We fall behind again

[LT_Oneal_PAC]

New Connecticut Bill passes senate allowing NPs to practice independently after 3 years of collaborative practice with a physician. It makes it the 18th state, including DC, to allow NP independent practice. Good for them. Too bad it wasn't us.

[WIPA-C]

All these bills are really depressing for me. I will be starting PA school in August, and sometimes I can't help but feel as if I made a bad decision. I need some positive news with regards to the PA profession!!

[cinntsp]

Why would assistants be allowed to practice independently? :|

 

Please join PAFT folks. We are fighting to bring this profession out of the shadows.

 

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[Guest Paula]

All these bills are really depressing for me. I will be starting PA school in August, and sometimes I can't help but feel as if I made a bad decision. I need some positive news with regards to the PA profession!!

 

Students like you will make a difference if you do not join the status quo.  Work hard, prove yourself that you are not an assistant and start the dialog with other students once your classes start.  Inform yourself with state laws and join  your state chapter.  Do not allow the naysayers to derail you from advancing the profession.  We can all make a difference in our profession when we decide to get involved.  PAs can start to push for collaborative practices with complete autonomy after 3 years just like the CT NPs.  It will take only one state to gain LIP status for PAs and the rest will eventually fall. 

[discogenic]

From the standpoint of the CT lawmakers, what is it that places NPs front and center while PAs seem to get no notice?  Is it purely lobbying efforts?  Are we that invisible?  And one would think that state legislators are sophisticated enough to look beyond our title (not saying that "assistant" is the greatest title, mind you), whereas the same argument can't always be made for the general public.  Or is there another sticking point that makes these lawmakers say 'nope, the PAs aren't ready for prime time because X, Y or Z'.  What are X, Y and Z?? 

 

What is it that NPs present to these folks that makes them appear so superior to us, so much so that they get this kind of legislation and we aren't even at the table?  It can't be education or clinical excellence.

[Joelseff]

From the standpoint of the CT lawmakers, what is it that places NPs front and center while PAs seem to get no notice? Is it purely lobbying efforts? Are we that invisible? And one would think that state legislators are sophisticated enough to look beyond our title (not saying that "assistant" is the greatest title, mind you), whereas the same argument can't always be made for the general public. Or is there another sticking point that makes these lawmakers say 'nope, the PAs aren't ready for prime time because X, Y or Z'. What are X, Y and Z??

 

What is it that NPs present to these folks that makes them appear so superior to us, so much so that they get this kind of legislation and we aren't even at the table? It can't be education or clinical excellence.

Just a guess but likely their Millions militant lobbyists?

 

And about title. In California, I was told our Corporations Code prohibits PAs from being a principal in a practice because we are assistants. This was what I was told when I tried to become a partner in my practice a few years ago, by the state board.

 

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[marktheshark89]

The governor's mother was a nurse, many people think that has a lot to do with it as well. ConnAPA stance was initially to oppose, but once it became a foregone conclusion that it would pass (and the nurses refused to add PAs to the bill or conversation) they decided to remain neutral with the hopes that PAs can soon follow the precedent of NPs as has usually been the case in CT. Also, at least among CT law makers, the "assistant" being in the professional title causes a lot of lost face validity for lack of a better term. 

[primadonna22274]

Actually I think the way this bill was worded offers a pathway that state PA societies could follow to draft their own bill. It took us several tried to get schedule II rx privileges for PAs in Oregon but eventually we gained enough support and the bill passed. This was about 10 years ago lol. I think this seems like a positive model to move to advanced/independent practice for PAs.

[KMD16]

^^ agreed. Such moves possible. But guess which group would strike it down? The NPs army of lobbyist. Particularly, if they already have an upper hand in the state of CT. Similar event is in play in OH. We are fighting three wars ( BOM, NPs lobbyist & individual state legislation).

[LT_Oneal_PAC]

Actually I think the way this bill was worded offers a pathway that state PA societies could follow to draft their own bill. It took us several tried to get schedule II rx privileges for PAs in Oregon but eventually we gained enough support and the bill passed. This was about 10 years ago lol. I think this seems like a positive model to move to advanced/independent practice for PAs.

This same model has been in Maine for NPs for years.

[LT_Oneal_PAC]

^^ agreed. Such moves possible. But guess which group would strike it down? The NPs army of lobbyist. Particularly, if they already have an upper hand in the state of CT. Similar event is in play in OH. We are fighting three wars ( BOM, NPs lobbyist & individual state legislation).

I doubt very much they (NPs) would oppose it, since it would shooting themselves in the foot. The medical boards and lobbyist would have a field day.

[Timon]

I doubt very much they (NPs) would oppose it, since it would shooting themselves in the foot. The medical boards and lobbyist would have a field day.

Nursing board opposes everything in CA. Most recently they opposed SB352 which allowed MAs to be supervised by a PA.

[LT_Oneal_PAC]

Nursing board opposes everything in CA. Most recently they opposed SB352 which allowed MAs to be supervised by a PA.

 

I doubt that very seriously, though I understand the human urge and the political advantage when things aren't going to plan to have a bogeyman to blame it all on. They opposed MAs in hospitals, as they didn't want them taking jobs from nurses. They did not oppose PAs supervising MAs in the clinic, which is where MAs work anyway. Once the "in hospital" section was dropped, so did the opposition.

[Timon]

Correct me if I'm wrong, I thought MAs were overseen by the Nursing Board?

[LT_Oneal_PAC]

Correct me if I'm wrong, I thought MAs were overseen by the Nursing Board?

Most states don't really regulate them. In CA, they are regulated by the BOM, I believe. I'm sure this varies by a state.

[LT_Oneal_PAC]

Correct me if I'm wrong, I thought MAs were overseen by the Nursing Board?

"This summary covers current (as of Sept 2013) scope of practice for Medical Assistants (MAs) in the state of California. In California, MAs are unlicensed personnel who work in physician (MD), podiatrist (DPM), or optometrist (OD) offices; and clinics. MAs may not work for inpatient care in licensed general acute care hospitals. They are regulated by the Medical Board of California. They must be over 18 years old, trained and supervised. They may be certified. Unless prohibited by law, California MAs can perform basic administrative, clerical and technical supportive services when conditions regarding supervision, training, specific authorization, and records are met. This summary covers MAs in physician and podiatrist offices and in clinics, but does not cover scope of practice for MAs in optometrist or opthamologist offices."

[LT_Oneal_PAC]

According what I have found, they aren't even allowed in hospitals, which explains why nursing didn't want the "supervise MAs in hospital" in the bill.

[Timon]

Excellent! Thanks for the clarification Oneal!

 

It's easy to just say "Oh.. here they go again.. someone trying to restrict / not give us more autonomy" and then you find out it had nothing to do with that. Makes feel better to know it wasn't a stab against the PAs and it was more so to correct a technicality.

 

=o)

[KMD16]

I doubt very much they (NPs) would oppose it, since it would shooting themselves in the foot. The medical boards and lobbyist would have a field day.

They've oppose us since inception and they will continue to do so. Case in point, in the state of Ohio.

[LT_Oneal_PAC]

They've oppose us since inception and they will continue to do so. Case in point, in the state of Ohio.

so I'm confusing my states. When taox mention the opposition for supervising MAs in CA, I was actually thinking of what went down in Ohio. So taox, I don't know what happened in CA. I'm sorry I confused my states with such a similar issue. Perhaps they were against us, but I imagine the actual situation is more complicated as usual.

 

It was Ohio that they opposed the supervision of MAs in hospital. They didn't even ask for this themselves because they flat don't want MAs in hospital. In the end, the NPs dropped their opposition after the wording was removed for in Hospital supervision of MAs.

 

They weren't against us , they were against MAs.

[KMD16]

^^. not referring to MA. Was referring to current piece of legislation that would allow better scope of practice for Ohio PAs.

[LT_Oneal_PAC]

^^. not referring to MA. Was referring to current piece of legislation that would allow better scope of practice for Ohio PAs.

And which bill is that? You'll have to provide proof of it to me because the latest ohio HB 412 passed this month out of committee and is exactly the one I'm talking about. Still needs to go before the house. Until you tell me the specific bill, I'm going to assume you are confused.

[LT_Oneal_PAC]

^^. not referring to MA. Was referring to current piece of legislation that would allow better scope of practice for Ohio PAs.

here is exactly what they oppose, straight from their mouths.

 

"HB 412 goes well beyond what ONA agreed to in HB 301. In essence, PAs would have the authority, derived from their supervising physician, to delegate any and all medication administration to an unlicensed individual. There are no limitations to venue, drug class, or method including IVs. If this bill were enacted, a physician assistant could delegate to an unlicensed worker the ability to administer a controlled substance in the hospital."

 

Here is 301, where you can see they aren't treating themselves any differently:

 

" HB 301. The legislation will grant APRNs holding a certificate to prescribe the authority to delegate medication administration to non-nurses as long as the route of administration is not intravenously and the medication is not a controlled substance. The APRN must be physically present at the location where the drug will be administered and the APRN shall ensure that the unlicensed person has the knowledge, skills and ability to administer the medication, which is also required by the employer. The delegation cannot occur in the inpatient care unit of a hospital or a freestanding or hospital emergency department."

 

This language has since been changed to not included in-hospital and they have now dropped their opposition.

[KMD16]

I take issues with such opposition. And, we all should. I take issues with this primarily because it's a behavior in the past and still is. Now, show me a piece of legislation put out by NPs that PAs had opposed in the past?

[LT_Oneal_PAC]

I take issues with such opposition. And, we all should. I take issues with this primarily because it's a behavior in the past and still is. Now, show me a piece of legislation put out by NPs that PAs had opposed in the past?

Um, the bill in the OP was initially opposed. Is that recent enough?