SoCal_PA Posted January 21, 2017 Share Posted January 21, 2017 I don't know about you guys, but the AAPA kind of blindsided me with this. FPAR = Full Practice Authority and Responsibility What exactly is the Task Force proposing? The Task Force believes AAPA should adopt policy to do four things:• Emphasize our profession’s continued commitment to team-based practice.• Support the elimination of provisions in laws and regulations that require a PA to have and/or reporta supervisory, collaborating or other specific relationship with a physician in order to practice.• Advocate for the establishment of autonomous state boards, with a voting membership comprisedof a majority PAs, to license, regulate, and discipline PAs.• Ensure that PAs are eligible to be reimbursed directly by public and private insurance. FPAR is a straightforward concept: PAs should be responsible for what they do each day; PAs shouldregulate their own profession; and services provided by PAs should be covered by public and privateinsurance. All of this can and should occur within the construct of team practice. What kind of changes should we expect and how soon? Fill out the survey here: http://news-center.aapa.org/fpar/ Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted January 22, 2017 Moderator Share Posted January 22, 2017 I think we will see more legislation like what just passed in Michigan uncoupling pa from md licenses. this is a good thing. Link to comment Share on other sites More sharing options...
SoCal_PA Posted January 22, 2017 Author Share Posted January 22, 2017 I think we will see more legislation like what just passed in Michigan uncoupling pa from md licenses. this is a good thing. This sounds huge. How can we show our support and spread the word? Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted January 22, 2017 Moderator Share Posted January 22, 2017 ask your state and specialty organizations to write letters of support and share them with their membership. Link to comment Share on other sites More sharing options...
overthehorizen Posted January 22, 2017 Share Posted January 22, 2017 I have a really uneasy feeling about the FPAR. Many of you are pitching this as an end run around the apparently unwinnable fight for independence. I might be characterizing this unfairly here but I think that some have said that this is what enables independent practice. Well, if true, I would be absolutely thrilled. What makes me uneasy is that even if this gains approval, there will still be legal threats from physicians and medical boards arguing for enforcement of their boards. You see, the adoption of FPAR in state legislatures would necessarily require the removal (ie elimination) of law regarding the State Medical boards for oversight of PAs. Physicians organizations would argue the elimination of laws governing PA oversight by physicians is tantamount to practice independence. I cannot see them accepting this without a fight. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted January 22, 2017 Moderator Share Posted January 22, 2017 it passed in Michigan already for all intents and purposes... Link to comment Share on other sites More sharing options...
camoman1234 Posted January 22, 2017 Share Posted January 22, 2017 Of course there will be a "fight", but isn't every new law that PAs try to pass some sort of "fight"? As I recall chatting with you a few weeks ago, you were all about independent practice? Now your whining about a possible "fight"? Sounds like your the type of person that would b*tch about cold ice cream. Link to comment Share on other sites More sharing options...
Guest Paula Posted January 22, 2017 Share Posted January 22, 2017 Michigan made inroads, yet a PA there cannot practice unless they have a practice agreement on file that they will work in a team. They made huge steps though, but I still am in favor of not having to have a physician listed on my license or at the MEB in order for me to practice. Seems like a restraint of trade thing to me, that the MEB's can restrict how, when,where, and if we practice medicine or obtain a job. So, I fully support FPAR. Yes, it will be a fight so strap on your Nike's and polish up your boxing gloves, and bring some kleenex. I'm ready. Link to comment Share on other sites More sharing options...
Moderator ventana Posted January 22, 2017 Moderator Share Posted January 22, 2017 I have a really uneasy feeling about the FPAR. Many of you are pitching this as an end run around the apparently unwinnable fight for independence. I might be characterizing this unfairly here but I think that some have said that this is what enables independent practice. Well, if true, I would be absolutely thrilled. What makes me uneasy is that even if this gains approval, there will still be legal threats from physicians and medical boards arguing for enforcement of their boards. You see, the adoption of FPAR in state legislatures would necessarily require the removal (ie elimination) of law regarding the State Medical boards for oversight of PAs. Physicians organizations would argue the elimination of laws governing PA oversight by physicians is tantamount to practice independence. I cannot see them accepting this without a fight. I see your point, but why would this scare you from trying?? It should empower you to work harder to get it! MD. And DO and established medicine just don't care about PA - we are a profit source and that is it..... on the other hand PAs care about PAs. We can regulate ourselves and we must push for this. The same arguements you made can be made about any progression in society, voting, rights, protections - all took time and effort Link to comment Share on other sites More sharing options...
overthehorizen Posted January 23, 2017 Share Posted January 23, 2017 Agree with everything posted above. Camoman1234, yes you remembered my words and articulated my view correctly. To clarify, I should say I don't fear the fight. I want to make sure we are taking the right hill. I'm wondering if substantial resources are pooled behind the FPAR only to be met with a legal battle later, might it have been better to go directly for practice independence. EMED points out that Michigan was a success and I agree. We can feel some confidence in this. Let's watch the landscape there to see who is able to start erecting their own practice in Michigan. Link to comment Share on other sites More sharing options...
Bandidorooobs Posted January 24, 2017 Share Posted January 24, 2017 I should start by saying I support FPAR and PAFT. One thing I'm wondering though, is if down the line FPAR will somewhat blur the lines between PA/MD/DO. What I'm asking is if this happens, besides not doing a residency, for those who have the thought in the back of their mind whether they should have gone to Med school or not, will there be a big difference in what docs can do and we cannot? I am not trying to say I think PA should be a shortcut to medicine, because I think there is value in a medical school education. I'm just wondering if this is the end goal, as I kind of feel that is what NPs are trying to do. I am in my rotation year and work alongside med students, and I feel our knowledge on rotations is pretty similar. Although working with them just keeps the thought in the back of my mind that maybe down the line I could consider something like the PA to DO program a little more. With these changes being proposed, would it be worthwhile besides for the title change for those seasoned PAs that have felt this way due to having a ceiling, not being respected because you are "not in charge" etc? Link to comment Share on other sites More sharing options...
BruceBanner Posted January 25, 2017 Share Posted January 25, 2017 Any change like this that requires new legislation is going to be long in coming. It takes a long time just to get it in the books and just as long to be realized in day-to-day practice statewide. I think Michigan was a great precedent and likely other states will start to follow suit. I dont think journeyman or veteran PAs will realize true FPAR in our careers. The newer PAs might. I could be wrong....but i'm probably not. Only PAs care about PAs and I think the profession is starting to get this. Of course docs will fight us, the AMA will fight us, and healthcare orgs will fight us. It's not really in any of their best interests. We make healthcare orgs money by generating as much revenue as our peer docs for 1/2 or less the pay. Physicians are only on our side inasmuch as we make their lives easier. Other than that they dont care....why would they? Do we care about MAs or LPNs outside of them doing what we need? And of course the AMA and similar orgs have always been against "midlevels" being uncoupled from physicians. Link to comment Share on other sites More sharing options...
BruceBanner Posted January 25, 2017 Share Posted January 25, 2017 I should start by saying I support FPAR and PAFT. One thing I'm wondering though, is if down the line FPAR will somewhat blur the lines between PA/MD/DO. What I'm asking is if this happens, besides not doing a residency, for those who have the thought in the back of their mind whether they should have gone to Med school or not, will there be a big difference in what docs can do and we cannot? I am not trying to say I think PA should be a shortcut to medicine, because I think there is value in a medical school education. I'm just wondering if this is the end goal, as I kind of feel that is what NPs are trying to do. I am in my rotation year and work alongside med students, and I feel our knowledge on rotations is pretty similar. Although working with them just keeps the thought in the back of my mind that maybe down the line I could consider something like the PA to DO program a little more. With these changes being proposed, would it be worthwhile besides for the title change for those seasoned PAs that have felt this way due to having a ceiling, not being respected because you are "not in charge" etc? You also bring up a good point here----down the road it may blur the lines a bit but I dont think physicians will ever fall out of place as the ultimate medical authority. I really dont. We may be unchained from them legally, but docs will always have superior depth of training and everyone knows it. That's ok---we arent trying to supplant them. We just dont want to be coupled to them any longer in order to do our jobs. Link to comment Share on other sites More sharing options...
overthehorizen Posted January 25, 2017 Share Posted January 25, 2017 Michigan made inroads, yet a PA there cannot practice unless they have a practice agreement on file that they will work in a team. They made huge steps though, but I still am in favor of not having to have a physician listed on my license or at the MEB in order for me to practice. Seems like a restraint of trade thing to me, that the MEB's can restrict how, when,where, and if we practice medicine or obtain a job. So, I fully support FPAR. Yes, it will be a fight so strap on your Nike's and polish up your boxing gloves, and bring some kleenex. I'm ready. So, Overthehorizen moves to Michigan with the passion and desire to start a direct pay primary care medical practice. Where does he go to get a medical license? You say he needs to be in a "team?" Ok. Overthehorizen says "Here is a lists of consultants that I will refer my patients to for subspecialist concerns" and "here is a list of fellow PAs that I will talk with when I feel it might be valuable even though they don't work with me in my practice or for me". The new board whoever that may be says "Overthehorizen, you have embraced FPAR appropriately and we wish you great success in your new business practice. You will have no interference from any medical doctors in Michigan." Overthehorizen responds "I'm so happy FPAR was passed and I'm living in Michigan. Of course, the above is a bit over the top in the sarcasm but would someone tell how FPAR helps accomplish this goal in Michigan. It doesn't seem to have any teeth. Link to comment Share on other sites More sharing options...
slolar Posted February 3, 2017 Share Posted February 3, 2017 Yes! Michigan just passed legislature that starts to uncouple PA from MD supervision. If you go over to the MAPA website there is lots of discussion, FAQ etc about the new legislation. No longer need MD name/DEA number on prescriptions--we are now considered "independent" prescribers. Still need a practice agreement on file, but much less cumbersome and only needs to be updated once or if changes are needed. Takes away a lot of the supervisory regulations. Even takes away the "supervising physician" terminology. This is a VERY positive thing. My employers are very excited about the new law. Sara Link to comment Share on other sites More sharing options...
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