A Crack In The Wall

I love Marie.  She's a cutie and a great friend of Margots.  But old guys going on about 21 years olds is not a good thing so enough.  And Marie has one major fault.  She's a Liberal Arts major.  Gasp.  Even worse, majoring in Psychology.  The shame of it all.

I know.  I've been there.  I'm a recovering Liberal Arts major.  In history.  I know the embarrassment when people turn up their noses and ask "What are you going to do with that?  Teach?"  When I met a girl's father the disappointment was written all over his face--great, a history major.  He was really thinking--bum.  I would mumble something about law school which I never would attend and thank God for that.  My father did want a lawyer in the family and he got one when my sister went to Stanford.  Good for her.  Go Cardinal.   

So when I delivered Margot's refurbished car down to College Station last month I studiously avoided any mention of majors and future plans with Margot, Megan and Marie.  (About twenty years ago there must have been a run on M names.)  In fact, I was pretty much shut out as I had the temerity to show up late and avoid, for once, my primary responsibility--paying for lunch. 

Also, I wasn't paying much attention until Marie announced she was studying to take an entrance exam to be a PA announcer.  I didn't know you had to take an exam to be a PA announcer and you don't but you do have to take an exam to become a PA.

A PA is a Physicians Assistant.  Margot jumped the gun on me and asked "Like, isn't that a nurse?" as I was thinking the same thing.  Marie said, "No, stupid, it's not."  If I had asked the question, Marie wouldn't have called me stupid but she would have thought it.  Marie went on.  It went something like this. 

"Physician assistants are health care professionals licensed to practice medicine with physician supervision. PAs employed by the federal government are credentialed to practice. As part of their comprehensive responsibilities, PAs conduct physical exams, diagnose and treat illnesses, order and interpret tests, counsel on preventive health care, assist in surgery, and in virtually all states can write prescriptions. Within the physician-PA relationship, physician assistants exercise autonomy in medical decision making and provide a broad range of diagnostic and therapeutic services. A PA's practice may also include education, research, and administrative services.

PAs are trained in intensive education programs accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) .

Because of the close working relationship the PAs have with physicians, PAs are educated in the medical model designed to complement physician training. Upon graduation, physician assistants take a national certification examination developed by the National Commission on Certification of PAs in conjunction with the National Board of Medical Examiners. To maintain their national certification, PAs must log 100 hours of continuing medical education every two years and sit for a recertification every six years. Graduation from an accredited physician assistant program and passage of the national certifying exam are required for state licensure.

Curriculum usually lasts for about 26 months, there are 130 accredited programs.  http://www.aapa.org/pgmlist.php3 

Education consists of classroom and laboratory instruction in the basic medical and behavioral sciences (such as anatomy, pharmacology, pathophysiology, clinical medicine, and physical diagnosis), followed by clinical rotations in internal medicine, family medicine, surgery, pediatrics, obstetrics and gynecology, emergency medicine, and geriatric medicine."

I was rapidly losing interest until I heard the Bottom Line.  "And they make about $100,000."

Pretty good for a psych major.  And then I heard the crack in the wall.

This is the future for medical costs.  The invisible hand is finally making itself known.  Costs are coming down, or at least, moderating.  The PA thing, Health Savings Accounts, and corporations limiting or eliminating health insurance are forcing the industy to become, gasp again, efficient.   

I have long had a plan for lowering health costs.  It is two fold. 1) Lower the entrance requirements for medical school and 2) set a cap on the amount you can sue for under medical malpractice. 

Lowering entrance requirements for medical school ain't gonna happen.  It's a monopoly. 

But the PA is the next best thing.    "PAs conduct physical exams, diagnose and treat illnesses, order and interpret tests, counsel on preventive health care, assist in surgery, and in virtually all states can write prescriptions."  What else is there?  May not be a doctor but if it walks like a duck, quacks like a duck...  And it costs less.  $100,000 is a lot of money but less than doctors make so medical costs go down.

The second step in my groundbreaking medical plan is limiting damages for malpractice.  That's a tough one but we are getting there.  Primarily anecdotal evidence but a friend of mine, a lawyer, had a partner specializing in medical malpratice.  He went out of business.  And there are precedents for limiting damages.  Like in just about every country outside the United States.

Go to Germany and some quack cuts off the wrong leg.  Tough luck.  The judge looks up legs in his book, sees 1,000 Euros and you get 1,000 Euros.  Just an example, of course, but that's pretty much the way it goes.  It's the future for us.

So good for Marie.  Go for that PA and bring down health costs.  Marie is the future.  And she is a cutie.