The ‘Dear Abby’ column is well known and loved for dishing out matronly advice on issues from household problems to relationship strife. Columns like “Neighbor’s Baby Cries Constantly”, and “Old Friend’s Schedule Leaves No Time to Catch Up” are bound to stir up a few sensitive souls, but are overall neutral in tone. This week, however, ‘Abby’ has stepped on the toes of one sector of the healthcare community and is feeling the aftereffects of her comments about physician assistants.
On July 8th, 2016, in an article titled “Wife Questions Care Received at Out-of-Town Walk-In Clinic“, an inquirer asked ‘Dear Abby’ this question:
DEAR ABBY: On a recent trip out of state, my husband became ill. The hotel we stayed in referred us to a nearby urgent care walk-in clinic.
The nurse took his blood pressure, which was very high. The “doctor” never took his temperature or mentioned the high blood pressure to us. He prescribed six drugs and we went on our way. My husband was happy; I was not.
When we returned home, I looked up the doctor’s name on the internet. Actually, he was a physician’s assistant, not a medical doctor. Abby, what should people do if they become sick while traveling? — TRAVELING MEDICAL EMERGENCY
Abby’s reply was this:
DEAR T.M.E.: You have asked an excellent question, one that may help many other people.
It is always wise when you travel to bring along a list of any medications you’re taking and a copy of your medical records. Medical records are online these days and can be emailed to you upon request. A lot of health insurance companies offer a 24-hour service to call for a referral to a physician in whatever locale you happen to be.
Physician assistants are standard in many areas of the country as long as they are supervised by a physician — and in your husband’s case, there should have been an M.D. on the premises. You, as the consumer, have a right to ask questions. It would not have been out of line to inquire about the certification of the person who was treating your husband, or to ask to see the supervising M.D.
If the medical emergency is dire, take no chances and call 911. If someone is really sick (having chest pains, muscle weakness, trouble speaking), an emergency room is better than an urgent care because more expertise and testing are available onsite.
Clearly, Jeanne Phillips, the woman behind the Abby pen name neglected to do her background research before drafting her reply. The response contains several inaccuracies about physician assistants. PAs, for example, are not required to practice with a physician on-site in most states. While patients certainly have the right to be treated by whatever kind of provider they like, ‘Abby’ is incorrect in her assertion that there should have been an M.D. on the premises during the patient interaction.
As a further knock to PAs, ‘Abby’ neglects to address the fact that dissatisfaction with care can occur in any patient interaction, regardless of the provider’s credentials. It seems like the inquirer in this circumstance did not receive adequate discharge and follow-up instructions. While there is room for the physician assistant to improve in this instance, the same type of miscommunication occurs in healthcare facilities among MDs, PAs, and NPs alike. ‘Abby’s’ message should have been more along the lines of helping patients seek the highest quality providers possible in urgent and emergent situations.
Dear Abby’s erroneous reply does a disservice to physician assistants by spreading false information about supervision requirements. It demonstrates a lack of understanding of the PA role, and serves to reinforce this among similarly uninformed readers. Furthermore, the article implies that physician assistants provide substandard care, an unfounded claim.
While one can appreciate that ‘Abby’ has limited space to address complex questions, there is no excuse for publishing false information. The American Academy of Physician Assistants says they have reached out to publishers of the ‘Dear Abby’ column, and “will continue to monitor the situation and will provide updates as they have them”.
What do you think about Dear Abby’s comments regarding physician assistants?
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