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Mainer

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About Mainer

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    Physician Assistant
  1. So flawed in this type of thinking. Medical school, similar to PA school, is about breadth not depth. Clinical level training will never delve into the deep recesses of scientific knowledge or develop a mind for scholarly inquiry. If you have the intellectual reach and curiosity, consider exploring pure academics, not medicine.
  2. Wrong about that.......I believe it is a valid argument, even if only part of the case PA's make for independence. NP in family practice training = 800 hours max PA's will do 600 to 800 in just family practice, but then they do internal medicine, and pediatrics for another 600 plus hours. Further, what completes your clinical training for family medicine is more your time in general surgery, emergency medicine, psychiatry, gyn/women's health ect. As an example, you'll see more breast masses, acute abdomens, colon cancer, rectal pathology, so forth, in a 6 week general surgery rotation than you will an entire career in family medicine.....How can you be a family practitioner if you've never done a psychiatry rotation? The point being that an NP would be better prepared for family medicine if they spent 400 hours family medicine and 400 in general surgery than spending 800 in family medicine. Not to mention all the other clinical deficiencies. Nursing is poor preparation for success in medical/PA school. Most RN's lack the science and math education to prepare them for successful matriculation into these programs. The whole point is that NP's are underprepared, lacking in breadth and depth. NP's have the least amount of training and education of all health care providers by as much as 1/2 or more (compare optometrist, PT's/OT's, Pharmacy, PA's, so forth) Also agreed, PA's need to develop a plan for independence....name change, change degree awarded from masters to doctorate (it's already more credit hours than every other clinical doctorate other than MD/DO, Maybe DMD), and agenda for 50 state independent practice.
  3. I've been involved in training 2 NP students, one starting their rotations, one at the end......Very different product compared to PA / Med students.
  4. I seem to deal with the dependent versus independent practice everyday. Just today..... 1. the organization is interested in more providers that can round on nursing home patients periodically, but feel it should be an NP since they are independent providers and getting the process approved for PA would be a burden with supervision requirements and dealing with the state board of medicine. 2. We're a FQHC with 5 different practices. We have a seasoned PA who we're interested who wants to do per-diem at the different clinics. Licensing is a burden, the docs don't want the "responsibility of supervising her" at all the different sites, and if they do agree, "want to the be paid" for supervising said PA. Administration says, "maybe we should just find an NP so we don't have to deal with this". Hard to argue with their logic. 3. The physician has periodic meetings with the PA's as part of supervision agreements. On one level this is welcome; however, almost never helpful. Meetings never happen b/t the NP's and physicians. It eats away at my pride.....hard to underestimate how this is viewed by support staff and administration.......or the simple fact that I'm having a supervisory meeting with a doc while NP's are eating their lunch. 4. Local hospital now only hiring NP's except for the surgical practices. They have a build in nursing senior administrator who effectively advocates for NP's. It's the same old rhetoric....they're independent, perceived to be better trained (despite the exact opposite), and lower risk to physicians. They no longer hire PA's in the ER, as hospitalist, or hospital owned primary care practices ect. About 1-2 years ago, the local ER was very short handed and they called our FQHC clinic looking for per-diem physicians and NP's and would "even consider a PA". I wasn't sure it would ever matter, but it has EVERYTHING to do with independent practice and our name (assistants). Time to modernize the PA profession. Administrators, physicians, legislators and even patients could care less about our superior training and education to that of NP's. It's all politics and we need to play the game. I support name change, awarding doctorate degrees (when compared to other professions, the content of PA education already supports this doctorate degree without change to the educational content), and full independent practice. Aligning ourselves with physicians doesn't seem to be working.
  5. I work with an RN with 25 + years of experience who is worse than the MA you describe. "Pick your soldiers", not the title or degree.
  6. To the original OP, I agree with your point, but certainly don't understand the politics. I would love to see a reasonable PA-C to MD pathway for independent practice in primary care medicine. I would fully support the MD non-residency trained to practice as a PA, with similar pathway to PA-C's for primary care independent practice. I support the PA profession but would absolutely support all PA's transitioning to MD with legislation and practice scope predicated on training and experience. In my mind, the ideal situation is to completely standardize training and education in medicine (3 year MD, phase out PA) Then different pathways after medical school.
  7. Inform them that you have more than twice the training of an NP. And deserve to be paid accordingly.
  8. NP'S HAVE THE LEAST AMOUNT OF TRAINING OF ALL HEALTHCARE PROVIDERS, PERIOD. THE DIFFERENCT IS ASTONISHING. DNP IS LESS THAN OPTOMETRY PHYSICAL THERAPY ATHLETIC TRAINER OCCUPATIONAL THERAPY AUDIOLOGY PHARMACY SPEECH PATHOLOGY ECT......JUST TO NAME A FEW AND A HECK OF A LOT LESS THAN A PHYSICIAN OR PHYSICIAN ASSISTANT
  9. I agree that experience as an RN is appropriate HCE that would be valued for PA school admissions. I don't believe that the education of an RN is good preparation for PA school. Further, their lack of basic science precludes them as candidates into medicine, unless they do the pre-medicine coursework. With that said, RN's are well educated to function in the role that they are trained and I have great respect for their work. What I don't have respect for is the marginal training programs of NP's, whom have little training beyond the RN. I can also remember the words of my program director (paraphrasing), "the rare occasion than an RN has the qualifications for PA school, we don't usually take them. They usually come with a lot of social baggage." From my experience, this couldn't be more true.
  10. " It's absolutely a political move. But healthcare has become a political game. Reality. Essentially, PAs will be the only non-doctor ally trained providers in not too many years. It will be detrimental for them. Plain and simple. As is their title. I'm an ICU RN. I have my choice of PA, NP or CRNA. I am leaning towards CRNA but if I were to choose an NP program it would be a reputable school and only an acute care NP program. If PA programs had stricter entry requirements (I just can't relearn the basics all over again with kids that have no clue how to even take a BP) a better title and a more independent practice, I'd probably be all in. " I'm a bit amused by this. This must qualify as trolling. D/NP programs lack even basic science entry requirements. Most (99%) of nurses lack the requirements to get into PA/MD school, plain and simple. An RN won't be doing much "relearning" in PA school, it's frankly very poor preparation for medicine. Futher, getting into NP school is a joke. You basically apply and your in. On the other hand, most PA schools have very limited class sizes and it would be unusual not to have hundred(s) of applications per spot. PA school = 5-6000 hours of training (not including pre-medical requirements) NP school = 1200-1500 hours of training (didactic and clinical) A little more training than an RN. (No premedical requirements) NP's have the least amount of training of all healthcare providers that currently exist. DNP programs in no way shape or form reflect a doctorate level education. Another political smoke and mirror show by the nursing lobby.....it's truly the bastardization of medicine and academics.
  11. "Everyone who took out student loans knew how much they were borrowing, and what the interest rates would be." In addition, some students new about income based loan repayment, loan forgiveness, national health service corps, ect. before they decided to pursue their education....not just loans and interest rates....
  12. Clearly people have different political opinions.... But conceptually, the theory is.....money needs to change hands among the American public for the economy to work If you aren't spending money relevant to your income, as a population, the economy takes a hit, the dollar loses value. The problem with gov loans has always been that you borrow from the gov and it goes directly back to the gov (at least until the inception of private institutions contracted to manage student loans) = no economic stimulus potential. Today's younger generations may very well be the first to make less than their parents did.... On top of that, they'll have more dept at a younger age (aka student loans) And won't be able to afford the same retail purchase, cars, ect May not be able to purchase a home at a reasonable age.... It's already doom and gloom for the housing industry.. To maintain the population, each couple needs to average a little over 2 children. The current average is about 1.8. A shrinking population has dire consequences on many levels, especially real estate.... It's simply a bone thrown at the middle working class people.....a minor shift from throwing welfare just to the poor and those making 300k and up.... Further, I consider myself a good investment to the gov.....I'm still paying the better part of 30k in taxes each year. Gov still wins.....
  13. Clearly, the political landscape seems quit volatile at the moment.... However, addressing what is perceived by economist as a "student loan crisis", "threatening national economic stability" and receiving bipartisan support, I would lean towards the more likely prospect that legislators will be looking to strengthen these measures.... "Possible Changes to the Current Tax Law In light of the grim prospect of paying a massive tax bill on your student loans, discussions about changing the current tax law have been held. Last year, US Representatives Mark Pocan and Frederica Wilson introduced the Relief for Underwater Student Borrowers Act. This act proposes to allow student loan borrowers in good standing with their repayment to become exempt from being taxed on their forgiven loans. Currently, only loans forgiven through Public Service Loan Forgiveness and Student Loan Forgiveness for Teachers are exempt from being taxed. Rep. Mark Pocan argues that the bill is important because it “closes a major gap in our tax code which penalizes some borrowers who have been granted debt relief after at least 20 years of consistent repayment towards their student loan debt.”
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