Wellness

[VaBelle35]

Every practice is different, but the way it works at my Gyn is that the PA meets with the physicians at the end of every day and they go over all of the PA appointments and her treatments, recommendations, follow up guidance, etc. with the physicians and if they disagree or want something more, they will have her change what she did, have you come back in for more tests, whatever.

I've had nothing but good experiences with PAs and NPs at both gyn and family medicine practices, so I don't mind seeing them as they are usually much more available than a doctor.

[Nonametoday]

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@VaBelle35 wrote:

Every practice is different, but the way it works at my Gyn is that the PA meets with the physicians at the end of every day and they go over all of the PA appointments and her treatments, recommendations, follow up guidance, etc. with the physicians and if they disagree or want something more, they will have her change what she did, have you come back in for more tests, whatever.

I've had nothing but good experiences with PAs and NPs at both gyn and family medicine practices, so I don't mind seeing them as they are usually much more available than a doctor.

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@VaBelle35 

That's the way it was back when I was working.

[Wsmom]

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@Trinity11 wrote:

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@granddi wrote:

It has been my impression that Physician Assistants and Nurse Practioners are well educated and trained to assist in providing routine medical care under the supervision of an MD/DO. Most of my experiences have been good but limited to general/routine/primary care such as cold, allergy, cough.

My question is the role of PA/NP in providing care in a speciality setting such as cardiology. I selected a cardiologist based upon excellent academic credentials and patient reviews. I really llike the cardiologist but it seems the very large group tries to divert care to their large staff of PA's.

Yes, I can decline the appointment with a PA but that means waiting months for the MD appointment. 

The PA I was appointed to has a degree in psycology and her PA degree. How can this person have the same clinical skills as an board certified cardiologist with 15 years experience. The MD has a degree in biomedical science from Rice University and MD from Stanford. 

What has been your experience or opinion about seeing a PA for initial treatment (not follow up) of your specialized medical issue?

Maybe PA's in a speciality practice (not primary care) should have advanced training and certification. 

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I saw a PA right before my first heart attack. All she did was keep exclaiming what great shape I was in and asked me for diet tips. LOL. She never ran enough tests to see I was about to have a heart attack.

I guess I had a negative experience. Actually, when I had shingles last year I went to an Emergi-Med. The doctor I expected to see was a PA and missed the correct diagnosis telling me I had an ear infection and prescribed antibiotics. I ended up getting the right diagnosis too late and now have post herpetic neuralgia.

Of course this is anecdotal and I am sure there are some very good Physician Assistants out there. However, my experiences have been awful.

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@Trinity11 , one of DD's specialists had that happen.  He went to his cardiologist, saw the actual cardiologist for his check-up, they did all the necessary tests and got an all is great!  As he was walking to his car from the visit he had a heart attack.

[Nonametoday]

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@Wsmom wrote:

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@Trinity11 wrote:

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@granddi wrote:

It has been my impression that Physician Assistants and Nurse Practioners are well educated and trained to assist in providing routine medical care under the supervision of an MD/DO. Most of my experiences have been good but limited to general/routine/primary care such as cold, allergy, cough.

My question is the role of PA/NP in providing care in a speciality setting such as cardiology. I selected a cardiologist based upon excellent academic credentials and patient reviews. I really llike the cardiologist but it seems the very large group tries to divert care to their large staff of PA's.

Yes, I can decline the appointment with a PA but that means waiting months for the MD appointment. 

The PA I was appointed to has a degree in psycology and her PA degree. How can this person have the same clinical skills as an board certified cardiologist with 15 years experience. The MD has a degree in biomedical science from Rice University and MD from Stanford. 

What has been your experience or opinion about seeing a PA for initial treatment (not follow up) of your specialized medical issue?

Maybe PA's in a speciality practice (not primary care) should have advanced training and certification. 

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I saw a PA right before my first heart attack. All she did was keep exclaiming what great shape I was in and asked me for diet tips. LOL. She never ran enough tests to see I was about to have a heart attack.

I guess I had a negative experience. Actually, when I had shingles last year I went to an Emergi-Med. The doctor I expected to see was a PA and missed the correct diagnosis telling me I had an ear infection and prescribed antibiotics. I ended up getting the right diagnosis too late and now have post herpetic neuralgia.

Of course this is anecdotal and I am sure there are some very good Physician Assistants out there. However, my experiences have been awful.

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@Trinity11 , one of DD's specialists had that happen.  He went to his cardiologist, saw the actual cardiologist for his check-up, they did all the necessary tests and got an all is great!  As he was walking to his car from the visit he had a heart attack.

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@Wsmom 

When my DH had shingles, I diagnosed it because the doctors missed it.  They had sent him for a litany of testing and cost us a fortune and I knew all along it was shingles.  Then when they broke out all over his chest, the doctor I was working with asked me if I would like to put "my shingle" above his on the door.  Just a funny anecdote about how streets run north and south.

[happycat]

I would rather see a doctor, especially for anything heart related. I hurt myself last summer, the orthapedic phycisian assistant gave me a steroid shot deep in area. Hurt like crazy, but it did get better.  Now it is starting to bother me again and I think I'm going to a different clinic. I want to see a doctor and I don't want another steroid shot. 

[Trinity11]

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@Wsmom wrote:

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@Trinity11 wrote:

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@granddi wrote:

It has been my impression that Physician Assistants and Nurse Practioners are well educated and trained to assist in providing routine medical care under the supervision of an MD/DO. Most of my experiences have been good but limited to general/routine/primary care such as cold, allergy, cough.

My question is the role of PA/NP in providing care in a speciality setting such as cardiology. I selected a cardiologist based upon excellent academic credentials and patient reviews. I really llike the cardiologist but it seems the very large group tries to divert care to their large staff of PA's.

Yes, I can decline the appointment with a PA but that means waiting months for the MD appointment. 

The PA I was appointed to has a degree in psycology and her PA degree. How can this person have the same clinical skills as an board certified cardiologist with 15 years experience. The MD has a degree in biomedical science from Rice University and MD from Stanford. 

What has been your experience or opinion about seeing a PA for initial treatment (not follow up) of your specialized medical issue?

Maybe PA's in a speciality practice (not primary care) should have advanced training and certification. 

---

I saw a PA right before my first heart attack. All she did was keep exclaiming what great shape I was in and asked me for diet tips. LOL. She never ran enough tests to see I was about to have a heart attack.

I guess I had a negative experience. Actually, when I had shingles last year I went to an Emergi-Med. The doctor I expected to see was a PA and missed the correct diagnosis telling me I had an ear infection and prescribed antibiotics. I ended up getting the right diagnosis too late and now have post herpetic neuralgia.

Of course this is anecdotal and I am sure there are some very good Physician Assistants out there. However, my experiences have been awful.

---

@Trinity11 , one of DD's specialists had that happen.  He went to his cardiologist, saw the actual cardiologist for his check-up, they did all the necessary tests and got an all is great!  As he was walking to his car from the visit he had a heart attack.

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@Wsmom, I am so sorry. I hope he is doing well now. I really think they can't actually tell all that much from just an EKG or even an echo. My doctor keeps telling me that until they actually do an angiogram it is still a guessing game.

[eadu4]

My experience with PA's is an excellent one.  When my daughter was 3 she was having "leg pain".  She was refusing to walk and would just sit there.  The doctors tested/did x-rays etc...nothing.  They said she had probably fallen and just was shy about running again.  Well I received a call at work and the daycare (her favorite aunt worked there) and they said I needed to come get her that it was getting worse.  I took her in andthe PA was the only one available to see her.   The PA was the only one to decide to do a "stick test" and check her white blood cell count.  She had Leukemia.  We had to get her to Boston asap because her counts were so high that they didn't think she would make it through the night.   That PA saved my daughter.  None of the great "doctors" thought to do that.  So there are some VERY VERY good PAs.   

[CJC]

I consult with a PA or NP only if I'm needing prescription refills. If having medical issue I always see my primary doc or a specialist. I have NP in my family. She is an RN who worked as nurse only for a short time (actually has a business degree from college), then took some drug and clinical classes which allows her to write scripts, giving her higher income and better working hours.  She hated working shifts. PA's and NP's have not been to medical school and should work only under supervision of medical doctor. 

[Deree]

I was wary of PAs handling my medical care years ago but then discovered just like there are differences in clinical excellence among doctors, so is there a difference in clinical excellence among PAs.  Imo, PAs are better than docs in many instances.

Doctors have been responsible for causing irreparable damage to me by misdiagnosis as well as a missed diagnosis.  I take what they have to say with a grain of salt and research everything they tell me or anything they prescribe.  They don't know everything.

[pitdakota]

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@Nonametoday wrote:

PAs are far more and better educated than RNs

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@Nonametoday,I actually have respect for both the role of an ARNP and PAs, but your information here about education is not correct.

PAs can & usually do have an undergraduate degree in something that is not medical related before they do the apply to the physician assistant program.  So they can have a baccalaureate degree in history and apply to a PA program if they have some health care experience in their background such as working as an EMT,etc.

To be admitted to a nurse practitioner program, it is a requirement to have obtained a bachelor of science degree in nursing.  So a baccalaureate nursing degree along with a nursing license is required for the NP program. A PA program does not require a special baccalaureate degree and does not require any type of licensing for admission to their program. 

There are bridge programs in nursing so that someone without a BSN can "bridge" through courses & meet the requirements for a BSN before they actually start the NP courses.  But it is still required that students have a BSN and an unencumbered nursing license to be admitted to any type of  ARNP courses.  Those students must successfully meet requirements for the BSNand successfully pass the NCLEX-RN exam to obtain a nursing license before they can start the NP program. 

From there, it is basically the same in that both programs are at the graduate (master's level) to graduate  & become licensed as an ARNP or a PA.  Both programs are similar in length of course work and clinical experience to graduate. 

Both areas also have the opportunity to advance to obtain a doctorate in the field if they choose to do so.