Specialty CAQs- Thoughts?

[nhpilot]

Plus, if you compare the education/expectations of a board certified EM physician to an EM CAQ PA, I think the differences are still pretty vast. Bottom line is they know a lot more than we do.

 

I have to agree with Boatswain2PA on this one....

 

I worked with many surgeons in the Navy who used to be Navy pilots, then went to med school. When I asked one of them why there were so many former pilots in the OR, he said, "Simple...Navy pilots and surgeons both think they are God."

 

Point being...they went to medical school and I didn't...I will always assume they know more than I.

 

NP's on the other hand...:;;D:

[EMEDPA]

I'm not sure I agree with this. While I certainly don't claim to have the "big picture", it seems like the majority of the EM PAs that I talked to at SEMPA do a lot of fast track, or they see the lesser-acuity patients in the ER while the Doc's take the "sicker" patients. This is also what I experienced during my preceptorship at the biggest ER in the region. The PA/NPs ran fast track, and when working in the main EDs they handled the greens. If they took any yellows they had to be checked out by the attending.

 

I know of some ED's where the Doc's and PAs just alternate patients, but I think that is actually pretty rare if you are multi-coverage.

 

Plus, if you compare the education/expectations of a board certified EM physician to an EM CAQ PA, I think the differences are still pretty vast. Bottom line is they know a lot more than we do.

working solo boatswain, you and I and kargiver are all held to the same standard as an emergency physician if a real disaster comes in...I agree we aren't trained the same way but we are responsible for the same procedures and interventions and expected not to miss the same things...that is why it is to our advantage to get as much training as we can....

[EMEDPA]

I already have my residency program picked out for when I graduate from my PA program. To me the surgical residency at Norwalk Hospital is unparalleled and is the gold standard for PA residency programs. NO medical residents...no fighting for cases....the floors are staffed and run by PA's. My dream environment.

.

you can't go wrong with norwalk. buddy of mine did the residency there and was for an intents and purposes an md pgy-1 surgical intern. after he finished he stayed on as chief of the icu service there for a while....he has worked in cv, ortho, neuro, spine, and general surgery sice then and 2 years ago made the switch to full time EM for schedule purposes(he wanted days off with no call....)

[kargiver]

Doing the same job doesn't mean having the same prep to do the job. We are all held to the same exact gold standard when it comes to EM (or any branch of medicine for that matter). Ask any PA involved with a lawsuit. We may think we get to pass the buck - but we don't.

 

I do agree, not all EM PAs have the same scope of practice as the PAs working solo in rural area, but that isn't the point. Working in a FT environment you have to know what is sick vs. not sick, when to boot em to the main side, when you can street them, all at the same time as moving the meat. If that doesn't mean people who do this well don't have a similar knowledge base as our physician colleagues, then frankly, we are sunk as a profession.

 

Where I work, my doc is available by phone only. I see him when he comes in to do admin work. I work in a PA-only ER seeing about 20K visits a year. We do it all. I have to function at the highest level possible as a PA and that is EXACTLY what I do. I realize PAdom cannot be brought up to the level where we are doing what all of the other docs are doing - what would be the point of med school then - but at a minimum, we are expected to practice gold-standard medicine in whatever vain we practice. That means knowing as much as the docs - at least when it comes to treating patients clinically.

 

G

[kargiver]

3GeronimoPA,

 

First off - thank you for your service.

 

Second, nothing that is being implemented is designed to replace OJT. On the contrary, there are other factors at play that haven't "made it to stage" yet to augment what is going in fellowship land. There will always be those who can transition while doing the OJT and making the best of it. Unfortunately, what we are seeing, quite clearly I might add, is a large, organic movement towards residencies in EM as no hospital or group wants to hire youngins without experience and none of them can get experience without training. This is a driving impetus for the evolution that is occurring. Long gone are the days of military medics and RNs making up the majority of PA classed. They are all young, inexperienced, but some have the personality for wanting to do EM. This is the evolution of that very thing. After reviewing several thousand apps over the last several years at 3 schools (Ivy to local), this seems to be an inescapable truth.

 

So we can either define it and shape it, or let those who wish to take advantage of us for their own personal and fiscal gain define the reality of how we work. I'd rather define it myself. And I am. Along with several of my colleagues.

 

G