I think it\u2019s time for physicians to end the assault on the clinical practices of PAs and NPs.<\/p>\n
Are you worried about PAs and NPs taking your job? If you\u2019re a good doctor, you should stop worrying. Great PAs and NPs are everywhere, and I think it\u2019s time physicians embraced them.<\/p>\n
PAs and NPs have excellent skills<\/strong><\/p>\n My first rotation as a third-year medical student was in the emergency department. There was a PA there who ran the trauma bay every third shift, alternating with second-year surgery residents.<\/p>\n I learned a lot from Greg. He was, indeed, a skilled clinician. He taught me how to suture, how to run a trauma code, and how to put in a central line.<\/p>\n Now, not all PAs and NPs will be such an excellent provider, and I understand that. News flash: I know plenty of doctors who aren\u2019t so great either. I think skill level has\u00a0much more to do with the individual<\/a>\u00a0than their degree.<\/p>\n On balance, physicians are qualified for areas of practice that PAs and NPs aren\u2019t qualified for. That shouldn\u2019t prevent us from accepting them as clinical providers.<\/p>\n PAs and NPs make you more productive as a physician.<\/p>\n This is especially true in gastroenterology, but I think there is a role for a PA or NP in every specialty.<\/p>\n As a gastroenterologist, a PA or NP can see a lot of patients in clinic, enabling me to shift my time to be more procedure-heavy.<\/p>\n Well-trained<\/a>\u00a0independent PAs and NPs will more than pull their own weight. Working with them will make you more productive by increasing your focus on issues only you can address.<\/p>\n America needs good PAs and NPs<\/p>\n It\u2019s important to American health care that we find ways to expand our ability to care for more patients.<\/p>\n With more physicians looking to go part-time, avoiding primary care, and talking increasingly about\u00a0retiring early<\/a>, we need more PAs and NPs to pick up the slack, not fewer.<\/p>\n I don\u2019t think physicians can have it both ways.<\/p>\n We can\u2019t say that PAs and NPs shouldn\u2019t be allowed to practice in the same way we do and simultaneously try to work as little as possible. That\u2019s not sustainable for a national healthcare model.<\/p>\n PAs and NPs as independent practitioners<\/strong><\/p>\n This issue has generated a lot of controversy over the past few years. I\u2019ve seen a lot of petitions circulated to physicians to sign to try to block bills that would allow PAs and NPs to practice independently.<\/p>\n I have some mixed feelings about this issue, I\u2019ll admit.<\/p>\n First, I think it would be unwise for PAs and NPs to go into independent practice immediately after training. That\u2019s especially true of the\u00a0subspecialties<\/a>\u00a0like GI and endocrinology.<\/p>\n My PAs and NPs work under my supervision, but they function largely independently. I trust them to make good clinical decisions and to come to me when they get stuck. That\u2019s based on years of experience, and seeing them gradually increase their independence as their skill level grows.<\/p>\n Second, I do think that it\u2019s incumbent on PAs and NPs to recognize their limitations and not seek to operate outside their scope of practice.<\/p>\n I\u2019ve taken care of plenty of patients that had clinical issues that were missed by a PA or an NP. Yes, it\u2019s frustrating. But guess what? I\u2019ve had that happen with patients under the care of physicians too.<\/p>\n I honestly don\u2019t have a problem with PAs and NPs practicing independently as long as they practice according to their skill level and recognize their limitations. I hold physicians to the same standards.<\/p>\n PAs and NPs aren\u2019t taking your jobs<\/strong><\/p>\n If you think they are going to take over your job, it\u2019s time for you to adapt or to\u00a0work with them<\/a>.<\/p>\n When I was on my OB\/GYN rotation in medical school, I learned a lot from our nurse-midwives. They were great! They could do most of the things the physicians could do, but they recognized their limitations and deferred certain cases to the doctors.<\/p>\n Did that diminish the practice of the OB\/GYN doctors? I have to say: I don\u2019t think it did. Everyone knew their role and stayed in their lane. It was efficient, productive, and safe.<\/p>\n Are you worried about losing your market share to a PA or an NP? Why not hire them, train them, and work with them?<\/p>\n Either do that or just get over it.<\/p>\n Trust me, there are so many patients that need care that even an independently practicing PA or NP won\u2019t be able to corner the market.<\/p>\n If that leads to increased delivery of quality health care for our patients, how can we not celebrate that?<\/p>\n Final thoughts<\/strong><\/p>\n As a group, I find PAs and NPs to be conscientious, skilled, and compassionate. They have a different skill set than us, and they will benefit from your mentorship and guidance throughout their practice.<\/p>\n They make me more productive and efficient. Our patients love them, and they offer excellent clinical care.<\/p>\n Physicians, it\u2019s time for us to stop demonizing PAs and NPs. They\u2019re not just \u201cmid-level providers\u201d or \u201cphysician extenders.\u201d They\u2019re highly competent clinicians who will make the practice of medicine better for our patients and for our health care system.<\/p>\n Let\u2019s celebrate them, mentor them, and work with them, so our patients get the excellent care they deserve when they need it.<\/p>\n Brent Lacey<\/em><\/a>\u00a0is a gastroenterologist and can be reached at the\u00a0Scope of Practice<\/a>.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":" I think it\u2019s time for physicians to end the assault on the clinical practices of…<\/p>\n","protected":false},"author":2,"featured_media":548,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-547","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/www.ehrreviews.com\/blog\/wp-json\/wp\/v2\/posts\/547","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ehrreviews.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.ehrreviews.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.ehrreviews.com\/blog\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.ehrreviews.com\/blog\/wp-json\/wp\/v2\/comments?post=547"}],"version-history":[{"count":1,"href":"https:\/\/www.ehrreviews.com\/blog\/wp-json\/wp\/v2\/posts\/547\/revisions"}],"predecessor-version":[{"id":549,"href":"https:\/\/www.ehrreviews.com\/blog\/wp-json\/wp\/v2\/posts\/547\/revisions\/549"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.ehrreviews.com\/blog\/wp-json\/wp\/v2\/media\/548"}],"wp:attachment":[{"href":"https:\/\/www.ehrreviews.com\/blog\/wp-json\/wp\/v2\/media?parent=547"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.ehrreviews.com\/blog\/wp-json\/wp\/v2\/categories?post=547"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.ehrreviews.com\/blog\/wp-json\/wp\/v2\/tags?post=547"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}