When Patients Don't Want To See a Physician Assistant
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- Опубликовано: 28 июн 2019
- It happens. Even after working for 5 years as a physician assistant, I’ll have the occasional patient who is less than thrilled about seeing a PA. Whether they were scheduled incorrectly or didn’t have the right expectations, it’s tough to walk into a room where you know you may not be welcome. Today I’m talking about how I handle those situations on the podcast.
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PAs are not doctors, especially in many specialties. PAs get 3-7 years LESS training than MDs, and the entry /certificate exams are much less difficult for the PAs.
Complex pts need a physician who has had 10-12 yrs medical training ; they're not being difficult lol. (I'm in the medical field too). PAs have less training then Dr's and more than NPs and is important to know the difference.
I've been in the field for about a decade as a Physician Assistant. From my experience, it's usually patients with minor issues that demand to see a DOCTOR. I'm usually relieved when that happens actually, but I do feel bad for the doctor that's about to experience this personality type. By this type, I mean demanding and rude. Of course, not all patients that want to see MDs are like that, but like I said, a majority are difficult to deal for any provider in my experience. Also, let me remind you why PAs exist. We exist because the health care system needs us. MDs are trained to be both scientists and clinicians. That's why it takes so long and so expensive to graduate a MD. A patient in need doesn't need to see a scientist; he/she needs a clinician to diagnose and treat the problem. That's exactly what PAs are trained to do. It's normal for patients to feel that they have a rare condition that only "Dr. House" can solve. In reality, it doesn't take much to diagnose and treat most of the problems. It comes down to pattern recognition and following standardized treatment protocols--with a touch of common sense for personalized care. MDs are great, so are PAs. I've seen both MDs and PAs do great work and also make mistakes. We're all human. We all strive to be better. This is why we call it medical practice. Patients are free to see who they want to see. But as a patient, please be respectful to the provider you're seeing; if you don't want to see a PA, you should have checked to make sure that you don't schedule to see a PA. I'm sure that PA would rather use his/her valuable time to see someone else as well. At the same time, be grateful that part of the reason why you can see a MD in a reasonably time frame is because there are PAs sharing the patient load, contributing to and making our health care system run more efficiently. Also be grateful that you can see any provider at all in America; there are poor people suffering in third world countries that don't have access to any care. As a MD, please be respectful to your PA colleagues. We're a team. I've seen PAs ask MDs for advice and vice versa. I understand the human nature to be competitive and territorial; I urge some of you to remain rational. Don't see PAs are threats to your jobs; see us as part of the solution to a very expensive health care system. Some of you say that PAs are not competent enough to see your patients, but are you willing to take a pay cut and work longer hours to see all the patients yourself?
@@David-sq3bs I didn't say there isn't a place. However, there is no substitute for 7-10 years of education plus training physicians receive. I've seen too much missed with mid levels only bc of the less training and not being properly overseen by physicians. However, if I had a choice between PA and a NP, (not the ones training many years ago bc the standard was much higher years ago), I'd pick a PA. We're now seeing diploma mills with horrible education and no prep for handling pts (NPs). Physicians are having trouble getting matched after me school and I think this is on purpose to claim Dr shortage --> comes mid levels. Now there is a nursing shortage in part bc they're fleeing the bedside, some go to school to try to escape issues. I'm a nurse and know this is happening. The docs I know and hear in groups I follow tell me about their issues. I feel like there is a systematic breakdown of our healthcare system tbh. After 2.5 decades of nursing, I never thought I'd see what is going on. Blessings
@@David-sq3bs too many are far to ill prepared and inept at the most basic of differential diagnosis or even ill informed or inept in the diagnostic methods or limits of them. It's not personal; the training and clinical experience is just not there and the gatekeeping within the education system is not weeding out people who have no business carrying the responsibility of full patient care. Maybe the field will develop; the standards higher, the education and clinical experience greater. Until then, you cannot fault the public and medical perceptions of the profession.
Say, no problem and let your appreciative supervising doc know he gets the honors!
I've been in the field for about a decade as a Physician Assistant. From my experience, it's usually patients with minor issues that demand to see a DOCTOR. I'm usually relieved when that happens actually, but I do feel bad for the doctor that's about to experience this personality type. By this type, I mean demanding and rude. Of course, not all patients that want to see MDs are like that, but like I said, a majority are difficult to deal for any provider in my experience. Also, let me remind you why PAs exist. We exist because the health care system needs us. MDs are trained to be both scientists and clinicians. That's why it takes so long and so expensive to graduate a MD. A patient in need doesn't need to see a scientist; he/she needs a clinician to diagnose and treat the problem. That's exactly what PAs are trained to do. It's normal for patients to feel that they have a rare condition that only "Dr. House" can solve. In reality, it doesn't take much to diagnose and treat most of the problems. It comes down to pattern recognition and following standardized treatment protocols--with a touch of common sense for personalized care. MDs are great, so are PAs. I've seen both MDs and PAs do great work and also make mistakes. We're all human. We all strive to be better. This is why we call it medical practice. Patients are free to see who they want to see. But as a patient, please be respectful to the provider you're seeing; if you don't want to see a PA, you should have checked to make sure that you don't schedule to see a PA. I'm sure that PA would rather use his/her valuable time to see someone else as well. At the same time, be grateful that part of the reason why you can see a MD in a reasonably time frame is because there are PAs sharing the patient load, contributing to and making our health care system run more efficiently. Also be grateful that you can see any provider at all in America; there are poor people suffering in third world countries that don't have access to any care. As a MD, please be respectful to your PA colleagues. We're a team. I've seen PAs ask MDs for advice and vice versa. I understand the human nature to be competitive and territorial; I urge some of you to remain rational. Don't see PAs are threats to your jobs; see us as part of the solution to a very expensive health care system. Some of you say that PAs are not competent enough to see your patients, but are you willing to take a pay cut and work longer hours to see all the patients yourself?
It's not that I mind seeing the PA but don't understand why I have to pay the full fledged price when I only see the PA and NOT the Dr. ? You would think there would be some kind of a discounted rate if I don't actually visit with the Doctor in person.
I totally agree with you, have thought the same thing before! It's disgusting when you've waited awhile to see your doctor about a worrisome matter and end up with a PA!
The best care I’ve received has been from NPs and PAs ! It’s one of the reasons I’ve decided to go the PA route.
Me too ✋
I have had wonderful experiences with the two PA's I've been under the care of. I like that they have the time to listen to me and they are clearly very intelligent people. You don't have to go to med school to be a great healthcare provider. :) Also, their bedside manner is just superb. They are kind and thoughtful people, and that goes a long way for a patient.
Yes. Exactly.
Thank you for making this video!! It’s important to know how to respond in the future!! I appreciate it!
Not wanting to see a PA doesn't mean that you are being "difficult." It just means that you want to see someone with more medical training. PA school is 2 years while medical school is 4 years with a residency of minimum of 3 years. A PA can be just out of PA school. I
I've been in the field for about a decade as a Physician Assistant. From my experience, it's usually patients with minor issues that demand to see a DOCTOR. I'm usually relieved when that happens actually, but I do feel bad for the doctor that's about to experience this personality type. By this type, I mean demanding and rude. Of course, not all patients that want to see MDs are like that, but like I said, a majority are difficult to deal for any provider in my experience. Also, let me remind you why PAs exist. We exist because the health care system needs us. MDs are trained to be both scientists and clinicians. That's why it takes so long and so expensive to graduate a MD. A patient in need doesn't need to see a scientist; he/she needs a clinician to diagnose and treat the problem. That's exactly what PAs are trained to do. It's normal for patients to feel that they have a rare condition that only "Dr. House" can solve. In reality, it doesn't take much to diagnose and treat most of the problems. It comes down to pattern recognition and following standardized treatment protocols--with a touch of common sense for personalized care. MDs are great, so are PAs. I've seen both MDs and PAs do great work and also make mistakes. We're all human. We all strive to be better. This is why we call it medical practice. Patients are free to see who they want to see. But as a patient, please be respectful to the provider you're seeing; if you don't want to see a PA, you should have checked to make sure that you don't schedule to see a PA. I'm sure that PA would rather use his/her valuable time to see someone else as well. At the same time, be grateful that part of the reason why you can see a MD in a reasonably time frame is because there are PAs sharing the patient load, contributing to and making our health care system run more efficiently. Also be grateful that you can see any provider at all in America; there are poor people suffering in third world countries that don't have access to any care. As a MD, please be respectful to your PA colleagues. We're a team. I've seen PAs ask MDs for advice and vice versa. I understand the human nature to be competitive and territorial; I urge some of you to remain rational. Don't see PAs are threats to your jobs; see us as part of the solution to a very expensive health care system. Some of you say that PAs are not competent enough to see your patients, but are you willing to take a pay cut and work longer hours to see all the patients yourself?
No, you don't need to see a MD most of the time. My NP and PA can do 90% of what comes thru my office. As a MD that has 10 years of training, I can hold my own ,but even I have to refer people to specialists. It's a team effort, PA and NP can the bread and butter of cases. If I have to refer someone, you won't like the outcome more then likely. And doctors make mistakes too. Don't think it's not possible. We have more training but If need to schedule time off in my practice, I need 6 months in advance to get someone to cover for me. If everyone wanted to on see a DO or MD, a lot of people would die, it takes a long time to get here where I am. So, if you value what a doctor does and it sounds like you do. Take my advice when we tell you that our NPs and PAs can take care of you 90% of the time. I have patients that feel more comfortable with a NP or PA because they had a issue with doctors in the past, as well. It happens. My NP spent 4 yrs to be a nurse, 2 and half years which were medical training and then another 3 to be a NP. She still doesn't have the same training as me, so without training to sound elitist, I think they have enough training to do mundane everyday BNB. On the other hand, a person with no medical training is not qualified enough to tell a NP or PA that their training isn't enough. Now if you don't like the staff at all, you are welcomed to go somewhere else. But if you can't find a place that will put up with you, then the problem is you.
I feel like sometimes the term physician assistant is not a good one. Because what people think when they hear that and they have limited information on their role, they hear, that's the physician's assistant. Like as if they are my secretary. My NP gets called doctor more often then not by comparison by the same people. But not my call. Just my 2 cents on that.
@Ellie5621 actually the title is changing to physician associate to reflect more of what we do. Assistant is actually misleading. Not that there's anything wrong with being an assistant. I was just pointing out the significance of my profession. I also said that doctors are great. It's a team effort. I had doctors ask me for medical advice just because I've been in the field a long time. So I'm "supervised" on paper, but it's more of a collaborative relationship. Also, time spent in school has little correlation to being a good provider. It takes a lot of patience, empathy, skill and knowledge. School system only selects for the latter two attributes.
Wow, you're really rude. Hopefully you're not in the medical profession. That would be a disgrace. If you read my whole comment, there was no ego. I tried to have a rational debate. What kind of person attacks or belittles another person's profession? What type of mindset would that be. Disgusting...I love my profession and I respect the people I work with.
@@David-sq3bs Unless they're MD/PhDs, MDs are not trained to be scientists.
PAs shouldn’t pretend to be doctors. There is considerable difference in length of training, liability, and licensing exams. That being said, it’s a valuable role and most PAs are incredibly understand and do not pretend to be a physician. However it’s dangerous if hospitals and health institutions try to cost cut and hire more mid levels and risk potentially compromising patient care especially when advanced diagnoses and treatments are required which more in line with the length and rigor of medical training. PAs have great job market, specialty flexibility, and time to do things outside of medicine so there are a lot of good things they have already without overdoing their role
PAs have a great work/life balance and make bank. Joke on the docs with 400k in student debt and sacrificing the best years of their 20s/30s.
@@marshallguy301 overall, by retirement, physicians make much more and will bypass PA net income by year 11 in their respective careers
@@marshallguy301 that's what it takes to become experts in our field. If/when you're very sick, you'll be glad to be treated by a physician with 4 years med school, 3+ year residency +/- fellowship instead of a PA with 3 years of school and nothing else
@@marshallguy301 most PA schools I just interviewed with cost 131k-225. PAs I literally work with don't make that salary annually unless they kill themselves every week at different jobs or they have been working awhile. I wouldn't say the joke is on anyone if they are happy doing what they do- which both docs and PAs I know usually are. The PA road isn't a cost efficient one, the only difference is their 8am-4pm schedule really stays one while a doctor's doesn't.
Many PA's know what a Dr knows. And if there is something rare then they know to ask the Dr a question. So the patient will typically get better treatment from a mid level. But the Doctor will handle Surgery (Surgeon). Also each state is different.
My primary care provider is a PA. She's fantastic and doesn't hesitate to send me to a specialist if something is out of her wheelhouse. But my elderly father has many health issues, he needs a doctor. He has geriatric DO, a cardiologist, and a urologist as well. Different situations call for different providers.
I see a PA as my Principal medical person. I don't like the doctor in the office. The PA spends time and I feel very comfortable.
Saying that a patient is probably going to be a "little bit difficult," because they don't want to see you is one of the reasons I don't want to see a PA.
Learn to admit that you are not all-knowing, and a doctor can spot things that a PA will miss behind all that ego
Right. Her EGO was the only thing I could hear in this wildly entitled video.
You are right, judging from what we have experienced with PA's! Everyone my husband has had, screwed up his health! Prefer doctors..after all on health insurance cards, they assign you to a doctor, not a PA!
@@muirgirl Totally agree with you and besides that, looked and talked like she's fresh out of high school!
@@deborahalviso9408 Totally!
I wish the original nomenclature was more distinctive I have worked in offices where we had MAs and PAs and patients interchanged them (especially since our MA was a male and the PAs were all female).
I work as a NP and I have had patients mistake me for a LPN, a MA, a RN and a few people mistake me for a MD (I am very clear that is not what I am). I do not have a supervising physician in house but I do have chiropractors that work in my office but no one has ever asked to see a physician instead of me yet.
Thank you for commenting! I interviewed a NP and was surprised to find out that people struggle with that name as well. I agree not the most appropriate or most specific name for PAs, but usually once patients interact with them they understand a little better!
I think Chiropractic office is completely different territory. Patient mindset much different
What’s up with the white coat with PAs? From what I noticed. 8/10 PA and NP wear a white coat at the hospital where I work at. And 9/10 physicians do not wear white coats just scrubs. I don’t know if it’s just my site or it’s like that everywhere?!
If you’re not a doctor you should not be acting like one. I saw a PA once and she totally misdiagnosed me. Never again.
A doctor can misdiagnosed you as well
@@daishabreaux5375like….hello 🤣 people just be talking just to TALK!
I shadowed at an orthopedic outpatient injury center and they had the PA come in and THEN the doctor... really? Even the PA told me it was strictly for the company to be able to bill more for the insurance. It's a complete disrespect on the companies behalf upon the scope of practice of Physician Assistant's and suggests to the patient that PA's are like RN's/LPN's or MA's and not medical providers.
Don't lump RN's/LPN's with MA's. There is a huge difference between someone who goes to school for 6 months.
This is why many distrust all PAs. I also have never encountered any HCP more unprofessional, unqualified, ignorant, and abusive than the Ortho PAs in Bozeman, MT. Apparently they are enabled to rediagnose against MDs in their practice and otherwise run the show. It is disgusting.
@@muirgirl that may be due to the PAs there having independent practice. In most states, PAs do not have independent practice under the labor laws and consumer affairs restrictions, and it would almost never occur where a PA is overriding or doing something against a supervising physicians diagnosis. Doesn't sound like a good setup for anyone there.
@@shad3128 Exactly.
@xe7535 I do see that your post was made over two years ago, but I'm surprised that no one replied to it.
Firstly, the commentator to whom you responded did not imply that S/HE thought that P.A.'s should be "lumped together" with, I dare say, lower-level healthcare personnel, but that COMPANIES TEND to (erroneously) suggest to patients that the role of P.A.'s and that of nurses and of nurse techs (which essentially is what an M.A. [medical assistant] is) are equal.
Secondly and lastly, you didn't complete your thought, "There is a huge difference between someone who goes to school for [six] months." Between someone like this and whom else?
Why would any rational person choose to be treated by a PA? A medical doctor has many years more training and had to achieve many more years of rigorous academic study.
I understand what you are saying, but also having more years of training doesn't equate to a great doctor. I had to go through several before getting diagnosed with my rare health issues, and a few of the first people that listened to me were PAs and NPs, when MDs wanted to diagnose me as a psych patient with fibromyalgia, CFS and IBS. 🤷♀️
In my experience, PAs are better listeners and spend more time with their patients than doctors. Not knocking their academics by any means, but if a doc isn't actually listening to the person who best knows what is happening (the patient) then they're not going to make a very good diagnosis.
If I had a serious illness, like cancer or heart disease a PA is only acceptable
for CONTINUING visits. I feel a full doctor is mandatory for initial consultations
and diagnosis'. I have a gigantic big toe and my PCP treated me for gout - which was a misdiagnosis.
She finally had an X-Ray taken and sent me to an orthopedic surgeon. I was sent to a PA instead.
I don't think i ever got a diagnosis, I just assume at this point after 3 years it's just a form of arthritis.
I guess you might say my initial PA experience was not positive. My provider has also started using NP's.
Your case is unfortunate. As in a lot of cases, not fully listening to patient's causes misdiagnosis. With that said, a pa is as good as a doctor. Not as specialized of course. But that's the point! Many times they consult together. Simply are a more economical route.
Just fyi: over the next few decades you'll likely see an increase in np and PA's. Decrease in doctors.
@@Jiron127 “a PA is just as good as a doctor.” Not in the grand scheme of things. Yes, there are PAs that have more clinical acuity than physicians. Some physicians have horrible bedside manners. But overall, physicians save on healthcare costs, will prescribe fewer unnecessary medications (antibiotics and opioids included,) and incorporate more aspects into patient care than NPs and PAs.
I am not a fan of PAs. My insurance pays for physicians and that's who I will see. Never a PA. They are always so cocky.
When you are with a patient and have a question for the supervising physician, what do you say to your patient before you leave the room?
Depends on the situation, but I usually explain what I think is going on and what the options may be, and then I'll say let me see if I can grab Dr. XYZ so she can put eyes on you too and we can put our heads together/before we biopsy/etc.
@Nowhere Man for you to be a harvard post graduate. you sure seem like you’re all over the place in these comments. get a job dude and stop talking down on any medical job.
If a patient states they would like to see the doctor or ask if the doctor will come in later, my default response is "Okay." It's no skin off my back. I tell the physician that a patient would like to see them and the doc will go in there immediately if serious or later if it can wait. For the more critical patients I'm managing in the ER, the physician will preemptively put eyes on the patient and/or the workup. From my experience, the ER patients screaming at the nurses to see "THE DOCTOR" tend to be ones the physician is trying to skirt meeting themselves. You know what I mean by this.
I've been in the field for about a decade as a Physician Assistant. From my experience, it's usually patients with minor issues that demand to see a DOCTOR. I'm usually relieved when that happens actually, but I do feel bad for the doctor that's about to experience this personality type. By this type, I mean demanding and rude. Of course, not all patients that want to see MDs are like that, but like I said, a majority are difficult to deal for any provider in my experience. Also, let me remind you why PAs exist. We exist because the health care system needs us. MDs are trained to be both scientists and clinicians. That's why it takes so long and so expensive to graduate a MD. A patient in need doesn't need to see a scientist; he/she needs a clinician to diagnose and treat the problem. That's exactly what PAs are trained to do. It's normal for patients to feel that they have a rare condition that only "Dr. House" can solve. In reality, it doesn't take much to diagnose and treat most of the problems. It comes down to pattern recognition and following standardized treatment protocols--with a touch of common sense for personalized care. MDs are great, so are PAs. I've seen both MDs and PAs do great work and also make mistakes. We're all human. We all strive to be better. This is why we call it medical practice. Patients are free to see who they want to see. But as a patient, please be respectful to the provider you're seeing; if you don't want to see a PA, you should have checked to make sure that you don't schedule to see a PA. I'm sure that PA would rather use his/her valuable time to see someone else as well. At the same time, be grateful that part of the reason why you can see a MD in a reasonably time frame is because there are PAs sharing the patient load, contributing to and making our health care system run more efficiently. Also be grateful that you can see any provider at all in America; there are poor people suffering in third world countries that don't have access to any care. As a MD, please be respectful to your PA colleagues. We're a team. I've seen PAs ask MDs for advice and vice versa. I understand the human nature to be competitive and territorial; I urge some of you to remain rational. Don't see PAs are threats to your jobs; see us as part of the solution to a very expensive health care system. Some of you say that PAs are not competent enough to see your patients, but are you willing to take a pay cut and work longer hours to see all the patients yourself?
See.. You're a classic P.A.. Demanding the respect of being a Doctor, while your didn't do the work of being an actual Doctor, and you have the attitude of thinking you're better than the patient. "Its no skin off my back"??? You are the perfect example of why we're not happy when we find out will be under the care of a lesser educated, lesser trained, lesser experienced person known as a P.A.
I saw a PA in the ER after having a stroke. She tested me for an MI and then discharged me, although I had balance issues, some confusion and left sided weakness. The ball was really dropped and it does make me hesitant to see a PA.
Ur still alive enough to make this comment😂
Yep. P.A.'s are "People of all trades and a master of none" as they can switch practices anytime they want.
This is more a reflection of the individual not the profession. To say that NPs or PAs are no good based on some missing a diagnosis misses the point that plenty of Drs also miss a diagnosis. Diagnosing is a mix of art and science, what we learn in a text book is very black and white what we see in the clinical setting is a broad range of shades of grey. It is experience and practice that helps you interpret the shade of grey.
Sorry for what you've been through. My husband has had some bad experiences with PA's, from neglect and poor judgement with medications, it landed him in the hospital twice and almost cost his life, with the wrong medicines prescribed.We ended up having to pay alot out of pocket for these hospitalization stays, his insurance did'nt cover everything. All of this is inexcusable, and why we now prefer or choose doctors!
@@deborahalviso9408 you and op’s comments are giving ama propaganda tbh.
I see a PA at my dermatology office and love her.
Same she spent so much time with me
Understandable!
I only decided PAs were a racket after being forced to see an abusive one. A PA is not an MD and anyone pretending otherwise needs to be ferreted out of this profession by their peers or be unsurprised when the public avoids PAs at all costs.
Cry me a river
Thank you so much for sharing !
I want doctor's. I don't want to filter through a 3rd party. I have had bad experiences with PA's. I certainly do not want my insurance to pay the same or my patient share isn't reduced. It's just a way for places to make more money without seeing the doctor. I have been told PA's are exactly the same, they aren't. It's being pushed on us and that is what is wrong. It isn't easy to find a different doctor either. I just think this is a way to scam insurance, get money as if we were seeing a certified md. It's the push I don't like, it's being forced on us. I certainly do not want to see a PA on my first visit to the doctor. I want the doctor to have a first impression of me on the first visit, so that he/she actually knows me. The provider isn't being swayed by a 3rd parties opinion. People need the choice when making their appointment, not be surprised by a PA when they get there. Expecting them to be surprised when they get their isn't fair to patients.
totally agree with you. If I make an appointment with the doc, do not want to be surprised by seeing only the PA. There are times when I don't care, like some followup stuff, but I should be given the option, not surprissed.
@@JM-ig4ed i think the PA conducting an initial exam and getting a history and getting to know you and see what brings you in to pass onto the physician, if available isn't a big deal. A lot of times the physicians not always available or in house on days and times that a PA is and their goal is to get you taken care of and to make care more available than it would otherwise be if they weren't in there. I see what you mean about the surprise part, though, as would be nice to know before your visit if you would see a PA or not
@@shad3128 Thank you for the reply. Yes - I agree, if the doctor isn't going to be available, then give me the choice.. If a PA is only seeing you to get background for the doc, it is a waste of their training. I also have had the situation where I give the Pa all the info, only to have them not pass on to the doc when he comes in all the concerns I told them about. I don't want them to filter my concerns. Like I said first though - when it is my choice, there are times when I might actually choose the PA - but need to be informed first.
@@JM-ig4ed for sure. It's a good detail to add. I too have had many negative, and positive, experiences with PAs and physicians alike. Healthcare is a rough place
No cancer patient should be shoveled off to a PA, NP, MA, or otherwise! 3 years of school! Hell to the no!
That doesn't always mean they didn't have valuable experience before 3 years of PA training. For example, I know a BSN nurse who worked in oncology and infusion therapy for 4 years, and became a PA, and continued in oncology. So, you're looking at 8+ years experience and training directly in her field. Not everyone is what the numbers would lead you to think.
@@shad3128 Some RN's are smart as doctors..ICU nurses and open heart surgery nurses.....SMART! but I still prefer a Doctor!
@@shad3128 nursing experience in oncology department is vastly different from diagnosing experience. According to your theory, anyone stays long enough in oncology is qualified to treat cancer patients?
@@shad3128working in an infusion teaches a person nothing about what it’s like to be the one who has to make medical decisions for a patient. An orderly in a hospital has experience being in a hospital but would have barely any more medical knowledge than a layperson on clinical decision making.
If you see about 30 patients a day, how many out of those does the doctor see?
Maybe 1 every couple of weeks? We probably discuss 1-2 a day, but she rarely has to actually go in the room with me anymore. (Also, I only work 2 days a week right now.)
What did you do before becoming a physician assistant?
CNA at a rehab hospital
I have had to deal with a similar stigma as an occupational therapy assistant. Oddly one of the reasons why being a PA has attracted to me!
Im a OTA too! I am starting my Pre Req in the fall for PA programs since PDPM pretty much wiped us out. Good Luck my friend!
@Nowhere Man Its not all about titles and how long you went to school for like how you guys make it seem. Its about what you can accomplish as a doctor and pa in your career. MDs go to school for like 10 years and yet PAs are STILL able to do just as much as them with just 2 years of training tells me that they have earned all that respect.
@Nowhere Man
“The doctor spends thirty times more in education bills.”
WRONG. PA school costs about $60,000-80,000 so it is about 1/3 of the tuition from medical school (approximately $160K-200K). Tell how HOW spending $60K-80K is cheap and worthless for a job that is employable after schooling (definitely more value than having a PhD in English or Humanities but not being able to find a job or tenure). Tell me again how a Master’s Degree is useless (your kids’ school counselors probably have Master’s Degrees.)
If you don’t want to see PAs when it comes
to your treatment, then you have a right as a patient to to do so but don’t fucking disrespect people’s professions like that.
@@aya-_-3045 👏
An OTR isn't any where near the same field or even near the same level of anyone in the Medical Field in any position. Sorry. But never is an actual Physical Therapist. PT's are fantastic but it's not a Medical field area. It's more in line with a gym coach or a massage therapist.
Hey I wanna ask you something. I am an International medical student studying the MD course in one of the medical schools in the caribbean island. My ques is can I as an IMG work as a PA if in case I remain unmatched till the time I can re apply for the match next year.
Nope! You have to complete a PA program to be able to sit for the PANCE and practice.
A lot of people who get into carribean med schools actually are not able to get into a PA school as it’s very competitive.
I think PA's and NP's are very helpful but I should know at scheduling that I am being scheduled with the PA and not the Dr. I'm paying for a doctor and their level of expertise. I find it rude when a doctor misleads the patient that their follow-up appointment will be with them, but when the appointment reminder is sent out, it says my appointment is with a PA. I find it rude and makes me feel that the doctor doesn't care about my care.
PA is cool, but I can't go to school for that because they do ask those questions a lot. Heard a Patient say no go get the Dr. 4 years is better than 2. But the patient just doesn't understand.
What do you think would be the best ap classes to take in high school to become a pa and what college major do you think would be the best? also what internships and jobs do you suggest
Reagan Joiner Hi! I just got into PA school. High school is not something that gets looked at unless you are going into maybe a combined BS/MS PA program. Generally speaking, you must have a good science background and succeed in the sciences. I think having those classes in high school will help you do better in college. Some of the best degrees to get prior to PA school are health science, life science, biology, anything heavy in science. This is best because there are many science pre requisites for PA school such as chemistry, organic chemistry, A&P, microbiology, psychology, statistics, genetics, biochemistry. Pick a degree that includes taking those classes. Best jobs are medical assistant,EMT, anything that gives you a lot of hands on experience with patients and healthcare experience in general. Volunteering in hospitals is good, medical mission trips,etc
Just start seeing a Midwest type of PA who is 40 years on this job and does better work than most MD. I don’t even want to see the MD.
If the PA was an oriental then I’d refuse it.
Your choices are a PA with a 2-3 year master's degree or a physician with 4 years med school, 3+ years residency, +/- fellowship. Real tough choice there
Pa is better from that view
You generally get more time to talk with the PA, and unless you've got something REALLY crazy going on, a PA can usually handle it. Now if it's something chronic and weird, by all means ask for a doctor.
You’re assuming the patient knows that it’s something serious in the first place. I would always go to a physician first because they have more experience and training.
I’m ok with going to PA for follow-up visits but for a first time appointment I’m going to see the physician.
I have a rule now if my insurance or I am paying out of pocket to see a doctor. I'm not going to see a lesser qualified person. And yes, as a PA you are lesser qualified
I have a master's degree in my field and there are people with doctorates in my field and I understand that they are more trained and more skilled than I am and I don't get upset about it
So because a patient doesn't want to see a someone less qualified than a real doctor, they are difficult?
Exactly. If i’m getting someone to treat me who isn’t a real doctor then why am i getting charged the same price? I should get a 50% discount since i’m getting a person who’s pretending to be a doctor sent in to treat me
i mean, PAs can pretty much do everything that an MD can. People just care too much about the title
@@aya-_-3045 No they can't! That is nonsense!
@@robertuk2006 Yes. They are difficult because they do not understand the medical field. Physician Assistants are well educated and can handle most patient presentations. A patient that demands to see a Physician for something that does not require a Physician is a difficult patient. The Physician will feel the patient is difficult too because now their time is being wasted.
It's like telling the nurse to fuck off with the IV and get a real doctor to put it in. I doubt you'd ever say something like that.
@@bryndrson8289most are missing the most important part the patient / physician bedside manners. You're not our doctor, your hisssssss Assistant
Love the videos. Just have one question. Is a PA the same as a NP ( nurse practitioner)?
The roles are very similar in most states, just some differences in schooling!
Different in scope of practice. A Nurse Practitioner needs to be a RN and attend nursing school.
I worked from 1978-2017 in eleven different medical specialty throughout my PA career. The experience that the PA profession has afforded me was delightful, honorable, and noble. Patients and families that I have dealt with were respectful, kind, and appreciative. I will admit that there were probably less than 20 patients that reminded me throughout my 39 year career that they would rather see the physician but once they get to know more of me (from patients talking in the waiting room) then they become quite eager to meet with me. I feel that my experience as PA is universal among most PA.
Right.. Eleven different medical specialty (Specialties??) So, as the old saying goes, you're "a man of all trades and a master of none". Its not right that this can be done when you're playing with peoples lives.
@@atticuskuhn1534 you are much too young to even judged me. Why do you think that I played with people’s lives? You haven’t lived long enough to value each person and have not faced any life or death decision. You might consider yourself an expert in your profession but you are still ignorant in general term. Don’t bully this old man.
That's all great and good but if I want to see a doctor I should be allowed to see a doctor and not someone with less than a quarter of the training
Lol to all the people who have no idea what a PA actually is or how to even become one and degrading the entire profession, how about first try getting into PA school before talking down on the profession as a whole. Your one bad experience does not define the profession and that goes for all other professions including MDs, DOs, NPS, etc. And clearly to everyone talking only about MDs, you do realize that there are DOs too right?
You're comparing a P.A. to MD's, DO's, ???? There is no comparison. P.A.'s have way less schooling and requirements that affect peoples health and their lives. Doctors are so far above P.A.'s that a P.A. will never earn the respect that a Doctor gets, and they shouldn't since they only want the prestige of the medical field, and the money, without having to do the schooling.
@@atticuskuhn1534 First of all I never compared PAs to MDs. Clearly you have no idea what a PA is nor their training. Try applying to a program, then we will talk.
I see a PA, for my diabetes. And shes amazing, plus she has diabetes as well. I love her
That's amazing!
And what will you say about the performance
Kinda funny, but I tend to get better care from NPs and PAs than MDs or DOs. I mean, there was one REALLY nice doctor I met with once who outdid the nurse on being easy to talk to, but most of the time it's the other way around. Heck, one time I went to the urgent care and the PA was so nice and helpful that I vaguely wondered if I could make him my primary doc.
Sorry, but the inflated premium that is taken out of my bi-weekly paycheck will be used to see an MD, not someone with a master's degree (that's usually in their 20s or 30s). And I don't like that these smaller providers try to hide this type of info, very un-professional.
If I got something serious I would rather speak to the actual doctor (your boss) not to be disrespectful but just because I want the best if you're the best and you're the PA then so be it .
And if you've got a good PA and it's something serious out of their scope, they would definitely involve the doctor. Totally fine to have a preference!
@@ThePAPlatform But if the PA is not educated on the problem they couldn't be expected to notice it, so your argument is wildly illogical.
Holy crap. If you are seeing 30+ patients a day there is no way they are getting optimal care.
Hmm... maybe that’s why they work long ass hours... dumb***
Welcome to the sickcare system
It's actually legal to provide minimal healthcare, and it's unfortunate.
30 is a good number…. Most MD are seeing 50/day with scheduled 10 minute visits. It’s the patients who should be refusing a 10 minute, rather than being seen by a PA, NP, or MD!!!!!
I feel like PA we’re designed to be able to pump out more meds with a lack of doctors in the US
This isn't about you, a PA is just a pretend doctor.
I refuse to be treated by a PA. U did not go to medical school. My drs who do that to me i walk out simple. Nothing personal. I pay for a dr visit its just to streamline the ers teiume and increase their revenue...
.own up to the fact u are not a doctor.
I searched if it’s true that patients are charged the same for seeing NP or PA vice a Physician and this is what I found posted on a forum:
That's a good question. Here is my cynical, but I think largely true, response:
Insurance companies are not interested in saving you money. They are interested in saving themselves money. Co-pays exist to give the patient skin in the game. If you could go to the doctor (or APN) at any time, paying nothing, you would be more likely to go for every little ailment. With a co-pay, you are more likely to consider the necessity of that trip. Reduce the co-pay, increase your likelihood of seeking care, increase the insurance company's payout. While they may pay the APN less than the doctor, they still pay him or her more than the zero it would cost for you to stay home.
I saw a pa before and they literally do everything that a doctor does.. I didn’t see a doctor not once that day.
That you know of. That's the point.
I think the name is the problem, Physician's Assistant implies you are not a Physician and therefore not qualified to do the doctor's job, which is true in many scenarios, so I think a different name might actually be helpful
Vice Physician, or VP
Maybe co junior doctor ? 😂🤷
With all respect to PAs as I think they are more than qualified health care providers, but the name shouldn't imply that they are physicians because they aren't
@Nowhere Man I think you're getting to caught up in titles
@Nowhere Man all I got from that is you got caught in the titles of some....whether it be a manager or doctor or PA. Im sorry you had a bad experience, hope it turns out for the best.
I am considering becoming a PA but the first encounter I've had with one really discourages me. I was at the clinic, came in sick just to get checked maybe get something to help me. The nurse asked if it was ok if I saw the PA. Said yes. Later the PA walked in and just really glanced at me and then wrote something down maybe a prescription idk but he said I'd need something and that I'd be ready. Then he walked out. Usually the doctor asks at least "How's it going?". The PA seemed really cold and in a rush. I believe it was due to his contract and pay, he was trying to see more patients so he's get a bonus. The doctor wasn't at the clinic yet so it was really his chance i guess.
Hi, one encounter with one pa does not represent the majority of them. After all, PA’s are people too. That person may have been going through something, who knows? I think that is a more personal problem, not a problem with the PA profession!
I have had bad encounters with MDs that was as cold as ice and unprofessional, so it all depends on the person or personality that a person comes encounter with. The United State ranks very low in the health industry when it comes to the patient to doctor relationship. Probably because they have 30 to 40 people to see a day and don’t have time be warm and friendly…..most times your just a number.
Paid for a doctor, want a doctor !
Honestly I would not care what the patient thinks, I’ll be happy to pass them off to someone else to care for. I would just hate to see someone else get a crappy patient because of me. Also. idk why PAs care so much about what people think they’re capable of and what they should be called, such as physician assistant or associate. Call me whatever you want as long as I’m paid and happy 😂
That's pretty much what comes off too, because you don't take into account a patient filled out 3 hours of paperwork that you didn't even bother to look at, asking the questions over again. Make a connection by showing interest, don't ask questions that don't pertain to the history of why the patient is there, take proper notes, if you didn't understand something ask again so patient history is not your convoluted information, have a personality stop acting like your our doctor,.we didn't pay to come see you!!
Lucky you, my SP relishes in the opportunity to make himself look smarter than his PAs..... And he's often wrong because he doesn't ever take time to listen to what the patient is saying.
That same situation makes me laugh, because when the dr is wrong, the patient ended up making thier situation worse, and of course if the dr hadn't been involved, the patient experience would have gone much better if the patient misconception hadn't gotten in the way
I bet he has a higher IQ! You can't handle med school!
@@robertuk2006 and you have?
Lose him quickly!
If PA's and MD's can basically do the same thing then whats the difference?
PA are generalist. Doctors have to specialize. Also pay, schooling duration and overall credentials.
PAs can do basic doctor stuff.Doctors are not always specialists as jiron127 wrongly said but even if they arent specialists their knowledge is WAY above a PAs
@Jordan if PAs are mid-level then what are nurses? Low-level? Entry-level?
PAs and NPs are advanced practitioners, no one said they have endured anything an MD or DO has to go through in the U.S. ( aspiring physicians in Europe and other places around the globe have it way easier)... however, calling them mid-level shows ignorance to the level of education and skill they acquire during their careers, required hours before being accepted into their prospective programs, and their education, which does require a lot from an individual.
Most of these people who become advanced practitioners do not desire replacing physicians, but help them by providing care and alleviating strain.
@@BritneyNicoleandMyeloma A lot of PAs and NP i know self identify as Mid levels. I think a lot people get caught up in titles and really should just be proud of what they can do and have accomplished 😊
@Jordan very cool! I am also a paramedic and I am an MS1 right now, hoping to go into either emergency medicine or critical care. That's awesome the youre in interventional cardiology!
I dare anyone who thinks PAs aren't knowledgeable to apply to PA school lol.
I've been in the field for about a decade as a Physician Assistant. From my experience, it's usually patients with minor issues that demand to see a DOCTOR. I'm usually relieved when that happens actually, but I do feel bad for the doctor that's about to experience this personality type. By this type, I mean demanding and rude. Of course, not all patients that want to see MDs are like that, but like I said, a majority are difficult to deal for any provider in my experience. Also, let me remind you why PAs exist. We exist because the health care system needs us. MDs are trained to be both scientists and clinicians. That's why it takes so long and so expensive to graduate a MD. A patient in need doesn't need to see a scientist; he/she needs a clinician to diagnose and treat the problem. That's exactly what PAs are trained to do. It's normal for patients to feel that they have a rare condition that only "Dr. House" can solve. In reality, it doesn't take much to diagnose and treat most of the problems. It comes down to pattern recognition and following standardized treatment protocols--with a touch of common sense for personalized care. MDs are great, so are PAs. I've seen both MDs and PAs do great work and also make mistakes. We're all human. We all strive to be better. This is why we call it medical practice. Patients are free to see who they want to see. But as a patient, please be respectful to the provider you're seeing; if you don't want to see a PA, you should have checked to make sure that you don't schedule to see a PA. I'm sure that PA would rather use his/her valuable time to see someone else as well. At the same time, be grateful that part of the reason why you can see a MD in a reasonably time frame is because there are PAs sharing the patient load, contributing to and making our health care system run more efficiently. Also be grateful that you can see any provider at all in America; there are poor people suffering in third world countries that don't have access to any care. As a MD, please be respectful to your PA colleagues. We're a team. I've seen PAs ask MDs for advice and vice versa. I understand the human nature to be competitive and territorial; I urge some of you to remain rational. Don't see PAs are threats to your jobs; see us as part of the solution to a very expensive health care system. Some of you say that PAs are not competent enough to see your patients, but are you willing to take a pay cut and work longer hours to see all the patients yourself?
"Personality type"??? People make a Doctors appointment. not P.A. appointments. I make a Doctors appointment. I don't make a P.A. appointment. I hate it when I make a Doctors appointment and a P.A. comes in and its been happening more and more to me in the last 10 years. I feel I've been lied to when that happens as no one tells me when I make the appointment or even when I go to the appointment. I've only found out I'm seeing the P.A. when they knock twice on the door, open it, and come in. It always leaves me in shock that I was lied to like this. I want to see someone who wants to be a physician, not someone who wants to be in the lucrative medical business but doesn't want the responsibility of being the Doctor but wants something better than a easy to get, 9 month Medical Assistant degree at minimum wage. I've asked P.A.s, I've scoured the internet. I've looked and looked as to why we even have P.A.'s. Everything lead to the answer of a P.A. with laziness that is wanting of something for doing near nothing and not have the responsibility that the actual Doctor has. Seeing a P.A. when you're expecting to see a Specialist is insane. The Specialist has schooling beyond Med School for that specialty. The P.A. gets a little training from the actual Doctor as P.A. schooling is General Med. .
Everyone gets angry when they're lied to. Everyone has a reaction when they're expecting one thing, and get something completely different. It should be illegal to not be told that you're seeing a P.A. instead of a highly educated Doctor with years and years of education and training. Not someone with just a few years of P.A. school and then put right to work. P.A's will never get the level of respect that Doctors have. If you want respect in the medical field, become a Doctor.
@@atticuskuhn1534 Good for you, loved your comment! Totally agree with you!!
Where did your M.D. board certified Dermatologist find the time to train you? My Dermatiologist sees a patient about every 10 minutes throughout the day. Why do you have a model of a human brain on a shelf behind you? If you were fortunate enough to own a Lamborghini automobile, would you be happy to have a young apprentice mechanic do the work or would you rather have a cerfified mechanic with 9 or more years of training and experience.
If i want to see my doctor i should be able to. You don't like it? Too bad but sorry if i don't think your master's degree is equivalent to the doctors med school, resudei and specialist training.
Im sick of seeing PAs
I'm supposed to be having back surgery and I keep having to see the PA instead of the guy who's going to be doing the surgery on me
Excuse me if I want to actually meet the person and talk with him before he cuts me open. And does life-altering possibly life ending surgery if it goes wrong since it's a very delicate pro
PAs need to get over it. You're not doctors but you want to be treated like it. If that's the case, go to medical school
If they’re going to have you see a PA then the cost should be less. Why should i be charged the full price of a doctors visit when i’m not even seeing a doctor? That’s like going to McDonald’s and paying for a Double Quarter Pounder and they give you a McChicken instead
No, it's like you pay for a Double Quarter Pounder & they give you a Mc Double
THE SYSTEM IS BROKEN!!!! I AM A PEDIATRICIAN'S DAUGHTER I KNOW HOW IT IS SUPPOSED TO BE AND IT IS NOT FUNCTIONING - this girl looks and sounds like she just graduated from HS - she may THINK she knows what to do, but there is a reason why a DOCTOR needs to see a patient when they come in - because EVEN the doctor will miss something, so the last thing a truly sick person wants is to get worse bc of EGOS
There's actually a licensed pediatrician of 8 years in my pa class.
As well as a pharmacist and 2 foreign doctors.
The PA profession is a spectrum, but by and large we all have access to the same study material and we are all licensed under the board of medicine. We take different exams.
Derm is not something people are referred to for life threatening diseases. So your entire case boils down to you not knowing how medicine works.
Similar to why PAs and MDs exist, optometrist and opthalmologist exist.
We can each develop our own niche and help bring in more revenue for healthcare employees. Don't you think healthcare workers deserve more pay?
I honestly rather see a Physician Assistant or a Nurse Practitioner. In my experience, PA’s & NP’s are much more thorough.
I rather a NP
I think the name should change. As we are not true assistants or associates. It seems to undermine our overall usefulness and scope.
I think something like a doctor/physician consult would be good! Or interim doctor/physician. Or physician generalist.
Btw im not a pa yet. I'm trying to get in school for it 😅😅
You not smart enough for med school then?
@@robertuk2006 what are you referring to exactly? People in school for PA are not in med school 🤣. Don't want to be doctors.
@@Jiron127 Doctors are physician generalists.U cant be like them if u dont become a doctor.So u want to not be considered the physicians assistant even tho your education is so much less?You rly believe that you have the same knowledge as a doctor?If so then how are all these years u need to become a doctor explained?Why doctors need to do residency and they cant easily chnge it?The reason PAs have an easy time changing where they work like from dermatology to emergency etc is become its a lot of easier to do.U dont have that much knowledge so its easy
@@tyler1594 As someone that was in med school, you clearly don’t work in medicine 😂 Or speak good English
@@haydenmoore4904 when u have no arguments u talk about grammar mistakes
I'd rather go to a real doctor not a physician assistant.
I believe assistant or apprentice physician is a better description than physician assistant. While not as educated as a doctor obviously , a PA is certainly closer in knowledge and responsibilities than a MA or CNA.
Most PA's are not planning to become doctors, no more than nurses are.
I disagree with your point of views about PAs. I have been to both medical school and PA school, there is no difference in the curriculum, it’s exactly the same model of teaching Allopathic medicine, all the same subjects, same rotations, same infrastructure. The only difference that PAs don’t undergo residency, while physicians do. PAs get training at work . I have been PA for 20 years.
Now I realized that PA profession is being undermined, abused and belittle by the physicians, by patients and by the other nursing staff.
PAs are equally competent as physicians in every aspect of allopathic medicine, we see the patients, diagnose them and then treat them and then prescribe medications.
Physicians do exactly the same thing. In the common person’s view a doctor is the clinician who treats the patients, so why not PAs should be called doctors.
PAs are not physicians but doctors, yes... the name PA gives very wrong message to the patients and create more confusion. It was the biggest mistake right from the start to pick up this name.
PAs are trained as family physicians ( like all rounders) like generalists, so the best name for the PAs should be General Medical Doctor( GMD) and they should be given 3-4 years of residency in family medicine and primary care medicine and should be independent after completion of the residency and after passing the boards.
This way, there won’t be a shortage of doctors and instead of hiring foreign medical graduates, they should focus of American trained medical graduates like PAs.
We don’t need physicians to tag along after few years of training... I know more than new physicians after being PA for 20 years...
Please don’t undermine your profession, please do respect yourself and then others will respect your profession.
We need big reforms just like DOs and should be independent at least to become GDMs( general medical doctors).
Please don’t confuse your patients, don’t confuse yourself, don’t confuse physicians and once you will have your full recognition and independence, you don’t need to explain and you don’t need to struggle for your recognition through your your life.
Trust me I have been there done that, in the beginning I was okay but with time I am very frustrated, dissatisfied and unhappy with my profession. It’s not the profession, it’s the struggle for the recognition.
We don’t need that... enough... just like other professions we need full recognition. But for that we need an independent mind, not a subordinate mind to become someone’s assistant... it’s just shameful.., just think about it...
Wow, that is completely untrue, medical school and PA school most certainly not the same. You will not pass even a USMLE step 1 if you went to PA school. Come on! 🤦♀️
No. This is prideful.
You know, self evaluation sometimes isn’t reflect the truth as everyone else clearly sees it.
Amazing response!!!🎉
I would refuse to see a PA! I want to see a real doctor! Not someone who can't handle med school! "Doctors" on the cheap!
@robbie Aikman you do you. But you should know that PAs become PAs because they DO NOT want to be a doctor or nurse/NP not because they can’t handle the schooling. They work in conjunction with The MDs not for the MDs. Furthermore, one can see a PA in say an ER setting and be charged a fraction of the cost than if an MD poked their head in and quickly did the exact same questioning and examinations as the PA. So respectfully, stop assuming that PAs are not good practitioners because they aren’t MDs. Also, stop trolling on a subject you obviously know nothing about.
PA school is more difficult to get into than Medical School. I would know, I applied to both.
@@bryndrson8289 More difficult? Don't make me laugh!
@@robertuk2006 Yes, MD/DO was my backup plan. PA is a better career. Especially DO requirements, those are quite pathetic in comparison.
@@robertuk2006 it's true. pa school is harder to get into than med school. as of 2021, overall, pa school has a 25%-31.6% acceptance rate whereas med school has a 40% acceptance rate.