Wednesday, June 24, 2009


Yesterday was the two-year old well child check at the doctors.

I love our doctors.

I understand the practice has grown faster than they planned, so I understand hiring a few PA’s to help take the load.

But seriously, I don’t like Physicians Assistants.

Our local emergency room likes them for non-life-threatening issues and I’ve found them (PAs in our town) about as useful as a hole in the head.

For example, I go in because I’ve dislocated my wrist. I know it’s dislocated. I can SEE it’s dislocated (badly). I want someone to pop it back in correctly without messing up the other small bones there so I go into an ER.

The PA informs me that I didn’t, that the problem is really my elbow. And it’s a strain. We argue. He sends me to radiology to prove me wrong. Radiology, at his direction, only x-rays my elbow—which is of course fine. I argue more. I try to get a doctor. Hospital says no, that a PA was all I needed and theirs said I was fine (I got a loading dock Teamster to fix it at work). This is fairly typical of how "Treatment by PA" has worked out for us.

But anyway, Sasha saw a PA at his 2 year.

She went down the list. His height was good, weight was good, ears…everything physical was fine.

She asked about his speech/cognition indicators.

PA: “Does he count to 5?”
Parent: “Sort of. He knows what each number is when he sees it written and if you give him identical items and ask how many he’ll tell you. And he can do that for everything up to 10”
PA: “But does he count off to 5?”
Parent: “No.”
PA: “He should by this age.” Writes things down.
PA: “Does he sing his ABCs?”
Parent: “No. But he knows his letters.”
PA: “That’s not the same thing. He should be singing the song.” Writes things down.

And on it went. Eventually, the PA declared him developmentally behind---because she’s an idiot. I could see that the list was trying to get whether the kids were beginning to understand the concepts, by picking the most typical way the kids started out. But not all kids are the same so anyone with sense would see that as a starting point.

So am I worried? Not at all. From what I can tell by the questions he’s tracking fine. I don’t know why they’d expect aptitude in “Please”, “Thank you,” or “You’re Welcome” or “Able to speak clearly and understandably to everyone at all times” in a two-year-olds assessment (those were also there), but since I don’t see many two year olds that fit that bill and have never seen them in a "Your Child Should" checklist before I don’t think it’s a big deal.

As for whatever school the PAs in my town come out of is concerned….that does worry me. Please….raise your standards. You are apparently graduating people who shouldn’t.

1 comment:

caramama said...

OMG! That is so ridiculous! Really, I'm concerned about that school, too. Maybe you should move. Into my county, where there are really great docs and nurses and we don't seem to run into this level of stupidity on a regular basis.