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1lovingmom Asked August 2017

What is a physician assistant's scope of practice?

My mom is being seen by a PA at the facility where she lives. Recently she was diagnosed with heart failure by a cardiologist. The PA convinced my sister to cancel moms next cardiology appointment because the PA stated, "they just want the money and he has worked with cardiologists in the past and knows how to take care of my moms heart needs." Is this PA overstepping his scope of practice? I was able to reschedule the cardiology appointment but my sister still thinks this PA can handle moms heart failure. I personally absolutely do not agree.

BarbBrooklyn Aug 2017
1Lov; Did you hear the PA say those words, or is that what your sister is reporting he said?

I absolutely agree with GA that if the PA told you the cardiologist is just looking for money, that should be reported to the DON and the director of the facility.

But....is there any possibility that what the PA said was interpreted by your sis, or embroidered a little? Just make sure before you go charging off.

talkey Aug 2017
Dad has a PA on his medical team, & to date, I trust her completely to tell me what she can & can't treat. Alas, they're surely not all the same, though, so I would follow my gut instincts if I were you.

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GardenArtist Aug 2017
This PA is absolutely, totally overstepping his authority, as well as being unprofessional. She should be reported to the DON.

I don't know of any legitimate, responsible, reliable and professional PA who would give the advice of which you wrote.

Adding, after thinking a few more minutes, that this PA is probably in violation of professional standards of the AMA.

BarbBrooklyn Aug 2017
I would have a talk with the Director of Nusing and get his/her opinion about the management of mom's cardiac issues.

What is the cardiologist's plan of action and is THAT what the PA is unhappy about?

When I moved my mom from her home to Ind Living, we ditched most of her doctors for a lovely Geriatrician. He took mom off all of her cardiac drugs. Nothing terrible happened. She had CHF and it progressed very slowly.

If a doc is going to prescribe meds, there needs to be followup. 

It seems to me what wants examining here are the courses of treatment each of these medical professionals is recommending.

1lovingmom Aug 2017
Thank all of you for giving me your insight. My sister is the one who told me this. After I took mom to her cardiology appointment (both my sister and brother were also at the appointment) my sister again told me that this PA was not happy that we went to the appointment and the plan of action the cardiologist gave to mom to relieve her of the edema. You are right, I need to make sure this PA is saying these things. I just needed to get some counsel from others if indeed these statements were made to my sister. Thank you so much!!!

kellse Aug 2017
Did you hear that from the PA yourself, or is that what your sister is telling you?

1lovingmom Aug 2017
I agree that mom needs to continue with the cardiologist. Her edema has improved and the cardiologist wants to work with the family and has my moms best interests in mind. He was my dad in-laws cardiologist and I personally have a history with him. He is very good and hate to lose him to lesser care.

I have decided to speak to the Director of Nursing with my concerns about this PA. I appreciate ALL the good counsel!

Arleeda Sep 2017
I personally intend to stop taking all of my preventive drugs at age 85, maybe sooner if I should lose mobility. That includes statins and blood pressure meds. I am more afraid of dementia than of stroke and heart attack, and I do carry a gene for Alzheimer's, although both my parents died (64, 80) before it became apparent in either of them. I think my great grandmother had Alzheimer's.

1lovingmom Aug 2017
Found out today that indeed, the PA did make these statements. I talked with my sister telling her that when she told me this I had red flags. She said that he did say this because he used to work in a cardiologist office and knows the overhead of running an office. They just keep having you in for follow ups. I, quite honestly, am shocked!!

BarbBrooklyn Aug 2017
1Lov, let us know how this turns out. We really do all learn from each other here and it's nice to know what kind of feedback you get from the DON, as well as your mom's progress with controlling her edema, which many of us struggle with.

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