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It's all about representation.


Guest Paula

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The AAPA offices have been located in the greater metropolitan area of DC since nearly the inception of the AAPA.

 

The office is staffed with folks who work on federal affairs full time, including all issues related to the VA.

 

the VAPAA is a very active and strong constituent organization of the AAPA that has lobbied long and hard for PAs within the VA system for decades.

 

There is a high ranking PA position within the VA that the AAPA / VAPAA fought for and succeeding in seeing it created to oversee PA issues. I don't know who is the current PA in the position.

 

The NPs and PAs are both recognized within the VA system, and it really is an issue of supply and demand. The jobs will go to the folks who are licensed and show up. We need to out produce the NP pipeline to take advantage of this demand.

 

 

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It has little to do with title.

 

From the VAPAA FAQs:

 

Are PAs required to have Preceptors listed in PCMM?

No. PAs work under a set of regulations that allow them, at the medical center's discretion, to carry a Primary Care Provider status and workload without a Preceptor being identified in PCMM. The PA still must have a Physician identified as the person from whom he receives guidance and this, in some states, is identified as a preceptor. It is not the same definition of preceptor that PCMM uses, however. PCMM rules are required only for resident physicians, not PAs. It is the same relationship that a Nurse Practitioner has with a physician in the same setting, only they refer to this as a collaborative relationship.
 

From the AAPA:

 

http://www.aapa.org/twocolumn.aspx?id=2120

http://www.aapa.org/workarea/downloadasset.aspx?id=3045

http://www.aapa.org/workarea/downloadasset.aspx?id=2253

 

BTW, Denni Woodmansee, PA-C, is director of PA services at the U.S. Department of Veterans Affairs

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It has little to do with title.

 

From the VAPAA FAQs:

 

Are PAs required to have Preceptors listed in PCMM?

No. PAs work under a set of regulations that allow them, at the medical center's discretion, to carry a Primary Care Provider status and workload without a Preceptor being identified in PCMM. The PA still must have a Physician identified as the person from whom he receives guidance and this, in some states, is identified as a preceptor. It is not the same definition of preceptor that PCMM uses, however. PCMM rules are required only for resident physicians, not PAs. It is the same relationship that a Nurse Practitioner has with a physician in the same setting, only they refer to this as a collaborative relationship.
 

From the AAPA:

 

http://www.aapa.org/twocolumn.aspx?id=2120

http://www.aapa.org/workarea/downloadasset.aspx?id=3045

http://www.aapa.org/workarea/downloadasset.aspx?id=2253

 

BTW, Denni Woodmansee, PA-C, is director of PA services at the U.S. Department of Veterans Affairs

 

 

That's great but the VA is whole different world than what most of us are/will be working in. I'm just a student and I'm already sick of having to defend and explain the "assistant" part of my title. 

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That's great but the VA is whole different world than what most of us are/will be working in. I'm just a student and I'm already sick of having to defend and explain the "assistant" part of my title. 

 

If you don't want to work for the VA when you actually become a PA, then don't.

 

I have practiced as a PA for 33 years and I honestly can't remember the last time I had to "defend" or "explain" my PA title. I work in a wonderful community hospital environment with many PAs and NPs on staff, and we are all highly valued and respected in our system. I promise you that when you have more experience, and are confident in what you contribute in your health care system, you will be less self-conscious about your title.

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I have practiced as a PA for 33 years and I honestly can't remember the last time I had to "defend" or "explain" my PA title. I work in a wonderful community hospital environment with many PAs and NPs on staff, and we are all highly valued and respected in our system. I promise you that when you have more experience, and are confident in what you contribute in your health care system, you will be less self-conscious about your title.

I've been a PA for 18 years and still hate the "A" word. I applaud AAPA's recent efforts to promote the title as "PA". the recent appearance of the AAPA president on C-span was huge for us.

I've sought out jobs where being a PA is not seen as being negative. It wasn't easy. I basically had to find rural and/or solo coverage positions to be appreciated based on my skills and experience, not on my job title. I do believe things are getting better, but of course would like to see huge changes in a short period of time. I'm learning to become happy with little steps forward as long as we prevent steps back. We need to be on equal ground with the NPs for all federal jobs and we need to be able to write for DME and hospice. The hi-tech mess still needs to be fixed for PAs unless I missed something recently. overall, we are doing better now as a profession than at any time in our past. Barriers to PA practice are falling. I think there is a bright future for the profession as long as we can maintain a quality product coming out of the 191 schools in existence today as well as the many programs in the works. There still are battles to be fought.

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We need to out produce the NP pipeline to take advantage of this demand.

 

 agree. I think we are well poised to expand our profession, but not at the expense of quality. Competency will always win out over politics in medicine.. I'm concerned about some of these PA programs popping up at liberal arts colleges. What is the AAPA doing to ensure that these schools aren't churning out poorly prepared grads that will embarrass our profession? Look what's happening to the pharmacists! Pharmacy was a hot career for awhile, but they overreached and are now probably doing worse than the PA's, despite transitioning to a doctoral degree. Where's the sweet spot between growth and quality, supply and demand? Has this been investigated thoroughly, or are we just letting these schools pop up willy nilly?

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 agree. I think we are well poised to expand our profession, but not at the expense of quality. Competency will always win out over politics in medicine.. I'm concerned about some of these PA programs popping up at liberal arts colleges. What is the AAPA doing to ensure that these schools aren't churning out poorly prepared grads that will embarrass our profession? Look what's happening to the pharmacists! Pharmacy was a hot career for awhile, but they overreached and are now probably doing worse than the PA's, despite transitioning to a doctoral degree. Where's the sweet spot between growth and quality, supply and demand? Has this been investigated thoroughly, or are we just letting these schools pop up willy nilly?

 

The AAPA has no jurisdiction. There is AAPA education policy, but PAEA and ARC-PA control the education pipeline. It is largely an economic issue also. As long as there is money to be made training PAs, schools will want to get in on the gravy train. As a preceptor continually training PAs on surgery rotation, I'm confident to call more that 90% of them my future colleagues. We still need to be vigilant, and involved in the education of our colleagues.

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And less likely to explain and defend your title or the "assistant"

I just brush it off now on the rare occasions it happens in my current jobs. I can explain very well what a PA is without using the "A" word.

A PA is a professional trained to practice medicine in the medical model alongside physicians. They do a few more years of training and receive a doctorate and specialty training in a specific field, while PAs get a masters degree after 6 or more years of education and are trained as generalists who can then specialize through residency or on the job training. I don't have the "A" word anywhere on my cards, scripts, or CV. They all say "Emergency Medicine PA".

I work without a doc the vast majority of the time. If they don't want to see me, their other option is to leave.

I win most of them over.

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 We still need to be vigilant, and involved in the education of our colleagues.

agree. I have students probably 50% of the time now. I fail a few every now and then who really don't get it, but most go on to graduate, pass pance and get jobs. I don't think the quality of students is where it was 10-15 years ago, but that is a topic for another thread.

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If you don't want to work for the VA when you actually become a PA, then don't.

 

I have practiced as a PA for 33 years and I honestly can't remember the last time I had to "defend" or "explain" my PA title. I work in a wonderful community hospital environment with many PAs and NPs on staff, and we are all highly valued and respected in our system. I promise you that when you have more experience, and are confident in what you contribute in your health care system, you will be less self-conscious about your title.

I don't want to be less self-conscious about my title.  In fact, I don't want to be self-conscious about my title at all.  No disrespect intended but I feel like there is an element of resigned complacency among many of the older PAs with regard to picking battles. 

 

As a recent grad, I can confidently tell you that I don't have a classmate or comparably aged colleague who wouldn't be ALL FOR getting rid of an antiquated professional title that we long ago outgrew.  I realize of course that many of you fought the good fight to advance the profession to where it is today, and we are thankful, but the notion that we have to compromise our continued progression is flawed.  Why can't we advocate for professional growth on all fronts AND fight for a name change?  Like it or not titles have meaning.  To argue that the "assistant" designation in our professional title does not create bias or influence the course of our profession (consciously or subconsciously) is absurd.  Marketing is real, or so every commercial break or magazine ad I have ever encountered has led me believe.  No more complacency, this profession is awesome and we should not have to make compromises regarding its future.  Many of us chose this profession because we believe in the model, not the title.

 

Perhaps this task is meant for the next generation of PAs.  I am happy to do my part, as are many others.

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As a student who is about to start rotations, I'd like to hear those stories. Care to start a new thread? :)

students I have failed in the past either refuse to study or just don't understand what being a PA is. One had a PhD in microbiology and felt he was smarter than everyone else. he refused to study at all and it showed. his answer to every question about abd pain was " it's an appy or an ulcer". another said "I'm going into family medicine , so I don't need to learn any procedures". he refused to suture, do I+Ds, etc on his EM rotation. we warned him this was not acceptable. he said his program would back him. they didn't. he failed out.

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"Many of us chose this profession because we believe in the model, not the title."

 

Agree. when I was in school we all were told that the name would be different within 10 years and a bridge to becoming a physician would be created. well, they were 1/2 right...

 

 

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students I have failed in the past either refuse to study or just don't understand what being a PA is. One had a PhD in microbiology and felt he was smarter than everyone else. he refused to study at all and it showed. his answer to every question about abd pain was " it's an appy or an ulcer". another said "I'm going into family medicine , so I don't need to learn any procedures". he refused to suture, do I+Ds, etc on his EM rotation. we warned him this was not acceptable. he said his program would back him. they didn't. he failed out.

 

Talk about not having any humility. How did he make it into the program with that kind of attitude? O_o

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AAPA sent a letter to the VA in August 2014 advocating for PAs to be considered as primary candidates for future positions.  They also mentioned that NPs salary in the VA system is $30,000 more than PAs and they were asking for the disparities to be corrected.  

 

The real issue then is will the VA hire the expensive NPs or the cheap PAs? Or will the VA hire PAs at the salary they deserve which should at least be the same level at NPs.  How is it PAs are paid less?  Is it the ranking system and based on the title, degree, or what? 

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AAPA sent a letter to the VA in August 2014 advocating for PAs to be considered as primary candidates for future positions.  They also mentioned that NPs salary in the VA system is $30,000 more than PAs and they were asking for the disparities to be corrected.  

 

The real issue then is will the VA hire the expensive NPs or the cheap PAs? Or will the VA hire PAs at the salary they deserve which should at least be the same level at NPs.  How is it PAs are paid less?  Is it the ranking system and based on the title, degree, or what? 

I believe historically they have paid based on lowest entry level degree. for NPs that is the MS. for us, it is the certificate or A.S.

 

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AAPA sent a letter to the VA in August 2014 advocating for PAs to be considered as primary candidates for future positions. They also mentioned that NPs salary in the VA system is $30,000 more than PAs and they were asking for the disparities to be corrected.

 

The real issue then is will the VA hire the expensive NPs or the cheap PAs? Or will the VA hire PAs at the salary they deserve which should at least be the same level at NPs. How is it PAs are paid less? Is it the ranking system and based on the title, degree, or what?

Wouldn't be surprise if the paid are base on ranking by degree>>years of experience which for NP, years worked as an RN are factored in. I once worked in a system where all of these were factors for higher pay. And, if you're a DNP; your collection are even better. See, they gets the upper hand.

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