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Those who refuse treatment from a Physician Assistant

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I work as a paramedic, at least for 12 more shifts until I start PA school, at a suburban urgent care in metro-Detroit. The UC is owned by a DO who shares shifts with her partner, a PA. Just now a patient walked in because of a wound on a finger that was infected that he wanted I&D'ed. He was informed of the cost, as he had no insurance, and that the PA would be treating him. Upon hearing the PA was seeing patients today, he promptly walked out. While this is frustrating, I know that it will soon be in my future. Any input on how best to deal with a situation like this would be great.


My first inclination is to shrug and let it go, if he doesnt want to be seen thats okay. Good luck finding what you need and feel comfortable with for care. My second inclination is to follow him to his car and talk to him about the PA profession, our training and qualifications and why he should rest easy knowing a qualified, competent and caring PA is a short time away from solving his problem expediantly. This second, more confrontational opinion, I am sure is stemming from me being defensive about my new profession and once I am seasoned I will take the "water-off-a-ducks-back" approach.


Thoughts? Any students/practitioners have personal experience that they can share?

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this happens maybe once or twice/yr out of 5000 pts/yr in the emergency medicine setting, less often now that I look"older"... as a 30 yr old who looked 20 when I started working it was hard to get respect as a new pa. throw on a wedding ring, grow a beard and voila, instant respect. weird, I know.

if working alone and they refuse to see you, document it as well as your recommendation that they seek care elsewhere as soon as possible. have them sign out ama.

if working with a doc, let the doc know and they will see them when they can if the pt is willing to wait. in my setting on the rare days when I work with a doc this usually means the doc sees them after every other pt in the dept of higher acuity is seen. by refusing to see you they are triaging themselves back to the bottom of the pile.

what is really refreshing is when a pt refuses to see a doc and wants to see you instead. happens more and more every yr.

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A similar situation occured in my clinic just a little while ago and I posted a thread about it here...


I was pretty bent out of shape about it for a bit (as a few of you will recall). No one had pulled anything like that in quite some time around here and I think that was the main reason it bothered me so much... I thought I'd put that issue to bed long ago... Well, here it came back again...


My point is, I suppose, that some people won't be happy no matter what. The fact is: there are more and more PAs out there treating patients. Eventually even the most subborn patient will have be seen by a PA if they want timely, affordable, competant medical care...


I'm trying to remind myself of that for when (not if) this situation arises again so I can be more like the duck and just let it go...

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