Guest Paula Posted July 12, 2014 Share Posted July 12, 2014 Missouri Creates Unique Medical Classification: Assistant ... Link to comment Share on other sites More sharing options...
Guest Paula Posted July 12, 2014 Share Posted July 12, 2014 I do not understand Ann Davis' comment. It will impact PA practice in Missouri and any other state who decides to put the same measure into law. PAs will not be hired in rural areas since we can't call ourselves doctor and the AP can. Link to comment Share on other sites More sharing options...
KMD16 Posted July 12, 2014 Share Posted July 12, 2014 PA vs AP @ war. Interesting that the bill was supported by the state medical society and the AMA were against it. Let see how this will play out. Link to comment Share on other sites More sharing options...
jsfelder0417 Posted July 12, 2014 Share Posted July 12, 2014 All the more reason to change the title to Physican Associate Link to comment Share on other sites More sharing options...
JohnnyM2 Posted July 12, 2014 Share Posted July 12, 2014 All the more reason to change the title to Physican Associate Yeah. Or something. Just get rid of the word assistant. Half the world doesn't know what a PA is and the other half equates it with medical assistant or doctor's assistant. When does a PA ever "assist" a doctor? (OK, maybe in surgery) When the Missouri legislature, with the stroke of a pen, created another whole new category, someone on this forum pointed out that it just can't be that hard to get a name change. Whatever the difficulty, the need is urgent. AAPA needs to get it done. This is getting to be like tax reform or immigration reform. The paralysis is mind numbing. Sent from my Kindle Fire HDX using Tapatalk 2 Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 12, 2014 Moderator Share Posted July 12, 2014 Yeah. Or something. Just get rid of the word assistant. Half the world doesn't know what a PA is and the other half equates it with medical assistant or doctor's assistant. When does a PA ever "assist" a doctor? (OK, maybe in surgery) When the Missouri legislature, with the stroke of a pen, created another whole new category, someone on this forum pointed out that it just can't be that hard to get a name change. Whatever the difficulty, the need is urgent. AAPA needs to get it done. This is getting to be like tax reform or immigration reform. The paralysis is mind numbing. Sent from my Kindle Fire HDX using Tapatalk 2 their (aapas) compromise position is to promote "PA" instead of "physician assistant"..... Link to comment Share on other sites More sharing options...
Guest Paula Posted July 12, 2014 Share Posted July 12, 2014 AAPA will not change the title IMHO. WIll an AP be able to supervise a PA? Link to comment Share on other sites More sharing options...
Guest Paula Posted July 12, 2014 Share Posted July 12, 2014 How will APs bill? The devil will be in the details. CMS and insurance companies will probably credential them just like a physician since technically they have graduated from med school and are doctors. This will be interesting to see how it all shakes out. Link to comment Share on other sites More sharing options...
primadonna22274 Posted July 12, 2014 Share Posted July 12, 2014 http://forums.studentdoctor.net/index.php?threads/ACGME-chief-upset-about-new-Missouri-law,-FMGs-to-flood-Missouri.1084970/ Link to comment Share on other sites More sharing options...
polarbebe Posted July 12, 2014 Share Posted July 12, 2014 Very disturbing precedent. Unfortunately, I agree with a previous post (on the other thread) that this will likely spread to other states over the next decade. Healthcare is in the midst of very big changes from regulations, coverage and now providers. Link to comment Share on other sites More sharing options...
Guest Paula Posted July 12, 2014 Share Posted July 12, 2014 http://forums.studentdoctor.net/index.php?threads/ACGME-chief-upset-about-new-Missouri-law,-FMGs-to-flood-Missouri.1084970/ Very interesting threads on this discussion plus offshoots of it on other links. SDN opinions generally sees the AP as better than PA/NP anyway and I found many comments that support the AP to a certain point. I'm beginning to see the PA profession will be relegated to surgical and other specialties in the near future if the AP trend continues to other states. It will be the end of PA rural practice and that is MY specialty. 8-10 years to go before I retire....will I make it before being replace with an AP? Sorry for being so negative but it really gripes me that the medical boards have no respect or consideration for the PA profession when we act to expand our scope of practice. The opposition to us is concerning to me. And now this happens. Ugh. Link to comment Share on other sites More sharing options...
PACdan Posted July 12, 2014 Share Posted July 12, 2014 Yikes, don't say that Paula, I haven't even started yet! I would hope that for various political and economic reasons that many other states would not let this type of legislation fly. I sincerely hope MO remains an outlier in this case. There are better ways to open up access to care than this "shooting from the hip" of creating "APs". At a minimum, I hope this ordeal sparks stronger opposition to such acts in the future. I know they snuck it in with important legislation to make a veto difficult. As for the "7th year pre-meds" over on SDN, I saw their comments on how obviously these "APs" are better than PAs off the bat. They must know, because they WILL be doctors....one day. ; ) Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted July 12, 2014 Share Posted July 12, 2014 ^^^ That fact may put you in the catbird seat (having not started). Link to comment Share on other sites More sharing options...
GreatChecko Posted July 12, 2014 Share Posted July 12, 2014 How will APs bill? The devil will be in the details. CMS and insurance companies will probably credential them just like a physician since technically they have graduated from med school and are doctors. This will be interesting to see how it all shakes out. THIS is where we have to oppose CMS has to figure out how they can bill and this is where it can die. How I can personally oppose this, I have no clue. Here's to praying someone has some pull in this area. I'll probably call and/or write some reps about this. Link to comment Share on other sites More sharing options...
primadonna22274 Posted July 12, 2014 Share Posted July 12, 2014 Sadly agree and really at the crux of why I went back to medical school after 11 yr of these frustrations as a PA. I have ALWAYS been financially self-supporting and needed to ensure that I will have an active career for another 25-30 years with commensurate compensation. My income as a PA stalled at the 5-6 yr mark...the only way I could make more money was to work more hours and have less of a work-life balance. Now, as an intern with avg of 8-9 hr off a day and no more than 36 hr off consecutively over the past 8 days, being paid about 30% of my first-year PA salary in 2000(! And I was underpaid then!!) if you account for hours worked, I'm not entirely sure I made a sane choice...but hell, let's make the best of it. I could really use some other PA insight/responses on the SDN thread I posted earlier. Link to comment Share on other sites More sharing options...
Guest Paula Posted July 12, 2014 Share Posted July 12, 2014 ^^^^^ In 3 more years you will be sane again. And thrilled with your autonomy. Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted July 12, 2014 Administrator Share Posted July 12, 2014 AAPA should file suit against the law, asking for a TRO because the title is confusing and may harm consumers. Link to comment Share on other sites More sharing options...
KMD16 Posted July 12, 2014 Share Posted July 12, 2014 Sadly agree and really at the crux of why I went back to medical school after 11 yr of these frustrations as a PA. I have ALWAYS been financially self-supporting and needed to ensure that I will have an active career for another 25-30 years with commensurate compensation. My income as a PA stalled at the 5-6 yr mark...the only way I could make more money was to work more hours and have less of a work-life balance. Now, as an intern with avg of 8-9 hr off a day and no more than 36 hr off consecutively over the past 8 days, being paid about 30% of my first-year PA salary in 2000(! And I was underpaid then!!) if you account for hours worked, I'm not entirely sure I made a sane choice...but hell, let's make the best of it. I could really use some other PA insight/responses on the SDN thread I posted earlier. Dr. Prima...keep your eyes on the price. You made the right decision. Don't look back. Can you moonlight for extra $$ as an R2 or R3? Some program allow it while others don't. Link to comment Share on other sites More sharing options...
primadonna22274 Posted July 12, 2014 Share Posted July 12, 2014 Oh you betcha--we can moonlight starting R2. The challenge is finding the time. We have one regular gig in our ED where the FM resident works in triage, low medical decision making, not crazy busy, and paid $100/hr. Easy work and decent pay (almost twice my PA ED hourly rate) but sounds soooooo boring and tedious. Lots of outside opportunities to cover small rural hospitals as EM/hospitalist for ~2k/weekend (low census places) and that sounds much more worthwhile to me. Link to comment Share on other sites More sharing options...
delco714 Posted July 12, 2014 Share Posted July 12, 2014 " The new law requires these doctors to be supervised on site by a "collaborative" physician for 30 days, after which the assistant physician could treat patients without that collaborator's presence in settings 50 mile away. These young assistant physicians will be able to prescribe Schedule III, IV, and IV drugs. Beyond that 30-day period, the collaborative physician is required to perform chart reviews on 10% of the assistant physician's cases every two weeks, but little else." So they practically skip fp residency huh? At least in the capacity they're allowed to work after 30 days. The next step is allowing them to sit for the fp boards after a few years without residency Link to comment Share on other sites More sharing options...
Dunedain Posted July 13, 2014 Share Posted July 13, 2014 Sadly agree and really at the crux of why I went back to medical school after 11 yr of these frustrations as a PA. I have ALWAYS been financially self-supporting and needed to ensure that I will have an active career for another 25-30 years with commensurate compensation. My income as a PA stalled at the 5-6 yr mark...the only way I could make more money was to work more hours and have less of a work-life balance. Now, as an intern with avg of 8-9 hr off a day and no more than 36 hr off consecutively over the past 8 days, being paid about 30% of my first-year PA salary in 2000(! And I was underpaid then!!) if you account for hours worked, I'm not entirely sure I made a sane choice...but hell, let's make the best of it. I could really use some other PA insight/responses on the SDN thread I posted earlier. I saw the SDN thread, typical responses from keyboard warrior physicians... Funny how none of them act so bold in the hospital with statements against or not in support of midlevels (or the rest of staff). Link to comment Share on other sites More sharing options...
primadonna22274 Posted July 13, 2014 Share Posted July 13, 2014 ^^oh so true. Link to comment Share on other sites More sharing options...
coloradopa Posted July 13, 2014 Share Posted July 13, 2014 How will APs bill? The devil will be in the details. CMS and insurance companies will probably credential them just like a physician since technically they have graduated from med school and are doctors. This will be interesting to see how it all shakes out. Actually they don't meet the Medicare definition for physicians. They don't meet the definition for PAs. So Medicare and Medicaid is out. Insurance doesn't credential non- BCE physicians for the most part. Highly unlikely that these positions will be reimbursed. This is going to be the biggest stop for the position. That and the tort environment in Missouri. Link to comment Share on other sites More sharing options...
primadonna22274 Posted July 13, 2014 Share Posted July 13, 2014 I tried to post something along these lines (thank you David) but then lost the post when I tried to attach the link. Ah well. I keep hoping the lack of viable reimbursement will make this issue a non-starter...but I really don't know how it's going to shake out. Link to comment Share on other sites More sharing options...
primadonna22274 Posted July 13, 2014 Share Posted July 13, 2014 And my latest response to "what's so different between graduated MD/DOs that haven't done residency from new graduate PAs?" http://forums.studentdoctor.net/index.php?threads/ACGME-chief-upset-about-new-Missouri-law%2C-FMGs-to-flood-Missouri.1084970/#post-15453767 Link to comment Share on other sites More sharing options...
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