What would you say?

[JFarnsworth]

I work with an MA in my derm office who tells me on a regular basis how she could do my job and the only reason she doesn't is because she doesn't have "those little letters" behind her name. She always prefaces these statements with, "no disrespect intended" which in my mind, means that a) she knows it's disrespectful and b) she thinks if she says that first then it's ok to say. At first I told her to go back to school and become a PA; you know the answer she gave me: "I'm too old, I don't have the time or money, I can't because _______". Later I said, "well, derm can be straightforward at times, but at other times it can be quite complicated and there can be medical reasons behind a person's skin condition."

Has anyone else encountered this?

[just_me]

Id tell her "well ya know what they say....excuses are like buttholes...everyone has one but apparently you have more than everyone else. if you could do what I do then you could go back to school and all that jazz just like I did too so you must either know you cant do what I do or youre just to lazy to do it it.....no disrespect intended" and then wink, smile and walk away

 

she'd hate me from that point on probably

[cinntsp]

I work with an MA in my derm office who tells me on a regular basis how she could do my job and the only reason she doesn't is because she doesn't have "those little letters" behind her name.

 

Then you reply with "I know and it's so unfortunate because you only make a quarter of what I do without them...darn...*shrug*...*walk off*." I'm sure that would shut her up if that's your goal, lol.

[winterallsummer]

IMO her comments probably stem not from the idea that your job is easy, but from her dissatisfaction from not being more career oriented in her life. I mean here she is, sounds like she is older than you, doing what she may view as medial tasks while watching you pen prescriptions and diagnoses with what may look like from the outside as relative ease. What she fails to realize is if it looks easy for you to do it, it's because you understand all the details beneath it. It's kind of like when some high school jock tells a kid at the gym, "you know, I could've got a scholarship like you, but I had other things going on, I had a family/hobby/whatever that kept me occupied." It's not so much to de-validate you as it is to validate themselves. She sees herself as doing the grunt work and feels inferior watching someone (again guessing you might be younger than her) getting all the glory.

 

You could take the higher road, tell her "look you are a great mother/provider/MA etc" and point out some things she does that you could never do. This way you are giving her the validation she's trying to get out of telling you that stuff while still setting a professional example. Or you could also shrug your shoulders and reply, "Sure, so just go back through four years of school, complete all necessary pre-reqs while continuing your life and continuing to work in health care, get into an extremely competitive program, go through two of the most challenging years of your life, and land a job into one of the most competitive fields of medicine. Yeah then you'll look like me in no time. Oh by the way can you clean the patient room I have an appointment in five." Note that I do not actually advise this but hey sometimes this is the only thing people will respond to, not that it would make for a great work environment!

[EMSArtist]

Couple of thoughts on this...

 

First thought- it might be an example of the general lack of respect for PA's. I'm pretty sure she would never turn around and say that $#it to an MD. Perhaps she wrongly feels that you are equal in some way because both of your job titles end in "Assistant" or something.

 

Second thought- She sounds like she is dissatisfied with what she can do in the office / her present career, but is terrified to try to do anything different and resorts to petty disrespect to cover her insecurity. You didn't say how old she was but I'm 90% sure there are PA's in school right now that are as old or older than her.

 

You could go a few different directions on this... Depending on on what you want to invest etc....

 

1- tell her that she is in fact quite offensive and disrespectful, and that you will not tolerate such comments in the future.

2- make sure the office management is aware of her disrespectful behavior- they might not be so forgiving.

OR

3- Take time to talk to her outside of work about her goals & desires for the future and help her figure out if there are possible paths towards career advancement she could pursue. (ie advanced certifications that would make her able to do more things on the office, or new career path at low cost, or PA school or whatever) Might not solve the problem, but it might make a huge difference.

 

Like I said it depends on how much you want to invest and how mad you are.

 

Cheers!

[Contrarian]

What would you say...???

 

Hmmm... I'd say "yeah... I encounter LOTS of folks who think they know my job, can direct my work, and/or do it better WITHOUT the benefit of any PA training"...

 

Then I'd give her this web address so she could post here with all the other non-PA-Cs/non PA-Ss that think its kosher and respectful to basically state the same thing.

 

Better to keep them all in one place so that you can watch them... :wink:

 

YMMV

 

Contrarian

[JFarnsworth]

just_me and wutthechris: if only I could say that and get away with it! I'd be rooming all of my patients and have to go solo on my excisions if I did... and I'd have to check my car for slashed tires :)

 

Or you could also shrug your shoulders and reply, "Sure, so just go back through four years of school, complete all necessary pre-reqs while continuing your life and continuing to work in health care, get into an extremely competitive program, go through two of the most challenging years of your life, and land a job into one of the most competitive fields of medicine. Yeah then you'll look like me in no time. Oh by the way can you clean the patient room I have an appointment in five."

 

That's an excellent response... I started out as an MA myself and I keep repeating this fact to the derm MA... with the implied message that I did what she did and am now a PA, so it can be done. I don't think she gets it. And she is actually much younger than I am.

 

EMSArtist: There is a huge discrepancy between how the MA treats the doc and how she treats the PAs. For sure she'd never say that to the doc. It's amazing to me how many people think that you can just walk into a PA program and -poof- 2 years later you are a PA. I have encouraged this MA to go to school and further her career, saying things like, "you have mad skills! You can do anything you want to!" She is in her early 30s and I've told her that our program had several people who were in their 40's and 50's in my program.

 

Thank you all for your input. It made me laugh and nod my head in agreement...it's always nice to get different views on things. I think I will take the middle road and tell the MA that if she thinks the only thing that separates her from me is 2 little letters (she forgot about the "C"!) then she should do something about it, put her money where her mouth is, or quit her *****ing. But I'll say it in a nice way.

[JFarnsworth]

Hmmm... I'd say "yeah... I encounter LOTS of folks who think they know my job, can direct my work, and/or do it better WITHOUT the benefit of any PA training"...

 

Then I'd give her this web address so she could post here with all the other non-PA-Cs/non PA-Ss that think its kosher and respectful to basically state the same thing.

 

 

Better to keep them all in one place so that you can watch them... :wink:

 

YMMV

 

Contrarian

 

Contrarian, I love you.

[Contrarian]

Contrarian, I love you.

 

............... :kiss: .................

[Hemegroup]

Inititally I thought ... maybe she's due for a raise? Maybe her benefits are crap. But then after reading more carefully, it sounds you like need to explain to her that the federal requirement for didactic MD training is 2300 hours ... the federal requirement for didactic PA training is 2000. Further, PA students don't get summer break. Additionally, PA program accreditation is overseen in part by representatives from the AMA, American Academy of Family Physicians, American College of Surgeons, and the American Academy of Pediatrics. Indeed, if she thinks it's just a 'few little letters' then it surely shouldn't be too difficult to go get them.

[just_me]

I definitely understand....I would let her know that what she is saying is offensive and disrespectful and you do not appreciate her minimalizing your accomplishments to make herself feel better. I would also tell her that if she really thinks that she can do do what I do then put up or shut up (maybe in not such a harsh tone but you get the point)....maybe call her in on something difficult and ask her what it is....pimp her (wow that just sounds weird when you read it back to yourself) this seems to be someone that obviously thinks her limitations are high or that you simply do MA work

 

just_me and wutthechris: if only I could say that and get away with it! I'd be rooming all of my patients and have to go solo on my excisions if I did... and I'd have to check my car for slashed tires :)

[Contrarian]

What's the problem... ??

She is entitled to her opinion... and ALL opinions about what WE do and how WE do it as PA-Cs are equally valid and should be accepted and respected, regardless of whether or not someone has any PA training or not.

 

The FACT that she thinks that she can do what WE do equally or better that WE can without the benefit of OUR training isn't in the least bit offensive, disrespectful or MINIMIZING our training or accomplishments... because we are all equal in knowledge, position, and understanding. That "PA-C" is just a few letters.

 

Riigghhtt...??? :wink:

 

This can get confusing to many... because the same folks advocating the notions above... elsewhere on this forum... seem to be agreeing that there is something wrong with this young lady's behavior.

[just_me]

that would not be me my good man......

 

to me its one thing to have an opinion and another to think that I know without the training to back it up....in this case it doesnt take training to be a smartass to someone who is trying to put me down....now whether or not someone gave an appropriate treatment plan.....I wouldnt have a clue without the training and wouldnt dare act as though I do

 

but I will ask questions....who knows...I may find myself in that same situation in 30 months

 

What's the problem... ??

She is entitled to her opinion... and ALL opinions about what WE do and how WE do it as PA-Cs are equally valid and should be accepted and respected, regardless of whether or not someone has any PA training or not.

 

The FACT that she thinks that she can do what WE do equally or better that WE can without the benefit of OUR training isn't in the least bit offensive, disrespectful or MINIMIZING our training or accomplishments... because we are all equal in knowledge, position, and understanding. That "PA-C" is just a few letters.

 

Riigghhtt...??? :wink:

 

This can get confusing to many... because the same folks advocating the notions above... elsewhere on this forum... seem to be agreeing that there is something wrong with this young lady's behavior.

[Hemegroup]

What's the problem... ??

She is entitled to her opinion... and ALL opinions about what WE do and how WE do it as PA-Cs are equally valid and should be accepted and respected, regardless of whether or not someone has any PA training or not.

 

In no way.

 

The FACT that she thinks that she can do what WE do equally or better that WE can without the benefit of OUR training isn't in the least bit offensive, disrespectful or MINIMIZING our training or accomplishments... because we are all equal in knowledge, position, and understanding. That "PA-C" is just a few letters.

 

Riigghhtt...??? :wink:

 

This can get confusing to many... because the same folks advocating the notions above... elsewhere on this forum... seem to be agreeing that there is something wrong with this young lady's behavior.

 

See, I don't look at TITLE, I actually listen to what a person is saying. You sound like the Dr. who won't consider an alternative diagnosis because it's from a lowly PA. I've learned from JANITORS, Contrarian, and my ego didn't prevent that from happening. It's called analyzing something as to its intelligence.

 

This person, has issues with rudeness and logic ... different situation altogether than the other thread. If someone presents input, I will listen and ascertain rather than simply disregard based on someone's position in the world. Plus I'm not a snob.

[Contrarian]

that would not be me my good man......

 

Twas NOT directed at YOU specifically...

 

See, I don't look at TITLE, I actually listen to what a person is saying. You sound like the Dr. who won't consider an alternative diagnosis because it's from a lowly PA. I've learned from JANITORS, Contrarian, and my ego didn't prevent that from happening. It's called analyzing something as to its intelligence.

 

This person, has issues with rudeness and logic ... different situation altogether than the other thread. If someone presents input, I will listen and ascertain rather than simply disregard based on someone's position in the world. Plus I'm not a snob.

 

Heme...

Thing is... you can't separate the TITLE from the training.

Its the Training and the milestones passed that make US PA-Cs.

The TITLE demonstrates that we have completed the minimum requirements and passed the tests... and SHOULD have a base level of knowledge.

 

This MA has NOT even begun to travel this ardurous road... but somehow thinks it isn't neccessary to perform to the required level.

Just as lots of posters to this forum hasn't even begun to travel the road to PAdom (aside from finding this forum)... but somehow thinks it isn't neccessary to pontificate and opinionate about what WE should be doing.

 

You sound like the Dr. who won't consider an alternative diagnosis because it's from a lowly PA.

Poor analogy when you consider that both the Dr. and PA are both trained to practice medicine.

A MA and a PA are NOT both trained to practice medicine.

 

Had you considered that I sound like a PHYSICIAN/PHYSICIAN ASSISTANT who won't consider an alternate diagnosis being offered by someone with no training to practice medicine... but who thinks it ok to assert that they should be listened to and that their opinion of my practice of medicine is just as valid as that of a PHYSICIAN/PHYSICIAN ASSISTANT... ?

 

Do you listen to or put any stock into the opinion of those JANITORS concerning your practice of medicine...??

[just_me]

Twas NOT directed at YOU specifically...

 

I know....just wanted to put that out there :-)

 

BTW when you get a chance can you PM the book that you suggested I read? I tried to order it way back when but something happened and I never got it...I wanted to try again but I no longer have the PM you sent me

[Hemegroup]

You're missing my point tho ... I DON'T agree with this MA, although not because she's an MA but because she's illogical. And while I do agree that most people of advanced degrees do tend to have better thought processes and opinions on such matters, due to their training ... sadly, not always. Usually, of course.

 

The other thread, well, I see that person to be the opposite in what they stated. I agree that it could be a different situation ... which is why it's important to listen to what's being said, not necessarily to who's saying it. I taught an ER Doc about new treatments for MS, and do you know what he said? "Whyyy", (crankily), "whyyy I've been an ER Doctor for 40 years and I've never had an orderly speak to me like this". Did he gain the information I was giving him? No. And that's too bad.

 

Janitors and practice of medicine, certainly, depending. I've been through a lot in my life, but I haven't encountered every situation there is out there ... maybe a janitor has, and what they have to say could improve or even save a situation.

 

If a janitor tells me what worked for them in medicine regarding a similar situation in their own lives, of course I'll listen ... I might not go that route, but I'll certainly be open enough to listen.

[just_me]

this made me chuckle

 

this happened to me and a coworker. someone on staff with less training said "i can do almost everything you guys do, why dont they pay me as much as you guys make?". my coworker replied: "they dont have us here to do everything you can do, they have us here for the things you cant do".

[Contrarian]

So we are missing each others points....

 

I DON'T agree with this MA... BECAUSE she is a MA and due to that very fact... she likely has NO IDEA what its like to be or how to function as a Physician Assistant. So to me... Not only does her premise seem to be illogical and disrespectful, its absurd.

 

If she was a non-licensed PA working as a MA... then yeah.

If she was a non-licensed NP working as a MA... then maybe.

If she was a IMG/FMG working as a MA... possible.

 

She... like the others I'm writing about here, are NONE of these things... to include being a trained PA.

 

So if these folks can think and function as PAs without the required training... why did YOU and I waste our time...??

 

We sure are stupid since we could have simply remained Psych Techs, CNAs, EMT-B/I/Ps, RNs and just done/do the jobs of PAs and saved the time and tuition.

 

You and a few other posters seem to think that I have a problem with differing opinions posted by non-PAs. I DON't...!!!

 

Opinions are welcome from EVERYONE here. How they are presented may not be.

 

It is the wise that "qualifies" their opinions before carefully wording them. Then respectfully wording them to those that are where they want to be. Even as licensed, certified PAs... it behooves one to carefully word ANY criticism of a fellow NPP and is stressed that you are tactful and careful how you opinionate to physicians.

 

As a PA-C... I have NEVER told a Physician or fellow Physician Assistant; "What their job was" or tried to direct their work.

 

If asked for a opinion or the need arose where I felt it imperative that I verbalize my opinion... as a patient advocate or for safety, I have ALWAYS tactfully explained what I would do if I was in that position... along with my rational for my actions.

 

Never "YOU SHOULD"... "YOU ARE SUPPOSED TOO" ...!!!

Always "I WOULD"... "If it was me"... "had you considered"...???

 

My position on this has NOTHING to do with advanced degrees and thought processes.

 

Its the professional Indoctrination and training that I'm taking about. The degree is irelevent.

 

My position is steeped in the notion that one must walk in the shoes to speak informatively, definitively, intellegently and respectably about the relative comfort or discomfort of THOSE shoes and how THOSE shoes should/will/does/doesn't perform.

 

I have a problem with folks who have not yet put on their shoes, tied them tight and "run the race"... claiming that they qualify for the same ribbon and glass of celebratory beverage as those standing at the finish line sweaty, cramping and exhausted from their ernest and taxing endeavor.

 

As a veteran, I have a problem with folks who see no need for deference and respect for those who are where they want to be. For example, troops showing up to Airborne/Air Assault/Scuba school, PJ/FR Indoc/RIP, BUDS or SFAS with their chests out and no obvious respect for the folks around them that has already completed the tryouts, training and is out their doing the deed.

 

As another member pointed out to me by PM...

 

This basically drills down to the fact that some folks are leery/weary of the time honored "Professional training Caste System" or shall we call it a "Pecking Order" that is inherent in EVERY level of professional and/or proficiency training.

 

As a Part of training for ANY profession, the trainee must submit to the natural order of things.

 

This natural order lives in the fact that socialization is part of the professionalization of any occupation.

 

A piece of that socialization calls for the trainee to recognize and respect the accomplishments of those that came before them. As one advances through their training, they must recognize that they are not equal in skill and knowledge to those ahead of them in training, but neither are they equal in skill and knowledge to those behind them.

 

This person also pointed out that:

Neither Pre-Meds, or Med Students would likely ever consider telling a Attending "What their Job was" in a thoughtless disrespectful manner... or even suggest that they could do that job equally well without any training and/or experience.

 

Neither CNAs or Nursing student consider telling their RN preceptors of instructors "What their Job was"... or even suggest that they could do that job equally without any training and/or experience.

 

EMT-Bs telling EMT-Ps What their Job was"... or even suggest that they could do that job equally without any training and/or experience....

 

I could give a hundred more examples of this but I won't...

 

If you can't see what I'm saying... you probably just don't want to... so I won't bother.

 

Hope you had a very PA day... :wink:

 

YMMV

 

Contrarian

[Hemegroup]

If you can't see what I'm saying... you probably just don't want to... so I won't bother.

 

I can see what you're saying ... but I don't typically disagree 'because I just don't want to'. Fyi, not everyone who sees things differently than you is automatically wrong. No one's perfect, not you, not me, and that doesn't mean that we can't learn and grow from each others points of view.

 

As to the situation you're referring to, you're bogging down in semantics ... when someone says, "your job was to", it doesn't take too much great insight to gather that it wasn't stated as some kind of power play, it was a rational statement regarding the nature of clinical care. There was no disrespect intended, that I could see. Sure they might not have all the ins and outs that a practicing provider does, but it doesn't take a genius to know that a provider's job is to treat symptoms. You jumped on someone out of context, imo ... and I'm entitled to that opinion.

 

I don't know how much teaching you do, but in my book, jumping on someone and telling them to shut up because they're a 'simple peon' doesn't do much of anything other than make you look like you have ego issues. It makes one appear incredible, as if they can't handle a debate on intelligent and rational ground without resorting to name-calling. Rational discussion and explanation (of your point) is what works ... unless you're some type of sadistic individual, I suppose. Teaching involves coaching, not silencing. And too, learning involves listening.

 

Thanks for the good wishes, I had a gnarly PA day. Tired here.

[Contrarian]

I purposefully didn't write see and AGREE...

I wrote see....

 

You are right... YOU don't know "how much teaching I do"

FYI... I teach/have taught 10 students/yr 30days each for a few yrs now. We start the 2012 school yr in August... and my clerkship is a required one with consistent HIGH reviews/evaluations... so don't even go there...

 

Never told ANYONE here to "shut up"... just reminded them that they can't tell someone how to do a job they themselves are NOT qualified to do.

 

Have NOT called anyone any names so don't know where that is coming from...

 

Have debated MY point consistently... even to the point where the person on the other side of the debate starts to make a point to comment on the length of my debate.

[Hemegroup]

Then again, maybe now that poster will remember this incident in their future and temper their words minding interpretation by others. Always a good thing.

[Hemegroup]

Never told ANYONE here to "shut up"... just reminded them that they can't tell someone how to do a job they themselves are NOT qualified to do.

 

They DIDN'T tell someone that (read my post above, see 'semantics'). Better imo would have been to say, 'You're right that part of a provider's job is to diagnose symptoms, however something you're not considering, which is understandable since you don't have that type of experience yet, is ... etc etc'. Unless you just can't HANDLE that type of communication. Or unless you feel you deserve a Freebie card since you take students ... one of my preceptors was one of the worst (terrible, awful) teachers I've ever known. I can only hope you're nothing like him!

 

Water a seed and give it sunlight ... don't put it in a dark closet. Unless of course it's a C4 pathway issue ... http://en.wikipedia.org/wiki/C4_carbon_fixation

 

And just for the record, for anyone else reading, Contrarian and I are arguing about a different thread ... I am fully on the 'shut your trap' side regarding the MA being discussed in these posts here.

[Contrarian]

Then again, maybe now that poster will remember this incident in their future and temper their words minding interpretation by others. Always a good thing.

 

YEP...!!!

Which was really my main point...

 

Right now... at one of my jobs... we are in the process of firing a few nurses because these particular nurses think they know how to practice medicine without the benefit of the training to do so.

 

They got so comfortable "opinionating" about what our psych providers should and should not be doing... that they worked themselves up into a tizzy and started confronting one of our physicians about her orders and directions.

 

My instructions (advice) as a trusted provider, mentor, and nurse was for them to "ASK Questions" instead of challanging and trying to direct these providers care. Pose every concern or opinion as a question and let the provider explain their rational and it MAY make sense.

 

Then one of them took it upon herself to report a physician to the BOM about inapropriate medication and discharge orders and such. Then a few others were foolish enough to join that doomed three wheeled bandwagon.

 

Problem was... their was NOTHING inappropriate about anything the providers were doing. They just weren't doing things as the nurses wanted them to do (??based upon what?? Since the most experienced one only had about 4yrs experince) or was used to being done a certain way.

 

Now they are looking like "entranced deer" and scrambling for support from those of us in Admin who have tried to mentor them in the past.

 

Its a simply case of folks getting too big for their britches and speaking to things that they know not...

[Hemegroup]

YEP...!!!

Which was really my main point...

 

Right now... at one of my jobs... we are in the process of firing a few nurses because these particular nurses think they know how to practice medicine without the benefit of the training to do so.

 

They got so comfortable "opinionating" about what our psych providers should and should not be doing... that they worked themselves up into a tizzy and started confronting one of our physicians about her orders and directions. Then one of them took it upon herself to report a physician to the BOM about inapropriate medication and discharge orders and such. Then a few others were foolish enough to join that doomed three wheeled bandwagon.

 

Problem was... their was NOTHING inappropriate about anything the providers were doing. They just weren't doing things as the nurses wanted them to do (??based upon what?? Since the most experienced one only had about 4yrs experince) or was used to being done a certain way.

 

Well, THAT certainly makes sense ... and makes me think that maybe you took the poster's words in the other thread based on what you're going thru personally.

 

I swear my MA is hiding my referrals somewhere ... and they had to remind our MAs not to offer diagnosis before we see the patient, so I totally understand where you're coming from.