Moderator ventana Posted February 27, 2012 Moderator Share Posted February 27, 2012 As I start up my own practice I am constantly reminded how there should be either 1-some type of independent practice level that you can attain for primary care after 10+ years of practice and advanced degrees 2-some type of attanable bridge program to MD/DO - I would go up against just about any foreign grad with only 4-6 years of post HS education on the practice of medicine and yet I can't do squat with out having some complex ownership scheme to make it all work.... Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted February 27, 2012 Moderator Share Posted February 27, 2012 As I start up my own practice I am constantly reminded how there should be either1-some type of independent practice level that you can attain for primary care after 10+ years of practice and advanced degrees 2-some type of attanable bridge program to MD/DO - I would go up against just about any foreign grad with only 4-6 years of post HS education on the practice of medicine and yet I can't do squat with out having some complex ownership scheme to make it all work.... Lake Erie COM, dude Link to comment Share on other sites More sharing options...
Moderator ventana Posted February 27, 2012 Author Moderator Share Posted February 27, 2012 Lake Erie COM, dude 3 years of school followed by 3-4 years of residency lost wages - 700k loans - 250k lost wife - priceless this is really not a bridge program my idea 5+ years real world IM experience Masters with over a 3.5 no MCAT one year academic to help pass USMLE 1 and 2 2 year residency (no intern year, skip resident year one) Full fledged IM Doc in 3 years - one year total lost wages, 2 years at 50k for residency this would be something I would do - but 7 years and a million dollar price tag for LECOM is out of reach for a midlife PA who is already functioning as a doc in almost every sense (can't sign death cert, need cosign on schedule II's - and besides this I function identical to the docs) Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted February 27, 2012 Moderator Share Posted February 27, 2012 Then let's call it a bridge to a bridge program :D Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted February 27, 2012 Moderator Share Posted February 27, 2012 I was also under the impression, so please correct me if I'm wrong (primadonna??) that the Lake Erie program allows you to go into ANY residency, not just IM Link to comment Share on other sites More sharing options...
Moderator ventana Posted February 27, 2012 Author Moderator Share Posted February 27, 2012 that is correct I think we should be able to waive the MCAT and take USMLE after one year academic and be restricted to the nonsurgical fields ie IM, geriatrics, internist, peds. so in my case I have 10 yrs PA experience with 8 years IM, an AAS, BA, MBA, and MS and I think one more year of formal education would allow me to pass the USMLE - then a little more training with a shortened residency and be a full fledged IM doc (as my experience is in IM) Link to comment Share on other sites More sharing options...
jmj11 Posted February 27, 2012 Share Posted February 27, 2012 As I start up my own practice I am constantly reminded how there should be either1-some type of independent practice level that you can attain for primary care after 10+ years of practice and advanced degrees 2-some type of attanable bridge program to MD/DO - I would go up against just about any foreign grad with only 4-6 years of post HS education on the practice of medicine and yet I can't do squat with out having some complex ownership scheme to make it all work.... Just wait, it will get worse. Even if you see 99% of the patients, as I do, you are invisible to some malpractice insurers, health insurance companies, banks and the list goes on and on. There is still a widely held assumption by those forementioned entities, that we are the physicians' gophers, handing them things, getting them coffee, seeing very simple patients on our own, such as pulling out a splinter. After all these decades, talking to these people is like hitting your head on the wall., I'm a realist. I believe that new PA, NP and even MD grads need more supervision than they get. But at the same token, after 10 years of excellent service, PAs should be able to test into a new career path that gives them more independence. Won't happen in my lifetime. Link to comment Share on other sites More sharing options...
physasst Posted February 27, 2012 Share Posted February 27, 2012 Won't happen in my lifetime. THIS^^^^^^^^^^ It's nice idea, but it'll never, ever happen. I can perhaps see getting the bridge program down to 2 years in the future. But there will never be a waiver of the MCAT, nor the USMLE's, nor ANY shortening of residency....ever. It's the way it is..... Link to comment Share on other sites More sharing options...
Contrarian Posted February 27, 2012 Share Posted February 27, 2012 As has been alluded to above... What is currently available ISN'T a "bridge" at all... but merely a alternate route with basically the same requirements as the traditional route. Link to comment Share on other sites More sharing options...
jmj11 Posted February 27, 2012 Share Posted February 27, 2012 I wasn't even talking about a bridge program. Just like the state of Washington as a two-tier set of laws for PAs (with C and without C) a third tier, after a decade of good service and maybe a national exam, you become a PA-II (or whatever) where we, at most, have a advisory role with an MD (no malpractice risks for the "advisory MD"). This is just dreaming and I know I won't happen in my life time. The AAPA wouldn't support it, in fear of the physicians, the physicians wouldn't support it in fear of Caste-penetration. But I'm just saying if good patient care was what we were really interested in, and not the politics, it would be a good thing. Link to comment Share on other sites More sharing options...
primadonna22274 Posted February 28, 2012 Share Posted February 28, 2012 Sorry Ventana, I don't see it happening either. Just the basic sciences for step 1 took the first 6 mos of med school for us. Finally into systems (hallelujah!) and for the first time since anatomy I'm feeling the PA advantage. Core is bitter cruel. WTF cares that it's the FGFR3 gene that codes for long bone formation, and if it's defective you get achondroplasia, and if REALLY defective lethal thanatophoric dysplasia? Or like today's exam question, which I missed...case presentation of typical Reiter syndrome/reactive arthritis: but knowing it's Reiter syndrome is not the prize--what is the mechanism of autoimmunity? Molecular mimicry. That's step 1 for ya, the PhDs making you feel small until you finally get the only way to play is by their rules and learn the silly stuff you freely acknowledge you will forget a year later. I am amazed quite frankly how much of it sticks, but sheesh.... The longer I do this the more impressed I am with PA education. Our profession's founders certainly did an outstanding job of separating the essentials from the fluff. I think knowing so much fluff is useful to acquiring a deeper understanding of pathophys (and indeed, this is why I'm doing it, and oh yes, to gain independence), but I acknowledge that for probably 80% of general medicine that fluff is just nice to know. Back to my Big Robbins ;) Nite ;) L. Link to comment Share on other sites More sharing options...
Moderator ventana Posted February 28, 2012 Author Moderator Share Posted February 28, 2012 I know it will never happen it's just my grumble...... Link to comment Share on other sites More sharing options...
jmj11 Posted February 28, 2012 Share Posted February 28, 2012 I'm becoming a libertarian in my old age. I think if we had a free market in the choice of health care, we PAs would do very well. My phone rings off the hook all day with customers (patients) wanting to see me. Yet, due to "outside controls" many of them can not. Those un-natural controls, in my case, are a couple of insurance companies that decided that because I am a PA with minimal physician involvement that I could not give quality care. But those decision were made in a far away place by, usually physicians, who don't know me nor my patient-wanna-bes. They have no interest in doing any type of evidence-based survey of the quality of care we give, patient satisfaction and etc. Simply, they see on paper that a PA owns the practice and they conclude that the quality of care must be poor. But the customers, the patients, are our greatest advocate. That wasn't always true. There was a time that when the patient saw us, they felt cheated. There is somewhat of a free market that these patients can eventually choose their insurance company, but often the choice isn't easy as their employer makes the choice for them. So, sometimes I think we are approaching the wrong groups in our efforts. The "regulators" who don't know squat about what we do (or care as it is just political) aren't the ones who will ever, willingly, open new doors for us. It is the patients, when mobilized and voices are heard, they will demand the freedom to see us for their care. I have a band of about 50 patients whom have worked tirelessly fighting with their insurance company (Group Health) to include us. They are my greatest advocates. Link to comment Share on other sites More sharing options...
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