What % of a doctor's knowledge do PA's have?

[Lemon Bars]

I realize that this is a rather crude question, so I apologize for that. But let's say a patient, or perhaps a friend or reporter asks you, "So, how much do you know compared to a doctor?"

 

What % of a doctor's knowledge and training does a PA have, generally speaking. I know it would depend on how many years of work and perhaps specialty, but in general what do you think and how might you answer that?

[TThielen]

There's no easy answer, even generally speaking.....it depends on the individual PA and the individual doctor. Some PA's are smarter and more knowledgable than doctors and vice versa, just a fact of life.

[Mordechai]

It's not something that can be quantified. A P.A. is exposed to the same information as a doctor, though often is a shorter span of time. It's all about what's absorbed in school and on the job. The PA that inspired me to pursue this line of work was one who clearly new more than the majority of physicians in her G.I. practice. Everyone knew it and the doctors went to her often for advice on many different topics. P.A.'s have the luxury of hopping from field to field and the nusence of having to rePANCE every 6/10 years. This can make for a very knowledgeable PA is a number of different specialties when a physician boards only once and really never needs to study anything again and is often limited to their field.

 

An example of this that I actually saw today. I had a friend who had been complaining of stomach pains for about two years now, ever since a botched hernia operation that nearly caused him to bleedout at home. He went to ER multiple times since and saw a local G.I. and was misdiagnosed each case. Almost all sent him home with PPI's. After seeing him recently I suggested he talk to the PA I mentioned a moment ago and she sent him for a second opinion but suggested gallstones. Today the results came back and it was gallstones. He has surgery set for next week. If I didn't suggest seeing her he would be in need of an opperation that the many doctors he saw were obli

[primadonna22274]

A PA is NOT exposed to the same info as a physician. Much of it, yes. There is quite a bit taught and tested in medical school that is never taught or expected of PAs.

I'm being polite, just so you know.

....

[Mordechai]

A PA is NOT exposed to the same info as a physician. Much of it, yes. There is quite a bit taught and tested in medical school that is never taught or expected of PAs.

I'm being polite, just so you know.

....

I would disagree based on what I know, but you may know more. What are MD's exposed to in their didactic phase that PA's are not? As far as what they are exposed to outside of school I don't think anyone can deny or prove one over the other as what anyone is exposed to is relative to their particular experiences.

[andersenpa]

This question is about as relevant as asking what percentage of knowledge one oncologist knows vs another oncologist, one general surgeon knows vs another, one PCP MD vs another, etc.

A PA is not exposed to the same info as a physician.

One PA is not exposed to the same info as another PA.

One physician is not exposed to the same info as another physician.

What we each exposed to is different than what/how we are tested and how we each further our postgraduate education.

 

Medical education, for the PA, MD, DO, etc, is so variable (much moreso on the clinical vs didactic) that it's hard to make apples-to-apples comparisons.

 

PAs are not trained like physicians. The closest comparison you may want to make is PA vs FP doc, since we are both trained as generalists in our field of medicine.

 

Given the compartmentalized feature of practice nowadays, the better question is how PA vs doc (vs NP) practice patterns compare- outcomes, referral frequency, prescription writing, costs of care, adherence to national practice standards, etc. That's what matters in 2013 and beyond.

[andersenpa]

I would disagree based on what I know, but you may know more. What are MD's exposed to in their didactic phase that PA's are not? As far as what they are exposed to outside of school I don't think anyone can deny or prove one over the other as what anyone is exposed to is relative to their particular experiences.

 

 

MD/DO education is of longer duration and greater depth in some areas.

You're chasing the wrong argument to claim equivalency in education when it's the other things mentioned in my post above that matter.

[primadonna22274]

Agree on all points with Andersen.

Too tired to state the same with his tact and brevity.

OP: do both, then we'll talk.

I just spent 40 minutes reviewing the histology of TEETH. Yes, teeth.

Day 1 of GI system, M2.

[bjl12]

Pointless thread/topic/question....so I decided to post? :;;D:

 

And to the OP: There are clearly differences between the two professions. This is evident in the enormous differences of education format (~1 year lecture plus ~1 year residency versus 2 year lecture and 2 year clinicals, THEN residency). Physicians endure ~twice the amount of schooling a PA does. Also, the national/accrediting exams are very different.

 

These factors suggest that while there is absolutely some overlap in subject matter and profession duties/function, there is also obviously some difference in terms of expertise. This should not be interpreted as "all physicians are more competent because of greater schooling". It's not that linear, I don't think.

 

As other posters contributed, there is likely some variance of efficacy between individuals and their respective job duties (hence why some physicians may ask a highly competent PA for advice and vice versa).

 

 

HOWEVER,

 

I am curious to know if there is any statistical research examining the occurrence of malpractice between the two professions. I.e., does one profession tend to "make mistakes" more than the other? Could this have something to do with the different educational models? That is, PA's typically have more clinical/hands-on experience within healthcare prior to even beginning their schooling, whereas it's probably less common with physicians.

Edited January 8, 2013 by bjl12

[Contrarian]

Kind of a ill formed question...

 

Why...??

 

Because learning doesn't (or at least shouldn't) start or stop in classrooms, only after tuition has been paid...

 

So if for a few yrs, in my spare time, my hobby is to read, and learn from all of ^^^ Primadonna's cast off histology, embryology, pathophysiology, etc... texts from Med school^^^, even though I'm still a PA and never attend a Physician training program... do I have that knowledge..???

Edited January 8, 2013 by Contrarian

[andersenpa]

....even though I'm still a PA and never attend a Physician training program... do I have that knowledge..???

 

 

Yes....85%, according to Medicare.

[Lemon Bars]

Agree on all points with Andersen.

Too tired to state the same with his tact and brevity.

OP: do both, then we'll talk.

I just spent 40 minutes reviewing the histology of TEETH. Yes, teeth.

Day 1 of GI system, M2.

 

 

The OP (me) is not claiming that PA's learn as much as MD's. I asked what percentage of MD knowledge PA's possess. 50%? And yes, I was thinking of the primary care PA compared to the family physician. I should have stated that from the beginning, though I guess the same question could be asked of a PA specializing in cardiology compared to a cardiologist MD.

[andersenpa]

The OP (me) is not claiming that PA's learn as much as MD's. I asked what percentage of MD knowledge PA's possess. 50%? And yes, I was thinking of the primary care PA compared to the family physician. I should have stated that from the beginning, though I guess the same question could be asked of a PA specializing in cardiology compared to a cardiologist MD.

 

Not really since the more subspecialized you get, thje further you migrate from the generlaist PA model. Even residency trained PAs are not close to docs who do residency/fellow in that field. The training programs are just light yrs apart. But at the PCP level it's alot closer.

Given that we have PCP PAs who carry their own pt panels, have great outcomes, no greater incidence of litigation relative to MDs, high satisfaction rates, etc, the applicable knowledge base (if you want to focus on that) is much higher than 50%.

 

Case in point, ask a PA w/ 5 yrs experience and a freshman PCP MD what they want to say about the histology of the teeth and you'll get similar answers.

[EMEDPA]

I think the better question is this:

what % of what a doc DOES can a pa do?

I think it is fair to say docs know a lot more than they need to to treat many of the conditions they treat. for example is there a big difference in how an ortho doc and an ortho pa treat an ankle sprain. ortho docs certainly know a lot more about ankles than pa's do down to the molecular level but is there a difference in tx?

I would argue a pa probably KNOWS 50% what a fresh ms4 recent grad/intern knows but can DO 80-90% of what they can before they have started residency. a lot of what the doc knows doesn't apply in most situations to the practice of clinical medicine.

[Contrarian]

Yes....85%, according to Medicare.

Ok...

 

So last I checked most of the PAs I've encountered were reasonably bright... so since we theoretically leave the program with 85% (excluding those "Quad-Quint" PANCE Takers"), then is it unreasonable to think that learning that last 15% is possible for those so inclined...???

[bjl12]

Ok...

 

So last I checked most of the PAs I've encountered were reasonably bright... so since we theoretically leave the program with 85% (excluding those "Quad-Quint" PANCE Takers"), then is it unreasonable to think that learning that last 15% is possible for those so inclined...???

 

If one were inclined and they really wanted to know, they could simply purchase the textbooks associated with a medical school. Why one would be inclined to do that I cannot say, as the realm of PA (I'm sure) has much, much, much to learn. And a PA would probably be better off honing their craft as opposed to trying to learn anothers. Just my 2 pennies.

[Contrarian]

ortho docs certainly know a lot more about ankles than pa's do down to the molecular level...

 

Again... here is where I see a problem.

 

This would be better worded as: "ortho docs were certainly taught a lot more about ankles right on down to the molecular level in their training programs than pa's were in theirs" ...

 

Stating that ALL ortho docs know more than ALL ortho PAs is unquantifiable... and patently false.

Edited January 8, 2013 by Contrarian

[Contrarian]

If one were inclined and they really wanted to know, they could simply purchase the textbooks associated with a medical school. Why one would be inclined to do that I cannot say, as the realm of PA (I'm sure) has much, much, much to learn. And a PA would probably be better off honing their craft as opposed to trying to learn anothers. Just my 2 pennies.

 

Spoken like someone with a lack of understanding...

 

The PAs "craft" is MEDICINE... so HOPEFULLY, that PA is spending a considerable amount of time YEARLY with their nose planted in a medical text " honing their craft"...

 

Just about ANY medical text is relevant to practice as a PA-C. I spend thousands of dollars a yr to LEARN about several different areas in medicine partially because I practice in several distinct specialties (IM/Psych/Addiction/Pain) and also because I just like to know WTF I'm talking about when people ask me questions.

 

Several times DAILY... I have discussions with patients and other Providers about the NiagralStriatal tract and dopamine receptor remodeling. Or about Seretonin/NorEpi/Glutamate/GABA Receptor plasticity. Or about the pathogenesis of Mu versus Delta versus Kappa receptors... Its all relevant.

 

 

For Clarity...

I am in NO way suggesting that what PA's are exposed to in school is equivalent to what physicians are typically exposed to in school.

 

What I'm saying is that there is NO super secret, special "physicians only" knowledge out there... its ALL in books somewhere.

 

All one has to do is have the DESIRE and capacity for understanding, open them, read and retain the info/knowledge.

 

Here is a PERFECT example of someone who knew more about a medical specialty than MOST physicians in and outside of that specialty he encountered.. but never attended medical school...

Edited January 8, 2013 by Contrarian

[andersenpa]

If one were inclined and they really wanted to know, they could simply purchase the textbooks associated with a medical school. Why one would be inclined to do that I cannot say, as the realm of PA (I'm sure) has much, much, much to learn. And a PA would probably be better off honing their craft as opposed to trying to learn anothers. Just my 2 pennies.

 

1.The "textbooks associated with medical school" are the same books used in PA school (Netter, Harrison, Cecil, Steadman, Bates, Guyton, Sabiston, etc....)

We both have to learn the same clinical medicine. The differences are what time and depth our programs put into underlying basic science (histo, embryo, level of patho, etc) and the time we have in clinical rotations.

 

2. We both are practicing the same craft- medicine. They're the same, not "MD Medicine" and "PA Medicine"....

[andersenpa]

Ok...

 

So last I checked most of the PAs I've encountered were reasonably bright... so since we theoretically leave the program with 85% (excluding those "Quad-Quint" PANCE Takers"), then is it unreasonable to think that learning that last 15% is possible for those so inclined...???

 

 

I guess on an average you could arrive at some number, but for some things it's 100% for both and some PAs learn far less than 50% of what the MS does.

 

But as we are getting at what matters is where the rubber meets the road and not the lofty cerebral heights of academia, no?

[KCMA79]

I realize that this is a rather crude question, so I apologize for that. But let's say a patient, or perhaps a friend or reporter asks you, "So, how much do you know compared to a doctor?"

 

What % of a doctor's knowledge and training does a PA have, generally speaking. I know it would depend on how many years of work and perhaps specialty, but in general what do you think and how might you answer that?

 

It's an apples and oranges comparison with no ans. I am not a physician or some sort of mini physician and while I may do many of the things physicians do I am a PA. PAs who start thinking they are some sort of physician are in dangerous terr.

[discogenic]

Kind of a ill formed question...

 

Why...??

 

Because learning doesn't (or at least shouldn't) start or stop in classrooms, only after tuition has been paid...

 

So if for a few yrs, in my spare time, my hobby is to read, and learn from all of ^^^ Primadonna's cast off texts from Med school^^^, even though I'm still a PA and never attend a Physician training program... do I have that knowledge..???

 

Ok...

 

So last I checked most of the PAs I've encountered were reasonably bright... so since we theoretically leave the program with 85% (excluding those "Quad-Quint" PANCE Takers"), then is it unreasonable to think that learning that last 15% is possible for those so inclined...???

 

Not to overthink a question without a real answer, but using your reasoning we'd have to consider that the MD's knowledge will also continue to expand along with that of the PA; therefore that theoretical equivalence (the last 15%, in this case) is a moving target that may never be reached.

[Contrarian]

Not to overthink a question without a real answer, but using your reasoning we'd have to consider that the MD's knowledge will also continue to expand along with that of the PA; therefore that theoretical equivalence (the last 15%, in this case) is a moving target that may never be reached.

 

If there is only 100%... how could it move...??

100 questions on a test. 100 correct answers..

How does little johnney make a 125%... ????

 

100 questions on a test with 100 correct answers.

The Physician answers 100 questions correctly.

The PA-C answers 85 questions correctly.

 

The PA-C studies on his own time and learns the answers to the last 15 questions.

The Physician already knew the answers to all 100 questions so whats to study...???

 

But to respond directly to the "unanswerable question" posed by the unanswerable question...

 

If that were possible, then Yes... it would expand IF the physician was so inclined to continue to expand it...

They usually do expand it... to a point... but only in a specific specialized area.

 

When I practiced Cardiology as a new grad... those Cardiologists devoured every pice of knowldge they could ABOUT THE HEART... and the trend was obvious in that as they got older and more established, they lost a lot of their general internal medicine knowledge/skills.

 

Same in Rheum... devoured every piece of knowledge they could ABOUT Rheum... Primary Care stuff... not so much.

 

Same in Psych, same in Addiction Med, obviously same in Ortho and the other popular subspecialties. Not so much in Surgery since they use a lot of that info in post surgical management.

 

I've been around the block a time or two or three... and have met PLENTY of physicians (and PAs/NPs) that I wouldn't allow to un-package a ban-aid. I've also met brilliant physicians and PAs. I regularly interact with some particularly bright Surgical PA-Cs who run circles around the average non surgical MDs/DOs in the Acute/Chronic/Emergent patient management realm.

 

So theoretically.... a Specialty PA-C 18yrs post school could know ALOT more about medicine in general than a Physician in that same specialty 18yrs post school.

 

Why...??? Because most older docs I know have forgotten most, not all, of the stuff PRIOR to MS3... and settled into their specialty. Whereas the PA-C has had to, by default (PANRE) revisit much of the general medicine stuff long forgotten by most not considered Primary Care atleast 3 times in 18yrs... AND have indepth knowledge in whatever specialty they are working in... AND probably whatever specialty they worked in before that one.

Edited January 8, 2013 by Contrarian

[discogenic]

Why...??? Because most older docs I know have forgotten most, not all, of the stuff PRIOR to MS3... and settled into their specialty. Whereas the PA-C has had to, by default (PANRE) revisit much of the general medicine stuff long forgotten by most not considered Primary Care atleast 3 times in 18yrs... AND have indepth knowledge in whatever specialty they are working in... AND probably whatever specialty they worked in before that one.

 

Not to change the subject abruptly, but is the PANRE generally seen by PAs to be a good thing (revisit, stay up on things) or an unnecessary pain in the butt? I've seen some comments along the lines of the latter, particularly when the topic of comparing PA to NP comes up, so I'm not sure where the majority of PAs stand on PANRE.

[Contrarian]

Typically considered a nuisance that must be tolerated.

Regardless... it must be taken by most if they want to retain their licensure and marketability and flexibility.

Most whine about it but breeze throught it with a week or two of dedicated and diligent study time.

 

The benefit is that a PA who has been in practice 7, 13, 19 yrs in ANY specialty/sub specialty/sub-sub specialty has proven that they know as much up to date and current general medicine (Family Practice) as a bright and fresh new grad... but has the adbvantage of experience to back it up.