andersenpa Posted March 27, 2015 Share Posted March 27, 2015 I'm reading the comments section here and I'm asking anyone reading this: CHECK YOUR SPELLING AND GRAMMAR! PLEASE! We are trying to make a point as a group of providers, and I'm telling you that every doc reading this is shaking his/her head and laughing at things like "Crebs Cycle" We need to go the extra mile in how we present ourselves in this important debate. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted March 27, 2015 Moderator Share Posted March 27, 2015 I know Dr. Klauer and he is a supporter of EM PAs. I think he might even still be on the physician advisory board for sempa. He is a frequent lecturer at the sempa conferences. Link to comment Share on other sites More sharing options...
andersenpa Posted March 27, 2015 Share Posted March 27, 2015 My letter to him: To the editor: I am writing in response to the piece you published “Opinion: Nurse Practitioners, Physician Assistants Should Not Have Same Drug Prescribing Authority as Physicians”. I am a PA practicing in Cardiothoracic Surgery, and have intimate familiarity with the two issues Dr. Menkowsky raises: prescribing authority and invasive procedures. I understand that this is an opinion piece, and not an official statement of the ACEP or ACEP Now. As a medical professional I am asking that ACEP Now do a more thorough evaluation of the validity of what it publishes. Your response to an issue with a separate, previously published opinion: ACEP does proudly promote ACEP Now as “The Official Voice of Emergency Medicine,” and takes that responsibility seriously and in the most literal sense. Our vision is to offer the most appropriate, unbiased forum possible for the discussion, deliberation, and airing of any issues impacting our specialty, especially the most complex and controversial of those issues. In doing so, we must allow diversity of opinion to be heard and, from a specialty society perspective and journalistic perspective, it would be inappropriate to avoid difficult topics and more importantly, it would be inappropriate, and even unethical, to censor valid opinions, whether or not they support ACEP policy or not. Our belief is that ACEP cannot be a credible leader in our specialty or in the house of medicine without such integrity. Interestingly, and historically, ACEP and ACEP News were formally criticized for the perception of such censorship. The key term here is “valid opinion”. Where in the realm of medicine is it “valid” to make denigrating remarks which have no evidence basis? Dr. Menkowsky makes no mention of supporting data that PAs or NPs are untrained or unqualified to prescribe medications, or perform procedures. Both professions are proven competent in those areas, and their scope of practice continues to grow state by state. Instead, he offers a stream of opinion whose purpose is to protect his place in the hierarchy of organized medicine. Emergency Medicine has a strong national PA/NP presence. The staff overseeing the publication of this opinion are expected to know the proven track record of Emergency Medicine PAs and NPs. I am disappointed that ACEP and its publication do not take greater ownership of the opinions they chose to publish. It is always important for there to be a free market of ideas, but ACEP must use a greater measure of intelligence in determining the validity of opinions which are so strongly contradicted by available evidence. Respectfully, Link to comment Share on other sites More sharing options...
jtmathew Posted March 27, 2015 Share Posted March 27, 2015 That reply isn't from the same opinion piece that is being discussed in this thread. I realize that. See andersen's post regarding publication of unfounded opinion by a distinguished organization (eg ACEP). Link to comment Share on other sites More sharing options...
Febrifuge Posted March 28, 2015 Share Posted March 28, 2015 Aww, I'm at work and the Web-nanny software doesn't like ACEP's site because it's "a parked domain." I've opened a ticket. Anyway, here's what I have been working on between patients today: I'm writing in response to the opinion piece by Dr. Menowsky, published in the xxxxxx issue. As many of my colleagues have already pointed out, this brief essay presents an opinion comprised of nothing but assertions -- which Dr. Menowsky supports with absolutely no evidence. As a piece of persuasive writing, it doesn't impress. Dr. Menowsky's commitment to quality medical care and patient safety is obvious, and commendable, but he simply fails on a basic level to connect the dots. I would be very interested to know if there is any evidence to support his opinions. As others have noted before me, anecdotes are not data, and a 'bad apple' in any role on the healthcare team should not be assumed to be a representative for their degree level or title as a whole. I wouldn't suggest that Dr. Menowsky represents any particular segment of the MD population, and indeed the overwhelming majority of my MD and DO colleagues, particularly in emergency medicine, have been vocal supporters of the PAs on their teams. Part of the reason I chose to become a PA and not an MD (and yes, I believe I did have that choice) was because of the advice of academic EM leaders I came to trust and respect, as I worked alongside them as an ER tech. I'm sure practicing medicine today is in some ways very unlike what it was even 10 or 15 years ago, and I know many of those changes are frustrating, but I think Dr. xxx conflates correlation with causation. We PAs are part of the system now, more than ever, it's true, but we are here to help, and the evidence I've seen - much of it published by ACEP - strongly suggests that we do. Here's an anecdote: my state medical license number happens to be recycled. I've noticed that other PAs have similarly low numbers compared to the MDs who are licensed and credentialed in the same general time period, and it seems it is not uncommon for my state's medical board to reuse numbers that have been retired. I looked it up, and a license with the same number as mine was held by an MD who graduated medical school in 1943. I suspect his courses may have been accelerated somewhat, as that was common during WWII. A little more Web-searching, and I came to learn that immediately after graduating, he was named Assistant Ship's Surgeon on a US Navy vessel. He held the license until his retirement in 1985. When Dr. Eugene Stead was putting together the nation's first PA program at Duke University in the late 1960s, it's my understanding that one of the influences on the design of the cirriculum was the kind of accelerated training that WWII- era doctors had done. I don't know if the previous holder of my license completed a residency in the traditional sense, after the war, but he was definitely reporting to his Ship's Surgeon right after graduation. I don't think it's too much of a stretch to say he was functioning very much like a modern-day PA, at least for a period of time. To suggest that my spiritual 'forebear' was any less a competent clinician because of the unusual timing and circumstances of his training would, I venture to guess, be insulting to Dr. Menowsky, and rightly so. We are all professionals. I can't speak for my NP colleagues, but PAs practice the same kind of medicine as MDs and DOs, because we learned it from them, and we practice it alongside them. We are not "the same as" or "equivalent to" MDs and DOs in many ways, but on a fundamental level we are members of the same team, and responsible to one another. That is in fact the entire point, and I find it troubling to see that even after 45 years of the PA profession, that point can be so spectacularly missed. I still need to run it through spell-check and proofread. Maybe I'll send it tonight. I also couldn't help but facepalm at the PA who wrote in all proud of the word "ASSISTANT" in all-caps. Ugh, not really helping but thanks, kid. Since I can't see the site now, have we gotten any backup from MDs at this point, or is it still a feeding frenzy of righteously wrathful PAs? Link to comment Share on other sites More sharing options...
Guest Paula Posted March 28, 2015 Share Posted March 28, 2015 Great letter, Feb. I haven't seen any MD/Do comments yet on the site. Link to comment Share on other sites More sharing options...
browndog Posted March 29, 2015 Share Posted March 29, 2015 Bull. I'm an NP who was trained by MDs exclusively during clinicals. Link to comment Share on other sites More sharing options...
Marinejiujitsu Posted March 29, 2015 Share Posted March 29, 2015 Bull. I'm an NP who was trained by MDs exclusively during clinicals.Yeah, but school wise it's mostly other NPs that teach, right? Tell me if I am wrong though. Mostly MDs, taught us in my program with an occasional PA lecturer. What's nice is the NPs structure pushes for advancement, ours not even close to as much. Link to comment Share on other sites More sharing options...
burnpac Posted April 3, 2015 Share Posted April 3, 2015 My blog for today on physicians practice is regarding this subject. http://www.physicianspractice.com/blog/pa-prescribing-authority-vital-care-delivery Sent from my iPhone using Tapatalk Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted April 3, 2015 Moderator Share Posted April 3, 2015 Very nicely written Steve! Link to comment Share on other sites More sharing options...
burnpac Posted April 3, 2015 Share Posted April 3, 2015 Thanks! My editors at the AAPA and Physician's Practice help me sound smarter and more articulate than I really am.... :-) Sent from my iPhone using Tapatalk Link to comment Share on other sites More sharing options...
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