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About hlj25950

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  1. I emailed and tweeted my representative in FL. No response yet. She’s not on the committee, but I asked her to speak with members of the committee. I did steal some of the language from a FAPA Facebook post, but felt it was better to have something anyway and they wouldn’t mind.
  2. I will not certify medical necessity for disability or disabled parking permits for most requests, especially things like arthritis which might benefit from exercise and weight loss and parking further away. I will not certify emotional support animals. I do not refer to chiropractors, ever. I will refer to ortho or PT.
  3. https://www.flsenate.gov/Session/Bill/2019/00821/?Tab=BillHistory Bill was passed by the house. Is before the Senate.
  4. As a Florida PA, I’m encouraged by this direction. This bill has been all over commercials, but only for NPs. I’m curious as to what changed to put PAs on the bill as well, but I hope this goes somewhere. It would really be nice to actually be ahead of the curve here. I don’t know if FAPA was involved, and I can see nothing about their involvement. I am ticked that PAs make the bill “less appealing.”
  5. Anything that doesn’t jive with evidence based medicine or chronic pain. Fibromyalgia, chronic Lyme disease, essential oils, 1000 “allergies”, etc? Can I just use reiki and crystals for that? “I know my blood pressure is 160/100 all the time, but I don’t like taking medicine, isn’t there something natural I could take?” I don’t drink. I don’t smoke. I eat a vegetarian fresh diet with no salt. I’m thin. But, like what if I take some more vitamin C? I took the lisinopril for a few weeks and my blood pressure was better, but I just don’t want to take it.” “Are you having side effects when you take it?” “No.” “I recommend you take your lisinopril as prescribed.” “I just don’t like taking medicine.” What the actual f*** do you want from me? I don’t have a magic wand here.
  6. I love being a PA. I didn’t want to be a nurse. I hate our title and stagnant leadership that sits by and does little no nothing to promote our profession. I work in primary care right now (trying to do ER, hopefully soon). I have little interaction with my SPs. Once I am in that room with my white coat on, Im the provider. I’m often called doctor. I always introduce myself as a PA. I had to fight for my job because “they only hire NPs because we have to supervise PAs and sign off on their charts.” I had to find the laws and correct them. I got my job. I have people ask me in the community. “What do you do?” “I’m a PA.” “What is a PA?” [emoji849]”I’m a physician assistant. I diagnose and treat patients. I write prescriptions.” “Huh?” “Kind of like a nurse practitioner.” [emoji362] “Ohhhhhhhhhh!” Which I get is part of the problem, but do I really have time to explain everything in every interaction? The public knows what an NP is. They think I’m a “medical assistant.” Meanwhile commercials are running all the time here about nurse practitioners and independent practice and how wonderful NPs are. We have no effective lobby. We have no effective public education measures. Our title is not reflective of our training, of our practice, of what we are. We are getting demolished.
  7. I was at work on Wednesday, and had a situation come up that caught me off guard. Right now I’m only working part time in an antiquated FM office, biding my time until my hopeful next job comes through (have an offer to start at a new free standing ED, but it’s still under construction...I digress). My current job sucks, but I don’t want to leave without something else in place, and this isn’t really the fault of my office completely. We still write out paper prescriptions as well as are completely on paper charts. I operate pretty autonomously in my office. When I was hired, I had to advocate for myself because they didn’t want “the extra work that comes from a PA vs an NP like signing our charts.” I’m in Florida, by the way, cannot move, and have been trying to get into ER, but it’s been difficult to say the least. In any event, a pharmacy kept calling the office and saying that on December 1st a new law went into effect that all my prescriptions require me to designate my supervising physician and their NPI. To my knowledge, they are not requiring this from NPs. I was busy, and this circled my SPs name and wrote SP by it on all my scripts that day. I came home and have looked for something about this, and couldn’t find anything. On a Facebook group for PA professionals, they have said that all CVS’s are going to require this of PAs starting January 1st. I cannot find much about this requirement, but it really hurts PAs, and seems to be a corporate requirement. This is the only article I could find: https://capanet.org/2018/11/cvs-prescriptions-alert/ As insurance and patient preference often dictates what pharmacy they use, and I don’t have time to urge all of my patients not to use CVS and I cannot e prescribe from my office, I’m stuck. This is making it even harder for me to compete for jobs and to practice as a PA. What is our leadership doing about this? What can I do? I’m a member of AAPA as well as FAPA for all the good it’s doing. We cannot afford to slowly change minds. We need a better lobby. I’m frustrated today.
  8. I meant that there is a political and hiring bias in favor of NPs, not that we aren’t suited for it. I’m in FP right now, and I had to fight this perception all the time.
  9. Very true! It should be based on what is best for you and family. Also, in general, you can probably work during an NP program, and you cannot work during a PA program.
  10. Depends on specialty you see yourself in. Some are easier as a PA (surgical, emergency, procedure heavy), and some are better for NP (primary care), some far superior or only available to NP with specialized tracks (anesthesia -CRNA, or Obstetrics/Gynecology (Nurse Midwife). You can do OB as a PA, but it’s much harder. You can’t really do anesthesia as a PA. You can do surgery or ER as an NP, but there is bias there (definitely able to overcome this with the right background). I preferred becoming a PA, just based on training and my track. Had I already had a BSN? I’d probably have gone the NP route. It’s a fact that they have a better lobby. Ours it crap.
  11. I’ve only been a PA for just over a year, so take that for what it’s worth. Being a doctor, for me, is definitely NOT worth it. Those of you who think doctors have it so good are missing the point. https://www.ncbi.nlm.nih.gov/m/pubmed/26599310/?i=19&from=physician%20satisfaction%20job&sort=[relevance] “Of 68 publications reviewed, 29 met criteria and were categorized in a Job Characteristics Model. Most studies report a high degree of job satisfaction when autonomy, income, patient responsibility, physician support, and career advancement opportunities are surveyed. Age, sex, specialty, and occupational background are needed to understand the effect on job satisfaction. Quality of studies varies widely.” https://www.ncbi.nlm.nih.gov/m/pubmed/29101932/?i=2&from=physician%20career%20satisfaction&sort=[relevance] I’m telling you most physicians I know wouldn’t do it again. I’ve been married since undergrad to an ortho surgeon, and it influenced my decision not to do medical school. Physician residencies are hell beasts that cannot be compared to PA residencies or practice. Physicians have higher liability. They have decreasing autonomy (due to hospitals buying them out and little to no choice in the matter) because they can’t negotiate favorable contracts with insurance companies and stay in business anymore. There are more administrators in medicine. Who know nothing about taking care of patients and just see $$$. Debt to go into physician practice is much greater. On balance it was well worth going to PA school rather than medical school. Yes, there are definitely disadvantages, but at least we have some lateral mobility. Physicians do not. Not without doing another residency. We have the ability to practice in the field we want for the most part. Physicians have less ability to do this. For residencies, they are matched by a computer (if they match - there are fewer residencies than applicants). Some specialties are highly competitive and only the top 10% in classes and on boards need apply. So you wanted to do______? And if you don’t match or finish a residency? You cannot work as a physician. I know several doctors who have committed suicide. I know a few who were not advanced in their residencies. A few were able to transfer to a new residency and start over in a completely different field, not their preferred field, and a few have jobs completely outside of medicine and are unable to pay their school debts, end up teaching Anatomy at a community college or something similar. Even if you do make it through, the at a bare minimum, triple the training, is not always worth it. And often, wasn’t worth it. You miss out on life. You sacrifice a lot. If you graduate, as a PA, however, and pass your PANCE? You can change fields if you really want to. It’s hard to change fields, no doubt, but you can without doing 3-10+ years of 80-120 hour work weeks. That is, if you can even rematch in a different field. I’m not sorry I chose PA over med school. Are there things that are worse? Sure. Worth it to be a PA and not a MD/DO? Absolutely.
  12. I don’t know very much about other states, but I agree that Florida is terrible. I love living here, and I cannot move at this time, or probably ever due to my husband’s career and children’s school, my parents moved here to be with us. This is our home, and we cannot move, but my job prospects are pretty terrible. My current/first job and pay is laughably bad. I had to take it for experience. After 9 months of looking, without a job, I was desperate. Every place is asking for 3-5 years experience. I’m 4 months in to this job. I’m going to continue to look and apply for something better.
  13. I wish it was a flash in the pan, but it has been going on for long enough with enough steam behind it to be more than that. Andrew Wakefield published his fraudulent studies in the 1990’s, just in time for the explosion of the internet. The ability of patients/laypersons to consume whatever someone writes and take it as fact demonstrates a pervasive war on public health, in my opinion. You have blogs that tout nonsense that sounds scientific that source other blogs that have no scientific basis or don’t source at all, and around and around we go. People are not critical and good consumers of this information. They see sensationalized anecdotes and hold on to them as fact. They are fearful. They don’t understand immunology or research, and so they hear, “washing hands is all you need,” and that’s comforting to them. It’s very much a PR war with words like “natural, organic, vitamins, and supplements” being lumped into an “always good” label never stopping to understand dose, potency, efficacy, or any other concepts that might be difficult to understand. Whereas words like “pharmaceutical, chemical, and genetic modification” adopt “bad” labels. I don’t know how to change this, but it’s really a drain on providers and a public health threat.
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