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Doctor and patient: A matter of degreeBrian T. Maurer, PA-CBrian Maurer practices pediatrics at Enfield Pediatric Associates, Enfield, Connecticut. He is the author of Patients Are a Virtue and is a member of the JAAPA editorial advisory board. For more on the author, please visit www.lulu.com/briantmaurer. Baylor College regents recently approved the doctor of science physician assistant (DScPA) emergency medicine residency, a new joint US Army/Baylor degree to be completed at Brooke Army Medical Center, Fort Sam Houston, San Antonio, Texas. The new doctoral program will provide Army PAs with an opportunity to develop advanced competencies in emergency medicine while they participate in evidence-based clinical management of critical illnesses and injuries. Ever since the beginning of the PA profession, students have been drilled never to misrepresent themselves as doctors to their patients. The recent introduction of doctoral level PA programs could result in some amusing confusion—not in the university research laboratory—but in the clinical exam room. The author offers the following dialogue between clinician and patient in the spirit of Abbott and Costello’s “Who’s On First?” “Good morning, madam. I don’t believe we’ve met before. Allow me to introduce myself: I’m Doctor P.A. Smith.” “Hello, Doctor P.A. Smith. I must admit, I didn’t expect to see you today.” “How so, madam?” “When I made the appointment, I was told that I would be seen by the physician assistant in your practice.” “I am the physician assistant, madam. The doctor is not in the office today.” “But you just introduced yourself as Doctor P.A. Smith. Are you not a doctor?” “On the contrary, madam; I am a doctor. That is to say, I possess a doctoral degree. I also happen to practice medicine.” “Don’t all doctors practice medicine?” “Many doctors do, but not all of them. Some work in other fields as well.” “Do you work in other fields too?” “No, madam. Medicine is my only field.” “So you are a doctor after all!” “To be sure, I am, madam. I’m just not that kind of doctor.” “What kind of doctor is that?” “The kind of doctor who practices medicine, madam.” “But you just told me that you do practice medicine—” “Indeed I do, madam. But not as a doctor. Do I make myself clear?” “Not exactly, no. You have a medical degree, but you aren’t a doctor, is that right?” “No, madam. I have no medical degree, but I am a doctor. Now you see where I’m coming from, don’t you?” “You’re saying it’s all a matter of degree, is that it?” “Exactly, madam. It always seems to come down to that, doesn’t it? No matter whether you’ve mastered the subject or not.” “And you—have you mastered the subject, Doctor?” “I have a master’s degree, if that’s what you mean. But I’m no doctor. Please don’t call me that.” “But I thought you were a doctor?” “I am, madam. But for your purposes, I am a physician assistant, not a doctor.” “This is all very confusing.” “I understand completely, madam. I myself have been immersed in an identity crisis for years.” “Years?” “Yes, years. Although some years have been better than others. As you yourself have said, madam—it’s all a matter of degree.” “I see. Tell me, Doctor; are you a bachelor?” “To a degree, I am, in a manner of speaking of course.” “Again, I’m confused. Let me put the question to you this way: are you married, divorced, widowed, or single?” “I’m afraid that I never participate in verbal questionnaires, madam. I’ve had enough of multiple choice exam questions during the course of my professional career.” “OK, so let me get this straight. To a certain degree you’re a bachelor. You’ve mastered your field, pursued a doctorate, are in fact a doctor who happens to practice medicine as a physician assistant, even though you aren’t a doctor per se—is that right?” “Madam, you’ve hit the proverbial nail on the head, as they say. Now let me ask you, what brings you into the office today?” “I’m afraid I’ve completely forgotten, Doctor.” |
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