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About Fairmeadow

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    Physician Assistant
  1. Today I received one of those too. I remember when my certificate was due to expire in Dec 2018 I received an email with the same type of subject title that said it was going to expire the previous December (2017). The body of the letter had the correct date both today and two years ago. It is a heartstopper.
  2. I have a 16GB ipod touch I carry at work with all my med apps on it, no music, though. I have a ton of books on it, both medical and nonmedical. I would never need more.
  3. Contrary to popular belief, the first PA's were used in specialties.
  4. You are absolutely correct. It came up last year. The Tennessee Hospital Association agreed, actually suggested a self imposed tax to stave off cuts. It was a win-win, because, if the cuts had occurred and they had not gotten the Tenncare patients, the hospitals would have lost the matching Federal funds. They have proposed to do the same this year, hoping that the economy will improve over the next year. The state legislature has to approve it. I can't imagine them not approving it. Anytime anyone comes to you as a legislator suggesting that you tax them more, you jump at it. So, AAPA sat on it a year. Will they sit on it another year? Are they clueless?
  5. I agree that fully independent practice is not the way to go. No one truly practices independently these days, not an MD, or anyone else. Medicine is too complicated for that. What we PA's need is the ability to control our own destinies. It is unAmerican and immoral for the MD profession to be able to decide whether they are going to let me practice my profession and to decide how they are going to let me do it. When I am dependent on them like that, I am nothing more than a slave. I have no problem with collaborative agreements that provide for consultations and referrals to optimize patient care.
  6. Speaking of lobbying efforts, I would like to know how PA's came out to be optional providers with CMS, and NP's, along with physicians, came to be mandatory providers. How was the AAPA involved in that? What were their lobbying efforts compared with the nurses' lobby. I don't think that money or numbers had much to do with it. That would not make any difference in whether 2 or 3 people from AAPA vs. 2 or 3 people from ANA were constantly hammering CMS. Was it that they tried harder? Does anyone know the story behind the lobbying efforts?
  7. Physasst: I hope your data and projections are right. I want the PA profession to continue to be successful. It has been so good to me. I would love for all the young PA's today to have had the wonderful experiences that I have had as a PA. I sometimes to be a sort of doom and gloom projector, but, in reality, as I look back, we always have had to fight to secure our place. And things have never been better than they are right now. I want us to continue to move forward, but we all have to fight for our rights. As a side note, I also do think that complacency will be a big enemy of our profession. As they used to teach us in Army aviation safety, "Complacency kills!"
  8. Data is a good tool, very helpful. The common sense rule has to apply, also. Take all data with a grain of salt. Increases in PA school applications and admissions do not necessarily mean more PA jobs. The jobs may not be there for the graduates. Common sense tells me that if NP's are marketed better to doctors and patients, that if they have rules and regulations that are less onerous to doctors, patients and themselves that they will win the fight. Rules are tools. Better rules mean better weapons in the turf wars. If I was not married, I would be in the most desolate, underserved place in America practicing medicine. Money has nothing to do with it, at least for me. There are plenty of doctors, PA's and NP's who, if they did not have families, would be living in underserved areas. The problem is, they do have families. While they are in the clinics, absorbed in helping the underserved with their medical problems, their families would be trying to live their lives in the community. Highly educated wives need jobs, too, that generally are not available in the rural areas. Children need educational opportunities that are not generally available in the rural areas. That is why the rural areas will never have enough practitioners. As long as PA's have to be under the thumb of doctors, and as long as doctors continue to leave primary care, the numbers of PA's in primary care will continue to decrease. Now, I am not for complete independence as a PA. I believe in collaboration and backup. But, generally, PA's have to practice under the license of their doctor. In many states, there is a limit on how many PA's doctors can supervise (I hate that word). We are optional providers, per CMS, so one could open a clinic seeing mostly Medicaid patients, and then just have the rug pulled out from them when CMS decides not to reimburse them for Medicaid in hard times because they are optional. So we practice more and more in the specialties. We would really like to be in primary care. But the governmental authorities who would benefit most from us doing that put obstacles in our way. Our national organization doesn't help us. We realize one day that the pay is better, the quality of life is better and we still can help people when working in a high paid specialty. That makes the decision to not go into primary care easier. And, physasst, what's with your signature? What is your definition of religious bondage?:smile:
  9. It's interesting. The Flexner report came out in 1910, about 100 years ago. Google it, if you are not familiar with it. It was commissioned by the AMA, supposedly to figure out ways to increase the quality of medical education. At that time, the AMA was coming into its' heyday. There were a lot of different kinds of practitioners out there then: allopathic, osteopathic, homeopathic, eclectic, Thomsonian, etc. all of whom had different philosophies of medical practice. This was before scientific medicine had really caught on. The AMA represented the allopathics. The Flexner report, used by the AMA as evidence, along with its' newly found political power, put all the other disciplines out of business by getting their schools closed. The osteopaths managed to hang on by the skin of their teeth. The AMA/Flexner report raised the educational level to get into medical school to the point where mostly, only those who were relatively well off, could afford to go to school. It got the law changed to where new medical schools had to be approved by the state government. It restricted the number of doctors being educated in several different ways. Now, I'm not totally knocking the Flexner report. There were some poor quality schools then, and the report helped to get them closed. The point I'm making is this. One hundred years ago, there was a major struggle between different medical disciplines. The allopaths won. With the exception of osteopaths, who were severely wounded, none of the other disciplines existed after the fight was over. There were winners and there were losers. I see similarities in what is happening now. We need to make sure that we, as PA's, are winners. In a struggle for one's life, one does not hold back. One does not let his attacker get the upper hand. I love the quote about the appeaser/alligator made by Winston Churchill that someone has posted above this.
  10. I agree that it is the rules and regulations that keep our profession from advancing, not the degrees. Many years ago, in the first half of the 20th century, when scientific medical education was new, many doctors had varying educational backgrounds. After the Flexner report, education was standardized. Many of the old doctors, who had less recognized degrees, had much experience. They continued to practice, but eventually died off. Then the new standard was the norm. Being from an earlier era does not make one less qualified. It may, in fact, make one more qualified due to experience. I am old, and graduated with an associates. I have a masters, but would not get a doctorate, because I am too old to need it. I do not feel that I am more qualified because of my masters. But an employer might feel that way. When you are trying to get a job, you have to look at yourself through the employer's eyes. We all know that the advanced degrees do not make us more competent. The patients and employers do not know that. Their opinions are more important than ours in many regards.
  11. Once again, this is not a state problem. The CMS is driving it. The state cannot change. AAPA, where were you when NP's were being classified as mandatory providers and PA's as optional providers. I would like to know. Like one of the above posters mentioned, if I was younger and needed to, I would go to NP school to continue to practice.
  12. Good job, but, as has been pointed out, if it had gone the other way, you would have been having a different conversation about it. No matter how good you are, you will have a bad outcome sooner or later. I would have consulted ENT before trying it. I, as an ER PA, have done similarly risky procedures, but only when no one more qualified was available, and the pt. would have had an adverse outcome without it. I do admire you for your willingness to be challenged. That is how you learn. Just CYA.
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