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About lemurcatta

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    Physician Assistant Student

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  1. Nursing school will still take 4 years (to get BSN). You’re only saving two years by doing nursing instead of PA, so if you want to do PA just go for it.
  2. This is very important. A new PA program’s goals are NOT aligned with the goal of keeping PAs employable. They need to make money, and will open new schools, expand the number of seats, and charge more tuition whenever they need to. Especially PA programs affiliated with small private “universities” who up u til they opened a shiny new PA program (to print money), they were essentially no-name liberal arts institutions.
  3. Is it bad that I really really want to hear them?
  4. But I really don’t understand that. Nursing has the bachelor of science in nursing and master of science in nursing. Makes sense. Clear, understandable. Physicians have doctor of medicine. PTs have doctor of physical therapy. We have “master of physician assistant studies”. Studies...what the heck does that even mean? Still worse, we have schools awarding different degrees. MPAP. MPAS. MSPAS. MHS. MMS. UC Davis has the winner- “master of health services.” Lol! Can’t even get the word science. A collection of ridiculously titled degrees with no standardization. Really great plan. MMS needs to be the standard degree. Now. Faculty will throw a fit claiming that it’s hard to change things at the university level. That’s fine, shut down until you are able to do it right. Something tells me it will change quickly if you can’t keep cashing tuition checks.
  5. The way we understand the word physician in the United States, in addition to the definitions you cite, is referring to a specific profession. Professions are self regulating, and they get to define the standards for entry, which is an MD/DO degree, passing the USMLE or COMLEX exams, and successful application for licensure. Just like we define our standards for entry: completion of an ARC-PA accredited program, passing the PANCE, and successful application for licensure.
  6. This is all so true. And its one reason I worry a bit seeing all these new programs entering the accreditation process. It seems that 90+% of them are not at academic medical centers and are just free standing little "universities" seeing to offer another degree. If the MINIMUM standard for PAs is to attend a program run out of a failing chiropractic school on an old high-school campus (https://en.wikipedia.org/wiki/Southern_California_University_of_Health_Sciences), we might be in trouble soon.
  7. AAPA provided $$ support to North Dakota’s Academy for this. Just something to point out to those who think they not working to advance change.
  8. Awesome. I just sent her an email too with my perspective a a California native who went out of state for training. I said I want to be able to come back home and serve California, and SB 697 will help make it easier for me to get a job. As it stands, the state I am in is much less restrictive and most jobs are open to PAs and NPs. Not so in Los Angeles area.
  9. So what about someone with GAD and panic attacks who does well on daily SSRI but needs occasional PRN Ativan? What if having a bottle in the purse or bag makes them feel more confident going out and doing things? I also fear the pendulum is swinging way to far in the other direction and people are going to be missing out on effective management of their disease.
  10. Just talking philosophically here (and also I do not support continued use of "assistant". ) But do we actually have our own "distinct" scope of practice? Our own unique body of knowledge? We learn in a model based off of medical school, with a year of preclinical studies and then rotations across core specialties. The textbooks I use are mostly written by physicians, for physicians (or physicians in training). We learn to approach clinical scenarios the same way that docs do: obtain a chief complaint, formulate a differential, narrow it during HPI and pertinent ROS, do an exam and lab testing to confirm suspected pathology based on knowledge of the body in health and disease. My teachers are physicians or PAs. It seems to me that we learn medicine, the same medicine that physicians do, but in an abbreviated format and without a formally required residency after our primary medical education. The differences are logistical and temporal, but not epistemological like nursing or physical therapy. They have their own unique approaches to patient care that are separate and distinct from medicine. Pharmacy has a different focus that overlaps sometimes. But these points are what makes this such a hard debate to have.
  11. One thing people might not realize is how the sausage is made. Bills are killed in committee all the time, before even going for a full vote. This is done though backchannels essentially. You need to craft something that can actually move through committee based on the political capital you think you have. Our PA organizations have much less money and influence than many of the physician and NP organizations. My state has abysmal membership percentage in our local academy. That affects what can be done. There isn't enough money or political capital to get what you are asking for right now.
  12. In response to Paula and others expressing a high amount of skepticism about the research firm, here is my view. I highly doubt that WPP will take one million dollars from a client and then deliver a final report that amounts to a steaming pile of crap. They have their own reputation to protect and have to stand behind their work. A comprehensive and independent investigation by a competent, highly respected research firm is not going to recommend that "assistant" is an acceptable word to keep in the title of graduate-trained clinicians who practice medicine. Anyone looking at this issue from an objective standpoint, not vested in the special interests of the various factions of health care will see that. The part we are paying for is a dispassionate look at what might work, what the perceptions are in the profession, and outside the profession. I hope I am not being naive and overly optimistic. But that is how I am currently thinking about it anyways. No matter what anyone thinks about the investigation, I think it is important for all of us to take that survey though. And to support our advocacy organizations in the mean time. Remember, lately AAPA doing some real work. They batted down NCCPA (who was literally threatening to let the practice act in IL expire in order to get their way). They have been running public campaigns like "You're PA Can Handle It". They are funding individual state academy efforts to pass OTP legislation. One thing I have learned from working with my current state's academy is that literally no one else in my state cares about PAs, our practice act renewals, our ability to get licensed in a timely manner from the board, our employment opportunities, etc., other than our advocacy organizations. If we blow them off because change isn't happening soon enough, they don't have money or numbers to do anything and then no one does anything (you cant do this alone). Even if HOD votes to support a title change, all that will become is an AAPA policy. Individual state chapters then have to do the actual work of getting legislation passed. and that is super hard to do.
  13. Hi Rev, I didn’t know you trained EMTs! I used to teach as well before PA school started. Anyways, I am (or was) a paramedic. And I agree wholeheartedly with the sentiment that if advanced care is going to be offered in the out-of-hospital setting, PAs who were trained as medics are honestly by far the most valuable resource for this position. What I am much less sure of is what the role will look like or how useful it will be. It’s not that FNPs or ACNPs or AGACNPs (or whatever NP, honest I can’t keep up with their titles anymore) can’t do it, but why not tap into people who have worked on that environment before and are experts in field response? Medics and emts have training that NPs do not get- extrication, scene safety, ambulance operations, extensive practice running codes, etc. There is a lot going on in EMS, and I have somewhat strong opinions on some ideas being tossed around. For example, the whole community paramedicine thing.. one of the pilot programs was medics doing directly-observed therapy with TB patients out in the community. This is a job that can be done by literally any employee of a public health department and there is nothing special about a paramedic with extra training doing it. Wouldn’t it be cheaper with an entry level public health worker? Another pilot was home safety inspections- why can’t a public health nurse do that? They already have training in this sort of thing. As far as APPs in the field, would just be building a system where you can call 911 and get an antibiotic script? Or will this be a platform to bring truly advanced care to the field like prehospital ECMO? They do it in France. I’m not opposed to any idea, just not sure what we want other than the cool-factor of a APP on a rig (LA city fire has a neat looking ambulance that says NP/PA-1 on it). Would need to be well defined. Rigjt now Illinois has a prehospital PA designation (not sure if it’s actually used), and The CA OTP bill will include language explicitly stating PAs can work in emergency vehicles.
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