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 Provided by Clinician 1
Lately the physicians of America (or at least their organizations) have been taking swipes at PAs and NP as they see us being looked at as a partial answer to the primary care crisis. Usually the organized medicine argument concerns itself with the “education” of the NP and PA and goes something like this:
The NP and or PA do not have four years of medical school plus four years residency training and thus have less scientific background to fall back upon. This extra training enables the physician to better understand the mechanism of disease, better predict disease states, response to treatments, drug function and interactions and the degree to which different concomitant illness contribute to the patients’ symptoms. To not understand this is dangerous and patients safety is put at risk when they see PAs or NPs, especially when they are not in very close physician contact.
This argument makes sense to many that hear it. Especially because there is a bit of truth to it. The true part is that we do not have as extensive formal training in medicine as physicians do. Please note I said formal. An NP or PA has years of prior experience before we enter our educational programs, giving us a different experience which can positively aid our ability to care for patients but it is not equivalent. The truth is we are not MDs or DOs. We are not mini-docs. We are different and that does not mean less than. It seems that organized medicine wants people to see not equivalent as not worthy. Today physicians train to be specialists in residencies as some of us do and increasingly will. Generally we PAs and NPs train to take care of complaints that surely overlap with physicians in 90% of cases, but we train differently. The point is our training works. What is incorrect in the physician argument (and what we should shoot holes in whenever we can) is the inference that everyone needs a physicians education to diagnose and treat people with illnesses. Or if we do not have one we are “unsafe” or dangerous. Poppycock!!
Our answer should always be that “we are more than adequately trained to diagnose and treat almost all illnesses that walk into any clinic or office”. Tinea, flu, immunizations, hypertension, bronchitis, asthma, rashes and all the rest can be cared for in a cost effective high quality fashion by NPs and PAs. We know what we are doing and we have shown that the care we give is excellent. If you are an NP in a rural clinic without a physician or a PA with a physician 100 miles away, the truth is you are there because you are filling a need and filling it well. My belief is that we have already proven that physicians are over trained to see these types of problems and that is exactly why many chose not to continue their careers in primary care. The physician market has spoken. Patients are happy when they see us and when we are studied, both professions do very well. Is there room for improvement? Surely. Can we make our programs better? You bet. But we do have a 45 year track record that says we are excellent clinicians and are capable of doing what we do best; providing safe, high quality medical care to people in need, across all specialties.
We are not physicians, nor do we need to be. We have already proven that.
Dave has been a PA, and later NP, leader for thirty years. He strongly believes that NPs and PAs must work together to insure a better future for both professions. Most recently Dave has been busy launching another dream; Clinician 1, the first internet community for PAs and NPs. In October 2008, Dave was honored by the New Jersey State society of PAs with its “Lifetime Achievement Award”.
The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
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