Future of Medicine - A New Educational Model?

[chatcat]

and end the MD vs. PA war.

.

 

I'm not aware of an MD vs PA war going on. While there is much discussion on this forum of choosing between PA versus MD training, once training is completed it seems we all fall into place as clinicians in our own professional niche without adversarial

tendencies. Like any other profession, there certainly can be some isolated incidents of conflict but for most of us practicing PAs our relationship with our supervising Docs is a good one.

[Hemegroup]

Nope, not me. But it seems my idea has been thought of before. I'm uneducated on the "nursing model" as compared to the "medical model". I've asked a few MDs and PAs about the main difference, and some have told me there are none, so I'm not sure where to go with that. If you have time to explain, I'm all ears.

 

Sure, no problem. Doctors and PAs are generally trained further in the sciences. Nurses only have to take the first leg of Chemistry, for example. The final say is that Doctors and PAs are both trained by Doctors and/or Doctors' curriculum. Nurses generally aren't.

[Hemegroup]

Nope, not me. But it seems my idea has been thought of before. I'm uneducated on the "nursing model" as compared to the "medical model". I've asked a few MDs and PAs about the main difference, and some have told me there are none, so I'm not sure where to go with that. If you have time to explain, I'm all ears.

 

Sure, no problem. Doctors and PAs are generally trained further in the sciences. Nurses only have to take the first leg of Chemistry, for example. The final say is that Doctors and PAs are both trained by Doctors and/or Doctors' curriculum. Nurses generally aren't.

[ScienceisAmazin]

The notion of a war of some kind is overdramatic.

 

When I consult premed/medical school forums, I see a strong trend of opinion that PAs are incompetent and trying to push MDs out of jobs/money. On PA forums, I notice attitudes towards and interactions with med students and physicians with a negative bias- generally from being treated poorly by condescending MDs. News articles and political cartoons often point out a stark difference between MD and PA, generally taking sides. You're right, though- saying it's a "war" is quite overdramatic. In my shadowing experience, MDs and PAs work side-by-side and appreciate what each brings to medicine.

[ScienceisAmazin]

The notion of a war of some kind is overdramatic.

 

When I consult premed/medical school forums, I see a strong trend of opinion that PAs are incompetent and trying to push MDs out of jobs/money. On PA forums, I notice attitudes towards and interactions with med students and physicians with a negative bias- generally from being treated poorly by condescending MDs. News articles and political cartoons often point out a stark difference between MD and PA, generally taking sides. You're right, though- saying it's a "war" is quite overdramatic. In my shadowing experience, MDs and PAs work side-by-side and appreciate what each brings to medicine.

[ScienceisAmazin]

Sure, no problem. Doctors and PAs are generally trained further in the sciences. Nurses only have to take the first leg of Chemistry, for example. The final say is that Doctors and PAs are both trained by Doctors and/or Doctors' curriculum. Nurses generally aren't.

 

Thank you. I do understand that PA and MD is more science-heavy, but how is the curriculum different?

[ScienceisAmazin]

Sure, no problem. Doctors and PAs are generally trained further in the sciences. Nurses only have to take the first leg of Chemistry, for example. The final say is that Doctors and PAs are both trained by Doctors and/or Doctors' curriculum. Nurses generally aren't.

 

Thank you. I do understand that PA and MD is more science-heavy, but how is the curriculum different?

[Hemegroup]

Thank you. I do understand that PA and MD is more science-heavy, but how is the curriculum different?

 

Deeper into physiology and pathophysiology. And that being said, Doctors go even deeper into those subjects than PAs. I sat in on grand rounds for Surgery and was blown away that there was physiology which I was unaware of. In fact, that's a good model to look at, that training ... Surgeons have to have a solid and encompassing baseline before they even reach their Surgical training. If NPs had the same level of training, they'd be able to go onto be Surgeons or work as First Assist in the OR ... but they're not. They're not trained in Surgery at all, generally. Doctors and PAs are.

[Hemegroup]

Thank you. I do understand that PA and MD is more science-heavy, but how is the curriculum different?

 

Deeper into physiology and pathophysiology. And that being said, Doctors go even deeper into those subjects than PAs. I sat in on grand rounds for Surgery and was blown away that there was physiology which I was unaware of. In fact, that's a good model to look at, that training ... Surgeons have to have a solid and encompassing baseline before they even reach their Surgical training. If NPs had the same level of training, they'd be able to go onto be Surgeons or work as First Assist in the OR ... but they're not. They're not trained in Surgery at all, generally. Doctors and PAs are.

[ScienceisAmazin]

Deeper into physiology and pathophysiology. And that being said, Doctors go even deeper into those subjects than PAs. I sat in on grand rounds for Surgery and was blown away that there was physiology which I was unaware of. In fact, that's a good model to look at, that training ... Surgeons have to have a solid and encompassing baseline before they even reach their Surgical training. If NPs had the same level of training, they'd be able to go onto be Surgeons or work as First Assist in the OR ... but they're not. They're not trained in Surgery at all, generally. Doctors and PAs are.

 

Great explanation. Much appreciated.

[ScienceisAmazin]

Deeper into physiology and pathophysiology. And that being said, Doctors go even deeper into those subjects than PAs. I sat in on grand rounds for Surgery and was blown away that there was physiology which I was unaware of. In fact, that's a good model to look at, that training ... Surgeons have to have a solid and encompassing baseline before they even reach their Surgical training. If NPs had the same level of training, they'd be able to go onto be Surgeons or work as First Assist in the OR ... but they're not. They're not trained in Surgery at all, generally. Doctors and PAs are.

 

Great explanation. Much appreciated.

[sts0001]

Thanks for the tip of the hat, I finally found my copy of of this JAMA article that was published in 1968 by the founders of the Nurse Practitioner profession, both nurse and MD, three years after its inception. It is definitely worth a read and gives you an idea of how they adapted the public health nursing role from the Breckinridge/frontier nursing/midwifery movement.

 

There is some some interesting PA history you may enjoy. Throughout the entire article there is reference to the nurse practitioners as associates, from what I have gathered several of docs involved in this and some nurses too were pushing to get the title changed from nurse practitioner to nurse associate. They feared backlash from the medical community or confusion of the NP title to others in the field. Some of the very early np programs were actually using the name nurse associate for a period of time. Since the PA profession was just in its infancy at nearly the same time I have heard this is why the title of physician associate was not adopted then or in the late 70s. Please correct me if I am completely wrong.

 

http://jama.jamanetwork.com/article.aspx?articleid=338928

(Just look on the right side and click on pdf and it will download, don't need a membership.)

 

I swear the funnest thing to me is when I left my NP program I think I had learned more about the profession's history than anyone else at that school. I think I was just trying to figure out how the program had ended up where it did.

[sts0001]

Thanks for the tip of the hat, I finally found my copy of of this JAMA article that was published in 1968 by the founders of the Nurse Practitioner profession, both nurse and MD, three years after its inception. It is definitely worth a read and gives you an idea of how they adapted the public health nursing role from the Breckinridge/frontier nursing/midwifery movement.

 

There is some some interesting PA history you may enjoy. Throughout the entire article there is reference to the nurse practitioners as associates, from what I have gathered several of docs involved in this and some nurses too were pushing to get the title changed from nurse practitioner to nurse associate. They feared backlash from the medical community or confusion of the NP title to others in the field. Some of the very early np programs were actually using the name nurse associate for a period of time. Since the PA profession was just in its infancy at nearly the same time I have heard this is why the title of physician associate was not adopted then or in the late 70s. Please correct me if I am completely wrong.

 

http://jama.jamanetwork.com/article.aspx?articleid=338928

(Just look on the right side and click on pdf and it will download, don't need a membership.)

 

I swear the funnest thing to me is when I left my NP program I think I had learned more about the profession's history than anyone else at that school. I think I was just trying to figure out how the program had ended up where it did.