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Extremely discouraging article in Family Medicine, the official journal of the Society of Teachers or Family Medicine


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This deserves as many comments as you all can give it concerning the fact that we practice medicine, not some other "different" field; that our programs are strictly accredited and standardized, that we are certified by one unified body, and that we staff some of the most complex medical facilities without direct physician involvement.    I made the point that taking this course of action would deny essential care to patients.  I urge people to comment strongly but respectively giving details of their training, experience, and current practice.  I think it deserves official comment by ARC-PA, PAEA, and the NCCPA as well.

 

http://www.stfm.org/FamilyMedicine/Vol48Issue5/Carek343

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I would like to know more about the author - grad date, school attended, years of experience. Whether he went to a PA/MD school setting. How is he qualified to make this assessment? 

 

It sounds like a disgruntled physician who either had a bad experience with a PA or might have been shown-up by a PA on rounds or something.

 

To belittle an entire profession without even consulting the profession for input is rude and ill advised. He did not cite specifics as to the reasoning behind our "separate profession" and his perception that we somehow lessen the experience of medical students and residents.

 

Who edits this publication?

 

I will definitely be commenting to the article after googling the author and trying to find more info. 

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Most of this looks like he's taking a swipe at NP's and lumping PA's in with them.

 

I note that this is a professor, not a practitioner, and that he appears to teach in Florida.

 

http://chfm.ufl.edu/chfm-faculty/faculty-by-program/clinical-faculty/peter-j-carek-m-d-m-s/

 

Looks like he's also a sports med guy, which makes me wonder how many PAs he's ever interacted with in any professional capacity.  Does he think we're just like ATCs only different?  Surely, he has little idea what I do in day-to-day medicine.

 

Let's also consider his world: He's teaching medical school, and people aren't matching.  Good, solid MD grads are going nowhere, because, I think that he thinks, practices are busy precepting PAs and NPs when they SHOULD be training more residents.  Just a bit of trying to walk a mile in his moccasins...

 

LET'S NOT BLAST HIM, however.  Each response should be as reasoned and polite as possible.

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His correspondence is listed as U of Florida - which has a great PA program (and an MD program though the two are not integrated).

 

His second to last paragraph indicates he is either unfamiliar with the role and training of PAs or he refuses to accept that we are trained for more than preventive care.  For example - we are, in fact, trained in much more than just family medicine.  But for those 4-6-8 weeks, we need to be immersed in it just like every rotation.

 

It appears to be a very subjective piece with no real detail for the reasoning or suggested improvements that, in his mind, need to made.  And Rev is right - all of his references indicate MD vs NP and PA was just a tag-a-long.

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I have never heard of this society or publication.

 

It seems odd to me that a Teaching Society for Family Medicine doesn't include PAs in their realm. Even though PAs aren't as populous in FP as we were designed to be 50 years ago - we still make up a big chunk of PCPs in this country.

 

Not sure how someone lives in such a sheltered environment medically when we are so present.

 

I will not bash him but would love to introduce him to the facts, figures and reality of what we actually do. 

 

Again, I can't figure out how an "educator" didn't do any more research and write such a disparaging article.

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Lots of baseless claims in this article that grossly shows that he has no understanding or knowledge of PA education. This article reeks of insecurity that PAs and NPs are competition instead of realizing that there is plenty of patients to go around and that this is a team effort that is needed to fix the gap in access to healthcare.

 

"The presence of other learners such as nurse practitioners and physician assistants may also provide the same professional satisfaction, but providing clinical education for this group of learners may also interfere with the education of medical students and residents."

 

Needs citation to back up this claim..

 

"Furthermore, providing nonphysicians with the same educational experience as medical students and residents might be detrimental to the overall health care system and our discipline if such education results in the perception of similar experience and skills."

 

This is a lie as there is plenty of data and studies that disprove this statement.

 

"These competing demands may have significant negative consequences if a thoughtful and reasoned approach is not taken."

 

Need citation to prove this claim.

 

"As family physicians, should we work with our colleagues from other professions to develop learning experiences for nonphysicians that allow them to excel in their role on the health care team without being perceived by some to be the equivalent to the training of a family medicine physician?"

 

This statement makes it obvious he has no clue of the roles of PAs..

 

"We should not expect or provide a training experience for nonphysicians that is similar or identical to the training experience of a family physician."

 

So in other words, PAs should not know how to diagnose and treat patients making us glorified MAs and RNs... Got it...

 

This guy is a clown and this article is filled with libel... I hope he gets served papers.. It would be one thing to make a statement and have data to support your claim, it's another to just state something so blatantly incorrect and detrimental to our profession with self motivated interest in self preservation..

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Meh.  Author's an idiot.  The very publication he submitted this to historically disagrees with what he's saying.  https://www.stfm.org/fmhub/fm2012/September/Jerry586.pdf 

 

I called attention to this in my comment.  Giving anecdotal information about what we do in primary care or emergency departments the world over does not help much.  It's got to be on paper and published somewhere for these academic wonks to believe it. 

 

Can we get more data linked in the comments which openly contradicts this guy?  That would be helpful.

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Dr. Carek was director of the family medicine program at the Medical University of SC in Charleston, where I did my PA training years ago  He is well aware of PAs, and of their training.  The chairman of the Family Medicine Department was active in the PA program, and the Department was a clinical rotation site.  He was the sports med/ortho guru.  I was not aware that he had left and gone to Florida.

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Dr. Carek was director of the family medicine program at the Medical University of SC in Charleston, where I did my PA training years ago  He is well aware of PAs, and of their training.  The chairman of the Family Medicine Department was active in the PA program, and the Department was a clinical rotation site.  He was the sports med/ortho guru.  I was not aware that he had left and gone to Florida.

Then his rant seems more absurd. He cites no facts or statistics and sounds more peeved and threatened than anything.

His blurb doesn't help our profession and makes no suggestionst regarding HOW it could change to HIS fancy.

 

He needs to be addressed by a leader at ARC-PA and his own department for chucking them under the bus

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Dr. Carek was director of the family medicine program at the Medical University of SC in Charleston, where I did my PA training years ago  He is well aware of PAs, and of their training.  The chairman of the Family Medicine Department was active in the PA program, and the Department was a clinical rotation site.  He was the sports med/ortho guru.  I was not aware that he had left and gone to Florida.

 

 

Meh.  Author's an idiot.  The very publication he submitted this to historically disagrees with what he's saying.  https://www.stfm.org/fmhub/fm2012/September/Jerry586.pdf 

 

I called attention to this in my comment.  Giving anecdotal information about what we do in primary care or emergency departments the world over does not help much.  It's got to be on paper and published somewhere for these academic wonks to believe it. 

 

Can we get more data linked in the comments which openly contradicts this guy?  That would be helpful.

 

 

So the truth comes out...

 

he has a personal axe to grind, and as "physicians always know best" he gets press/print time...

 

 

 

just sad, and another reason why we need to get out from under the physicians and "grow our own" PA education process....

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My typo - he was director of the family medicine RESIDENCY program; he was not the department chair. Many PA students did rotations in that department.

Well, considering that's generally considered the worst FM residency and the most restrictive in SC, I'm less surprised. FM folks in big university settings feel disrespected...and they are dissed. I'm thankful to train where we don't have "internal medicine" patients and "family medicine" patients...they're all MEDICINE patients, and we don't have those petty turf battles.

 

Sent from my SAMSUNG-SM-N910A using Tapatalk

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