jmj11 Posted March 22, 2014 Share Posted March 22, 2014 I've said before that insurance companies need much better education about PAs. Yesterday I had a conversation with a major insurer after they removed my listing from their directory. First they point out that they have removed all PA listings, but have left the NP listings. The reason? Because PAs are not providers. They assist providers. NPs are providers. They consider PT, Massage Therapist as providers too. Their directory is called the "Provider Directory." I've been fighting with these people for three years. This is a nationwide decision. I'm exhausted with these battles and will not take this one on. There needs to be someone bigger than me to educate them. We will soon see NPs paid at 100% of MD rate and PAs paid at 85%. This will greatly de-incentize hiring of PAs over NPs. I find these things very frustrating. It hurts my practice. It hurts patients who can not find me and needs my care. It makes us get paid less because when we bill them, it is harder for them to find me to pay me. I often get this overwhelming feeling that no one really gives a damn about how we are perceived. And also, greetings from Istanbul. Link to comment Share on other sites More sharing options...
Timon Posted March 22, 2014 Share Posted March 22, 2014 Have you brought this up to PAFT and the AAPA? Link to comment Share on other sites More sharing options...
Guest Paula Posted March 22, 2014 Share Posted March 22, 2014 @JMJ: Please send this to AAPA. I know you are exhausted and AAPA has not always responded to you. We need this information to present to the HOD so we can get the collaboration resolution passed. These real life experiences may help us. Link to comment Share on other sites More sharing options...
PACProvider Posted March 22, 2014 Share Posted March 22, 2014 This is a problem in the VA as well. PAs are subjected to "supervision" of whatever form the service chief likes. It can range from chart reviews monthly, weekly or staffing every patient. Nurse Practitioners on the same service with the same credentials and same experience are given free reign. The NP receives no "supervision." It creates an environment where physicians few PAs unfavorably because they are subjected to more work than if they hire a NP. Experience and education do not matter. Some service chiefs in the VA are working feverishly to marginalize and eliminate the PA profession. Creating added time and cost to deliver the same services makes the PA less valuable. Communications with PA leadership in the VA leads to retaliation against the PA on the service. PAs are now being cautioned against joining the VA given the disparate treatment and negative career impact. Link to comment Share on other sites More sharing options...
Guest Paula Posted March 22, 2014 Share Posted March 22, 2014 ^^^^^ The VA approved and implemented the collaboration practice policy for PAs in December, 2013. Hopefully the PAs will now be able to practice in a more favorable environment. The question to ask now of the VA PAs is if they have noticed any changes yet to the practice environment? Plus, if nurses are in charge of administration then they need to be informed and held accountable to making sure the changes are fully implemented. (I do not work in the VA so I am speaking from a naive viewpoint of the inner workings of the VA). Is there really retaliation and if so, is it regional? Which VAs are trying to eliminate the PA from their system? Is this really true? Link to comment Share on other sites More sharing options...
benhwa Posted March 23, 2014 Share Posted March 23, 2014 jmj, please just send a quick note of the insurance company name to either the president or immediate past president of the AFPPA and we will take care of the rest. I agree, we are ALL getting tired of being treated as second-class providers (and in this case, non-provider). I agree with Paula in regards to sending it to the AAPA. They are actually trying to come around and be a little bit more pro-active when it comes to disparagement's against PAs and big companies. Link to comment Share on other sites More sharing options...
Guest Paula Posted March 23, 2014 Share Posted March 23, 2014 From a colleague of mine who asked me to paste this into this forum discussion: So let me get this straight.We have a belief system that tells the world we "assist". We are assistants. We tell the world that we need to be "supervised" and when the AFPPA brought up a "collaboration" resolution last year at the HOD, they were told it was a "nursing word" by the AAPA Board. Absurd!! We go on stage touting the "MD led PA/MD team" and the MDs don't back hiring us in the VA? How the heck do we expect people to realize we really are PROVIDERS? It's time for change, if not we come in third place and that's ugly. It's not the NPs fault-it's OURs. Ready to act? Join PAFT. Link to comment Share on other sites More sharing options...
Joelseff Posted March 23, 2014 Share Posted March 23, 2014 That sucks that the VA changes did not cover us. I though it did. Which reminds me, I just got my renew membership email from PAFT. Let me square that away now. Sent from my SAMSUNG-SGH-I537 using Tapatalk Link to comment Share on other sites More sharing options...
Guest Paula Posted March 23, 2014 Share Posted March 23, 2014 ^^^^^ not really sure about the VA changes not covering us.......that policy should be in place by now but you know how government moves like molasses in January. I would like to hear what VA PAs are saying about the policy. Can anyone from VA chime in here? Link to comment Share on other sites More sharing options...
PACProvider Posted March 27, 2014 Share Posted March 27, 2014 ^^^^^ The VA approved and implemented the collaboration practice policy for PAs in December, 2013. Hopefully the PAs will now be able to practice in a more favorable environment. The question to ask now of the VA PAs is if they have noticed any changes yet to the practice environment? Plus, if nurses are in charge of administration then they need to be informed and held accountable to making sure the changes are fully implemented. (I do not work in the VA so I am speaking from a naive viewpoint of the inner workings of the VA). Is there really retaliation and if so, is it regional? Which VAs are trying to eliminate the PA from their system? Is this really true? The document is VHA Directive 1063 "Utilization of Physician Assistants." It was authored by Denni Woodmansee Director of Physician Assistant Service at the VA. It was released to all service chiefs nationally at the VA on December 24th 2013. Implementation varies regionally and even varies within the VISN. Some service chiefs are determined to marginalize and alienate Physician Assistants. Those service chiefs have taken VHA Directive 1063 and contorted the meaning to infer "Supervision" and more restrictive levels of autonomy than what is specified. The service chiefs create their own documents describing their own "supervision" of PAs. Reference to the VHA Directive is met with some real hostility from specific service chiefs. There is a concentrated political force within the VA at the service chief level to favor NPs at the expense of PAs. While VHA Directive 1063 was intended to help PAs, it has been the trigger for retaliation. Regrettably, the PAs at the VA have no voice. http://www.aapa.org/uploadedFiles/content/News_and_Publications/News/News_Items/VHA_Directive_1063_Utilization_of_Physician_Assistants%20(2).pdf Link to comment Share on other sites More sharing options...
Guest Paula Posted March 28, 2014 Share Posted March 28, 2014 The document is VHA Directive 1063 "Utilization of Physician Assistants." It was authored by Denni Woodmansee Director of Physician Assistant Service at the VA. It was released to all service chiefs nationally at the VA on December 24th 2013. Implementation varies regionally and even varies within the VISN. Some service chiefs are determined to marginalize and alienate Physician Assistants. Those service chiefs have taken VHA Directive 1063 and contorted the meaning to infer "Supervision" and more restrictive levels of autonomy than what is specified. The service chiefs create their own documents describing their own "supervision" of PAs. Reference to the VHA Directive is met with some real hostility from specific service chiefs. There is a concentrated political force within the VA at the service chief level to favor NPs at the expense of PAs. While VHA Directive 1063 was intended to help PAs, it has been the trigger for retaliation. Regrettably, the PAs at the VA have no voice. http://www.aapa.org/uploadedFiles/content/News_and_Publications/News/News_Items/VHA_Directive_1063_Utilization_of_Physician_Assistants%20(2).pdf This saddens me to hear there is retaliation. Who are the service chiefs? Nursing administrators by chance? Link to comment Share on other sites More sharing options...
Recommended Posts
Archived
This topic is now archived and is closed to further replies.