jmj11 Posted July 30, 2015 Share Posted July 30, 2015 Something happened this week that took me back to my career in the 1980s. This happens rarely now, so rare that I had forgotten what it was like. I have a very difficult patient (psychologically), who has extreme anxiety, somatization disorder and I think a personality disorder. She is very hard to deal with and is the wife of an important business owner in Seattle. Per her request, I gave her an order for PT in Seattle. She went to the large PT clinic and they did an evaluation. They decided that she needed four weeks of therapy and sent an order, addressed to my SP, for him to sign. He doesn’t know this patient from Eve (as in Adam and Eve). I wrote them back that they had made a mistake and she is my patient and they need to retype their order form with my name on it. They refused and said they could only accept orders from an MD, DO or NP because they are practitioners where an order would originate. A PA doesn’t originate orders but follows orders of the practitioners. I corrected them. I refused to sign the order or have my SP sign it. The patient is now upset at me because she really wanted to go that that premier PT clinic and they told her that I refused to cooperate to get them orders so that they could see her. So this is not a big deal in itself. I will refuse to cooperate with them until they change their policy. However, this was a strong reminder what every day was like in the 1980s. Radiology refused to honor my orders for CT. Nurses at the hospital refused to honor my orders and it was a constant daily battle everywhere. The head nurse at clinic where I was hired, resigned the day I started because she "refused to work in a clinic with such low quality of care that they would hire a PA." Be thankful that you live in an age where stupidity like this is so rare that it really grabs my attention when it happens. Link to comment Share on other sites More sharing options...
MediMike Posted July 30, 2015 Share Posted July 30, 2015 Hate to sound a little cheesy here, but thank you for putting up with this sh#$ and fighting a path for the rest of us. You are appreciated. Link to comment Share on other sites More sharing options...
LKPAC Posted July 30, 2015 Share Posted July 30, 2015 #1. Have your SP sign the order. Don't put your patient and her care in the middle of this pissing match. #2. Keep fighting the fight. In some states, there are laws about accepting our legal orders. Talk to the owner of this business, why would they turn down you referrals? That's money for them! Maybe it was just a mistake. Get your state chapter to help. Contact AAPA. Call your state attorney general, etc. Keep fighting. And please, let us know what happens. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 30, 2015 Moderator Share Posted July 30, 2015 I worked at a place 10 yrs ago where the nurses decided to not take pa orders anymore(they wanted to staff their np friends there). all the PAs quit over it. justice was slow. 5 years later a new medical director/chief of staff of the hospital fired any nurse who refused pa orders and started hiring pas again. Link to comment Share on other sites More sharing options...
Guest Paula Posted July 30, 2015 Share Posted July 30, 2015 jmj: Ask the PT clinic to send you a copy of the regulations that state they cannot accept an order for PT from a PA. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 30, 2015 Moderator Share Posted July 30, 2015 #1. Have your SP sign the order. Don't put your patient and her care in the middle of this pissing match. I disagree. we can't let them get away with that. there are other PTs in town who will do the job just as well and work with JMJs practice. these folks need to change their tune or lose business. I do the same thing if I call a specialist and they refuse to talk to me. fine, you just lost business. there are other surgeons, ent's etc in town who are not a$$clowns. This practice is obviously illegal. In WA state there is specific legislation saying a PA can sign ANYTHING their SP can. Often this practice is started by an RN office manager who has a chip on their shoulder against PAs. (if there were only 1 PT practice in town I would have my sp sign it while working on changing their policy, but that is not the case here). Link to comment Share on other sites More sharing options...
jmj11 Posted July 30, 2015 Author Share Posted July 30, 2015 #1. Have your SP sign the order. Don't put your patient and her care in the middle of this pissing match. #2. Keep fighting the fight. In some states, there are laws about accepting our legal orders. Talk to the owner of this business, why would they turn down you referrals? That's money for them! Maybe it was just a mistake. Get your state chapter to help. Contact AAPA. Call your state attorney general, etc. Keep fighting. And please, let us know what happens. The PT has Zero value for this patient (somatization disorder). It was something PT had the chance of helping I would puruse it. Link to comment Share on other sites More sharing options...
Moderator ventana Posted July 31, 2015 Moderator Share Posted July 31, 2015 #1. Have your SP sign the order. Don't put your patient and her care in the middle of this pissing match. #2. Keep fighting the fight. In some states, there are laws about accepting our legal orders. Talk to the owner of this business, why would they turn down you referrals? That's money for them! Maybe it was just a mistake. Get your state chapter to help. Contact AAPA. Call your state attorney general, etc. Keep fighting. And please, let us know what happens. jmj: Ask the PT clinic to send you a copy of the regulations that state they cannot accept an order for PT from a PA. do you realize this was in the 1980's? I almost just pulled every single script from the single biggest pharmacy in town - over them refusing to honor my signature for DME...... it still is happening, and we all need to push AAPA, our representatives, our states, hospitals, and employers to allow us to practice as we know how, with out restrictions. Link to comment Share on other sites More sharing options...
MediMike Posted July 31, 2015 Share Posted July 31, 2015 Vent, I do believe he is saying that he is currently dealing with the above mentioned situation which is bringing him back to the 1980's. So this is an active problem at this time. Link to comment Share on other sites More sharing options...
Guest Paula Posted July 31, 2015 Share Posted July 31, 2015 Right before I left for vacation this week I my work checked email and got a notice from our clinic manager regarding signatures for DME. The email said that insurance companies are now asking for physician signatures for proof of the F to F visit for DME that PA/NPs order for patients not on medicare. The email said something that insurance companies are now following similar rules like CMS. Are you kidding me????? My email back to the manager was done in haste and I basically said I was going crazy with a rule like that. I will address it when I'm back to work. What is going on? Our local DME companies still will not accept PA/NP signatures for the F to F visit for any medicare patient. Does anyone care at the CMS level, AAPA, our employers? Apparently not. Link to comment Share on other sites More sharing options...
CAAdmission Posted July 31, 2015 Share Posted July 31, 2015 The head nurse at clinic where I was hired, resigned the day I started because she "refused to work in a clinic with such low quality of care that they would hire a PA." Be thankful that you live in an age where stupidity like this is so rare that it really grabs my attention when it happens. It's worse today. The a-holes generally don't resign these days. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 31, 2015 Moderator Share Posted July 31, 2015 It's worse today. The a-holes generally don't resign these days. nope, they get promoted. Link to comment Share on other sites More sharing options...
cbrsmurf Posted July 31, 2015 Share Posted July 31, 2015 That's pretty crazy. Appreciate all the older PA's who fought for our rights. Back in the 80's I was battling my parents for my right to dress myself and wear the clothes I wanted. Link to comment Share on other sites More sharing options...
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