RetNavyPAC Posted September 16, 2014 Share Posted September 16, 2014 Attached is an article from the latest issue of Emergency Medicine Australasia from Judith Tintinalli (yes THAT Judith Tintinalli) from UNC Chapel Hill. Plenty in here to give us heartburn. She lumps all "mid-level providers" together (including EMTs, FNEs, CNMs, even ED scribes for Christ's sake!) Then she uses some specious 'studies' (one of them the Mayo Clinic referral 'study') to draw spome pretty broad and erroneous conclusions. This dovetails with the recent article in EM News by Dr Guarisco from Ochsner about PAs & NPs. What's going on? Love to get everyone's take on this. Link to comment Share on other sites More sharing options...
RetNavyPAC Posted September 16, 2014 Author Share Posted September 16, 2014 Ahhhh. Forgot to click the 'Attach This File." Doh!MLPs and emergency care - Let's not lose the force.pdf Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted September 16, 2014 Moderator Share Posted September 16, 2014 Can't read the file for some reason Link to comment Share on other sites More sharing options...
gbrothers98 Posted September 18, 2014 Share Posted September 18, 2014 Attached is an article from the latest issue of Emergency Medicine Australasia from Judith Tintinalli (yes THAT Judith Tintinalli) from UNC Chapel Hill. Plenty in here to give us heartburn. She lumps all "mid-level providers" together (including EMTs, FNEs, CNMs, even ED scribes for Christ's sake!) Then she uses some specious 'studies' (one of them the Mayo Clinic referral 'study') to draw spome pretty broad and erroneous conclusions. This dovetails with the recent article in EM News by Dr Guarisco from Ochsner about PAs & NPs. What's going on? Love to get everyone's take on this. I didnt get much heartburn from this article. The section prior to the referral of the Mayo Clinic study was the proponent argument for NP and PA in the healthcare workforce. So there was an attempt to also discuss the pros before the cons. What I got out of this article was a call for physicians to take an leadership interest in the future of EM. She made several good points. ED residents are not exposed to enough 'urgent' patients but instead focus their training on 'emergent' patients, therefore missing opportunities to also become proficient at simple procedures. I can give an anecdotal experience of working with an attending fresh out of residency who clearly stated to me he preferred I see all lacerations because he had not sutured anyone during the last 2 years of his residency and felt I would do a better job. She also pointed out that there is no clear measurement or standard for ED training for PA nor NP. This is something that is being addressed by the CAQ and residencies along with various bootcamps and academies but this really is only affecting a small sample of PA and NP that are working in the ED. For example in my ED, we have 4 full time PAs and 3 part time PAs. I am the only one with the EM CAQ. All are eligible. We have one ED residency trained PA, the rest are all OJT. When I graduated there were zero ED PA residencies available. This article does anticipate and assume that physicians should be the leader in the ED. I do think in many EDs that will be the case. There is also the case where a small community hospital ED may choose an PA or NP to be the leader. This would have to do with costs and also with the ability to attract and retain a physician leader long term. Would it be better to have the PA whom has been a committed stalwart in the dept hold the leadership reins vs a physician whom will use the opportunity as a either a stepping stone or a transition to retirement? Regards G Brothers PA-C Link to comment Share on other sites More sharing options...
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