Are PAs "Experts"?

[NoClinic4Me]

in my experience this doesn't happen- PAs act as expert witnesses regarding PA practice; they wouldn't comment on the role of physicians. Not that it hasn't happened, but I can't see it realisitically since the court wants an apples-to-apples comparison.

 

I purposely tell them I have no opinion of the MD's in the cases so that they don't "go there". If you say you do, they go on a line of "Did you go to medical school?", "did you do a residency?" and "did you do a critical care fellowship?" type stuff. I've been on cases where I think the ICU doc is an idiot and made an idiot decision but I do not say that in deposition. You are asking for trouble if you do. Just my opinion.

 

Pat

[andersenpa]

So what happens when/if the title is changed to physician associate? Then PAs can be considered experts? Even though the body of knowledge and ability remains the same?

 

Bill Gates holds no title, he dropped out of college. Would anyone not consider him an expert in computers or business because he doesn't have a license or title with a name that implies so? And what about the MDs that are not even fit to practice medicine, are they considered experts just because of their title?

 

Well I would hesitate to use outliers (college dropouts who become multibillionaires, unfit MDs) as the standard by which we measure oursleves against.

 

And the title change relates largely to how we present oursleves professionally to the public outside the sphere of medical professionals (patients, insurers, legislators, health care administrators). Part PR, part "appropriate branding". The title change doesn't change the content of our education and training, so it shouldn't change our level of expertise....

[andersenpa]

"Are PA experts?" and "are they considered experts?" are two VERY different questions. They can be experts in their field, certainly, but are not ever considered such by the public at large and I would imagine rarely by those they associate with.

 

Then by that reasoning the problem is perception and not reality.

Also- getting back to the previously mentioned expert witness idea- PAs certainly are considered experts on the role and function of PAs and the PA practice of medicine.

[andersenpa]

Exactly, I think of Rod's study from last year, where he examined a patients WILLINGNESS to be seen by a PA in an ED. Patients, regardless of complaint, overwhelmingly wanted to see an attending physician.

 

Hell, he repeated it in Australia, and they were MORE willing to see a PA and they don't even have them there yet.

 

I don't think there is any chance that the US public sees PA's as experts when compared to their physician colleagues. It might make an interesting study though.

 

There's a few problems with this extrapolation

 

first patient willingness does not reflect patient understanding, which is biased. Patients muse appreciate that (for PAs) the physician-PA relationship states that a PA visit is with physician supervision, no matter how remote or indirect.

 

the second is this is a relativistic way of looking at it. the better question is how PAs are experts as isolated entities.

 

If you asked lay patients "who would you raher have manage you if you had difficulty breathing" and offered an ER doc or an anesthesiologist, a good portion would say the ER doc (they see this as an "emergency", they watch "ER")...when we all know anesthesia are the real airway experts.

 

Again, perception.

[LT_Oneal_PAC]

Then by that reasoning the problem is perception and not reality.

Also- getting back to the previously mentioned expert witness idea- PAs certainly are considered experts on the role and function of PAs and the PA practice of medicine.

 

Exactly my point. I was illustrating that since others seemed to be arguing there opinion on two different questions.

 

Now I see I may be guilty as well. I'm unsure if you are asking "are all PAs experts?" or "can PAs become experts?" or "are PAs specialist in something other than physician assisting?" based on your posts. Most PAs are generalists and start out as such, so they are not experts. PAs certainly can become experts and are very capable of convincing individuals that they are. And yes, I would consider some PAs to be specialist, however, I see that many do believe our "specialty" is physician assisting. I think part of that is our title and a lot of it is that we give out degree such as "masters in physician assistant studies," which is a misnomer. We study medicine, imho, not assisting.

[andersenpa]

Exactly my point. I was illustrating that since others seemed to be arguing there opinion on two different questions.

 

Now I see I may be guilty as well. I'm unsure if you are asking "are all PAs experts?" or "can PAs become experts?" or "are PAs specialist in something other than physician assisting?" based on your posts.

 

I am interested in the distinction that is made between PAs and physicians. In some categories, identical; in others, separated.

If you inserted "physician" where it says "PA"...

 

"are physicians experts?"

"can physicians become experts?"

 

then the answers would likely be different.

 

Most PAs are generalists and start out as such, so they are not experts.

 

So then a generalist physician cannot be an expert?

 

PAs certainly can become experts and are very capable of convincing individuals that they are.

"Convincing"? Sounds deceptive.

 

And yes, I would consider some PAs to be specialist, however, I see that many do believe our "specialty" is physician assisting. I think part of that is our title and a lot of it is that we give out degree such as "masters in physician assistant studies," which is a misnomer. We study medicine, imho, not assisting.

 

Agree with your last point.

 

 

............................................

[LT_Oneal_PAC]

............................................

 

I suppose generalist are experts. It's just weird to say they are experts by being good at a bunch of things instead of really good at one thing.

 

As far as the "convincing" thing, I suppose I picked a word that has different connotation than it needs. I mean they are certainly capable of displaying enough expertise that colleagues would come regard them as experts in certain areas.

[jdtpac]

I purposely tell them I have no opinion of the MD's in the cases so that they don't "go there". If you say you do, they go on a line of "Did you go to medical school?", "did you do a residency?" and "did you do a critical care fellowship?" type stuff. I've been on cases where I think the ICU doc is an idiot and made an idiot decision but I do not say that in deposition. You are asking for trouble if you do. Just my opinion.

 

 

Very well stated, I couldn't agree with you more. In the malpractice suits that I was asked to give my opinion as an expert witness, with the exception of 2 cases, all invariably named both the physician and the PA. We always proclaim that we provide services as a physician/PA team, so inasmuch; we are almost always sued as a team. When they started asking me questions about the physician’s expertise or scope practice I would avoid them like the plague and always say" you'll have to ask the physician that question". Invariably the issue always boils down to 3 things: #1) was the PA properly trained and privileged to provide this service #2) did the PA provide the service according to acceptable standards of care that is expected of a PA (and not a physician), and #3) was the PA properly supervised within the parameters of state law, whether the PA had one year of experience or 30 years, the physician was on site or 60 miles away, it didn't matter. And if it is discovered that the PA egregiously did not comply with the parameters in #2, open up the pocketbook.

 

Whether you are "supervised" or function in a "collaborative" role with the physician, the parties that credential you and the physician often are jointly or separately beholden to some level of responsibility for the PAs performance of duty. If #1 and #3 are found to be in order, it is up to the PA expert witness to prove or disprove #2. I guess you could say, the PA expert witness testifies to justify or discredit the PA practicing "expertly" within the scope of practice (field) of a PA regardless of what medical/surgical specialty the PA happens to be providing patient care services. Actually, I am in favor of how this system works because up to about 15 or so years ago many times it was a physician that decided if a PA was functioning properly within their scope of practice. Now the laws in most all states required a PA be judged by a peer. I guess you could qualify that and say that most states recognize that PAs are supposed to be experts in our field.

[burnpac]

Anytime you have a job title that says "something" and there is another title that says "something assistant" you already know who the superior expert is.

 

I'm certainly not saying it is right or logical, but I can easily see a jury believing a physician one year out of residency over a PA with 30 years experience. That is the life we have chosen...

 

This is not true in criminal cases. I have served as an expert witness on a couple child abuse cases from burns and two people are cooling their heels in the big house because of it.

 

Any attorney worth his or her salt will get right at the clinic experience aspect and turn the experience of the physician out of residency into a pile of nothing in front of a jury against the years I have spent in direct patient care in a burn unit evaluating hundreds of children.

 

If you can cite a significant body of direct experience, and can back it up with evidence-based information, PAs and NPs can be a credible witness in a case.

 

While my main experience over the years is with legal consulting is as an expert in PA practice at disciplinary hearings and civil cases, the nature of my work now has exposed me to more criminal expert witness work.

[burnpac]

Anytime you have a job title that says "something" and there is another title that says "something assistant" you already know who the superior expert is.

 

I'm certainly not saying it is right or logical, but I can easily see a jury believing a physician one year out of residency over a PA with 30 years experience. That is the life we have chosen...

 

This is not true in criminal cases. I have served as an expert witness on a couple child abuse cases from burns and two people are cooling their heels in the big house because of it.

 

Any attorney worth his or her salt will get right at the clinic experience aspect and turn the experience of the physician out of residency into a pile of nothing in front of a jury against the years I have spent in direct patient care in a burn unit evaluating hundreds of children.

 

If you can cite a significant body of direct experience, and can back it up with evidence-based information, PAs and NPs can be a credible witness in a case.

 

While my main experience over the years is with legal consulting is as an expert in PA practice at disciplinary hearings and civil cases, the nature of my work now has exposed me to more criminal expert witness work.