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Issue at heart of the PA profession?


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We all know that PA education provides a stronger and more comprehensive medical education than NP programs, and is designed to seamlessly integrate into medical practice alongside physicians.

 

 

The issue it seems is that physicians, while some may acknowledge the stronger aptitude of a PA, still and will continue to group PAs and NPs in the same 'midlevel' category. So, as the war rages on with nursing organizations for increasing autonomy and a greater piece of the pie, MDs will only hold tighter onto the reigns of the midlevels they CAN control- PAs, who are governed by the boards of medicine.

 

 

It's a sick cycle, really: Physicians do not want (the better trained) PAs to gain autonomy like the nurses, but then many hospital and MD groups actually end up hiring MORE nurse practitioners instead because they don't want to deal with the supervisory documentation commitment and paperwork that THEY enforced and fought for.

 

 

Does anyone else see the irony?

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We all know that PA education provides a stronger and more comprehensive medical education than NP programs, and is designed to seamlessly integrate into medical practice alongside physicians.

 

 

The issue it seems is that physicians, while some may acknowledge the stronger aptitude of a PA, still and will continue to group PAs and NPs in the same 'midlevel' category. So, as the war rages on with nursing organizations for increasing autonomy and a greater piece of the pie, MDs will only hold tighter onto the reigns of the midlevels they CAN control- PAs, who are governed by the boards of medicine.

 

 

It's a sick cycle, really: Physicians do not want (the better trained) PAs to gain autonomy like the nurses, but then many hospital and MD groups actually end up hiring MORE nurse practitioners instead because they don't want to deal with the supervisory documentation commitment and paperwork that THEY enforced and fought for.

 

 

Does anyone else see the irony?

Absolutely. If this were a film, it would be directed by Woody Allen. It is the same irony that physician groups would agree that one of the greatest challenges facing medicine is bringing quality care to the masses. Then the PAs stand up and say, "We can help." To which the physicians will say, "Like hell you will. We'll let the masses starve before we will let you help them." It were a painting, Salvador Dali would have done the honors.
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It were a painting, Salvador Dali would have done the honors.

one of my favorite painters. total genius. if you are ever in Tampa don't miss the Dali museum there. totally awesome.

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This is an issue that really bothers me as someone who is applying this cycle. Why the hell should I bother with a 2 year masters degree, a 1 year intensive residency to specialize, only to be seen as a lowly dependent provider by the general public/nursing/medical providers? I feel like I've wasted the last 3 years post-bacc with getting clinical hours/upping my science gpa/etc. I have a relative who is finishing her associate degree RN and will then proceed to do an ADN-->NP with the didactic 100% online, do her 500 clinical hours, and earn a doctoral degree that gives her full independence to practice independently. Meanwhile, I'll have a neutered professional lobby and a lifetime of reporting to "superiors" who will NEVER allow PA independence to occur/evolve. Truly, I feel like I may have made a mistake in this career choice, maybe PAFT will save us all.

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This is an issue that really bothers me as someone who is applying this cycle. Why the hell should I bother with a 2 year masters degree, a 1 year intensive residency to specialize, only to be seen as a lowly dependent provider by the general public/nursing/medical providers? I feel like I've wasted the last 3 years post-bacc with getting clinical hours/upping my science gpa/etc. I have a relative who is finishing her associate degree RN and will then proceed to do an ADN-->NP with the didactic 100% online, do her 500 clinical hours, and earn a doctoral degree that gives her full independence to practice independently. Meanwhile, I'll have a neutered professional lobby and a lifetime of reporting to "superiors" who will NEVER allow PA independence to occur/evolve. Truly, I feel like I may have made a mistake in this career choice, maybe PAFT will save us all.

 

I feel the same way many times (and it seems as if these sorts of threads have been multiplying lately). At this point I'm strongly leaning towards just doing the BSN, working a couple years and do an Acute Care or Adult NP DNP program (at a reputable, non-online program of course).

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Here is an argument I have used with physicians (with mixed success):

 

It is a fact that whether you like it or not there is a need for "midlevel" practitioners and we are here to stay. In fact, with the coming changes in healthcare policy in the country, the need will grow exponentially. There are essentially two big possible outcomes looming in the future of healthcare staffing:

 

1. Physicians can exert their leverage to promote the PA profession. PAs were invented by physicians, are trained like physicians, think like physicians, and are generally happy to collaborate with physicians.

 

2. Physicians can squander the above opportunity and continue to kick PAs around. Doing so will cause physicians to someday find the "midlevel" market fully stocked with alternate "midlevel" practitioners that neither listen to physicians nor give a damn what they think.

 

I guess the crux of my argument is if you really want to hate midlevel practitioners, pick carefully which one you want to hate less...

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Here is an argument I have used with physicians (with mixed success):

 

It is a fact that whether you like it or not there is a need for "midlevel" practitioners and we are here to stay. In fact, with the coming changes in healthcare policy in the country, the need will grow exponentially. There are essentially two big possible outcomes looming in the future of healthcare staffing:

 

1. Physicians can exert their leverage to promote the PA profession. PAs were invented by physicians, are trained like physicians, think like physicians, and are generally happy to collaborate with physicians.

 

2. Physicians can squander the above opportunity and continue to kick PAs around. Doing so will cause physicians to someday find the "midlevel" market fully stocked with alternate "midlevel" practitioners that neither listen to physicians nor give a damn what they think.

 

I guess the crux of my argument is if you really want to hate midlevel practitioners, pick carefully which one you want to hate less...

 

solid reasoning. put that in a letter and send it to the ama and aafp. seriously.

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This is an issue that really bothers me as someone who is applying this cycle. Why the hell should I bother with a 2 year masters degree, a 1 year intensive residency to specialize, only to be seen as a lowly dependent provider by the general public/nursing/medical providers? I feel like I've wasted the last 3 years post-bacc with getting clinical hours/upping my science gpa/etc. I have a relative who is finishing her associate degree RN and will then proceed to do an ADN-->NP with the didactic 100% online, do her 500 clinical hours, and earn a doctoral degree that gives her full independence to practice independently. Meanwhile, I'll have a neutered professional lobby and a lifetime of reporting to "superiors" who will NEVER allow PA independence to occur/evolve. Truly, I feel like I may have made a mistake in this career choice, maybe PAFT will save us all.

 

Be the change you want to see then. Or save your money. If you're jealous of your relatives online NP degree, I wonder where your priorities are. I know plenty of PAs that are treated as physician colleagues with great respect. It will be what you make of it. If you want to be "independent" then don't specialize; just go work in rural medicine. You'll have plenty of independence when your SP is an hour or more away.

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Attitude gives you latitude. Like C2PA, I've seen more PA's that act autonomously than those that act dependently. At the end of the day, it comes down to what's important to you. Is it the work you do, or how it's perceived?

 

In the end, only you can make that decision. The NPs that I work with are excited that our hospital is FINALLY getting more PAs and in no way do they, the doctors or nurses look down on their abilities or their position.

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