physasst Posted February 6, 2011 Share Posted February 6, 2011 Obama care, which is opposed by 60% of the country! You got data to support that? Every poll I've seen, and I follow a lot of them pretty much religiously has shown about a 50/50 split ever since the bill was passed. This is something I've used frequently to do regressions, and chart analysis of trends for various organizations. http://www.pollingreport.com/health.htm One of the more recent ones just done, showed that 48% prefer to let it stand, and 40% favor repeal.... The interesting part, was when you drill deeper only 50% of those who answered "favor repeal" wanted to repeal all of it, but 44% only want certain parts of it repealed. The highest number I've seen was 54% favoring repeal. And it made sense when you looked at their methodology, sampling republicans at roughly 1.5 times the rate of democrats. But even with that, with a +/- 3% MOE, it's still close to 50%. The point is..this bill has polled at about 50/50 ever since it was passed. BTW, the AAPA has never completely supported any political party or bill, they supported PARTS of this bill only after protracted negotiations to get favorable language and funding for PA's into the bill. The AAPA does not back or endorse any specific party, ideology, or bill. Link to comment Share on other sites More sharing options...
Kaepora Posted February 6, 2011 Share Posted February 6, 2011 http://www.tnpa.com/tenncare2011.php Isn't there anything to be done? Contact... Someone? How are PAs optional yet NPs are mandatory?? I think a name change would have been a big help here... Link to comment Share on other sites More sharing options...
bradtPA Posted February 6, 2011 Share Posted February 6, 2011 It's not exactly USMLE step 3, but supposedly "comparable". The questions were taken from the pool of "no longer used" questions from previous USMLE step 3 exams. Step 3 is usually taken by first or second year MD residents, or people who are not in residency but have passed step 1 and step 2. Although the pass rate is low, but I assume they can retake it, and those who had passed can claim they are equivalent to MD? So I guess they're called "Dr. Nurse"? Medicine has, unfortunately, become more of a political battle for power than helping the need.I'm saying PAs should be given a chance to do something similar to this, since the nursing side is doing it. Hell, I'm preparing for my USMLE step 3 right now and will be taking in a few months. Your original post stated they were allowed to take the USMLE, not an exam based on it. Be careful of your wording;). DNPs feel, or at least the founder of the movement, Dr. Mundinger feels, the degree alone allows them to be called doctor. No test is required for that title. Dr. Mundiger is trying to use the exam as an argument that her students have the same knowledge as MDs, which we all know is false. Midlevels, including PAs, do not have the equivalent education to make that claim. There is no way I will buy into this chase the degree the nurses are getting crap and force PAs into getting doctoral level dgrees. The only folks that benefit from that are the universities and their ilk, not the profession, and certainly not my patients. Also, we already have a testing method that works well for PAs: it's called the PANCE. The biggest difference in our education IMHO is the fact that we are standardized through an accrediting body, with a certification exam. They are not. Link to comment Share on other sites More sharing options...
Greg Cain PA-C Posted February 6, 2011 Author Share Posted February 6, 2011 By this logic ALL physicians should meet the grand rounds litmus test. They don't. Exactly right. I thought that was a little naive when I read Heme's comment, but didn't want to start an argument. Link to comment Share on other sites More sharing options...
eddoc Posted February 6, 2011 Share Posted February 6, 2011 You, as an individual PA, may not buy into the degree chase, but applicants (who can be pretty brand conscious) do. IMHO that more than anything drove the profession to the master's degree. There are entry level doctorate programs on a couple of university drawing boards and once that happens, more will follow. Is it the right way to go? If it results in more clinical training, then the result is good for the patients, right? If it, like the DNP, is full of nonsensical, nonclinical garbage, then clearly the impetus for the degree is the title. I am not sure that I agree with your statements about that "The only folks that benefit from that are the universities and their ilk, not the profession..." At what point does the degree, whatever it is, become a liability rather than an exemplar of preparedness? As a profession, we have lost control of the language of who we are and what we do - most especially around "supervision" - Lord I hate that word. Lastly, I wouldn't put much stock into the PANCE - not with a 92% pass rate, for crying out loud! What kind of discrimination is that? Sorry if I've rambled - not enough coffee yet. Link to comment Share on other sites More sharing options...
Greg Cain PA-C Posted February 6, 2011 Author Share Posted February 6, 2011 You got data to support that? Every poll I've seen, and I follow a lot of them pretty much religiously has shown about a 50/50 split ever since the bill was passed. This is something I've used frequently to do regressions, and chart analysis of trends for various organizations. http://www.pollingreport.com/health.htm One of the more recent ones just done, showed that 48% prefer to let it stand, and 40% favor repeal.... The interesting part, was when you drill deeper only 50% of those who answered "favor repeal" wanted to repeal all of it, but 44% only want certain parts of it repealed. The highest number I've seen was 54% favoring repeal. And it made sense when you looked at their methodology, sampling republicans at roughly 1.5 times the rate of democrats. But even with that, with a +/- 3% MOE, it's still close to 50%. The point is..this bill has polled at about 50/50 ever since it was passed. BTW, the AAPA has never completely supported any political party or bill, they supported PARTS of this bill only after protracted negotiations to get favorable language and funding for PA's into the bill. The AAPA does not back or endorse any specific party, ideology, or bill. Physasst, Leave it to you to make this into a Lift vs. Right debate. That was never the point of this thread or even the one quote that you seized upon out of all of my posts here. You believe any number, poll, DNC talking point, MSNBC talking head, or whatever you want to believe. I don't care to hear it. Your opinion on any issue or discussion is informed first and foremost by your political ideology. That's fine with me - I couldn't care less what you believe. If you believe that monkeys fly; then great. All I would ask is that you not come onto a thread that I started and try to troll for an argument. Please cease and desist. Unless you live and practice in Tennessee then this doesn't have anything to do with you. If you are concerned with what this means for PAs on the national level then you should start a thread that addresses that point, get off of my thread, and stop looking for a fight. Link to comment Share on other sites More sharing options...
bradtPA Posted February 6, 2011 Share Posted February 6, 2011 You, as an individual PA, may not buy into the degree chase, but applicants (who can be pretty brand conscious) do. IMHO that more than anything drove the profession to the master's degree. There are entry level doctorate programs on a couple of university drawing boards and once that happens, more will follow. Is it the right way to go? If it results in more clinical training, then the result is good for the patients, right? If it, like the DNP, is full of nonsensical, nonclinical garbage, then clearly the impetus for the degree is the title. I am not sure that I agree with your statements about that "The only folks that benefit from that are the universities and their ilk, not the profession..." At what point does the degree, whatever it is, become a liability rather than an exemplar of preparedness? As a profession, we have lost control of the language of who we are and what we do - most especially around "supervision" - Lord I hate that word. Lastly, I wouldn't put much stock into the PANCE - not with a 92% pass rate, for crying out loud! What kind of discrimination is that? Sorry if I've rambled - not enough coffee yet. Can we stand to learn more as a profession? Absolutely. But the best place IMHO to add on more education for our career is in clinicals, not textbooks. Build more residency programs that admit more than 2 PAs per year, and let us spend that year doing similar work to a PGY-1, not spending $50k to add an additional degree to our name that we don't really need. Maybe you don't put too much stock in the PANCE and it's pass rate, but at least we have a tool that is standardized; NPs don't. In contrast, the USMLE pass rate for 1st time takers graduating from US and Canadian schools was 93%In 2007. http://www.usmle.org/Scores_Transcripts/performance/2007.html Link to comment Share on other sites More sharing options...
marilynpac Posted February 6, 2011 Share Posted February 6, 2011 I have always felt the bottom line is the bottom dollar. I think Greg Cains post speak for that. Now let me tell you a story. Here in the US there is a certain subgroup that has invaded our country illegally. They work for much lower wages and have powerful lobby groups representing them(ACLU, LaRazza(sp). Those people representing those lobby groups have proclaimed they will change the political landscape of America...they have and they are. NPs have worked pretty much the same way, improving their numbers and b/c even more powerful. What have we as PAs done. We get out of school and try to find the highest paying job to start paying off our massive debt. Now it's b/c more and more difficult to find employment. With our political landscape changing rapidly it may become impossible. Our Organizations have failed us miserably, we know it and yet we continue to pay them to keep failing us. Did you know that in the state of IL, where I live, that we have to be board certified but the doctors don't???? I bet many on this forum didn't know that. With the AMA right here in Chicago the doctors in IL don't have to be board certified. Talk about a powerful lobby. When I mentioned this to a few docs they smiled and said "you PAs need better representation" My response...compared to the none we have now??? What happened in TN is just one more example of our failed lobby. How often are we going to keep throwing good money at a failed system? Would anyone care to comment??? Link to comment Share on other sites More sharing options...
LESH Posted February 6, 2011 Share Posted February 6, 2011 That test is not the USMLE. And from other postings I read, I believe their pass rate was not the greatest at 50%.http://nurse-practitioners-and-physician-assistants.advanceweb.com/News/Doctorate-of-Nursing-Practice-News/Results-for-DNP-Exam-Announced.aspx Thanks bradt Interesting article. I've been looking for that. You might be interested in this blog: http://doctorsofnursingpractice.ning.com/profiles/blogs/dnp-exam LesH Link to comment Share on other sites More sharing options...
physasst Posted February 6, 2011 Share Posted February 6, 2011 Physasst,Leave it to you to make this into a Lift vs. Right debate. That was never the point of this thread or even the one quote that you seized upon out of all of my posts here. You believe any number, poll, DNC talking point, MSNBC talking head, or whatever you want to believe. I don't care to hear it. Your opinion on any issue or discussion is informed first and foremost by your political ideology. That's fine with me - I couldn't care less what you believe. If you believe that monkeys fly; then great. All I would ask is that you not come onto a thread that I started and try to troll for an argument. Please cease and desist. Unless you live and practice in Tennessee then this doesn't have anything to do with you. If you are concerned with what this means for PAs on the national level then you should start a thread that addresses that point, get off of my thread, and stop looking for a fight. I wasn't looking for a fight..it's not about "left vs. right"..it's about facts...I was merely responding to a "claim" that you made in your post. As for me, I don't believe in any political ideology, economics perhaps, but not political. In fact, I think that political ideologies are likely the greatest problem for America...and one of the reasons we are far from a great nation anymore. The AAPA is trying to address this, but the fact remains that we are "dependent" medical providers. If you don't like that, then by all means, apply to medical school...I hear that they accept applications every year. Link to comment Share on other sites More sharing options...
physasst Posted February 6, 2011 Share Posted February 6, 2011 I have always felt the bottom line is the bottom dollar. I think Greg Cains post speak for that. Now let me tell you a story. Here in the US there is a certain subgroup that has invaded our country illegally. They work for much lower wages and have powerful lobby groups representing them(ACLU, LaRazza(sp). Those people representing those lobby groups have proclaimed they will change the political landscape of America...they have and they are. NPs have worked pretty much the same way, improving their numbers and b/c even more powerful. What have we as PAs done. We get out of school and try to find the highest paying job to start paying off our massive debt. Now it's b/c more and more difficult to find employment. With our political landscape changing rapidly it may become impossible. Our Organizations have failed us miserably, we know it and yet we continue to pay them to keep failing us. Did you know that in the state of IL, where I live, that we have to be board certified but the doctors don't???? I bet many on this forum didn't know that. With the AMA right here in Chicago the doctors in IL don't have to be board certified. Talk about a powerful lobby. When I mentioned this to a few docs they smiled and said "you PAs need better representation" My response...compared to the none we have now??? What happened in TN is just one more example of our failed lobby. How often are we going to keep throwing good money at a failed system? Would anyone care to comment??? It's not a failed lobby Marilyn....the simple fact is, WE DON'T HAVE THE NUMBERS, THE MONEY, OR THE POLITICAL POWER that either the medical or nursing lobbies have.... We likely never will. There's less than 100,000 PA's in practice....versus 800,000 physicians and over 4 million nurses. It's a numbers game....and we have the short end of the stick. Link to comment Share on other sites More sharing options...
marilynpac Posted February 6, 2011 Share Posted February 6, 2011 Hells bells forget the med school, go NP...faster, cheaper, and have it all in the end too...thanks to a powerful lobby... Link to comment Share on other sites More sharing options...
physasst Posted February 6, 2011 Share Posted February 6, 2011 with 100k members, the towel is being thrown in on getting adequate representation? its about focus, not numbers. Exactly, it is about focus, and that is what the AAPA has been doing...it seems anytime there is unfavorable legislation of language regarding PA's, the AAPA is the big bad boogeyman, and anytime favorable language is introduced into legislation, like the ACA, regarding PA's, they still aren't working hard enough. It seems that many of you simply hate the AAPA...... Link to comment Share on other sites More sharing options...
bobuddy Posted February 6, 2011 Share Posted February 6, 2011 "The AAPA is trying to address this, but the fact remains that we are "dependent" medical providers. If you don't like that, then by all means, apply to medical school...I hear that they accept applications every year" If this is the opinions of the PA's then we might as well hang it up and kiss our jobs/profession goodbye. This is not about going to medical school or not - this is about the PA's choking on the NP's dust as they leave us behind. Again and again. It is time for a name change and for us to get out from under the supervision rules that are antiquated and time to stand up for ourselves. No one else is going to - not the other "midlevels" or the MD's. It is either that, or hand over our stethoscopes and go back to school. Again. What are we waiting for??? If you think that what is happening in TN wont affect you - wrong again. Link to comment Share on other sites More sharing options...
physasst Posted February 6, 2011 Share Posted February 6, 2011 "The AAPA is trying to address this, but the fact remains that we are "dependent" medical providers. If you don't like that, then by all means, apply to medical school...I hear that they accept applications every year" If this is the opinions of the PA's then we might as well hang it up and kiss our jobs/profession goodbye. This is not about going to medical school or not - this is about the PA's choking on the NP's dust as they leave us behind. Again and again. It is time for a name change and for us to get out from under the supervision rules that are antiquated and time to stand up for ourselves. No one else is going to - not the other "midlevels" or the MD's. It is either that, or hand over our stethoscopes and go back to school. Again. What are we waiting for??? If you think that what is happening in TN wont affect you - wrong again. I support the name change...I was one of the first PA's to sign the name change statement. I don't understand the sentiment of "choking on the NP's dust".....It's not about US versus them.....and it shouldn't be. It's not about comparing PA's to NP's....it's about worrying about our own profession. I believe strongly in increased autonomy for PA's, especially in primary care, and in rural areas. But if you want to push for complete independence over time, good luck with that. I have no interest in that, and won't advocate for it....In my opinion there much bigger and more subtle battles to be fought. I'll be focusing my energies on those. Link to comment Share on other sites More sharing options...
marilynpac Posted February 6, 2011 Share Posted February 6, 2011 Michael, how many members are there in the AMA now? I hear their numbers are very low, but it remains a powerful force...maybe you don't think it's failed but tell that to the PAs in TN... Link to comment Share on other sites More sharing options...
physasst Posted February 6, 2011 Share Posted February 6, 2011 Michael, how many members are there in the AMA now? I hear their numbers are very low, but it remains a powerful force...maybe you don't think it's failed but tell that to the PAs in TN... I'm just reciting from memory, but it was less than 250,000. Considering there are over 800,000 physicians, their membership is maybe 31% or so....Additionally, IIRC, when you look at their demographics from the Master File (THE BIBLE for workforce wonks/researchers), the average age of the AMA member is fairly old...like 57 or so. Additionally, A LOT OF THEIR membership is medical students....Younger physicians are joining Sermo and their specialty groups. The AMA still has some clout, but in DC, their influence is waning. The specialty groups have much more money and firepower, and are able to focus on specific specialty related issues....THEY are the one's to watch for. Here's a quick link: http://www.medpagetoday.com/MeetingCoverage/AMA/6006 The AMA's Council on Long Range Planning and Development had more specificity. It reported that there are 1,060,333 physicians and medical students in the United States and 238,977 of them AMA members. BUT.... Of those members, 20.5% are medical students, 9% are residents, and 36.5% are 56 or older. As one delegate put it, "we have a lot of students and a lot of old docs, but not a lot of practicing physicians." Which fits with what I was remembering.... Link to comment Share on other sites More sharing options...
BigDuke06 Posted February 7, 2011 Share Posted February 7, 2011 I miss CAdams as well. We didn't agree on much politically, but I could usually count on him for good debate. I never noticed that he went too far over the line, I guess I missed it. Politics and his unwillingness to be a muzzled lapdog to certain people's views. He has no right to disagree with certain views openly on the PAF, which is not a public domain or forum. Obey the edicts of others in power or face the consequences. He and I still argue with each other over a beer and he won't change....good ridence! Link to comment Share on other sites More sharing options...
andersenpa Posted February 7, 2011 Share Posted February 7, 2011 Exactly, it is about focus, and that is what the AAPA has been doing...it seems anytime there is unfavorable legislation of language regarding PA's, the AAPA is the big bad boogeyman, and anytime favorable language is introduced into legislation, like the ACA, regarding PA's, they still aren't working hard enough. It seems that many of you simply hate the AAPA...... No. The problem is that constituent PAs don’t see any response from the AAPA on issues of importance. I get an email form the AAPA almost every day-AAPA medical watch, etc. Have I seen any report from the AAPA about this issue in Tennessee? No. Let’s look at the AAPA’s Tennessee web page. It says “Need to know what’s happening with PAs in Tennessee? Here is all the information you need.” At the time I am writing this, this page is blank. http://www.aapa.org/state-map/tennessee Google News Search for “Tennessee AAPA”: No hits. http://www.google.com/search?hl=en&rls=com.microsoft%3A*&tbs=nws%3A1&q=tennessee+AAPA&aq=f&aqi=&aql=&oq= By searching TAPA, you can find a statement: http://www.tnpa.com/tenncare2011.php I don’t need an email every day for two weeks about completing the AAPA survey; I surely don’t need another email about “medical watch” on topics that 1) don’t apply to my practice or 2) things that apply to my practice that I already know about. The leadership needs to inform the members of what they are doing or how they plan to address it. I continue to renew my membership to the AAPA and my state chapter every year. As members we expect to have the reputation (???) and financial support (???????) of our national representative body when it comes to pressing professional practice matters. Don’t reduce other PA’s criticisms of the AAPA into emotional nonsense. Link to comment Share on other sites More sharing options...
marilynpac Posted February 7, 2011 Share Posted February 7, 2011 I don't hate the AAPA Michael, but it safe to say many of us are extremely disappointed. We feel we have been let down and the TN situation is just another example of that. I could see this happening in the early 90s, but not now...this is a major step backward. I'm sure if you were a PA in TN you would feel the same way.. Link to comment Share on other sites More sharing options...
Davidson25 Posted February 7, 2011 Share Posted February 7, 2011 I have been busy contacting our governor, the AAPA, my fellow classmates, and other PAs I know regarding the issue taking place here in TN. I have yet to receive a response from anyone at the governor's office but the AAPA replied just a bit ago. In essence, the person told me that AAPA is working hard to get PAs recognized as providers again and that the best thing I can do is contact my state legislature regarding the issue. Link to comment Share on other sites More sharing options...
physasst Posted February 8, 2011 Share Posted February 8, 2011 No. The problem is that constituent PAs don’t see any response from the AAPA on issues of importance. I get an email form the AAPA almost every day-AAPA medical watch, etc. Have I seen any report from the AAPA about this issue in Tennessee? No. Let’s look at the AAPA’s Tennessee web page. It says “Need to know what’s happening with PAs in Tennessee? Here is all the information you need.” At the time I am writing this, this page is blank. http://www.aapa.org/state-map/tennessee Google News Search for “Tennessee AAPA”: No hits. http://www.google.com/search?hl=en&rls=com.microsoft%3A*&tbs=nws%3A1&q=tennessee+AAPA&aq=f&aqi=&aql=&oq= By searching TAPA, you can find a statement: http://www.tnpa.com/tenncare2011.php I don’t need an email every day for two weeks about completing the AAPA survey; I surely don’t need another email about “medical watch” on topics that 1) don’t apply to my practice or 2) things that apply to my practice that I already know about. The leadership needs to inform the members of what they are doing or how they plan to address it. I continue to renew my membership to the AAPA and my state chapter every year. As members we expect to have the reputation (???) and financial support (???????) of our national representative body when it comes to pressing professional practice matters. Don’t reduce other PA’s criticisms of the AAPA into emotional nonsense. That's a fair criticism Andersen...as someone on one of the leadership councils, I am going to pass this recommendation on to James Potter and Michael Powe. I'll let you know, and everyone here, what I hear. Link to comment Share on other sites More sharing options...
bobuddy Posted February 10, 2011 Share Posted February 10, 2011 http://www.knoxnews.com/news/2011/jan/28/300m-tenncare-cut-planned/ According to this article above, these budget cuts were actually proposed LAST YEAR but were never implemented. The article reads: "The benefit cuts were originally planned by former Democratic Gov. Phil Bredesen last year, but they were delayed through a combination of federal stimulus money, prescription refunds and a temporary fee on hospitals." So, if I am reading this correctly - the AAPA actually had a year to address this issue of PA's being optional providers - but didnt????? I cant remember in all of the different threads/posts I have been reading if this has been brought up before. Due to the financial, housing and employment crisis nationwide - every state budget that I know of is hurting. If we think TN is the only state government that is looking hard at their bottom line we are deluding ourselves. We need to make sure that PA's are mandatory practitioners in every state or we are in more trouble than we realize. Link to comment Share on other sites More sharing options...
Fairmeadow Posted February 10, 2011 Share Posted February 10, 2011 http://www.knoxnews.com/news/2011/jan/28/300m-tenncare-cut-planned/ According to this article above, these budget cuts were actually proposed LAST YEAR but were never implemented. The article reads: "The benefit cuts were originally planned by former Democratic Gov. Phil Bredesen last year, but they were delayed through a combination of federal stimulus money, prescription refunds and a temporary fee on hospitals." So, if I am reading this correctly - the AAPA actually had a year to address this issue of PA's being optional providers - but didnt????? I cant remember in all of the different threads/posts I have been reading if this has been brought up before. Due to the financial, housing and employment crisis nationwide - every state budget that I know of is hurting. If we think TN is the only state government that is looking hard at their bottom line we are deluding ourselves. We need to make sure that PA's are mandatory practitioners in every state or we are in more trouble than we realize. You are absolutely correct. It came up last year. The Tennessee Hospital Association agreed, actually suggested a self imposed tax to stave off cuts. It was a win-win, because, if the cuts had occurred and they had not gotten the Tenncare patients, the hospitals would have lost the matching Federal funds. They have proposed to do the same this year, hoping that the economy will improve over the next year. The state legislature has to approve it. I can't imagine them not approving it. Anytime anyone comes to you as a legislator suggesting that you tax them more, you jump at it. So, AAPA sat on it a year. Will they sit on it another year? Are they clueless? Link to comment Share on other sites More sharing options...
DrPA Posted February 11, 2011 Share Posted February 11, 2011 AAPA article: http://www.aapa.org/advocacy-and-practice-resources/reimbursement/2538-tennessee-medicaid-proposal-threatens-pas Link to comment Share on other sites More sharing options...
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