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We can't practice medicine????


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Fifty years since the first PA class graduated and yet, this kind of thing is still happening. We shouldn't be upset with the Nacodochees Medical Center. We need to be upset with our leadership who allows PAs to be treated like this. It's time for total independence. If the Physician doesn't want to be on a team any more and their lack of cooperation reduces access for patients, then it is time for patients to have increased access to care by authorizing PAs for independent practice. Offering physicians a collaborative environment continues to be met with disrespect. Let's stop offering. NPs wised up along time ago. PAs need to wise up. We need to win independence in one state in order to start a domino effect. Our leadership needs to mount a campaign for one state practice independence. Physicians know that PAs can perform as well or better than a residency trained physician. The attacks by physicians are motivated by fear. They know their wallets will shrink if patients learn that PAs perform superior work for less cost. The time for civility is over. 

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Ughhhhh... I know where this is coming from. There is some weird wording in Texas law that actually states that delegation to PAs is "if" we do not represent to the public that we are practicing medicine. 

I still wouldn't sign it.. that is a ridiculous agreement. 

It took a minute to search but here is the actual text:

 

Sec. 157.001. GENERAL AUTHORITY OF PHYSICIAN TO DELEGATE. (a) A physician may delegate to a qualified and properly trained person acting under the physician's supervision any medical act that a reasonable and prudent physician would find within the scope of sound medical judgment to delegate if, in the opinion of the delegating physician:

(1) the act:

(A) can be properly and safely performed by the person to whom the medical act is delegated;

(B) is performed in its customary manner; and

© is not in violation of any other statute; and

(2) the person to whom the delegation is made does not represent to the public that the person is authorized to practice medicine.

(b) The delegating physician remains responsible for the medical acts of the person performing the delegated medical acts.

© The board may determine whether:

(1) an act constitutes the practice of medicine, not inconsistent with this chapter; and

(2) a medical act may be properly or safely delegated by physicians.

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Ughhhhh... I know where this is coming from. There is some weird wording in Texas law that actually states that delegation to PAs is "if" we do not represent to the public that we are practicing medicine. 

I still wouldn't sign it.. that is a ridiculous agreement. 

It took a minute to search but here is the actual text:

 

Sec. 157.001. GENERAL AUTHORITY OF PHYSICIAN TO DELEGATE. (a) A physician may delegate to a qualified and properly trained person acting under the physician's supervision any medical act that a reasonable and prudent physician would find within the scope of sound medical judgment to delegate if, in the opinion of the delegating physician:

(1) the act:

(A) can be properly and safely performed by the person to whom the medical act is delegated;

(B) is performed in its customary manner; and

© is not in violation of any other statute; and

(2) the person to whom the delegation is made does not represent to the public that the person is authorized to practice medicine.

(b) The delegating physician remains responsible for the medical acts of the person performing the delegated medical acts.

© The board may determine whether:

(1) an act constitutes the practice of medicine, not inconsistent with this chapter; and

(2) a medical act may be properly or safely delegated by physicians.

i would interpret this as "general Authority to delegate" and not within the scope of pa delegation do to the fact that we are licensed to "practice" medicine. essentially the above can include physicians delegating tasks to janitors

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i would interpret this as "general Authority to delegate" and not within the scope of pa delegation do to the fact that we are licensed to "practice" medicine. essentially the above can include physicians delegating tasks to janitors

 

Pretty sure a janitor is neither qualified nor properly trained :)

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Born and raised in Texas, trained in Texas.

Left 20 yrs ago.

 

I was there when we went from registered to licensed. Thought it was awesome until I read the verbiage.

 

It reads like the Commandments- thou shalt not...

 

Very oppressive, very Bible Belt, very Doctor is God kind of thing.

 

Deep Sigh - the deep south gives us sweet tea and some of the best food but is still run like the 1800s

 

The bigger the hair, the closer to heaven.....

 

Hope someone can bring some changes to that piece o carp regulation

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Born and raised in Texas, trained in Texas.

Left 20 yrs ago.

 

I was there when we went from registered to licensed. Thought it was awesome until I read the verbiage.

 

It reads like the Commandments- thou shalt not...

 

Very oppressive, very Bible Belt, very Doctor is God kind of thing.

 

Deep Sigh - the deep south gives us sweet tea and some of the best food but is still run like the 1800s

 

The bigger the hair, the closer to heaven.....

 

Hope someone can bring some changes to that piece o carp regulation

 

 

Don't forget Whataburger also.  I can remember the early 80's as well and how the guidelines said that we couldn't formulate a treatment plan since we didn't diagnose.  If that's the case, then why were we taught pathophysiology and pharmacology?  I can't speak for the rest of you but I was darn good at rooming patients, slamming x-rays (in correct order I might add) on the view box, and authorizing refills on prescriptions though I couldn't prescribe them myself.

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Per federal statute, PAs are specifically NOT allied health professionals.  

 

https://www.law.cornell.edu/uscode/text/42/295p

 

 

(5)The term “allied health professionals” means a health professional (other than a registered nurse or physician assistant)—

(A)
who has received a certificate, an associate’s degree, a bachelor’s degree, a master’s degree, a doctoral degree, or postbaccalaureate training, in a science relating to health care;
(B)who shares in the responsibility for the delivery of health care services or related services, including—
(i)
services relating to the identification, evaluation, and prevention of disease and disorders;
(ii)
dietary and nutrition services;
(iii)
health promotion services;
(iv)
rehabilitation services; or
(v)
health systems management services; and
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Don't forget Whataburger also.  I can remember the early 80's as well and how the guidelines said that we couldn't formulate a treatment plan since we didn't diagnose.  If that's the case, then why were we taught pathophysiology and pharmacology?  I can't speak for the rest of you but I was darn good at rooming patients, slamming x-rays (in correct order I might add) on the view box, and authorizing refills on prescriptions though I couldn't prescribe them myself.

Love their biscuits and gravy.

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I got curious and went and scoped some stuff out.

 

Interesting that the Texas Medical Board website freely uses the word PRACTICE in a whole lot of places in its PA verbiage.

 

http://www.statutes.legis.state.tx.us/Docs/OC/pdf/OC.204.pdf

 

This describes practice pretty much to a T.

 

WAY better than 20 years ago.

 

It is out of date and lists CAHEA instead of ARC PA and discusses prescriptive privileges and even signing for samples which I found interesting.

 

Sounds like the hospital is using seriously out of date info and wording. Honestly, probably written by a drone with no medical knowledge and written ages ago and never ever updated. 

 

There is a PA Board in Texas or at least one is listed.

 

Perhaps OP could send this horrid document to them along with a copy of the link above and see what they have to say.

 

Just a thought

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Don't forget Whataburger also.  I can remember the early 80's as well and how the guidelines said that we couldn't formulate a treatment plan since we didn't diagnose.  If that's the case, then why were we taught pathophysiology and pharmacology?  I can't speak for the rest of you but I was darn good at rooming patients, slamming x-rays (in correct order I might add) on the view box, and authorizing refills on prescriptions though I couldn't prescribe them myself.

 

psh, In-N-Out is way better

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