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JAAPA Letters to the Editor, May 2008

Doctoral degrees for PAs: What happens next?

To the Editor:

I enjoyed the editorial by Mr. Cawley, published in March 2008. His comments made me think about the direction of our profession. The move to a Master’s level benefited me because I was able to pursue another career path after only 2 additional years of college. I have 7 years between my Bachelor’s and Master’s degrees. I have never regretted that decision and I am proud to be a PA.

I think that we need a Doctoral degree for academia reasons, but what would benefit our profession and patients more is a program that bridges the gap from PA to MD. That way anyone who wants to continue on to become a physician has that path, but becoming a PA is not taken out of the reach of people like me who want to start a new career.

If professional organizations do not get involved and instead allow the doctorate degree to develop on its own, I believe that our profession will lose much needed diversity. A PA degree will only be obtained by going through 8 to 10 years of schooling. I know that I would never have been able to do that and, if I was younger, I would have applied to med school instead of a PA program. Now is the time for PA groups to wage into this issue and not let the universities and their financial well being dictate what happens to our profession.

Eric Asp, PA-C
Kane, Pennsylvania

A Day in the Life

To the Editor:

After reading the recent installment of A Day in the Life (Stephen Steiner, PA-C, published in the April 2008 issue), a deep wave of nausea struck me. While I do not belittle in any way the important services that dermatology clinicians provide, have we as medical professionals come to the point where 8 to 5 with a 1-hour lunch is considered hard work? Maybe I’m just getting old after 14 years in primary care but I hope we all don’t expect to help our fellow man by working 8 hours a day. Let me give you a day in the life of a primary care PA.

7 AM: Rounding on patients from regular beds to ICU.

8-8:30 AM: I arrive at the office and I am greeted by 40 charts for patients that need refills and 80 charts for patients that need their lab results reviewed on my desk.

8 AM-12:30 PM: 12-15 patients most mornings. Any patient who has fewer than three life-threatening chronic illnesses is considered an “amateur” patient. In an average morning, I may be a cardiologist, endocrinologist, orthopedist, and psychiatrist for one patient.

12:30-2 PM: Either meetings, hospital, or the rare pleasure of drive-thru food!

2-6 PM: Usually 10-15 more patients, sometimes procedures. More forms, more formularies, more phone calls. In between patients, I try to get to the ever increasing stack of charts on my desk that my need attention. Will the last PA out of primary care please turn off the light!

6:30 PM or so: I get home to my family. Some nights I’m on call so dinner may be interrupted by my pager.

11 PM: I go to sleep knowing that I truly love being able to help so many people and sometimes … I dream I’m a dermatology PA!

Patrick Watterson, PA-C
High Point, North Carolina

Author’s response:

Many thanks to Mr. Watterson for sharing his insights on the life of a primary care PA. Most physician assistants know that seeing 30 high-acuity patients in one day is taxing to mind and spirit, and I am glad there are individuals who are skilled and led to that calling.

One of the most appealing attributes of our profession is the ability to move from primary care to a specialty. With dedication, study, and a little luck, anyone’s dream can become a reality.

Stephen Steiner, PA-C