archerry Posted March 18, 2011 Share Posted March 18, 2011 IMHO, the best lobbying can be done by the state organizations. The state PA organization in NC is well funded by high membership rates compounded by the length of time we have been active in the state. Join your local organization if you are not a member and voice your opinion to your elected representatives if you want change. How is the political climate in NC so far as potential legislative changes? Such as a National level push focused at the NC State level for two basic name changes: professional title and inter-professional agreements. Link to comment Share on other sites More sharing options...
marilynpac Posted March 18, 2011 Share Posted March 18, 2011 IMHO, the best lobbying can be done by the state organizations. The state PA organization in NC is well funded by high membership rates compounded by the length of time we have been active in the state. Join your local organization if you are not a member and voice your opinion to your elected representatives if you want change. Then that must be the difference. In IL we have the AMA right in Chicago, the UnivofIL has 3 schools, one in Chicago and one in Springfield. The reason I mention this b/c the UofI has the NP program and promises them employment upon graduation. Two very powerful lobbies and we are outgunned and outmaned. Link to comment Share on other sites More sharing options...
bobuddy Posted March 18, 2011 Share Posted March 18, 2011 =Contrarian;289778 Here a NP could open a Infusion clinic, Acute Care/Walk-in Clinic or weight loss clinic and not need a SP. If the PA wanted to do this, they still could, but would need a SP. Thing is that if the PA is nationally certified, and experienced, then there is NO chart review requirement here. This certified and experienced PA-C could simply file a practice plan with the state as a "remote-site" which requires that the SP only be on the clinic site ~10% of the time. If the PA-C opens his/her clinic, hires a SP and sets up a standing bi-weekly lunch appointment then the SP only needs to come to the clinic 24 times/yr to pick up their retainer/consultant fee... A dear PA friend of mine - also lives in KY - got around our state regulations of "No PA can own a practice" by she owning 49.9% of her business, her husband owning 50.1%. She "employs" a SP to sign her charts and gives him 10%???? ( I think) of the revenue collected. Working out for her pretty good so far. She is the first PA in the state of KY to do this and the Kentucky Medical Board did not know what to do with her :) Link to comment Share on other sites More sharing options...
discogenic Posted March 18, 2011 Share Posted March 18, 2011 A dear PA friend of mine - also lives in KY - got around our state regulations of "No PA can own a practice" by she owning 49.9% of her business, her husband owning 50.1%. She "employs" a SP to sign her charts and gives him 10%???? ( I think) of the revenue collected. Working out for her pretty good so far. She is the first PA in the state of KY to do this and the Kentucky Medical Board did not know what to do with her :) There is only 1 PA in the whole state that owns a practice? I guess PA's owning the practice is pretty rare. Is this true nationwide? What's the limiting factor: finding an SP? Startup money? State laws? Link to comment Share on other sites More sharing options...
marilynpac Posted March 18, 2011 Share Posted March 18, 2011 I truly believe if that happened in IL the AMA would shut it down and look for an excuse/reason after the fact. They sent out letters in the late 90s telling the docs of IL not to hire midlevel. In the letter they also promised the docs that they(AMA) would never allow midlevel to gain any ground in the state of IL. While they were protecting their doctors from midlevel a much more sinister/evil force was lurking around the corner...the trial lawyer. Malpractice ins premiums flew to the sky, we lost a doc every 3 days from this state, usually a specialist. Now the once powerful Chicago, the mecca for healthcare is no more. People go to Mayos, and Iowa City and take all the revenue with them out of IL. The powerful nursing lobby didn't let a crisis go to waste and moved in quickly. PAs were shut out cold. I love your post bobuddy, it makes my mouth water... Link to comment Share on other sites More sharing options...
bradtPA Posted March 18, 2011 Share Posted March 18, 2011 How is the political climate in NC so far as potential legislative changes? Such as a National level push focused at the NC State level for two basic name changes: professional title and inter-professional agreements. I am not sure, but I will try to talk my former program director who was voted to lead the organization this year and see what he thinks can be done locally.... Link to comment Share on other sites More sharing options...
bobuddy Posted March 18, 2011 Share Posted March 18, 2011 There is only 1 PA in the whole state that owns a practice? I guess PA's owning the practice is pretty rare. Is this true nationwide? What's the limiting factor: finding an SP? Startup money? State laws? The easier part for her is that she is doing LTC work - so she has almost no overhead. No nurses or front office staff to employ. No building to rent. She pays her own malpractice. She bought a computer and hired someone a few hours a month to do her billing for her. What JMJ is doing in WA is far more complicated than what she is doing. It has been quite a headache for her - to actually GET PAID by medicare/medicaid, etc. and she continues to struggle with this. However, what may ultimately shut her down is the mandatory EMR coming in the near future. She cannot afford to do this and figures with medicare cuts in reimbursement, she might as well just fold up and go work for someone else. Marilyn - I am sorry to hear about IL. I grew up on the south side of Chicago - and after reading your posts - I know it would be impossible to go home again. Where in IL are you located? Link to comment Share on other sites More sharing options...
Contrarian Posted March 18, 2011 Share Posted March 18, 2011 The easier part for her is that she is doing LTC work - so she has almost no overhead. No nurses or front office staff to employ. No building to rent. She pays her own malpractice. She bought a computer and hired someone a few hours a month to do her billing for her. What JMJ is doing in WA is far more complicated than what she is doing. It has been quite a headache for her - to actually GET PAID by medicare/medicaid, etc. and she continues to struggle with this. If you go back and read some of my earlier posts (Circa 2004-2005) you will see that I too did this EXACT same thing here in this state. I Incorporated (PrimeCare PLLC), bought Tablet Computers with cellular internet, bought Smartphones, used Internet Fax (WinFax), had a few Phone lines set up in my home office, Designed Letterhead, bought a AWD fuel efficient Subaru, bought Malpractice Insurance, etc. I then contracted with a Physician for "Sponsorship." I built up my patient panel to ~ 600 patients. I was consistently seeing 10-15 patients per day which is actually considered a lot for doing HouseCalls. Problem was that they were all Medicare/Medicaid patients and Medicare/aid would only pay direct to a MD or NP. They wouldn't even discuss contracting directly with PrimeCare (my PLLC)... So at the end of that yr... after all bills were paid... I made $12k... :sadface: It was time to get a job...!!! So I did a 90 day Locum in Iraq for $70k, then 180 days in Afghanistan for $126k, then 13 months in Sudan for $196k... However, what may ultimately shut her down is the mandatory EMR coming in the near future. She cannot afford to do this and figures with medicare cuts in reimbursement, she might as well just fold up and go work for someone else. Nahhh.... Tell her to buy a Tablet PC and use Medtuity EMR. Its tablet based, point and click and FREE to install. It costs $0.75 per NEW Encounter. (see here) I grew up on the south side of Chicago Where...??? I grew up in Altgeld Gardens (130th), and in Englewood (65th St.) Contrarian Link to comment Share on other sites More sharing options...
marilynpac Posted March 18, 2011 Share Posted March 18, 2011 I'm by Starved Rock...everyone from Chicago knows where that is... Link to comment Share on other sites More sharing options...
bobuddy Posted March 18, 2011 Share Posted March 18, 2011 Richton Park/ Matteson/Park Forest area. I went to St. Xavier University for undergrad - South Side Irish rules! :) Link to comment Share on other sites More sharing options...
Hemegroup Posted March 18, 2011 Share Posted March 18, 2011 YOU don't get to dictate to me how I respond. Right back at ya ;) Might not want to get on your bad side tho, because after those gigs overseas, dude is loaded. Hook a brother up! Link to comment Share on other sites More sharing options...
Joelseff Posted March 18, 2011 Share Posted March 18, 2011 @Heme: yah I know I saw that on contrarians post about the overseas gigs and I was like, "Hmmm....What am i doing in the next 180 days that's SO important????" lol whew thats righteous bucks! Hey Contrarian, Is that TAX-Free since its overseas? Link to comment Share on other sites More sharing options...
rcdavis Posted March 18, 2011 Share Posted March 18, 2011 @Heme: yah I know I saw that on contrarians post about the overseas gigs and I was like, "Hmmm....What am i doing in the next 180 days that's SO important????" lol whew thats righteous bucks!Hey Contrarian, Is that TAX-Free since its overseas? I'll take that c, If you go ex- pat while doing contract work overseas, you can be exempt from taxes if and only if you stay outside on CONUS for most of the year. The current rules require that you cannot be in conus any more than 29 days in a calendar year to be eligible for the tax break. And those days include ports of entry into the US. Link to comment Share on other sites More sharing options...
bobuddy Posted March 18, 2011 Share Posted March 18, 2011 @Heme: yah I know I saw that on contrarians post about the overseas gigs and I was like, "Hmmm....What am i doing in the next 180 days that's SO important????" lol whew thats righteous bucks!Hey Contrarian, Is that TAX-Free since its overseas? HAHA - that is the same thought I had too...... :) Link to comment Share on other sites More sharing options...
Contrarian Posted March 18, 2011 Share Posted March 18, 2011 Can only spend ~35 days CONUS for the tax break which is ONLY the first $80k tax free. The rest is taxed at the normal rate. So the yr I made $196k... I was officially taxed on $116k. To exceed my 35 days CONUS ... I had my Family meet me in Vancouver BC a couple times (we only live 40 min away). Keep in mind that It wasn't free money... There was some training, shooting & being shot at involved. Joelseff check out the hat... :wink: [ATTACH=CONFIG]737[/ATTACH] [ATTACH=CONFIG]736[/ATTACH] Link to comment Share on other sites More sharing options...
andersenpa Posted March 18, 2011 Share Posted March 18, 2011 [ATTACH=CONFIG]733[/ATTACH] [ATTACH=CONFIG]734[/ATTACH] Welch-Allyn is making some pretty aggressive looking oto-opthalmoscopes nowadays..... Link to comment Share on other sites More sharing options...
Joelseff Posted March 19, 2011 Share Posted March 19, 2011 I cant get the attachments to open C! I wanna see.... Link to comment Share on other sites More sharing options...
Joelseff Posted March 20, 2011 Share Posted March 20, 2011 The hat goes well with the umm..."Otoscope" LOL :=D: Link to comment Share on other sites More sharing options...
Contrarian Posted March 20, 2011 Share Posted March 20, 2011 Welch-Allyn is making some pretty aggressive looking oto-opthalmoscopes nowadays..... Yeah... but if used correctly... I could see -->CLEAR THRU -->to the other side... :;;D: Link to comment Share on other sites More sharing options...
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