It's all about representation.

[gbrothers98]

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

 

Here's the link to the letter. 

While a letter is well and good, what would have been more impressive and also more useful would have been a face to face with the new secretary along with the VA director of PA services in tow. Relationships are built face to face not by referring the person you want to meet to another person to arrange a meeting.

GB PA-C

[LT_Oneal_PAC]

Nurses are paid more for a few reasons, but one is their salary is based on locality.

 

For those that have been following the PA Forum, you probably noticed the resurgence of frustration (some would use different expletives here) over the PA-NP pay disparity. This is an issue that VAPAA has been and will continue to push forward. There are basically two roads to travel:1. We can bombard our elected officials in Congress to put pressure on the Secretary to include PAs in the Nurses Locality Pay System. This would be the easiest and quickest way to start correcting the pay disparity. It likely would not bring total parity but would be a step in the right direction. To do this I need all VA PAs, VAPAA members and none members to become involved by emailing their elected officials and asking them to contact the VA Secretary. I will provide the template and language that I feel would be most effective.2. We can work with Congress to pass a VA PA Pay reform bill much like the VA Nurses did with the Nursing Pay Act of 1990. I believe this path will be the longest and hardest, especially when you consider that Congress is unable to agree on anything and has passed very few bills of any real substance over the past several years. I’m sure they would disagree with me that but I do have freedom of speech.I think we can travel both paths, at least for the foreseeable future.VAPAA will be the guests of the Society of Army PAs (SAPA) at their annual conference, 28 April through 2 May 2014, please plan on attending. During the SAPA Conference, we will have our Annual Board of Directors and General Membership meetings along with quality CME and you can visit with old friends and make some new ones.VAPAA Elections are just around the corner. The offices of President and Vice President as well and three (3) Directors will be on the ballot for 2014-2016. Please consider becoming more intimately involved in your organization.We are in the final stretch of a much needed and long overdue Bylaws revision which will return power to the members. Thanks to Rubina, Mike, and Denni for all the hard work!Best,Jim Cavanaugh, PA-CPresident VAPAA

[gbrothers98]

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.

There is something to be said for PA longevity at facilities. One thing to put into perspective is that 15-30 years ago when we were breaking ground at these places, there were plenty of others that PAs did not and until recently were a little felt and not appreciated presence. Combine that with the fractured nature of healthcare employment and physician dominance, the small numbers of PAs, in comparison to physicians and nurses, have been unable to make significant broad headway with any sort of agenda directed at improving the overall status of PAs. This generation of PAs coming into the profession will be of sufficient number to start to make that impact and their desire combined with impatience will force some of that change to occur sooner than the usual glacial changes that occur in the healthcare workplace.

For example, the turnover in PA positions at many places due to gaining experience and jumping to the next better paying job will be recognized as the drain on resources it really is. If anyone with insight realizes that if you can keep someone happy for an extended length of time and retain them similar to Stephen, the monies saved in recruiting, training, moving every few years tallies up. In fact the next time there is consideration of leaving a position you like due to money, benefits and working conditions, specifically discuss that replacing you costs money, money that if they spent on you, would keep you in place. There is also the continuity that staff and patients will benefit from also.

What a forward thinking concept. It may not be guaranteed to work but you wont know that till it is discussed.

G Brothers PA-C

[gbrothers98]

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

These stories all boil down to two things:

Effort and ownership.

Very easy to stop the effort when out on rotation, not directly under the influence of the program.

Very easy to turn to your preceptor for the answer.

Find the answer to your own questions. Given the plethora of information available today, answers are readily available and this is how you learn, by experience.

Talk to recent graduates of your program about their first year or so of practice. Makes your time at PA school look like child's play. 

G Brothers PA-C

[Guest Paula]

While a letter is well and good, what would have been more impressive and also more useful would have been a face to face with the new secretary along with the VA director of PA services in tow. Relationships are built face to face not by referring the person you want to meet to another person to arrange a meeting.

GB PA-C

 

I agree.  I posted the article about NPs on the AAPA FB page and they responded with the letter from Mr. McGinnity.  Then I mentioned that a face to face meeting is key for PAs to be recognized.  No response yet if a meeting was ever arranged.  

[jsfelder0417]

In regards to the VA, I have been offered a job at the Salt Lake City VA. I am a new grad (MPAS,) with 7 years HCE as an Army Medic with time overseas. I also speak Spanish. I was offered a GS-11, Step 5 position. $81,264/yr, which is good for a new grad PA in Utah, one of the lowest states for pay.

[burnpac]

There is something to be said for PA longevity at facilities. One thing to put into perspective is that 15-30 years ago when we were breaking ground at these places, there were plenty of others that PAs did not and until recently were a little felt and not appreciated presence. Combine that with the fractured nature of healthcare employment and physician dominance, the small numbers of PAs, in comparison to physicians and nurses, have been unable to make significant broad headway with any sort of agenda directed at improving the overall status of PAs. This generation of PAs coming into the profession will be of sufficient number to start to make that impact and their desire combined with impatience will force some of that change to occur sooner than the usual glacial changes that occur in the healthcare workplace.

For example, the turnover in PA positions at many places due to gaining experience and jumping to the next better paying job will be recognized as the drain on resources it really is. If anyone with insight realizes that if you can keep someone happy for an extended length of time and retain them similar to Stephen, the monies saved in recruiting, training, moving every few years tallies up. In fact the next time there is consideration of leaving a position you like due to money, benefits and working conditions, specifically discuss that replacing you costs money, money that if they spent on you, would keep you in place. There is also the continuity that staff and patients will benefit from also.

What a forward thinking concept. It may not be guaranteed to work but you wont know that till it is discussed.

G Brothers PA-C

G,

 

Points very well taken, however I have only been on medical staff at my current facility for the past five years. I have worked in my local community my entire career as a PA. Every job change was a step up for me. It is great to work in a profession in demand as I don't have to put up with a lot of the BS that other professions do. The hospital here is "getting it" and creating a wonderful practice environment for PAs, NPs, and CRNAs. This creates a domino effect as the five other hospitals in my area have to keep up with good medical staff rules or PAs and others don't want to practice there. My situation is different in that I work for my own corporation and contract with various entities. I have a contract (annual) with the medical group that is contracted to cover the burn service at our hospital, and the local medical director of burn services and I are business partners, and we have a robust plastic and reconstructive surgery practice were I'm not paid by him, but allowed to bill all my own clinic and first assist directly. I also am one of the first PAs in California to have direct billing contracts with organizations like Kaiser and our local IPA.

 

Having done my time and worked for years in state and national government affairs, my current focus is on the local work environment. Assisted by the AAPA staff with expertise in the CMS / hospital area, I and other PAs on staff have worked hard to improve medical staff bylaws in all areas governing non-physician providers. In five years time, major improvements include formal due process for PAs, full membership in medical staff, and voting, among other things. Change has come slow, but steady. A lot of small steps eventually amount to significant change. All it took was a group dedicated to change, and an enlightened and supportive medical staff leadership. The success is demonstrated by being viewed as a facility where PAs want to practice.

 

As a PA who is so close to retirement that I can taste it ( :-)  ), I'm satisfied in the progress made since the inception of the profession. However, I am not about to stop fighting for positive change until I draw my last breath. I just pick my battles more carefully than when I was younger (think Serenity Prayer)....  We have demonstrated much more strength and ability to get the important things done to break down the barriers of PA practice that our numbers would have predicted. I challenge the present and future generation of PAs to take it to the next level, and be at least as successful as us old "dinosaurs" were. 

[EMEDPA]

I was asked to add this to the thread by a friend:

As a point of accuracy the 2012 AAPA Census Said that more pas felt their name did not represent what they were or did than thought it did represent the profession. Thus the shift to "PA". This needs to be picked up by all of us now. 

[EMEDPA]

here is the hard part. I've had 7 jobs. 2 that met this criteria(both current).

"All it took was a group dedicated to change, and an enlightened and supportive medical staff leadership. The success is demonstrated by being viewed as a facility where PAs want to practice."

 

 

[ventana]

This thread might be derailing but I really cannot comprehend why PAs do not want a name change. I remember there was a vote (put on by the AAPA?) a few years back and the majority voted to NOT change the name. WHHHHHAAT??? 

 

 

no that never happened

 

There was a resolution brought to part of the AAPA and there was a vote taken on rather to even consider it - From what i hear from people that were in attendance (I was not) is that the AAPA already had fancy flyers printed up and basically railroaded everyone into voting down the resolution to even open a form discussion on the name change.

 

There was never a vote on the name change

 

Since then AAPA is trying to remove it's head from it's ars, and has been dragged into the new medical setting courtssy of some great leaders, and the formation of PAFT.

 

 

 

PAFT was formed in this time frame, as MANY of us established PAs saw the AAPA being essentially disconnected and ineffective with what the real issues were in the medical communities of today and tomorrow.  Honestly I have seen the start of a huge shift in the AAPA in the past year, and am hoping for more.

 

 

 

If you are not a member of PAFT you need to join. 

[jd799]

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. 

 

FWIW, and I'm not trying to be argumentative, but I'm a recent grad who doesn't support the "physician associate" title change, and the majority of my classmates were on the same page about that. It's not as cut and dry as you say; what is true for your region doesn't apply across the board.

[ventana]

FWIW, and I'm not trying to be argumentative, but I'm a recent grad who doesn't support the "physician associate" title change, and the majority of my classmates were on the same page about that. It's not as cut and dry as you say; what is true for your region doesn't apply across the board.

 

 

just to point out a fact

 

you have been spoon feed and are anew grad by your own admission.  You are part of the profession, but really don't have any idea of the true issues facing the profession on a whole that, like medical knowledge, takes years and years to develop.  If you talk around to many of the old school established PAs who care about this stuff - you will likely find very different answers. I have heard horror stories of programs drilling into their students that they are not as good as doc's, will never be as good as doc's....... and so on.  

 

 

So please realize that although you are a part of the profession, you are newer and you very likely have not been accosted by the discrimination that comes with being and Assistant

 

 

Also, I talk about established PAs who care.  I know and have meet a few older PAs who just don't care about names.  Seems to be one of 3 reasons -

1) they are "just and assistant" in their own mind.  One small step above a factory worker and they just do as their doc tells them.  

2) they are so close to retirement and set up in a long term job they they simply don't care about where the profession is going as they are so close to exiting it and

3) those that have never given serious thought about the issue, and talked to other PAs about their issues. 

 

 

I have had some great discussions with the PAs fitting #3 and 100% of them have come back to me in the future saying "hey I never thought about it, but you are right"   this is in regards to midlevels (we don't practice lower care then doc's and higher care then nurses - we have the same standards as doc's) and the dreaded "Assistant" word.  After they take the time and energy to listen, learn and educate themselves of the issues facing the profession as a whole they always seem to come around.

 

 

#1 and #2 PAs - well they are out there (I know of a single #2 who is just waiting on retirement and they truly don't care about the profession - they are done with medicine....   I can't fault them for this)

I have never meet a #2

 

 

 

I have however meet a fair number of newer PAs that are still learning the ropes and correctly so feel comfortable with the "Assistant" term as they have not yet outgrown it.  However when I go back to talk to them in a few years, they almost universally have moved jobs a few times, and are now realizing that we are not "Assistants" but sometimes get treated as such purely due to the name......

 

 

 

It is great to have a discourse and I am not saying you have to agree with me, but the same way you send a patient to Cardiology for complex management, there is a knowledge curve and glass ceiling that most PAs bump into at some point PURELY due to our name.  Office managers are great at second guessing us and pointing out that we are the doctors ASSISTANT and in general forming the wrong notions about the profession purely based on the name.......

[KMD16]

Wow! Recent graduate who doesn't support name change. You're one of a kind. Come back in 3 or 5 years in practice and tell us what you think, if you're still in support of the name change or not.

[db_pavnp]

Even if every PA wanted to keep the assistant title, there would still be an argument for name change if the public, by clear majority, finds the term distasteful.