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sshaikh712

Role of PA in ENT practice

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I've been working part time as an ENT PA for 2 years straight out of PA school. I see patients in a private outpatient office; I do not do surgery. So far I've relied heavily on my supervising physician. I am slowly becoming more and more independent and can see patients on my own regarding otitis media, epistaxis, sialadenitis, hoarseness, vertigo, hearing loss, cerumen impaction etc and I'm able to do epistaxis cauterizations and laryngoscopies on my own.

 

I still have difficulty figuring out some ear cases. Patients with cholestateoma or who have come for debridement of mastoid cavity requires more skill under the microscope which I am still having trouble using. Or patients who have come from abroad with lots of work done on their ear but they have no idea what was done. Because I have always worked hours that the supervising physician is always in office, I always ask him to come in for these cases. Same with any cases regarding mass and possible carcinoma. I have not done any FNAs.

 

What I'm wondering is if there are any PAs out there who do see patients on their own? What do you do when you are faced with cases that you have absolutely no experience with? I would eventually like to start seeing patients without needing the supervising physician on site especially because I am bound to his office hours.

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I shadowed an ENT PA pre-PA school, and it sounds like her scope of practice was pretty similar to your own.  In non-emergent situations, you are always able to schedule the patient for a follow-up with the doc, if they're outside your skill and confidence.

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There are times I have seen patients without any physician on site due to emergencies. It's such a tough situation when I have to reschedule appointments with the physician and the patient took off of work to be there or had a difficult time getting a ride to be there. I absolutely hate doing that to my patients.

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I would just give it a little more time.  I am in a specialty, not ENT and I would say at the 4-5 year mark I felt like there was very little that I had not seen.  Yes, occasionally there was something I just wasn't sure about but I could usually tell the patient I needed to consult with my SP and would call them with a treatment plan.  Now my office hours are always while my SP is doing procedures so I work pretty much completely independently.  You will get there, it sounds like you have a really good base of knowledge, it just takes time.

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