"so, you are going to be a doctor?"

[Guest lisnek]

This comes up alot as I am introduced as the new Physician Assistant to our patients (often, I am introduced as "our new Physician's Assistant " which drives me insane). The patient either asks: so you are going to be a doctor or you are a doctor? or when will you become a doctor or what school are you attending.... the list goes ON. i esp like the, "now what is it that you do? i didn't know the doctor needed an assistant."

 

Being a new grad, as well as new PA - how do I answer that in a concise way that educates the patient? I mean a one or two liner explanation. They always look at me like they don't know what the h_ll i really do even after I try to explain. I am a Urology PA mainly in OR setting but I have been training for the last 2 mos in both the clinic and OR.

 

Any advice? I feel like people rarely know what a PA does in the Pacific NW or even CA for that matter...It is very frustrating!

 

Thanks:eek:

[Guest al3747]

I'm experiencing similar issues, but in family med in MN/WI... any suggestions?

[Guest tmarkie]

I agree that Californians as a whole are a bit behind the times as far as the PA profession goes, but I have seen a definite improvement in this over the past 7 yrs that I've been back in California, (however I still refer to this state as the last frontier). I believe we have had a thread on this subject in the not too distant past, but for me, my answer to those patients depends on the amount of time I have to educate them.

 

My quick answer (albeit not real popular with some PA colleagues) is "Do you know what a NP is?" (The answer is usually yes - thanks to a strong nursing lobby unlike ours - but I digress). I then just say "we are like an NP" This usually gets a resounding "OH".

 

If I have more time, I'll get into the differences between the two, but with this I've at least dispelled the notion that we are the same as other "Assistants".:rolleyes:

[jer_sd]

About 2 months ago a patient was impressed with the care I gave him.... so he asked why I dont go to school to be a PA or a MD. So there are some people in california who know about PAs but not NPs.

Jeremy

[jmj11]

I agree that Californians as a whole are a bit behind the times as far as the PA profession goes, but I have seen a definite improvement in this over the past 7 yrs that I've been back in California, (however I still refer to this state as the last frontier). I believe we have had a thread on this subject in the not too distant past, but for me, my answer to those patients depends on the amount of time I have to educate them.

 

My quick answer (albeit not real popular with some PA colleagues) is "Do you know what a NP is?" (The answer is usually yes - thanks to a strong nursing lobby unlike ours - but I digress). I then just say "we are like an NP" This usually gets a resounding "OH".

 

If I have more time, I'll get into the differences between the two, but with this I've at least dispelled the notion that we are the same as other "Assistants".:rolleyes:

 

I must, unfortunely, admit that I do the same. The patient almost always knows exactly what an NP is. One time I said that to a patient (a man) and his wife (who was an RN) became very angry and scream . . . "That's a pile of crap. A PA is nothing like an NP. An NP has a nursing degree then a masters while a PA has a few months of vocational school after highschool." I had the opportunity to educate both of them about the profession.

 

So, welcome to the club. Most of us have been explaining the PA concept to every new patient for 20+ years. The only time I didn't have to explain was when I was in the Air Force. There, everyone seemed to know what I did for a living.

 

Mike

[EMEDPA]

"My quick answer (albeit not real popular with some PA colleagues) is "Do you know what a NP is?" (The answer is usually yes - thanks to a strong nursing lobby unlike ours - but I digress). I then just say "we are like an NP" This usually gets a resounding "OH"."

 

I have used this as well but then I say" I was a paramedic instead of a nurse and I also have a degree in medical anthropology and a masters in clinical emergency medicine. I also did 3 times the clinical hrs of any np program, more like the 3rd or 4th yr of medschool".

patient: "oh so pa's are more like doctors?"

me: "yes."

[JenGintheED]

As a student I told people that our education was the same as medical shcool except not quite so much detail, that we got a master's degree instead of a doctoral degree, and that after graduating we work in partnership with doctors. People seemed to understand that, and have respect for the position.

[ToppDog]

Although I'm not a PA yet, I still get asked a lot by patients what PA's & NP's are, & how they are different from doctors. I usually tell them that PA's & NP's are healthcare professionals that have taken a two-year course to enable them to "practice medicine" in a similar manner as a physician, but not to the same degree or scope.

 

When asked the difference between an NP & a PA, I usually say that while the training is somewhat different between the two, they often qualify for the same jobs & get paid about the same when working for an employer of any specialty... & that the main differences are that NP's are typically able to start their own practices without physician supervision if they wish, but are often limited to the variety of specialties they can practice in; while PA's technically always work under the umbrella of physician supervision, but have virtually no limitations on the medical specialties they can work in.

[Guest lisnek]

Thanks BUT we still aren't answering: "What is it that you do? Oh, you assist the doctor...." (and in the OR, I do)

 

What is a concise explanation of the PA role - I know, I know. I should no this "by heart" (lol) but I am still developing my answer.

 

Please help.

 

 

THANK YOU!

 

yippeeeeeeee - finally credentialed!

 

lk

[Guest lisnek]

As a student I told people that our education was the same as medical shcool except not quite so much detail, that we got a master's degree instead of a doctoral degree, and that after graduating we work in partnership with doctors. People seemed to understand that, and have respect for the position.

 

I like that the best. Nice answer. You always have good things to add!;)

 

lk

[themadmedic]

Similar to E, mention that I started in the military as a medic.

 

As for what we do, mention that we practice medicine, but since we don't go through the whole course of medschool and residency have a physician that we can consult for back-up...then go on to say that I manage patient's nonsurgical, preop and post op care and assist in the OR.

 

When asked about PA vs. NP, I tend to use the MD vs DO comparison that has been mentioned here before...

[EMEDPA]

"When asked about PA vs. NP, I tend to use the MD vs DO comparison that has been mentioned here before..."

 

 

md's and do's have equivalent clinical training though, so not really a good comparison.....

[JenGintheED]

I like that the best. Nice answer. You always have good things to add!;)

 

lk

 

Thanks, lis... but I remembered later that we don't all have master's. And I'm actually one that supports the multiple pathway thing... duh. :rolleyes:

[caldje]

I usually use the "6 semesters to become a PA" and "8 semesters to become a doc" instead of giving the years because the years we are in school is not an acurate representation since we go year round and medical schools gets tons of time off to pursue personal interests. I also don't think its acurate to say that NPs can work without docs. That is by far, by percentage, not the truth. There are a few low population states where NPs can work without a doc but only after a doc agrees they should be allowed to and with established protocols and referal arrangements. Its just not accurate to say they are "independent." Although the rhetoric of their laws leans more towards it than ours usually do the end result is very similar if not looked at through rose colored nursing glasses.

 

chris

[Moonwalk]

I've encountered this question many times.

 

I usually answer that I intend to continue working as a Physician Assistant. Then I explain that PA training is like 3 years of medical school rolled into 2 calendar years and that upon graduation a PA practices medicine under physician supervision indefinitely, whereas a physician must first complete an internship and residency and then will practice medicine independently.

 

When asked about NP's, I explain that NP's are first registered nurses who then complete additional training as a nurse practitioner. Although I was never an RN, I always make mention of the fact that most physicians were never RN's either.

[JeffPA]

I usually start out saying that I have a medical background (I use the semester comparison too, though I say 7 semesters of PA school to 10 semesters of medical school). I then go on to say we are trained the same way to treat the more common medical problems in our area, but the docs generally handle the more rare problems and it's my job to make sure they (the patient) get the attention they need (My practice had a 6 week backlog before I started, now its generally a 1-2 day wait to see me. When you explain that you are the reason they did not have to wait 6 weeks to see someone, they generally soften up a bit :) )I explain that I can write Rx, refill meds and order the same tests the docs do. I try to explain that I collaborate with my docs (I like that word collaborate, I try to use it a lot) and I'm pretty upfront that if there is anything I am uncomfortable with, I will make them an appointment with the doc ASAP. Unfortunately 8/10 times I have to resort to "have you ever heard of a nurse practioner...." then the lightbulb goes on. I feel a little dirty every time I do it, like I'm shaming our profession. But I do emphasize that while NPs and I both have masters degree, I speant over 2000 hrs in clinical training and they usually do 400-500 hours. At this point the patient is usually so tired of me talking they just nod and say OK, hoping I will shut up:)

[andersenpa]

I never get asked this question. I say who I am, that I work with their surgeon, and that's the end of it. Perhaps being in a surgical specialty, the patients see what I do, hands on every day, so there's no confusion as to the role. We practice medicine. We take care of them.

 

Although the training is different, we practice the same medicine the docs do- except in the decision to operate and the technical duties in the OR- different. To say we practice medicine to a lesser or similar degree is misinformation; it's the same!

[ToppDog]

...except in the decision to operate and the technical duties in the OR...

 

To say we practice medicine to a lesser or similar degree is misinformation; it's the same!

 

You contradict the above statement with your own quote directly above that one. While I don't think using the word "lesser" is a good idea, using "similar" is quite on the mark, & is a good concise explanation, which is what most patients want. Anything else will typically result in a glazed over look. Whether PA's practice medicine the same or not is dependant on many factors, and any slight exceptions, like the one above, change the definition of practice from being the "same" to being "similar" from the patients point of view.

[Guest JDM ER PA]

This comes up alot as I am introduced as the new Physician Assistant to our patients (often, I am introduced as "our new Physician's Assistant " which drives me insane). The patient either asks: so you are going to be a doctor or you are a doctor? or when will you become a doctor or what school are you attending.... the list goes ON. i esp like the, "now what is it that you do? i didn't know the doctor needed an assistant."

 

Being a new grad, as well as new PA - how do I answer that in a concise way that educates the patient? I mean a one or two liner explanation. They always look at me like they don't know what the h_ll i really do even after I try to explain. I am a Urology PA mainly in OR setting but I have been training for the last 2 mos in both the clinic and OR.

 

Any advice? I feel like people rarely know what a PA does in the Pacific NW or even CA for that matter...It is very frustrating!

 

Thanks:eek:

 

 

I find this situation as the prime time to educate our patients.

 

For those that don't understand, I have basically a pre-scripted "Mid level practitioner" speech in my head.

 

The way I explain it, is much how our profession began - we filled the voids that medical residents were not filling in primary care.

 

So instead of saying "we're like NPs", I say "we are like medical residents; we work independently for the most part, but are supervised by our attending physician" And for those that are interested, I explain the differences in the training in the medical model versus the nursing model, and give a brief history of the profession.

 

I have found some people "just don't get it". It doesn't matter age, race, gender, etc... some people in all facets of life just don't understand no matter how much you explain. The problem is that the "assistant" word generally throws people off, especially with the field of "medical assisting", so patient's may become concerned/confused. Some places have even used the term "Physician Associate" which still does not solve any problems.

 

Bottom line, explain it the best you can - I generally explain more towards a Medical Resident/Intern then I do an NP as it is easier to explain the medical model then the nursing one; and if they don't understand, you can always send them to aapa.org for more info so they can be an "educated patient".

[Guest natetalia2002]

My respond: I do the same as the doctor but under his supervision. This goes well for internal medicine..I am in Florida and I found that I have not been asked that question alot.

 

The truth is PA practice within the scope of the Doc but under his/her supervision.

 

The docs do not introduce me to the pts I enter the room, introduce myself then jump straight to business...of course with a smile and confidence !

[Guest docmartin]

I usually use the "6 semesters to become a PA" and "8 semesters to become a doc" instead of giving the years because the years we are in school is not an acurate representation since we go year round and medical schools gets tons of time off to pursue personal interests.

 

That is not an accurate representation. Residency is REQUIRED to be a doctor. You wont find a single doctor practicing that has not completed a residency. REsidencies are optional for PAs.

 

So its really 2 years for PA, minimum of 7 years for doctors. You cant really argue that residency does not count because its REQUIRED training in order to get a job as a doctor.

 

As for the difference in time off for PA school vs med school, i disagree that med student get "tons of time off" to do whatever they want. Yes, they have more free blocks than PA students. Med students generally get the summer between M1 and M2 off, however the rest of their summers are full time schooling. Most M4s take about 2 months off to go on interview trips, but the rest of the time they are doing electives which are full time clinical work, or some others choose to do research electives. Either way you dont see med students just hanging out doinng nothing. They are either doing research electives, clinical electives, or on the interview trail for residency.

 

Even in the summer between M1 and M2 which med students technically have "off" the vast majority choose to work on research or do clinical electives.

 

PA students schedules are more structured than med students, but you are mistaken in assuming that it means they are working more or harder than med students.

 

I also don't think its acurate to say that NPs can work without docs. That is by far, by percentage, not the truth. There are a few low population states where NPs can work without a doc but only after a doc agrees they should be allowed to and with established protocols and referal arrangements. Its just not accurate to say they are "independent." Although the rhetoric of their laws leans more towards it than ours usually do the end result is very similar if not looked at through rose colored nursing glasses.

 

Well i agree that 90% of NPs work in "collaboration" with doctors. However, its not true to say that they CANT work independently, because nursing state regs clearly state that6 they can, and there are no state laws overruling that. The bottom line is that most NPs CHOOSE to collaborate with doctors because its much easier to get a job that way than by choosing to open up your own clinic. But thats true for doctors too. The vast majority of doctors join a group practice, they dont open up their own clinics because in this economy its hard to do that.

 

If an NP wants to, there is really nothing stopping them from independent practice. But most of them CHOOSE not to do it because of the hassles/financial uncertainty of opening up a solo practice.

[andersenpa]

You contradict the above statement with your own quote directly above that one. While I don't think using the word "lesser" is a good idea, using "similar" is quite on the mark, & is a good concise explanation, which is what most patients want. Anything else will typically result in a glazed over look. Whether PA's practice medicine the same or not is dependant on many factors, and any slight exceptions, like the one above, change the definition of practice from being the "same" to being "similar" from the patients point of view.

 

Hence the word except, as there are clear exceptions in every field that define differences in duties. The use of similar or lesser implies a global difference in 1) the medical services rendered 2) the knowledge base used to do so. The regular contributers to this forum include a headache specialist, an veteran ER PA, a pain specialist....I don't want to speak for them, but their level of competence likely exceeds many physicians in their respective fields. Are they practicing "similar" medicine based on the letter after their name, or are they practicing the same medicine physicians do? And that doesn't even mention the remote/rural folks who are truly flying solo....

 

Don't get me wrong, I'm not implying total independence- I just think it's selling the profession short to look at the competent, expert patient care PAs provide and not call it as it is- the practice of medicine, no different than MDs in the majority of cases (again, not all).....

[andersenpa]

I find this situation as the prime time to educate our patients.

 

For those that don't understand, I have basically a pre-scripted "Mid level practitioner" speech in my head.

 

The way I explain it, is much how our profession began - we filled the voids that medical residents were not filling in primary care.

 

So instead of saying "we're like NPs", I say "we are like medical residents; we work independently for the most part, but are supervised by our attending physician" And for those that are interested, I explain the differences in the training in the medical model versus the nursing model, and give a brief history of the profession.

 

I have found some people "just don't get it". It doesn't matter age, race, gender, etc... some people in all facets of life just don't understand no matter how much you explain. The problem is that the "assistant" word generally throws people off, especially with the field of "medical assisting", so patient's may become concerned/confused. Some places have even used the term "Physician Associate" which still does not solve any problems.

 

Bottom line, explain it the best you can - I generally explain more towards a Medical Resident/Intern then I do an NP as it is easier to explain the medical model then the nursing one; and if they don't understand, you can always send them to aapa.org for more info so they can be an "educated patient".

 

See my above post, but the comparison to residents is also compromising the perception of PAs. Our training is complete, and we exhibit far more autonomy....

 

I agree that "assistant" is not a helpful part of the title; even "supervision" leaves a bad taste in many people's mouths. The well-honed PA-SP relationship is much more nuanced than that....

[caldje]

I dont know where to start here.

 

1st. I know very well that a residency is required and also know very well that most PAs in the work force also have extended clinical experience like residency offers. The fact is, though, to get the degree and MD does not have to go through residency. There are jobs out there for MDs who don't have residencies. Yes, many MDs choose to do things in between their required schooling times but that is their choice and exactly what I meant by "pursue personal interests." They are NOT, however, required to be in structured medical training at that time. The fourth year? I won't even get into the forth year. It has been the best year of all of my friend's lives who went to medical school. Mostly because it is fun and easy. and by the way, I NEVER said PA students are working harder than medical students. please dont put words in my mouth.

 

I am glad you agree "90%" of NPs dont practice independently. Now when are you going to agree about the other 9%. Why do NPs CHOOSE to practice collaboratively when the salary figures show that NPs in private practice make much more money. Why do you lump all states together? In my state the laws are very clear that NPs are not independent and that is the way it is in MOST states. I have personally read the BONs laws in the states that do allow "independence" and every single one of those states has stipulations that include a physician's approval, consultation, and mentoring. There are PLENTY of things stopping them from being independent. plenty.

 

chris

 

 

That is not an accurate representation. Residency is REQUIRED to be a doctor. You wont find a single doctor practicing that has not completed a residency. REsidencies are optional for PAs.

 

So its really 2 years for PA, minimum of 7 years for doctors. You cant really argue that residency does not count because its REQUIRED training in order to get a job as a doctor.

 

As for the difference in time off for PA school vs med school, i disagree that med student get "tons of time off" to do whatever they want. Yes, they have more free blocks than PA students. Med students generally get the summer between M1 and M2 off, however the rest of their summers are full time schooling. Most M4s take about 2 months off to go on interview trips, but the rest of the time they are doing electives which are full time clinical work, or some others choose to do research electives. Either way you dont see med students just hanging out doinng nothing. They are either doing research electives, clinical electives, or on the interview trail for residency.

 

Even in the summer between M1 and M2 which med students technically have "off" the vast majority choose to work on research or do clinical electives.

 

PA students schedules are more structured than med students, but you are mistaken in assuming that it means they are working more or harder than med students.

 

 

 

Well i agree that 90% of NPs work in "collaboration" with doctors. However, its not true to say that they CANT work independently, because nursing state regs clearly state that6 they can, and there are no state laws overruling that. The bottom line is that most NPs CHOOSE to collaborate with doctors because its much easier to get a job that way than by choosing to open up your own clinic. But thats true for doctors too. The vast majority of doctors join a group practice, they dont open up their own clinics because in this economy its hard to do that.

 

If an NP wants to, there is really nothing stopping them from independent practice. But most of them CHOOSE not to do it because of the hassles/financial uncertainty of opening up a solo practice.

[Guest JDM ER PA]

See my above post, but the comparison to residents is also compromising the perception of PAs. Our training is complete, and we exhibit far more autonomy....

 

I agree that "assistant" is not a helpful part of the title; even "supervision" leaves a bad taste in many people's mouths. The well-honed PA-SP relationship is much more nuanced than that....

 

 

I understand, and we all understand... but it's so hard to get patients to understand that I even wish that there was some sort of "universal" pamphlet that we can hand out to identify our role in healthcare.

 

Again, I use the medical resident as an easy analogy because I feel that a resident is equivalent to a mid level practitioner until they graduate to attending. Of course there are senior and chief residents that may know more then some attending physicians, but that doesn't mean their role is any different, they still have to report to, and have an attending physician have the final say... where I see the same as a PA - even though after years of seasoning we can be more knowledgeable then Physicians, it still doesn't negate the fact that we are still mid-level practitioners regardless of our extensive training in a particular field.

 

So although after years of experience we develop a sense of autonomy and a respect from seasoned attendings, it doesn't make us autonomous - they still need to agree with out decisions.