it’s a pirate’s life for me

Just call me a Sailor.

For our latest episode of The 2 View (found here), we interviewed our dear friend, and faculty partner Randy Danielsen. Feel free  to download the episode and take a listen.

We got a little somber and serious discussing hot topics of EM politics. Bear with me for a few minutes here as I explain what is going on in the world of APPs vs. Physicians in healthcare, and why it is so troubling. As if you didn’t know.

Some physicians are taking the bullying and hatred of each other in the ER workplace to new levels. I want to mention one group that has been particularly awful - and that was on the EM Doc’s page on Facebook. This group is a collection of EM physicians who not only bash APPs, but their own kind as well. When I saw them spewing out hate messages and posts to some of the top EM docs in the country (quite possibly the world) such as Rick Bukata, Diane Birnbaumer, Gillian Schmidt, Ken Milne and many others - that’s when I knew none of those statements posted there were credible.

The group is filled with insecure and ill-tempered trolls, who just literally have nothing better to do than post garbage on that site. They complain that APPs ask stupid questions on their Facebook pages - and then I see and hear the posts on the EM docs page where physicians literally ask the same questions. This behavior carries over to twitter, other social media outlets and eventually into the workplace. 

It is total garbage.

I have hundreds of doctor friends in the EM community, many who give me updates about these types of groups and feedback. As of late, I didn’t want to hear it. But most recently, I was sent a thread that talked about the PA name change - and in that people suggested new names for PAs. Let me just tell you verbatim what some people said in that EM docs page for new names for the PA: “Private equity bottomliner. Alternative path medical associate, Healthcarister, top of licenser, partially trained practitioner (also you spelled practitioner wrong idiot), specialty hopper, corner cutter, shortcutter, useful idiot, patient assassin and the last one: license to kill.”

This is behavior from “Educated” physicians. Like, whoa. Also, adults. I think?

And I am an NP and it bothers me, for obvious reasons - but also because PAs are my partners and some of them my best buds.

There has to be more insight into what is hateful vs. real concern for real issues in the physician world - as APPs continue to build their careers - and by this I mean, it’s one thing to say “I support PA and NPs in a physician led environment”. That’s great. I am totally 100% on board with that. Practicing medicine is a team sport. Nurses and physicians and extenders of any kind all practice medicine together.  

I feel like what we have here is similar to interpersonal or domestic violence. The beat downs are harsh, and it seems like we just sit back and have to take it. That’s unacceptable. We are battling each other - instead of making amazing leaps and bounds in healthcare - moving forward in the field of emergency medicine - the physicians who state ignorant things like “stop scope creep” and “I won’t work with a midlevel” and “only MDs and DOs should practice medicine” seem to me to be more like bullies that make our healthcare system worse. Think of all the amazing things we could do with a really great team that is all on the same page - not hating on each other - not disrespecting each other - but teaching, growing, communicating, building - and moving a well-oiled machine or sailing on that great solid ship.

We are teaching patients to trust healthcare less and less, by being this hateful.

We talked last time on our show about how I felt the ER was like a pirate ship. There has to be a leader helping lead the team - sure - totally get that - and that’s the captain. Great! Then there are first mates and a crew. There is also an annoying parrot who won’t stop talking, a bunch of people getting drunk and we are helping put their clothes back on and not break things. But in the end, if you’re the captain, a matey or the crew, you are all keeping the boat afloat - and everyone is a sailor.

What I mean by this is that saying things like “stop educating APPs” because it gives them “scope creep” is just foolish. You want all the people in the room at the top of their game. You want all minds to want to be smart and educated and fully capable of a disaster. You need a partner and a second look at things sometimes. You all want the ship to stay afloat and not sink. Therefore, not just the captain needs to know how to tie knots and shoots guns. And, the crew needs to teach the captain how to hoist the sails and drop the anchor should he be alone on the ship. The captain has many jobs, and the crew must be up to speed on the latest and greatest so that no one dies.

Literally. So NO ONE DIES.

With that being said, I just have to add that any APP who wants to increase their knowledge and gather or gain education is not a bad person nor creep - education is a good thing and it helps all of us be our best. And if that troll physican is worried that an NP or a PA is going to take their job, hey with your attitude we just might! I’m sure the hiring board you applied to knows all about your inability to work with others as a team. No one wants you on their team with that mentality anyways. So yeah, we will take that job, thanks, and best of luck.

MR