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Joined: Feb 4, '11; Posts: 166 (61% Liked) ; Likes: 440

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  • Jun 5

    Quote from Katie5
    I hope you know the patient gets stuck with the bill and for an uninsured patient even worse.So unless you ABSOLUTELY have no idea,sticking to the NECCESSARY Tests would be economical. Disregard if you were not referring to tests.

    Again, I'm not sure you should gloat about it, I would expect an over and beyond attempt at least- human beings have one life.Just saying.:heartbeat

    Not gloating at all, I did the exam I felt was needed on the patient. Giving a reference to this case in this discussion is to provide the less educated OP with the "Data" he so desperately needs. Go back and read the post again, never mentioned test, only mentioned the PE I did based on the risk to the patient and propensity of prostate CA to mets to back, ribs and long bones. Also add to the possiblity of hematogenous spread of the disease. I was not looking for spotted zebra's I knew what I was looking for and did the appropriate exams.

  • Jun 5

    Ok, lets look at this from another angle. By your logic, Midlevel's can not give a level of care equal to a MD/DO. So get rid of midlevels. Now, same argument, CNA's, MA's, LPN's can not give the same level of care as an RN so why not get rid of them as well. Since an RN can do the job they do but they can't do the job of the RN then I guess they serve no role, going by your logic.

  • Jun 5

    I'm getting some popcorn and gonna pull up a chair on this one.

    Being a new grad, and by your statements, you really are clueless about the important role midlevels assume. NP's and PA's both serve to fill the gap left by lack of primary care docs. Let me ask you this, if you had a medical problem and called your doc how long would you have to wait for an appointment. Most docs in my area its 4 wks or more. How would that number change if they had a midlevel in the office seeing pts? Could cut it by 50%. I've worked with outstanding providers from all camps, MD, DO, NP, PA and all give good quality care. Just do a little research before you label a provider roleless. just my 2cents

  • Jun 3

    oh, and to give you some data on a pt I saw in clinic the other day. Follow up on PSA level with hx prostate ca, gleason 6, 1/10 biopsy. He was seen by the MD 3mo ago and his note was 4 lines long. My H&P on him was full ROS, PE I covered HEENT to get my CN's, neck and nodes, back, post/ant thorax/lungs, CV, GI/GU and extremities and a DRE since I could not find in notes of one in almost a year. Prostate CA is slow grow with direct extension mets but hematogenous spread can occur once out of capsule.
    Do I think I gave him better care than the doc, nope, not at all but the next person that see's him will have a clear picture of what I covered when I saw him. I went a little farther than are general rule of system above and system below complaint but that is the beauty of being a provider, you can do whatever exam you feel is warranted.

  • Jun 2

    I'm getting some popcorn and gonna pull up a chair on this one.

    Being a new grad, and by your statements, you really are clueless about the important role midlevels assume. NP's and PA's both serve to fill the gap left by lack of primary care docs. Let me ask you this, if you had a medical problem and called your doc how long would you have to wait for an appointment. Most docs in my area its 4 wks or more. How would that number change if they had a midlevel in the office seeing pts? Could cut it by 50%. I've worked with outstanding providers from all camps, MD, DO, NP, PA and all give good quality care. Just do a little research before you label a provider roleless. just my 2cents

  • May 31

    Quote from Katie5
    I hope you know the patient gets stuck with the bill and for an uninsured patient even worse.So unless you ABSOLUTELY have no idea,sticking to the NECCESSARY Tests would be economical. Disregard if you were not referring to tests.

    Again, I'm not sure you should gloat about it, I would expect an over and beyond attempt at least- human beings have one life.Just saying.:heartbeat

    Not gloating at all, I did the exam I felt was needed on the patient. Giving a reference to this case in this discussion is to provide the less educated OP with the "Data" he so desperately needs. Go back and read the post again, never mentioned test, only mentioned the PE I did based on the risk to the patient and propensity of prostate CA to mets to back, ribs and long bones. Also add to the possiblity of hematogenous spread of the disease. I was not looking for spotted zebra's I knew what I was looking for and did the appropriate exams.

  • May 25

    I'm getting some popcorn and gonna pull up a chair on this one.

    Being a new grad, and by your statements, you really are clueless about the important role midlevels assume. NP's and PA's both serve to fill the gap left by lack of primary care docs. Let me ask you this, if you had a medical problem and called your doc how long would you have to wait for an appointment. Most docs in my area its 4 wks or more. How would that number change if they had a midlevel in the office seeing pts? Could cut it by 50%. I've worked with outstanding providers from all camps, MD, DO, NP, PA and all give good quality care. Just do a little research before you label a provider roleless. just my 2cents

  • Jan 2

    Said "Californy is the place you ought to be" So they loaded up the truck and moved to Beverly. Hills, that is. Swimmin pools, movie stars. I loved that show when I was a kid.
    Anyway, prob talking about Cali, I've been working out here off and on as a travel nurse and dependent upon the job, would average around 85-90k per year with monthly take home of around 6500/month. Would work 1-2 extra days per month and I didn't work at all November and December. Out here it's all about selling yourself and I had no problems going to the highest bidder. I went to Hawaii 3yrs ago for the summer at 35/hr x40hr/wk, the other travelers in the ER were getting 25/hr, you had to be able to play the game and negotiate. Now, things are tighter out here but with PA school, there's no way I could work but if I need some quick cash one 12hr shift at the trauma center up the road through my registry would get me $550 after taxes. Now to the OP's question.

    I've got a buddy back home that is CRNA and loves his job, the money is great but he loves what he does more than the money. He once told me he loved it so much he'd almost do it for free, almost... Two other guys (we all 4 worked nights at the same ER) went the FNP route and both love what they do as well. One got hired on at the same ER we all worked and the other is doing primary care. You have to ask yourself where you would be happiest and go from there.

  • Nov 11 '17

    Ok, where do I start....the whole ideology of NP's taking care of the whole patient is perpetuated by the academic world in their efforts to differentiate themselves from others. In my 20yrs as a RN I honestly can't tell the difference in the care that experienced NP's give from experienced PA's. Every NP I've ever worked with practice medicine, no "Advanced nursing". I'm sorry if this stepped on any toes but it's what I've seen in numerous encounters with NP's and PA's alike.

    Now, the idea that PA school is less schooling is absolutely false, research PA education a little before you make that comment. Every PA school has different admission requirements, same with nursing. Some require a BS degree and some don't. Some award AS degrees, some give BS degrees and some give MS degree's. It does not mean you can do the bare minimum and still get in, my school awards an AS degree but 90% of our class have their BS degree. But all these degree differences isn't anything different than the direct entry BSN or MSN programs out there.

    PA are able to change specialty area with ease, PA's can do psych and peds and OB and whatever other area you want to work. Can't do anesthesia but don't really want to anyway. Most every PA school will do 1500 to >2000hrs of clinical rotations compared to 600-1000hrs in NP school. NP's have independent practice in a number of states and that is something many will throw out there as their badge of honor but if you ask many of them about where their own practice is then, well, very few actually have their own office. Personally, I don't want to worry about keeping the lights own, just let me see patients and give me my check on Friday, something that is echoed by many of the NP's I've worked with. People will also toss the supervision thing about PA's, true, I'm tied to my SP and we have to have a delegation of services agreement for my practice but the job I'm taking next year when I'm done my SP's office and my office are about 30 miles apart. He has to be available for phone consult or email or whatever means to get in touch and 4hours in my office a month to sigh charts.

    These are just a few things, sorry to drag it out but in closing I'd say, personally, I would have never gone to nursing school if I'd known about PA's 20yrs ago. It took me the last 5yrs to get financially stable enough to not work for 2yrs while in school. Big advantage of NP school is part time and full time status in school and the ability to work close to, if not, full time hours. PA school, very few work, none in my class but there are some that worked in PA school but you'd be hard pressed to find them. Every NP I've ever worked with, worked during school except one girl and she was an ER nurse that married one of the surgery residents. There's no shortcut to either route so chose what is the best fit for you. Talk to some NP's and PA's in your area, visit schools and educate yourself on both professions and then you will have the info needed to come to your own conclusion and not listen to the ramblings of some unknown PA student that hasn't slept in about a year and trying to recall what the difference is between the negative-negative and positive-positive or was that the negative-positive or positive-negative trendeleburg test for varicosities......think I need another 5 hour energy.

  • Oct 21 '17

    Ok, lets look at this from another angle. By your logic, Midlevel's can not give a level of care equal to a MD/DO. So get rid of midlevels. Now, same argument, CNA's, MA's, LPN's can not give the same level of care as an RN so why not get rid of them as well. Since an RN can do the job they do but they can't do the job of the RN then I guess they serve no role, going by your logic.

  • Oct 2 '17

    There are no bridge programs to go from anything to PA and no part time programs to become a PA. Like Neo said, Extremely rigorous. I'm at the end of my didactic year and since last july we have been in class M-F 33-36 hours per week, I study about 40-60 per week outside of class, I've not worked since July 4th last year and prob won't work til I'm done with school. Our clinical rotations start end of July and by graduation July 2012 I will have 1800-2000 clinical hours in PA school. We go for 16 week terms the 1st year with 1 week of between and got 1 week for Christmas. Clinical year we only get a week off at Christmas.

    As a PA you do have a delegation of service agreement with your supervising physician and yes your tied to that doc but they are not looking over your shoulder and most times not even in the same office. As a PA you can jump specialties whenever you like but you can't carry your previous scope of practice with you. Basically if your SP doesn't do it then you can't do it. I could do ER for a few years, move to surgery if I want, jump to pediatrics or whatever I desire without any further education. One thing to consider is PA's re-test every 6 or 7yrs, can't remember but as a NP one and done. Make your decisions based on your own needs, PA school = no work so >school loans but also more freedom to choose your career. NP school = part time vs. full time, ability to work so < school loans, the independent practice chip they so readily toss out. For me personally, I don't want the headache of running my own clinic, just let me see patients and give me my check on Friday. I've seen, worked with and known many NPs that during school they carried that moniker religiously, "I'm going to open my own practice and not ever have to answer to another doc" and several have done so. Most, however, have realized that working to keep the lights on is worse that working for a doc. just my 2cents tho.



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