{"id":30,"date":"2010-11-02T23:29:13","date_gmt":"2010-11-02T23:29:13","guid":{"rendered":"http:\/\/blog.beliefnet.com\/medicinetomoveyou\/2010\/11\/the-value-of-physician-assistants-and-nurse-practitioners.html"},"modified":"2010-11-02T23:29:13","modified_gmt":"2010-11-02T23:29:13","slug":"the-value-of-physician-assistants-and-nurse-practitioners","status":"publish","type":"post","link":"https:\/\/www.beliefnet.com\/columnists\/medicinetomoveyou\/2010\/11\/the-value-of-physician-assistants-and-nurse-practitioners.html","title":{"rendered":"The Value of Physician Assistants and Nurse Practitioners"},"content":{"rendered":"

I opened the doors to my practice years ago as a solo family
\npractice doctor.  <\/span>When I say ‘solo,’ I
\nmean ‘solo.’  <\/span>I was the check-in
\nreceptionist, the medical assistant, the physician, the check-out receptionist,
\nthe office manager and the billing department. 
\n<\/span>Since then, I have brilliant staff filling each of these positions and added
\nsome more.  <\/span>Some of the most important
\nadditions to my team are midlevel practitioners.  <\/span>Physician assistants and nurse practitioners,
\nas they are more commonly known, have long been involved in helping physicians
\ntake care of patients in a meaningful way. 
\n<\/span>However, many times, I come across a certain snobbery that disturbs me
\ntremendously.  <\/span>Patients, without meeting
\na physician assistant or nurse practitioner, impart judgment about the quality
\nof care they will receive from a ‘sub-MD’ provider.  <\/span>Could they be right?  <\/span>Are ALL doctors better than ALL midlevel
\npractitioners?  <\/span>If yes, then it makes
\ncomplete sense to ask for “The Doctor” at all times.  <\/span>Obviously, I think this is absurd as a
\nscientist and card-carrying member of the Society of Logic!!!  <\/span>You cannot judge a person’s abilities by the
\ninitials behind their name.<\/p>\n

I have been in the company of Great Physicians, those that
\nare continual students of the human body and the human existence.  <\/span>These physicians comb the literature and
\nresearch journals looking for the best practices and evidence available to help
\ntheir patients attain a better quantity and quality of life.  <\/span>Interestingly, most of a physician’s training
\nis done in medical school and residency training.  <\/span>This might be a 7-11+ year process depending
\non the medical specialty a physician chooses. 
\n<\/span>However, when a physician graduates from the halls of his academic
\ntraining hospital, the burden of continuing his medical education falls back on
\nhimself.  <\/span>For example, Dr. Oldschool
\ngraduates in 1980 from a prestigious medical school or residency.  <\/span>If he then chooses to ‘just get by’ with his
\nrequirements to maintain his physician licensure, he may never critically
\nanalyze new information and incorporate it into his patient care process.  <\/span>Said differently, the patients he sees in
\n2010 might not be getting the robust evaluation and treatment available to them
\nby the latest evidence-based medicine.  <\/span>To
\nmake things even more complicated, a majority of the post-graduate physician education
\nis given by pharmaceutical industry representatives.  <\/span>Although, I am appreciative of their
\nknowledge of the new research and new classes of medications they have to teach
\nme about, I am a New York skeptic and question the impartiality of the information
\nbeing presented (especially as I am analyzing the data on behalf of my
\nsuspicious patients). <\/p>\n

Now, let’s take the example of Dr. Renaissance.  <\/span>He also graduates in 1980 from the same
\nwell-respected medical school and residency program.  <\/span>However, upon graduation, he not only listens
\nto what the ‘reps’ teach him; he scientifically analyzes it for its use in his
\npatients.  <\/span>He keeps current on his
\nAcademy’s recommendations (e.g. American Academy of Family Physicians for my
\nspecialty); he listens to his patients’ contributions about disease patterns
\ncomparing them with other similar patients for more clues on cause and effect.  <\/span>All the while, he goes above and beyond to be
\na patient advocate and supporter.  <\/span>Of
\ncourse, this same example can be made about any occupation, but doesn’t it seem
\nespecially important for those professionals in charge of steering the future
\nhealth or demise of your body?  <\/span>So, I
\nargue, a physician stuck in old information or slow to accept new information
\nis not who I would demand to guide my healthcare decisions, even if he is “The
\nDoctor.”   <\/span>Based on the stories I hear, I
\nwould easily bet that each one of you has or knows someone who has a ‘bad
\ndoctor’ story that comes to mind within 60 seconds flat.  <\/span>I hear them all the time.  <\/span>That’s why I don’t understand why people don’t
\nentertain other potentially capable providers knowing this common issue exists
\neverywhere.<\/p>\n

Follow me now to my next point.  <\/span>An experienced Dr. Renaissance-like PA or
\nNurse Practitioner would absolutely be worth my time and energy.  <\/span>If she were led by a Dr. Renaissance that
\nbuilt his office on good science, good compassion and best care practices, I
\nwould be even more comfortable that I was getting good care.  <\/span>Karen (our office Physician Assistant) and
\nRobin (our office Nurse Practitioner) exemplify the standards of quality
\npatient care and could likely win a clinical showdown with many primary care
\nphysicians.  <\/span>I am proud to support these
\nindividuals in our office as the organizations that train them are built upon
\nthe very premises that Integrative Medicine strives to add to the current
\nmedical model.  <\/span>PA’s and NP’s add the
\nhumanity component, the psychosocial factors, and the ‘holistic’ foundations of
\nwhat medicine was originally built upon hundreds of years ago.   <\/span>Actually, I have found as a group, they are much more likely to be interested in Integrative Medicine than physicans on the whole.  As a conscientious Integrative MD who hand
\npicks the people she entrusts with her patients, I am proud of the type of providers
\non my team.  <\/span>They choose to do extra
\nreading, extra thinking and extra everything to improve their quality of care
\nfor patients… that’s who patients need on their side.<\/p>\n

As for me, my vision still remains clear- to provide the
\namazing benefits of Integrative Medicine to the many people of my community and
\nbeyond… to you.  <\/span>I am eternally grateful
\nfor Karen, Robin and all my dedicated staff who work tirelessly to make this
\npossible.  <\/span>In this current healthcare
\nculture that doesn’t always comprehend the exponentially increased amount of
\neffort it takes to pioneer and provide this type of meaningful health care, I
\napplaud any physician, PA or NP who takes this challenge on and does it well.  <\/span>I look forward to a day where the hierarchy
\nof medicine degrades and value is once again placed upon knowledge, scientific curiosity,
\nand compassion- not just initials and rank. 
\n<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

I opened the doors to my practice years ago as a solo family practice doctor.  When I say ‘solo,’ I mean ‘solo.’  I was the check-in receptionist, the medical assistant, the physician, the check-out receptionist, the office manager and the billing department.  Since then, I have brilliant staff filling each of these positions and added…<\/p>\n","protected":false},"author":220,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1,10],"tags":[],"class_list":["post-30","post","type-post","status-publish","format-standard","hentry","category-embrace-change","category-mindful-medicine"],"yoast_head":"\nThe Value of Physician Assistants and Nurse Practitioners - Medicine to Move You<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.beliefnet.com\/columnists\/medicinetomoveyou\/2010\/11\/the-value-of-physician-assistants-and-nurse-practitioners.html\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The Value of Physician Assistants and Nurse Practitioners - Medicine to Move You\" \/>\n<meta property=\"og:description\" content=\"I opened the doors to my practice years ago as a solo family practice doctor.  When I say ‘solo,’ I mean ‘solo.’  I was the check-in receptionist, the medical assistant, the physician, the check-out receptionist, the office manager and the billing department.  Since then, I have brilliant staff filling each of these positions and added…\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.beliefnet.com\/columnists\/medicinetomoveyou\/2010\/11\/the-value-of-physician-assistants-and-nurse-practitioners.html\" \/>\n<meta property=\"og:site_name\" content=\"Medicine to Move You\" \/>\n<meta property=\"article:published_time\" content=\"2010-11-02T23:29:13+00:00\" \/>\n<meta name=\"author\" content=\"Dr. Shilpa P. 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