Do you really want a PA or NP taking care of your grandmother?

From  Sermo:

PA misdiagnosis – this is the future of medical care

86 yr old woman, previously in remarkably good health, physically and mentally active, still very involved in town government, cultural activities, the arts,etc, looks and acts ten to fifteen years younger than her age.  Seen as outpt by PA for new SOB and weakness (no appt. available with IM doc).  Diagnosed with pneumonia, despite no fever, no antecedent respiratory infection, placed on antibiotic and sent home.  Overnight developed increased SOB, ambulance to ED this AM, diagnosed with PE.

This is the wave of the future.  We would be better off training PAs and NPs to be technicians – in other words, proceduralists – than handing off to them the responsibility to think and diagnose.    The PA never did the five years of clinical training to be able to recognize a pulmonary embolus.  He hasn’t got the training to think that weakness, shortness of breath, decreased breath sounds, without fever or any upper respiratory symptoms, might be something other than pneumonia.

Expect a tsunami of similar cases.  There’s a reason why we go through all the years of training.

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