Kaepora Posted January 30, 2018 Share Posted January 30, 2018 All 3 of the PA programs near me use NPs as clinical preceptors for their students. So these programs must be graduating subpar providers... But in all honesty, there's no difference in outcomes between providers. If NPs were killing people left and right, something would be done about it - no amount of lobbying in the world could change that. We all have anecdotes about poorly trained providers of all sorts. I have plenty myself. Taken in isolation they mean nothing. Until PA outcomes exceed those of their NP counterparts, all of this derision and mockery is just self serving a bruised ego. The fact of the matter is assistants will always be viewed as... assistants... Even if your educational pathway was identical to physicians, being an assistant would keep you as a second tier provider. NPs are advancing their profession and PAs aren't. Link to comment Share on other sites More sharing options...
Miaow Posted January 30, 2018 Share Posted January 30, 2018 17 minutes ago, ACNPstudent said: The fact of the matter is assistants will always be viewed as... assistants... Even if your educational pathway was identical to physicians, being an assistant would keep you as a second tier provider. NPs are advancing their profession and PAs aren't. What were you saying about derision, mockery and bruised egos? Link to comment Share on other sites More sharing options...
Kaepora Posted January 30, 2018 Share Posted January 30, 2018 1 hour ago, Miaow said: What were you saying about derision, mockery and bruised egos? My point being you need a name change. An "assistant" will always be viewed as lesser than a "practitioner". Even if you had the same training as a physician - you'd be just an assistant. And posting on an anonymous forum about being so much better than NPs without anything other than anecdotes to back it up isn't helping your cause. Ultimately, your training doesn't matter all that much. As long as outcomes are the same. Focus on changing your name and gaining more independence. Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted January 30, 2018 Moderator Share Posted January 30, 2018 I think everyone here is being a bit harsh. While I think NPs have some education quality control issues (the best and worst provider I’ve seen in our clinic were both NPs), we are not without our faults. From my perspective, ours is rife with people who want to be assistants, to not take responsibility for clinical actions (I’m not talking about people who support a physician in charge, but the people who want to run everything by an attending and be free from liability), are referral machines, and want to handle the lowest patient complexity possible. I got down voted to oblivion on reddit and had another PA argue with me about how OTP will ruin the profession. ACNP is not wrong that NPs are advancing and we aren’t, and honestly they deserve that pot shot for the mud we’ve been slinging. i don’t necessarily blame anyone. I had a NP student in my clinic say some disparaging things about PAs. How about we just not say these things though? We can lift ourselves up without bringing others down. Let’s just chill Link to comment Share on other sites More sharing options...
lemurcatta Posted January 30, 2018 Share Posted January 30, 2018 2 hours ago, ACNPstudent said: All 3 of the PA programs near me use NPs as clinical preceptors for their students. So these programs must be graduating subpar providers... But in all honesty, there's no difference in outcomes between providers. If NPs were killing people left and right, something would be done about it - no amount of lobbying in the world could change that. We all have anecdotes about poorly trained providers of all sorts. I have plenty myself. Taken in isolation they mean nothing. Until PA outcomes exceed those of their NP counterparts, all of this derision and mockery is just self serving a bruised ego. The fact of the matter is assistants will always be viewed as... assistants... Even if your educational pathway was identical to physicians, being an assistant would keep you as a second tier provider. NPs are advancing their profession and PAs aren't. The name is an issue, you’re right. But the name of our profession isn’t relevant to the education standards of NPs. Also, I don’t think all or even most NPs are bad clinicians. I’m sure there are rockstar NPs who are very capable of teaching PA and medical students. However, you mentioned outcome studies. There are limitations to applying the cited studies broadly. We don’t take one or even a few studies and make broad conclusions. Just some considerations: what outcomes are being measured (mortality, morbidity, patient satisfaction, something else?) what is their survey/data collection methodology, what setting were they in, are there author conflicts of interest in the study outcome, etc. I don’t think we should say for certain that outcomes for NPs, PAs, and physicians are the same for all patient types, in all settings, all of the time. I don’t think there is any reason to suspect that would be true a priori Link to comment Share on other sites More sharing options...
Acebecker Posted January 30, 2018 Author Share Posted January 30, 2018 I should clarify a couple of things as I am the OP. The problem is not one with medical knowledge. This particular NP seems to be ok as far as that goes. But I have had NP students and PA students and there are things that I have had to teach NP students that my PA students all have a firm grasp on by the time they reach me. Rudimentary charting has not been something I have had to teach in the clinical setting before. I also teach 3rd year medical students for reference's sake. As far as the statement above about PA and NPs being equivalent by 2 years - this was not regarding outcomes. To my knowledge, and the research bears this out, there is no difference in outcomes. What I believe there are differences in are things that are tangible such as clinic flow, speed and confidence with decisions. And, in looking for a reference, I have not found a scientific, peer reviewed article supporting this. I do believe it is anecdotal, from other providers here on the board. And I will second the statement that mud-slinging, name calling, etc. is not what this post was about. Nor is it constructive. Link to comment Share on other sites More sharing options...
gbrothers98 Posted February 5, 2018 Share Posted February 5, 2018 Andrew Your person may have several problems. First, if this is the first clinical job, they are likely struggling with the patient interaction, getting through the H&P, determining a diagnostic plan and treatment. The EMR could be the final cognitive straw that overwhelms them. 2nd, while many will proclaim to be tech savvy, most of this is limited to Googling and sending email. EMRs are challenging and very few, if any are user friendly or intuitive. A PA student attending clinical rotations will likely get exposure to a half dozen or more by the end of clinical training enabling them scaffold into another. The nature of NP training is that they may just get exposed to one. 3rd, we all can usually get to the same point, just some take more time than others. Suggestions: Provide recommended reading: Guide to Clinical Documentation 2nd Edition by Debra D. Sullivan PhD RN PA-C (Author) Give homework: test patients in the EMR based upon usual scenarios seen in the clinic. Place back with IT to review and refresh EMR training during onboarding. Allow more time to 'get it'. Good luck. George Link to comment Share on other sites More sharing options...
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