Still Angry at MAs playing nurse or PA

[CaLLaCoDe, BSN, RN]

My wife called her Doctor's clinic today in order to discuss her Provera prescription. She was told that the Physician was out of the office and would not be back by friday, so "we'll have our MA return your call." And so the MA calls back and says that its ok for my wife to reduce her dose from 10mg to 5mg daily and she can check back with the physician on Friday. I thought MAs were supposed to work under direct supervision of a doctor. Sure this MA may have heard the doctor say the give the same advice to another patient, but it doesn't make this practice right (not conferring directly with the MD). Even I as a nurse would never consider prescribing a dose without consulting a physician...because we're trained to do so. So how can we stop this common practice from happening?

My wife loves her clinic and wouldn't think of complaining. Since her physician had stated that the Provera could be stopped by her at any time without side effects, she thought of it as no big deal. So, it's not my place to complain. Or is it? She's not my doctor and I did not speak directly to the MA. My wife specifically asked if she were a Physician's Assistant and was told MA. (So no confusion there!) Should I as a nurse write a heads up letter or speak directly to the physician that this is putting her practice in jeopardy? How would you handle this?

[caliotter3]

I think you would be doing the doctor a favor by writing a letter to inform him of the situation. Your wife should probably consider going elsewhere for her care if you speaking up about this causes unpleasantness.

[thinkertdm]

Definitely call the office about this. Did the MA who called state that they had spoken with the dr?

[dorisc1981]

That once happen to me and the doctor and the MA got along pretty well, meaning I guess the MA either felt comfortable enough to make a decision since in some places believe it or not I guess still do that. However I didn't feel comfortable and once I got a chance to speak to the doctor I did so. The doctor completely understood and I guess it won't happen again or I guess in front of me. I didn't had to go to higher authority some things could be handle on a one to one level.

[canoehead, BSN, RN]

If the doctor told her she could stop it, perhaps he wrote it on the chart. If the MA consulted the chart and saw that, she would be correct in the advice she gave.

[AbeFrohman, BSN, RN]

Reminds me of the girl with her mother on Boston med in the ED. In the thickest new englander accent "I'm a teachor eand I'm also in meadicine. I'm a meadicol asseestent eand I knoa dat my mudda needs" blah blah. Actually sounds more like from jersey when I hear it in my head. Just gotta hit 'em with the hard truth.

[CaLLaCoDe, BSN, RN]

Definitely call the office about this. Did the MA who called state that they had spoken with the dr?

No, she just gave the advice over the phone: MD was out of the office, to return on Friday.

[gettingbsn2msn, MSN, RN]

Most of the public does not understand this. My 80 year old dad always gets medical info from the MA. I happen to know she is a MA as she is also going to nursing school. The problem is that the public (especially the elderly) do not know the difference between a NP, PA, MA. I know his doc is so busy he would probably get rid of a MA that did not comply. Plus I am sure he would not want to pay a NP or PA more than $8 an hour. You get the picture.

[Otessa, BSN, RN]

My wife called her Doctor's clinic today in order to discuss her Provera prescription. She was told that the Physician was out of the office and would not be back by friday, so "we'll have our MA return your call." And so the MA calls back and says that its ok for my wife to reduce her dose from 10mg to 5mg daily and she can check back with the physician on Friday. I thought MAs were supposed to work under direct supervision of a doctor. Sure this MA may have heard the doctor say the give the same advice to another patient, but it doesn't make this practice right (not conferring directly with the MD). Even I as a nurse would never consider prescribing a dose without consulting a physician...because we're trained to do so. So how can we stop this common practice from happening?

My wife loves her clinic and wouldn't think of complaining. Since her physician had stated that the Provera could be stopped by her at any time without side effects, she thought of it as no big deal. So, it's not my place to complain. Or is it? She's not my doctor and I did not speak directly to the MA. My wife specifically asked if she were a Physician's Assistant and was told MA. (So no confusion there!) Should I as a nurse write a heads up letter or speak directly to the physician that this is putting her practice in jeopardy? How would you handle this?

Perhaps there is a protocol or standing order. e.g. some places automatically pre-medicate with Tylenol and Benadryl prior to a blood transfusion due to a protocol that is signed by the attending MD.

otessa

[Penguin67]

If a non-MD gave permission to alter the dose of a prescribed medication, that is practicing medicine without a license. If an adverse event occurred with a dose change (unlikely in this situation, but always possible), the MA is liable, and they are not allowed to prescribe in any state that I know of. The only way out of that situation would be if the MA talked with an MD who was covering for the MD who was out of the office. As a nurse, if I were in the same situation, I'd talk with the MD and tell the patient when I returned the call "Dr. X said you can decrease your dose from y to z."

[DeeAngel]

Reminds me of the girl with her mother on Boston med in the ED. In the thickest new englander accent "I'm a teachor eand I'm also in meadicine. I'm a meadicol asseestent eand I knoa dat my mudda needs" blah blah. Actually sounds more like from jersey when I hear it in my head. Just gotta hit 'em with the hard truth.

I saw that episode too! That person and her mother both looked like huge jackasses on national TV. It's one thing to be a fool and something else entirely to bray that informational publicly in a loud voice.

[blondy2061h, MSN, RN]

Are you sure it was an MA and not a PA? I hate how those two titles are so close together when the licensing and scope of practice are totally different.