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What are we afraid of?


Guest Paula

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I've been reading posts on the PAs for Physician Associates Facebook site about the Doctorate PA program in VIrginia.  Comments are interesting and made me wonder...

 

What are PAs afraid of?

 

(This is not to rehash doctorate programs but the comments made on FB made me think some are afraid of change and progress).

 

Are we afraid of independent practice?

 

Are we afraid of ruffling the medical feathers?

 

Are we afraid of being responsible for the care we provide for a patient?

 

Are we afraid of being sued and think that by having an SP that we will not be liable for anything we do?

 

Are we afraid of the state medical boards that control us?

 

If so, why are we afraid?

 

WHY?

 

I don't have the answers.  

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Are we afraid of ruffling the medical feathers?

 

Are we afraid of the state medical boards that control us?

 

If so, why are we afraid?

 

these two. if docs decide to crack down on our practice, scope of practice, or autonomy and require more stringent oversight there is currently nothing we can do about it. currently a state medical board could decide overnight that PAs can only see pts when a doc is present and must present 100% of those pts in real time. they could also strip us of prescription rights. unlikely, but state medical societies in several states(say kentucky, louisianna, etc) would love to do this. they could void our licenses overnight and we would have no recourse.

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^^^^^^^^^^^^ Federal Trade Commission involvement might not be a bad idea.  That agency might help us so we will not be unduly prevented from our work and employment and restrictions to our trade put on us by another trade. 

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I've been reading posts on the PAs for Physician Associates Facebook site about the Doctorate PA program in VIrginia. Comments are interesting and made me wonder...

 

What are PAs afraid of?

 

(This is not to rehash doctorate programs but the comments made on FB made me think some are afraid of change and progress).

 

Are we afraid of independent practice?

 

Are we afraid of ruffling the medical feathers?

 

Are we afraid of being responsible for the care we provide for a patient?

 

Are we afraid of being sued and think that by having an SP that we will not be liable for anything we do?

 

Are we afraid of the state medical boards that control us?

 

If so, why are we afraid?

 

WHY?

 

I don't have the answers.

I've been wondering this for so long. Same here. No answers.

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...and NPs seem to practice medicine as well and are overseen by nursing boards. Isn't the difference between NPs and PAs more like that between DOs and MDs? Here both are overseen by the same medical board.  Seems like if you practice medicine, you should be overseen by the same board with, more or less, the same rules.

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I think instead of a doctorate level degree we need to unionize, like nurses do. we are so taken advantage of, with no protection.

Doctorate degree is necessary IMHO. Unionize a plus. I agreed; we have no protection. Upset an MD and your behind is out the door. This doesn't applies to NP. The road ahead's dusty.

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I am a pre-pa and let me say that i have no doubt i want to be a PA. I do not want to be a nurse at any level. I have been paying attention to the recent healthcare climate.  Frankly I am afraid that companies like CVS who are trying to re-position themselves as "Health Care Providers" will soon open clinics connected to their stores and PAs will be left on the sideline because of our required "supervision".  They are already working with NPs.  How do we get ahead of this so it's not something we are trying to fix after the precedent is set?

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  How do we get ahead of this so it's not something we are trying to fix after the precedent is set?

the precedent has been set. we "can't be trusted" to provide even basic primary care services without immediate access to physician supervision.

the VA have been the only ones to fix this so far.

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I am a pre-pa and let me say that i have no doubt i want to be a PA. I do not want to be a nurse at any level. I have been paying attention to the recent healthcare climate. Frankly I am afraid that companies like CVS who are trying to re-position themselves as "Health Care Providers" will soon open clinics connected to their stores and PAs will be left on the sideline because of our required "supervision". They are already working with NPs. How do we get ahead of this so it's not something we are trying to fix after the precedent is set?

My understanding is that the pharmacies will be utilizing their pharmDs who undergo an extra year of clinical training to run those minute clinics. Not NPs...I could be wrong.

 

Regarding the OP, Paula poses an excellent question but I think the powers that be right now have zero interest in breaking away from "big-brother-almight-tee" (physicians). I don't know the answers as well but have been thinking about it for some time but still have no answers.

 

My feelings:

It is sad that we are "under the thumb" of another entity in order for us to work. NPs have gained much ground in this arena. I don't think joining NPs would be an answer because then we are just trading one Master for another. The simple truth is, we were doomed when we began because of the dependent nature of our profession (which was necessary at the time for us to practice-i understand this fact). It really is a rock and a hrad place type of situation....don't have answers....

 

Sent by my Samsung S4 Active via Tapatalk

 

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A lobbying effort, state by state, like you've never seen before

 

The Michigan PA bill to amend the Public Health Code included developing a separate PA/Md/DO/NP board so each profession could govern itself.  Each profession would write their own scope of practice, rules, etc. and each ultimately would be responsible for their own profession.  The Michigan State Medical Society was in support as one of the pieces of the bill was that PA/NPs would work in collaborative teams.  The collaboration would be determined on the practice level.  Supervision and delegation would be removed from the current PA SOP and the PA and NP professions would be given independent prescribing rights...no more physician delegation for controlled substance prescribing.

 

Right now the bill is in limbo for the reason that the lobby guy and MAPA are making sure the Governor understands the bill.  I have not heard any feedback from the NPs, but I suspect they are against it.  It will mean they will have to "give up independent NP practice" and work with some type of collaboration, but would gain independent prescribing.   This is a forward thinking bill for MI PAs and a lobbying effort is underway.  I do not know how active or strong it is.  I will email our lobby guy and ask again the status.  Perhaps we should all flood MI with letters in support????  Send MAPA support letters that they could submit to the Governor even tho not all of us practice in MI.  

 

I predict if one state, just one state can gain independent PA board and autonomous practice the dominoes will start to fall.   Which state has the where-with-all to push, push, push?  

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There are very few things in this world that I am "afriad" of Paula, certainly nothing on your list.

 

I do, however, disagree with removing the physician from the helm of the healthcare team.  I understand the angst of PAs who look at the (politically appointed) independence of the NP, but two wrongs still don't make a right.  The NPs shouldn't be independent, and neither should we. 

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There are very few things in this world that I am "afriad" of Paula, certainly nothing on your list.

 

I do, however, disagree with removing the physician from the helm of the healthcare team.  I understand the angst of PAs who look at the (politically appointed) independence of the NP, but two wrongs still don't make a right.  The NPs shouldn't be independent, and neither should we. 

I would like to see "collaboration" across the board in all PA practice settings though like the VA just did. that keeps a doc involved but gives us more autonomy.

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My understanding is that the pharmacies will be utilizing their pharmDs who undergo an extra year of clinical training to run those minute clinics. Not NPs...I could be wrong. Regarding the OP, Paula poses an excellent question but I think the powers that be right now have zero interest in breaking away from "big-brother-almight-tee" (physicians). I don't know the answers as well but have been thinking about it for some time but still have no answers. My feelings:It is sad that we are "under the thumb" of another entity in order for us to work. NPs have gained much ground in this arena. I don't think joining NPs would be an answer because then we are just trading one Master for another. The simple truth is, we were doomed when we began because of the dependent nature of our profession (which was necessary at the time for us to practice-i understand this fact). It really is a rock and a hrad place type of situation....don't have answers....Sent by my Samsung S4 Active via Tapatalk

I agree, the dependent nature of this profession basically "doomed" it from the beginning. As a potential PA it concerns me that as a PA (no matter how experienced) we are always dependents. Never can we be an independent. We must always rely on the indirect supervision of the "big dogs" above (physicians). Considering I am under 30, I can see the dependency of the profession being an issue later on in my career once I have experience--this makes me question if this is the best path. Any advice on this? Have any of you struggled with this as well?

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My concern has little to do with physician anger, or worry over PAs becoming more indep. In fact, I believe we need to be more indep., have name change, and advance our practice through high quality data and practice theory.  The question is does a doctorate degree move us in that direction ? I am interested in what skills the doctorate degree will give PA's. Is the purpose to train researchers to demonstrate the value of a PA profession ?  Is the purpose to develop PA leaders to run our schools and hospitals ? Is the answer is YES why not have the PA study biostats and health management at an established top notch PA program ..... or take on an executive healthcare MBA at a top 10 business school.  Why have a program which may or may not have instructors with COMMAND over the aforementioned subjects teach a PA doctorate which will hold little credibility in settings and cost someone perhaps big bucks.  WAKE FOREST had it right in my opinion with the dual PA PHD program. Bravo to them ! They seem to be forward thinkers.

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