Innovations in Healthcare w/o PAs

[primadonna22274]

Oh you bet. One of the reasons I chose my residency is because our hospital we will be hosting the new PA program to start in 2016--only the 2nd in the state (SC) and long overdue. I hope to guest lecture, take PA students on rotation, consult on curriculum and hopefully work up to Medical Director ;)

[wjm7]

Prima, a question: How many years of experience do you think a PA should have before applying to LECOM?

 

Discussions like these make it seem more and more likely that I will eventually return to school for DO or MD.

[Guest Paula]

Has anyone actually sent this to AAPA yet?

 

I'm devising a letter right now and will be sending soon.  Will be cc-ing to a bunch of AAPA folks so it goes to more than one person. 

[primadonna22274]

Prima, a question: How many years of experience do you think a PA should have before applying to LECOM?

 

Discussions like these make it seem more and more likely that I will eventually return to school for DO or MD.

A minimum of 3. Enough to have significant patient care experience and build on your knowledge, and early enough to know you're hungry for more.

It becomes much, much harder to go back after a longer career. I tried to talk myself out of it for a decade and finally went back in year 11. A little bit nuts and financially very challenging but I survived!

[wjm7]

Yeah, I anticipate it would present quite a few difficulties.  I might consider it once I've paid off my loans (likely a year or so past the 3 years experience mark), though my future wife (currently engaged) might not love the idea!

 

I'm curious, do you know anyone that attended the Seton Hill campus?  Are you aware of any particular positives/negatives of that option?  I'm actually most interested in the self-directed study as I enjoyed learning in a similar manner during my previous, basic science heavy Master's degree.  But I would consider the PBL at Seton Hill to be close to family.

 

Hoping there will be multiple bridge options by the time I'm considering going back to school, but I haven't heard of any others in the works.  Hopefully that will change.

[primadonna22274]

One of the 7 PAs in our inaugural class chose Seton Hill. He has a wife and kid and I think worked part-time in his previous job. I don't know him well as we rarely saw each other but he seems quite happy and matched ACGME Anesthesia at Rochester, NY.

[ventana]

so where do I sign up for that PA--> DNP program??

[dmdpac]

I'm devising a letter right now and will be sending soon.  Will be cc-ing to a bunch of AAPA folks so it goes to more than one person. 

 

Thanks, Paula.

[GetMeOuttaThisMess]

Here's a question for thought.  I've seen quite a change in this profession during my 30 or so years.  Do we recognize this profession thirty years from now?  Does it still exist?  Has it been swallowed up by the nurses?

[Guest Paula]

Here's a question for thought.  I've seen quite a change in this profession during my 30 or so years.  Do we recognize this profession thirty years from now?  Does it still exist?  Has it been swallowed up by the nurses?

 

You ask a pertinent question and I have wondered the same thing myself.  It appears NPs have gotten the recognition as PCPs and thought leaders are starting to accept their place in that venue.  It makes me wonder if the PAs will truly end up being glorified licensed medical assistants that DNPs will eventually gain rights to supervise?  And then make money off of us?  Does anyone feel chained at times?  I do.  Not in my job but by restrictions and the movement forward of the NP profession.

 

The IOM report was and is instrumental piece of research that has made NPs recognized.  I first heard of it several years ago shortly after it was published and heard Donna Shalala discuss it on Wisconsin public radio.  I was stunned and my first thought was...oh,, oh....what about PA's?  Mind you, this was before I was part of PAFT, had never heard of the "name change" group, was still an AAPA member.  For some reason the radio broadcast made me sit up and take notice of the PA profession and where we were going.  Then I learned of he HITECH act, sent letters to AAPA about that and the rest is history about that debacle.  Then I learned of name change and now I am a revolutionary    (sitting here on my computer!!!).  

 

Honestly, people we need to organize and put a strong front together to protect and push PA-dom ahead.  I do believe AAPA has listened to us and it has been under duress.   Are you listening AAPA?

 

I sent the letter and I think it is lost in cyberspace as there was a glitch on my server.  Not sure if it got to the recipients and I can't find it anywhere in my files.  So I plan on calling AAPA tomorrow to see if it was received.  Otherwise it is back to the drawing board.  Frustrated. 

[Amina]

so where do I sign up for that PA--> DNP program??

It will be a sad sad day if this ever comes to fruition. 

[dmdpac]

Is there a link to the video in question?  I'm thinking the more people who bring it to AAPA's attention the better chance we have of really making them aware of the situation.  (What they'll do with it, however, is a separate question.)  I've done a little looking around and haven't found what I think is the same video as mentioned in the OP.

[discogenic]

Nursing  derives much of its influence from its large numbers.  While PAs will never match those numbers, there are many new PA programs slated to come into existence in the very near future, which will consequently increase the number of PAs.  Will this growth of the PA profession help us politically?  (We can leave the discussion as to whether increasing PA numbers will create future employment and salary problems for another thread.) 

[Guest Paula]

Is there a link to the video in question?  I'm thinking the more people who bring it to AAPA's attention the better chance we have of really making them aware of the situation.  (What they'll do with it, however, is a separate question.)  I've done a little looking around and haven't found what I think is the same video as mentioned in the OP.

 

I've been looking too.  To the OP:  Do you know where a copy of the video can be found? 

[LIPPER]

So, I heard NPs mentioned at least 100 times. PAs? Not once. Not even alluded to ("Midlevels"). Absolutely nothing. There is a problem here folks. We are not on the radar of the thought leaders at this juncture..

NOTE; I quoted what was said, not at all interested/concerned about who posted it

 

 

First is it possible the PA's weren't mentioned due to the fact that the two issues you mentioned; Minute Clinics And Telemedicine are areas PA's really don't participate in? Maybe this is less about ignoring PA's and more about defending NP's as legitimate providers?

 

I don't see a title change a key to solving this problem....- absolutely not on anyone else's radar. I'd be willing to bet if someone chose to communicate with those lecturers, changing our title wouldn't be at the top of their solutions list...

 

 

Sent from my iPhone using Tapatalk

[KMD16]

Gravely concern that the profession will be face out. Their agenda and noises seem to finally stick. I've said this time and again here for a push for doctorate program + better scope of practice. Join PAFT.

[jmj11]

Here is one of the lectures, this on on Retail Clinics. You must listen to the end to see the conclusion:

[Guest Paula]

I just listened to the program.  One statement made near the end was that some retail clinics are considering expansion to caring for select chronic care issues such as HTN, DM and asthma.  Also co-branding of retail clinics with a health system may be a setting for patients to get care and stay within a primary care practice.  An example would be Mayo clinic partnering with Minute Clinics sharing EHRs and PCPs.   NPs were mentioned that their quality of care and outcomes are the same as MDs including the care they give in a PC office....not just a Minute Clinic.

 

Scope of practice, government regulations and health plans are the de facto regulators that impede NPs.  The speaker made a joke about physician supervision for NPs that must have a collaborative agreement and that a doc hired to review charts is a waste of a physician's time.

 

No mention of PAs yet we know that PAs work in retail clinics too.  Maybe not as much because of the supervision requirement BUT disruptive innovations in health care is happening around us.  We aren't at the table. 

[winterallsummer]

Ultimately the future of the profession IMHO and relatively inexperienced view will be decided more so by market, non clinical business execs, and insurance companies. While events like this are as upsetting to me as anyone, I am not ready to jump on the doom bandwagon just yet. Visit forums for NP, DO, any specialty - everyone is pessimistic. NPs have their own hindarences in many states, med students are not getting residencies, DOs are facing osteopathic board issues, etc. doom is everywhere.

 

The numbers and trends however are still on our side. And the unrolling of ACA is going to be unpredictable as far its direct impact on our profession. The other thing is many negative press for PAs gets posted here and replied to with 2+ pages but positive changes are quickly forgotten. Salaries and positions are still up trending unless I'm mistaken. And hopefully rural spots will always be a safety net. Anyway all I am saying is things need to be kept in perspective. Props to jmj who has been a long time leader for PAs.

[Guest Paula]

NOTE; I quoted what was said, not at all interested/concerned about who posted it First is it possible the PA's weren't mentioned due to the fact that the two issues you mentioned; Minute Clinics And Telemedicine are areas PA's really don't participate in? Maybe this is less about ignoring PA's and more about defending NP's as legitimate providers? I don't see a title change a key to solving this problem....- absolutely not on anyone else's radar. I'd be willing to bet if someone chose to communicate with those lecturers, changing our title wouldn't be at the top of their solutions list... Sent from my iPhone using Tapatalk

 

It's possible PAs are not mentioned because of the Minute clinic connection. However, the video briefly discussed NPs as quality care providers in primary care, not just in MInute clinics.  Plus a brief discussion of Minute clinics to expand into a chronic care model for certain conditions.  PAs are  not on the radar because we are not LIPs and must have a supervising physician in all states.    The key to solving the problem is for PAs to be Licensed Independent Providers. 

[ventana]

so where do I sign up for that PA--> DNP program??

 

 

It will be a sad sad day if this ever comes to fruition. 

 

if you can't beat em join em.....

[GetMeOuttaThisMess]

Neither are NPs in Texas but that doesn't seem to be holding them back in the pharmacy clinics. It all goes back to perception since reality in Tx is that they're as hamstrung by guidelines as PAs.

[EMEDPA]

TX is one of the few states that requires NPs to work in the field in which they were trained(which makes sense).

lots of places use FNPs in hospital settings and in areas in which they have no training...

[KMD16]

Ultimately the future of the profession IMHO and relatively inexperienced view will be decided more so by market, non clinical business execs, and insurance companies. While events like this are as upsetting to me as anyone, I am not ready to jump on the doom bandwagon just yet. Visit forums for NP, DO, any specialty - everyone is pessimistic. NPs have their own hindarences in many states, med students are not getting residencies, DOs are facing osteopathic board issues, etc. doom is everywhere.

 

The numbers and trends however are still on our side. And the unrolling of ACA is going to be unpredictable as far its direct impact on our profession. The other thing is many negative press for PAs gets posted here and replied to with 2+ pages but positive changes are quickly forgotten. Salaries and positions are still up trending unless I'm mistaken. And hopefully rural spots will always be a safety net. Anyway all I am saying is things need to be kept in perspective. Props to jmj who has been a long time leader for PAs.

First of all, I respect your being optimistic. When you said " med students are not getting residencies, DOs are facing osteopathic board issues" mind to provide or reference the source of your data? Last I check, 94% 4th year med student matched in their chosen specialties. Most likely, a large portion those that did not match wanted the ROAD specialty. A lots of these med students doesn't want to go into primary care. Now, if NPs are recognized as LIP and at the forefront of primary care, and are supported/advocated for by these well recognize/renounced larger academic medical center like mayo clinic, without the mentioning of PAs, then, we are screwed! It's just a matter of time, our referral base for those of us in specialty/subspecialty would comes from NPs aka LIP aka forefront of primary care. Primarily, NPs in retail clinic are being utilized for common illnesses. Now, there's a talk for expanding services at these retail clinic where these NPs could manage chronic disease condition/playing the role of PCP w/ no MD/DO supervision. Our training are way superior than NPs/DNP training. As you can see, the NPs are being embraced and the doors are constantly being shot at our face. If none of what I've said here makes sense. Then, never mind. I just finished a 12hrs shift solo coverage as an assistant to the doctor in the middle of no where.

[GetMeOuttaThisMess]

TX is one of the few states that requires NPs to work in the field in which they were trained(which makes sense).

lots of places use FNPs in hospital settings and in areas in which they have no training...

 

At least the state got something right...well, they did approve tort reform several years back and several recent changes have taken place to arguably lessen restrictions (not sure that I buy it), but all in all, it still seems to me like it's putting lipstick on a pig.