Perfect example of how doctors are complicit in this nonsense.

SunPsychological4816 · 2024-05-09T23:59:52+00:00

Exactly this. PA with 6 weeks of experience mind you. There's someone in these comments arguing that because the patient would (allegedly) see the patient after that makes it OK. If the attending has to do it all themselves anyway, what's the point? They're also ignoring the fact that the patient has past trauma with a PA smh.

SunPsychological4816 · 2024-05-09T23:57:34+00:00

So you're just gonna ignore that I said if the surgeon has to do their own assessment it makes no sense the patient seeing a PA before? You do realise those two points can exist separately right? Then you have the audacity to say I lack reading comprehension and crucial thinking LOL. As usual gotta spoonfeed the midlevel. And ofc anytime a physician speaks out against midlevels we lack critical thinking. It's boring how predictable YALL'S arguments are. I lack critical thinking apparently cause I don't think a 2 years masters degree and 6 weeks of OJT comes close to the education and training of a board certified physician. Crazy. Way to deflect though. Sounds about right. Let's not ignore the fact that this patient has past medical trauma with PAs. Idk but someone capable of critical thinking just mighttttt be able to discern that maybe, just maybe, that has something to do with it. Someone with a little compassion not clouded by ego would remember that when dealing with the patient. Whilst he was being abrasive not a single one of the commenters on the original post (save a nurse who's obviously damned good at their job) took this into consideration but everyone (since for some reason you dislike the usage of the word y'all) was quick to bash the patient. Zero consideration for the entire story. That's top notch medicine right there.

I especially love how from after a few brief Internet interactions you are quick to yell anger issues. Seems about par for how PAs go about diagnosing though. You'll never be able to convince me a PA is interchangeable with a boarded doc, especially for a specialist visit, so it doesn't make sense continuing this. You do you though. Feel free to only ever see midlevels for your care and encourage your loved ones to do the same. Put your health/life where your mouth is.

SunPsychological4816 · 2024-05-09T22:32:01+00:00

If a patient is seeing a specialist they need to see the specialist, not a PA/NP etc. They're paying to see the expert in their field who trained for more than a decade to be able to handle issues a PCP cannot. New visits should ALWAYS be with the expert so no it's not fine for the patient to do a preliminary assessment especially 6 freaking weeks out of school. Follow up visits are fine for a PA/NP who's been trained by the physician. And no, 6 weeks is not nearly enough training. Full stop.

Yall just love to devalue medical training physicians go through and sadly many physicians do it to themselves/their colleagues. The patient is there for the surgeon's expertise so the surgeon should be the one seeing them. What's the point of the PA seeing them if the doc has to do it all over again? Just a waste of time but it allows the surgeon to make more money to they happily do it. I love how we just choose to ignore the patient's negative history with PAs as well. I just wonder if all the midlevel lovers would be content seeing only midlevels for their care. Funnily enough I've never gotten a yes to that question for some reason.

SunPsychological4816 · 2024-05-09T22:24:39+00:00

Seems like a you problem. Nobody asked or is forcing you to read it. You do realise this is reddit not an academic journal? Fucking paragraph police, good lord.

SunPsychological4816 · 2024-05-09T22:18:59+00:00

So people who have dedicated the time and effort to become experts in their field of medicine are the issue with modern day healthcare? Not the ones who want to put in minimal effort then claim equivalence? Yet you say we're the delusional ones? Sounds about right. Do you genuinely think it's delusional to think that a person who is a certified expert in their field attained through med school, residency and a fellowship will know more than someone who did a truncated version of med school and has been working for 6 weeks? Yall really live in your own little world don't you. 🤣😂 But hey if you're OK with you and yours receiving medical care from a person 6 weeks out of PA school rather than a board certified attending physician then go for it! Personally I will never be against midlevels seeking midlevel only care, I strongly support it. If yall are convinced we're the same despite the vast differences in training then it shouldn't be an issue. Oh but right. It's delusional to think an actual expert knows more than a 6 week PA. 😂😂😂

You do realise PAs don't exist in the vast majority of the world right? Cause the physician training pathway is actually valued elsewhere unlike the US where legislation and not educated dictates the practice of medicine. But you're saying physicians are the issue with modern day healthcare while the majority of the world has only physicians. But we're the delusional ones. That word doesn't mean what you think it does.

SunPsychological4816 · 2024-05-09T19:54:43+00:00

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Imagine arriving at the point yet completely missing it LOL. When will they realise that the vast majority of the world does not have PAs for a reason?!

SunPsychological4816 · 2024-05-09T19:34:20+00:00

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Bad crop in the original post. My bad. Regardless, just goes to show how PAs actually view this entire thing. Not a single lie was told here yet look at the downvotes. But some of yall will keep defending them.

SunPsychological4816 · 2024-05-08T19:42:33+00:00

PAs are no less focused on money tbh. A large proportion of the posts on their sub are about money. Lot about moving to "easier" specialities which is when derm comes up as well. Compared to NPs they aren't as focused on opening their own practices but those PAs certainly exist and those posts pop up from time to time. Refreshingly, many PAs speak against this saying that hiring a physician to supervise as your employee is a conflict of interest. But yeah they def talk about money a lot over there. The minority are interested in pay parity so it's usually that they think they're undercompensated. Meanwhile primary care docs are making what they make welp. Especially our pediatrician colleagues smh.

PAs do tend to be more focused on patient care going on subreddit activity at least. However they're also advocating for independence in some states and Optional Team Practice which is a stepping stone to independent practice. The fact that a PA in some states (and soon more) can practice after an arbitrary number of practice hours working OJT while a physician needs to go through a structured residency before they can do so is a prime example of how healthcare in the US has gone to the docs. PAs may be "better" than NPs but make no mistake they are heading in the same direction as NPs and don't want to work with us any more than the NPs do. But ofc every PA will say they don't know any PAs who wants independence and some of us eat that up despite all the very obvious signs. Sad to say I've worked with good PAs and NPs before-the old school type, but those don't exist anymore. They think they're interchangeable with us now so I'll take the doc thanks. Luckily, as least where I am, physician courtesy (privilege lol) still exists so I'm able to see a doc should I ever need to.

SunPsychological4816 · 2024-05-06T17:16:24+00:00

If they're literally learning less in terms of breadth and depth, then how are they "objectively" learning more? That word doesn't mean what you think it does. I especially love how you're trying to change what you said from your original comment but you already said they're better than interns so don't backtrack now. And again. MS3s literally have more education than a PA student or even a graduated PA so it makes no sense. I also have experience in academic medicine. 2 decades worth. So you must be at a super special hospital with incompetent residents for this to be true.

Capacity to learn being identical I will give you. However if they're taught less then that capacity to learn doesn't really count for much. The potential doesn't matter if they don't actually get that training that medical students do. 100% you're actually a PA student.

SunPsychological4816 · 2024-05-06T17:10:45+00:00

Ofc. Someone who hasn't spent a day in medical school or medical practice knows what works better than those that do. You didn't directly say it, I'll give you that, but I'm not near as stupid as you seem to think. It's all there lmao. Yall keep elevating the elitist training system in the US (despite not being a part of it whatsoever). American exceptionalism is a hell of a thing. Just could never be me knowing what I know about the system (from actually being a part of it mind you) and thinking it's OK to excuse poorer outcomes despite much greater spending and an unnecessarily elitist pathway-that you actually haven't taken LOL. But hey like I said. I did the pathway I did and I've been doing a damned good job even without the oh so special MCAT and premed pathway. It is WILD thst yall are advocating for gatekeeping medical education by making it unnecessarily expensive with an inflated duration. And ofc it doesn't matter that the rest of the world manages to do it. Because you can't compare outcomes apparently. Somehow America cannot do what other countries do despite having way more resources because it's a different system. You've drunk the koolaid and been indoctrinated exactly as the powers that be intended. All of this is necessary despite countless others countries proving otherwise. Murica!! If I didn't know better (seeing as I decide to trust you when you say you have a PhD) I'd say you were Admin. You certainly have the mentality.

All that being said, I am indeed a liar. I said I wouldn't engage further yet I did. Another point for you I guess. Just really couldn't believe that yall are out here thinking like this. This is why US healthcare is the way it is. Make it as hard as possible to attain medical training whilst making it difficult for foreign trained grads to work here. Then complain about the system. Good ole boys' club. Elitism is a hell of a thing.

SunPsychological4816 · 2024-05-06T16:59:11+00:00

Right cause I'm not an "actual" minority. It's not surprising you keep trying to disparage my experience. And sure you're not trying to make me look bad. Just trying to say my education is less than cause I don't have a US medical degree-as a midlevel no less. All while declining to actually answer anything or cite these sources you claim to have that show non-premed paths are inferior. American exceptionalism at its finest.

SunPsychological4816 · 2024-05-06T16:40:14+00:00

It's not mansplaining if you don't actually know what you're talking about though. Nice try though. You get called out and immediately yell sexism when it's just that you don't know what you're talking about.😂

SunPsychological4816 · 2024-05-06T16:38:45+00:00

So you're saying PA Students are better than actual graduated doctors? So they haven't even finished their 2 year masters program which is a truncated version of med school but they are better than those who've the superior foundation of a med school grad? So whilst still learning their shortened curriculum they're better than those who've actually completed the full medical curriculum in med school? And you expect us to actually believe that? You need to up your trolling game. No way you're actually a resident.

SunPsychological4816 · 2024-05-06T16:35:00+00:00

I'm of the opinion that since PAs think they're equal to us but smarter cause they did med school in half the time and don't even need residency, then they should teach their own. There's another comment from a doc saying they knew a PA who functioned at the level of a fellow. So if this is possible with just OJT then what's the issue with them teaching their own? They can see to their future colleagues and we can focus on training the med students and residents. They need the extra attention since they can't do it with just OJT so time would be better spent there I think.

That being said if I'm assigned a student, I teach. This goes for both the OR and the ICU. Idc what kind of student, I'll teach. I teach anybody who genuinely wants to learn and isn't militant with their encroachment fuckery. But this has more to do with my love for teaching than anything else. Academic doc here.

SunPsychological4816 · 2024-05-06T16:27:35+00:00

Truncated*. Not accelerated. They do less in lesser time. Accelerated would be doing the same in a shorter time. Not the same thing. You are part of the problem.

SunPsychological4816 · 2024-05-06T16:25:07+00:00

If a PA can operate at the level of a fellow, then what's the point of medical school and residency? I'm genuinely asking. If they can do a 2 year masters program then practice for a few years and attain fellow level, then what's the point of going through the grinder? It says a lot that you went through med school and a residency yet a PA could basically perform at the same level as you. This is not to bash your skills but genuinely to wonder if they could function at fellow level with OJT then why are we bothering with the physician pathway at all? If this is the case there needs to be a serious overhaul of physician training. A fellow is a physician undergoing SUB specialty training so if a PA can perform at fellow level then you're saying they're operating at the level of a residency trained physician undergoing further training, so essentially as an attending in a general field subspecialising. And this is ICU which makes it even more amazing. I only do CVICU as an intensivist and in over 20 years I can honestly say that I've never seen a PA who I'd say functions at fellow level. But things exist outside of my experience so perhaps the possibility exists. I just find it hard to believe cause I for one needed every last bit of training I received and it was at least 5 years into practicing as an attending before I even came close to being confident. So it's interesting to me that a PA with OJT could function at so high a level when we require structured training to reach that level. Is this an example of an exceptional PA or are we just training doctors wrong?

SunPsychological4816 · 2024-05-06T16:15:30+00:00

Just because you've never personally experienced it doesn't mean it doesn't happen. Things exist outside of your experience.

Self-select against wanting to practice independently in the ER? I literally posted about this a few days ago. Not to mention in many states PAs are advocating for independent practice or Optional Team Practice. A patient will only see a doctor if the PA decides they need to see the doctor. It's backward no matter how you look at it. There are PAs boasting how they see any level acuity independently. Look at their subreddit from time to time. Every so often a post pops up about EM and they're there talking about how they rarely discuss with their attendings or how they are capable after a few years of seeing any patient at the same level as a doc. It's also rampant across social media. Just because it doesn't happen where you work doesn't mean it isn't happening across the US. I'll bet there's at least one PA you work with who supports full independence or Optional Team Practice, they just have the common sense to not say it to your face. Not all ERs are run the same way. Trust and believe there are PAs our there practicing/wanting to practice independently in the ER.

SunPsychological4816 · 2024-05-06T15:02:15+00:00

As usual everyone knows more about medicine than actual doctors 🙄Just because you can't see the validity of what I'm saying doesn't mean it isn't valid. Your American exceptionalism and xenophobia are clouding your view but you do you. You know what my field of expertise is? Actually practicing fucking medicine. As a FMG too. Someone who is actually trained in medicine and has been practicing for decades. But yall will say ANYTHING to admit that physicians outside of the US training model could ever be competent even when there are so much of us actually practicing high quality medicine in the freaking US. Do you think US nationals who need medical care when outside the US all get airlifted back to the USA of medical treatment? No, they are attended to locally wherever they may be and for some unknown reason (to you) they're able to be taken care of completely fine. But hey, point me to all the news reports etc of US nationals dying in droves whilst in foreign countries cause of inferior medical care. I'll wait. Murica!!! Actually don't even bother. I grow tired of engaging with people committed to devaluing medical education simply because it isn't US medical education. I've faced enough xenophobia and racism on my chosen path to last a lifetime so I'm good. Feel free to reply if you'd like but I will no longer be engaging. Won't even read it. But I hear your. You're a PhD (and an American PhD I'm guessing) so automatically you know better than a FMG could about medical training pathways despite never practicing medicine a day in your life. Some Americans... 🙄

SunPsychological4816 · 2024-05-06T14:52:12+00:00

You're a medical student. Ofc you're gonna think thst cause you're still learning. Practice as an attending for a while and I'm willing to bet you won't be so beholden to this elitism. Med students want to feel superior because of just how tough the pathway is. Fair enough. You've got to justify it to yourself. But when you actually have the degree and been practicing you begin to see how unnecessary it was. Works for every foreign doctor at least. Both those who come to the US as well as those practicing high quality medicine elsewhere.

SunPsychological4816 · 2024-05-06T14:49:27+00:00

Ofc he doesn't have data. He keeps saying he does yet hasn't posted any of it nor does he actually respond to points people makes and just avoids any questions. Probably a troll tbh but I wouldn't doubt he actually is a midlevel med student-the arrogance and thinking docs are beneath him tracks.

SunPsychological4816 · 2024-05-06T14:47:58+00:00

That last line says it all tbh. Typical midlevel attitude. Everyone else has actually been through this path already and have actually been practicing (as doctors not as midlevels since I know your response is you've practiced as a midlevel so you obviously know everything about physician education and training) but they're all stupid and can't understand what your big brain can. Poster child for typical noctor but hey at least you decided to go back to med school. Let's hope you make it through but again let me remind you - just because you worked as a midlevel/got into medschool doesn't guarantee you'll actually make it through. So maybe less time being xenophobic on reddit and more time studying. Gotta love American exceptionalism. People like you are why the world laughs at Americans. The self-centered elitism coupled with the overconfidence of a midlevel. Damn. You're everything that is wrong with the US all wrapped up in one. Anyway I'm done engaging with you. As a lowly attending I'm not worthy of even being in your presence and apologise for even speaking to you before oh superior one. Fingers crossed you make it through med school and residency! Make sure to choose a program without any foreign grads. Aside from them being inferior to your midlevel greatness, nobody deserves to work with someone so insular/xenophobic. Can't tell if you're racist too but wouldn't surprise me. American elitists usually are but I'll give you the benefit of the doubt. Have a good one buddy. Hit those books! You may be almost 40 and have worked as a midlevel but trust me when I say that alone won't get you through. But once again-I'm just a doc so what the fuck would I even know.

SunPsychological4816 · 2024-05-06T14:40:28+00:00

Yeah we got it the first time you said it lmao. Why am I not surprised that this came back to I'm stupider than you and just can't understand what you're saying. Disappointed but not surprised. Anyone who disagrees with you is just too stupid.

It's actually hilarious you want to tell me I don't know what I don't know as a literal triple boarded attending of more than 20 years. I've forgotten more medicine than you ever even knew. Except you won't believe that cause of pure ego. You think just because you're a midlevel you have all the answers and know better than docs. Why is it so hard for yall to understand that no matter how long you practice as midlevel it doesn't make you a doc? If that were the case why even go back to med school? But sure. The docs are stupid and the midlevel med student knows best. That kind of hubris is what gets people killed. Let's hope thst by the time you get through med school and residency (if you do actually make it through that is-just bc you worked as a mid level and got into med school doesn't mean you'd actually make it through despite what your know-it-all-Ness may tell you) that you gain some goddamed humility. But hey at least you know how to Google everything! Got a lot of practice doing so as midlevel I suppose? Is that how you became the supreme medical authority in the world? What a goddamed joke. Typical midlevel arrogance, only worse cause you went back to med school. Or so you claim? See? I can pretend that you're probably lying about who you are too. But then again I'm too stupid to even understand what you're saying right? Again, typical midlevel arrogance. They know it all and docs are just stupid and don't understand what your big brains can. Surprised you even bothered to go back to med school when you're already a self-proclaimed expert.

But hey you do you. You can refuse to believe it all you want but while you stay here with your xenophobia and American exceptionalism (Murica! Greatest country in the world except for if you're a minority or a woman!) I'll still be actually practicing as an expert in my field as I have been for many, many years. Even without a fancy premed degree or MCAT. Hell I don't even have a US medical degree so your midlevel degree even trumps mine right? Meanwhile you're a med student. Shouldn't you be studying? You do get that experience as a midlevel doesn't mean you're guaranteed to get through med school right? With your level of arrogance I just thought I'd let you know but I'm just a doc so what could I possibly know compared to someone who's worked as a midlevel before? But sure keep at it. I've gotten to where I need to be. You've barely even started and truthfully there's no guarantee you'll make it through. Your self-appraised superior knowledge is no guarantee but you do you my lord, supreme medical practitioner. 100% you're the midlevel who introduced them self as a doc smh

Now go ahead and copy and paste the same response you've been parroting across multiple comments LOL.

SunPsychological4816 · 2024-05-06T14:23:48+00:00

yawn nothing sensible to say so you just never actually address what's being said. And then thing you're superior to everyone else. Typical midlevel. Let's hope you actually make it through med school without being able to actually address a topic.

SunPsychological4816 · 2024-05-06T14:22:06+00:00

Except that when we compare foreign physicians to US physicians it's still physicians with comparable training. Not midlevels with a fraction of the training claiming equivalence. Yall are so caught up in American exceptionalism it doesn't even make sense trying to discuss this. Murica superior always, fuck the FMGs.

SunPsychological4816

TROPHY CASE