PA Doctoral issues

[physasst]

The last thread by Grinder got me thinking about the whole PA doctoral issue. One thing however, was that I noticed many people insinuating that the AAPA doesn't care about this, or doesn't want to talk about it, which simply isn't true.

 

We did discuss this. In 2009. We had a summit, with many stakeholders present, most of them PAs and we voted on a number of issues pertaining to a PA doctorate. You may not like the results, but the fact is, this was discussed and voted on...

 

http://www.aapa.org/uploadedFiles/content/Common/Files/padoctoralarticle.pdf

[Grinder993]

The last thread by Grinder got me thinking about the whole PA doctoral issue. One thing however, was that I noticed many people insinuating that the AAPA doesn't care about this, or doesn't want to talk about it, which simply isn't true.

 

We did discuss this. In 2009. We had a summit, with many stakeholders present, most of them PAs and we voted on a number of issues pertaining to a PA doctorate. You may not like the results, but the fact is, this was discussed and voted on...

 

http://www.aapa.org/uploadedFiles/content/Common/Files/padoctoralarticle.pdf

 

I think most people are aware that it was voted on 4 years ago. Problem is you voted on the wrong issue. You voted on making the entry degree a doctoral degree, most PA's do not want that. What many of us are rallying for is a PA doctoral route. The AAPA was wrong about the Master's degree issue in the 90's and they are wrong again on this issue. This needs to be revisited considering that the DNP was not a reality in 2009, it is today. The landscape has changed and this issue needs reconsideration. To ignore that we are the only allied health profession without a doctoral option is to do so at your own peril. What concerns me also is that many of the PA's that are in current leadership positions are (with all due respect) mostly near the end of their careers. I do not think many of htem have 30 years of practice left in them. I would bet most are within 15 years of retirement. Meaning they really don't have a dog in this hunt. They will be gone by the time the fallout from this hits those of us currently practicing and those younger PA's coming up behind us.

[physasst]

No, this is what was voted on, and how the majority voted:

 

Consensus was reached on all the previous mentioned recommendations except for those two pertaining to the post-graduate doctoral degree. Participants then created three options upon which they voted:

• Option 1. We endorse the medical model of post-graduate clinical education and training for PAs. Therefore we conclude that it is unnecessary for the PA profession to adopt the clinical doctorate.

• Option 2. We recommend full professional support for advanced education to enhance knowledge and clinical skills which includes the option of earning a post-graduate, PA clinical doctoral degree.

• Option 3. We recommend that the PA profession support the option for colleges and universities to offer post-graduate non-professional specific professional doctorates (such as doctor of medical science or doctor of health science) as part of a group of options available to PAs for career development. This could be a "clinical doctorate" but not PA-specific.

A majority voted for option three and the specific recommendations were then written.

 

[physasst]

No, this is what was voted on, and how the majority voted:

 

Consensus was reached on all the previous mentioned recommendations except for those two pertaining to the post-graduate doctoral degree. Participants then created three options upon which they voted:

•

Option 1. We endorse the medical model of post-graduate clinical education and training for PAs. Therefore we conclude that it is unnecessary for the PA profession to adopt the clinical doctorate.

•

Option 2. We recommend full professional support for advanced education to enhance knowledge and clinical skills which includes the option of earning a post-graduate, PA clinical doctoral degree.

•

Option 3. We recommend that the PA profession support the option for colleges and universities to offer post-graduate non-professional specific professional doctorates (such as doctor of medical science or doctor of health science) as part of a group of options available to PAs for career development. This could be a "clinical doctorate" but not PA-specific.

A majority voted for option three and the specific recommendations were then written.

 

 

You may not like how the vote turned out, but this was a big meeting with multiple PAs from different arenas represented, and this is how the vote came out!

[Grinder993]

No, this is what was voted on, and how the majority voted:

 

Consensus was reached on all the previous mentioned recommendations except for those two pertaining to the post-graduate doctoral degree. Participants then created three options upon which they voted:

•

Option 1. We endorse the medical model of post-graduate clinical education and training for PAs. Therefore we conclude that it is unnecessary for the PA profession to adopt the clinical doctorate.

•

Option 2. We recommend full professional support for advanced education to enhance knowledge and clinical skills which includes the option of earning a post-graduate, PA clinical doctoral degree.

•

Option 3. We recommend that the PA profession support the option for colleges and universities to offer post-graduate non-professional specific professional doctorates (such as doctor of medical science or doctor of health science) as part of a group of options available to PAs for career development. This could be a "clinical doctorate" but not PA-specific.

A majority voted for option three and the specific recommendations were then written.

 

 

Option 1 was going nowhere b/c the AAPA does not want to "force" residency attendance as a requirement. Option 2 they likely didn't want b/c they fear the specialization of our profession. This is something that is happening anyway. Option 2 would have been the appropriate way to go, support doctoral residency training in the model of Baylor/Army. The idea of protecting the "bounce around" ability of PA's is not necessarily a great thing. Furthermore, I don't know many PA's that "bounce around" much anymore. Maybe this used to happen more in the past, but I don't see PAs bouncing from ER to Derm to Psych to Family. If you are doing that.......you may be a confused and flighty individual to begin with. Option 3 does absolutely nothing for PA's. This goes into the what we discussed on my thread, if the degree is not PA specific, not a PA professional degree, it really doesn't matter for the purposes of our discussion. I can go get a PhD in history, that won't help me get autonomous practice.

[True Anomaly]

What has always bothered me about the DNP and the use of term "doctor" in the clinical setting is that when it gets down to reality, they are doing exactly what we or physicians are doing- practicing medicine. "Advanced nursing" is just a way to get around the state medical boards. Give a patient with pnemonia to an NP (whether masters or doctorate), PA or physician, and it is expected that the patient will be treated the same way.

 

In light of this, the NP already has a clinical doctorate for what they do in practice- the MD/DO. It's the same as us. I'm against the idea of a DNP being called "doctor" because they are not the highest trained degree in the medical field- a physician is.

 

All that being said....many years ago on this board I scoffed at the idea of a PA with a doctorate, because I couldn't get my head around the idea of a "Doctor of Physician Assisting". Now, though, I know that perception is reality for those not in the medical field, and I too have concerns for PA's losing out to NP's on this "doctorate" issue. I really really really really hope it doesn't turn out as dire as some make it out to be.

[physasst]

Option 1 was going nowhere b/c the AAPA does not want to "force" residency attendance as a requirement. Option 2 they likely didn't want b/c they fear the specialization of our profession. This is something that is happening anyway. Option 2 would have been the appropriate way to go, support doctoral residency training in the model of Baylor/Army. The idea of protecting the "bounce around" ability of PA's is not necessarily a great thing. Furthermore, I don't know many PA's that "bounce around" much anymore. Maybe this used to happen more in the past, but I don't see PAs bouncing from ER to Derm to Psych to Family. If you are doing that.......you may be a confused and flighty individual to begin with. Option 3 does absolutely nothing for PA's. This goes into the what we discussed on my thread, if the degree is not PA specific, not a PA professional degree, it really doesn't matter for the purposes of our discussion. I can go get a PhD in history, that won't help me get autonomous practice.

 

This wasn't just the AAPA board....There were 34 PAs in attendance and 1 student PA from across the country. Some were from clinical practice, others were from education, some had doctorates, some did not.

 

There were also 4 MDs in attendance, 3 from PA programs or schools with PA programs, 1 from clinical practice, there was 1 nursing representative and 1 PT representative. There was also 1 PhD representative from the AAMC.

 

 

There were only 3 attendees from the AAPA staff.

 

This was overwhelmingly voted on by YOUR peers, IE; other PAs, and this was the outcome. Even if we concluded that all the non PA votes were against this there would still only be 11 nays (if you count the PA student as a non PA) versus 34 votes by PAs.

 

PAs decided this vote...not the AAPA, not the non PAs.....PAs did. You might not like the outcome or result, but this was how your peers voted.

[Grinder993]

This wasn't just the AAPA board....There were 34 PAs in attendance and 1 student PA from across the country. Some were from clinical practice, others were from education, some had doctorates, some did not.

 

There were also 4 MDs in attendance, 3 from PA programs or schools with PA programs, 1 from clinical practice, there was 1 nursing representative and 1 PT representative. There was also 1 PhD representative from the AAMC.

 

 

There were only 3 attendees from the AAPA staff.

 

This was overwhelmingly voted on by YOUR peers, IE; other PAs, and this was the outcome. Even if we concluded that all the non PA votes were against this there would still only be 11 nays (if you count the PA student as a non PA) versus 34 votes by PAs.

 

PAs decided this vote...not the AAPA, not the non PAs.....PAs did. You might not like the outcome or result, but this was how your peers voted.

 

So a whopping 34 PA's voted. I dismiss the attendance of the student. As a student you can't possibly grasp the scope of these professional issues if you have not "been in the field" for some time. I further dismiss the attendance of the MD's, they of course would scoff at the idea of "doctoral PA's". They have their own best interest to look out for and whether many of you want to admit it or not, the truth is that with looming insurance changes, we are seen as a growing threat to MD's more so than a help to them. I can only say that for the 34 PA's that voted this down, they were wrong. Time will prove it. Just like with the Master's degree creep, the market demand is going to bypass the AAPA. They would be better off getting in front of the issue and offering a doctoral pathway, or schools will begin issuing doctoral PA degrees and over the next 20 years it will become the entry degree which is NOT what I am championing for.

[EMEDPA]

apparently there are a few doctoral entry level pa programs in the works....

[ventana]

2009 is just about ancient history at this point with all the changes in health care

 

and I quote "The summit was not the end but the beginning."

 

So where is the follow up, the beginning means that there should be something after it....

 

What about PAFT -

 

What about 6k + signatures for name change that AAPA swept under the table...(don't get me started)

 

 

AAPA is not our friend, they advocate well for themselves (self fulfilling) and at times are helpful at the state level

 

 

BUT WHY can I still not order VNA services.

 

and now they want a face-to-face for any DME, and we are left off the incentive money for electronic medical records, and now the nurse practitioners have a doctorate level degree. AAPA is failing us. granted they have had good victories along the way, but these are all at the state level, nothing on the national level that comes to mind.

 

 

 

why can't a AAPA get a PA to order VNA services and DME. Most states recommend this is primary care providers. Yet we can't provide primary care.

 

 

sorry, but I will be one of the 1st ones in line for either a doctorate PA degree or at DNP transition program with a reasonable cost and time investment as their national lobbying is so much better and more effective

 

 

 

 

Addendum:

 

 

And when researching more, this was the recommendations

 

 

 

 

Assignment

 

Your assignment is to flesh out the recommendation from the list below that you have chosen to work on:

A)We recommend that there should be no change to the Entry Level Degree for PAs.

B)We recommend that the Masters Degree should be promoted as the Entry Level Degree for PAs.

C)We recommend that there should be no Post-Graduate Clinical Doctorate offered for the PA Profession.

D)We recommend that the PA Profession should support the development of an optional Post-Graduate Clinical Doctorate degree.

E)We recommend that the PA Profession explore a MD/DO Bridge Program.

F)We recommend that the PA Profession explore the “Stem Cell” model.

 

 

 

 

 

 

So please tell me where the AAPA has followed up on D and E

[waitingblessing]

Thank you for sharing this. As a person who dropped a career to become a PA I like hearing about important stuff like this. It is important for me as I will hopefully be carrying on in the profession. I have a friend who just finished nursing anesthesia school she told me that they are now requiring students to earn a doctor of nurse anesthesia luckily for her she finished in 12/12 so she didn't have to.

 

Anyway I don't know if a dnp will have more authority- I haven't really looked into it...... NP already have practice right a little diff than PA. I am all for a doctrine of PA after completion of the Masters degree route. I would do it immediately. I will continue to follow the aapa decision on this.

[waitingblessing]

May I ask when was this last voted on?

[Avalon]

I resigned my hard earned tenure as a uiversity professor to attend PA school and become a PA. I have a doctorate in an adjunctive health care field and would never promote myself as a "doctor" in a medical setting (read what some of the DNPs are posting about how they have earned the title of "doctor" and demand that it be respected). I resigned my AAPA membership this spring over the issue of DNP advancement, with no similar advocacy by our leaders for the PA for profession. I wrote a letter detailing my reasons for the decision and my concerns about the jeopardy we seem to be in as a field. I received no reply except for ongoing notices that my membership dues were now overdue.

 

I'm trying desperately to remain optimistic, but I have made significant sacrifices, as have most of us, to become a PA and I really don't know what my future as a provider will look like in the next 5-10 years. Do I want to earn another doctorate? No, not really. Do I want the public, and our medical colleagues, to see us as fully and equally as capable as DNPs, who will assuredly become primary care providers? You bet. Shouldn't this be the concern and the focus of the AAPA?

[MedicinePower]

I feel quite strongly that there should be a "Doctor of Medical Practice" degree available for those PAs who 1) have a MAPAS or equivalent, 2) willing to do a 1 year residency, 3) and one year of coursework.

[PAS2014]

bstone: I like that idea!

[ventana]

I feel quite strongly that there should be a "Doctor of Medical Practice" degree available for those PAs who 1) have a MAPAS or equivalent, 2) willing to do a 1 year residency, 3) and one year of coursework.

 

 

YES YES YES

 

Let anyone come up with even one good reason against this????

 

 

Bring it on.....

 

 

 

so here is the next question....... I am thinking of trying to spearhead starting an internal medicine residency through my local health system...... not sure if this is even possible, but does anyone have any experience with starting a residency and what might be entailed in creating a new DPA degree?

(please no conjecture, but instead actual experience)

[Joelseff]

I feel quite strongly that there should be a "Doctor of Medical Practice" degree available for those PAs who 1) have a MAPAS or equivalent, 2) willing to do a 1 year residency, 3) and one year of coursework.

 

Where do I sign?

 

They should add years in practice though.

 

Sent from my myTouch_4G_Slide using Tapatalk 2

[Staplemyfoot]

The doctorate of PA studies is inevitable, it will come.

[MedicinePower]

The DMP (Doctor of Medical Practice) is the analog to the DNP (Doctor of Nursing Practice). The DMP would have more hours of both clinical and didactic education than the DNP, so it would be more worthy of respect from our physician peers.

 

Using my DMP formula a PA would have the same number of years of education as a physician (MD or DO).

[Monkeyball]

The doctorate of PA studies is inevitable, it will come.

 

The sooner the better. Sign me up.

[Gordon, PA-C]

The DMP (Doctor of Medical Practice) is the analog to the DNP (Doctor of Nursing Practice). The DMP would have more hours of both clinical and didactic education than the DNP, so it would be more worthy of respect from our physician peers.

 

Using my DMP formula a PA would have the same number of years of education as a physician (MD or DO).

 

 

Why the hell would I spend the same amount of time/money to get a DMP when I can get an MD instead? DMP only works if it is less years than a physician.

[primadonna22274]

Why the hell would I spend the same amount of time/money to get a DMP when I can get an MD instead? DMP only works if it is less years than a physician.

 

Agreed--I don't see the appeal at all.

[ventana]

Why the hell would I spend the same amount of time/money to get a DMP when I can get an MD instead? DMP only works if it is less years than a physician.

 

 

not sure how you made this logic step?

 

fastest to get to MD practice is 6 years (3 lecom, 3 residency)

 

WITH 3 years loss of salary, and 3 years at about 40% salary and 200,000 in debt.....

 

 

DMP would be two years TOTAL with only one year of no income or possible little income.....

 

 

 

they are not the same things

[Guest JMPA]

Why the hell would I spend the same amount of time/money to get a DMP when I can get an MD instead? DMP only works if it is less years than a physician.

 

Just because YOU may not want to does not mean others should not have that option. There are plenty of PAs whom have worked for many years and would like the OPTION of more education and independence without having previous education disregarded.

[MedicinePower]

Why the hell would I spend the same amount of time/money to get a DMP when I can get an MD instead? DMP only works if it is less years than a physician.

 

Avoiding your use of vulgarity, the end-result is quantifiably different. No physician, MD or DO, is able to obtain a medical license after 4 year of school unless they have completed 1 year year (in some states) or 3 year (most states) residency. A PA who completed my envisioned DMP degree would be fully capable of practicing medicine as they have already done so. The DMP is not an entry-level degree one rather an optional degree for an already practicing PA so obtain a clinical doctorate.