Talk:Physician assistant

Removed Links

Hi guys. I'm writting this article because I inserted a link to a site I think is very helpful and relevant to this article, but is removed by one "GoodDamon" as vandalism. I am aware of the linking rules and terms and I in no way think this site is vandalism. The information on the site is actually very helpful in scope of the article. I have applied to three PA schools now and interviewed for two. It wasn't until I started to prepare for my third interview that I ran across the website when looking for interview tips and a more personable website than a site that just states the same old facts. I think the site gave myself, and it seems others from the comments I have seen on the site, a real look at what to expect as a PA, what a PA is, and more importantly for me, application and interview tips from a student that is actually going through it. Like I said, I don't think this link should be removed because without it I wouldn't have gotten the help and information that other, textbook answer sites give. The link to the is www.lifeofapa.com A Day In The Life Of A PA. I hope this link can be added back.

Painformation (talk) 13:22, 2 February 2008 (UTC)Brandi

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I think this page should include a section on how nurses dislike physician assistants because they require less training yet are assumed to have higher qualities of medical care. (Clamster5 00:54, 8 July 2006 (UTC))

Actually, PAs are trained differently that nurses; PAs are trained in medicine, nurses in nursing. I know that sounds like I'm stating the obvious, but there is a significant difference. Also, most nurses have an RN (2 years) while PAs have a BA/BS + PA school (6 years), and have a much greater education in medical science and medicine. Gtadoc 02:39, 18 June 2007 (UTC) note: I'm not a PA.

Clamster5 you're welcome to write a bit about the conflicits between PAs and other health care professionals. Nephron  T|C 23:00, 14 July 2006 (UTC)

Good experiences

Its unfortunate for Clamster5, but all the experineces i've had with PA's has been great. I work at a major medical center in Boston and I can't praise them enough! — Preceding unsigned comment added by Peck10 (talk • contribs) 16:28, 29 October 2006 (UTC)

I have found them woefully undertrained. In the hospital they mostly do scut work that even the residents don't want to do. -THB 22:19, 29 October 2006 (UTC)

Well THB, maybe in Australia that is your experience. Here in the USA they are very well educated and are a vital resource. — Preceding unsigned comment added by Peck10 (talk • contribs) 18:39, 29 October 2006 (UTC)

Fortunately, there are no PAs in Australia. I must admit that not all PAs in the US are completely incompetent and they are useful to transport patients to radiology, do routine documentation, fetch supplies for the residents, and check vital signs. As long as they work under close supervision of physicians, the potential for harm is somewhat limited. -THB 03:40, 30 October 2006 (UTC)

What evidence can you supply that shows a lower level of training for a PA than that of a nurse? There are nurses with 2 year degrees, 4 year degrees, masters and doctorate level degrees. There are PA's at each of those levels as well. Check the malpractice statistics and you will find that on a per capita basis, physician assistants are successfully sued less often than physicians. Physician Assistants serve in the military and public health services and are often the first line of care for an injured servicemember--and make the difference between life and death, or keeping limbs! I believe you have used the wrong definition--those doing routine documentation, transporting patients, etc, are typically called MEDICAL assistants. — Preceding unsigned comment added by Roadster (talk • contribs) 07:44, 31 October 2006 (UTC)

--They get sued less than physicians because they deal with the simpler problems-- —Preceding unsigned comment added by DrSandman (talk • contribs) 01:25, 26 September 2008 (UTC)

No, I'm not confused at all about PAs and Medical Assistants, not at all. And personally, I don't want someone with a two or four year PA degree (or even a Masters, for that matter) running amok claiming to "practice medicine" on me or anyone I care about. (Something nurses don't claim to do.) I suppose they are useful in the military as well as for doing the scut work in the hospital. -THB 16:32, 31 October 2006 (UTC)

Nurse practioners claim to practice medicine, and many hope to do so without supervision! Gtadoc 02:41, 18 June 2007 (UTC) No, a PA is not a physician, but then neither is a nurse. Its simply a matter of economics that we can't afford to have a MD do everything anymore. Gtadoc 02:41, 18 June 2007 (UTC)

THB still hasn't supplied any evidence to support his claim that shows a lower level of training compared with a nurse.

It is quite clear that THB is uneducated about that of which you speak. PAs do practice medicine and are educated based on the medical school model and do not pretend to be physicians. They embrace the relationship with their precepting physician and are very skilled clinicians (I would hunch that THB is a NP hmm...) Most PAs worked in medicine (paramedics, RTs, and/or RNs) before becoming PAs and most PA programs require prior medical experience, so before painting things in broad strokes, educate yourself. PAs are not MDs and do not claim to be. However their level of autonomy is based on thier clinical experiences and skill set. So no, you are not going to have a PA fresh out of school doing your cut down and harvesting your Saphenous Vein for a CABG, but you will have a PA with experience doing it, and following and managing you in the ICU. — Preceding unsigned comment added by 71.192.0.5 (talk • contribs) 22:14, 31 October 2006) (UTC)

I am a Physician Assistant. Says so on my diploma and my license. Yes, I graduated with an Associate of Science [this was 26 years ago!] but I was required to have 2 years of college work to get in, and had 140 semester hours credit when I graduated. I did later finish a BS, now having around 197 semester hours. I've long joked I won't go after a Master's Degree unless there's money in it for me. The vast majority of programs are now on the graduate level, and more accomplish that each year. I had 8 years of medical experience, civilian and Navy, before PA school.

I am held to the SAME PROFESSIONAL STANDARD OF PERFORMANCE AS A PHYSICIAN. (caps intentional) As a matter of fact, PAs are often actually held to a higher standard, as a physician believes that even if (s)he cuts corners, no one but another physician can criticise the work. As an example, in the psychiatric hospital where I have worked over 20 years, the physical examination documentation before PAs began performing them was pathetic. Physicians would customarily just write "NML' on every line down the form. These physical exams were often completed within 2 minutes. It takes me about 1/2 hour to perform an exam on an uncomplicated patient from greeting to filing of the paperwork. Now, tell me that I am poorly trained, probably incompetent, and fit only for patient transport!

Nurses have more training??

Though the ANA (American Nursing Association) has declared the basic credential of an RN is now the BSN, there are 4-5 ADNs graduating for every BSN in my state! My hospital has to run an orientation program for newly graduated nurses. I may be old school, but I thought they were taught how to do the work in nursing training!

I consult with my SPs (supervising physicians) several times daily, and take great comfort in having them backing me up! If they get in trouble with a patient, they have to dig _themselves_ out.

I take pride in taking good care of patients and feel sorrow when I cannot help a patient reach wellness.

I agree that THB should read WP:Etiquette and WP:Civility.

Bob Franks, Physician Assistant, Goldsboro, NC — Preceding unsigned comment added by Bob2 (talk • contribs) 00:33, 26 November 2006 (UTC)

Actually, if you had carefully read what was written, the etiquette/civility statement was directed at someone else. Thank you for the anecdote supporting my contention that PAs are useful for doing routine documentation. -THB 05:15, 26 November 2006 (UTC)

I don't think the back and forth is very productive. Perhaps the place for this would be an article called conflicits between medical professionals or medical hierarchy. It would be interesting to have a hierarchy like this one. Nephron  T|C 22:41, 26 November 2006 (UTC)

It's such a shame that so many people are still unaware about the profession and the capabilities of a PA. Just a few weeks a ago i read an article on yahoo.com about PA's being the number 1 profession to have!Vatchdog 18:04, 21 March 2007 (UTC)

Physician's "Associates" ??

PA stands for "assistant" and assistant only. Associate implies equals, though PAs are midlevel providers along with nurse practioners and nurse midwives. PHysicians are top level providers. The word "Associate" should be removed from the opening paragraph. It is totally made up. — Preceding unsigned comment added by 68.50.28.153 (talk • contribs) 00:22, 23 November 2006 (UTC)

This is simply not the case. Some PA programs in the USA are refered to as Physician Associates. [1] [2][3] just a few for example. In recent discussion groups in the PA world, the term Associate is being debated because it better reflect the relationship of the PA with the Physician. PAs do not pretend to be (nor want to be) physicians. However in todays world of medicine the role they play is more of an associate than the term assistant implies. Hences the debate. — Preceding unsigned comment added by 132.183.65.204 (talk • contribs) 09:15, 23 November 2006 (UTC)

I would tend to disagree. I graduated with a Bachelor of Science Degree as a Physician Associate, and subsequently received a second degree as a Master of Physician Assistant Studies--Family Medicine. Do I consider myself to be an equal of a physician, absolutely not. In 1971, what is now the American Academy of Physician Assistants was the American Association of Physician Associates (http://www.pahx.org/period03.html). Roadster 15:18, 27 November 2006 (UTC)

The certification uniformly appears to be called physician assistant. I looked at the three references provided; the first (Yale) states "... and advance the physician assistant profession."[4] and the third states "... is to educate physician assistants...", if one looks a bit further. The second reference is a page about a training program for medical students (i.e. physicians-in-training)-- "[Rural Physician Associate Program] is open to third year medical students enrolled in the University of Minnesota Medical School at the Twin Cities or Duluth campuses." -- and in a sense justifies the criticism by User:68.50.28.153. To me, it looks like a few physician assistant programs are trying to push the envelope a bit and make their program sound like they are training people that are equals to physicians.

In any case, I encourage both of you (User:68.50.28.153 & User:132.183.65.204) to register (see WP:REGISTER). Nephron  T|C 22:07, 26 November 2006 (UTC)

I have removed the reference to "Physician Associates" -- based on this reference (Physician Assistant History Center): "In the 1980's, the American Academy of Physician Assistants (AAPA) recommended that graduates of AMA accredited programs refer to themselves as physician assistants and that legislation enacted by states use this terminology to reduce confusion. Physician Assistant is the current term used to describe the profession." Nephron  T|C 22:23, 26 November 2006 (UTC)

Thank you to Roadster

For removing your personal attack. However, removing Nephron's comments was inappropriate:

Roadster: Your comments are not constructive. Further, I do not think they are in the spirit of Wikipedia --please read WP:Etiquette and WP:Civility and sign your posts (see: WP:SIG). Nephron  T|C 22:34, 3 November 2006 (UTC)

-THB 15:59, 27 November 2006 (UTC)

HOW MUCH DO PA'S GET PAID?

Physician or Physician's?

Physician's assistant makes more sense, as the assistant assists the physician, meaning that the assistant belongs to the physician. Does anyone agree with me? MarcGushwa 17:28, 7 April 2007 (UTC) —The preceding unsigned comment was added by MarcGushwa (talk • contribs) 02:18, 6 April 2007 (UTC).

I have to disagree. The PA is not owned by the physician. The PA acts as a partner in medicine not an object that is owned. Actually some programs refer to themselves as physician associates (Duke for example).

--Wrong. PAs technically exist to assist physicians. They are an assistant to the physician. Without the physician, there is no such thing as a PA. Hence, "Physician's Assistant" is the more appropriate terminology. --DrSandman —Preceding unsigned comment added by DrSandman (talk • contribs) 01:17, 26 September 2008 (UTC)

Physician assistant is the proper term, many a PA are bothered by an inappropriately placed little ' Gtadoc 02:45, 18 June 2007 (UTC)

--But this is not a question of ownership. It's a question of syntax. Grammatically, if John is assisting Karen, John is Karen's Nurse. It doesn't mean that John is Karen's possession, John is merely temporarily, the object of a sentence in which Karen is the subject. That said, "Physician Assistant" seems to be the dominant term, so we should keep it that way, despite how badly I, as a future physician would like to grammatically have an assistant... Dwinetsk 09:49, 25 October 2007 (UTC)

---

Have you spent a great deal of time working with Physician Assistants? If, when you graduate, want an "assistant," I would recommend you employ a medical assistant. If you want to increase your productivity and revenue, then you may want a Physician Assistant. As you will find out during residency, if you utilize your PA by having them physically assist you in seeing patients, neither of you will be able to bill for their (the PA's) time; on the other hand, if they are also seeing patients and having you review the work, then they (the PA) will be able to bill for their services.

I admit, "Physician Assistant" is a confusing name, which does not represent the profession well; however, at this point it would be very difficult to change due to the way laws are written. Physician Associate is also a term that does not accurately represent the profession. Some schools (University of Washington) utilize the term MEDEX, or Medical Extender; however, due to licensing must utilize the traditional Physician Assistant term after graduation of its students.

We are basically talking about semantics that are sometimes inflammatory to a group that, in general, has spent years pursuing an education, which is often misunderstood. As a PA, I have two bachelors’ degrees in medicine (BS Paramedics, BS Clinical Health Sciences) totaling over 8 years in school, which is more time spent than if I had just become a physician. I know of very few Physician Assistants or ARNP's that claim to be or replace physicians, but is simply an adjunct to them.

Thanks, 66.36.223.162 (talk) 16:22, 9 February 2009 (UTC)

---

ok, here goes. I am a PA (Physician Assistant) and proud of it. We believe in the Physician-PA team. "We" is the main stream PA profession. By "Physician-PA" team I mean TEAM. With the Physician first. Yes, we are treated well by our supervising physician. And yes, we understand who is ultimately responsible for the practice. But we work together to help our patients.

As far as NPs go, well, some are my best friends. There is a difference in how we practice, a difference in how we are trained, but why fight? It makes no sense in this health care crisis.

And for the record, the Australian government has come to the AAPA to explore a pilot program in their country. There are now PAs in the Netherlands and England. The entire medical community is becoming aware of our value. So educate yourself and stop the fighting.

Texas PA — Preceding unsigned comment added by 71.41.159.222 (talk • contribs)

Title

Shouldn't the title of the article read Physician Assistant (vs. Physician assistant)?

Fixed Gtadoc 04:42, 10 July 2007 (UTC)

Nope. Like airline stewardess, carpenter, or neurosurgeon this should not be capitalized as an occupation, but only as the title of an article. Does someone out there know how to (re)fix this. Sfahey (talk) 03:38, 13 March 2008 (UTC)

Per the American Academy of Physician Assistants's own usage], this should be a lowercase title, "physician assistant." This is a description of a job, like attorney or accountant, not a proper noun. I will move the article to physician assistant. --ZimZalaBim ^talk 16:51, 3 May 2008 (UTC)

The Military PA

Added a link to the US Military's Interservice Physicians Assistant Program page. Will add a short section on Military PAs as time permits. Focus to be on the unique role PAs hold in the modern military, specificaly the expanded role in the US Military over the past 5 years as the 'First Line' trauma subject matter experts. If anyone has info on Military PA's in other countries and their role in treating soldiers and civilian populations, please let me know and I'll be sure to include it! -- Eric Bouchard 10:09, 23 August 2007 (UTC)

Added 'The Military PA' section to main page. POV is very limited at this time, but I tried to highlight the differences in the practice of military PAs. Also did not mention the program requirements or instruction to keep in context with the article and avoid taking to much space. There are probably better ways to link statements than the bullet style used, but I'm still learning the hyperlinking style here. --Eric Bouchard 07:29, 24 August 2007 (UTC)

DO and MD in the lead

I think that it's inappropriate for the lead to refer to an entirely irrelevant (for this article) difference in the training and licensing of physicians in the United States. However, when I removed it, one editor reverted the change without any explanation. I'd like to hear from other editors: does anyone think that the distinction between DOs and MDs is important for this article? Does it actually have any difference at all for PAs? Does a PA, for example, do materially different work in a family practice setting or urgent care clinic if the supervising physician is an MD instead of a DO? WhatamIdoing (talk) 21:19, 2 May 2008 (UTC)

No, there is no difference. I have removed that portion of the lead. Antelan^talk 21:38, 2 May 2008 (UTC)

I agree - it makes no difference to a PA whether his or her supervising doc is an MD or DO. My supervising doc is an MD, and my colleagues that work with DOs have the same duties.

However, as one of my former classmates put it, "My supervising doc [a DO] does a hellaciously good back and neck manipulation."

GMan552 (talk) 22:28, 2 May 2008 (UTC)

We should probably have a whole article about that. Actually, an article wouldn't do it justice. We need demonstrations! Antelan^talk 22:52, 2 May 2008 (UTC)

Changed references and most links to in-line format

I changed these in order to properly document the references in this article, and to place them in their own section. Let me know what you think.

GMan552 (talk) 05:55, 8 May 2008 (UTC)

"Clinical officers" in sub-Saharan Africa

User Ronns has provided interesting information regarding "clinical officers" - however, this links to his user page. I have suggested to him that he start a new article on clinical officers and place a link in this (PA) article to the new article. What do you all think?

GMan552 (talk) 21:18, 24 May 2008 (UTC)

Length of study in the UK

The newly listed source says two years for the PgDip and two and a half (30 months) for the MSc. Is this right? Are there other programs? WhatamIdoing (talk) 06:44, 11 August 2008 (UTC)

Taiwan

We have an edit war over ===Taiwan===. Here are the two opposing sides:

In Taiwan, nurses can be trained to practice medicine in a 36-month program, being offered at the private Fooyin University <ref>[http://www.aapa.org/international/global-applicability-poster05.pdf]</ref>.

and

In Taiwan, nurses can be trained to practice medicine under the supervision of a licensed physician. Otherwise, the nationwide law of their own registered license is still discussed between nurses and physicain.

Note that Nomad added the pdf file because I requested that s/he cite actual sources. Obviously, I don't know if there are other programs in Taiwan; it's not my area of expertise. However, this back-and-forth edit warring really needs to stop. I'd like to ask editors here to spend a few minutes with Google and see whether information can be found. Alternatively, is there any reason why we can't include all of the information here? WhatamIdoing (talk) 02:10, 1 November 2008 (UTC)

In the absence of any other input, I'll try to combine these into a short paragraph. WhatamIdoing (talk) 03:24, 6 November 2008 (UTC)

Nomad keeps deleting the information about any options other than his/her favored university plus the reference for the information that he wants to include, which is a violation of Wikipedia's core verifiability policy. Please, let's talk about it here. Don't just keep deleting things because you can. WhatamIdoing (talk) 06:47, 11 November 2008 (UTC)

File is a study of the global applicability of PAs according to the number of US-trained PAs. Currently nurses are not being trained to practice medicine. [User:Nomad2u001|Nomad2u001]] (talk) 16:47, 11 November 2008 (UTC)

But they can be so trained? That's all that our page was saying.

Also: are there any other ways to become a PA in Taiwan, other than Fooyin University? WhatamIdoing (talk) 19:31, 11 November 2008 (UTC)

I've removed Taiwan. PA's unestablished in Asia per pdf file. U.S.-trained PA's scope is per state regulations, institutions, and American Academy of Physician Assistants. Barcat (talk) 17:58, 15 November 2008 (UTC)

Barcat, did you read the pdf listed in this section, or the refs that you actually deleted? WhatamIdoing (talk) 00:57, 16 November 2008 (UTC)

Just a comment, I'm not familiar with nurses anywhere being trained to practice "medicine". They are trained to practice "nursing", a different skill, in a variety of practice settings and scopes. ChillyMD (talk) 02:21, 13 January 2009 (UTC)

History

These edits over comments regarding Taiwan also deleted edits showing that the PA profession has changed radically from original goals by Dr. Eugene Stead. The PA profession was started by Dr. Stead with the intention of training experienced nurses and "street" and military medics to fill the gap in rural and urban medically under-served areas. However, most PAs schools now demand little or no previous medical experience, focusing instead on high GPA. As a result, fewer than 9 percent of PAs are practicing in rural areas. This is fact, and failure to include this information violates Wikipedia's neutral point of view policy by removing information that provides clarity, balance and objectivity.News4a2 (talk) 04:12, 16 November 2008 (UTC)

And can you provide the name of a reliable source that asserts that fewer than 9% of PAs practice in rural areas? Wouldn't that also vary from country to country? And mightn't a comparison to the number of people living in rural areas, and the number of physicians living in rural areas, also be appropriate? WhatamIdoing (talk) 23:36, 16 November 2008 (UTC)

If you even read the entire Wiki entry and perused down to "Employment," you will see the same statistic that you question. You suggest not editing to say U.S. but deleting entirely only from the history section? The grand and lofty goals of Dr. Stead have been corrupted. Facts prove it. PA's were supposed to fill the medically under-served gap ... and do not. They were supposed to have extensive experience in patient care before being considered for didactic and are not. Skill, not GPA, was the prime criterium. It's doubtful the earliest Vietnam veteran medics would ever be accepted into _any_ program today, much less the one at Duke.News4a2 (talk) 10:29, 17 November 2008 (UTC)

Wikipedia reports what is Verifiable, not what is True™. We must have a reliable source. How do we know that 9% is the right number? What if the correct number is 8%? We must have a source. The fact that you and I happen to believe it is completely unimportant. WhatamIdoing (talk) 19:42, 18 November 2008 (UTC)

AGAIN, you're commenting without even fully reading the entry. The source is there and verified. I again refer you to the original article, under the "Employment" section. It's _been_ a part of this Wiki entry, the results of a 2007 AAPA survey (most recent) -- 9% -- not me, the AAPA. I can only say your edits are Orwellian in nature. Its placement in the history section is important to illustrate that the original intent behind the formation of PAs has been corrupted and PAs and PA schools generally have failed to fulfill Dr. Stead's wishes.68.11.139.174 (talk) 11:57, 19 November 2008 (UTC)

The reference must be at that sentence, not elsewhere in the article. And the ref needs to directly state this particular fact, which, if you're relying on Table 3.13, it does not. Table 3.13 in that survey divides PAs according to whether they're in a metropolitan or non-metropolitan area, and it puts 15.0% of PAs in non-metro areas. If you exclude suburbs and exurbs (small towns adjacent to large cities), then the number is 6.3%. If you want to set up a standard that the surveyors rejected (defining rural as <20,000, even if that city of 19,999 shares a border with New York City), then the numbers add up to 8.2%, not 9%. WhatamIdoing (talk) 20:05, 19 November 2008 (UTC)

I placed the reference at that sentence. And as far as your disagreement goes with the "9%" I suggest you take that up with the AAPA. Your argument is akin to the number of angels dancing on the head of a pin. "If you can't fool them with facts, baffle them with BS." Any sensible person can add it up. Moreover, if you're that adamant against using the official data of the AAPA, why haven't you questioned the addition of the information when it was first added in the Employment section? Your failure to do so there but adamance to do so here indicates you have a hidden agenda in your editing.News4a2 (talk) 22:07, 19 November 2008 (UTC)

Have you actually pulled out your calculator and added up the numbers? When I add 4.4% + 2.4% + 3.7% + 2.9% + 0.6% + 1.0%, I get 15.0%, not "about 9%". Similarly, when I add up the Wikipedia-editor-selected sections of this column, which are 3.7% + 2.9% + 0.6% + 1.0%, I get 8.2%, which might be "about 8%," if you're determined to round to a single digit, but really can't be represented as "about 9%".

I don't object to the inclusion of accurate information (are you aware that I've repeatedly restored its inappropriate deletion?). Do you have an objection to removing basic arithmetic errors from the article? WhatamIdoing (talk) 03:40, 20 November 2008 (UTC)

Well, so now it's not a citation, it's the number! Okay. I'm still trying to figure out why you're taking your stand on the history section when apparently this so-called math error has been existent on the entry for how long? You've failed to answer that question several times, which is surprising because you apparently like to argue for the sake of the argument. And while I submit those numbers are subject to interpretation defined by the government's definition of medically under-served areas, the deletions in the history section comprised the entire paragraph entry and not just a math correction here OR in the employment section. It was a wholesale deletion not an edit of math errors. 6 or 10, it still says that the _vast_ majority of practicing PAs went to the city and left the medically under-served, under-served despite Dr. Stead's dream and promise to provide care for those most vulnerable and in need. You pick the number ... but apply it consistently.News4a2 (talk) 05:52, 20 November 2008 (UTC)

The history section must have a citation added to it.

Both sections must have the correct number.

I have personally not deleted this information from this article ever.

Are we clear on these points? WhatamIdoing (talk) 20:47, 20 November 2008 (UTC)

If you didn't delete it, then WHY, pray tell, are you even chiming in here? When the lock gets pulled off, put in whatever edits you want on the numberS and state your reasons. My grief is with the person who kept deleting the 'graf in its entirety. Are we clear on that point?News4a2 (talk) 21:04, 20 November 2008 (UTC)

The person that kept repeatedly deleting this paragraph was User:Nomad2u001, who has been temporarily blocked for his efforts. Are you familiar with the "History" tab?

The reason that I care about this is because the sentence as written (that is, including the error and not including a proper citation) is out of compliance with Wikipedia's core policy. WhatamIdoing (talk) 23:18, 20 November 2008 (UTC)

(grammatically, that would be "the person WHO" sted that unless you can verify they're a "that" sted "who") If you will go to the history page you will see the cite as it was placed on my last insert/undo. "http://www.aapa.org/research/07census-content.html#3.13" This is the same format that was used in the "Employment" section. If I erred, then the error was never corrected in the "Employment" section in the first place and I repeated it thinking that was the style. Regarding the numbers, perhaps a range would be best.News4a2 (talk) 09:28, 21 November 2008 (UTC)

Actually, using that for all restrictive clauses, including those that describe humans, is perfectly correct. It's simply more formal than the most common American English usage.

Actually, it's grammatically incorrect. The "that" in your sentence refers to "The person," and persons are "who" not that.68.11.139.174 (talk) 08:17, 23 November 2008 (UTC)

What range of numbers do you propose? And why did you exclude so many non-metro areas? WhatamIdoing (talk) 23:24, 22 November 2008 (UTC)

6.3 (excluding rural/non-metro suburbs adjacent to metro areas) to 15 (including same). If it's non-metro, greater than 2,500, and adjacent to a metro area, it's a suburb or exurb.68.11.139.174 (talk) 08:17, 23 November 2008 (UTC)

(undent) Actually, you misunderstand the grammar issue. People can correctly be referred to as either that or who. The choice of that is less common in modern American English, but its declining popularity doesn't make the older use wrong. See, for example, Matthew 7: "Not every one that said to me, Lord, Lord, shall enter into the kingdom of heaven; but he that does the will of my Father," or Othello's famous line, "Then must you speak/Of one that lov'd not wisely but too well" (emphasis added, obviously). Furthermore, it's the only way to indicate that a speaker intends a clause referring to a human to be restrictive instead of non-restrictive (descriptive); who serves both functions.

Back on the actual topic: Why not just say 15% serve in counties that are not considered metropolitan areas? That's the distinction that all the government agencies consider to be most important.

Additionally, are you aware that only 17% of the US population lives in these counties (as of the 2000 census)? That suggests that just about the correct number of PAs are working in nonmetro areas. There's currently little need for "extra" PAs in geographically rural areas; inner city Los Angeles is vastly more underserved from a medical perspective than, say, tiny Poweshiek County, which is considered code 7 (Nonmetro county with urban population of 2,500-19,999, not adjacent to a metro area), but which also has many medical clinics and a relatively large, "full-service" hospital, not to mention several major medical centers (e.g., University of Iowa Health Care) within less than an hour's drive. WhatamIdoing (talk) 19:15, 24 November 2008 (UTC)

I'm sorry, how many angels did you say were dancing on the head of the pin? An hour's drive is 70 miles you can't travel if you don't have a car. Your thinking is self-centered in _your_ world ... step out of it. I've worked this areas, not Scarsdale of course, but real by-golly rural areas 20 miles+ from a definitive care hospital. If the people don't have transportation, they don't have health care and _all_ their health needs become emergencies. And that, madam, is why it's necessary. I'm sorry to have to say this, but you obviously have too much time on your hands and really like to argue. I don't have that time, but this is very, very, very important information and I won't continue to trivialize it by getting muddy in the sty with you. When the lock comes off, I'll edit it and put it the numbers as I see fit. If you don't like it, delete it. I'll undo it. And before long, it'll be locked again, the paragraph won't be included and PAs and PA schools will continue to migrate toward boutique medicine, without penalty or the reprobation from society due them, and crap on the dreams of Dr. Stead and society's most vulnerable.68.11.139.174 (talk) 03:24, 25 November 2008 (UTC)

I don't see that what you are saying is helpful. You seem to have only edited this article.[5] Do you have any sourced information you can provide that will improve the article? —Mattisse (Talk) 03:47, 25 November 2008 (UTC)

I provided balance to a section containing unbalanced information. One can't just cite the lofty goals of Dr. Stead without also citing that that aims were not achieved, the promise unfulfilled.News4a2 (talk) 22:19, 25 November 2008 (UTC)

Not exactly. You provided your personal point of view, without any support for your assertion that Dr Stead had a particular desire to see PAs in rural areas (as opposed to any geographic area that happens to be underserved). WhatamIdoing (talk) 05:13, 26 November 2008 (UTC)

Not POV but established fact. Once again, you're either failing the read the information already included in the Wiki, to wit: "The PA profession came into existence in the mid-1960s due to the shortage and uneven geographic distribution of primary care physicians in the United States," or trying to argue the minutia like some kind of usenet troll. It was started because of uneven distribution and there still exists uneven distribution. The information I included, already accepted in the employment section, illustrates that. Regarding this particular section, I'm not adding information to the Wiki that wasn't already there, just adding it to a section to provide balance to an unbalanced statement.News4a2 (talk) 09:55, 27 November 2008 (UTC)

I read the actual source listed in that paragraph, and it makes no mention at all of rural areas. Do you have a source that specifically declares that PAs are supposed to be in rural areas? WhatamIdoing (talk) 20:32, 27 November 2008 (UTC)

Try this [6]link.68.11.139.174 (talk) 21:43, 29 November 2008 (UTC)

That's much better, but it spends just as much time talking about underserved populations, suggesting that their inability to access a physician is more important than their geographic location. 03:21, 2 December 2008 (UTC)

I've read your edit of the employment section and it is nothing but obtuse and confusing to anyone who reads it. Angels on the head of a pin. As I've said before, you relish debating the minutia. I doubt Dr. Stead saw Hollywood as "underserved" if there were not enough plastic surgeons to tighten the sagging wrinkles but you want to expand the definition to include this minutia. You are trying to confuse the true reasoning behind the formation of the PA profession, and for reasons I cannot fathom.News4a2 (talk) 10:54, 14 December 2008 (UTC)

Nomad2u001, I consider your wholesale deletions without discussion and without explanation vandalism. WhatamIdoing, you don't _own_ the page. I suggest you compromise on some of your disagreements or we're going to going in circles on this until it's locked again.News4a2 (talk) 07:13, 19 December 2008 (UTC)

---

(undent) As I have said previously, if you have a problem with the sourcing of the information or the way the information is presented, you should have piped up long before now.News4a2 (talk) 10:54, 14 December 2008 (UTC)

That a mistake was made a year ago is never an excuse for perpetuating it now.

I'm just pointing out that you seem enthusiastic debating the minutia here but never had a problem with the information as placed in the employment section and it makes one curious is all.68.11.139.174 (talk) 21:43, 29 November 2008 (UTC)

Please do not stick your comments in the middle of someone else's; it leaves other readers confused about who said what/when. I've moved your comment here so we can carry on two separate conversations, since that seems to be your goal.

This article has been on my watchlist (along with about 900 other pages) for about six months, to keep an eye out for vandalism and edit warring. I've never actually bothered to read the entire article at once: it's not necessary to know what every sentence says to figure out whether replacing the entire page with I LOVE CHEEEEZZEEBURGERS!!!! is vandalism.

As for your implied accusation of a conflict of interest, I'm not a licensed healthcare professional of any sort (it's been years since I had even as much as a CPR certification), and I don't care one way or the other about PAs as a profession. I'm perfectly indifferent (unlike you) and therefore a neutral party.

What I do care about is whether Wikipedia is publishing outright errors or making assertions that aren't backed up by proper sources. I addressed the lack of proper sourcing and the errors as soon as I was aware of them. Do you have any problem with that motivation? Or were you just expecting me to correct problems before noticing them? WhatamIdoing (talk) 03:21, 2 December 2008 (UTC)

News4A2-- You keep mentioning that Dr. Stead meant for the profession to serve "rural areas," when in reality he meant for PA's to provide care to the under served. Rural and under served are not necessarily synonymous. Many urban areas are very under served; thus, were included in his vision for PA's also. 66.36.223.162 (talk) 16:22, 9 February 2009 (UTC) —Preceding unsigned comment added by 66.36.223.162 (talk) 16:07, 9 February 2009 (UTC)

In Spanish...

I'm removing this line. I don't see it as adding anything to the article and if a person wants to know what it is in Spanish can simply check the Spanish article's title. 翔太 ^{「Shouta:talk」} 17:53, 13 November 2008 (UTC)

It's been undone without a reason given in the edit summary. I'll remove it again. At least give some justification please. :) 翔太 ^{「Shouta:talk」} 04:25, 15 November 2008 (UTC)

Rural numbers

News4a2,

Thanks for adding another source, but the census numbers you cite don't use the same methodology and therefore aren't comparable. The survey uses the USDA Economic Research Service's Rural-Urban Continuum Codes to determine the number of PAs practicing in rural counties. Therefore the only accurate comparison is to the number of people living in the same list of counties (that is, those counties with the same RUCC codes).

The list you cited didn't use counties as its basis; it uses urban boundaries set by the US census office, and counts as 'rural' everyone that lives outside a designated urban area -- even if they only live ten feet outside a major urban area. For example, it probably would have counted as "rural" a high school classmate of mine that actually lived across the street from a 300-bed hospital (the street in question was the city's legal border). She would have been considered 'urban' in the RUCC system, because the county line was another five and a half miles north of her home. WhatamIdoing (talk) 21:27, 17 December 2008 (UTC)

Actually "methodology" means the "study of methods" not "method." I assume you mean "... don't use the same method." It's a common faux pas. I see you're back to your bureaucratic argumentative ways. The only solution, as I see it then, is the deletion of your 17% number. Because from my perspective, that 17% isn't comparable with the one and only correct number of 21%. However, I'll compromise and leave your 17% there because it provides _balance_.News4a2 (talk) 19:17, 18 December 2008 (UTC)

The article should move to the 2008 report, which was released more than two months ago. The numbers don't change: both the 2007 and 2008 reports summarize the important figure thusly: "Metropolitan Status of Work Site: Fifteen percent of respondents work in counties that are non-metropolitan."

The 2008 (like many, if not all, of the previous reports) clearly names the source of its numbers: "Zip Code of primary work site was linked to County Rural-Urban Continuum Code from the Area Resource File obtained through the Bureau of Health Professions, US-DHHS." If you want to see how many people live in the same places served by these people, you need to use the same system. Your approach is like comparing "People living in New England" to "People living in Maine, New Hampshire, Vermont, Massachusetts, and Rhode Island, but nobody from southern Connecticut, because half of them work in New York City anyway." Using system A for one set of numbers and an unrelated system B for the other set of numbers doesn't compare apples to apples. WhatamIdoing (talk) 21:53, 18 December 2008 (UTC)

Again, News4a2, we need to compare apples to apples. We need to use the same method of determining population in both the how-many-PAs study and also the how-many-patients study. We cannot use the RUCC county system for counting PAs and switch to any other system for counting patients just to get a "better" number (that is, one that was chosen to promote your point of view).

I'm not interested in an edit war. Would you like to get a third opinion? Are you interested in dispute resolution? WhatamIdoing (talk) 06:02, 20 December 2008 (UTC)

As someone who claims not to want to start an edit war, you certainly have taken actions like you _own_ this page. I disagree with your methods and your numbers and your sources. Accept the compromise. There is always more than one interpretation of the numbers. Providing a range provides balance. You apparently can't see the forest for the trees and, again, are bogged down in the minutia.News4a2 (talk) 21:08, 20 December 2008 (UTC)

I do not want to have an apples-to-oranges comparison in this article. I will not accept your proposed "compromise" because I believe it to be flawed (as explained above). Do you have a preference for how this gets resolved?

As for "owning" the article: Since Wednesday, the only edit I've made was to remove an out of date template that was accidentally replaced by another editor. You, on the other hand, have been rather busily reverting Nomad2u001's changes without any effort at discussing your concerns with him (or her). WhatamIdoing (talk) 02:26, 21 December 2008 (UTC)

As far as I'm concerned, Nomad is you logged in on another name ... or a tag team buddy of yours. I've already posted a note to you/it with no response. You/it deleted whole sections without comments under the Nomad name. Re: the 21% ... you've made comments and I disagree. The sources and numbers I used are just as accurate. You are not the only one who has read the book "How to Lie with Statistics." However, I note that although I disagree with your numbers _I_ have always left them in while you are a wholesale contribution deleter with anything you disagree with.News4a2 (talk) 12:47, 21 December 2008 (UTC)

You can file a Request for Check User if you'd like to find out on your own. It's possible that they will require a more substantial level of justification than "all accounts that oppose my personal view must be operated by the same person, because surely no two people in the world would ever disagree with me on the same point", but I don't know: I've never filed an RFCU.

If you have any interest in taking my word for it: Every single interaction I've ever had with Nomad2u001 is posted on his/her talk page, and therefore available for public inspection. WhatamIdoing (talk) 06:25, 22 December 2008 (UTC)

Which numbers should be used

After reviewing the wording and statistical content of the the three reports at the heart of this controversy:

1. http://www.aapa.org/research/07census-content.html#3.13 - 2007 AAPA census, table 3.13 (not table 3.4)
2. http://www.ers.usda.gov/Briefing/Rurality/RuralUrbCon/ - Measuring Rurality: Rural-Urban Continuum Codes
3. http://www.nemw.org/poprural.htm - Rural Population as a Percent of State Total By State, 2000

The first source, a survey of Physician Assistants, includes among other data a classification of respondents by "Metropolitan Status and Degree of Rurality of County of Primary Work Site". Nine Degree-of-Rurality categories are grouped as three metro and six non-metro classifications. A total of 15% of respondents have primary workplaces in non-metro counties. The second source also deals with rural population at the county level and apparently uses the same nine categories for classifying counties as metro and non-metro. Using the population figures given, approximately 17% of the 2000 US population falls into counties classified as non-metro. This is a close match to the first report. The third source classifies the US population as "rural" and "non-rural" (not "metro" and "non-metro". Also, it does not appear that this report is derived from US census data that defines metropolitan statistical areas in a manner that does not always match county boundaries. This is not a good match to the data in the first report. Using the third source would imply a greater rural population to PA ratio than than is warranted. If the first source had categorized PA work locations as rural/non-rural using the same criteria as is used in the third report, I would expect that the stated number and percentage of PAs working in a "rural" location would be somewhat larger that the number and percentage working in a "non-metro" location.

Based on the above review, I am of the opinion that the second reference above is the best source to use with the first, and references to the third should be removed. On this issue, I agree with WhatamIdoing above and the edits by Nomad2u001 regarding the edits to the Employment section. That said, I see no reason given for the removal by Nomad2u001 of additions to the History of the profession section. I therefore believe these changes should remain until such a reason is provided.

-- Tcncv (talk) 02:39, 22 December 2008 (UTC)

Thanks for taking the time to look into this. WhatamIdoing (talk) 06:25, 22 December 2008 (UTC)

I disagree, on several levels. First, AAPA doesn't cite that it uses the numbers proposed by WhatamIdoing, so it is left up to interpretation. And interpretation requires a range for balance. I suspect they used numbers totally different from her source and totally different from my source. I've never deleted her numbers, just added a second number as a range while she has proposed there is only one number and it's hers. Tough. :P If there was a cite on the AAPA page specifically pointing to the reference proposed by her highness, the grand deleter, I wouldn't have a problem with it. But there isn't. She's just flapping her gums under the old adage "If you can't fool them with facts, baffle them with BS." Well, I'm not a naive college freshman. I figure if you can't say it succinctly it's balderdash, and she can't. So I'm not going to side with her numbers and neither should anyone else who seeks knowledge. It's the difference between accuracy and precision. You include your data and sources as part of peer review and the AAPA survey doesn't. She's guessing, you're guessing and I'm guessing. So the range is appropriate for balance. Secondly, the "Metropolitan Status and Degree of Rurality of County of Primary Work Site" section that you mention on the AAPA has a little asterisk after the title, meaning the data are presented with conditions, notes, etc., but the little asterisk isn't referenced anywhere. So what's it mean? Why's it there? You've come to conclusions without full information, again, something that lends itself to a range.News4a2 (talk) 13:12, 22 December 2008 (UTC)

Both the 2006 and the 2008 surveys state, immediately under the matching table, "Zip Code of primary work site was linked to County Rural-Urban Continuum Code from the Area Resource File obtained through the Bureau of Health Professions, US-DHHS." How do you interpret this sentence if it does not mean that they are using the RUCC coding system?

Additionally, your preferred source specifically does not use counties, so if you're going to edit-war it in, would you mind not misrepresenting your source as being based on counties? 21% of the US population does not live in counties that are designated as non-metropolitan. WhatamIdoing (talk) 20:20, 22 December 2008 (UTC)

Your error is exactly as you state "How do you interpret this sentence if it does not mean that they are using the RUCC coding system?" I don't interpret anything because interpreting is guessing. And guessing is not scholarly research. As I have said, had the AAPA placed a link to the numbers you're using, this discussion never would exist in the first place. But it didn't. And anything else is pure speculation on your part, mine and any other. So, if you want to put numbers, a range is more appropriate. Of course, you don't "win" the argument, so obviously you won't agree.News4a2 (talk) 22:33, 22 December 2008 (UTC)

New text

I propose updating the text to use the 2008 census, like this:

In the 2008 AAPA census, 56 percent of responding PAs worked in physicians' offices or clinics and 24 percent were employed by hospitals. The remainder were employed in public health clinics, nursing homes, schools, prisons, home health care agencies, and the United States Department of Veterans Affairs. Fifteen percent of responding PAs work in counties classified as non-metropolitan communities by Economic Research Service of the United States Department of Agriculture; approximately 17% of the US population resides in these counties.

Aside from News4a2's ongoing push for equating census boundaries with counties, are there any objections to using the more recent information? WhatamIdoing (talk) 21:27, 22 December 2008 (UTC)

Suggestion re proposed paragraph: Delete the word 'communities'. The sentence reads OK without it. Its inclusion adds nothing but yet another geographical / political / social boundary. - Hordaland (talk) 03:02, 23 December 2008 (UTC)

History of the profession

Twice now I have removed an assertion that schools "have shifted from this street-experience focus of Dr. Stead and now recruit students with high GPAs and limited "hands-on" patient care experience", which is only sourced by linking to numerous schools' admissions websites. This is inappropriate as it is original research - an editor is surmising what a school's admission decisions are based only on that editor's reading of their website. Who knows what goes on behind their doors. Unless an independent and reliable source can be found to support this assertion, it should not be re-inserted. --ZimZalaBim ^talk 14:15, 22 December 2008 (UTC)

I agree. It's also silly to base this "profession-wide" assertion on the stats produced by some of the most prestigious universities in the country. Admissions to (for example) any program at Duke University have become much more competitive in the last half century. It's not specific to PA programs. WhatamIdoing (talk) 20:22, 22 December 2008 (UTC)

Surprise, her highness agreeing! Pardon me for placing _sourced_ information in an article as opposed to your POV. "Original research" would be things like a survey I completed, interviews I'd done, etc. You two either don't know what "original research" is or are just anti-anything I've placed here. These sources would be appropriate in any scholarly research; they are therefore appropriate here. Again, it provides balance, comparing original intent and design to how programs have morphed over the years.News4a2 (talk) 20:43, 22 December 2008 (UTC)

The issue is not "original research" in the common sense, but a violation of one of Wikipedia's core policies. Please read the policy. If you wish, you can list your concern at the noticeboard for this kind of question. I'll cheerfully abide by the decision made there. WhatamIdoing (talk) 21:08, 22 December 2008 (UTC)

It would have been nice if you'd read it too ... again before your wholesale deletions. And I quote "you must cite reliable sources that are directly related to the topic of the article, and that directly support the information as it is presented." Duh!News4a2 (talk) 21:15, 22 December 2008 (UTC)

You seem to misunderstand the policy. To make a statement like, "Admissions standards have changed", you must find a source that says that the admissions standards have changed. You cannot find a copy of the admissions standards for one school (or four schools) in 1960 and the admissions standards in 2005 and say "Look, they've changed!". You must find a source that specifically talks about changing standards. For all we know, a change in GPAs for admitted students could be solely due to grade inflation, or changes at the specific programs that you happen to look at. You must find a source that complains about changing standards; you may not do your own research to determine that the standards have changed. WhatamIdoing (talk) 21:31, 22 December 2008 (UTC)

WhatamIdoing is correct. It is one thing to notice what is listed on a school's website. It is another to assert that "admissions standards have change." It is not for us to say if the actual standards and practices of an admissions department have changed. We need to have a reliable source stating that this has happened. Your selection of random sites and personal assessment of what the content on those sits mean is original research/ --ZimZalaBim ^talk 21:44, 22 December 2008 (UTC)

The original class of PAs were ex-Navy corpsmen and Army medics. They were discharged. They became civilians. They had no college, no GPA, only a lot of healthcare experience but they were accepted into Dr. Stead's first PA program at Duke. And that's included in this article. Ex-Navy corpsmen and Army medics no longer are admitted to PA programs directly following discharge, regardless of how much healthcare experience they have. They have to have college credits. They have to have certain GPAs. They have to have certain pre-requisites. But they don't have to have all that much healthcare experience anymore. This is a serious change from the program formed and envisioned by Dr. Stead. All that information is presented from my sourced information. I really don't know how to more simply explain it so you'd be able to understand. Not that it would do any good. Honestly, I'm going to stop these discussions if you keep deleting my contributions. I've said what I'm going to say. It's obvious that you think only your contributions are acceptable. Tough. :P You don't own the article.News4a2 (talk) 22:07, 22 December 2008 (UTC)

And neither do you. Perhaps you should review how to try to achieve consensus in this group project. --ZimZalaBim ^talk 22:23, 22 December 2008 (UTC)

I don't define consensus as having you, WhatamIdoing and Nomad2u001 delete any and all contributions I make to articles. Consensus involves compromise and that's something that none of you three are obviously willing to do.News4a2 (talk) 22:36, 22 December 2008 (UTC)

Yes, and consensus and compromise must be achieved via discussion prior to the inclusion of the disputed material. That is why we continually remove the contentious content you are adding. You, on teh other hand, simply revert without discussion (and rarely an edit summary). I suggest you pause, and discuss here first before trying to include the content again. --ZimZalaBim ^talk 22:46, 22 December 2008 (UTC)

Apparently, you don't even read your own referrals, to wit: "Editors typically reach a consensus as a natural and inherent product of wiki-editing; generally someone makes a change or addition to a page, and then everyone who reads the page has an opportunity to leave the page as it is or change it." Consensus is not achieved before but after. Silence implies consensus, but consensus is not written in stone. And, again, wholesale deleting of any and all contributions I make is not what I consider good faith effort to reach a compromise.News4a2 (talk) 23:13, 22 December 2008 (UTC)

And, praytell, how is you wholesale reverting - without edit summary or content - of multiple editors attempts to keep improper material out of the article help achieve consensus or compromise? --ZimZalaBim ^talk 23:24, 22 December 2008 (UTC)

I'm keeping my contributions intact so they may be discussed. If the information isn't there, it can't be discussed. Only one edit summary is necessary if the reversion is just a continual reversion of deletions by you and the sockpuppets. Anything else I have to say will be said here. And your method now is if you can't stop the message, kill the messenger.News4a2 (talk) 23:33, 22 December 2008 (UTC)

As is the nature of this wiki's software, a history of all edits is viewable for each page. Further, I included a "diff" showing the edits in question in my very fist post in this discussion thread. As such, blindly re-inserting contentious material to "contributions intact so they may be discussed" is not necessary. Please stop. --ZimZalaBim ^talk 23:36, 22 December 2008 (UTC)

I know we're wrestling ... just wanted to find out if you're enjoying it.[7]News4a2 (talk) 23:46, 22 December 2008 (UTC)

After taking a look at the material and its sources, I have to agree with WhatamIdoing that the material constitutes original research - specifically the Synthesis section. As the policy states "synthesis occurs when an editor puts together multiple sources to reach a novel conclusion that is not in any of the sources." The conclusion contained in the added material is, "many PA programs have shifted from this street-experience focus of Dr. Stead and now recruit students with high GPAs and limited 'hands-on' patient care experience.", but this view is not stated in any of the referenced sources. (I do not doubt that there may indeed have been such a shift, but it is not Wikipedia's policy to make that call on its own.) Even if the material were restated in a manner that were allowed, I think it would belong in a section other than History. For now, I support its removal. -- Tcncv (talk) 01:24, 23 December 2008 (UTC)

Any contributions I've made are as much "original research" as WhatamIdoing adding up census numbers. She added them up, placed a total on the page and referenced her source. Does adding numbers up constitute original research? No. But she has synthesized the separate numbers, coming up with a total. By the same token I've looked at the pages of the colleges, added them up and placed a general statement regarding that total. I could have gone to this [page] and counted the number of schools requiring healthcare and those that don't. Same difference. News4a2 (talk) 19:41, 23 December 2008 (UTC)

No, these two things aren't comparable. I've added up a couple of numbers in a column, using the same sub-division that the authors wrote. You've posted the admissions requirements for schools, and rather than simply stating what's in your refs (for example, "Most graduate school programs do not require any hands-on healthcare experience"), you have written something only tangentially related (that the admissions requirements have changed compared to half a century ago).

If you have any reliable sources that talk about change, then I'm totally willing to include it. But you can't post the current requirements, which don't say a single word about the original requirements, and then assert that they prove that changes have happened. Do you understand the difference? WhatamIdoing (talk) 22:54, 23 December 2008 (UTC)

Surprise! WhatamIdoing disagrees! Shocking! Way to strive for consensus Wha! Let me guess ... the only reliable source would be one you'd found? Health care experience was a founding plank used by Dr. Stead to build the Duke program and now 77 schools only recommend but do not require applicants to have health care experience; 10 have _no_ health care experience requirement. A good portion of the remaining schools which do require it define health care as anything from medical secretarial experience to "shadowing" a PA for a limited amount of time. Nah ... that doesn't signify change to even the most casual of observers. The average GPA requirement is now 3.5 [[8]] and few street medics and military medics have a 3.5. If they did, they'd be in school with a bunch of scholarships instead of on the street or in the military. News4a2 (talk) 23:49, 23 December 2008 (UTC)

I'll accept any published source that meets Wikipedia's usual criteria, which you'll find at this page. Note that if you want to talk about changes over time in the admission criteria for PA programs, then the source has to talk about changes over time in the admission criteria for PA programs (that is, exactly the thing that you want to talk about). I don't actually disagree with your belief about the changes; they probably mirror the changes seen in medical schools. (A hundred years ago, you could dramatically shorten your time in med school by spending the summer shadowing your uncle, the kindly country doctor.) I'm merely unwilling to compromise Wikipedia's verification standards to include it. Surely if this change is either well-known or controversial in the profession, then somebody will have published an article about it.

Oh, and my primary goal is not "consensus" about what we personally want to include; my primary goal is reaching a consensus that the information and sourcing complies with Wikipedia's mandatory policies. We don't have that now, and we can't have that so long as you simultaneously refuse to provide a reliable source that talks about changes in academic programs while insisting that the article include unsupported assertions about these alleged changes. WhatamIdoing (talk) 06:27, 24 December 2008 (UTC)

Malpractice insurance

I've removed this reference because I can't view the source without paying to view it. All I can see is the title. Additionally, the article cited is from 2001. Any fees would have changed in the seven years since and any information it contains is dated. That source could be saying anything. If you want to keep it in, find a source that can be reviewed by anyone who seeks to edit this article.News4a2 (talk) 20:51, 22 December 2008 (UTC)

I'd be happy to have you provide more recent information, but the fact that a source isn't free does not make it wrong. Non-free sources are allowed on Wikipedia. WhatamIdoing (talk) 21:28, 22 December 2008 (UTC)

Proposed cleanup

Since the article is currently edit-protected, we need to show a consensus and submit a request to an administrator to get any edits applied. I believe from the above discussions that all but one of us are in agreement. To restore the article, I propose that we request that this edit be undone. This will remove recent additions to both the History of the profession and Employment sections.

Please add your vote below with a brief reason and signature.

• Support - For reasons already stated in the above discussions. -- Tcncv (talk) 01:55, 23 December 2008 (UTC)
• Support - I support reverting the recent addition to the History section; no opinion regarding the Employment section (I haven't scrutinized it). --ZimZalaBim ^talk 04:13, 23 December 2008 (UTC)
• Support - "History" is a clear violation of WP:NOR. "Employment" is (1) a POV push that is discussed in great detail elsewhere and (2) deleted because the reference isn't free. However, if the admin is willing to make a slightly more complicated fix, I've proposed a slight change of the text (above) to incorporate the 2008 version of the annual AAPA survey instead of the 2007 survey, and it is always nice to have up-to-date information in an article. WhatamIdoing (talk) 05:55, 23 December 2008 (UTC)
• Do not Support - "I'm going to log on to Wikipedia here and I am going to change it ... You see, any user can change any entry, and if enough other users agree with them, it becomes true!" [9] Stephen Colbert, Colbert Report. News4a2 (talk) 02:32, 2 January 2009 (UTC)

Dr. Stead, huh?

(Removed {{editprotected}} tag. To be replaced by request below. -- Tcncv (talk) 19:57, 24 December 2008 (UTC))

A paragraph reads, "Today, however, many PA programs have shifted from this street-experience focus of Dr. Stead and now recruit students with high GPAs and limited "hands-on" patient care experience." (Italics mine) I do not know who Dr. Stead is and while I am sure he's a fine fellow I don't think it's meant to be in the article. Can an admin please clean this up? Bstone (talk) 02:00, 23 December 2008 (UTC)

The above is not a paragraph, but a sentence taken out of context from within a paragraph. If you go to the original paragraph, it explains who Dr. Eugene Stead was and provides the base for the above sentence.News4a2 (talk) 03:42, 23 December 2008 (UTC)

Dr. Stead is the recognized founder of the PA program. As for the other material, we are currently working through a dispute. If you have time to review the disputed material, references, and discussion, please feel free to add your vote to the above proposal. -- Tcncv (talk) 02:04, 23 December 2008 (UTC)

Er, the whole Dr Stead thing just kinda jumps out at you. Perhaps instead of writing his name write something like "PA programs have recently begun to shift from those with a great deal of practical experience to those with high academic achievements." or something like that. Do you get what I mean by the Dr Stead thing? Bstone (talk) 02:09, 23 December 2008 (UTC)

I'm not a regular on this page, just a passer-by who decided to assist with dispute resolution. In my opinion, the first reference to Dr Stead seems fairly benign and justified in the context of PA history. I agree that the second reference is a bit awkward. That statement part of a proposed for deletion (next topic up), but if the consensus is that it be retained, I'd support rewording as you've suggested. -- Tcncv (talk) 02:52, 23 December 2008 (UTC)

• There seems to be consensus among those who have commented that the sentence can be reworded as I propose. Perhaps a responding uninvolved admin can do this? Bstone (talk) 04:11, 23 December 2008 (UTC)

Actually, I think it should simply be deleted. It's a massive violation of WP:NOR, as none of the listed sources actually comment on changes in professional training. They're simply lists of what the current requirements are for getting admitted to various programs, almost all of which (carefully selected?) result in the student earning a Masters degree. It's not necessary to have a masters degree to be a PA any more than it's necessary to have a masters degree to be a Registered nurse. WhatamIdoing (talk) 06:05, 23 December 2008 (UTC)

I think you have a point there, What. Bstone (talk) 06:24, 23 December 2008 (UTC)

---What a surprise. The WP:Meatpuppets have reached a consensus without involving anyone with a dissenting opinion! Shocked, I tell you, I'm shocked! News4a2 (talk) 11:08, 23 December 2008 (UTC)

Are you claiming I am a meatpuppet? You may want to read up on WP:AGF. Bstone (talk) 15:13, 23 December 2008 (UTC)

Request for administrator edit

{{editprotected}}

It appears that we have a general consensus regarding a couple of specific changes, so I am requesting the following edits:

1. Based on the discussion and vote under Proposed cleanup above, please undo this edit. User News4a2 appears to be the only dissenting editor in the related discussions.
2. Also, based on the New text discussion above, please replace the first paragraph of the Employment section with the following (including embedded references):

In the 2008 AAPA census, 56 percent of responding PAs worked in physicians' offices or clinics and 24 percent were employed by hospitals. The remainder were employed in public health clinics, nursing homes, schools, prisons, home health care agencies, and the United States Department of Veterans Affairs. Fifteen percent of responding PAs work in counties classified as non-metropolitan by Economic Research Service of the United States Department of Agriculture; approximately 17% of the US population resides in these counties.

Thank you. -- Tcncv (talk) 19:57, 24 December 2008 (UTC)

• Done. Jclemens (talk) 02:13, 25 December 2008 (UTC)

Socks deleting others' comments

I've semi-protected the Talk page for two days (three different editors have removed large numbers of comments so far this evening). Any admin may undo this protection if they think appropriate. Since the vandal might be a sock of someone who has participated in editing the article, an WP:RFCU might be worth considering. EdJohnston (talk) 05:18, 3 January 2009 (UTC)

Just for future reference, several of the edit wars here recently have been due to Sockpuppets of Nrse. WhatamIdoing (talk) 01:45, 17 January 2009 (UTC)

Globalize

This article is very US centric. Most of the article is how the program works in the US and then there are little short sections for a few countries. The article above the International section should be generalized to a worldwide view and then the International section should give the local information about Physician assistants. A new name 2008 (talk) 19:16, 17 February 2009 (UTC)

I have mixed feelings about this. PAs are essentially a US creation that has been exported to a handful of other countries in the last few decades. It's not the same as, say Nurse or Physician, which are very old professions with a worldwide base (and which obviously need to present a global view). I have an impression that the majority of PAs in the world are actually in the US. WhatamIdoing (talk) 20:15, 17 February 2009 (UTC)

About "Dr" Stead

From WP:CREDENTIAL: "Academic and professional titles (such as "Doctor" or "Professor") should not be used before the name in the initial sentence or in other uses of the person's name."

Please stop adding this inappropriate use of Stead's professional title to the article. WhatamIdoing (talk) 03:07, 24 February 2009 (UTC)

First Paragraph

I don't understand this sentence in the first paragraph...

"PAs are not to be confused with medical assistants, ..., or PAs."

Sounds like PAs are not to be confused with PAs. Huh? —Preceding unsigned comment added by 159.119.128.87 (talk) 22:34, 2 April 2009 (UTC)