Advanced Practice Nursing Degrees to be Doctorate level after 2015

[BruceBanner]

I think we should all be able to take a 1 year online program based on arbitrary standards and come out with a DPA-C. 

 

 

Oh wait, that's the nurse quacktitioners...

[siddhartha]

we can debate this topic all WE like, but the fact is that if the NPs are getting doctorates, and the other professions (Pharm-D, DPT, etc) are as well, we'd be foolish as a profession not to.

 

The independent practitioner is a different battle, and shouldn't be fought alongside the "doctor" one, as it does, in essence, make us competition rather than collaborators, as I think it should be.

 

We may argue "degree creep," but if you are looking as an employer, or outsider/layperson, it's a matter of perception. "Doctor" to the layperson means "expert in their field," which many, many PAs are, or become with training already. I think it should be there in the initials following your name, as well. Doesn't change our collaboration requirement, nor our actual clinical skill, but gives what we have validation to many who aren't so close to our profession.

[2234leej]

I see.  I didn't know that.  I'm wondering how common it is for students to take that route.  I've only known people to take the BA/BS --> PharmD path.

 

 

My wife did this. She did 2 years of prerequisites and went straight to get her PharmD (6 years total, no bachelors degree).

 

I did something similar with my physical therapy degree (crammed undergraduate into 3 years, 3.5 years for grad school + 1 year for orthopedic residency= 7.5 instead of 8.5).

 

 

@BruceBanner: hah dude you sound so frustrated at PT's and NP's. What's with the hate?

 

For the record, I am a physical therapist and do not request pt's call me "Doctor." Secondly, while some NP's are all for the DNP, there are plenty out there who think it is absolutely ludicrous. I was against the clinical doctorate degree for PT; however, I can understand it given their vision of direct access for physical rehabilitation for patients in collaboration with physicians.

[2234leej]

For the record, if the AMA (both physicians and PA's) did a better job promoting the PA profession, the topic of a PA doctorate would be insignificant and unnecessary.

 

I honestly don't know how the profession can change to a "doctorate" (regardless if is similar in credit load to another doctorate) without the physicians losing respect for the PA profession. No matter how you spin it, they will look at it negatively. The profession will forever be tied to physicians; that is the root of the profession. What needs to be changed is words like dependent (more like collaborative).

[PACdan]

The independent practitioner is a different battle, and shouldn't be fought alongside the "doctor" one, as it does, in essence, make us competition rather than collaborators, as I think it should be.

 

We may argue "degree creep," but if you are looking as an employer, or outsider/layperson, it's a matter of perception. "Doctor" to the layperson means "expert in their field," which many, many PAs are, or become with training already. I think it should be there in the initials following your name, as well. Doesn't change our collaboration requirement, nor our actual clinical skill, but gives what we have validation to many who aren't so close to our profession.

 

I think that some fear that physicians will see a push for a PA doctorate AS a push for independence, not distinguish the two. I'm sure many are aware of the silly degree creep game, and will get that it is just that, a game to keep parity in the industry.... BUT, a few might take it as an omen.

 

They'll envision the domino effect of a few PAs succumbing to the strange vapors emitted from a "DocPA" degree and before you know it those DocPAs will be introducing themselves as "Doctor John" in clinic. It doesn't help that the DNPs have done this. Most physicians are not amused.

[whoRyou]

... I would NEVER support independent practice for a new grad green PA. The learning curve from just-graduated to well-seasoned PA is just too steep. Physicians take a minimum of 3 years in residency to become independent and it's under a systematically structured rubric of "graduated responsibility". This is to protect the patient and the physician from harm. ... I can imagine and we are no smarter than the DNPs in pushing for that kind of foolhardy risk.

^ This is why one should NEVER hurry their HCE as well as their academics as a Pre-PA, PA-S, AND PA

[BruceBanner]

 

@BruceBanner: hah dude you sound so frustrated at PT's and NP's. What's with the hate?

 

 

 

I'm partly just making jokes here, but it is frustrating.  On an organizational level they (NPs) are well-funded and have huge numbers, which translates into robust political influence. Make no mistake, the NP community would not lose a wink of sleep if PAs were to become non-viable in the healthcare market. They are our direct competition, and in some aspects (independent practice and insurance reimbursement) they are winning.

 

Between their quasi-standardized training, the 'doctorate' farce, and their overall ****-don't-stank attitude, they just rub me the wrong way. I actually have no problems with PTs (unless they call themselves doctor, lol), I just lumped them into the whole clinical doctorate thing.

 

What sucks is that it looks like PAs will also soon be forced go the doctorate route, which I think is totally unnecessary and will ultimately result in higher costs for the student, with no net benefit beyond remaining employable. Yeah, sure, you could say we'll be more educated and better trained clinicians overall, but the catch is we may be FORCED to, if not officially at least in a de facto sense.

[BruceBanner]

And not that one PA's opinion matters, but I personally think the AAPA should redirect all of their efforts into getting PAs independent practice rights (that is, no SP and full insurance reimbursement) under the following conditions:

 

1. New grads MUST have an SP, or work in a general field for 3 years before obtaining independent privileges.

2. In lieu of experience, PAs can opt to do a 1-2 year residency.

 

This would secure the future of the profession as well as any doctorate shift.

[db_pavnp]

If you know that you'll be forced into a doctorate, design the doctorate to handle your #1 and #2 without creating a bizarre tiered system of PAs that requires the compliance of employers to walk new grads through baby steps.  There are a lot of great ideas in this thread, but I can't help but feel that employers are just going to be more likely to choose NPs if PAs have to jump through all these extra hoops to "reach the same level".  That is all it looks like from the outside, more bad news.

[blueridge]

This is interesting, from the AMA:

 

"Accreditation of foreign medical schools-good idea, or not?

The Educational Commission for Foreign Medical Graduates has announced that it will require accreditation of medical schools attended by all international medical graduates (IMGs) who seek ECFMG certification beginning in 2023.

The ECFMG believes this requirement will improve international medical education, leading to higher quality health care and enhanced protection of the public. The long time frame for implementation of this new requirement allows time for one or more entities to undertake the process of accrediting the world's 2,000 international medical schools.

Currently, IMGs must pass the USMLE to receive an ECFMG certificate and enter US GME programs.
We asked the readers of the AMA’s GME e-Letter their opinions on this new requirement and received the following feedback."

http://www.ama-assn.org/ama/pub/education-careers/graduate-medical-education/question-of-month/accreditation-foreign-medical-schools.page

 

Due to the increasing number of physicians from other lands who choose to practice in America, and given the lobbying effort of the associated professional organizations, many in Congress already strive to reduce barriers for foreign docs to practice forever in America - to meet the demand of providing healthcare to the masses.  Congress does this without regard to the brain drain left behind in many countries, which creates yet more among the multitudes in dire need of healthcare globally.   

 

The president of the AMA, Ardis Hoven, MD, expresses this in relation to the physician shortage in America:

 

"…. I gained much better insight into the contributions that foreign-born and international medical graduates, or IMGs, make in this country and how much we all — physicians and patients — depend on them for the success of our American health care system.  Fully 25% of physicians practicing in the U.S. and 27% of residents and fellows are IMGs. These physicians overwhelmingly are the men and women who provide care in underserved and rural areas and to populations that might not otherwise have access to health care. Our numbers tell us that IMGs tend to practice in areas that have a ratio of fewer than 120 physicians for every 100,000 people and a high percentage of elderly and minority patients. We need them. Badly." 

 

http://www.amednews.com/article/20130729/opinion/130729950/5/

 

The bulk of IMGs practice in primary care and internal medicine, areas in which seasoned PAs are especially well suited. 

 

Doctorate, seems inevitable.  As in real estate - location, location, location.  Same for PA title and doctorate degree - perception, perception, perception.  Yet, there is great value in the present though tweaked PA model for the non-seasoned PAs and those desiring  to practice in a more collaborative nature.  This is where the tiered education concept is most appealing.  Furthermore, the tiered education model appears to be in line with the WHO concept of innovation in medical education and to award proper credit for prior relevant education.  There must be a design incorporated therein for the present master's level PA to attain a doctorate as well - a tailored residency with classroom and appropriate hurdles to win the graces of the various entities.  Something…

[Guest Paula]

This is interesting, from the AMA:

 

"Accreditation of foreign medical schools-good idea, or not?

The Educational Commission for Foreign Medical Graduates has announced that it will require accreditation of medical schools attended by all international medical graduates (IMGs) who seek ECFMG certification beginning in 2023.

The ECFMG believes this requirement will improve international medical education, leading to higher quality health care and enhanced protection of the public. The long time frame for implementation of this new requirement allows time for one or more entities to undertake the process of accrediting the world's 2,000 international medical schools.

Currently, IMGs must pass the USMLE to receive an ECFMG certificate and enter US GME programs.

We asked the readers of the AMA’s GME e-Letter their opinions on this new requirement and received the following feedback."

http://www.ama-assn.org/ama/pub/education-careers/graduate-medical-education/question-of-month/accreditation-foreign-medical-schools.page

 

Due to the increasing number of physicians from other lands who choose to practice in America, and given the lobbying effort of the associated professional organizations, many in Congress already strive to reduce barriers for foreign docs to practice forever in America - to meet the demand of providing healthcare to the masses.  Congress does this without regard to the brain drain left behind in many countries, which creates yet more among the multitudes in dire need of healthcare globally.   

 

The president of the AMA, Ardis Hoven, MD, expresses this in relation to the physician shortage in America:

 

"…. I gained much better insight into the contributions that foreign-born and international medical graduates, or IMGs, make in this country and how much we all — physicians and patients — depend on them for the success of our American health care system.  Fully 25% of physicians practicing in the U.S. and 27% of residents and fellows are IMGs. These physicians overwhelmingly are the men and women who provide care in underserved and rural areas and to populations that might not otherwise have access to health care. Our numbers tell us that IMGs tend to practice in areas that have a ratio of fewer than 120 physicians for every 100,000 people and a high percentage of elderly and minority patients. We need them. Badly." 

 

http://www.amednews.com/article/20130729/opinion/130729950/5/

 

The bulk of IMGs practice in primary care and internal medicine, areas in which seasoned PAs are especially well suited. 

 

Doctorate, seems inevitable.  As in real estate - location, location, location.  Same for PA title and doctorate degree - perception, perception, perception.  Yet, there is great value in the present though tweaked PA model for the non-seasoned PAs and those desiring  to practice in a more collaborative nature.  This is where the tiered education concept is most appealing.  Furthermore, the tiered education model appears to be in line with the WHO concept of innovation in medical education and to award proper credit for prior relevant education.  There must be a design incorporated therein for the present master's level PA to attain a doctorate as well - a tailored residency with classroom and appropriate hurdles to win the graces of the various entities.  Something…

This is what I'm talking about when I asked the question of why medical education is so entrenched in old ways of education.  AMA thinks an IMG is better than a PA simply because they received their MBBS and can say they are doctor.  Yet now the AMA is saying the IMG doctors have a less than adequate education (which they also tell the PAs).  So instead of recruiting IMGs and making the foreign schools adhere to certain accreditation standards why is the AMA not promoting advancement for PAs?    WHY???  Can someone tell me?????  Have they ever THOUGHT of approaching their own PA programs within their sacred halls of medicine and offering the PAs a chance to replace the IMG????   Why not develop PA programs that already have the infrastructure in place to be the new PCPs who will be able to practice with their own independent license within a collaborative relationship with physicians and others?  Why does the AMA and AFPP think we are incapable and unsafe practitioners when they are now inferring that IMGs are unsafe practitioners?  (Read the comments in the links).  AMA only supports the work of a PA IF the PA will be a forever dependent practitioner and an assistant.

 

Their reasoning does not make sense to me.  Many PA schools are within medical schools and courses are taught by physicians.  Yet they tell us we are inadequately trained by their own hands.  Are they embarrassed to admit (by their own reasoning) medical schools do a crappy job of education for PAs and thus tell us we are unsafe and patients will be unsafe being treated by us...yet it is their own fault.    

 

P.S. AAPA has state associations afraid to advance the profession out of the assistant category IMHO.  Fear drives the PA bus. I will await expectantly for the HOD resolution for collaborative practice presented at the AAPA in May and hope the HOD votes yes for AAPA to support a move for collaboration.  If voted no then there will be little help from AAPA for state chapters to move forward. 

[primadonna22274]

The AMA doesn't think of PAs at all...and when they do, it's more than the AOA ever has.

The problem with expecting AAPA to overhaul the PA education and practice is that AAPA has little to no authority to make change.

ARC-PA oversees accreditation of all new and existing PA programs. And who do you think are delegates to ARC-PA? The AMA, AOA, leaders from all of the major specialty organizations (ACP, AAFP, AAP, ACOG, ACS). None of these groups have an interest in promoting independent practice for PAs. These groups also have a significant stake in NCCPA so there's little chance of that changing either (remember CAQs, a concept that didn't exist in the PA world a decade ago? That too trickled down from the ACP and AAFP).

I'm beginning to think the smallest organization that has a vested interest in protecting the interests of PAs is PAFT--and thankful you guys are making some real headway, but the obstacles are huge.

[Guest Paula]

The AMA doesn't think of PAs at all...and when they do, it's more than the AOA ever has.

The problem with expecting AAPA to overhaul the PA education and practice is that AAPA has little to no authority to make change.

ARC-PA oversees accreditation of all new and existing PA programs. And who do you think are delegates to ARC-PA? The AMA, AOA, leaders from all of the major specialty organizations (ACP, AAFP, AAP, ACOG, ACS). None of these groups have an interest in promoting independent practice for PAs. These groups also have a significant stake in NCCPA so there's little chance of that changing either (remember CAQs, a concept that didn't exist in the PA world a decade ago? That too trickled down from the ACP and AAFP).

I'm beginning to think the smallest organization that has a vested interest in protecting the interests of PAs is PAFT--and thankful you guys are making some real headway, but the obstacles are huge.

That's why I belong to PAFT.  The burden is heavy though and we need more PAs who really believe in us as a profession and are willing to work with us.  We cannot be expected to do all the work.  We are a committed group. Small and mighty.  Kind of like Mighty Mouse.  Here I come to save the day!!!!!   Some of  you younger PAs will not get that MM analogy!!!!  

[whoRyou]

^^^ "That's one small step for a (wo)man; one giant leap for (wo) mankind." Source: The New York Times."Armstrong Adds an 'A' to Historical Quotation." 31 July 1969   (p. 20).

[KMD16]

The AMA doesn't think of PAs at all...and when they do, it's more than the AOA ever has.

The problem with expecting AAPA to overhaul the PA education and practice is that AAPA has little to no authority to make change.

ARC-PA oversees accreditation of all new and existing PA programs. And who do you think are delegates to ARC-PA? The AMA, AOA, leaders from all of the major specialty organizations (ACP, AAFP, AAP, ACOG, ACS). None of these groups have an interest in promoting independent practice for PAs. These groups also have a significant stake in NCCPA so there's little chance of that changing either (remember CAQs, a concept that didn't exist in the PA world a decade ago? That too trickled down from the ACP and AAFP).

I'm beginning to think the smallest organization that has a vested interest in protecting the interests of PAs is PAFT--and thankful you guys are making some real headway, but the obstacles are huge.

...spot on! Furthermore, these same groups who are delegates to ARC-PA (the AMA, AOA), leaders from this specialty organization (ACP, AAFP, AAP, etc, etc) most were trained off-shore (IMG).

[Joelseff]

^ This is why one should NEVER hurry their HCE as well as their academics as a Pre-PA, PA-S, AND PA

Post of the day my friend, post of the day!

 

Sent from my SAMSUNG-SGH-I537 using Tapatalk

 

 

[matchb0x]

I've read this entire thread with varying amounts of interest and dread.  I have a BSN and wanted to go PA as it aligned with my life/family goals and a desire to be in the medical model of healthcare instead of the nursin version.  I have never considered NP because the nursing model's rediculous focus on classes and ideals that dont make a better clinician (nursing leadership, stats, etc) combined with the ultra low clinical hours that make me wonder how anyone could have the balls to practice as an NP.  PA seemed like the ideal fit for me.  But the future seems dim, almost bleak for the PA profession.  The horror stories of SP's dyin, or moving without much notice, or retiring leaving the PA high and dry.  The legislation seems stacked in favor of NPs with the seemingly real possibility of PAs falling by the wayside.  I really want to be a PA, but damn, someone paint a brighter picture for the love of gawd. 

[siddhartha]

I've read this entire thread with varying amounts of interest and dread.  I have a BSN and wanted to go PA as it aligned with my life/family goals and a desire to be in the medical model of healthcare instead of the nursin version.  I have never considered NP because the nursing model's rediculous focus on classes and ideals that dont make a better clinician (nursing leadership, stats, etc) combined with the ultra low clinical hours that make me wonder how anyone could have the balls to practice as an NP.  PA seemed like the ideal fit for me.  But the future seems dim, almost bleak for the PA profession.  The horror stories of SP's dyin, or moving without much notice, or retiring leaving the PA high and dry.  The legislation seems stacked in favor of NPs with the seemingly real possibility of PAs falling by the wayside.  I really want to be a PA, but damn, someone paint a brighter picture for the love of gawd. 

I think you have to take this in perspective-the PA profession is robust, and a wonderful career. We as working PAs, however, want it to be even better, and to secure the profession for the future. That is why we are passionately discussing the options.

 

A SP could always leave/die, and it's not much different than a physician partner dying/leaving, or a boss. We all have bosses, and will always have that as a consideration, but shouldn't scare you away from the profession. There will always be another practice happy to have you come on board.

 

I love having PA students, and new grads, because they are usually still excited about the profession and their future, and they are the ones to organize to get things done. For me, I'm very happy with my choice, and have not regretted it one bit. I used to wonder if I should have been a surgeon, but I talk it over with my wife (a surgeon) and we both think that being a PA is the better deal. It could be even better, and that's why we here are talking about it.

[Guest Paula]

I've read this entire thread with varying amounts of interest and dread.  I have a BSN and wanted to go PA as it aligned with my life/family goals and a desire to be in the medical model of healthcare instead of the nursin version.  I have never considered NP because the nursing model's rediculous focus on classes and ideals that dont make a better clinician (nursing leadership, stats, etc) combined with the ultra low clinical hours that make me wonder how anyone could have the balls to practice as an NP.  PA seemed like the ideal fit for me.  But the future seems dim, almost bleak for the PA profession.  The horror stories of SP's dyin, or moving without much notice, or retiring leaving the PA high and dry.  The legislation seems stacked in favor of NPs with the seemingly real possibility of PAs falling by the wayside.  I really want to be a PA, but damn, someone paint a brighter picture for the love of gawd. 

I love my job!!  I'm in primary care.  It is great and my salary is very good.  PA is a profession is growing so join us and then get active in helping us advance the profession.  Don't let us scare you as there will be jobs when you graduate.  PA Forum has lively debates and we are all passionate about where PAs are going and what we are capable of doing.  I think most of us really do like our jobs and just get frustrated with the misconceptions and urban legends that just are not true and perpetuated by some medical groups and interests. 

[ventana]

I have strong feelings about where PA needs to go, and I vocalize them.

 

BUT

 

I don't want to be anything else!  I love it and try to get people into it all the time!

[BruceBanner]

Matchb0x, the PA profession is very healthy. Keep in mind this forum is a very small sample size and the vast majority of PAs are not voiced here.

 

The problem we see as working PAs is that our public perception needs an overhaul if we are to remain viable and employable in the coming decade(s). NPs are direct competition with us, as are IMGs to some extent, and when an employer looks at potential options they are going to look at the best return of investment. An NP not tied to a supervising physician, with a "doctorate" after their name? For about the same cost as a PA? Ok, sign here.

 

Like a few of us have said, the public (and congress for that matter) is generally clueless about medical training. They have no clue what we go through---They look at titles and pedigrees. That's what this whole doctorate rubbish is about----perception. We know that our training is sound, rigorous, and proven; but at the end of the day no one really cares and what they see is an ASSISTANT who needs an SP to work. Competent assistants, sure, but assistant nonetheless. No one is really advocating for PAs except for.....PAs. We don't have the numbers or the political influence the nursing profession has, and if we sit back and do nothing we are going to eventually get hung by our own antiquated titles and legal restrictions. 

 

There are a lot of ideas out there, but so far not much is getting done. Everyone is looking to the AAPA but I'm not sure they have the power or the inclination to initiate a huge overhaul like a title change and independent practice rights. That takes money, manpower, influence, and time.