What do you think about Physician Assistants?

flightnurse2b, LPN · Oct 26, 2008

ive worked with several PA's in the ED and they have all been wonderful. they are knowledgeable and thorough and spend alot more time at the bedside acually listening and assessing. none of the ones i worked with have ever had the god-complex like some doctors tend to get and have been totally down to earth. they definately know their stuff too..ive seen a PA pick something up on a CT scan that a radiologist missed.

i recently saw a PA when i had an asthma attack and she was awesome. she even gave me her direct #, because my physician was unavailable, and told me to call if i ever needed anything.

core0 · Oct 26, 2008

thanks for all your replies and clearing this up for me. i wasn't trying to say in the least that they weren't needed (i have this compex about being misunderstood:) ) it sounds like we need more of them.
the career sounds very interesting and i am very happy for my sister. when she just couldn't decide what she wanted to do, i had suggested she go with me to nursing school-well i'm glad she waited and has now found something she wants to do.
thanks so much again!

in response to your original question, i like them but i'm biased:rolleyes:. if your sister is interested in the profession, i would recommend she check out the aapa website:

http://www.aapa.org/geninfo1.html

and the pa forum (our equivalent of allnurses):

http://www.physicianassistantforum.com/forums/index.php

from my point of view its a great profession. we take care of patients. i don't worry about running the practice, policy manuals or whatever the local politics are. i practice medicine and take care of patients.

now in the interest of correcting a few misconceptions:

snip
the pa was something that the medical community came up with in response to advanced practice nurses. if you look into pa training programs you will see that they are accredited by medical boards or the ama.

we have our own accrediting commission for pa programs the arc-pa as well as our own independent certification agency nccpa. pas are licensed under the board of medicine.

as for how the profession developed, the pa profession actually preceded the np program at university of colorado by a year. dr. stead gives dr. silver and dr. ford credit for proving that a non-physician provider would be welcomed by regulatory agencies. the reality is the first attempt to develop the pa was with rns. however this was rejected by the nursing community. instead he turned to navy corpsman for the first pas. so the pa is a response to organized nursing just not in the way that you imagine. interestingly dr. stead also developed the first cns program, however it was rejected for accredidation by the nln. for more on pa history please see:

http://www.pahx.org/index.htm

the timeline is especially informative.

one aspect you might want to consider is the ability to transfer a pa license to other states. several years ago a friend of mine was a great pa in arizona for years. after the kids grew up and flew the coup, they moved to florida. she was told she was ineligible to apply for pa as their requirements were different and they wanted her to complete 2 more years of school!!! so they moved to another state. you might want to check the reciprocity of licenses as a pa.
i don't think this is such of a problem if you are a nurse practitioner.

florida has some of the more backward pa (and np) regulation in the country. in general any masters prepared pa graduate will be able to work anywhere in the country. those pas without a masters will not be able to work in three states and those without a bachelors cannot work in additional four states. this is not too different than non-masters prepared nps.

david carpenter, pa-c

HeartsOpenWide, RN · Oct 26, 2008

before nursing school I worked as an CMA in a family practice and have worked with three different PAs; one who also did hospital work. My friend just graduated for UC Davis with her PA certification and will be taking her exam to be licensed in November. She went this rout vs going to nursing school for four years plus two years for her FNP because she could go to PA school for two years and essentially do the same things...Honestly, working with them in the office setting I could not tell them apart from the NPs...except I knew their charts had to be signed off by an MD.

I do however wonder what is going to happen to PAs in 2015 when ANPs are required to become DNP...I know many PAs out there that just have their AS degree plus their PA certification (like my friend)...the pre-req requirement for PA and NP is already vast (an AS degree plus pre-reqs resulting in a minimum of a certification vs a BSN/BS+RN plus pre-reqs resulting in a masters degree)...

core0 · Oct 27, 2008

before nursing school I worked as an CMA in a family practice and have worked with three different PAs; one who also did hospital work. My friend just graduated for UC Davis with her PA certification and will be taking her exam to be licensed in November. She went this rout vs going to nursing school for four years plus two years for her FNP because she could go to PA school for two years and essentially do the same things...Honestly, working with them in the office setting I could not tell them apart from the NPs...except I knew their charts had to be signed off by an MD.
I do however wonder what is going to happen to PAs in 2015 when ANPs are required to become DNP...I know many PAs out there that just have their AS degree plus their PA certification (like my friend)...the pre-req requirement for PA and NP is already vast (an AS degree plus pre-reqs resulting in a minimum of a certification vs a BSN/BS+RN plus pre-reqs resulting in a masters degree)...

You can find some discussion on this in the NP forum under the DNP sticky. Hopefully from a PA point of view it won't affect us. The move to masters has affected us slightly with three states now requiring masters. However, for the most part PA education and certification remains competency based. There is a dedicated cycle among the certification, program accreditation, and educational agencies to identify necessary competencies for PAs. These are then validated by PAs in the field.

The PA profession recognizes that PA education is at a graduate level, however, the accrediting agencies recognize that local communities are best able to determine the educational resources for the community. While there not very many certificate or associates programs left, they provide a disproportionate share of PAs to rural and underserved areas. These communities may not have a masters granting institution but still are able to support a PA program.

David Carpenter, PA-C

PageRespiratory! · Oct 27, 2008

...........There is a wonderful PA that posts here every now and then, I can't remember his name, but, I love his insights. He is so informative and is a wonderful addition to our site.

See above posts. As usual, David sets 'em straight!

I'd like to add that I've worked with so many PA's over the years I've lost count, and I've never met one that wasn't masters prepared.

pattymac · Oct 27, 2008

We have tons of them here and I have to say that I like them a lot. They are very knowledgeable and they work really hard. I don't feel they get the respect they deserve. It's the NP's that seem to be rude and arrogant. The PA's seem to work harder with less respect. They do the "grunt work" here too. Anyway, just my 2 cents. :twocents:

SunnyAndrsn · Oct 27, 2008

they do more than just that. in order to be able to write a 'script, they need to exam a pt and assess them, have accurate data. they are making medical dx.

just like mds, rns, lpns, cmas, and np's, i've met great ones, and not so great ones.

i do recall that there are some limitations on what pas can prescribe, we had a foster child who took methadone r/t pain from 3rd degree burns, and he could not renew that 'script. an md had to do that.

but he managed his other non-burn related care. this particular pa is my best friend's primary hcp.

excuse me if i posted this in the wrong area-but i was just curious as to what you all thought of p.a's from a nurse's point of view?
my sister, who is 10 years younger than i am, told me that she is going for that. i heard of it before and just finished researching it, but i can't say that i have ever come across one in the hospitals or offices.
i am happy for her because she had been having such a time deciding what she wanted to do. when i suggested that she go to nursing school with me, she kinda scoffed and said that she wanted to feel like she was doing more o_o i mean no offense to p.a's but from what i read the only real difference i see between them and nurses is that they can write prescriptions. please correct me if i'm wrong. please pardon my ignorance-not trying to be funny or offend-really.
just wanted to hear from some nurses who knew more about them first hand.
tia!

OgopogoLPN, LPN, RN · Oct 27, 2008

I'm in Canada and we don't have PA's.

What is the educational difference between a PA and an MD?

What are they referred as? Doctor?

And what is the main difference between a PA and an MD?

core0 · Oct 28, 2008

I'm in Canada and we don't have PA's.
What is the educational difference between a PA and an MD?
What are they referred as? Doctor?
And what is the main difference between a PA and an MD?

You do have PAs you just probably haven't met them yet. The Canadian Military has been using PAs for many years. There are US PAs working in Alberta and Ontario that I know of and probably more provinces. Here is a recent press release:

http://www.caopa.net/documents/CMA-Oct2008.pdf

Here is the CAPA website:

http://www.caopa.net/

As far as education the pre-requisites are roughly the same. 1-2 years of chemistry, A&P biology etc. Most PA schools currently also require a bachelors (although bachelors, associates and certificate programs exist). PA school is generally one year of full time didactic training (around 1400 hours on the average) and one year of clinical training in a variety of setting (around 2100 hours on the average). Medical school is four years with the first two being didactic and the second two being clinical. The closest comparison of PA education with medical school is probably the second and third years of medical school. The physician gets much more in depth training in A&P, biochemistry and other basic sciences. The physician then goes on to residency which lasts 3 to 7 years (and may be followed further by a fellowship).

One of the best explanations that I have seen was posted on SDN by a PA that went on to medical school. In essence PAs have focused training as clinicians with broad medical training that allows them to function with the supervision of a physician after graduation. Physicians are trained as physicians in medical school and then undergo clinical training in residency that allows them to function as a clinician within their specialty.

As to how we are referred, I can't speak for everyone but I go by Dave.

Hope this helps.

David Carpenter, PA-C