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Respected Contributor
Posts: 3,943
Registered: ‎03-16-2010

Re: Discussion of the role of Physician Assistants


@CJC wrote:

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. 

 

_____________________________________________________

 

@CJC, there are only 12 states in the United States that required what is commonly referred to as "restricted practice" which means that a NP must work under the direct supervision of a medical doctor.  21 states have unrestricted practice, and the remaining states have what is commonly called "reduced" practice, meaning they have to have a collaborative relationship with a medical doctor for certain activities, but they are not under direct supervision.

 

It has been that way for quite some time.  


 


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Honored Contributor
Posts: 31,716
Registered: ‎03-10-2010

Re: Discussion of the role of Physician Assistants

I've had good and bad experiences.  I had some that I didn't really feel like knew what they were doing or talking about.  I've had others that were fine.

 

I love the NPs at my PCPs office.  When I first started with her, it was just her.  Then she brought a couple of NPs on board.  Since the doctor is so good, I had no doubt she would bring great NPs with her and I was right.

 

If I have to make an appointment for something I consider minor like a UTI, I am generally seen by the NP if it's in office.  All telehealth visits have been with my doctor. 

 

For my annual wellness check-up, I start with the NP and then my doctor comes in and finishes.  

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Posts: 8,302
Registered: ‎03-09-2010

Re: Discussion of the role of Physician Assistants


@pitdakota wrote:

@NameAlreadyTaken wrote:

PAs are far more and better educated than RNs


______________________________________________________

 

@NameAlreadyTaken,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.   


@pitdakota 

It might not be now, but when I attended school, PAs were required to have a bachelor of science in premed courses and then a a 2-year program for PAs and a residency.  So, have it your way and I will have it mine.  

Honored Contributor
Posts: 8,302
Registered: ‎03-09-2010

Re: Discussion of the role of Physician Assistants


@pitdakota wrote:

@NameAlreadyTaken wrote:

PAs are far more and better educated than RNs


______________________________________________________

 

@NameAlreadyTaken,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.   


@pitdakota 

 

I know nurses that have 2-year RN degrees and are entering the CRNP program.  So maybe each state has different requirements.

Trusted Contributor
Posts: 1,836
Registered: ‎03-16-2010

Re: Discussion of the role of Physician Assistants

I appreciate all your input and experiences.

 

I was curious as to your thoughts as to when is the medical decision making too advanced for a PA/NP? 

 

Yes, the physician oversees the PA. But the physician is not hearing and listening to the patient. The physician is reviewing the chart , testing and treatment plan.

 

I'm just not convinced that speciality care from a PA is equal to that of a board certified physician with about 12 years of medical education and years of clinical experience. 

 

I think the PA/NP provides valuable service for the general family medical practice but not so sure they are truly qualified to take full responsibility of care for cardiology, neurology, infectious diseases and so on.

Honored Contributor
Posts: 13,426
Registered: ‎03-10-2010

Re: Discussion of the role of Physician Assistants

@granddi 

 

"When is it too advanced"? That, I believe is up to the patient to decide. There is no flag that pops out telling anyone. I see it as a patient knowing their own body, and doing as much research as they can find on their specific medical issue(s).

 

Also think that also has to do with a patient trusting the Doctor involved. 

 

You asked for my thoughts, there are a couple off the top of this very old brain.

 

 

hckynut 

Respected Contributor
Posts: 3,943
Registered: ‎03-16-2010

Re: Discussion of the role of Physician Assistants


@NameAlreadyTaken wrote:

@pitdakota wrote:

@NameAlreadyTaken wrote:

PAs are far more and better educated than RNs


______________________________________________________

 

@NameAlreadyTaken,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.   


@pitdakota 

 

I know nurses that have 2-year RN degrees and are entering the CRNP program.  So maybe each state has different requirements.


________________________________________________________

 

@NameAlreadyTaken, yes a 2 year associate degree RN can apply to a bridge program, but they have to take credits in that bridge program to meet the BSN requirement before they can start the ARNP program. That is what the word "bridge" means.  It offers a bridge so to speak with degrees.  So an associate degree nurse starts a bridge program and takes courses required for a BSN (that is the bridge), when successfully completed they receive credit for the BSN and then they start the NP courses.  

 

There are 2nd degree nursing programs out there as well that allows someone with another degree other than nursing to receive credit for all their other hours and take around a 1 yr or 18 months of intensive nursing courses to graduate with a BSN.  Then those individuals can enroll in a NP program.

 

Have no idea what a CRNP is.  The official title is Advanced Registered Nurse Practitioner (ARNP).  Depending on what track they finish, they have certification in that track such as Family ARNP, Critical Care, Psy/Mental-Health etc.  Not familiar with a CRNP title or program at all.

 

I taught nursing and also taught courses in our ARNP program.  A program will not receive nursing accreditiation (CCNE) if it did not bridge hours for an associate degree nurse & require an unencumbered nursing license as a conditon to starting NP courses. 


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Respected Contributor
Posts: 3,943
Registered: ‎03-16-2010

Re: Discussion of the role of Physician Assistants


@granddi wrote:

I appreciate all your input and experiences.

 

I was curious as to your thoughts as to when is the medical decision making too advanced for a PA/NP? 

 

Yes, the physician oversees the PA. But the physician is not hearing and listening to the patient. The physician is reviewing the chart , testing and treatment plan.

 

I'm just not convinced that speciality care from a PA is equal to that of a board certified physician with about 12 years of medical education and years of clinical experience. 

 

I think the PA/NP provides valuable service for the general family medical practice but not so sure they are truly qualified to take full responsibility of care for cardiology, neurology, infectious diseases and so on.


______________________________________________________

 

If you are asking me, I am absolutely fine with both PAs and ARNPs.  In fact, my husband had a hip replacement just around 2 years ago. He only saw the actual orthopedic surgeon the day of surgery & one postop visit.

 

The PA saw him for all his preop visits, made hospital rounds after surgery, and saw him for his post op visits except for one.  Loved her and had all the confidence in the world with her.  She knows her stuff.  Leave the surgery to the surgeon and the rest of the care to her.  She is fabulous.  In fact, I have made referrals to this office for a couple of friends and they all love her (the PA) as well. 

 

It is really about what you are comfortable with or not.  


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Respected Contributor
Posts: 3,943
Registered: ‎03-16-2010

Re: Discussion of the role of Physician Assistants


@NameAlreadyTaken wrote:

@pitdakota wrote:

@NameAlreadyTaken wrote:

PAs are far more and better educated than RNs


______________________________________________________

 

@NameAlreadyTaken,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.   


@pitdakota 

It might not be now, but when I attended school, PAs were required to have a bachelor of science in premed courses and then a a 2-year program for PAs and a residency.  So, have it your way and I will have it mine.  


___________________________________________

 

@NameAlreadyTaken, many PA programs will admit with a bachelor's degree in other areas that are not pre-med if they have experience such as working as EMT.  Of course, in both these programs the admission is stiff competition, so those that have degrees in a science would probably be more desirable & get higher consideration for admission.  But desired and required are not equal.

 

Same time of course work at the graduate level for both the PA and ARNP programs. 

 

So bottom line, is they both have very similiar requirements and one is not less educated than the other.


* Freedom has a taste the protected will never know *
Honored Contributor
Posts: 8,302
Registered: ‎03-09-2010

Re: Discussion of the role of Physician Assistants


@pitdakota wrote:

@NameAlreadyTaken wrote:

@pitdakota wrote:

@NameAlreadyTaken wrote:

PAs are far more and better educated than RNs


______________________________________________________

 

@NameAlreadyTaken,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.   


@pitdakota 

It might not be now, but when I attended school, PAs were required to have a bachelor of science in premed courses and then a a 2-year program for PAs and a residency.  So, have it your way and I will have it mine.  


___________________________________________

 

@NameAlreadyTaken, many PA programs will admit with a bachelor's degree in other areas that are not pre-med if they have experience such as working as EMT.  Of course, in both these programs the admission is stiff competition, so those that have degrees in a science would probably be more desirable & get higher consideration for admission.  But desired and required are not equal.

 

Same time of course work at the graduate level for both the PA and ARNP programs. 

 

So bottom line, is they both have very similiar requirements and one is not less educated than the other.


@pitdakota 

Thanks.  It was different back in the 1970s or perhaps it was different areas had different criteria.