I must reiterate, an NP is not a physician helper but is an independent practitioner. While you may feel this piece was demeaning, it was truly not intended that way. After I found out that hospitols where allowing class room full of stufents to come into surgury and all take a turn sticking their fingers in patients vaginas to do pelvic exam for practice with out their knowledge or permission! Christie Kidd, as the go-to MD practicing in Beverly Hills., The article shared how Ms. Kidd treats the Kardashian-Jenner family, helping them to look luminous in their no-make-up selfies., While most of us cannot grasp the distress caused by not appearing luminous in no-makeup-selfies, this is significantly concerning for Kendall Jenner. There is a place for PAs and NPs in healthcare. I have a PA in my practice and hes a genius (and overall badass.) Any RN can go to NP school and most now do it online. NPs will meet their maker when they start getting sued for their stupidity. I commented below about the professions not being comparable: there is no us vs. them. I hope so. Regardless, I agree with you that collaborative environment with respect amongst colleagues is the best choice and yes, many of us in rural areas are so darn busy, we would love to have an MD, NP, or PA join us; because our patient loads can really be overwhelming.. You brought up the situation of a sicker patient being sent to the PA vs the MD and that it should be the other way around. Doctors Should not be Treating Physician Assistants as Substitutes. As a physician, the insecurity by PAs here is astonishing. As for the subject matter we should all be very clear about our licensing and skill set. Why is this so disagreeable to you? Medicine is not just about spending time with patients and being caring, it is about correct differential diagnosis and using evidence based medicine for testing and treatment. Consider the various stories of physicians committing Medicare fraud as a result of such practices. That is a dangerous Sorry to disappoint you there. All the best to you in the future. My questions neither favor the physician or the extender. Why does she refer to herself as Dr. Kidd? But, we are all fallible people and unless you see these things once in awhile, we are all going to miss them, including the sharpest doc. Perhaps she doesnt misrepresent herself but rather others have done so. You will find that piece was almost as controversial as this one. Respectfully, most of us dont. RNs love to tout how their RN exoerience should count fir something toward their NP. Clinical time is required in all nursing rotations. In our area other providers know my name and associate me with excellent care.there are always bad apples, and I have meet some physcians that I am truly shocked how they even made it through medical school. I too am a PA who always ensures my patients know exactly who they are seeing. In many areas of medicine it is nearly impossible to tell a PA and a Physician apart. Note, I do not say that midlevels are inferior, but the role of midlevels is different than that of physicians. WebRadiologist Assistant (RA) Respiratory Care (RC) Active Military - Temporary License; FAQs; Renew. I have much to learn in the world of writing and am always looking to improve my skills. Ms. Kidd seems almost ashamedin action, not words. Its sad when there are some who take offense when no offense was intended however. This article IS about misrepresentation and it happens to be a PA this time. The HMO blurred the lines using the term healthcare provider. There was a time if a patient referred to a PA as Doctor they were immediately corrected by that PA. This is called OTC drugs True A generic drug has a chemical composition that can increase the effects to the patient False Aspirin which is composed of acetylalicylic acid, is a brand-name drug False Physician assistant are legally allowed to write prescriptions True While a PA is educated in the medical model, as is a MA, and an AA, this level of training is not at the same level of detail, nor does it specifically train to provide the necessary prerequisites for independent practice; hence all non physicians trained in the medical model are called assistants. Every area of medicine and every Physician is going to be somewhat unique in how they see the role of PAs and I think Physicians are in the best position to be leaders in defining the role of the PA. Your email address will not be published. Absolutely nailed it. I can out diagnose and give flat out better care than many MDs I have worked with but that doesnt make me go around claiming I had more training and education by passing myself off as an MD. Many times I get a call at 2am from a physician who has been up all night trying to figure out why a patient is not responding to care as they should. Im going to address your post in the order in which I see something I would like to comment on. WebWhen any medical provider-physician, nurse practitioners or physician assistant-works outside the scope of their education and training, patients are at risk. see my comment above. The fact that this person would try to obfuscate her credentials speaks to her character. So yes, its a problem. Point is have you ever told a patient that would or did happen? Next time, direct your extinguisher to the fire (aka, PA Kidd) directly. My step son is a NP. I work with an incredible team made up of NPs, PAs, and physicians and we all show the utmost respect for one another. Also She is cutting me off some of my meds because its been 2 months since Ive seen her can she do this? The MD and PA team that I work with have provided me with seamless care in a world renowned facility. As far as grading we could have PAs take the same test FMGs take when they enter the country and then for generalists they could take the Internal Medicine Boards and the subspecialty boards if they are specializing. However, no matter what degree you obtain, there multiple prerequisite course requirements in biology, inorganic chemistry, organic chemistry, statistics, and upper-level science courses ranging from microbiology to embryology. That PA Kidd, that your blog wrote about must be an excellent provider as I doubt such well known would return to her practice otherwise. Thanks for bringing this up. I have heard some good Physicians say that after about 5 years of practicing, a good PA who studies the evidence and is mentored by Physicians can be every bit as knowledgeable as any Physician, especially given our rapidly changing medical environment. Exact requirements may differ between schools, but overall you must have taken courses in the hard sciences regardless of your undergraduate degree. Did you consider that her patients know she is a PA and are very happy with the care she gives? During several years of Blogging, I have never seen such a fuss. Good luck to you. Thank you for reading and commenting. I understand where you are coming from, feeling concerned regarding the education differences between MD/DO and PA/NP. You dont really want to go there, do you? I woke up to the pa handing me my underwear and was told they where removed during surgury. Im lucky to work in a truly team based practice setting so perhaps some of the attitudes conveyed here are simply more foreign to me. Handles you roughly. This is learned in Medical School and Residency/Fellowship. (CCI), which has locations in Harlingen and Brownsville, following the suspension. I am a PA who greatly respects the MDs I work with and who feels incredibly grateful for their mentorship. She flat out lied to me!!!! Thank you. The search for truth, left unattended, is no longer an alternative when the choral ending occurs. Please leave my father out of this. However, the content of your article and the subsequent commentary from others here substantiates my point. Does being a helper mean you do not provide quality care? Before you slay all of us for being unethical, uneducated, clinicians, you should do some actual research. Can you say the same? I wonder how many people are killed by docs every year as opposed to PAs? PA school was very challenging. Patients should have the right to know who is treating them and clearly understand the differences in their health care provider. WebPros and Cons of Physician Assistant Pros of Physician Assistant Adjustable schedule: An individual working as a physician assistant can have a flexible and adjustable schedule, Mid level providers have a role, but given the more limited training that they have, that role should be supervised by board certified physicians. Yes, for hundreds of years medicine was more of an apprenticeship than a formal didactic education. Think of the electrician that has the certifications necessary to do the electrical work on a new home or remodel. Do I have to meet the CME requirement in the Risk and Abuse Mitigation Strategies rule? You brought up the situation of a sicker patient being sent to the PA vs the MD and that it should be the other way around. My contention however is that the major difference between a good and bad provider is their bedside manner and caring nature and not their years of education or even their breadth and depth of knowledge. My claim is that I am a good PA that can out diagnose and give better care because I learned how over eight years of practicing and studying and caring. I know this is a long comment, but I will not apologize for it. She will not give me a sleep medication for this Being open, honest, and transparent builds a patients trust and that is good for patients, all clinicians, and our healthcare system as a whole. Surely you could have made your point in a more eloquent and sophisticated way, dont you think? WebEligibility requirements for physicians and physician assistants: Full, active, and unrestricted licenses are required for online registration. Treats his nurses and assistants poorly. Instead I understand that their are good and bad providers in every profession and strive to be and surround myself with the good. Right now it seems too many responders are in a defensive position rather open to debate on policy considerations. If you understood the history of PAs and their current educational standards and the accreditation process then I dont think any measure of the quality is needed. If your practitioner talks down to you or does not speak respectfully, this could be a sign that they are a bully. Niran Al-Agba, MD is actually a physician. She practices in Washington state. I dont think we can make generalized statements about the quality of current PA and NP graduates but certainly the more we have the greater the variety. Why is it ok to mislead a patient about educational background and credentials as long as no patients complain? That is a fact, not an opinion and not a merit-based statement about the profession. In practice PAs are being given virtually identical roles and responsibilities. Instead, she spent the time to write a piece, based on a TV show, and a newspaper article (with a MD who has written a large number of articles which are derogatory about anyone other than an MD working in dermatology) about a single PA but titled it The PA Problem and implied that it is an issue with the profession. Her really happy patient Kendall Jenner called her a dermatologist. I think that approach is terribly unethical. Two years of prerequisites is not always a necessity, there are nursing programs that accept students straight out of highschool, so that is not a constant. I think what myself and other PAs are trying to point out is that the piece very much is demeaning to PAs as a whole and in actual practice there are many more important factors that distinguish a PA from an MD rather than their training. Pitches for healthcare-focused startups and business.Write-ups of original research. Apply Renew Maintain Practice Information They disregard or become offended by my leadership, which is the same style I have used for 22 years. WebHear straight from our own Physician Assistants. There are providers from every field with whom I wouldnt entrust my dog, and those with whom I would trust my life. Im not saying this is the best way to manage things, but it is the gold standard today. Maybe it is just a notation mentioning he passed away in 2017 after founding our business partnership? Furthermore, NPs have no ongoing certification maintenance requirements outside of CMEs (75-150 hours) and clinical hours (1000 in their field of practice) per 5 years. You will have to take that up with the authors of that piece. I owe my life to the entire team, including the nurses and administrative staff. In healthcare, honesty and transparency are paramount. I am done. In short, there are providers from every field who excel and those who just get by. There should always be some degree of collaboration with physicians because, as much as we can argue about whose education is more rigorous, NP and PA education does not compare to that of a physician. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4730953/. Further discourse makes no sense. change in the law that requires that a physician must provide adequate supervision of delegates. I did not question the competency of thousands of clinicians. That is why the MD supervises the PA and not the opposite. WebI am a physician assistant (or nurse practitioner) with a QACSC. and you were able to articulate in your short paragraph the importance of not misrepresenting yourself much better than this entire piece. June 26, 2023 | Views: NaN. I think all MDs, DOs, PAs, and NPs should be aware of this and help us all stay within our boundaries. Honesty, trust, and transparency are ideals essential to the medical profession. Also, the first paragraph, about mid-levels over-treating benign skin lesions, does not logically lead to the content of the remainder of the article, which Dr. Al-Agba states is about transparency and which discusses the case of a single PA failing to clarify that she is not a physician. There are no derogatory statements about ANY profession being made. That is not to imply that other industrialized nations do not provide excellent medical care, they do. In my humble opinion, it added little to this discussion. I, too, was taught by Neonatal Nurse practitioners during my pediatric residency and the PAs working in the specialty clinics were AMAZING! True, you can have a 4 year degree in anything. The Delaware legislature passed new laws last year around the time of the Dobbs decision, allowing advanced practice clinicians to do early-term medication and vacuum aspiration abortions. Perhaps Dr. Al-Agba could ask the editor to restore her original title, as the current title appears to be a point of contention with the mid-level practitioners. It is sad to know that there are medical professionals out there with such a biased, prejudiced view of their colleagues. Your comment is incredibly uneducated, damaging, and inaccurate. A person who portrays themselves as a physician, but who is not is falsely advertising themselves as someone who has training and credentials that they do not have. Perhaps many of the respondents may have taken offense by Dr. Al-Agbas delivery, but do not allow that to cloud the issue. I, for example, had 2 years pre reqs, 3 years for my associate in nursing. New Jersey and Delaware are among them. emergency medicine, psychology etc. I used to hear that quite a bit. Rather than forging down that path, PAs embraced the physician lead healthcare team as we always have. Glad you saw the point I was trying to make that this is a piece about misrepresentation, not a commentary on the physician assistant profession as a whole. Absolutely agree. Dr. Al-Agba, This is about truth in advertising. Yes, it would have benefited our profession to actually prominently display herself as a PA, being clearly very good at what she does. Two to 4 years of nursing school is comparable to the required 4 year degree of all PA programs. Its sad to see one who feels she needs to misrepresent herself as a doctor. your license is under a current board order, or if you have notified the TMB that you are not actively practicing medicine, or. I dont understand why so many mid level providers are upset by this post. What on earth is wrong with being a PA? They have said they will be sorry to see me leave bedside but look forward to collaborating with me. Are you saying that such assessments should not be considered? Do not minimize the significance of this contribution to good clinical medicine because you believe it to be overrated. Do you realize the physician in this article is dead? No one has said PAs are all bad.. Further more, I dont recall that any of the national health system certification processes have ventured into this problem. She practices in Washington state. Are you telling me that you did not write that with the intent of putting down other clinicians who are not ACTUALLY MDs. WebDecember 3, 20215:00 AM ET From By Jordan Rau Enlarge this image Leslie Clayton, a physician assistant in Minnesota, says a name change for her profession is long overdue. PAs can be fined and disciplined by their own board for misrepresentation, however, her supervising physician is, in fact, also out of compliance with the law. I think patients deserve transparency. Now at least clinical hours are required . Dr. Al-Agba, you waded into this by publishing this article being critical of a profession that you have to work alongside. This is not what it was about! Her google business page used to read dermatologist. WebYes, the PAs supervising physician must delegate prescriptive authority allowing a PA to sign prescriptions for controlled substances, also called scheduled drugs, as well as Dangerous Drugs. It used to be they didnt need any clinical before they began practice. It was well-written and her critique of the PA in question was restrained and fair also. This was not intended to insult the profession as a whole. WebIt threatens patient safety. NP training is online and this allows the student to work, would this be considered full time? This is true, and I work with some fantastic NPs that were ICU nurses for 7+ years before beginning NP programs. Secondly, I would again urge you to do some self reflection. In my opinion, the gist of the article is a failure to be truthful in advertising ones title, education and practice. Especially for new graduates. On her clinic website, his name and biography is still prominently displayed as one of two practicing physicians, the other is the author. it is incredibly difficult to get into a quality accredited PA program, many say it is harder than med school.. However, the point of the article was not to highlight who is more important, but how hazardous and wrong it is to claim yourself as someone you arent authorized or trained to be. What you call insulting is simply the truth. And theyre acting like doctors., They are working like doctors, yet do not have training equivalent to physicians. I believe most physicians have confidence in RNs. I have experienced white privilege on a daily basis. It is offensive to me for you to say that the educational process of becoming a physician is unnecessary. The average NP program, comparatively, requires about 500 classroom hours and between 500 and 700 clinical hours. I dont have the answers but wanted to open the discussion. This is a common problem in society and not just the medical profession. But as a reader and interested inhabitant of the peanut gallery, perhaps I can suggest a bit of clarification. Next time, my cars fuel pump goes out, ill try to look for the nice guy instead of a mechanic. Thank you for your comments. I am at a loss for words. So I personally thank you. To intentionally misrepresent ones self as something he/she is not, especially in healthcare, seems especially egregious to me. We are having an important conversation about collaboration and better defining roles on the healthcare team. Licensing. Thanks Bill you adding some extra incentives to the mix. Google Business modified the Kidd Dermatology listing from Dermatologist to Medical Spa. The unsinkable Christie Kidd struck a compromise, settling on the designation as a skin care clinic. Carpe Diem, Ms. Kidd, Carpe Diem. ID RATHER DIE! However, he I agree PAs must have doctor oversight at all times, unless employed by a federal program. I am surprised that as a caregiver you lack the self-awareness to know that your tone and demeanor would likely be offensive to PAs. Ms. Kidd intentionally misrepresented herself and it is wrong. Furthermore, while I work with NPs and feel very strongly about them as colleagues, NPs are very clearly forging ahead in an effort for continued autonomy of practice. Whatever the case, we should hold all our clinical peers to the same standard.
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