 What's up y'all? It's Adonis. So I did a video last week about the PAs that own their own practices and how that is a thing and if your PA wants to own your practice you can do that and there was naturally lots of comments pro and against this idea of PAs being independent enough to own their own practice. So if you haven't seen that video go check that out. I will link it right here for you and then you can you know leave me a comment on what you think about that. But from those comments I saw things about like PAs should not be inexistent or PAs provide inferior care because they only go to two years of PAs school three sometimes versus the four years of med school and then residency however long you may go through your residency. Okay so because of that I wanted to kind of like talk about that that narrative and give my own little opinion on it and then we can have a discussion about it in the comment section. Okay so let's get into that video right now. What's up you guys? It's Adonis. Welcome back to my channel. Okay so like I said I heard all of these very different narratives about like the what PAs are and what they can do. They're a lack of knowledge. The fact that they're bad providers and they provide inferior care and blah blah blah. Okay and you know I'm very much a PA advocate. I am pro PA because I chose this profession and I love it and I love what I do and I love the fact that I'm able to see patients and I am you know to be honest I do have a sense of autonomy and there are things that I'm able to do on my own and there are things that I need to rely on my attending for and that's okay and I'm fine with that. And so with that being said like this whole narrative about inferior care is like completely yes. Okay there are tons tons of patients that will absolutely disagree with that narrative that PAs provide inferior care and then there are tons of patients that would say the opposite that that narrative is true but guess what it all depends on the provider that you get and with all of these statements and comments and things that are being made a lot of it is provider specific. I hate the fact that we keep making these broad statements about PAs or the PA profession or MDs and the physician of profession and it's like how are you taking this one experience or these couple solitary experiences that you may have had and then bring it across the board it just doesn't make any sense. You can't do that in life with like simple things so why do it with a particular profession it makes zero sense. So I first wanted to get into the fact like after I did that right first wanted to get into the fact of what a PA is right so if you don't know what a PA is a PA is a provider but essentially I feel like the best way that I've kind of thought of how we are trained and how we are utilized in hospitals and in outpatient settings is that we are an extension of our attending's medical decision making. Now what I mean by that is we as APPs PAs and NPs advanced practice providers we are extensions of our attending so we've like learned with them you know we've kind of come up with them in terms of we've been working with them for a little while so we know okay my attending kind of likes this or when he sees this or she sees that she really likes to use this particular antibiotic versus you may have worked with another attending who loves a different antibiotic and so you kind of are a chameleon you kind of change with whatever setting that you're in that's why we are trained as generalists because we can go over like throughout all different specialties but at the same time when we're spending years in a particular specialty we learn what the the nonzebras are right what the the common things being common so common things being common you know somebody has a small bowel obstruction I'm going to make them NPO and I'm going to put an NG tube in them so that hey you know they don't aspirate and die and those are like just kind of right off the cuff things that you learn being in a particular specialty so we are trained as extenders now I've heard the statement that PAs or APPs equal are the same as residents or we're like lifelong residents meaning that the residents come in and they are learning under the tutelage of an attending they're not making their own decisions per se but they are learning they're running things by they're attending and that is essentially what the PA is doing now I can see why that argument is being made and I can see why people say that and I can see why some may disillusion to that but let me like educate you like by no means are we the same as a resident physician no we're not okay we are PAs if we wanted to be resident physicians we would have gone to med school and we would have gone through residency to become a physician a resident physician and eventually an attending and then you know like just practicing autonomously on our own and doing that as an MD but that's not what we wanted okay and vice versa if physicians wanted to be PAs then they would have gone to PA school because I've heard the argument that okay well every you know med student that doesn't match then should be able to just be like mid levels or APPs in that they're they get a license and they're able to practice in the same scope okay and so all right cool whatever that's an argument for another day but if they wanted to be APPs they would have gone to school to be APPs all right it just is what it is it's not like our profession is not like a fallback okay this is not a fallback profession it's standalone on its own like don't don't do that don't demean like what we went to school to to learn and to be just to be like a fallback kind of decision okay that being said again you know when it comes to residents they are trained by their attendings to make to learn how to make their own decisions because they're going to be doing that in the future so we're learning like how to do a particular procedure while they're learning you know okay well this is the approach that we're taking and this is why I took this approach the the reasoning behind a particular approach and then they can determine on their own in their future when their woman's making the decisions why i'm going to choose one approach over another while we're learning the basics of the particular procedure okay so that's that's how it is it's different our training is different our knowledge base is different and that's okay there is a space for all of us okay so this whole like us fighting or this like you know p.a. shouldn't be in existence or app shouldn't be in existence thing like it's just so ridiculous like i get why some people are salt to you okay you're seeing somebody just go to school for two years and they're making very good money while you're in residency not making as good money but at the same time you're going to be making good money like two three times what they're making in the future so why why are you so salty like stand alone in your space and in your area and where you're you're working and what you're working towards um and they'll do the same i think all of these decisions or these the different feelings around you know what p.a. should and shouldn't be able to do or the cure that they give is all based on the provider so ultimately what i really want to leave you guys with is the statement that quality of care is not based on the career but it's based on the provider there are going to be p.a.s that make mistakes and physicians that make mistakes it is what it is we're human okay that is just the kind of the way of life we are going to make mistakes we're not perfect but with that being said it's what you do with those mistakes are you going to learn from them or are you going to like brush it off and be like you know what i'm still really good at what i do because that the that point where you decide what you're going to move on to from this mistake that is what makes a good provider one who actually wants to get better and treat their patients better and make sure that their patients get the best care okay so ultimately that is what it is this whole argument on like independence and or you know should they should they not like why do you care so much if you're if the patients are happy with the care that they're getting if the knowledge base of the primary care and urgent care independent p.a.s is up to par and everybody's happy in that like why are you upset about that like just just let it be the patients are still getting good care because their providers are good okay so i just like that is ultimately my thing i don't want us to sit up here and just be like okay just because you're a p.a. you're going to give in for your care because that is not true okay so that's my statement but um you know whatever that's my opinion this is my channel and you came to my channel and you got my opinion but if you have an opinion of your own go ahead and leave them in the comment section below and let's have a discussion about it thank you guys so much for watching if you haven't already done so like this video follow me on instagram at and on the p.a. and on instagram at get that's the university don't forget to subscribe thank you guys again i will talk to you guys next time