What can be done to improve the perception of the PA profession.

[tunafish]

As I am getting into PA world, I would really like to know your opinion on the above subject. Really, what concrete steps could be taken to improve the recognition of PAs? What do you guys think PAs should do to let everyone know what can be expected?

 

I will be going back to school from after a decade of leadership faculty position in medical research and clinical trial development. I am so discouraged to see that in the eyes of majority seasoned MDs NPs and PAs are equal. The university where I used to work has both NP and PA programs. The admission criteria for PA is MUCH harder than NP. NP offers part time classes with tons of on-line options. Being in class with some of the future NPs makes me scared to realize that these people could be first line providers in many "provider in a box" clinic.

 

You can throw rotten tomatoes at me, but you can not teach a nurse how to develop a clinical analytical thinking and a mindset in an online class. It is a totally different beast altogether. My personal clinical encounters only confirm my fears. During my wife's last internist visit, NP was clueless in her condition and was unable to do a simple differential analysis. She listed aloud "it doesn't look like this and it doesn't look like that and let me get an MD to help us here". At the same time she was right on with all of the administrative fluff associated with script writing and follow up visits. This is exactly what I see: perfect administrators in need of constant helping hand when it comes to professional leadership.

 

I understand there is a talk that both professions need to unite, but I think it would be a blow to PA potential and everyone's hard work at school.

 

Once again, what can be done? Where students can start voicing their opinion and continue to do so upon graduation. 

[tunafish]

Ironically, when I was writing this, google ad threw "affordable, accredited online nursing degrees" banner.

[winterallsummer]

Getting involved with the community, name changes, people contacting the AAPA when work related problems arise, more leadership in the profession.  Focus on helping PAs and not slamming NPs.  

[MedicalRN]

Nothing can be done, really, and ultimately it is up to individual employers to research the merits of both PAs and NPs and decide which they want for their organization. Trying to trash an entire profession to ensure that yours looks better is not the way to do it - don't you get annoyed at med students who bash PAs as inferior to justify their going to medical school?

 

The best way you can improve the "perception of PAs" is to go to school, become a PA, and do the best that you can. Sometimes you will interact with health care professionals who are great, and sometimes they will be subpar, but which two letters come after their name is irrelevant. Creating a hierarchy where one profession always ranks above another will just cause more friction when people should be focusing on collaboration.

 

Furthermore, the way you view and speak of NPs is highly offensive, and is perhaps a reflection more of the school you attend versus the entire NP profession. There are hundreds of NP programs out there, and many produce providers who have proven themselves as excellent at meeting the needs of their patients.

[tunafish]

I know that I open myself to a criticism by wide generalization. There are several fields like it: optometry vs ophthalmology for one. To be the best you could is granted and not for discussion here. It boils down to pure politics: what can be done to get an advantage. History has its lessons - at one point cardio surgeons were too lazy to see their patients and this is how interventional cardiologists became rich. Same with nursing board vs medical board. Pure politics.

[tunafish]

Nothing can be done, really, and ultimately it is up to individual employers to research the merits of both PAs and NPs and decide which they want for their organization. Trying to trash an entire profession to ensure that yours looks better is not the way to do it - don't you get annoyed at med students who bash PAs as inferior to justify their going to medical school?

 

The best way you can improve the "perception of PAs" is to go to school, become a PA, and do the best that you can. Sometimes you will interact with health care professionals who are great, and sometimes they will be subpar, but which two letters come after their name is irrelevant. Creating a hierarchy where one profession always ranks above another will just cause more friction when people should be focusing on collaboration.

 

Furthermore, the way you view and speak of NPs is highly offensive, and is perhaps a reflection more of the school you attend versus the entire NP profession. There are hundreds of NP programs out there, and many produce providers who have proven themselves as excellent at meeting the needs of their patients.

It is harder to get into med school. there is no question about it. In general, med student has bragging rights. Their bragging rights will result in a better financial outcome later on. It is harder to get into PA school vs NP program. The payback should be the same. You disagree?

[MedicalRN]

It is harder to get into med school. there is no question about it. In general, med student has bragging rights. Their bragging rights will result in a better financial outcome later on. It is harder to get into PA school vs NP program. The payback should be the same. You disagree?

I do disagree, because "getting in" is only half the battle. Physicians sacrifice 4 years of schooling plus 3-7 (sometimes more) years in residency. Those tens of thousands of hours of extra training give them strong bragging rights over PAs and NPs, and it is that large time sacrifice that provides a "better finacial outcome later on." PA vs NP is not as large of a gap as MD vs PA. The school lengths are similar, and despite what you say about it being "harder" to get in, that doesn't mean that all NPs meet only the bare minimum qualifications. I, for one, expect based on my grades, HCE, and GRE to be admitted to both NP and PA programs. In the end, I may choose NP over PA - does that mean my sacrifice to get into school was lessened?

 

The NP vs PA vs MD vs DO debate has raged on for far too long. Each profession is a profession in its own right, and they should not be fighting each other or trying to prove who is better. Attacking the education of nurse practitioners will not "help" the PA profession. What exactly would you like to see happen? Is your goal for all NPs to be fired and replaced entirely with PAs, thus wiping out an entire profession? I see a lot of people complaining that one being better than the other, but what are the implications of that? If someone DID objectively prove that PAs are "better" than NPs (which is simply not the case), what should be done with that data? Think about that:

 

If you say that employers should then prefer PAs to NPs, then why not just prefer MDs to PAs? If the job always goes to the "best" in your hierachy, it would eliminate both positions. If you say not all cases would require the knowledge of an MD and could be handled by a PA for less money...then how do you know it also can't be "handled" by the NP for even less money? Obviously this is all hypothetical, but the point I am trying to make is that there is no absolute rule that MD > PA > NP. There are PAs posting on this forum who I'd trust to take care of me or my family in the ED over a new MD any day. There are NPs with years of experience in their field that have a knowledge base that would blow away a novice PA. There simply IS NO hierachy, and as I said before, it is up to individual employers to hire the best person for the job using a combination of facts, as well as set the compensation for that position. It is not up to YOU to decide that, sorry, and no matter how much you complain there is never going to be a grand epiphany that all NPs should make less than PAs.

[ventana]

Change the name to physician associate

 

Independent practice.  5 years after school

 

create Bridge program to DO     see tagline

 

Problem solved

[mashlee]

It's impossible to prove which profession (PA or NP) is superior, however, this is a PA forum and since most of us here will be or are PAs it makes sense that we want the career to succeed and gain more respect. That being said NPs and PAs compete in many ways and since this is a "dog eat dog world" NPs may take a hit if PAs make gains. I totally agree with ventana's points and I believe those types of changes would help PAs with the possibly of hurting NPs. A lot of the points Tunafish has made I agree with also. I do agree that PA school is more competitive and rigorous in general that NP school. I believe that with time and hard work to progress the PA career, PAs will stand out and will gain the upper-hand.

[tunafish]

Change the name the physician associate

 

Independent practice.  5 years after school

 

create Bridge program to DO     see tagline

 

Problem solved

Why DO and not MD? Just curious...

[Will352ns]

Better the perception of PA.....lets see.

 

Stop the "sky is falling attitude" and focus on being the best practitioner you can be.  This isn't a stepping stone, it isn't Doctor light, and it isn't the medical "answer" to NP's.  It is a career in it's own right that is tied to the team approach to medicine where the Physician is team lead (if you can't deal with that...go to Med school).  Be a good PA....a clinician that works with Physician back-up if needed....not "the doctors' little helper".

 

Earn your keep.  Speak softly and carry a big stick...and all that jazz.

[LT_Oneal_PAC]

Getting involved with the community, name changes, people contacting the AAPA when work related problems arise, more leadership in the profession. Focus on helping PAs and not slamming NPs.

Quoted for truth.

[LT_Oneal_PAC]

Better the perception of PA.....lets see.

 

Stop the "sky is falling attitude" and focus on being the best practitioner you can be. This isn't a stepping stone, it isn't Doctor light, and it isn't the medical "answer" to NP's. It is a career in it's own right that is tied to the team approach to medicine where the Physician is team lead (if you can't deal with that...go to Med school). Be a good PA....a clinician that works with Physician back-up if needed....not "the doctors' little helper".

 

Earn your keep. Speak softly and carry a big stick...and all that jazz.

Bold talk to tell other people that want to advance the profession to basically piss off. Just because you don't like where some want to take it, doesn't make them wrong. It certainly doesn't make you righteous enough to talk down to them.

 

Furthermore, there is nothing wrong wanting a bridge program so that when, not if, you hit the professional ceiling, you have options to break through without going back to square one.

[EMEDPA]

team based medicine is all well and good but in real time unless you are working side by side with a doc you need to know what you are doing and who to ask when you don't know the answers. you will discover fairly quickly that this generally is NOT your SP but a specialist in the field related to the pts problem.

I can't remember the last time I asked any of my sps a question and they didn't say " I don't know, why don't you call the xyz specialist". now I don't ask them, I skip the middle man and go right to the source.

[MedicalRN]

I would like to know how PA to DO bridge programs would help the PA profession..

 

Wouldn't that actually hurt the PA profession? All of the "good" PAs would simply convert to being DOs, leaving only those that do not want to advance their career. Those that remain as PAs would be asked "why do you not wish to become a DO?" Obviously becoming a DO would mean you would command a "physician" salary, thus an employer might as well hire another physician. For true "midlevels", they would have no choice but to hire NPs.

 

Converting from a PA to a DO does nothing for the PA profession but reduce the number of intelligent PAs. A PA who becomes a DO is NOT a PA, so I fail to see how they help the PA professional image.

[Will352ns]

Bold talk to tell other people that want to advance the profession to basically piss off. Just because you don't like where some want to take it, doesn't make them wrong. It certainly doesn't make you righteous enough to talk down to them.

 

Furthermore, there is nothing wrong wanting a bridge program so that when, not if, you hit the professional ceiling, you have options to break through without going back to square one.

Well, that escalated quickly. 

 

Who is telling anyone to piss off and who is putting anyone down?  Really, you may want to thicken your skin a little.

 

I'm simply advocating being a good PA....what's wrong with being happy with ones choice and working at being good at it?  Competence speaks volumes...which is my point.  I have no problems with advancement of the career....didn't say otherwise.  If you want to go to a Bridge program....go right ahead, just know that it has nothing to do with being a PA.  Until then....be a good PA.  I'm not going to the be guy who is constantly bit#@ing about my own choices. 

 

"E" you have doing this long enough to have almost complete autonomy....most folks don't have that.  There are many posts here where you even admit it took you a while to achieve that level.  The fact of the matter is, most PAs have a relationship with their SP that exceed yours.  *I know there are exceptions.  What I am saying, is that I am ok with that as long as I'm not baby-sat.....hence the "doctors little helper" line in my post.

[ventana]

Why DO and not MD? Just curious...

lecom has already started it....  DO seems more open to it or atleast LECOM is....

[jwells78]

My first thought was: work harder, learn as much as possible, basically be the best clinician you can be. DONT be the guy who, after 15 years of practice, cant do a simple belly pain/ chest pain workup or interpret an EKG - that makes us look bad. DONT MAKE US LOOK BAD. DONT.... MAKE... US.... LOOK ....BAD.

 

The public/employers/whoever are looking for reasons to distrust our medical decisions; to have proof that "see, the poor outcome is BECAUSE he/she is a PA." They dont care that a Doc could have made the same mistake. We ARE less trained; we ARE more of a liability (out of school), but we CAN do something about it. What we do is settle for nothing less than clinical excellence; form strong cooperation with our physician counterparts, and we educate ourselves in the clinical practice AND the business of medicine.

 

Politically, we need strong leadership and reimbursement- and we need to ante up and fight to maintain our piece of the pie before the rest of the table takes it out from beneathe our noses. I dont want to end up working in a walgreens for cryin out loud.

[ventana]

I would like to know how PA to DO bridge programs would help the PA profession..

 

Wouldn't that actually hurt the PA profession? All of the "good" PAs would simply convert to being DOs, leaving only those that do not want to advance their career. Those that remain as PAs would be asked "why do you not wish to become a DO?" Obviously becoming a DO would mean you would command a "physician" salary, thus an employer might as well hire another physician. For true "midlevels", they would have no choice but to hire NPs.

 

Converting from a PA to a DO does nothing for the PA profession but reduce the number of intelligent PAs. A PA who becomes a DO is NOT a PA, so I fail to see how they help the PA professional image.

 

 

Who would be a HUGE advocate for a PA profession other then a PA?    What we need is some dedicated PAs on the inside of the physician club....

[LT_Oneal_PAC]

Well, that escalated quickly.

 

Who is telling anyone to piss off and who is putting anyone down? Really, you may want to thicken your skin a little.

 

I'm simply advocating being a good PA....what's wrong with being happy with ones choice and working at being good at it? Competence speaks volumes...which is my point. I have no problems with advancement of the career....didn't say otherwise. If you want to go to a Bridge program....go right ahead. Until then....be a good PA. I'm not going to the be guy who is constantly bit#@ing about my own choices.

 

"E" you have doing this long enough to have almost complete autonomy....most folks don't have that. There are many posts here where you even admit it took you a while to achieve that level. The fact of the matter is, most PAs have a relationship with their SP that exceed yours. *I know there are exceptions. What I am saying, is that I am ok with that as long as I'm not baby-sat.....hence the "doctors little helper" line in my post.

 

If you thought I was escalating or being mean because I decided to use the word "piss," your skin might be the thin one. I was simply using a colloquialism to most briefly describe your tone. I will be more verbose in order to adequately and gentlemanly convey my opinion. You were, with your tone, suggesting people go else where if they can't "deal with it." Denying it doesn't make it any less true.

 

Don't you worry about my skin. Its plenty thick and I promise I won't lose a wink if sleep. I just grow weary of condescension from those that disagree about the future of this profession.

 

I see you advocating for being a good PA, which is excellent. I also never said you were against career advancement. You are, however, against this profession advancing in a way you don't seem fit. I assume you are against bridge programs by saying "[PA] isn't a stepping stone" All of that is fine and you are perfectly entitled to believe such, but don't talk down about those that do. If you want status quo, then just keep doing what you're doing.

 

I am very happy with my choice, for now. If that were to change one day then I would like to have options available. I'm sure an intelligent and active PA-S like yourself knows why this profession was started and what Stead said the problem with medical education was, right? This is paraphrasing but very similar: there are a series of ladders in medical education. Problem is, one ladder goes only so high. So to move higher you have to go all the way down the ladder and up another, instead of moving laterally. This is why there should be a bridge.

 

As far as graduated autonomy, why is it we must always be supervised? Why can't a move be made to collaboration? There are military PAs and missionary PAs who are treating patients with no SP on the same continent. Are you saying these people are practicing unsafely? That they are not qualified to deliver care in this model? I'm sure you are not, but it seems that way when you speak of PAs unable to be team leader.

 

Edited to fix autocorrect.

[MedicalRN]

Who would be a HUGE advocate for a PA profession other then a PA?    What we need is some dedicated PAs on the inside of the physician club....

I've seen NPs and PAs who go on to be physicians. They do not advocate for their former profession. If anything they attack now that they can use the "I didn't know what I didn't know" argument.

[LT_Oneal_PAC]

Who would be a HUGE advocate for a PA profession other then a PA? What we need is some dedicated PAs on the inside of the physician club....

Agreed.

 

I would like to know how PA to DO bridge programs would help the PA profession..

 

Wouldn't that actually hurt the PA profession? All of the "good" PAs would simply convert to being DOs, leaving only those that do not want to advance their career. Those that remain as PAs would be asked "why do you not wish to become a DO?" Obviously becoming a DO would mean you would command a "physician" salary, thus an employer might as well hire another physician. For true "midlevels", they would have no choice but to hire NPs.

 

Converting from a PA to a DO does nothing for the PA profession but reduce the number of intelligent PAs. A PA who becomes a DO is NOT a PA, so I fail to see how they help the PA professional image.

Even with CNMs, all kinds if NPs, CRNAs, RNFAs, Nurse admins, there are still plenty if RNs. The PA profession would be fine.

[Will352ns]

Haha...escalated due to your left field reaction to my post. 

 

I will paraphrase because you read so far into my post, I don't have time to respond (school tomorrow). 

 

So....basically, what you are saying is that I am being condescending if I disagree with anything you say?  Even when, I really haven't disagreed with much of what you have said...other than I do think bridge programs have nothing to do with improving the perception of the PA profession; it adds numbers to physicians.  I don't think PA should be looked at like a stepping stone.  There you have it.  If this garners the time and effort to write the diatribe you have, then yes...get thicker skin.

[LT_Oneal_PAC]

Haha...escalated due to your left field reaction to my post.

 

I will paraphrase because you read so far into my post, I don't have time to respond (school tomorrow).

 

So....basically, what you are saying is that I am being condescending if I disagree with anything you say? Even when, I really haven't disagreed with much of what you have said...other than I do think bridge programs have nothing to do with improving the perception of the PA profession; it adds numbers to physicians. I don't think PA should be looked at like a stepping stone. There you have it. If this garners the time and effort to write the diatribe you have, then yes...get thicker skin.

I'm sorry if my post offended you. I've made my point, so I'm done.

 

[Will352ns]

I'm sorry if my post offended you. I've made my point, so I'm done.

No offense taken.  It's been a laugh.  :)