P.A. can fluoro in Oregon; P.A. specialty vs R.A.?

[out_foxed]

So, Oregon will pass House Bill 2880, allowing P.A. to use fluoroscopy after certification with their Medical imaging board.  Reportedly they have to go through training (likely radiation safety training) http://gov.oregonlive.com/bill/2015/HB2880/ 

 

I'm an RT (rad technologist), and prospective P.A. student.  I've read some of the debate vs. R.A. (radiology assistant)  I do not want to become an R.A at all, but I support it's scope and it has been proven as a useful position. 

 

 Loma linda California helped to start the original R.A. (radiology assistant) programs, where as they assist and independently (or indirect superv.) perform fluoro procedures, i.e. barium swallows, enemas, UGI, myelograms, ESI in some cases.  This saves the hospital money and keeps the Radiologist in their dark room, as they usually like. But nearby in Portland, for example, I work with a R.A. but they don't have a job, there's only about 4 positions in the whole area.

 

Here's the deal.  Should there be a cross over? for P.A. to R.A.? Interventional or diagnostic.  And if yes, I would emphatically agree with oregon, education should be required (not an excessive amount) on Rad safety / biology and maybe diagnostic procedures, in order to specialize.  (I've spoken with P.A.s about this)

 

I'm not a P.A. but what is usually required for specializing in PA? Is it just on the job stuff - or do other specialties require actual didactic classes?

 

[NeoTrion]

I think the RA s going by the wayside.  The main problem comes down to dollars and cents.  Reimbursement is difficult in some states to get for their services.  My group started out with RAs / RPAs, and had this problem.  They wrote off all the lines they were putting in due to reimbursement.  There was also the issue of supervision.  I know in Texas there were instances that the radiologist had to be there during key points the procedure (lumbar puntures, biopsies, etc..).  Most would rather do it themselves if they have to be there anyway.  Plus the PA has his/her own medical license and DEA, which currently RAs and RPAs do not.  We can order additional meds or studies if needed (ie chest tube, water sealed atrium, albumin for paracentesis, etc....) without having to run to the supervising rad every time.  Plus the supervision for PA is a lot more manageable in terms of when a rad has to be there.  In our practice we need the Rad to be there for targeted biopsies and some intrathecal injections.  Otherwise our profression does keep them in the dark room reading films and making money.  Plus we can bill 80% for everything we do in just about every state.  Here we do the usual fluoro stuff but also biopsies in different modalities, drain placements, fine needle aspirations, paras and thoras, line placements, dialysis catheters, LPs / Myelograms, etc....  You can't get that versatility with reimbursement with an RA.  In fact I have a friend that moved to Colorado because of this issue.  At that time you had to be an RT or MD/DO to hit the fluoro button in that state.  That made her very desirable there.

 

I do not know about the RAs and the school in Loma Linda, but I belive that the RPAs were first on the scene and the original school was in Ogden, Utah.  In Texas if you are not an RT you have to take a class and an 8 hour class every year in order to hit the fluoro button.  Most of the training on how to do the procedure is on the job.  On average we use less than most of the Rads do.  It works well for us here.  I do not agree with needing a cross over, but definately agree that being an RT helped on lots of levels.  My co-workers were not when they started.  Currently there are 3 of us working for large group.  The times are changing and unless RAs can get on the medicare/medicaid band wagon for reimbursement in all states their days may be numbered.

 

That is just my observation being on both sides of line here.