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| In Medicine, In Egypt and In Life The People Always Win: A PA's Perspective |
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by David Mittman, PA - February 14, 2011
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 Provided by Clinician 1
For the last 17 days I kept watching Hosni Mubarak not “get it”. I saw hundreds of thousands of people marching asking for change and yet he and the entire ruling class stayed rigid. They listened to their people reluctantly, trying tricks and false promises. They were “in charge” and only they would decide when things change. Even though things had ALREADY changed. All they had to do is look around at the people. Look at things like Twitter and Facebook. Listen to them. Talk with them. Instead they blamed “troublemakers” and said the people did not understand the “full picture”.
I got to thinking. They sort of sound like organized medicine. Please, I am not comparing any physician or groups of physicians to dictators, but the excuses they use sound the same. They too have been in power for a hundred years or so over their country called medicine. They have started to see that the public and even many of their peers realize that change is needed. They know that the “revolution” in medicine has begun. There are fewer physicians providing primary care. There is a crisis today that calls for open leadership. The crisis has been looming for years and yet nothing was done. The public and many leading physicians call for change. They call for a new way to provide care. They call for the use of NPs and PAs to the fullest extent of our training. They realize that PAs and NPs can provide all types of care and are wonderful providers. Yet, the answer from organized medicine is usually the mantra of giving more money to more medical schools or to pay family doctors more. It is never to say, “NPs and PAs have proven they are valuable answers to the provision of healthcare and we need them”. “Let us all work together to educate each other so that we can meet the challenge of providing healthcare to all Americans”. If they did say this, I was not at that press conference.
Instead of embracing change or even trying to manage that change, they resort to the same tactics so many who have had power use. There is no tranparency. No dialogue. They talk differently to different groups. Their narrative is really out of touch with the reality of what PAs and NPs are doing in 2011. They belittle the clinicians they see as competition to them. They want to use words like “supervision” to control others, even after you practice fifty years, you must still need supervision. Foolish. They tell newspapers and interviewers that we are nice people but “we do not have the education to know what we don’t know”. People see right through it. They use their well deserved expertise and excellent education not to study the evidence, but to control.
Even within the NP and PA professions some leaders “know better”. I have heard a few leaders suggest that grassroots people can’t see the whole picture, that things the profession feels are problems are really because of rabble-rousers and malcontents. Sometimes they might be, many times, it is the majority talking.
Eventually, the people vote with their membership dollars. Look at the AMA's membership trends. Still they don’t listen.
Sooner or later the people win. The people will always get to call the shots when what they feel, or need, or want is not being provided.
Even though they want to treat you like you are children, or need to be supervised forever, or like you “don’t get the whole picture”.
Until you do.
Just ask Hosni.
 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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