Understanding educational pathways for NP, PA

parentologist
Fri, 28 Jan 2022 17:10:02 +0000

I beg to differ. Primary care is being taken over, in fact, has been taken over, by NPs and PAs, Even when one is referred to a specialty for a complex medical issue that requires high-level training, high-level algorithmic diagnostic skills, and many years of clinical experience, one’s first visit is often with an NP or PA. Society seems to believe that one doesn’t need the education and training to become a board-certified MD to think - just to do procedures, when in fact, it is exactly the opposite! One needs only focused technical training to do a repetitive procedure, such as a bone marrow biopsy, whereas one needs a lot of education, plus years of clinical experience to recognize atypical presentations and properly diagnose and treat. This is what the last two years of medical school and all of residency/fellowship are - many years of clinical training compressed because one spends so many hours, at least 80/week, and it used to be at least 100 hours/week, in the clinical setting, seeing case after case after case. This is the training that allows an MD to recognize the rare case of pneumonia in a sea of cold viruses, the one case of lymphoma in a career of strep throats, the appendicitis in an ocean of gastrointestinal viruses, the pulmonary embolus instead of pneumonia. Procedures are easy. They’re simple, and they’re repetitive. Yes, they require technical skill, but in many ways, they don’t require more education that any other field in which technicians do procedures. But society has spoken, and has deemed that primary care and many other specialties that require thinking can be managed by physician extenders, rather than MDs, whereas the lucrative procedures (such as endoscopies) are reserved for MDs, even though they’d probably be better done by an NP or PA technician.

My kid is heading towards MD, but I tried to convey to them that unless kid wants to conduct research and teach in an academic medical center, their intended specialty is currently being taken over by NPs, in addition to all the primary care fields. Doesn’t matter - that is what kid wants, and what kid is suited for, this is what kid will do.