Yet ANOTHER unbelievably idiotic article.

[ICRob0351]

http://www.bloomberg.com//news/2013-11-04/the-primary-care-technician-will-see-you-now.html

 

For anyone who hasn't seen this article - it is absoutely astounding. I hope one of the heavy hitters on this site who has some pull can email the editors and educate them a little bit and tactfully tell them what idiots they are.

[SHU-CH]

We should use this article as a springboard for a discussion of our profession.

 

Tell the editor, "These clinicians you are looking for already exist. In fact, have much more training, experience and expertise than the PCTs you describe. And the only thing holding them back in most cases are antiquated practice laws."

[EMEDPA]

We should use this article as a springboard for a discussion of our profession.

 

Tell the editor, "These clinicians you are looking for already exist. In fact, have much more training, experience and expertise than the PCTs you describe. And the only thing holding them back in most cases are antiquated practice laws."

totally agree.

we don't need to create a new profession that does much of what physicians already do. we are already here....it says something that many folks are unaware of our existence after almost 50 years...

[ICRob0351]

I honestly thought it was a joke at first... How is it that people can still be so in the dark about the existence of our profession? It honestly blows my mind. The AAPA needs to get in gear and roll out a massive public awareness campaign.

[68W2PA]

Bloomberg did a bad job with the article, but if you go to HealthAffairs.gov, you will see that they aren't ignorant about the role of PAs. This article was just one part of the "Redesigning the Health Care Workforce" theme of the November issue.

 

Here is the abstract:

 

Abstract

Efforts to close the primary care workforce gap typically employ one of three basic strategies: train more primary care physicians; boost the supply of nurse practitioners or physician assistants, or both; or use community health workers to extend the reach of primary care physicians. In this article we briefly review each strategy and the barriers to its success. We then propose a new approach adapted from the widely accepted model of emergency medical services. Translating this model to primary care and leveraging the capabilities of modern health information technology, it should be possible to create primary care technicians who can dramatically expand the impact and reach of patient-centered medical homes by providing basic preventive, minor illness, and stable chronic disease care in rural and resource-deprived communities.

[Timon]

The author should patent the idea and present it before congress. I seriously cannot believe this idea was never thought of before?!

 

There definitely should be some sort of clinician that is "more than a nurse but less than a doctor." Some sort of "mid level provider" that can help in primary care and especially target areas where physicians usually don't access or "rural areas".

 

The government should immediately create some sort of health "service core" to also help place these "para physicians" in the areas where access to healthcare is needed the most.

 

I can't believe it took this long for someone to think up such a brilliant idea! I mean who would of thought of converting an EMT into a cost efficient and reliable healthcare provider in the areas we need them the most!

[EMEDPA]

wait, would these new providers be "assisting physicians" ?

[68W2PA]

Again, they are calling for something new "below" PAs or NPs with a restricted scope of practice.

I think you could almost call them Physician Assistant Assistants? Or maybe Assistant Physician Assistant? How about Sub-Mid Level? Physician Assistant Extenders? Physician Assistant Associate?

 

The closest thing to what they are proposing is something like an Independent Duty Corpman.

[EMEDPA]

"lower level provider"

"less than a physician, a PA/NP, and a nurse and more than a cna..."

[ToppDog]

Again, they are calling for something new "below" PAs or NPs with a restricted scope of practice.

I think you could almost call them Physician Assistant Assistants? Or maybe Assistant Physician Assistant? How about Sub-Mid Level? Physician Assistant Extenders? Physician Assistant Associate?

 

The closest thing to what they are proposing is something like an Independent Duty Corpman.

Alaska has something like this, although I have no idea how well trained they are or how they compare to corpsman, EMTs, or MAs.  I just know that they are used in very remote areas because medical facilities are not readily available.

 

That being said, if they're looking for ways to fill the MD shortage in primary care, yeah, it should be obvious that NPs & PAs can do that.  And, if they were to develop PA to MD bridges to fill that gap as long as it were for primary care, there would be enough experienced PAs that would step up.

[mdebord]

I think y'all have missed one of the most important points in the article: They want to train these people who ALREADY live in the areas.  In an ideal situation, would PAs be perfect instead?  Of course.  But as you all know, less are going into Primary Care and even fewer in rural areas.  I work in such an area, we're currently hiring, and yet we can't GET PA's, NP's, or Docs.  

[problem child]

well, before you complain, I think part of the problem is in the first paragraph, and the problem is partly us:

 

"One obvious way to address the shortage of primary medical care in the U.S. is to train more people who can provide it. Even if this could somehow happen overnight, though, it wouldn’t necessarily solve the problem: Only 1 in 4 medical-school graduates goes into primary care (the least lucrative area of medicine), and no more than half of nurses and physician assistants do.".

 

 

further, at the end of the article the aurthor states:
 

"Nor could PCTs by themselves solve the shortage of primary care doctors -- a problem that’s set to worsen as millions more people get health insurance through the Patient Protection and Affordable Care Act. Increasing the number of primary care doctors, nurse practitioners and physician assistants remains essential.".

 

 

so the article is stating that although healthcare already has trained providers who are able to provide primary care, those providers usually opt not to.

 

I think what the article suggests is actually a great idea, if nobody is going to fill the ranks of primary care. 

 

***

 

didn't they teach you in PA school to read everything...like, to the end? tsk, tsk  :)

[Gordon, PA-C]

Great idea!

 

Of coruse, after a few years these rural primary care technicians will decide that they need more formal training.  Hence, the advancement to an associates degree.  5 years later, they get envious of a 4 year degree, so they make having a bachelors a requirement.  A few more years later, they note that they are the only non-masters degree providers and therefore decide that they need to be "on par" with master degree professions.  A few years after that, well.... you get the idea.

 

Creating a "profession" inevitably leads to degree creep.  Degree creep leads to higher debt loads.  Higher debt loads leads to working in big cities.  

 

 

[Guest Paula]

Does anyone else think that these ideas reflect the inability of the status quo medical community to recognize and validate PAs and  NPs?