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About montanapup

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  1. Hi, looking for an update on your prospective job; have you received an offer?
  2. Hello! Is everyone aware of the proposed Fee Increase? Why are our fees increasing 96% vs the docs 54%? It appears there is no stopping this and will pass and go into effect this October. By the way, how many of you are members of the WSMA? In light of their lack of support (or also known as not taking a position) for progressive PA laws, why are we paying members? We do not have voting rights as dues paying members of the WSMA. I had an interesting discussion with a former board member, and he didnt even know that, let alone understand PA laws. I've since then provided him with information. As for my upcoming membership renewal of the WSMA, I'm not renewing at the end of this year as I'll need it to apply it to my new license fee increase. . February 27, 2019 Medical Commission Releases Timeline and Workshop for Proposed Fee Increases After stating its intention to raise license renewal fees for several health professions, including allopathic physicians and physician assistants, the Washington Medical Commission has now issued an anticipated timeline for rulemaking and announced a public workshop to share information with the affected professions. The commission's proposed fee increase for MDs and PAs remains unchanged: The proposal would raise physicians' renewal fees 54 percent (from $657 to $1012) and physician assistants' renewal fees 96 percent (from $202 to $396). The commission has explained that the fee increases are necessary to meet a state requirement that health professions be self-supporting, which includes correcting for budget deficits and covering program cost overruns. To provide an overview of these costs, the Department of Health is inviting stakeholders and licensees to attend a public workshop this Thursday, Feb. 28, starting at 11:30 a.m. The MD/PA increase will be discussed from 11:50 a.m.-12:10 p.m. The workshop can be attended in person or remotely. See the WMC announcement for information on how to join the meeting. The WSMA's Jeb Shepard be in attendance representing the WSMA. The commission has issued the following timeline for rulemaking (all dates 2019): Feb. 28 – Stakeholder meeting to provide overview of program costs. March (day TBD) – File proposed fee rules (CR-102). April (day TBD) – Hold hearing on proposed fee rules. June (day TBD) – Adopt final fee rules (CR-103). Starting July – Send out renewal notices with new fee amount. Oct. 1 – Effective date of new fees. The WSMA continues to oppose the fee increases—see this recent Spokesman-Review article as well as our formal comment letter to the commission for more on our position. Be on the lookout for calls to action on this issue once rulemaking is initiated in March For questions on this issue, contact Hailey Hamilton in our Olympia office at hailey@wsma.org or 360.352.4848.
  3. One point; what happens when these docs are no longer around or retire? Reality is PAs are tied to a physician and as long as you have a great relationship everything is rosy. That could all change unless PAs gain full independent practise (unlikely to happen soon) or you get to buy into that practise as a full partner. If you're worried about the lost income, live like a resident now, during school, residency and post residency. If you can manage it, work a day or two while in school. Recouping that 1 million is achievable if you dont spend like a sailor and feel the need to keep up with the joneses. In the end, you'll have more options as a MD/DO vs PA including higher income, the credentials for advancement (in many fields) and the portability of your degree internationally.
  4. Reviving this thread as I have a question regarding billing in the ED Observation setting. APCs staff the unit, all MDM by the PA/NP. Rounding in the mornings, otherwise, if no questions/concerns, disposition by APC. All charts with attestation once complete. I'm trying to figure out how and under who this is this billed. It's all technically Outpatient. Everything I'm searching for seems to indicate it's under the Attending physician which leads me to believe that billing is under the physician as well even if the patient's care has been entirely under the APC for the duration of the stay. I'd love some clarification if anyone on this forum has some experience with this as it doesnt demonstrate my productivity, capture my worth or give me a cut of the RVUs generated. Thoughts? Thanks!
  5. That's great! I've found the folks in Olympia to be very responsive. Some really awesome folks down there.
  6. Go or you will regret it. If you decide it's not for you, there's always a return to the PA profession. You've worked hard for this, it's a wonderful opportunity and in the long term, will afford you more opportunities. Good Luck!
  7. I have the dual degree. Hasn't made a difference and I've not used it to date. Originally I intended to do more, but life makes some interesting turns. Make sure it is accredited especially if you intend to use it internationally with NGOs and like WHO, otherwise, it's another 30 hrs and $$$ and only applicable in the USA.
  8. yes. I get these regularly and for the last couple of years. why?
  9. This past week, I sent the following (abbreviated) below to my state organization after several months of frustrating lack of response in regards to an issue on the administrative and leadership level. Leadership Advancement Restrictions - PAs have found their leadership roles and advancement potential removed and/or restricted. We do not have voting privileges for policy and hospital bylaws. Until March of this year, I and others in my organization were removed from director positions and committees. Reason cited, "reorganization" and improvement of a physician-lead organization. Leadership has stated directly that expertise of medicine is to remain with physicians as they are the "expert". This has hampered my efforts for career advancement and effectively reduced my income. I have lost greater than $10,000.00+ per year as a result of this policy. Current leadership positions are allowed with nurse doctorates and MD/DOs. Career and income advancement is effectively stalled and goes nowhere. Delegation Agreement - my organization has become more anti-PA. It has been brought to my attention by former leadership individuals that there is a preference of NPs vs PAs. Hiring new staff has leaned to NPs vs PAs with the exception of the surgical field. Many physicians are unwilling to partner/work in tandem with experienced PAs and sign delegation agreements without extra compensation or contract amendments. Mind you, PAs do not receive compensation when yoked to poor examples of physician clinicians, despite our licensure being at risk if a malpractice claim were to occur. Student Teaching - I've precepted NPs, PAs and medical students. However my opportunities are now nonexistent. The organization is unwilling to have certified PAs precept students because we are technically under supervision and there is an unwillingness to allow teaching due to concerns of liability. Additionally, I until this past month was welcomed as a preceptor for student NPs with an offer as adjunct faculty. This was declined after having taught their NP students for the last year. The state university stated "due to change in focus". After a more frank discussion, it was disclosed that the NP organization has chosen to interpret the WAC regulations as PAs prohibited from teaching NPs. She was uncertain as to why the organization has chosen to move in this direction despite the students appreciating the additional perspective and access to our skillset and knowledge. As for medical students, I have been told that I am not allowed to teach, again because of the supervisory condition.
  10. I suspect this will spill over to PAs. Cant emphasize enough need to have NPs on our side and working together. Need the AMA to modernize and get on board. https://www.healthcaredive.com/news/nurses-slam-ama-for-stance-against-independent-practice-for-nonphysicians/511391/ Nurses slam AMA for stance against independent practice for nonphysicians AUTHOR Meg Bryant PUBLISHED Nov. 21, 2017 TWEET Dive Brief: The American Association of Nurse Practitioners (AANP) slammed a resolution adopted by the American Medical Association (AMA) that opposes independent practice for nonphysician practitioners. In an ongoing feud between nurses and doctors, the AANP accused the AMA of “fear mongering” and putting physicians’ profits ahead of patients. Resolution 214 calls for a national strategy to oppose legislative efforts that allow nonphysician practitioners to practice independent of a physician. It was adopted at last week’s interim meeting of the AMA House of Delegates. Dive Insight: AMA opposes what it calls "inappropriate scope of practice expansion," while the nurses group says care from nurse practitioners is safe and typically more efficient than care from physicians. “The American Medical Association has asserted, once again, its commitment to put the profit of its physician membership ahead of patients and their access to high-quality health care,” AANP President Joyce Knestrick said in a statement. “We call on the AMA to stop hampering access to care,” she continued. “Stop the rhetoric and resolutions that undermine patient choice, access and true coordinated care. The AMA’s ongoing fear mongering and physician protectionist resolutions are hurting patients and negatively impacting the health of our nation.” The AMA resolution targets advanced practice registered nurses (APRN) and the APRN Multistate Compact, which would let APRNs with a multistate license practice without a doctor’s oversight or involvement. To date, three states — North Dakota, Idaho and Wyoming — have enacted the compact. At least 10 states must enact legislation before it will be implemented. AAPN represents more than 234,000 nurse practitioners in the U.S. At a time when many communities are facing physician shortages, particularly in underserved areas, APRNs could increase access to care. Exacerbating the shortage is administrative “burnout” and the retirement of baby boomer physicians, as well as policies of President Donald Trump’s administration that could threaten the supply of foreign-born doctors. For instance, Trump’s travel bancreated confusion and anxiety in medical residency programs as visa seekers were put through more intensive vetting. Likewise, his threat to end the Deferred Action for Childhood Arrivals (DACA) program could exacerbate the physician shortage if potential medical students are forced to leave the country.
  11. @ primadonna22274 - your messages inbox is full! I'm trying to send you a message - any way to contact you privately to chat on PA to DO?
  12. not that i'm not interested, just not sure how or what kind of input to offer as i felt the initial survey was "rigged" and my comments at the end were very specific regarding the recert process. i'm not happy with the current method. so - i thought i'd put it out here in this forum, see if my fellow PAs have some idea of what they'd like and make it collective. seriously, what do we consider "core medical knowledge"? that we shouldnt kill someone or that i have to manage a diabetic when my specialty is nowhere near primary care?
  13. Hello everyone, I rarely post - mostly lurk. But I feel it is important to share this. I received the following email from the NCCPA. I dont recall stating in my response I would do this/participate - but now I've been asked to respond. Have any of you received this? I want to respond, but...... Core Medical Knowledge and Skills: Recruitment Survey When you responded to NCCPA’s recent survey about a proposed new recertification model, you expressed interest in participating in a two- to three-day meeting to help further refine aspects of the proposed model. More than 7200 PAs have indicated that they would be interested in this work, and we thank you for your interest in this important project! Later this year, the NCCPA Board will consider the feedback received through that survey and other means and will make a decision about whether to pursue this new approach to recertification. In the meantime, we are working on important details that will help us develop cost estimates, possible implementation timelines and specifics regarding how the new exams would be structured and delivered IF the Board decides to move ahead. That information will help inform their decision-making process. One of the questions we have to answer is: What constitutes the “core medical knowledge” that would be assessed on the take-at-home component of this recertification exam model? Defining that content will help us determine important details about the length and design of those exams. We are now contacting you to determine your availability for specific meeting dates to define the "core" medical knowledge and skills that would be the focus of the take-at-home assessments if this model is pursued. Approximately 60 PAs will be invited to work with NCCPA to determine the most important aspects of medical knowledge and skills that should be included in these potential new assessments. Participants will be selected to ensure that a diverse group of individuals representing the PA profession are engaged in this project. The final group of participants will be selected using a stratified random sampling strategy to ensure broad representation and objectivity in the process. If this work interests you – or if you remain interested in working with NCCPA in some other capacity --please complete the survey at the link below. This survey will close on Sunday March 20th at 11:59:59 PST.
  14. How many of you are aware of this? I have to say - I'm not exactly thrilled. “Associate physician” idea comes to Washington In anticipation of the legislative session, Rep. Eileen Cody (D-West Seattle) has introduced House Bill 2343 , which would create a new “associate physician” license in Washington state. The bill is modeled on laws recently adopted in several states (Missouri, Arkansas and Kansas), and allows a medical school graduate who fails to be matched with a residency to practice medicine under the supervision of a licensed physician. Rep. Cody is bringing the legislation forward in response to concerns about physician shortages raised in recent years by the WSMA and other groups. The WSMA has been consistent in advocating for increased funding for residency slots to address the need for more physicians (and was successful last year in securing over $24 million for new residencies). While this legislation may be well-intentioned, it has the potential to cause more problems than it solves. HB 2343 is scheduled to receive a public hearing this Friday in the House Health Care & Wellness Committee, which Rep. Cody chairs. The WSMA will monitor the bill closely.
  15. Drug Allergies: albuterol - reaction? shortness of breath, cant breath. "allergic to vicodin - makes me itch and throw up. But i can take percocet or oxycodone"
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