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 Provided by: Clinician 1
Like “Assistant” the PA profession uses words to describe ourselves that are inaccurate and that we, over the years, have changed the meaning of. Please allow me to explain......
I went to see a PA last week. Before I was able to say that I was a PA, she gave me her “rap” about what a PA was. Before I knew it she used the “S” word. It hit me again like a ton of bricks. I know, I know, I have written about it before. Just how the “S” word hurts both PAs and NPs but this time I experienced it as a patient would.
Can I ask all the PAs and NPs who have the word “supervision” in their practice acts to do me a few favors?
Especially for the PAs, please realize supervision means something different to everyone else who hears it than it does to us. Everyone. Even most NPs don’t understand the “PA meaning” of the word supervision. Anyway, this nice lady tells me she is a PA and practices under the supervision of the specialists in this group. That’s all she tells me. If I did not know better, I would think she was a medical assistant with an attitude. At least by definition.
Why? To the rest of the world, “needing supervision” in any employment sense, means you are not yet fully competent and have to be watched. Or else, why would people spend that valuable time watching you? How could it be possible to most people that you are in a very responsible position and ALWAYS, FOREVER AND EVER until you retire need “supervision” to do your daily job? Please understand that the “S” word mislabels us and taints everything else we do.
Just for accuracy there are some things about the “S” word that need explaining. I am licensed in a state where I need supervision to practice, BUT supervision in my state can mean that the physician can be in another city. In fact, the physician never has to be physically present in my practice. There is no chart review, no protocols, nor do I even routinely have to tell the state the name of that physician. This is not the way everyone practices, but this gives the PA the latitude to bring our care to those that really need it. It has worked for 40 years. That, my colleagues, is not “supervision” by any definition of the word. When I tell most NPs the “reality” of the word for me, they are amazed. Many NPs still think supervision means the doc has to be “on sight”. Imagine what other people really think?
What PAs have is collaboration, not supervision. Always have had it. In most states and practice settings our definition is a complete misinterpretation of the word and it will get us into trouble if we keep using it. The intent of the word is vastly different from the reality of the definition. Too different. Ask a lawyer. Maybe ask a jury. It says someone physically watches you do your job. It is about time we not leave the impression that we need to be watched all day or someone is there watching us.
So I will ask us all to not use the “S” word in the first sentence when we define ourselves. The second is OK, but maybe not at all. Maybe use other, more accurate words in all our sentences. This is not a cry for independent practice for PAs, just truth in packaging.
Here’s what I mean and here’s the way I hope we can start to say it.
New Patient: “Excuse me, one question please; what’s a PA?”
Common PA Answer: “A PA is someone who practices medicine under the supervision of a physician.”
What the patient really hears us say: “A PA needs to be closely watched by the doctor.” Some sort of trainee I guess?
What our answer should be:
“A PA is someone with extensive professional training and clinical experience who practices medicine. We may practice it in many different types of sites and in all of the different medical specialties. We work in a team with a physician and other professionals so that we can rely on the expertise of many different types of professionals to make you feel better. In fact, Dr. Smith, and Nurse Jones and I have been working together for 10 years now.”
If I were a patient, I’d much rather hear the second. Especially if I really needed your expertise at the moment. More importantly, the second answer is much closer to the truth. Words are powerful. Let’s choose them carefully.
Dave
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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