Children’s Hospital doubles down on their statement that PA students are equal to residents
Who doesn’t want to ride a donkey backward? Can’t say that I do. Can’t say that I’ve ever thought about it. But reading this story on Reddit made me think about it today. This article is a story about:
PA student cared for 2-year-old with lethargy and vomiting post fall. Patient was never assessed by PA. Hospitals risk management okays this because a “PA student reporting to a PA is like a resident reporting to an attending “
This article is about a nurse that had a horrendous experience with care of their child who never saw a physician or even a licensed PA. This involved a head injury, subsequent sequela, symptoms, and an inappropriate discharge at the hands of a PA student. The complainant described an email they receive from the hospital risk management section that (hospital) “are a teaching hospital, we do allow a spectrum of autonomy.” So, let’s see – a head injury, neuro symptoms, and “I am still concerned. I am starting to realize that a doctor isn’t coming.” How in 2021 can this take place? Actually….. maybe it’s more like that in 2021 it’s more likely to happen than in other times. The incident took place at Phoenix Children’s Hospital.
I’m no expert on PA’s or PA students, I but did practice as a mid-level NP for years before med school. While in 3rd year surgery clerkship, we did have 2nd year PA students rotating with us. It’ not derogatory or demeaning to point out that a 3rd yr. med student at this juncture has 2 yrs. of in-depth basic sciences and clinical knowledge versus 1 year for the PA. It’s not a bad thing. It’s just a different thing. It’s like one is training to be an apple, and the other training to be an orange. Both may be fruit, but the training is different. It’s meant to be because of the different roles. It’s not a bad thing. It’s like in the nursing realm where you have licensed practical nurses versus registered nurses. Again, not a bad thing, just a different thing.
This brings me to a point of contention I have on the topic. A PA or even NP (with which I’m more intimately familiar) can practice and even in some states have full practice authority (FPA). Where here I am as an unmatched MD, and I can’t. I have 4 yrs. of med school which is 2 yrs. longer than the NP and PA with each phase of the didactic and clinical portions being a year longer, and I can’t. I’ve passes all USMLE steps – Step 1, Step 2CK, Step 2CS (before they canceled it), and Step 3 and still can’t practice as an MD. And I might point out also that even resident physicians still have attending physician oversight. As it should be. Part of me is grateful for this that medicine is held to the higher standard. I don’t think we should lower this standard. I think we should raise the standard of the NP/PA. But the irony is, I could reinstate my NP license and practice with FPA but can’t do a darn thing as an MD.
Remember, the “top of the curve” of the bell curve (normal distribution) are those most exuberantly mediocre. Mediocre attentings bask in the adulation of the mediocre sprigs who yearn to grow up to be mediocre just like their mentors.
Beware the outliers. If you have anything whatsoever that identifies you AS DIFFERENT, you are like a restless gazelle in a herd – you make the other ones nervous.
Hence we see PA’s AS NP’s AS MD’s/DO’s. If the goal is any practice that surpasses the verdict of “not guilty,” the professions are relatively freely interchangeable. I’ve been waiting for independent prescribing authority for EMT’s for some time, now; and a broad sweep of prescription medicines to OTC, to allow for independent R.Ph. practice. Why should we strive to be better than the rest of the world, anyhow.
Sorry about your matching status, but I matched at a program where the residency director committed unspeakable acts with the female residents and students. In many of the Ivy League Residencies, the capacity to give a killer __ job is all it takes to do well. I’m sorry to sound cynical, but give me better facts.
Good luck. Independent thinking is not rewarded. It will, sooner or later, allow you to save a life or two, which is its own reward. Trust me.
Mr.Steve O.
If you matched at a program where the Director did unspeakable things to female residents and students and did nothing YOU are part of the Problem.. If none of the Females spoke out,they are part of the problem..
I faced a Killer MD in my second PA-C position. I went thru the State Board, hospital board and Duke Endowment. None would help,my national PA organizaxtion would not Help.
So I faced those facts,gathred my evidence,took the public PSRO report went public. Got fired 3 times rehired 2 times. Had my life threatened. Did not bother me, then they threatened my wife and 18 month old child.
I confronted them publicly . THEY STOPPED.
I had a Family Practice Physician in the Army,supervising me. The PA who I replaced told me there was a
problem. I talked to a couple females who said they had been abused by that FP. I contacted the unit IG.
He instituted an investigation, Army CID got involved and that physician was sent to another camp while the investigation continued. 13 Females were abused bythat guy.Eventually he was removed from the Army. He tried to affect my career was not able to. He did threaten me.
I do Not Fear Evil.. I fear all the good people who see Evil and DO NOTHING…
Did my time as a combat medic do any good? Yes my actions saved a few lives and a dog.
44 Years as a PA-C has made a difference , one life at a time. I am old , still love being a PA-C.
I am not brave, but I cannot abide anyone messing with our SACRED business/Profession.
I just did what was right . No good deed goes unpunished. Complications do come about.
If I had it ALL to do over again I WOULD. That was the right thing to Do..
OK, I gotta ask.
Tell us about the dog.
Dr.Duprey;
Full practice authority marches on for NPs and PAs. Much to my dismay.
PA students need 3 to 5 years supervision after they graduate since many have no practical experience
as Lab techs,Nurses, Xray or medical corpman,Paramedic. . They make upfor their lack of experience by arrogance and passing the buck.. Just my personal experience as a PA-C for 44 years.
Have you considered legal remedies to get your license to practice?. Plan carefully and pick the state or states you wish to sue in Your prior RN and NP experience may be substituted for residency? In this crazy world might work..
Good article ,thank you and keep plugging away.. Discriminaton may be a factor due to your age…
Have you seen about a military residency. Army,Navy,Air Force, Public Health service? Many programs have military connectons and get funds.. As a veteran thst might apply to you…
From recent things I have seen the Military needs lots of experienced people who give a damn.. Not many
are there.
Good Luck and see if any resident programs have developed any vacancies since selection..
Thank You
Jesse Belville,PA-C