Moderator LT_Oneal_PAC Posted June 19, 2012 Moderator Share Posted June 19, 2012 Direct means in the room and doing nothing that would prevent them from being immediately and instantly available if complications arise. If that is the case, what is the benefit of the PA? It would only happen as a learning experience I imagine or in a bilateral case. Appies are, of course, not bilateral. So again, what is the benefit of the PA doing it? ETA: I do many PAs that open and close to speed up the surgery. By law, the surgeon must be present for and major portion of surgery (basically anything opening and closing). A heart surgeon at a major hospital I worked at did this. The PA and team would basically get everything open and ready. All the surgeon would do is the cut the sternum, go on and off pump, and the bypass anastomosis. Needless to say he would knock out several CABGs in a day. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted June 19, 2012 Moderator Share Posted June 19, 2012 It would only happen as a learning experience I imagine or in a bilateral case. Appies are, of course, not bilateral. So again, what is the benefit of the PA doing it? helping out a lazy doc or as you say for learning purposes. as a student I did open tubal ligations with the doc(my preceptor) scrubbed in and watching/commenting but I did 100% of the procedure. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted June 19, 2012 Moderator Share Posted June 19, 2012 It would only happen as a learning experience I imagine or in a bilateral case. Appies are, of course, not bilateral. So again, what is the benefit of the PA doing it? helping out a lazy doc or as you say for learning purposes. as a student I did open tubal ligations with the doc(my preceptor) scrubbed in and watching/commenting but I did 100% of the procedure. Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted June 19, 2012 Moderator Share Posted June 19, 2012 helping out a lazy doc or as you say for learning purposes. as a student I did open tubal ligations with the doc(my preceptor) scrubbed in and watching/commenting but I did 100% of the procedure. Have to be pretty lazy to sit in the OR watching a PA and another first assist do the work, because first assist is not a lazy job. I can totally see for training purposes, especially in the military for emergencies. However, in a real practice this would just be throwing money in the trash. Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted June 19, 2012 Moderator Share Posted June 19, 2012 helping out a lazy doc or as you say for learning purposes. as a student I did open tubal ligations with the doc(my preceptor) scrubbed in and watching/commenting but I did 100% of the procedure. Have to be pretty lazy to sit in the OR watching a PA and another first assist do the work, because first assist is not a lazy job. I can totally see for training purposes, especially in the military for emergencies. However, in a real practice this would just be throwing money in the trash. Link to comment Share on other sites More sharing options...
andersenpa Posted June 19, 2012 Share Posted June 19, 2012 I'm talking about the semantics we use to describe what PAs do, and what the words mean when you are talking with physicians. Explaining the PA role is all about perception. In the minds of physicians, performing surgery carries the idea of leading an operation. In my practice I harvest conduit, open and close the chest, occasionally put patients on bypass, etc. And in the context of talking with other PAs or surgeons I might use the term such as "I'm operating today". But I would not use those same terms when talking to people not familiar with PAs, particularly those who probably carry a negative impression of PA competency. Because when you say "the PA did an appy" it means two very different things to the PA saying it and the doc hearing it. It actually has very little to do with the act being performed or the skills necessary to do it. That is not really the matter here. If a PA is doing a case with little to no participation from the surgeon, which may be totally within the skill set of the PA, most docs still see the situation as a first assist who will need to be bailed out any second. It is ALL about how you are communicating PA practice to a PA-naive doc and what their biases are. Trust me, when you have a doc who doesn't know PAs or has prejudgement about them, and you say "the PA did an appy", they are rolling their eyes and you are not making any positive gains in marketing PAs to a physician. I am a surgical PA with experience/exposure, and I am ALL in favor of growing the model of what we do. I just think we need to tread lightly in how we deal with docs not familiar with PAs. The moment anyone THINKS you are 1) trying to oversell your role, or 2) practicing without awareness/respect of the training/competency needed for a BC/BE surgeon, you have lost your position. Link to comment Share on other sites More sharing options...
andersenpa Posted June 19, 2012 Share Posted June 19, 2012 I'm talking about the semantics we use to describe what PAs do, and what the words mean when you are talking with physicians. Explaining the PA role is all about perception. In the minds of physicians, performing surgery carries the idea of leading an operation. In my practice I harvest conduit, open and close the chest, occasionally put patients on bypass, etc. And in the context of talking with other PAs or surgeons I might use the term such as "I'm operating today". But I would not use those same terms when talking to people not familiar with PAs, particularly those who probably carry a negative impression of PA competency. Because when you say "the PA did an appy" it means two very different things to the PA saying it and the doc hearing it. It actually has very little to do with the act being performed or the skills necessary to do it. That is not really the matter here. If a PA is doing a case with little to no participation from the surgeon, which may be totally within the skill set of the PA, most docs still see the situation as a first assist who will need to be bailed out any second. It is ALL about how you are communicating PA practice to a PA-naive doc and what their biases are. Trust me, when you have a doc who doesn't know PAs or has prejudgement about them, and you say "the PA did an appy", they are rolling their eyes and you are not making any positive gains in marketing PAs to a physician. I am a surgical PA with experience/exposure, and I am ALL in favor of growing the model of what we do. I just think we need to tread lightly in how we deal with docs not familiar with PAs. The moment anyone THINKS you are 1) trying to oversell your role, or 2) practicing without awareness/respect of the training/competency needed for a BC/BE surgeon, you have lost your position. Link to comment Share on other sites More sharing options...
PAstudentCanada Posted June 20, 2012 Author Share Posted June 20, 2012 Thanks. I appreciate the advice. :) I'm talking about the semantics we use to describe what PAs do, and what the words mean when you are talking with physicians. Explaining the PA role is all about perception.In the minds of physicians, performing surgery carries the idea of leading an operation. In my practice I harvest conduit, open and close the chest, occasionally put patients on bypass, etc. And in the context of talking with other PAs or surgeons I might use the term such as "I'm operating today". But I would not use those same terms when talking to people not familiar with PAs, particularly those who probably carry a negative impression of PA competency. Because when you say "the PA did an appy" it means two very different things to the PA saying it and the doc hearing it. It actually has very little to do with the act being performed or the skills necessary to do it. That is not really the matter here. If a PA is doing a case with little to no participation from the surgeon, which may be totally within the skill set of the PA, most docs still see the situation as a first assist who will need to be bailed out any second. It is ALL about how you are communicating PA practice to a PA-naive doc and what their biases are. Trust me, when you have a doc who doesn't know PAs or has prejudgement about them, and you say "the PA did an appy", they are rolling their eyes and you are not making any positive gains in marketing PAs to a physician. I am a surgical PA with experience/exposure, and I am ALL in favor of growing the model of what we do. I just think we need to tread lightly in how we deal with docs not familiar with PAs. The moment anyone THINKS you are 1) trying to oversell your role, or 2) practicing without awareness/respect of the training/competency needed for a BC/BE surgeon, you have lost your position. Link to comment Share on other sites More sharing options...
PAstudentCanada Posted June 20, 2012 Author Share Posted June 20, 2012 Thanks. I appreciate the advice. :) I'm talking about the semantics we use to describe what PAs do, and what the words mean when you are talking with physicians. Explaining the PA role is all about perception.In the minds of physicians, performing surgery carries the idea of leading an operation. In my practice I harvest conduit, open and close the chest, occasionally put patients on bypass, etc. And in the context of talking with other PAs or surgeons I might use the term such as "I'm operating today". But I would not use those same terms when talking to people not familiar with PAs, particularly those who probably carry a negative impression of PA competency. Because when you say "the PA did an appy" it means two very different things to the PA saying it and the doc hearing it. It actually has very little to do with the act being performed or the skills necessary to do it. That is not really the matter here. If a PA is doing a case with little to no participation from the surgeon, which may be totally within the skill set of the PA, most docs still see the situation as a first assist who will need to be bailed out any second. It is ALL about how you are communicating PA practice to a PA-naive doc and what their biases are. Trust me, when you have a doc who doesn't know PAs or has prejudgement about them, and you say "the PA did an appy", they are rolling their eyes and you are not making any positive gains in marketing PAs to a physician. I am a surgical PA with experience/exposure, and I am ALL in favor of growing the model of what we do. I just think we need to tread lightly in how we deal with docs not familiar with PAs. The moment anyone THINKS you are 1) trying to oversell your role, or 2) practicing without awareness/respect of the training/competency needed for a BC/BE surgeon, you have lost your position. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted June 20, 2012 Moderator Share Posted June 20, 2012 Have to be pretty lazy to sit in the OR watching a PA and another first assist do the work, because first assist is not a lazy job. I can totally see for training purposes, especially in the military for emergencies. However, in a real practice this would just be throwing money in the trash. there was no first assist on these. there was just me and the doc. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted June 20, 2012 Moderator Share Posted June 20, 2012 Have to be pretty lazy to sit in the OR watching a PA and another first assist do the work, because first assist is not a lazy job. I can totally see for training purposes, especially in the military for emergencies. However, in a real practice this would just be throwing money in the trash. there was no first assist on these. there was just me and the doc. Link to comment Share on other sites More sharing options...
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