Friday, November 30, 2012

you are cutting your own throat

We are about to get PAs (physician assistants) in our ER.  They will staff part of the ER part of the day.  They will probably take on more of the ER as time goes on. Big change. From what I understand, this is being done because our doctor group doesn't have enough docs to staff the several hospitals they cover.

I don't like this. Seems like docs should staff ERs.  Here's the thing: You are not going to believe this but they don't give a shit what I think, here they come.  Its reality. So I will adjust and so will everybody else.

However, I wonder if by employing PAs, doctors aren't cutting their own throats. Lets face it folks, the vast majority of ER medicine is not rocket science. With a little experience, you pretty much know what the problem is. So PAs will do fine with their background. In fact, I would say that PAs and NPs could easily staff most ERs with a doc to supervise and handle the critical cases.

So really, is this what the future holds? Perhaps.  Health care costs will have to be cut.  PAs and NPs are a lot cheaper, will cost hospitals less, insurance companies and medicare/medicaid less. You can pay a PA/NP maybe $125,000 versus and ER doc $250,000, thats a lot of savings.

Like I have thought for a while, the future of general practice is PA/NP and perhaps some specialty areas too.  


Tinyfeet28 said...

We have PAs in the B.S./belly pain/ortho area of our ED and I really like them! Just like physicians, some of them are great, friendly, and efficient, while others are tentative and work everyone up for everything. They defer to the physician whenever they feel they are over their head. I like some more than others, but honestly none of them give any better or worse care to these kinds of patients than any M.D.

Some have worked with more critical patients at other hospitals and their knowledge and skill set astound me! They could run circles around some of our Doctors.

From one nurse to another: Give 'em a chance :)

Rachedy said...

I like them. We have 1 in fast track, 1 in triage, 1 in express care (lacs,sprains) and one who floats. They keep the meat moving and only prescribe Motrin for pain. Luv them!

Nurse Practitioners Jobs said...

Nurse Practitioners are advanced nurses, so some may have worked in the ER or other area of the hospital for years as an RN, before becoming a NP. This gives them practical knowledge and experience that I think sometimes Doctors lack.

ThorMD said...

I think you are thinking about the economics of this wrong. My group uses NP's and PA's and this lets the docs make MORE money - not less.

If you have 2 docs each making 250,000 and now you have one doc making 250 and a PA making 100. Where does the other 150 go? It goes in my pocket because I work for a private ER group. If the ER docs are employed by the hospital, they may or may not get some kickback from that. I don't know - it depends on the group. But for MY group, we use the PA's so we can make more money.