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recent thread, 3geronamoPA wrote (edited for brevity)

.... and pursue issues that I want addressed then I'd be interested. We have a similar thing going on in the Army currently. We have a bunch of our senior people making decisions that will pull PAs out of clinical medicine and into administration for the purposes of career (rank) advancement. They never asked the lowly types that became PAs to take care of patients (God forbid) what they wanted. Now we have a mass exodus of PAs from the Army because they don't want to do Healthcare Administration for 3+ years. which got me to thinking...

is an administrative tract for PAs a bad thing??

 

i would propose that THAT is what we want:

 

-- a seat at the head table

 

-- a voice in the organizations in which we work.

 

-- an opportunity to influence PA working condidtions and the delivery of health care in general?

 

-- a counterbalance to forces of evil ( apply whichever initials you desire there...r and n admin come to mind)

 

I admire 3 geronimoPA's dedication to actually doing that for which he was trained: taking care of patients.

 

he, and the apparent droves of fellow army PAs who are leaving due to this, are true trenchers (as am I).

 

however, sometimes a trencher at the admin table aint a bad thing.. sometimes he can provide a cogent arguemnt to an issue being discussed.

 

once, the EM reprepresentative to the department of orthopedics monthly meeting, when the chief of ortho was blasting the head of lab and admin about the turn around time it was taking for micro to complete hip replacement bone sa mples (gram stains etc), he lamented, that there is nothing more urgent for the lab to be doing than processing a sample from a patients open hip. I mentioned that maybe analysis of spinal fluid might be one example of such a circumstance.. trencher experience over admin experience..

 

the point is.. the more we become a part of the administration, the more admin will see us as actually having "skin in their game".. and (my argument) the more they will actually listen to and be concerned with our ideas.

 

instead of merely considering us as meat moving fodder.

 

so, i would like to open it up:

 

(my position is in soft opposition to 3 geronimoPA's lament against administration for PAs (actually he seems to be against the decision having been made without PA input.. which sorts makes my case, doesn't it?)

 

should we, as a profession, be advocating an administrative role for PAs within the local organizations that we work?

 

Should we be pushing for this?

 

in the army, it appears that this role will become a needed ticket punched for advancement.

Should we be taking a position that PAs in the field become administraors?

 

Should there be an "administrative PA" role? nationally? locally only?

 

should our goal be that ONLY (former) trencher PAs be allowed to become an "Administrive PA (APA)"? to avoid hospital administrators from hijacking the positon..

 

just for your pondering..

 

davis

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rcdavis...

 

Much loud applause! I do think that seasoned PAs need to pursue seats at that table! My perspective is somewhat limited considering I won't be entering practice until 2016. However, I have been around in medicine clinically and administratively for about 15 years. So, I'm confident that a PA with 8-10 years of practice behind them could express the experiential chops necessary to combat some of the other personalities at that table - and, yes it is a combat zone! A lot depends on the self-confidence and communicative abilities of said candidate to the administrative position. Also, such an individual might better serve in a local capacity. Cutting your teeth on a local medical or hospital administrative board would be where the most impact could be felt. I think that Representative Karen Bass could speak volumes as to her actual influence nationally - for example (my guess is that things move rather slowly before policy is affected let alone changed). As you truly seasoned veterans can attest better than I; medical practice is about experience and the ability to express/sell an idea to a somewhat narrow audience. Those same skills can be easily transferred to a larger audience to great effect.

 

Just some thoughts... Thanks for the thread to chew on!

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recent thread, 3geronamoPA wrote (edited for brevity)

.... and pursue issues that I want addressed then I'd be interested. We have a similar thing going on in the Army currently. We have a bunch of our senior people making decisions that will pull PAs out of clinical medicine and into administration for the purposes of career (rank) advancement. They never asked the lowly types that became PAs to take care of patients (God forbid) what they wanted. Now we have a mass exodus of PAs from the Army because they don't want to do Healthcare Administration for 3+ years. which got me to thinking...

is an administrative tract for PAs a bad thing??

 

i would propose that THAT is what we want:

 

-- a seat at the head table

 

-- a voice in the organizations in which we work.

 

-- an opportunity to influence PA working condidtions and the delivery of health care in general?

 

-- a counterbalance to forces of evil ( apply whichever initials you desire there...r and n admin come to mind)

 

I admire 3 geronimoPA's dedication to actually doing that for which he was trained: taking care of patients.

 

he, and the apparent droves of fellow army PAs who are leaving due to this, are true trenchers (as am I).

 

however, sometimes a trencher at the admin table aint a bad thing.. sometimes he can provide a cogent arguemnt to an issue being discussed.

 

once, the EM reprepresentative to the department of orthopedics monthly meeting, when the chief of ortho was blasting the head of lab and admin about the turn around time it was taking for micro to complete hip replacement bone sa mples (gram stains etc), he lamented, that there is nothing more urgent for the lab to be doing than processing a sample from a patients open hip. I mentioned that maybe analysis of spinal fluid might be one example of such a circumstance.. trencher experience over admin experience..

 

the point is.. the more we become a part of the administration, the more admin will see us as actually having "skin in their game".. and (my argument) the more they will actually listen to and be concerned with our ideas.

 

instead of merely considering us as meat moving fodder.

 

so, i would like to open it up:

 

(my position is in soft opposition to 3 geronimoPA's lament against administration for PAs (actually he seems to be against the decision having been made without PA input.. which sorts makes my case, doesn't it?)

 

should we, as a profession, be advocating an administrative role for PAs within the local organizations that we work?

 

Should we be pushing for this?

 

in the army, it appears that this role will become a needed ticket punched for advancement.

Should we be taking a position that PAs in the field become administraors?

 

Should there be an "administrative PA" role? nationally? locally only?

 

should our goal be that ONLY (former) trencher PAs be allowed to become an "Administrive PA (APA)"? to avoid hospital administrators from hijacking the positon..

 

just for your pondering..

 

davis

A couple of issues. The issue with the military is an up or out phenomenon. If you want to stay you have to keep getting promoted. If you get promoted you will be placed in a different (usually administrative) position. From a military point of view they want a balanced pyramidal force. Its part of the game.

 

From a non-military point of view one of the nice things about medicine is that you don't have to get promoted if you don't want to. There are plenty of PAs (or physicians) that are happy to spend their entire life in the trenches as it were and retire from that point. There are also a few that get promoted either based on the peter principle or because they genuinely believe that's the best way to help patients and the profession. One of the best hospital medicine physicians I know is now VP of operations for the health care system. So when he's in a meeting and some admin says that x won't effect patient care his bull**** detector goes off right away and he can shut stuff down. This is what we need for PAs. We don't need a pyramidal workforce but we need people in leadership capacities so that we can represent our profession and help take care of patients globally. It can start off small such as going to QI and asking the right questions that really affect patient care. We also need PAs to be in charge of PAs instead of MBAs or physicians. And we eventually need PAs in more senior level hospital roles to make sure we are represented.

 

In some ways this is an evolution of medicine. In olden time (say 10 years ago) most physicians were in private or group practices and physicians with interest in "leadership" became small businessmen and leaders. PAs were generally employees. Increasingly we (physicians and PAs) are all employees of some type of corporation. If we want PA friendly policies and PA representation we need to be sitting at the table.

 

The other corollary to this is we need to generate more research and publication about the work we do. If you are doing something new and novel write about it. Get it out there so other PAs can use it to advance their cause.

 

So in the end if you just want to work in the trenches that should be an option but support those PAs that have the talent and the drive to do administrative work.

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-- a counterbalance to forces of evil ( apply whichever initials you desire there...r and n admin come to mind)

 

davis

 

Until recently we could use initials (jcaho)...now we have to call them something far more sinister....the joint commission....or the other set of initials being forced down our throats to sap away productivity....EMR....in answer to your actual question, yes, I think there should be a role for PAs who want to work in administration and/or research, like Dr. Halasey.

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This is not the first time, or the first profession, to move technical people to administrative jobs, and often too early in their careers.

 

When I was a young lieutenant and fresh from engineering school, a colonel tried to move me into an administrative job. I said "I'll do it if you order me to, but I would rather stay technical at this point in my career." I kept the job I wanted and he slammed me in my next evaluation. I eventually appealed to higher headquarters and won.

 

My point is that people's careers evolve and you need to be the steward of yours. A day may come that you want to be out of the clinic, but don't let it be a day before you are ready for it.

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