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PA's without borders?


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Can someone tell me why PA's are not allowed to do the doctors without borders program?

 

On the website it says:

 

Do you recruit only doctors?

MSF recruits doctors and other medical and non-medical staff. Examples include surgeons, anesthesiologists, nurse anesthetists, registered nurses, mental health professionals, midwives, financial controllers, logisticians, and water-and-sanitation specialists.

 

Does MSF recruit Physician Assistants?

No. The traditional Physician Assistant role of primary health care provider is done by the national staff in the field. However, Physician Assistants with extensive international NGO experience can still be considered for coordinator level positions.

 

Does anyone know why this is? I'm confused as to why NP's can do it but PA's can't. Have you ever tried to participate in this program and/or are there similar programs? I'm very interested in doing something like this but I'm upset with the fact that PA's are not able to participate.

 

Thanks ahead of time :)

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I have spoken a long time with a patient/friend of mine who had been a nurse with DWB (Medecins Sans Frontieres) for a number of years, then took a position with their HR office in Paris for about three years before moving here. She says the official position is that PAs are not recognized in so many countries that they didn't want the hassle of trying to bring in people where the hosting country might have issues with. Remember too that it is a French organization and frankly, many countries around the world do not understand who we are or the quality of work that we do. The French physicians, starters and key players, probably don't see a lot of merit in our profession, compared to how they see physicians. I do understand that they use NPs in some roles, sometimes as RNs and some (in the field) as practitioners. Please change this if you can. I spent a couple of years arguing with them. I spent the same couple of years talking to several governments and groups (Egypt, UAE, Jordan and Nepal) about our roles and it was very difficult for them to see what we bring to the table. In my experience, they saw us as medical assistants despite my clear description of who we are. Now, as you know, we are making some limited headway in several countries and some countries have had semi-PA roles for decades. But in general, we have a lot of work to do to help the world see our qualities. Someone here knows a PA who has worked with MSF in some limited role and maybe they can share more.

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From my experience working around MSF/DWB and drinking extensively in frontier/ex-pat bars third world dives with a lot of them... the way in would be for PAs to get reciprocity as "Clinical Officers." MSF/DWB works with a LOT of COs and therefore understand the roles, training and capabilities.

 

So if a PA could go to say, Kenya and get licensed as a Clinical Officer... they could probably work for MSF/DWB.

 

Read about the different kinds and levels of "Clinical Officers" here

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Honduras took my PA license - said thank you and I carried $4,000 worth of meds through customs.... they treated me as a Doc - and I functioned as one - when no doc was on the trip - mostly because this was through www.capecares.com and the honduras organization known of Knighs of Malta as the local connection. Great times and really rewarding - I would HIGHLY encourage other PA's to consider (it is all primary care so speciality PA's get left out a little bit..)

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To clarify, neither I or any of the 3 other American PAs who served with MSF had their MPHs BEFORE going to work for MSF; they came afterward.

 

The organization is VERY still Eurocentric, despite a recently added operational section in the US. They still want and need people with international experience, (Based upon my experience at the time even I wouldn't get in today if I were applying!)

 

Since they received the Nobel PEace Prize they have been inundated with applications, so they can afford to be choosey. Now that there are some 750 Dutch and 150 British PAs (and German PAs coming online) and some of them want to apply there may eventually be reconsidered. In the meantime, I remain a member of the MSF Association and I continue to push to get EXPERIENCED US PAs in.

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Can I assume that despite being "treated as a Doc and functioning as one", that you always identified yourself as a PA??

 

As a reminder to all PAs working abroad:

 

From the American Academy of Physician Assistants Policy Manual

HP-3700.3.0 International

HP-3700.3.1

Guidelines for PAs Working Internationally

1. PAs should establish and maintain the appropriate physician-PA team.

2. PAs should accurately represent their skills, training, professional credentials, identity, or service both directly and indirectly.

3. PAs should provide only those services for which they are qualified via their education and/or experiences, and in accordance with all pertinent legal and regulatory processes.

4. PAs should respect the culture, values, beliefs, and expectations of the patients, local health care providers, and the local health care systems.

5. PAs should be aware of the role of the traditional healer and support a patient’s decision to utilize such care.

6. PAs should take responsibility for being familiar with, and adhering to the customs, laws, and regulations of the country where they will be providing services.

7. When applicable, PAs should identify and train local personnel who can assume the role of providing care and continuing the education process.

8. PA students require the same supervision abroad as they do domestically.

9. PAs should provide the best standards of care and strive to maintain quality abroad.

10. Sustainable programs that integrate local providers and supplies should be the goal.

11. PAs should assign medical tasks to nonmedical volunteers only when they have the competency and supervision needed for the tasks for which they are assigned.

[Adopted 2001, reaffirmed 2006, and amended 2011]

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Can I assume that despite being "treated as a Doc and functioning as one", that you always identified yourself as a PA??

 

As a reminder to all PAs working abroad:

 

From the American Academy of Physician Assistants Policy Manual

HP-3700.3.0 International

HP-3700.3.1

Guidelines for PAs Working Internationally

1. PAs should establish and maintain the appropriate physician-PA team.

2. PAs should accurately represent their skills, training, professional credentials, identity, or service both directly and indirectly.

3. PAs should provide only those services for which they are qualified via their education and/or experiences, and in accordance with all pertinent legal and regulatory processes.

4. PAs should respect the culture, values, beliefs, and expectations of the patients, local health care providers, and the local health care systems.

5. PAs should be aware of the role of the traditional healer and support a patient’s decision to utilize such care.

6. PAs should take responsibility for being familiar with, and adhering to the customs, laws, and regulations of the country where they will be providing services.

7. When applicable, PAs should identify and train local personnel who can assume the role of providing care and continuing the education process.

8. PA students require the same supervision abroad as they do domestically.

9. PAs should provide the best standards of care and strive to maintain quality abroad.

10. Sustainable programs that integrate local providers and supplies should be the goal.

11. PAs should assign medical tasks to nonmedical volunteers only when they have the competency and supervision needed for the tasks for which they are assigned.

[Adopted 2001, reaffirmed 2006, and amended 2011]

 

 

HUMM do I sense an attacking tone?

 

FYI - yes I identified myself as a PA

 

 

But after having gone overseas (poor 3rd world country) and seen and worked there let me tell you they could not give even the slightest bit about the name or initials after a name, but instead just that you are a medical professional and are going to care for them. sort of refreshing..... Heck if the Honduran gov't places their trust in me to care for their residents I feel a high standard to identify myself.

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To clarify, neither I or any of the 3 other American PAs who served with MSF had their MPHs BEFORE going to work for MSF; they came afterward.

.

sorry, thought you guys got the positions based on having an mph. so why then did they take you guys and not the other thousands of pa's who want to work for them?

as a side note to others here, there are MANY international and disaster organizations that will allow pa's to work with them. don't be discouraged because msf does not. they are just one kid on the block that is disaster medicine.

Dr. edward o'neil's book, A practical guide to global health service, lists 100 international organizations which use pa's and it is not a complete list. www.medicalmissions.org also lists hundreds of opportunities(512 slots when I checked today).

also contact http://www.kenyarelief.org they use pa's. I was in contact with them today in fact about a possible future trip.

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