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Once in a Life Time Legislative Change


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Touted as a once in a life-time opportunity, the state of Washington is offering PAs the chance to totally "modernize" and re-write PA laws in the state. If you are a PA in the state, you can make one recommendation per e-mail and all ideas will be considered before the final bill is written.  The contact information is here: modernizePArulesinWA@gmail.com

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Also, this has to be done by Dec 31st.

 

I've submitted suggestions and supporting statements for::

 

1) The right to use the title: Physician Associate

 

2) Make it illegal for an commercial entity to discriminate against a practice because they hire or are owned by a physician assistant. This would include banks, commercial insurance companies, labs, radiology groups or other medical practices.

 

3) If a PA has a masters degree, is certified and has 10 years of impeccable full time practice, that PA can apply for an advanced practice license (APL).  With the APL, the PA must have a collaborative relationship with a physician or physician group, but that relationship would not require direct contact, chart review, or even constant phone contact. The physicians in that contract would be shielded against a lawsuit brought against the PA.Only the PA's name and DEA would be required to be on the prescriptions.

 

4) No commercial insurance companies would be allowed to discriminate again the services provided by the PA by reimbursing less for those services .  While a PA may earn less than an MD, more that 60% of the reimbursement monies goes to pay for over-head cost rather than provider salary, and the overhead cost are the same between a PA and a MD.

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What do you think the chances are there will be a substantial change (e.g. Can use associate name or collaborative practice)?

A year ago I would say a snowball's chance in hell.  Then, a few months ago they passed a very aggressive pro-PA bill with full support of the physician community.  Also, it appears that the state came to us and asked what can they do to improve the laws for PAs.  They are looking for input for the rank-n-file, in the streets PA as well as SPs.  So nothing would surprise me anymore.  Maybe a snowball's chance in purgatory now.

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This gives me hope that one state will totally modernize their laws.  

 

Michigan has a bill that is attempting to re-write the public health code and it includes amending the supervision and delegation responsibilities of the physician and putting in place a collaborative patient care team approach, where the PA/physician/NP all work in collaboration.  Physician is still required as a team member.   It would also amend prescribing acts to include independent licensure for DEA and PA/NPs would apply for our own MI controlled substance license.  It removes the 's from MI laws but did not go as far as associate.   The Michigan Medical Society apparently was in favor....NPs not so much. 

 

There is a slow sea-change going on in PA world and now is the time for the Washington PAs to push hard.  I say encourage every PA to reach high and far in what you want.  Push the 10 year "autonomy" idea.  

 

As I say...Shoot for the Stars and you will land in the Moon, don't shoot for the trees or you will land in the ditch. 

 

Will Washington NPs be against anything the PAs ask for?

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Will Washington NPs be against anything the PAs ask for?

I've never seen nursing opposition to us in Washington at any level, but I may have missed it. It is far different from what I ran into in Kentucky and Michigan, where there was strong anti-PA nurse voices. In Washington, the NPs have put themselves under the nursing board and they don't answer to physicians anymore and I think they see us as "little physicians" so not in their world.

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In my opinion that Adv Practice License is the BEST development for PA's and healthcare. Forget sending PAs back to medical school to spend 150K  for 3 years then residency. This does not make healthcare affordable or better. PA's who are seasoned and educated should be allowed expanded practice and designated as such. Bravo ! Good luck.

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  • 4 weeks later...

Send you comments directly to the Washington state Quality Medical Assurance board here:

 

Please be advised that you may submit your comments regarding the rules being considered by the commission and board at any time.  Please send comments to:

 

Medical Quality Assurance Commission at

SHB1737MQAC@DOH.WA.GOV

or

Board of Osteopathic Medicine at

SHB1737Osteo@DOH.WA.GOV

 

Be nice and be professional as this is important.

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In my opinion that Adv Practice License is the BEST development for PA's and healthcare. Forget sending PAs back to medical school to spend 150K for 3 years then residency. This does not make healthcare affordable or better. PA's who are seasoned and educated should be allowed expanded practice and designated as such. Bravo ! Good luck.

I really like this idea and as a seasoned PA almost complete with medical school I would support it for my colleagues who don't desire or can't feasibly afford to become physicians. If such a pathway were available to me as a PA I'm not sure that I would have gone through the emotional, financial, physical and relationship toll of med school if there had been an alternate path to independence :)
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Can only Washington state PAs comment?  With the VA system announcing collaborative and autonomous practices for PAs recently, Washington might sit up and notice and seriously consider removing the restrictions on PAs.  

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  • 2 weeks later...

Just finished the meeting and was overwhelmingly disappointed.  Physician-dominated.  It was hard to track from a remote webinar, while some were in the room.  Couldn't tell who was saying what.  The process got bogged down by a physician who is entangled in changing the language in ways that I can't see until I get the document.   I assume he is part of the quality medical assurance board.  PA leaders in the room were mostly mute.  I only got one word in because our remote mics were muted unless we had a question (which had to be done to limit background noise). I asked about the use of "MPAS-C" since the laws use "PA-C."  No on on the board seemed to have ever heard of a MPAS-C.  Finally a PA leader chimed in that it wasn't an important part of our label. None of our (PA) pre-written questions were addressed. The next meeting is in two weeks and for a live audience only in Kent.  It must be for the types who are not in the trenches everyday seeing patients.  I wish I could go.  Maybe I will have better things to say later as we sort this out.

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I will add that the AAPA was represented and the person (can't remember her name) did make a valid point at the very beginning.  In the state of Washington we have three entities.  Physician Assistant, Physician Assistant Certified and Physician Assistant (either of the previous titles) that work with DOs.  Each have a different set of rules.  She commented that "Physician Assistant" is confusing and they should create a new title for that, far more limited role, than Physician Assistant - Certified.  For example, "Non-Certified Physician Assistant (I think)."  I think they disregarded that recommendation. 

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  • 1 month later...

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