day of patients on 12/2 so that I can drive to the other end of the state and testify before an executive committee that PAs can and should be PCPs in the MASSHEALTH system so that we can sign the forms for things like home day care and other MASSHEALTH programs - as we are only "assistants" why would we need this ability?  We should just have the doc sign is as we are their assistant......  words, titles and names matter and saying they do not is ignorant.... Getting the AAPA to realize this is a monumental task

 

Schools have got to realize the their is a HUGE pent up demand for a MS--> Clinical doctorate level bridge program that is affordable (I will not spent $25 or even $15k on this but <$10k and I am there in a heart beat.)  This is not to call myself doctor as my own belief is that I am first and foremost a PA, but instead to put us on level playing fields with every other "Allied Health" field that we give orders to.  Oh yeah BTW we are not even allied health per CMS - so why on earth should we not have at least and equivalent degree to the people that we are giving orders to??

 

 

I will always introduce myself as PA Kellogg

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^^^^^   Agree with JKellogg.    The biggest mistake PAs are making is not pushing for independence (full practice autonomy or whatever buzzword you want to call it). 

 

Nothing will change for us until we are no longer supervised medical providers, no longer dependent practitioners and no longer delegated to providers.  AAPA needs to get the message and cut the apron strings that they have to insurance companies, AMA, AAFP, etc.  and to start listening to those of us in the trenches who do not want what has been dished out to us.  Plus, does the AAPA get it that NPs are way ahead of us and are gaining ground in places like the VA and Federal Services.  They are starting to be the preferred provider and if have the DNP get the higher salaries.  Plus are being given more and more independence w/i the VA system, while PAs seem to languish as the assistant. 

 

As I have said in the past and am saying now I believe the PA profession should be a separate and independent profession much like the OD is independent of the Ophthalmologist and the DPM is independent of the orthopedist.   Each profession works within their own scope of practice and is accountable to their own boards.  

 

PAs are no longer the assistant that is only hired to help the physician make money or make his/her life easier.  Nope.  We exist now to provide medical care to patients for THEIR benefit.

 

JKellogg:  Good luck with your presentation to MASS HEALTH.  If they decline what you want and need then we will all realize the PA is truly not as valued as we think we are.   

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I recognize that I am only a newly accepted PA student who has yet to matriculate, and therefore lack the understanding on this subject compared to most of the other posters in this thread. However, I am concerned about degree creep, NP competition, continued misunderstanding of the PA profession among the general public and lawmakers, and the AMA and AAPA that appear to have not yet responded in a tangible way. Like it or not I know I will be involved in and directly impacted by these issues.

 

It seems to me that a good approach to this would be to expand and revamp postgraduate PA programs and award a doctorate upon completion of one of those - placing the emphasis of earning the doctorate on actual clinical practice. Currently practicing PA's could be offered a short and manageable self-paced bridge to the doctorate degree while continuing to work in their area of practice. It could also count (at least partially) as CME hours.

 

Look at the other professions that have gone to doctorates that have a much more limited scope than a PA - Audiology, Physical Therapy, Optometry, etc. I heard from a respiratory therapist recently that his profession is now going to transition to a masters requirement "so that will make me more like a PA" - no joke! I am for a PA doctorate, but we need to institute it reasonably - however unreasonable and ridiculous all this degree creep actually is. We either need to adapt or accept being pushed out in many areas.

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The point is that a new grad PA has more education, more training, more exposure in the hospital and bigger skill set then a DNP - so why not just awared the Doctorate level degree on graduation (just like physicians) then become specialty certified (just like physicians)

 

I do agree that residency is a needed thing - the days of highly experienced PAs (those with a lot of experience going into school) are oer and the new reality is that the brainiac's are getting the slots, and the need to protect the patients is a very real issue and therefor there should be residency's offered after a doctorate degree for PA.

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The point is that a new grad PA has more education, more training, more exposure in the hospital and bigger skill set then a DNP - so why not just awared the Doctorate level degree on graduation (just like physicians) then become specialty certified (just like physicians)

 

I do agree that residency is a needed thing - the days of highly experienced PAs (those with a lot of experience going into school) are oer and the new reality is that the brainiac's are getting the slots, and the need to protect the patients is a very real issue and therefor there should be residency's offered after a doctorate degree for PA.

I don't think the schools would ever go for this, not when they can instead squeeze an extra 20 or 30k out of each student to complete additional doctoral coursework.  And once you start tacking on an extra year or so to the PA curriculum, and bearing in mind that some medical schools are moving toward a shorter, 3-year curriculum, when does it become no longer sensible to go PA instead of MD/DO?

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I don't think the schools would ever go for this, not when they can instead squeeze an extra 20 or 30k out of each student to complete additional doctoral coursework.  And once you start tacking on an extra year or so to the PA curriculum, and bearing in mind that some medical schools are moving toward a shorter, 3-year curriculum, when does it become no longer sensible to go PA instead of MD/DO?

Still not sure the idea is there....

 

We all should be graduating with a Clinical Doctorate RIGHT NOW

 

We have enough credits, our job is important enough, we give orders to many of the other Clinical Doctorate level, we are not Allied Health(but instead providers), NPs are already doing it.....

 

No additional time needed - just give the doctorate

 

Think law school  2-3 years after BA/BA

DNP is an online

DPT is 5 years total

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Still not sure the idea is there....

 

We all should be graduating with a Clinical Doctorate RIGHT NOW

 

We have enough credits, our job is important enough, we give orders to many of the other Clinical Doctorate level, we are not Allied Health(but instead providers), NPs are already doing it.....

 

No additional time needed - just give the doctorate

 

Think law school  2-3 years after BA/BA

DNP is an online

DPT is 5 years total

I understand your point, but the reality is that additional coursework and class time would be required before a school could ever go from Masters to Doctorate.  And that's time and money extracted from students.  How much additional time and cost is feasible?

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The point is that a new grad PA has more education, more training, more exposure in the hospital and bigger skill set then a DNP - so why not just awared the Doctorate level degree on graduation (just like physicians) then become specialty certified (just like physicians)

 

I do agree that residency is a needed thing - the days of highly experienced PAs (those with a lot of experience going into school) are oer and the new reality is that the brainiac's are getting the slots, and the need to protect the patients is a very real issue and therefor there should be residency's offered after a doctorate degree for PA.

bs(4)+ DMS(3)+internship(1)= 8 years vs min 11 for md.

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bs(4)+ DMS(3)+internship(1)= 8 years vs min 11 for md.

But if the 'years of training' gap shortens while the income gap (and prestige/respect gap?) remains large, at some point the MD route will appear much more attractive.  Currently, it's BS(4) + MMS (2) =6 vs 11, about half.  If that 11 goes to 10 via shortened MD school, and the 8 yrs PA becomes reality, we'd be talking about only 2 yrs difference.

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in theory at least the pa also needs some time to get a cert and work to get hce...at least for better programs....

for me it was bs(4), medic school(1), 10,000 hrs of hce, pa school(2) so pretty much a wash vs md.

by the time I am done with my DHSc it will be 10+ yrs of post high school education not counting any of the hce time.

bs #1(4), medic (1), pa/bs#2 (2),  ms(1), postmasters cert in em(1), prereqs +global health cert(1), DHSc (4)-although to be fair the DHSc could be done in 2 years by taking extra courses every term. so min 12 years post high school.

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bs(4)+ DMS(3)+internship(1)= 8 years vs min 11 for md.

 

I would like the DMS to be meshed with a year of postgraduate training after the typical 2 year PA program - bringing that total down to 7 years.

 

bs(4) + MSPAS(2) + DMS/Internship hybrid(1) = 7 years.

 

And for currently practicing PA's who already hold a Masters, the DMS could be earned without the internship.

 

In my mind, 8 years is about where I would stop seriously considering PA school, suck it up and take the MCAT, and apply to MD/DO programs. Would make very little sense with the debt to income ratio to do otherwise. But of course this is all hypothetical.

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As everyone who has read the other post on "Reality Check needed", I will go on record again as full support of PA's doing what it takes to be independent practitioners.   Right now at my PA school - the length of the program is 2 years and 8 months for the masters degree upon completion - going full time year round with both a 4 week and 8 week summer session.  IF we added a doctoral level program - I would imagine it would take another year of school - which then brings our program to 3 years and 8 months.  So...... why again would I go to school for the PA degree when the MD program is a few short months longer and I would be fully independent and make a better salary?????   Degree creep to keep up with the NP's is nothing without the end goal of independence, IMO.

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I can't be convinced that PA makes sense over MD/DO beyond a 2.5 year curriculum. As you approach the 3-year mark it seems to me that the advantages of shorter curriculum, lower tuition and reduced opportunity costs are chipped away.

If we really talk seriously about a PA doctorate I think it's time to totally overhaul the PA education as we know it and put it on a continuum towards medical school (the "stem cell" model).

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I can't be convinced that PA makes sense over MD/DO beyond a 2.5 year curriculum. As you approach the 3-year mark it seems to me that the advantages of shorter curriculum, lower tuition and reduced opportunity costs are chipped away.

If we really talk seriously about a PA doctorate I think it's time to totally overhaul the PA education as we know it and put it on a continuum towards medical school (the "stem cell" model).

And this leads to the gradual end of the PA profession.  An unpopular opinion on this forum...but there it is. 

 

Extending program lengths, mandatory residencies, and decreased lateral movement (CAQ) take away the very aspects that many were attracted to PA in the first place. 

 

Overhauling PA education as a "continuum" towards medical school negates the profession as a whole.  This is a great plan for someone who wants to be a MD/DO...but what about the folks who actually want to be a PA?  It will do absolutely nothing for them.  The same problems that PAs currently have will still be there.  If anything, I can see the PAs being looked down on if they didn't continue.  So why be a PA at all?  This solution doesn't address the current problems that have led to the question being asked in the first place. 

 

Before the flames, do know that I personally have zero problems with PA's going on to become a MD/DO and I am all for educational institutions giving PAs credit towards MD/DO...I just don't think it should be an expected career progression.

 

There has to be a happy medium.

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perhaps if folks knew what a pa was and didn't confuse us with medical assistants we would be more respected within the medical community and fewer of us would want to make the jump to md/do. most docs don't even understand our training unless they trained at a place that uses pas. unfortunately, most of the docs where I work my primary job trained at a place with lots of nps and no pas so they look down on us as inferior providers.

that is the fault of the aapa for NEVER launching a pa public relations campaign. they are talking about starting one soon( after 40 years!) and maybe that will do some good.

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that is the fault of the aapa for NEVER launching a pa public relations campaign. they are talking about starting one soon( after 40 years!) and maybe that will do some good.

The first step in solving a problem is defining the cause of the problem.  This very well could be it.

 

With all the doom and gloom about more programs and more PA's...there might be a silver lining.  There is strength in numbers.  Numbers = membership = money = influence.  Now just get the right folks in.  Just a thought...I profess no expertise in medical politics.

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