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I'm curious if anyone has ever had issues with a patient not taking them as serious as they would an MD...how do you respond to them respectfully if they genuinely believe a PA can't proficiently provide care as well as an MD?

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It is a question I've asked myself as well. It seems less and less frequent that I have a patient treat me shabbily because I'm not a doctor. I do my very best to remain humble but confident. The more I practice the more confident I've become. Most patients call me doctor or doc and I will tell them twice that I'm a PA (there are no doctors where I work). Occasionally, I will meet a patient who presumes that I will simply "rubber stamp" whatever he requests. When they discover that PAs perform history and physical examinations and utilize evidence based medicine to formulate diagnoses and treatment plans, they are either converted or angered. I work in Primary Care so the observed differences between a PA and DO/MD are negligible. In specialty medicine, I would wonder what PAs experience. 

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Just few days ago, I walked in to a patient's room and introduced my self as a PA and patient said " I paid 20$ copy and not even going to see a Dr?"

 

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And I quickly said " you can see the Dr but you will have to come back another time when he is here" and I gave her a choice and informed her that I have other patients eagerly waiting to see me. She immediately stop fussing and let me see her. Ofcourse I tried to educate her what a PA is

 

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Skeptics seem to be won over by letting them talk about their hx. They like to tell you, makes it seem thourough. Its the first thing I start asking them when they seem aprehensive. "Before we discuss the reason for your visit, tell me about your medical hx". One patient told me she thought Was less important if she didnt see a doctor. But once they feel you know what to do, and explain the wait times, aprhension seems to melt away, this has worked for me majority of the time. If the person cont to be rude or dismissive, I flat out say, if you would like treatment and a workup it will start with me, or you may have a seat back in the WRoom. One person in 2 years went to the WR. They sat another 2 hours for a dx of conjunctivits. The physician asked me "what do you want me to do for her tx? It was nice back up. Pt got the same thing she wouldve gotten in the first place. 2 hours later. He he. There are just some unhappy jerks out there use any chance they can to be awful. On the other hand, the ones that keep calling you doctor, and you tell them, you are A PA or NP, they are so familiar with PAs/NPs they want to call you doc bc saying PA is impersonal. They nic name you in a sense. There are Way more peeps that will see a PA/NP than wont. Keep educating the people. They will get in another 10 years or so.

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I've only had one patient ask to see the MD instead of me in the past few years, and it was after I turned down her request for a few weeks worth of percocet for lower back pain from an MVC the week before (this is an ED patient).  The ironic thing is that she was a DNP (which she reminded the staff of every few minutes) and a nursing educator.  She had derided the nursing staff from triage on about not doing things the way she taught her nursing students (her first complaint when I entered the room was that her call bell wasn't in reach and her side rail was left down...).  

She raved about my care until the time of discharge when I wasn't a candy man; suddenly she wasn't comfortable with my care and wanted to see the attending physician....  

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I have to laugh. Just yesterday there was a patient of ours (s/p ORIF bilateral mandible fx) in the waiting room bitching about waiting, and bitching about never seeing the "surgeon" (who works three jobs in private practice, burn services medical director and department chair of plastic and recon surgery at county). I do most of the surgical followups by design. There was another breast reconstruction patient waiting at the same time and she just lit into this patient and told him that Steve and Dr. Freeman were interchangeable and the best team out there, and he should be thankful to be seen by the best.... 

 

Needless to say, the patient was very meek and respectful as I released his IMF wires and took out the pins.... 

 

I never make an issue of patients wanting to see the physician, and I always win over even the most difficult patients with an unfailing positive attitude and focus on their health care needs.

 

I love our patients!

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And I quickly said " you can see the Dr but you will have to come back another time when he is here" and I gave her a choice and informed her that I have other patients eagerly waiting to see me. She immediately stop fussing and let me see her. Ofcourse I tried to educate her what a PA is

 

Sent from my SCH-I535 using Tapatalk

 

Just go about your business. As Steve and others have said, kill em with kindness and give them your ear. Most people want to talk about themselves more than they want to complain about others. Give them a chance to do the former and they will forget about the latter.

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Let them know they can cancel the appt and re schedule and move on with the day. No sweat, no problem. Wouldnt spend more than 30 seconds on that issue. Document in the chart the patient refused to see a PA and be aware of state laws as some may require MD on site and available in these situations. I have no idea.

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I've only had one patient ask to see the MD instead of me in the past few years, and it was after I turned down her request for a few weeks worth of percocet for lower back pain from an MVC the week before (this is an ED patient).  The ironic thing is that she was a DNP (which she reminded the staff of every few minutes) and a nursing educator.  She had derided the nursing staff from triage on about not doing things the way she taught her nursing students (her first complaint when I entered the room was that her call bell wasn't in reach and her side rail was left down...).  

She raved about my care until the time of discharge when I wasn't a candy man; suddenly she wasn't comfortable with my care and wanted to see the attending physician....  

 

This x 1000.  I experienced this more in the northeast- the only time someone requested to see the doctor was when I denied them getting refills of chronic opioids.  Depending on who the attending was, they either just refilled them because they didn't want to fight or they backed up my decision.

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Let them know they can cancel the appt and re schedule and move on with the day. No sweat, no problem. Wouldnt spend more than 30 seconds on that issue. Document in the chart the patient refused to see a PA and be aware of state laws as some may require MD on site and available in these situations. I have no idea.

This is a common response I see on the forum, and I think it's a bad idea

This attitude is putting the PA's personal feelings ahead of the patient. Each patient is different and I'd say more often than not they will be willing to be seen if you display yourself in a professional manner.  These pts want treatment, and if you can offer it, you will have won over another potential anti-PA pt. By brushing them aside, our profession loses an ally.

 

Don't get me wrong, I know there are some that are rude or dismissive or won't listen to a thing you say b/c of the initials on your badge. But I wouldn't instruct our up and coming PAs to close the door too quickly.

 

The other (more important) issue is that you are in a business and your customer probably walks away with a negative experience. This is bad PR for your business, bad feedback on you to your manager/SP/HR/etc....

 

I'm sure there will be posts to follow about the horror stories PAs have had with rude pts. They've had them, I've had them, we've all had them. I would remind my PA colleagues out there that it's not about YOU, it's about THEM. If the pt comes seeking treatment and you provide it, by winning them over, you should feel like you've succeeded and not by sacrificing your pride.

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It's all in your delivery.

 

I rarely, if ever get attitude from pts regarding my credentials. I just waltz into the room, shake their hand, say "Hi I'm BruceBanner, what brings you in today?", and let them do their thing. I ask them a lot of questions--clinical and social--and touch them often. Shoulder, leg, etc. It really helps.

 

Every once in a while someone will say "so are you a doctor?" To which I say " I'm a PA." Usually they just leave it at that but sometimes they give me the old "so when are you going to be a doctor?" routine and I just briefly explain what we do and what our scope is, and that it was my plan to be a PA.

 

Just make them talk about their problem(s). Then follow up with some flowery clinical language and pointed questions. 

 

If you are getting attitude you need to work on owning the room more. It's your show (unless you're in the OR or rounding or something).

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