What constitues a "Mid-level Provider"

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JPINFV

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jrm818

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State runs out of money to pay employees? simple! issue placeholder to keep people quiet: IOU

State runs out of doctors to provide medical care? simple........
 

Veneficus

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I think US doctors, based soley on greed, are to blame for the shortages of US doctors.

It is the fault of such groups as the AMA that midlevels were ever permitted to exist, and in the near future there will be a fight over jobs.

As I said somewhere, I think it was PM, when the system eventually rights itself, midlevels will be on the block. They simply bloat an already overtaxed system, they do not provide the underserved care they clamed to be for in any great number.

I also stand by my statement that it is only through greed and political maneuvering that mid-levels have what they do. It is certainly not for their incredible medical knowledge and outstanding patient care.

In order to recieve a license and practice medicine, the WHO developed a world accepted minimum education. Those who meet this minimum standard, enjoy the social and professional benefits of being a doctor. Along with the responsibilities.

Mid levels do not meet this minimum but instead claim to be cheaper and easier to produce.

Then following the same "evidence based" epidemiological guidlines as all techs, they demonstrate that they can follow them just as well as doctors from a hands on perspective.

But me wrenching on a car doesn't make me a mechanic. Even though I did take a cheaper and shorter vocational class in highschool for it, rather than pay a community or votech and spend longer in school and supervised practice. I might even wrench as good as somebody that did and I certainly am cheaper than taking your car to a real mechanic.

Keep telling yourself how good you are and how equal to the world wide minimum you are despite not meeting that requirement. Tell your parents you are as good as a doctor even though doctors in 3rd world countries have more education and training than you do.

Don't forget to tell those politicians in California, which incidentally amplifies an already shortage of doctors with its crazy licensing and recognition requirements, that with 1/2 the training, you can do the same thing a doctor can and you want paid the same. Because you are just as good and worth it.

Tell your patients too. About the same time you tell them you are treating them like a number despite the desire and scientific advances towards individual care.

But f course they told you in PA school that you didn't need all that molecular biology, biochemistry, work because you are going to perform the guidline treatment and if it doesn't work refer them to somebody who really can help them.

Also make sure to tell them that you are billing for your "treatment" and if they had gone to see a doctor to begin with, she could have helped whether they fell into the guidline or not.

That is why you keep citing simple studies. Anyone who understands medical research is not fooled. Direct cause and effect in human body can onl be discovered by selective experimentation.

The body is an electrical current in a water medium, a very large interconnected soup each with different ingedients. You must be far smarter and more capable than I am to figure out all the things I have about medicine in your 2 year PA program. Perhaps it is my retardation that has kept me in school so long? I did put forth considerable effort to be just as good as a PA.

But then again, I did meet the world recognized minimum standards for my position. PAs, NPs, CRNAs?

Nope.
 
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ExpatMedic0

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haha you guys crack me up, can we bring back the nurses and paramedic argument into this? Lets just create a variable cornucopia of penile measuring and ego stroking across a larger spectrum ;-)
 

Veneficus

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haha you guys crack me up, can we bring back the nurses and paramedic argument into this? Lets just create a variable cornucopia of penile measuring and ego stroking across a larger spectrum ;-)

Yea, it is strangely reminiscent of PAs telling paramedics how undereducated and incapable they are isn't it?

In a "just because you see a skill performed doesn't mean you have the knowledge it takes to safely, efficently, do it" sort of way.

They like to dish it out but don't take it very well.
 

Agent Cooper

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I have to say I'm surprised by some of the responses on this thread. I had no idea there was so much animosity towards PAs. :unsure:
As someone considering PA school, it never occurred to me to want to be called a doctor or mistaken for a doctor. In my mind, PAs have a scope of practice like everyone else in the healthcare profession. They are not doctors, and cannot do everything a doctor can do.

That said, I think they have their place. For example, I had to see a specialist. The wait time to see him was several months. But, they did have a PA appointment available in a few days. I knew it wasn't the same as seeing a doctor, but I was able to see her, get some basic tests ordered, and know that if there was something blatantly and seriously wrong with me she would tell the doctor and I could see him sooner. I appreciated that system because I got access to basic care much faster. I thought that was the point of PAs? :blink:

I guess I'm naive.
 

JPINFV

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I have to say I'm surprised by some of the responses on this thread. I had no idea there was so much animosity towards PAs. :unsure:

...

They are not doctors, and cannot do everything a doctor can do.

...

I thought that was the point of PAs? :blink:

I guess I'm naive.

The problem is not when mid-levels assist physicians. The problem is when mid-levels advocate that they are equal to physicians and deserve unrestricted practice rights, including independent practice.
 

Veneficus

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The problem is not when mid-levels assist physicians. The problem is when mid-levels advocate that they are equal to physicians and deserve unrestricted practice rights, including independent practice.

and bill the same.
 

RocketMedic

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Schulz, I think that a PA is, on its face, an answer to a half-asked question.

Doctors have worked themselves into a shortage here in the US due to the sheer expense of becoming one and the selectiveness of their educational process. Realistically, to become a doctor now, as a married, white, 24-year old male just starting college, I need to defer raising a family and be prepared to give up 4-6 years for medical school after I earn an undergraduate degree. Most importantly, I either go far in debt or rejoin the active military. Heck, look at Veneficus- he had to move overseas and attend medical school in Europe at least in part due to the expense of American medical schools.

A PA is what a paramedic should be- it is literally the same job. We are extensions of a physician, and a PA is essentially a technician, following the same guidelines that we follow as paramedics. Valuable, yes, but a self-imposed and ultimately false distinction between the levels of care. Simply put, there are Doctors and there is Everyone Else. 'Mid-level provider' is like being half-pregnant.

Nurse Practicioners fall into this same category, although I'm perfectly willing to let them be autonomous in terms of nursing care (does a doctor really need to detail how to bathe someone?)

My belief, however, is that doctors and the American medical educational system will have to come to reality in the not-so-distant future and make medical school a more realistic prospect for American students. Costs are simply astronomical, even with loans. A proper government-funded nonmilitary medical-school accessions program would be helpful here.

Me? Lawyer, baby. I really do enjoy it, and that's my current long-term goal. That or some sort of something...astronaut? Mars's first paramedic would be cool.
 

ExpatMedic0

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I just like watching the doctors, PA's, and medical students fight. Wish we could put them all in thunder dome.

I have no problems with PA's in fact, its a great option for many Paramedics with undergraduate degree's who decide to move on to something else. Now a PA billing the same as an MD and claiming to be equal to an MD is kind of funny. Don't get me wrong I love PA's, a lot of my previous co workers went on to that and I know its always an open door for me in the future should I decide. Its not a doctor though, period. same as NP
 

WTEngel

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Making medical school more obtainable is not necessarily the answer. More affordable and more opportunities for loan forgiveness when choosing to pursue specialties where there is a shortage I can definitely support.

The main issue I have with making medical school "easier" to get into is that the primary public education system for the most part is very flawed, and produces students who are not ready to pursue higher academia. By proxy, universities are succumbing to the same fate, and getting a bachelors degree in the USA is not real crowning achievement anymore. The American university system is turning out a generation of "rapid access to information" students, with very little ability for synthesis and higher order reasoning. Because the answers are so easily accessible for most questions, the pursuit of scholastic excellence has been turned into little more than a quest to easily learn the material for an exam and get an A, regardless of actual retention of information.

I would say the MCAT is the great equalizer, but it too is flawed. It is flawed primarily in the fact that exam prep companies have figured out the formula for scoring well on it, and any applicant with a reasonable amount of time on their hands can train hard and break 30. 30 is the new 25, and the scores are still trending upward.

The 2015 MCAT will likely suffer he same fate after it has been around for a few years. Test prep companies make a living on training people to take an exam well, and if the MCAT proves anything about an applicant, it would be that they can score decent on an exam for which they have been given the formula to.

So, what does all this have to do with the price of tea in China? Making medical school more accessible is not the answer. Not from an admissions standpoint anyway. If the applicants being produced are on the whole underprepared, we will not see an increase in people flunking out, we will see an decrease in overall quality of medical education.

I am all for a newly graduated doctor having some chance of receiving their degree with zero debt. I am not for allowing a generation of "is this going to be on the exam" type students into higher education.
 

WTEngel

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I just like watching the doctors, PA's, and medical students fight. Wish we could put them all in thunder dome.

I have no problems with PA's in fact, its a great option for many Paramedics with undergraduate degree's who decide to move on to something else. Now a PA billing the same as an MD and claiming to be equal to an MD is kind of funny. Don't get me wrong I love PA's, a lot of my previous co workers went on to that and I know its always an open door for me in the future should I decide. Its not a doctor though, period. same as NP

Remember Saudi Schulzenstein? Everyone and their brother claimed to be a doctor of some sort!

Now there's an example of a place where respect was based on the alphabet soup after your name. It didn't matter what the degree was in or where you got it, as long as it came with a pretty certificate and a good foil seal!
 

Simplify

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I think US doctors, based soley on greed, are to blame for the shortages of US doctors.

It is the fault of such groups as the AMA that midlevels were ever permitted to exist, and in the near future there will be a fight over jobs.

As I said somewhere, I think it was PM, when the system eventually rights itself, midlevels will be on the block. They simply bloat an already overtaxed system, they do not provide the underserved care they clamed to be for in any great number.

I also stand by my statement that it is only through greed and political maneuvering that mid-levels have what they do. It is certainly not for their incredible medical knowledge and outstanding patient care.

In order to recieve a license and practice medicine, the WHO developed a world accepted minimum education. Those who meet this minimum standard, enjoy the social and professional benefits of being a doctor. Along with the responsibilities.

Mid levels do not meet this minimum but instead claim to be cheaper and easier to produce.

Then following the same "evidence based" epidemiological guidlines as all techs, they demonstrate that they can follow them just as well as doctors from a hands on perspective.

But me wrenching on a car doesn't make me a mechanic. Even though I did take a cheaper and shorter vocational class in highschool for it, rather than pay a community or votech and spend longer in school and supervised practice. I might even wrench as good as somebody that did and I certainly am cheaper than taking your car to a real mechanic.

Keep telling yourself how good you are and how equal to the world wide minimum you are despite not meeting that requirement. Tell your parents you are as good as a doctor even though doctors in 3rd world countries have more education and training than you do.

Don't forget to tell those politicians in California, which incidentally amplifies an already shortage of doctors with its crazy licensing and recognition requirements, that with 1/2 the training, you can do the same thing a doctor can and you want paid the same. Because you are just as good and worth it.

Tell your patients too. About the same time you tell them you are treating them like a number despite the desire and scientific advances towards individual care.

But f course they told you in PA school that you didn't need all that molecular biology, biochemistry, work because you are going to perform the guidline treatment and if it doesn't work refer them to somebody who really can help them.

Also make sure to tell them that you are billing for your "treatment" and if they had gone to see a doctor to begin with, she could have helped whether they fell into the guidline or not.

That is why you keep citing simple studies. Anyone who understands medical research is not fooled. Direct cause and effect in human body can onl be discovered by selective experimentation.

The body is an electrical current in a water medium, a very large interconnected soup each with different ingedients. You must be far smarter and more capable than I am to figure out all the things I have about medicine in your 2 year PA program. Perhaps it is my retardation that has kept me in school so long? I did put forth considerable effort to be just as good as a PA.

But then again, I did meet the world recognized minimum standards for my position. PAs, NPs, CRNAs?

Nope.

No. Generalizing about an entire profession based on your own limited personal experiences is ignorant and speaks more about your own hangups and biases than it does about the state of midlevels in this country. Believe it or not, the average PA school student currently enrolled today, CHOSE PA SCHOOL OVER MEDICAL SCHOOL. Blasphemy? Impossible you say!? Hardly. Most programs receive in excess of 2,000 applications for 30 or 40 coveted spots. If you think the people who make the cut with stakes this high are anything short of brilliant you are delusional. These students have near perfect GPA's, backgrounds in genetics, cellular biology, biochemistry, research, etc and they only get better every year. These are people who could of gotten into a multitude of medical programs, but again, they CHOSE PA school.

I have worked with many phenomenal PAs who don't just follow algorithms- they are competent, respected members of the team with a very solid, conceptual understanding of medicine. They teach residents and collaborate with other providers, yes MD and non-MD! There is actually very little "doc envy" within the profession as you see it. Rather, there is a growing movement amongst PAs to be utilized up to one's actual level of training and potential. Much of this actually stems from bitter MD's who are realizing all too late that those two weeks spent studying the histology of teeth has done squat to make them a better provider. You can reduce the profession down to fit your preconceived notion of MD=GOD/ Non-MD=HACK, but as they say, opinions are like :censored::censored::censored::censored::censored::censored::censored:s. A concept you are surely familiar with.
 

ExpatMedic0

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Remember Saudi Schulzenstein? Everyone and their brother claimed to be a doctor of some sort!
!

Aaron even would say he was a doctor sometimes because no one knew what a paramedic was haha. One of the guys with an undergraduate degree had "Doctor" on his licence
 

WTEngel

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No. Generalizing about an entire profession based on your own limited personal experiences is ignorant and speaks more about your own hangups and biases than it does about the state of midlevels in this country. Believe it or not, the average PA school student currently enrolled today, CHOSE PA SCHOOL OVER MEDICAL SCHOOL. Blasphemy? Impossible you say!? Hardly. Most programs receive in excess of 2,000 applications for 30 or 40 coveted spots. If you think the people who make the cut with stakes this high are anything short of brilliant you are delusional. These students have near perfect GPA's, backgrounds in genetics, cellular biology, biochemistry, research, etc and they only get better every year. These are people who could of gotten into a multitude of medical programs, but again, they CHOSE PA school.

I have worked with many phenomenal PAs who don't just follow algorithms- they are competent, respected members of the team with a very solid, conceptual understanding of medicine. They teach residents and collaborate with other providers, yes MD and non-MD! There is actually very little "doc envy" within the profession as you see it. Rather, there is a growing movement amongst PAs to be utilized up to one's actual level of training and potential. Much of this actually stems from bitter MD's who are realizing all too late that those two weeks spent studying the histology of teeth has done squat to make them a better provider. You can reduce the profession down to fit your preconceived notion of MD=GOD/ Non-MD=HACK, but as they say, opinions are like :censored::censored::censored::censored::censored::censored::censored:s. A concept you are surely familiar with.

Then why is medical school longer, and why is a residency still required if you intend to specialize?

Surely they could shave a few months or a year or two off of medical school and give the newly graduated doctors some OJT, and it would be just as good, right?
 

WTEngel

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Aaron even would say he was a doctor sometimes because no one knew what a paramedic was haha. One of the guys with an undergraduate degree had "Doctor" on his licence

Probably Hale...and I am sure he lived up to every letter in the word "doctor" :rofl:

Oh my, how did we get to this place old friend? I am pretty sure all expats in KSA for any duration of time contract some sort of prion disease...

I loved that place, I made a ton of Saudi friends, and I would love to go back someday...but sometimes there was nothing to do other than just shake your head...
 

RocketMedic

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No. Generalizing about an entire profession based on your own limited personal experiences is ignorant and speaks more about your own hangups and biases than it does about the state of midlevels in this country. Believe it or not, the average PA school student currently enrolled today, CHOSE PA SCHOOL OVER MEDICAL SCHOOL. Blasphemy? Impossible you say!? Hardly. Most programs receive in excess of 2,000 applications for 30 or 40 coveted spots. If you think the people who make the cut with stakes this high are anything short of brilliant you are delusional. These students have near perfect GPA's, backgrounds in genetics, cellular biology, biochemistry, research, etc and they only get better every year. These are people who could of gotten into a multitude of medical programs, but again, they CHOSE PA school.

I have worked with many phenomenal PAs who don't just follow algorithms- they are competent, respected members of the team with a very solid, conceptual understanding of medicine. They teach residents and collaborate with other providers, yes MD and non-MD! There is actually very little "doc envy" within the profession as you see it. Rather, there is a growing movement amongst PAs to be utilized up to one's actual level of training and potential. Much of this actually stems from bitter MD's who are realizing all too late that those two weeks spent studying the histology of teeth has done squat to make them a better provider. You can reduce the profession down to fit your preconceived notion of MD=GOD/ Non-MD=HACK, but as they say, opinions are like :censored::censored::censored::censored::censored::censored::censored:s. A concept you are surely familiar with.


Howdy, welcome to the forum. Please be a bit more respectful when talking to others on our boards, we try not to use too many exclamation points or vulgarity.

Would you like to introduce yourself? I'm a paramedic from Oklahoma.

Lastly...*popcorn*.
 

WTEngel

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Howdy, welcome to the forum. Please be a bit more respectful when talking to others on our boards, we try not to use too many exclamation points or vulgarity.

Would you like to introduce yourself? I'm a paramedic from Oklahoma.

Lastly...*popcorn*.

Yes...popcorn indeed!

Plenty of 1-10 post count contributors around these threads in the past few days.

Coincidence, I think not...
 

ffemt8978

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Play nice, or become the focus of my complete and undivided attention.

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Simplify

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Then why is medical school longer, and why is a residency still required if you intend to specialize?

Surely they could shave a few months or a year or two off of medical school and give the newly graduated doctors some OJT, and it would be just as good, right?

I agree wholeheartedly. Medical school should be shorter. The healthcare crisis in this country and lack of providers which is slated to reach critical mass within the next decade seems to corroborate this notion as well. Longer does not always mean better, and I would argue that many med programs could trim the fat and consolidate their curriculum. The antiquated model of provider education in this country is analogous to gun fanatics claiming that the 2nd amendment is somehow still applicable in the 21'st century. Times, as they say are a changin.
 
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