PAs

This is the first rotation I'm on that uses a lot of "mid-level practitioners" - nurse practitioners (NPs) and physician assistants (PAs). I'm still getting used to it. I don't know officially what the background and role of an NP or PA is, but they are nearly physician equivalents: they can diagnose, prescribe (including controlled substances), treat, and first assist in surgery under the supervision of a licensed MD. I've found on this rotation that they act as ward residents. They take care of all the hospital patients while the MD residents are operating. They do the day-to-day "scut," see clinic patients, and act as continuity for the service as all the other members of the team rotate.

It's an interesting system. PAs do nearly everything that a resident (MD) does other than operate, yet their educational requirements are fewer and they do not do residency training. It almost raises the question: how much can non-MD practitioners do and what does being an MD really mean? Indeed, many medical conditions can be managed without having 7+ years of postgraduate training. But does 2-3 suffice? In talking to the PAs and working with them, I find them replete with practical knowledge: how to manage electrolyte replacement, how to put in arterial lines. But I think their training, method of thinking, and goals are fundamentally different from those of a doctor.