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Turf battles are interesting as there is always a nugget of truth and a mountain of hysteria, greed, jealousy, false reports, lack of knowledge or just plain ignorance. The Docs did this to us in the early days of the PA profession as well as almost every state nursing association. We won the hearts of our initial adversaries by demonstrating the same type of concern and commitment that nurses have always shown, and, in addition, we were able to demonstrate a knowledge of medicine and a desire to cure the patient, as well as work as a part of the team. I helped nurses with bedpans, acted as a tour guide when a patient’s family looked confused, picked up refuse on the floors, covered my nursing colleagues if they made an error that could have hurt them professionally. I stood by them as they tried to have collective bargaining units and actually was the medical staff liaison for nursing in one hospital. Respect is earned not gratuitously given. The Docs could not imagine that someone other than themselves were able to listen to a patient’s heart and lungs, do a physical exam, work up a disease and implement a medical treatment plan. In surgery, we demonstrated that we were more than adept at our skills and that, when faced with a new procedure, we actually read up the evening before, knew the anatomy as well as the physiological changes that were taking place because of the procedure, and we studied the potential complications of the surgery which helped us to prevent them.
Patient care is learned initially from a book but ultimately by caring for patients. We learned this craft by carefully listening to our supervising physicians and practicing evidence-based medicine three decades before the concept existed. We learned from our errors and our successes, and we won the physicians’ respect. There are still Docs that wish we were never born, as we can do most of the care that they do, and they perceive us as competitors instead of partners in medicine, but that’s the way the cookie crumbles. We have become their “bastard” children, as they gave birth to our profession because America had a need, and we returned from war with skills that were well proven.
OR nurses regret the day that they taught, mentored and opened the doors for technicians at that time, as the techs formed an association, developed standards, had an outside agency create a certification exam, and now are in every OR in America. They too, were considered the “bastard sons” of the nursing profession. This resembles mothers that reject their children. Yet once again, they have the respect of their nursing colleagues who see them demonstrate the appropriate knowledge on a daily basis and many have pride in their “children.” Solomon said, “There is nothing new under the sun.” Whenever a new class of provider steps up and do our jobs it causes insecurity. I say, “This too shall pass.” Regardless of the opposition, the people will see the need, the government will certify the providers, and the Canadian PA will stand side-by-side in every province with their American counterparts. It takes the will to fight, the knowledge of the community’s needs and the faith in the future and it will come to pass. Anyway, thanks Dave for being one of the very first to address this situation.
 Robert M. Blumm has received national recognition as a distinguished fellow of the American Academy of Physician Assistants (AAPA). He is the past president of the Association of Plastic Surgery Physician Assistants, and was past-president of the American Association of Surgical Physician Assistants, past president of the American College of Clinicians and NYSSPA, as well as Chairman of the Surgical Congress of the AAPA. In addition, Bob received the John Kirklin MD Award for Professional Excellence from the American Association of Surgical Physician Assistants. Along with his associate, Dr. Acker, Bob was the first recipient of the AAPA PAragon Physician-PA Partnership Award. He has been a contributing author of three textbooks, written 150 plus articles and is a sought out conference speaker throughout the United States.
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