New pa program

[crystaltide]

In the Google search I did, I found a PDF of the Tufts School of Medicine meeting where they discussed the program, and it said they were looking for accreditation as soon as Fall 2012.

[Contrarian]

ummmm to return to the subject of tufts PA program specifically...

 

any one know if they are even accredited?

 

Why do you think that they would be if they haven't matriculated a single class yet...???

 

Specifically... it has been my understanding that a program has to actually exist and be actively teaching students and have outcomes to show... to be accredited. I guess they can apply for "provisional accreditation" but I think the doors have to be open to evaluated for accreditation.

 

I'm sure someone will be along shortly to clear this up.

 

Contrarian

[EMEDPA]

I do think this means there is going to need to be another type of advanced certification or practice level that captures the fact that a PA with 10+ years experience in a field is FAR superior to a new grad or even a 1-2 year PA - and this should be reflected in additional levels of responsiblity - sort of the same as BLS vs ACLS ambulances..... No reason I should not be able to hang up a shingle, take on my own caseload of patients and run my own business in primary care as long as I have an official doc supervisor.

 

we have talked about this before; class A and class B pa's.

class A significant prior medical experience, do well in school, rock boards etc(maybe call these folks physician associates....)

class B everyone else; minimal prior low level experience, struggled through, barely passed pance(might have taken several tries....)

 

after 6 yrs and passage of panre class A's get some additional benefit that class B's don't get. I'll leave it up to your imagination....there could be some mechanism for a type B to become a type A like completion of a residency for example....

[FSUnoles]

 

Opening up a one room school house in the middle of a cow pasture and calling it medicine reeks of the Chiropractic plan...

 

Just a few thoughts based upon what I've seen...

 

Contarian

 

This. I interviewed a just opened for profit career college program and their classroom was a room in the top floor of an office building. No labs nothing

 

Needless to say I value my education and turned down their acceptance and am going to a much more respected program. I've noticed lately that a lot of career colleges are trying to get in on the pa profession

 

Sent from my HTC Glacier using Tapatalk

[dolcezolce]

Thanks.. i figured it was a bit of BS... considering that there was very minimal info on line about their program. Im not that desperate to get into a PA school... hopefully ;)

 

Thanks for the help guys!

[Planteater]

How about Class A- or Class B+= no significant health care experience; but older, wiser, and possessing enough life experience and wisdom to think for myself, to lack arrogance, to work my tail off learning all I need to know (not just meet the minimums), and to care about my future patients (and not about the $$$)? Do those things count for something?

[Contrarian]

Thanks.. i figured it was a bit of BS... considering that there was very minimal info on line about their program. Im not that desperate to get into a PA school... hopefully ;)

 

Thanks for the help guys!

 

Sigh...

 

Ummm... lt seems like YOU are a bit confused padwan...!

 

Just because a NEW program isn't accredited YET doesn't equate to it being "BS."

 

EVERY new program has a period of time between planning and graduating the 1st or 2nd class when it has NOT been granted full accreditation yet. Full Accreditation requires a program demonstrate (and be evaluated) that it can meet or exceed the minimum standards set for ALL programs by the accreditation committee.

 

A NEW program... still in its planning stage can't do this. There are NO lectures for the evaluators to sit in on, no clinical sites for them to see students actively learning at, no student records or instructor's bio's for them to peruse, no current or past students to interview, no PANCE pass/fail rate to scrutinize and compare with national averages.

 

So... it is my understanding that these things (all required for full accreditation) typically happen during the first two matriculating classes, during which time, the program will have been granted "provisional" accreditation.

 

Hopefully someone intimately involved with the process will be along shortly to clear up any further misconceptions that you and I may have about the process.

 

Contarian

[Vulgatus]

we have talked about this before; class A and class B pa's.

class A significant prior medical experience, do well in school, rock boards etc(maybe call these folks physician associates....)

class B everyone else; minimal prior low level experience, struggled through, barely passed pance(might have taken several tries....)

 

after 6 yrs and passage of panre class A's get some additional benefit that class B's don't get. I'll leave it up to your imagination....there could be some mechanism for a type B to become a type A like completion of a residency for example....

 

I really like the idea. Although, IMHO, making residencies the sole difference between Class A versus B might also be a good way to go. It would place a greater demand for more residency spots and would produce higher quality new grad PAs entering the workforce.

 

As a side note, and it's just my opinion, but I think too much emphasis has been placed on previous HCE. The typical argument is that people with more HCE come out better prepared after graduating from a PA program versus someone with minimal HCE. People don't seem to take into account that not all HCE is created equal. 10 years as a paramedic versus 10 years as a medical technologist simply won't compare. Heck 3 years as a paramedic versus 10 years as a medical technologist still doesn't compare (not trying to pick on medical technologists as I am one but I recognize the lack of direct patient contact versus other fields). Yet if you reward the experience of one type of job over another, you risk alienating potential applicants to PA programs. Point being that rewarding previous individual experience, that may or may not have prepared the individual postgraduation, doesn't compare to the experience and refinement you'd receive in a residency.

 

Residencies have to be one of the most underutilized weapons in the PA arsenal.

[hilaryofriel]

I attended PA school in Boston and did both psych and emergency medicine rotations at Tufts. I have to say that it is a very impressive facility and a wonderful teaching hospital. PA students will be treated as equals along with the medical students there (as I was during my clinical rotations). I find it very exciting that Tufts is creating a PA program. I wish them all the best! :)

 

To comment on the rural school statement- I feel like that is a very rash statement without having any comparative study of quality of PAs coming out of medical schools vs non-medical schools. One of my best rotations was in urgent care at at very small rural community. I was working along side a physician one-on-one and was allowed to do many procedures independently whereas at the larger teaching hospitals associated with medical schools I had to fight to not be placed secondary to medical students and residents. Having experienced a little of everything I would say there are benefits and drawbacks to both.

[ventana]

 

Contrarian, why are you such a hater? you seem disgruntled… lol

 

:O_O:

 

 

DOH that almost hurts......

 

 

so contrarian - what is the answer? to to draw an anology.... those darn PA's are just not as good as Doc's and they should not be used in the medical system..... or those rural grad PA's are not as good as the grads from a medical school in a big city.....

 

 

remember the premise of PA is OJT - what better spot then rural??

[hilaryofriel]

haha I thought I deleted that fast enough for no one to see. guess I thought wrong.

[bradtPA]

If I had my way...

 

The only new programs that would be allowed to apply for accredidation would be REQUIRED to be a part of a Medical School... and as the older programs that weren't attached to medical school family medicine programs lost accredidation, they wouldn't be allowed to re-apply until they were a REAL part of a medical school.

 

IMNSHO... this whole PA program in the middle of a cow pasture with NO affiliation to any school of medicine does our profession NO GOOD...

 

I will have to respectfully disagree here. Having graduated from a program affiliated with a liberal arts college, I can attest that we were provided a good education despite not having a medical school attached. Oncology was taught by oncologists, Peds by pediatricians, anatomy by a general surgeon, and clinical rotations were done at a teaching hospital. We had a real anatomy lab with real dissections, and our first time pass rates on the PANCE equaled those medical school trained folks from Duke.

 

The military also does a fine job of training PAs at Fort Sam without a medical school in sight....

[Contrarian]

Contrarian, why are you such a hater? you seem disgruntled… lol

 

Umm... you REALLY don't want to do this little girl...!!!

 

so Contrarian - what is the answer? to to draw an anology.... those darn PA's are just not as good as Doc's and they should not be used in the medical system..... or those rural grad PA's are not as good as the grads from a medical school in a big city.....

 

remember the premise of PA is OJT - what better spot then rural??

 

Ventana:

 

Your reading and comprehension skillz seem to be slipping.

 

1.) IMO... there are TOOOOOO many programs. Many were opened simply to make cash. When the economy started slipping, and investment stock and portfolios started declining, many folks said "hey... lets open a PA program, get rid of the experience requirement, and make it a masters degree program so that we can charge more for it."

 

2.) It is the perception of the Physicians and the folks that are blocking YOU from starting your own clinic that you talk about that PAs don't practice medicine... but merely "assist" physicians. These are the folks that reflexively spit at you "Wanna practice medicine, or own/open a clinic... GO TO MEDICAL SCHOOL...!!!!! Or come here and insist that every patient YOU see needs to be seen by a physician because you didn't GO TO MEDICAL SCHOOL...!!!!! Or automatically ASSumes that "you don't know... what you don't know" because you didn't GO TO MEDICAL SCHOOL...!!!!! In your multi specialty clinic insist that they should automatically make at least 2-3x your salary... regardless of the fact that you bill much more than them because you didn't GO TO MEDICAL SCHOOL...!!!!! These are the folks who insist on only talking to your SP even if your SP didn't even see the patient being discussed because you didn't GO TO MEDICAL SCHOOL...!!!!! These are the institutions that refuse to pay for your services unless they are co-signed by a physician (Any sort of physician will do!) simply because you didn't GO TO MEDICAL SCHOOL...!!!!!

 

Part of this notion stems from the FACT the many/most PA programs have NO affiliation with medical schools. Another part of this notion stems from the widely varying "end-product" that programs produce, which "may" or may not have something to do with NOT being affiliated with medical schools.

 

As for the second part of your analogy... pure fantasy on your part...

I didn't write anywhere in this thread that city/rural PAs are better or worse.

YOU made that up or somehow what to get that message out there.

 

What I stated was that there are toooo many programs... and all programs should be part of medical schools.

 

Especially since we like to claim that we practice what they do and insist that we want to remain subservient to.... ummm I mean PArtners with them.

 

What I stated was that rural physicians who are focused on "productivity" and not "teaching/mentoring" often find themselves underwhelmed and disappointed with the widely varying degree of competence and clinical excellence but consistent and predictable demand for higher, and higher salary displayed by this new demographic of PA new grad.

 

Work on your reading and comprehension skilz...

 

I never even suggested that there should be NO rural programs... that rural programs are inferior, or that urban programs are superior. As I understand it... they ALL teach the same thing if they are all accredited. What I suggested was that they should ALL be a part of a medical school and there should be a moratorium on opening new ones unless they are part of a medical school. Lots of Medical schools have rural residency sites so I can't see why having a rural PA program as part of the School of Medicine would be a problem.

 

Its funny how you guys like to parrot "we practice medicine," but bristle at and resist the notion of programs being required to at least be affiliated with MEDICAL SCHOOLS...

 

Kinda like the Chiropractors setting up their schools in BFE, handing out "Doctorates" then claiming to "practice medicine."

Kinda like the Nurse Practitioners setting up their programs independent of medical learning, but practicing "Advanced Nursing" which somehow looks strikingly familiar to those who "practice medicine."

 

For those with cognition issues...

 

To be clear:

I think there are tooo many programs. I don't care if they consolidate programs, increase class sizes to 100-200/program, whatever.I think ALL PA programs should be administratively housed in a School of Medicine.

 

There are too many un-affiliated programs built in one-room school houses out in BFE teaching what... Medicine or Assisting...??? Lots of physicians and the lay public can't seem to tell.

 

As it stands, whats to stop Palmer Chiropractic from opening up a PA program on the back lot of its San Jose, Davenport and Port Orange campuses and then tying our profession to theirs so that they can prescribe.

 

Yeah... our Physician PArtners would LOVE that...!!! :heheh:

 

 

BradPA:

 

No where above... in any of my posts in this thread did I suggest that the education in rural programs was somehow sub par.

If you re-read what I wrote, you may see that I suggested ALL programs be affiliated with/housed within a Department of Medicine... in a medical program. Not bastardized children of a medical program, but actual, sit on the board, have a say/committee chair and a budget in a Family Medicine department of a medical school.

 

As for your military comparison... it doesn't work if you follow the Org. Chart/Decision tree up high enough... think AMEDD, and is a poor comparison since historically the military is a different creature all together and somehow successfully trains HS drop-outs, bumpkins, thugs and vahtos/essa's to do things independently and manage millions of dollars in personnel and equipment. Nowhere else will a CNA be allowed to insert a chest tube... so poor comparison.

 

 

 

Again...

 

All acredited PA programs teach the same things... so all PA students are exposed to the same material regardless of degree granted or location.

 

I am of the opinion that there are tooo many programs. No m,ore should be accredited.

 

I am of the opinion that ALL PA programs should be administratively housed in the Family Medicine/Primary Care division of a School of Medicine. Just as a Physician can supervise multiple PAs... a School of Medicine should be able to have multiple PA programs and sites.

 

Tufts SOM got it right and will be a great program.

Harvard Meds should be next.

Yale did good with its Physician Associate program

U of Chicago SOM should also open a PA program

 

EVERY Medical School in the US should have a PA program... but the number of PA programs should be the same as the number of Medical Schools not more (schools can have multiple sites so in reality... there could be 200+ matriculating PA classes each yr but there would only be as many PA programs as there are Medical Schools).

 

I get the impression from the retorts/responses from many physicians and lay public that OUR credibility concerning our "practice of medicine" versus simply "assisting" suffers from the fact that most of the programs out there are NOT affiliated with a School of Medicine. This conception of US as a profession is also affected by the increasing numbers of cute but inexperienced grads that simply want to function at the "uber-MA" level, with a high salary for "practicing medicine," and a requisite boutique schedule.

 

Contrarian

 

P.s... someone please enlighten hilaryofriel that historically... no good will come from engaging me in the sort of comments she made... it will only end BADLY

[bradtPA]

If the education at a non-medical school PA program is not sub-par, then you have NO GROUNDS to your claim to close them other that a screwed up notion that they have to be tied to a medical school for prestige. And to insinuate that the military is full of bumpkins and thugs is just downright insulting to this retired military member. In regards to educating a certain board member, remember that sometimes you go way too far and insert your foot down your mouth so far it tickles your anus. IMHO this is one of those times....

[Contrarian]

If the education at a non-medical school PA program is not sub-par, then you have NO GROUNDS to your claim to close them other that a screwed up notion that they have to be tied to a medical school for prestige.

Sigh...

Legal Assistants don't practice law...

Medical Assistants don't practice medicine.

Executive Assistants aren't executives...

Dental Assistants don't practice dentistry

By its very definition, "Assistants" help others accomplish their tasks...

 

The question from those who haven't attended a program is often... Physician "Assistant" programs teach its students to do what... Assist a Physician...???

 

Patient: "I don't want to see the Assistant... I want to see either the Doctor or the Nurse Practitioner"...! :sadface:

 

Again..

IMO... part of the reason there IS confusion as to what we are and what we do is because of our title AND the fact that MOST of our programs have NO affiliation with a School of Medicine.

 

 

And to insinuate that the military is full of bumpkins and thugs is just downright insulting to this retired military member.

 

Thanks for YOUR service... but really I couldn't give a crap any less how insulted you WANT to be about my statement.

 

Dude... YOU aren't the only person who served on this board. Many of US also served, are veterans and continue to do so as civilians.

 

So it has been my, and the experience of other veterans here that while the military has its share of scholars, geniuses, and millionaires... it also has its fair share of semi-literate bumpkins, thugs, essa's, vahthos, drunkards, and addicts... most of whom develop into outstanding, upstanding, productive, mature folks. Some... not so much and either end up kicked out, or not allowed to re-enlist.

 

The 10% rule applies here also...:wink:

 

The US military is but a reflection of the society it protects and draws its personnel from. So you WANTING to be "insulted" means absolutely NOTHING... as YOU are NOT the only person to wear a uniform in the service of this country.

 

POUND SAND....!!!!

 

The point YOU missed while expending valuable and obviously limited cognitive resources getting "insulted" was...

 

The recruitment, culture, structure, ethos, resource pool, laws/rules/regulations, litigeous environment and very mission is totally different when comparing military medical training and civilian medical training. Trying to pattern any civilian training on what the military does is in most cases (not all) a "fools errand."

 

This is often evidenced by taking a few moments to peruse the typical AARTS transcript of 91A/91B/68w...

 

This person may have done LOTS of "high-speed" stuff medically and inserted lots of tubes during their 2-4 deployements and 10-20yrs of service, but once they discharge from service and hit a college campus or civilian job, that AARTS transcript will proudly reflect all that 'high-speed" training and performance and knowledge as 5-15 credit hrs of "First Aid" training and a few Physical education credits. :saddd:

 

So... to reiterate... the military is a reflection of the society it serves, the society isn't a reflection of the military. Just because something is done or acceptable in the US Armed Services doesn't mean it is acceptable, proper, or reasonable in civillian society and vis-a-versa.

 

So instead of insisting on being "insulted"... try reading what I wrote and seeking clarification of meaning and intent for those ambiguous bits and pieces prior to the requiste "wadding if the panties."

 

Thank You for your service... and I'll just ASSume you are thanking me for mine.

 

Have a very PA day..!!

 

Contrarian

[ventana]

contrarian

 

 

It seems you have a lot of time to digest this - you have insinuated that rural programs "are in it just for the money" "that they turn out subpar graduates" "that they provide less of an education" "all schools should be associated with a medical school" and a slew of other things....

 

 

yet then debate these exact points. Seems to me that you are stuck in the past and thinking that only medical schools can teach medicine, (?) and that there is too many programs (yet we are within about 20 of the # of medical schools - is there too many medical schools too? Your logic seems to be breaking down somewhere.

 

 

I propose there is not enough graduates and there needs to be a dramatic increase in the numbers of either programs or class size. That medicine can indeed be taught outside of a medical school (or we can continue to crawl deeper in bed with the MD/DO's and have the DNP/Nursing movement leave us farther behind!). We have a national certifying exam and standards that have to be meet at the state level to get a license - are these standards not adaquate?

 

 

I suspect what we have going on here is the old guard, seeing the up and coming (which is noticably a very different breed of PA) grumbling and saying things need to change and this is the answer. Well the problem is that you can not go backwards, and in fact we are being out paced by NP's (and almost every other allied health career as they move to doctorate level degrees) and if we rely on the MD/DO medical boards to protect us we are not going to go anywhere fast and in fact may loose ground.

 

 

We should outnumber physicians, not the other way around.

 

 

Honestly your replies were to much dribble to read through so it took a few tries to get through all of it..... but I think you are wrong and in fact the opposite is true - MORE PA's - strength in numbers, continue to associate with a medical school is possible, but not required (get out from underneath the doc's and the "old school" establishment) and become more of a force in modern american health care - don't hold us back, but instead motivate us to get bigger and better.....

[cinntsp]

IMO... part of the reason there IS confusion as to what we are and what we do is because of our title AND the fact that MOST of our programs have NO affiliation with a School of Medicine.

 

Do you really believe that patient confusion stems from not all PA programs being affiliated with medical schools? I'm willing to bet it has nothing to do with it and more so entirely with the title. Even if all programs had that affiliation, when a patient asks "did you go to med school?" and the reply is "no but I went to a school that was affiliated with a medical school" will they really care?

[Contrarian]

Ventana:

 

Thanks for the reply...

 

The problem here seems to be that you guys are "half-a$$ed" reading what I wrote and jumping to erroneous conclusions about what I mean.

 

- you have insinuated that rural programs "are in it just for the money" "that they turn out sub par graduates" "that they provide less of an education" "all schools should be associated with a medical school" and a slew of other things....

 

1.) About Money: I stated that within a very short period... there was a exponential increase in the number of programs. When I applied there were ~50 programs... within what seemed to be 3-4 yrs... there were 150 programs. Why did all of these colleges suddenly "jump on the PA program BandWagon"...??? What happened during this time frame that wasn't happening or hadn't happened in the previous 30 yrs this profession has been around...?? Why did the entrance requirements suddenly get tossed out the window and the standards lowered..??? Were they NOT working for the previous 30+ yrs PA programs had been matriculating students...? If the exponential increase in programs were/is about health care access for the general public.. why aren't/weren't there lots of new Certificate/AAS PA programs..? All accredited PA programs teach the same things right...? Would the difference in tuition (CC= ~$100/cr-hr v/s MS= ~$540/cr-hr) provide an answer..?

 

Many of these programs function with a skeletal permanent staff of 3-4 people (Program Director, Medical Director, 1-2 "secretaries/coordinators" and a passel of un/under-paid associate faculty). Many of these programs have their students commuting long distances all over their and neighboring states for the required clinical experiences. Most if not ALL lecturers and Clinical Preceptors are Un-paid VOLUNTEERS. Soooo... what is that $60k-$100k in tuition money per PA student... x 25-50 students/yr being spent on...???

 

Surely, that undergraduate English 102 style paper... that requires NO original research or findings, that is often called "the masters project," doesn't cost $30-40k to read and grade. This is really the ONLY difference between Certificate/AAS/Bachelors programs and these new Masters programs.

 

If you know anything about the history of the proliferation of MBA programs and Computer programing/Software engineering programs and what's happening to the graduates of MOST of these programs, you may see a correlation.

 

2.) Rural Programs: Again... I didn't place the "sub par" performance of some new grads on the "rural" programs. I placed the "sub par" performance on the the notion that historically, educating oneself to practice medicine as a PA has been the providence of internally motivated, mature, self-starters who grew into increasing levels of psychosocial medical competence. Somewhere in late 1999 to the present ... becoming a PA became the new FAD...

 

Lots of folks started showing up talking about "I'm thinking about doing PA"... or "I'm gonna Do PA"...

 

I placed the "sub par" performance on the the notion that in meeting the demand of this FAD, many new programs lowered the standards of admission for financial gain, NOT to provide enhanced access to health care for the general public. If you do a search of the locations of the newer programs during this PA program proliferation time frame... you may see that few newer programs are in urban settings. nationally, the urban centers are just as "under-served" as many of the the rural areas... so why so few if any of the newer programs are located at lower cost CCs in urban under-served areas...???

 

I commented on the conversations I have actually had with physicians about their thoughts on and experiences hiring and working with PAs and why they would or would NOT hire another PA-C versus a NP.

 

The re-occurring themes during these conversations with these physicians seem to be 'young, cute, nice, helpful, not really productive, fluff versus substance/competence, naive, expensive.' I've also heard, "if I gotta see em all... and sign all the notes, then what am I paying for"..??

 

Level of Education Provided by Rural Programs: Ummm... please direct me to where I stated that rural programs "provide less of an education"...

 

If you re-read what I actually wrote, you will see that I actually stated ALL accredited programs expose ALL students to the same material regardless of program or degree awarded. My contention is that simply exposing this new demographic to the material that was designed to work on the old demographic has caused some issues.

 

3.) All schools should be associated with a medical school:

 

Since WE do practice medicine... why shouldn't we all be associated with a medical school.

Wanting to claim "we practice medicine" but avoid attending or associating with a "school of medicine" seem a bit odd... and gives our detractors ammo.

 

PA-C program directors and PA program medical directors sitting on the boards, committees, and as professors and faculty of Family Medicine divisions and residencies throughout the US would be able to advocate for us and have a serious hand in ensuring that the collaboration with and utilization of PAs is integral and ubiquitous in all aspects of medical education.

 

Think about it... if EVERY medical school in the US was affiliated, supported, and provided academic and clinical professors and faculty to EVERY PA program in the US... EVERY physician (MD/DO) in the US would be exposed to and likely learn next to and from PAs. Since these physicians and PAs would be attending the same program, at the same time, housed in the same settings, directed by the same directors and divisions... a lot of the divisiveness between PAs and Physicians would likely go away. Since ALL physicians and ALL PAs would belong to the same Alumni organizations, have shared clinical experiences and will have learned together throughout training... a true PArtnership could be forged.

 

Thing is... it is my understanding that the "powers that be" in PAdom are REQUIRING all programs be affiliated with Masters degree granting institutions to remain accredited... so it would seem [to me] that ensuring ALL programs are affiliated with actual institutions of medicine should have been a priority before this.

 

This (^^^ See #3 Above^^^) is my reasoning for suggesting that ALL PA programs be directly related in a truly meaningful way to ALL Schools of Medicine.

 

Not because I think they do it better or that PA programs have thus far done a poor job exposing us to the practice of medicine. I'm just tired of being told "GO TO MEDICAL SCHOOL" if you want any respect from physicians and patients or parity regardless of performance.

 

It has been my experience that being able to state "I attended XYZ SCHOOL OF MEDICINE for my Physician Assistant training" when asked about your training, credentials and experience... goes a Looooong way in easing resistance and doubt about your ability, knowledge and understanding of medicine from both patients AND physicians. At this point, you have a opportunity to confirm your ineptness and incompetence without it automatically being assumed...

 

4.) Agitating for eventual Independence:

Thing is ... a large part of me agrees with your notion to "free ourselves from the doc's and the old school establishment and become more of a force in modern American health care."

 

I'm down for that, but YOU know as well as I do that the powers that be in PAdom and the average PA doesn't even want a Name Change... so even suggesting that we should strive to ""free ourselves from the doc's and the old school establishment" seems verboten and sacrilege.

 

So in reality... the notion I verbalized above is a compromise after being called out for uttering the independence word or even suggesting that we "free ourselves from the doc's and the old school establishment...

 

If you have read some of my many thoughts/post about our relationship with NPs and how we shouldn't be "hatin" but "Congratulatin" and "emulatin" them (not clinically but strategically and tactically)... you would see that there was a time that I openly preached "freeing ourselves from the doc's and the old school establishment."

 

When I dared suggest this... 7-8yrs ago... on this very forum... guess what the overwhelming response by the PAs and PA students here was... GO TO ""MEDICAL SCHOOL"...!!!

 

As to the notion that we need many more programs and lots more PAs... look to the Job market in PA and NY to see how that's gonna play out when every state has 5-20 PA programs pumping out 50-100 grads each yr. Look at what the salaries and PA respect levels are like in those areas where the physicians KNOW that another 50-100 new grads PAs will be going door-to-door looking for work every 9 months.

 

Again... thanks Ventana for reasoned the response...:smile:

 

Contrarian

[Contrarian]

Do you really believe that patient confusion stems from not all PA programs being affiliated with medical schools? I'm willing to bet it has nothing to do with it and more so entirely with the title. Even if all programs had that affiliation, when a patient asks "did you go to med school?" and the reply is "no but I went to a school that was affiliated with a medical school" will they really care?

 

Chris...

 

Thing is, can't have it both ways.

 

How and why do we believe that NO ONE but physicians should be called doctor in a medical setting if we believe that patients are intelligent enough to know that physicians aren't the only folks who walk the earth or work in healthcare to earn Doctorate degrees...?

 

In this same vein... historically, and culturally... patients know that the folks who "practice medicine"... attended some sort of SCHOOL OF MEDICINE. Claiming to "practice medicine" but insisting that you didn't attend a "school of medicine," and that you are nOT a physician... gets confusing to LOTS of patients.

 

Try claiming to practice nursing but insisting to your patients and nurses that you didn't attend nursing school and watch the expression on their faces...

 

If all programs had that affiliation, when a patient asks "did you go to med school?" your reply would/could HONESTLY be "I attended XYZ School of Medicine to train as a Physician Assistant " or "I completed my Physician Assistant training at XYZ School of Medicine."

 

YMMV

 

Contrarian

[Joelseff]

This. I interviewed a just opened for profit career college program and their classroom was a room in the top floor of an office building. No labs nothing

 

Needless to say I value my education and turned down their acceptance and am going to a much more respected program. I've noticed lately that a lot of career colleges are trying to get in on the pa profession

 

Sent from my HTC Glacier using Tapatalk

 

About 10 years ago, there was a "Career College" here in the bay area, Hayward to be exact, that had plans to open a PA program that was applying for accreditation and was taking apps. I made an inquiry into it and about 7-8 months later, I get a phone call from the PD and he says that they were unable to attain accreditation and thanks for my interest blah blah blah...I would be leery about PA schools popping up everywhere and would have to agree with C, that this is much akin to Chiro schooling. I say this because it appears as if these schools are "in it for the money."

 

Edit: I guess I could be wrong by generalizing tech/career schools. I should say that some are held to higher standards thus being granted accreditation. To clarify my position, I am NOT against tech schools per se, but against "PA Mills."

[Contrarian]

PA walks into exam room to see a patient.

 

 

PA-C says: "Hello... My name is XXX, I'm a physician assistant working with Dr. Jones."

 

Patient says: "Umm... I came to see the DOCTOR"..!!!

 

PA-C says: "Doctor Jones is here today. He is also seeing patients down the hall. When you called an hour ago to schedule this visit, they informed you that Dr. Jones' shedule was full and that you could either wait until next week or that you could be seen by me."

 

Patient says: "Uhhh... well whats wrong with me really needs to be seen by a doctor."

 

PA-C [smiling warmly] says: "I'll tell you what, why don't you tell me whats going on, and WE will figure out a plan to take care of it. Since Dr. Jones and I work closely together and discuss all the patients we see, if your problem is one that you and I can't handle... it may take a while, but we will get Dr. Jones in here."

 

Patient [still skeptical, head tilted back, looking at PA-C name tag through bi-focals] says: "Where did you go to medical school... to be a... ummm... what.... Physician ASSISTANT..? Where did you get your training"... ?

 

[before you can answer... the patient's cell phone rings and holding up one finger says, "oh, excuse me one second" then answers pnone and says into the phone, "No I can't right now. I'm sitting in the Doctor's office... Yeah in the Doctors office... No he is not in the room right now, I'm waiting on him, but talking to his ASSISTANT right now... Yeah... to his Physcian'S Assistant...! Ok... bye."]

 

PA-C says: "I went to Cochise College of Culinary Arts and Computer Programing. I was in their new PA program."

 

OR...

 

PA-C says: "I attended the XYZ School of Medicine for my Physician Assistant Training"... conversly "I was trained by the XYZ School of Medicine to practice medicine as a physician assistant"

 

 

Which response do you guys think will foster confidence and understanding in the patient and help build a "therapeutic alliance," and which response by the PA will hinder it...???

[Firemedic13]

 

.......

 

If you know anything about the history of the proliferation of MBA programs and Computer programing/Software engineering programs and what's happening to the graduates of MOST of these programs, you may see a correlation.

 

........

 

Contrarian

 

I was reading this thread mostly for information... but the above quote from Contrarian struck a chord with me. I can't say a lot about PA programs, but...

 

This is an issue with Law Schools too. There are 40,000 graduates a year for 30,000 jobs. Only about 5% of those jobs pay over $100K a year. The rest are averaging about $50K. And the majority of the good jobs go to the most prestigious schools, with the graduates of newer programs and for-profit programs having as low as 20% job placement.

 

While I don't believe y'all are in that position yet, it would be a good idea for you to monitor your educational institutions closely. If the growth of PA programs (combined with an increase in class sizes) continues like this for another decade you could easily find yourselves in the same position: new grads without jobs, and average pay declining.

 

Heck, the reason this happened is eerily similar to what you guys are beginning to see: In the 80s new lawyers began to make bank. In addition the emphasis on the LSAT that began to appear in the 90s made it easier for any tom, dick, or harry with half a brain to get in. Now everyone with a useless BA in liberal arts found a way that they could make a lot of money with just 3 more years of education. It was the hot job of the 80s, 90s, and early 2000s (along with MD, of course). They were all happy to shell out the loans for it... they figured if they could make $100K a year, what did it matter? Prices began to go up, but students kept coming. So suddenly every university wanted a law school. Eventually they were able to charge $40K a year, making money for their institution from the law school, and pump out so many graduates that the market became flooded.

[convulsed]

Ventana:

 

Thanks for the reply...

 

The problem here seems to be that you guys are "half-a$$ed" reading what I wrote and jumping to erroneous conclusions about what I mean.

 

 

 

1.) About Money: I stated that within a very short period... there was a exponential increase in the number of programs. When I applied there were ~50 programs... within what seemed to be 3-4 yrs... there were 150 programs. Why did all of these colleges suddenly "jump on the PA program BandWagon"...??? What happened during this time frame that wasn't happening or hadn't happened in the previous 30 yrs this profession has been around...?? Why did the entrance requirements suddenly get tossed out the window and the standards lowered..??? Were they NOT working for the previous 30+ yrs PA programs had been matriculating students...? If the exponential increase in programs were/is about health care access for the general public.. why aren't/weren't there lots of new Certificate/AAS PA programs..? All accredited PA programs teach the same things right...? Would the difference in tuition (CC= ~$100/cr-hr v/s MS= ~$540/cr-hr) provide an answer..?

 

Many of these programs function with a skeletal permanent staff of 3-4 people (Program Director, Medical Director, 1-2 "secretaries/coordinators" and a passel of un/under-paid associate faculty). Many of these programs have their students commuting long distances all over their and neighboring states for the required clinical experiences. Most if not ALL lecturers and Clinical Preceptors are Un-paid VOLUNTEERS. Soooo... what is that $60k-$100k in tuition money per PA student... x 25-50 students/yr being spent on...???

 

Surely, that undergraduate English 102 style paper... that requires NO original research or findings, that is often called "the masters project," doesn't cost $30-40k to read and grade. This is really the ONLY difference between Certificate/AAS/Bachelors programs and these new Masters programs.

 

If you know anything about the history of the proliferation of MBA programs and Computer programing/Software engineering programs and what's happening to the graduates of MOST of these programs, you may see a correlation.

 

2.) Rural Programs: Again... I didn't place the "sub par" performance of some new grads on the "rural" programs. I placed the "sub par" performance on the the notion that historically, educating oneself to practice medicine as a PA has been the providence of internally motivated, mature, self-starters who grew into increasing levels of psychosocial medical competence. Somewhere in late 1999 to the present ... becoming a PA became the new FAD...

 

Lots of folks started showing up talking about "I'm thinking about doing PA"... or "I'm gonna Do PA"...

 

I placed the "sub par" performance on the the notion that in meeting the demand of this FAD, many new programs lowered the standards of admission for financial gain, NOT to provide enhanced access to health care for the general public. If you do a search of the locations of the newer programs during this PA program proliferation time frame... you may see that few newer programs are in urban settings. nationally, the urban centers are just as "under-served" as many of the the rural areas... so why so few if any of the newer programs are located at lower cost CCs in urban under-served areas...???

 

I commented on the conversations I have actually had with physicians about their thoughts on and experiences hiring and working with PAs and why they would or would NOT hire another PA-C versus a NP.

 

The re-occurring themes during these conversations with these physicians seem to be 'young, cute, nice, helpful, not really productive, fluff versus substance/competence, naive, expensive.' I've also heard, "if I gotta see em all... and sign all the notes, then what am I paying for"..??

 

Level of Education Provided by Rural Programs: Ummm... please direct me to where I stated that rural programs "provide less of an education"...

 

If you re-read what I actually wrote, you will see that I actually stated ALL accredited programs expose ALL students to the same material regardless of program or degree awarded. My contention is that simply exposing this new demographic to the material that was designed to work on the old demographic has caused some issues.

 

3.) All schools should be associated with a medical school:

 

Since WE do practice medicine... why shouldn't we all be associated with a medical school.

Wanting to claim "we practice medicine" but avoid attending or associating with a "school of medicine" seem a bit odd... and gives our detractors ammo.

 

PA-C program directors and PA program medical directors sitting on the boards, committees, and as professors and faculty of Family Medicine divisions and residencies throughout the US would be able to advocate for us and have a serious hand in ensuring that the collaboration with and utilization of PAs is integral and ubiquitous in all aspects of medical education.

 

Think about it... if EVERY medical school in the US was affiliated, supported, and provided academic and clinical professors and faculty to EVERY PA program in the US... EVERY physician (MD/DO) in the US would be exposed to and likely learn next to and from PAs. Since these physicians and PAs would be attending the same program, at the same time, housed in the same settings, directed by the same directors and divisions... a lot of the divisiveness between PAs and Physicians would likely go away. Since ALL physicians and ALL PAs would belong to the same Alumni organizations, have shared clinical experiences and will have learned together throughout training... a true PArtnership could be forged.

 

Thing is... it is my understanding that the "powers that be" in PAdom are REQUIRING all programs be affiliated with Masters degree granting institutions to remain accredited... so it would seem [to me] that ensuring ALL programs are affiliated with actual institutions of medicine should have been a priority before this.

 

This (^^^ See #3 Above^^^) is my reasoning for suggesting that ALL PA programs be directly related in a truly meaningful way to ALL Schools of Medicine.

 

Not because I think they do it better or that PA programs have thus far done a poor job exposing us to the practice of medicine. I'm just tired of being told "GO TO MEDICAL SCHOOL" if you want any respect from physicians and patients or parity regardless of performance.

 

It has been my experience that being able to state "I attended XYZ SCHOOL OF MEDICINE for my Physician Assistant training" when asked about your training, credentials and experience... goes a Looooong way in easing resistance and doubt about your ability, knowledge and understanding of medicine from both patients AND physicians. At this point, you have a opportunity to confirm your ineptness and incompetence without it automatically being assumed...

 

4.) Agitating for eventual Independence:

Thing is ... a large part of me agrees with your notion to "free ourselves from the doc's and the old school establishment and become more of a force in modern American health care."

 

I'm down for that, but YOU know as well as I do that the powers that be in PAdom and the average PA doesn't even want a Name Change... so even suggesting that we should strive to ""free ourselves from the doc's and the old school establishment" seems verboten and sacrilege.

 

So in reality... the notion I verbalized above is a compromise after being called out for uttering the independence word or even suggesting that we "free ourselves from the doc's and the old school establishment...

 

If you have read some of my many thoughts/post about our relationship with NPs and how we shouldn't be "hatin" but "Congratulatin" and "emulatin" them (not clinically but strategically and tactically)... you would see that there was a time that I openly preached "freeing ourselves from the doc's and the old school establishment."

 

When I dared suggest this... 7-8yrs ago... on this very forum... guess what the overwhelming response by the PAs and PA students here was... GO TO ""MEDICAL SCHOOL"...!!!

 

As to the notion that we need many more programs and lots more PAs... look to the Job market in PA and NY to see how that's gonna play out when every state has 5-20 PA programs pumping out 50-100 grads each yr. Look at what the salaries and PA respect levels are like in those areas where the physicians KNOW that another 50-100 new grads PAs will be going door-to-door looking for work every 9 months.

 

Again... thanks Ventana for reasoned the response...:smile:

 

Contrarian

 

Speaking for myself ,I've been humbled thoroughly by your response :D

[bradtPA]

PA walks into exam room to see a patient.

 

 

 

Which response do you guys think will foster confidence and understanding in the patient and help build a "therapeutic alliance," and which response by the PA will hinder it...???

 

It's an argument that looks good on paper, but it's nothing more than dramatic fiction. Patients don't ask me where I went to school, and it won't matter whether it's the Duke University PA program or Methodist University PA program that I graduated from if they want to see an MD only; they see no distinction between PA to PA programs, only in MD to PA.

[Contrarian]

It's an argument that looks good on paper, but it's nothing more than dramatic fiction. Patients don't ask me where I went to school, and it won't matter whether it's the Duke University PA program or Methodist University PA program that I graduated from if they want to see an MD only; they see no distinction between PA to PA programs, only in MD to PA.

 

Ummm....

The conversation detailed above is a condensed, loose version of the hundreds of times I've been asked, or a student I'm precepting has been asked in my presence by patients... about our training and/or credentials.

 

~99% of the time, the patient was convinced to see me/us, and then later returned looking forward to seeing a PA-C.

 

So.... while I appreciate your persistent but silly adversarial stance, YOU can't speak for the patients many of us see daily.

 

One reason why your stance is simply a silly canard is because first you state: "Patients don't ask me where I went to school,"

 

Then you state: "it won't matter"

 

Finally: "they see no distinction"

 

My rhetorical circular question to you is... How do YOU know it doesn't matter or they see no distiction... if "Patients don't ask me where I went to school."

 

Another reason why your position is silly is because your claim that patients don't care and don't ask is contrary to the THOUSANDS of posts on this very forum detailing how WE, collectively, must constantly educate "one patient at a time" in the exam rooms we practice in daily... and how many of us are growing weary of this chore but have successfully convinced and converted patients "skeptical" of our knowledge, skills, and medical understanding, who were insisting on ONLY seeing a physician to happily seeing PAs for their health care.

 

I will give you... due to demeanor, outlook, personality, and bedside manor that maybe where YOU are practicing they really don't care anything about you or that you may have gotten you certificate from Cochise College of Culinary arts, and maybe they are just glad to have someone/anyone show up to see them... but this is simply NOT the case everywhere/most places PAs practice.

 

Personally, I've been asked hundreds upon hundreds of times upon meeting new patients... 'where I went to school'... but then again, I'm approachable and don't feel entitled to some level of deference because I got a pay check for wearing a uniform ... :heheh:

 

YMMV

 

Contrarian