On behalf of the physician-assistant profession as well as the nurse-practitioner, or NP, profession, I and many of my colleagues wish to extend our gratitude for having the fortitude to print the truth. Most of the problems for which patients present to healthcare professionals do not need a “Moses who can part the Red Sea.” Most problems are fairly similar, sometimes basic, require knowledge of a differential diagnosis and the acumen to know when the patient needs to be referred to a specialist.
Physician assistants can do a lot for patients
This is why it is often touted that NPs and PAs can do 85% of what a physician does, because it is the truth. The education is very similar and the difference lies in a residency. That residency is not to be underestimated but is provided on a formula of years working in a specific area where one has the opportunity to see all of the red herrings and zebras. We work well with physicians but certainly do not need their oversight for so many of the presenting symptoms that walk through the doors of emergency rooms and clinics every day. No patient needs to or should feel denigrated by having to wait six hours in an emergency department and pay exorbitant costs for the pleasure.
I have been a PA for 40 years, and I am a strong advocate for the family health system or the essence of patients receiving treatment in a medical home. Whether that “home” is owned an operated by a NP/PA or physician is not important. What is important is that the proper tests are done within the framework of national guidelines and that appropriate care is given and referrals made when they are indicated.
Do you know why patients love PAs and NPs? It's simply because we speak their language, take the time to sit down and describe their problems and how to both prevent them and to care for them. We offer assistance in getting them medications by being knowledgeable of our pharma companies that have special incentives and programs for those who cannot afford medications and do not have health insurance. PAs and NPs will hold a patient's hand and discern the inner conflicts and insecurities and will address them. We do not try to see eight patients in an hour because it is impossible to discern, communicate, take a history, examine a patient and give counseling and a prescription in that short period of time.
When I retire in the next 10 years, I am hoping that this country will awaken to the fact that many of us consider this a calling and would work free one to two days per week if we were covered by some type of national malpractice insurance. Think of the millions or even billions of dollars that could be saved if 225,000 NPs and PAs did likewise.
Everyone in this great nation has something to offer to society. We differ in our skills and our mode of delivery, but volunteers holding the hand of a lonely geriatric patient in a nursing home is contributing as much as I am when treating a medical disease or closing a wound. We are people attached to each other by a matrix of concern and commitment. PAs and NPs have demonstrated commitment, excellence and the ability to engage a patient in a talk about preventive medicine for the past 42 years. People like yourselves, who take the time to consider our value and place it in print, are performing a service to our professions and to the United States of America and all its citizens.
Robert M. BlummImmediate past president American College of Clinicians
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