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I understand the relationship between empathy and experience. I just don't agree with where Rev seems to draw a hardfast line regarding the specific experience required to make a better PA. His examples were home ownership, starting a business, and raising a child. This is what I was responding to. I'll say it again, I do think experience is important. I am just challenging the way Rev seems to think is the ONLY way to get appropriate experience and the age at which he defines it to be valid.

 

How do you know rev is male?

 

edited to add: doh! never mind, i saw his profile lol

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I think I am at the end of my contribution to this thread. I am not sure I can say anything more that will clarify my position. I do respect those that contributed even if I disagree. Misinterpretation always showing its ugly face in these kinds of scenarios, I will just leave this thread with the assumption that each is motivated by making this a better profession. Best of luck to everyone.

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When you go get an elective surgical procedure done, do you ask for references from that surgeon? Why? Is it because you hope they are fresh out of school and you want to be their first patient? Or you want them to have some time in the trenches getting some experience?

ELIMINATION OF IGNORANCE

"One of the most troublesome problems of humanity is ignorance, lack of knowledge, or false and incorrect knowledge. Everyone believes they know what they are talking about, while, in fact, nothing is farther from the truth. Most of the time, people are just repeating what they have heard or what they have read. They really have no knowledge of the issue. Children and teenagers repeatedly say, “I know, I know,” without having any knowledge of the subject. This trait carries over to adulthood and old age. People debate and discuss issues without having any true knowledge of the subject. They even insist that their points of view are the correct ones. Most people’s knowledge of a subject, compared to what they do not know about it, is like a drop of water compared to an ocean. For example, a top professor of medicine has knowledge of his or her specialty, but his or her knowledge outside of his or her expertise is limited. And, furthermore, his or her knowledge in philosophy, economy, and politics is even more limited. Even the most educated and learned ones have knowledge of only a few subjects. Additionally, most people forget most of what they have learned. As it is said, people usually end up forgetting more than they learn during their lifetime" - G. B. Nejad

 

That little bit on ignorance applies to me, to you, to everyone. Rev wrote an opinion piece and by partaking in a web based forum, we all consent in being subjected to that opinion. Then we all get to chime in with our support or disagreement with that opinion. As one of the Mythbusters say..."I reject your reality and substitute my own".

 

I support Rev in what he said. I am one of those people with 23 years in medicine who are stuck in the belief that experience doing ANYTHING makes you better prepared to advance in YOUR PARTICULAR FIELD. I don't care if it's digging ditches, milking cows, sweeping floors, mixing rocket fuel, or flying the Space Shuttle...the person doing it for six months is TYPICALLY not as skilled as the person doing it for 10 years. Yes, weird ticks do occur and there is the occasional savant that defies the odds but those are rare moments indeed, despite what TV and movies may feed your brain. This applies to sitting down and talking to patients as well. The nuances of not only hearing what they say, but reading HOW they say it can tell you volumes. You don't develop that skill doing mock training with classmates or actors. You develop it working with real patients and going "oh damn...I missed that clue, I'll have to remember it for next time." People with quality HCE have already had a bunch of "oh damn" moments and have a brain full of things they are remembering for next time. I feel that is a critical skill to have.

 

As for being upset that this thread is now a sticky....it's not our Sandbox..We are invited to play here but not forced to stay. The rules can be made up by the sandbox owner how they see fit. This topic is particularly a hot topic with folks and makes for a spirited discussion. Beats the pants off of boring, tired, dead sites with no traffic...

 

Dad always said if two people never disagree, one of them is not thinking. Debate is healthy. Just don't take it too serious...it is the internet after all.

 

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I'm 22 and have been an EMT for 2 years now. I knew I wanted to do something in the medical field coming out of high school but instead of jumping the gun and claiming a definitive medical major I decided to start from the ground up. I felt out of all the lower tier medical jobs, an EMT would suit me best. I knew after just a couple of months of working in an ambulance alongside a paramedic that it was just not enough. I knew I want to be more hands on with the patient rather than a 2 min transport to the nearest hospital. Mind you, this is going on while I'm graduating with my AA where all the focus was put towards science classes. I guess that shows some hint of disciple for a 22yr old. Just recently I decided Im going to pursue the PA profession at the same college I've been studying at. My point is, I didn't have to sit behind a cubicle for 20 years in dissatisfaction to figure out what I wanted to do. I was smart enough to establish a medical foundation at a much younger age and now I'm ready to move forward and hopefully graduate from PA school without a single gray hair. Regardless of age, we all have the right to pursue whatever we want. So I'm sorry baby boomers, but the profession does not die off with you.

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I still don't understand how any of you old-schoolers can agree with the statement that "PA is not for the young", which is the inflammatory statement that has brought on this swirl of disagreement, in my eyes. There ARE advantages to being a PA over an MD besides less time invested in school. Lateral movement, as someone mentioned earlier, is a concept that every PA I've shadowed enjoys. And in terms of time committed, it is also not wrong to want to practice medicine and help others with less time committed between point A and point B.

 

While the role of PA served as an excellent complement to those with extensive medical history and training in the past, that role appears to be changing. To me, that change is very appealing. I'm excited at the notion of helping others receive quality healthcare in a time where such a commodity is difficult to acquire.

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And many of those that agreed with it are huge contributors that I have learned a lot from. So I am saddened that this standoffish attitude is so widely celebrated as a "yeah stick it to 'em Rev, show those young punks a thing or two about what REAL PA's look like" victory. /QUOTE]

 

I too, came across this forum this as a great way to learn about the profession. I am not a PA student, just looking into POSSIBLY going that direction with my education. I saw that many of the contributors to this forum are long time PA's, people that i would look to for seeking advice. People whom i respected for their wisdom in providing me the answers that i needed in order to learn more about PA.

 

Now i see that to them, the questions i asked were just plain 'stupid' and a waste of their time. Well, that is what i am taking away from this thread and rev, who started it. Thinking this was a place filled with friendly people who wanted to spread their knowledge was wrong. I now see that this is not the place i perceived it to be at first. Curious 'newbies' like me are a nuisance to the 'old timers' and moderators on this website...

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Interesting to see how this thread has progressed. One thing that surprised me is that in for pages it doesn't look like the argument of the origins of the PA profession has been used as a reason for wanting more experienced (and older) students. Along these lines, I think that a key benefit of having only truly experienced healthcare providers become PAs (i.e. not people who simply did the minimum number of hours in whatever HCE job was the easiest cert to get) is in terms of how patients who truly research or ask about the profession perceive it. It would nice to be able to describe the profession including mention that PAs are experienced healthcare providers such as paramedics, RTs and nurses who went back to school. Yes, it is good to be able to talk about the master's degree that is becoming common as well, but I think that some patients would appreciate that even though that PA might be new, he was a paramedic for 10 years before becoming a PA. This is just my perception and I'm sure that many of you will disagree with it.

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As a mid 20's PA that's been working for 3 years. I can't believe the bitterness on this thread! :sad:

 

For one some of the most influential PA's that I encountered started when they were "young"

 

1) My program director was 24 when he started in the early 1980's. (currently 20+ years experience)

 

2) The PA i shadowed who is now an Administrative director/Surgical PA also started when he was in his early 20's. (currently 20+years experience)

 

3) A critical care PA who was my instructor had 30+ years experience , he started in the late 70's (1976?) as a Surgical Assistant at Cornell. He's now in his early 50s, so I'm assuming he must of started young too to the bane of the OP.

 

I mean I understand the frustration and perhaps it's more potent in certain regions than others, but the wheels are already in motion...

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I will add my rant here ask well. I see over and over again posts about "I want to be a PA because it is more family friendly". Unless you are one of those lucky enough to find a high paying part time job, there is nothing family friendly about having to work more hours, pulling more call, working more weekends, and getting less vacation time than the MDs in the practice. The ONLY benefit is being able to start a family at graduation in a shorter amount of time. Those kids are still going to need a nanny or daycare whether or not your a PA or MD....

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Starseed: asking about whether a GRE score is good enough CAN mean that somebody wants to get away with the least amount of effort possible, but to assume it on all those asking is really unfair.

I never claimed that all took this approach.

I took the GRE and did pretty well. I asked that question on this forum because I would rather spend my time doing other things to improve my chances of getting into school IF my score is good enough as is.

Congratulations. My comment then was not pointed toward you, as I believe Rev's comment was not pointed at me or any one person for that matter. Concerning the OP the only point I disagree with is #3. That is it, I disagree. My feelings are not hurt, I do not feel attacked, and I do not think any less of Rev. It was simply his rant, as he stated first, on a subject that obviously concerns him. Now the rest of the thread has gone astray so I am only speaking of the OP. Opinions are like.......... (mine included)

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Bitterness? Hurt feelings? Saddened?

 

People really need to lighten up (this is the internet) If you are young and trying to get into, or are, a PA student or a young working PA...STICK IT TO THE MAN! and be the best PA there is.

 

You want to really know why I am a HUGE advocate of the young to go to med school? You really curious? Will it make you feel better? Well I'll tell you...

 

MAXIMIZED POTENTIAL!

 

That's right. As wonderful as I think that I am with all my experience, I regret not going to med school. If someone would have snatched me up at age <28 and said "dude, you joined the rescue department at 15 years of age, you joined the Navy at 17 doing medicine, you are good at it, you like it, you need to dig deep into yourself and find the fortitude to go the distance. Stop fooling around and COMMIT!"

 

I don't think young people can't be a PA. Heck, by the time I was 21 I had already completed 4 years of being a Navy Corpsman dinking around in cardiac step down units, cardiac ICUs, and ERs. By the time I was 24 I was splitting my time between the OR and running an acute care clinic. Young people can do lots. We have young 20somethings doing trachs under live combat fire in the Middle East...I don't doubt young peoples' ability. I just don't believe that's the job for them. I hold strong to the original creation of the PA program of extending the knowledge of someone who has had several years of allied health experience and giving them a boost up later in life when they have gathered a pile of other obligations. When those young people have gathered some rightous skill, life experiences,grown weary of bouncing around in HumVees and ambulances and desire the next step up, get their fannies to PA school...

 

Hindsight is 20/20. The lessons I have learned is that if you are young and have a desire of medicine, go the distance. The statement of "lack of lateral movement as a Dr is a downside" isn't really supported. Somewhere in the annals of PAForum there are numbers representing the number of PAs that change disciplines and it's not impressive. When you go through your clinicals, the vast majority of people find what clicks and roll with it. Same thing as a physician. That four years of med school gives them plenty of time to find what tickles their fancy. Of the doctors that I have heard say "boy, I sure wish I was in xyz specialty instead of this" typically did very little to no shadowing/HCE during undergrad and they are seeing the white coat for their first time. Of course there will be some buyer remorse. Ever buy a car and not test drive it first?

 

People state they feel more comfortable being an integrated member of a team where there is supervision to give them a hand if they get stumped....the idea of being a doctor with the finality of that position makes them uncomfortable...Doctors have peers. They have other specialties. The line of "buff the chart, turf the patient" holds credibility. Maybe in not such a blunt way but I have never met a physician wearing a name tag that says "finality specialist". Do doctors sometimes make tough decisions that keep them up at night? Damn Skippy they do. Do PAs? You betchya they do. That fantasy of having a great SP who will swoop in like a super "Resource Man...here to save your day" when you stumped is a fantasy for the most part. You get stumped as a PA, you bounce it off your peers, and you refer. Once you have worked out your ddx and your patient rolls back to you after being referred to relevant specialties...you still get to make the hard decisions.

 

Do I see PA as selling yourself short? No...I see it as a great job for people who spent some time in the trenches and want a promotion of knowledge, patient interaction, responsibility, decision making capacity, and yes, pay. Do I see Physician as the only health care job for young people? No. Proven by the face that for 23 years now I have been doing health care and having a great time with it.

 

In the end, you all are going to do your own thing but if you seek opinions on the internet, be prepared to hear opinions that may not always jive with yours. If you can't handle hearing opinions that don't jive with yours then good luck getting very far in medicine. Sometimes preceptors will antagonize you on purpose just to make you squirm a bit and see how you do under pressure. If this forum makes you squirm, how will you do when it really matters?

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How often have you practiced in a rural area? I mean rural......

 

 

You're missing the point. The original argument is the value of HCE for a practicing PA.

Your original statement says that these newbie PAs with no HCE are a risk for being in a rural solo practice, when the reality is ANY new PA, with HCE or not, should not be in that setting without adequate precepting.

 

Folks here claim "there's no substitute for experience", but don't acknowledge that there's no substitute for experience as a PA-C......

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I now see that this is not the place i perceived it to be at first. Curious 'newbies' like me are a nuisance to the 'old timers' and moderators on this website...

 

I wouldn't take that too far....and as a moderator, I don't think that the general impression we give as mods is dismissive.

YES, we want you to know about the profession.

YES, we want you to take the initiative that all successful people do (call the program, do a google search to get the information instead of asking here first)

 

Coming to this site as a newbie with an INFORMED opinion/question is the best thing you can do for yourself.

 

eg, instead of asking "What are the problems facing PAs today"....the better question would be "I read on Advance an article about PAs having difficulty getting ordering hospice care" etc.....

 

No one wants to be a spoon feeder.

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All that really matter is your experience AS A PA! I couldn't care less about what you did before that.

Who would you rather see?

PA1: started PA school when he/she was 24 and now 40 (14 years as a practicing PA) or

PA2 someone like Rev: let's say started PA school when he/she was 35 and now they're 40 (3 years as a practicing PA).

Best advice: start when you're young! You will be a WAY more experienced PA, and that's what matters. Not buying a house, or having kids, or believe or not being an EMT for 15 years. HCE helps, but age... no way! By the way I'm 24 in PA school and have a lot more HCE (>8000 hrs) than some of my "older" classmates. Age shmage.

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These posts are foolish.

 

I think the career you chose, no matter what it may be, is a PERSONAL choice. No doubt everyone looks back when they are older and thinks that maybe they would do things differently or 'gee 10 years doesn't seem so long now!' but you live and you learn and you do what is best for you at the moment.

 

The PA career is not constructed soley for those who are mid-aged and realize they need a more intellectually stimulating, or purposeful career or whatever the reasons may be.

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Fascinating thread.....with lots of generalizations and assumptions....and lots of "facts" that are derived from nothing more than personal anecdotal experiences. I am a newcomer and have also been occasionally discouraged by the attitude that you cannot be a quality provider without years of paid healthcare experience prior to PA school. Then I realized that no one on this forum knows me or my individual story and they cannot judge how I will provide care. I learn quickly, reason thoughtfully, love unselfishly, serve gladly, and research thoroughly. I have a great story and will share it willingly with anyone who cares. I will share it on my application and if the school I have chosen does not like it then I do not want to go there anyway. I just hope the staff at my school of choice is not made of close-minded people that think there is only one path to being a good medical practitioner (oh I mean physician assistant).

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By the way I'm 24 in PA school and have a lot more HCE (>8000 hrs) than some of my "older" classmates. Age shmage.

Soooo....how are you doing in class compared to your classmates with no HCE?

 

I don't think anyone is saying age trumps experience...I think 4 years of HCE is a great way to start off PA school

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Soooo....how are you doing in class compared to your classmates with no HCE?

 

I don't think anyone is saying age trumps experience...I think 4 years of HCE is a great way to start off PA school

 

Everyone was required to have a min of 2000 hrs. A few older and younger students barely hit the minimum. We just started but I think everyone will do good. Some of the older folks have not studied for a while and need to get back in the groove. Some have kids at home which I TG I don't! I don't know, I'm thinkin' the younger ones may have a one up :wink:

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We just started but I think everyone will do good.

 

Revisit this question in two years when you are about to graduate and see what your answer is. I'm thinking until you have been through the pressure cooker called PA school you will have no idea the full benefits of at least some prior HCE before attending;).

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Bitterness? Hurt feelings? Saddened?

 

 

The bitterness I see in this thread is mainly from PAs who regret not becoming doctors. The advice is not relevant to everyone. It's certainly not advice I'd give people who I just finished smearing as being unready for PA school or unknowledgeable about medicine. "Face it, you don't know what you want to do with your life, so become a doctor. Trust me, I wish I was a doctor. But PA school is not a shortcut. But if you're older, become a PA." is convoluted advice no matter how you try to retcon it.

 

As for me, I'd rather see someone with 7 years of PA experience and 1 year CNA experience than someone with 7 years CNA experience and 1 year PA experience. I guess I'm just funny like that. Ideally, yes, I'd see a PA with 7 years army medic experience and 10 years PA experience, but the world isn't full of army medics waiting to become PAs.

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[As for me, I'd rather see someone with 7 years of PA experience and 1 year CNA experience than someone with 7 years CNA experience and 1 year PA experience. I guess I'm just funny like that. I

 

Yup!

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You're missing the point. The original argument is the value of HCE for a practicing PA.

Your original statement says that these newbie PAs with no HCE are a risk for being in a rural solo practice, when the reality is ANY new PA, with HCE or not, should not be in that setting without adequate precepting.

 

Folks here claim "there's no substitute for experience", but don't acknowledge that there's no substitute for experience as a PA-C......

No, you missed the point. My original statement said they bring nothing to the table as far as the didactic year...and yes they did have it more difficult during clinicals than someone who had hce as an RN. We were constantly helping them in study groups during the study year, it didn't bother us...but it was noticable, their lack of medical knowledge. We didn't blame them, but questioned the school about the choice. Figured there was someone on the app that stood out...maybe a mission trip. You didn't answer the question...when have you worked in a very rural setting??? Also when did I NOT acknowledge that there's not substitute for experience as a PA-C??? Ball is your court my friend...

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marilynpac, Just Steve, Hemegroup, rev ronin, I want to say thank you for all the help you have provided me, both directly, and indirectly by way of replies to other people's threads.

 

Could it be that everyone's situation is different? The specialty PAs that I've shadowed have told me that virtually none of the knowledge they acquired in PA school is used in their field of practice. To that end, I can't imagine they use much of their experience as CNAs or EMTs either, besides showing a record of making responsible decisions (which can be indicated by other activities in life besides work as a CNA, EMT or RN). I don't doubt that years of HCE makes for a better PA applicant, and carries through for the rest of a person's life. But defending the stance that "MD is for the young and PA is for the old" does a disservice to the PA profession. That's like treating the PA profession as a consolation prize to those who have missed their boat to be an MD.

 

I realize that the PA profession was initially designed to complement naval corpsmen and army medics with significant experience, but that has changed. In the meantime, prerequisite courses are increasing as a way to prepare potential students. Whether or not this shift is a fair way of broadening the base of potential applicants in beyond the scope of anyone's power on this forum. But one of the strengths of making PA school more accessible is the potential to help America's need for healthcare, a factor that only strengthens the PA profession. If everyone needed 15 years of HCE experience - experience that may or may not help much in the long run - this need would certainly be left unsatisfied by the PA profession.

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