More good news for NPs...

[ICRob0351]

As a soon to be PA that will be practicing in CT, can someone explain to me how providers with significantly less training than PAs can now practice completely independently? Who decides their scope of practice? How is this regulated? This makes absolutely no sense to me. What does this mean for our profession? 

 

http://www.medscape.com/viewarticle/824465

[Lexapro]

Can't see the article, but I believe you're referring to the fact that CT is about to grant independent practice to NPs? I believe there's a 2 year of supervision requirement...

[Guest Paula]

NPs have a powerful nursing lobby, the IOM report, the Governors report, AARP, and skilled lobbyists all who have contributed to the marketing of NPs.  Their goal is to achieve complete practice authority (independence from another profession) by 2020.  They are nearly half-way there.  They were able to negotiate in CT and I think NJ or NY for independence after a certain amount of practice hours supervised by a physician or another NP.

 

They are regulated by the nursing board. 

 

What does this mean for our profession?  Less jobs? Less pay? Assistantship forever? No more rural or underserved areas will hire PAs in full-practice authority states? I don't know anymore.

[ICRob0351]

Can't see the article, but I believe you're referring to the fact that CT is about to grant independent practice to NPs? I believe there's a 2 year of supervision requirement...

Yes - You are correct. I'm just having a hard time wrapping my mind around how this works. What is the scope of practice? Is it family medicine only? Where are PAs supposed to fit in? No one can argue that PAs have superior clinical training, and yet they can't even convince local and federal legislatures to allow a name change that more appropriately reflects what the PA does. PAs were created to provide healthcare to rural/under-served areas - it just seems like we're not moving in the right direction. It's more than a little discouraging.

[cinntsp]

No one can argue that PAs have superior clinical training, and yet they can't even convince local and federal legislatures to allow a name change that more appropriately reflects what the PA does.

 

Nobody has tried.  We can't even convince the people within our own profession first so that we can take that next step.

[Guest Paula]

Yes - You are correct. I'm just having a hard time wrapping my mind around how this works. What is the scope of practice? Is it family medicine only? Where are PAs supposed to fit in? No one can argue that PAs have superior clinical training, and yet they can't even convince local and federal legislatures to allow a name change that more appropriately reflects what the PA does. PAs were created to provide healthcare to rural/under-served areas - it just seems like we're not moving in the right direction. It's more than a little discouraging.

 

PAs have not tried to convince local and federal legislatures to allow a title change that more accurately reflects what we do.  We tried to convince AAPA and the HOD but were spurned.  PAs in general don't get it IHMO. One state chapter needs to wade in the waters to advocate for a correct title and modernization of PA practice to do away with supervision/delegation and to adopt collaboration.  What state will be first?

 

Should we take bets?

[Guest Paula]

Nobody has tried.  We can't even convince the people within our own profession first so that we can take that next step.

 

I didn't see your post....you beat me to the answer!  I am so pleased to see students and new PAs get involved in advocacy.  Keep it up.

[andersenpa]

PAs have not tried to convince local and federal legislatures to allow a title change that more accurately reflects what we do.  We tried to convince AAPA and the HOD but were spurned.  PAs in general don't get it IHMO. One state chapter needs to wade in the waters to advocate for a correct title and modernization of PA practice to do away with supervision/delegation and to adopt collaboration.  What state will be first?

 

Should we take bets?

Meeting with my state DOH next week.

[Maverick87]

PAs have not tried to convince local and federal legislatures to allow a title change that more accurately reflects what we do.  We tried to convince AAPA and the HOD but were spurned.  PAs in general don't get it IHMO. One state chapter needs to wade in the waters to advocate for a correct title and modernization of PA practice to do away with supervision/delegation and to adopt collaboration.  What state will be first?

 

Should we take bets?

How do you join a state chapter?

 

How do you take leadership of one?

 

Why are the leaders of these state chapters not fighting for this?

 

OR are they fighting for it and failing?

[andersenpa]

How do you join a state chapter?

 

How do you take leadership of one?

 

Why are the leaders of these state chapters not fighting for this?

 

OR are they fighting for it and failing?

The HOD, given the results of the poll on the name change opinion survey, voted against it for fear of what it might do to "opening the books" on our current practice legislation.

I have not heard a good answer to why this didn't happen when states formally changed from Physician's Assistant.

[Guest Paula]

How do you join a state chapter?

 

How do you take leadership of one?

 

Why are the leaders of these state chapters not fighting for this?

 

OR are they fighting for it and failing?

 

Look up your state PA organization.  You can find it listed on AAPA website.  Contact the chapter and pay your dues....voila....you are a member.  Then volunteer for a leadership position or help out in some way.  Submit an article to their newsletter.  Challenge the status quo thinking.  Get to know the other leaders and find out where the chapter is in their quest for modernization of PA practice.  Argue graciously for your position and you will sway some.  Arm yourself with statistics and ask questions of what will happen to PAs when NPs have independence in 50 states?  Make friends with them.  If you are not a member of PAFT, join us too.  You will be enlightened.  

 

MI has submitted a bill that is stalled.  In it we asked to have the 's moved from the books and asked for a descriptor that more accurately defines what we do, lobbied for collaboration, deletion of supervision and delegation from the public health code laws.  The medical society was in support as long as we maintained in the law a requirement to work in a "patient care team" with a physician.  It is a great first step and hopefully will be taken up again.  I have high hopes Michigan is the first state to gain collaboration language.  

[Guest Paula]

Meeting with my state DOH next week.

 

What state?

[gbrothers98]

I live and work in a state that allows NPs to be independent of physician supervision. Regardless of this, the 2 outpatient clinics associated with the hospital I work at have a mix of MD, DO, PA and NP. I work closely with the NPs at both clinics when they send pts to the ED and I refer to them all the time. They are good people and do an excellent job (many times better than the MDs and the PAs IMHO). Our ED is solely staffed with PAs and a part time MD ED director. The OR is essentially run by CRNAs, another form of advanced practice nurse. Both of my kids were delivered by nurse midwives. I see an MD for my primary care, my wife sees an NP, my kids an MD, my parents an NP or an MD, whomever is available at their rural health clinic. My point is that the reality of medicine opens opportunities for everyone. 

 

I find the concern about NPs lacking physician supervision to be reactionary. Is there evidence that PAs have lost jobs? Couldn't physician's say the same concerning PAs? I work solo in an ED and my SP makes no bones that the standard he holds me to is that of a board certified MD in EM, which is what he is. Since I strive on a regular basis to reach this standard, shouldn't all the area ABEM certified physicians view me as a threat since I am paid less than half their median salary but actually work more hours and probably see more patients? Couldn't they say the 5 full time and one part time PA at my shop took jobs that should go to doctors?

 

So what are we really concerned about here? More likely somebody else has beaten us to what we desire for ourselves? But what is this desire worth, if anything? How many PAs would really hang out a sign and start seeing patients on their own? A great ED nurse I worked with for years became a NP, then obtained his Doctorate and started his own practice. It is a daily struggle because he is not only a clinician but now a business owner and has to worry about paying the bills and keeping the lights on. He faces disregard from the local MD community on a regular basis but he sees the patients they refuse or dont want to see and he is a great clinician. Will there be NP clinics popping up all over CT in the next several months that will serve the same purpose? Is it that easy?

 

Lets look at CT. According to the AAPA, there are 1900 PAs in CT. Only 22% are in areas considered primary care, the remainder are in specialties, subspecialties, surgery and EM. Since that primary care % seems a bit on the lower side, maybe CT needs NPs to fill the void that physicians and PAs are not?

 

Let's say you want that ability to practice without supervision. I think you would be hard pressed to get a job in my ED. The hospital, the board of trustees, the credentialing committee, the medical staff and it's bylaws would place many obstacles in the way. Eventually, there would be a QA and QI process in place that would amount to collaboration and supervision under a different name. And if you are an orthopedic PA or a CT surgery PA, do you really think you are going to replace a hip or crack a chest on your own?

 

So this will really only work for PAs in primary care areas and only if they are willing and brash enough to go out and establish their own practice. This could be what provides the incentive to push more PAs into primary care and into areas that truly need. It could also help PAs that are in small practices seeking ownership or running into SP successor issues. This could be a legitimate issue for the AAPA and state chapters to pursue but it would have to be directed along that venue of alleviating a real problem and not a tit for tat situation with NPs.

 

For my personal practice in the ED? I want supervision. I desire the legal guarantee I have someone to review my care, someone that has to take my call when I have a concern and seek advice or direction. Someone that will stand with me before the medical staff and support me, someone that will support me when ridiculousness is brought to the state medical board, someone that respects me as much as I respect him or her.

 

George Brothers PA-C

[rstoutpa2003]

I live and work in a state that allows NPs to be independent of physician supervision. Regardless of this, the 2 outpatient clinics associated with the hospital I work at have a mix of MD, DO, PA and NP. I work closely with the NPs at both clinics when they send pts to the ED and I refer to them all the time. They are good people and do an excellent job (many times better than the MDs and the PAs IMHO). Our ED is solely staffed with PAs and a part time MD ED director. The OR is essentially run by CRNAs, another form of advanced practice nurse. Both of my kids were delivered by nurse midwives. I see an MD for my primary care, my wife sees an NP, my kids an MD, my parents an NP or an MD, whomever is available at their rural health clinic. My point is that the reality of medicine opens opportunities for everyone. 

 

I find the concern about NPs lacking physician supervision to be reactionary. Is there evidence that PAs have lost jobs? Couldn't physician's say the same concerning PAs? I work solo in an ED and my SP makes no bones that the standard he holds me to is that of a board certified MD in EM, which is what he is. Since I strive on a regular basis to reach this standard, shouldn't all the area ABEM certified physicians view me as a threat since I am paid less than half their median salary but actually work more hours and probably see more patients? Couldn't they say the 5 full time and one part time PA at my shop took jobs that should go to doctors?

 

So what are we really concerned about here? More likely somebody else has beaten us to what we desire for ourselves? But what is this desire worth, if anything? How many PAs would really hang out a sign and start seeing patients on their own? A great ED nurse I worked with for years became a NP, then obtained his Doctorate and started his own practice. It is a daily struggle because he is not only a clinician but now a business owner and has to worry about paying the bills and keeping the lights on. He faces disregard from the local MD community on a regular basis but he sees the patients they refuse or dont want to see and he is a great clinician. Will there be NP clinics popping up all over CT in the next several months that will serve the same purpose? Is it that easy?

 

Lets look at CT. According to the AAPA, there are 1900 PAs in CT. Only 22% are in areas considered primary care, the remainder are in specialties, subspecialties, surgery and EM. Since that primary care % seems a bit on the lower side, maybe CT needs NPs to fill the void that physicians and PAs are not?

 

Let's say you want that ability to practice without supervision. I think you would be hard pressed to get a job in my ED. The hospital, the board of trustees, the credentialing committee, the medical staff and it's bylaws would place many obstacles in the way. Eventually, there would be a QA and QI process in place that would amount to collaboration and supervision under a different name. And if you are an orthopedic PA or a CT surgery PA, do you really think you are going to replace a hip or crack a chest on your own?

 

So this will really only work for PAs in primary care areas and only if they are willing and brash enough to go out and establish their own practice. This could be what provides the incentive to push more PAs into primary care and into areas that truly need. It could also help PAs that are in small practices seeking ownership or running into SP successor issues. This could be a legitimate issue for the AAPA and state chapters to pursue but it would have to be directed along that venue of alleviating a real problem and not a tit for tat situation with NPs.

 

For my personal practice in the ED? I want supervision. I desire the legal guarantee I have someone to review my care, someone that has to take my call when I have a concern and seek advice or direction. Someone that will stand with me before the medical staff and support me, someone that will support me when ridiculousness is brought to the state medical board, someone that respects me as much as I respect him or her.

 

George Brothers PA-C

I have to agree with some of these points.  Having also worked in the solo ED role, it is nice to pull the "PA-Card" and pass an unstable or difficult case off to the MD.  You're remembered less for managing difficult cases really well or the clinical decision that changed death to life.  It's the narc'd out family that is pissed because you only gave their 16 year old daughter ten T#3s instead of a Sam's Club supply of Percocet for her sore throat that filed a formal complaint to the CEO and the board of the hospital.  It's your SP that is the voice that tells people that just don't want to deal with complaints (i.e. administration) that your clinical decision did not justify the complaint.  Or the 30 year bariatric patient that died from an MI and you were the last person she saw before her arrest for something other than chest pain.  Despite the fact she not only had her surgeon, but a cardiologist evaluating her and her heart that went bad post operatively, a whole month before she saw you.  When the unexpected death happens, whose charts do they scrutinize the most?  Not the cardiologist or the surgeons, but the less trained Physician Assistant/Associate that last saw the patient.  If it wasn't for my SP, I would have been hung out to dry.  For all I know, maybe there was something I missed that I could have prevented a death before its time, but my SP defended my clinical actions to the DOH resulting in a hand slap for not charting enough about my clinical decision making regarding the patient's complaint of constipation (i.e. why did I not get a CT of her abdomen or call her bariatric surgeon or cardiologist?)  The surgeon and the cardiologist did not receive a hand slap and yet they evaluated, dissected, and treated her before I saw her.  If I learned anything, I will always just be a PA when something goes clinically wrong and the probable scapegoat, which I have also seen over and over throughout my career to other colleagues.  The other thing I learned is you can never know everything, so know exceedingly well what you don't.  Having the ability to have the safety net of your SP is not a bad thing at all and higher on the ladder only means farther to fall.

[Guest Paula]

While some NPs view independence as one that gives them the right to open their own practice, many don't.  They like the collaboration with others including physicians.  Their definition of independence is one of being free from another profession that dictates them.  They desire to have the nursing board as their sole "supervisor".  That is what it is for many professions.  They manage their own, discipline their own, deny licenses to their own.  NPs have done a good job and have a vision for where they want to go.

 

PAs not so much.  When we (I) talk about independence I am envisioning a PA profession that is in charge of it's own profession.  Should we collaborate?  Absolutely.  It is an ethical and professional given for the benefit of the patient.  

 

The PA profession was originally developed to fill the gaps in primary care.  We are losing (or have lost?) that specialty.  I work primary rural care.  Where physicians go so do PAs because we are forced to secondary to our dependent licenses and physicians leaving rural/primary care.  That is why I want an independent PAs license and board that determines our fate.  NY has granted independence to NPs too.  They must first have 3600 hours of supervised practice before being given an independent license or the ability to have full practice authority.  In addition NY NPs must have a collaboration agreement on file with hospitals or groups of physicians who will accept their referrals.  They are not required to have a signed practice agreement, however.  I like this model and feel it would be a win-win for all Advanced Practice Clinicians nationwide.  It allows ACPs to manage their own profession yet each must be responsible to develop the collaboration with hospitals and physicians/physician groups.  It would work so well in rural care.  If my collaborating physician leaves the practice I am out of a job.  If I had full practice authority such as the NY NPs I could still work because I would have collaboration agreements with the three hospitals we send our patients to plus with all the specialists we refer to. 

 

The NY model is do-able.   Gotta go, more later. 

[GetMeOuttaThisMess]

Paula, there you go bringing common sense and real world facts back into a discussion.  Keep this up and we'll never reach our desired goal as stated in the movie "Idiocracy".  ;-)

[Joelseff]

While some NPs view independence as one that gives them the right to open their own practice, many don't. They like the collaboration with others including physicians. Their definition of independence is one of being free from another profession that dictates them. They desire to have the nursing board as their sole "supervisor". That is what it is for many professions. They manage their own, discipline their own, deny licenses to their own. NPs have done a good job and have a vision for where they want to go.

 

PAs not so much. When we (I) talk about independence I am envisioning a PA profession that is in charge of it's own profession. Should we collaborate? Absolutely. It is an ethical and professional given for the benefit of the patient.

 

The PA profession was originally developed to fill the gaps in primary care. We are losing (or have lost?) that specialty. I work primary rural care. Where physicians go so do PAs because we are forced to secondary to our dependent licenses and physicians leaving rural/primary care. That is why I want an independent PAs license and board that determines our fate. NY has granted independence to NPs too. They must first have 3600 hours of supervised practice before being given an independent license or the ability to have full practice authority. In addition NY NPs must have a collaboration agreement on file with hospitals or groups of physicians who will accept their referrals. They are not required to have a signed practice agreement, however. I like this model and feel it would be a win-win for all Advanced Practice Clinicians nationwide. It allows ACPs to manage their own profession yet each must be responsible to develop the collaboration with hospitals and physicians/physician groups. It would work so well in rural care. If my collaborating physician leaves the practice I am out of a job. If I had full practice authority such as the NY NPs I could still work because I would have collaboration agreements with the three hospitals we send our patients to plus with all the specialists we refer to.

 

The NY model is do-able. Gotta go, more later.

So true, funny how it seems (wait that's a song lyric lol) that the issue of where the Doc goes, we MUST follow is not so much stressed when we discuss independence. This is a huge limitation on us as practitioners of medicine andespecially as part of the supposed answer for rhe pcp shortage.

 

I love PC. I dont see myself working in specialty medicine. Ive tried it, not for me. But, and ive brought rhis up before, should my Doc retire or God forbid, die. I would be one, out of a job, and two, given the shortage of primary care jobs in my area, be forced to move or go into specialty. Not to mention forcing my patients to find a new pcp.

 

Having independence is beyond "hanging out our shingle," its preservation of our trade and preserving the relationships we have woth our pts.

 

Sent from my Galaxy S4 Active using Tapatalk.

 

 

[andersenpa]

What state?

WA

[ventana]

 

 

So this will really only work for PAs in primary care areas and only if they are willing and brash enough to go out and establish their own practice. This could be what provides the incentive to push more PAs into primary care and into areas that truly need. It could also help PAs that are in small practices seeking ownership or running into SP successor issues. This could be a legitimate issue for the AAPA and state chapters to pursue but it would have to be directed along that venue of alleviating a real problem and not a tit for tat situation with NPs.

 

 

 

George Brothers PA-C

 

 

So true, funny how it seems (wait that's a song lyric lol) that the issue of where the Doc goes, we MUST follow is not so much stressed when we discuss independence. This is a huge limitation on us as practitioners of medicine andespecially as part of the supposed answer for rhe pcp shortage.

 

I love PC. I dont see myself working in specialty medicine. Ive tried it, not for me. But, and ive brought rhis up before, should my Doc retire or God forbid, die. I would be one, out of a job, and two, given the shortage of primary care jobs in my area, be forced to move or go into specialty. Not to mention forcing my patients to find a new pcp.

 

Having independence is beyond "hanging out our shingle," its preservation of our trade and preserving the relationships we have woth our pts.

 

Sent from my Galaxy S4 Active using Tapatalk.

 

 

 

 

The issue truly lies in Primary care - in the specialties there is a need/desire/reasonable expectation to have an SP.

 

however in Primary care the current system stinks - SP's want to be paid 5-15k per year for "supervision" on top of the 15% cut we get from  medicare for being a PA - yet we truly do the same jobs - data is slow developing to say that PA and MD outcomes in primary care are not different, and to "be attached" to a single doc who demands payment is not a good business model.  

 

I have been exceptionally lucky in finding an SP who enjoys the role and has reasonable expectations on payment (and more importantly I cover his practice when he is on vacation)  BUT he is a sole practitioner - and those are a dying breed...... so we are left with no ability to open our own clinic if we can not get an SP - which hurts the community and leaves them with out health care.  This is no a "it could happen" type of thing...... I was looking at opening a PCP clinic in NYS but due to state law I could not own the clinic and employ an SP - hence I set up in MASS - the town I was going to open in has no health care, nor do the surrounding towns, and the hospital is some distance away - so how does the state law and "supervision" help the community??  It does not - it hurts......

 

 

honestly a new grad PA (and especially a new grad NP) is no where near close to being independent - as well I think there should be a full 5 years in clinical practice a a PA in before allowing a more "independent" roll.  This whole "independent thing" is just smoke anyways - if you are truly practicing INDEPENDENTLY right now you are fool, no way you can know enough about every  system to not rely on specialists....

 

 

I think PA + 5 years experience, and going into a health profesions shortage area for PCP services should be a top priority for AAPA as well as at the state level.

 

Of course before this happens Medicare (CMS) needs to change the VNA and Hospice regulations so we can actually function as PCP's.......

[matchb0x]

I live and work in a state that allows NPs to be independent of physician supervision. Regardless of this, the 2 outpatient clinics associated with the hospital I work at have a mix of MD, DO, PA and NP. I work closely with the NPs at both clinics when they send pts to the ED and I refer to them all the time. They are good people and do an excellent job (many times better than the MDs and the PAs IMHO). Our ED is solely staffed with PAs and a part time MD ED director. The OR is essentially run by CRNAs, another form of advanced practice nurse. Both of my kids were delivered by nurse midwives. I see an MD for my primary care, my wife sees an NP, my kids an MD, my parents an NP or an MD, whomever is available at their rural health clinic. My point is that the reality of medicine opens opportunities for everyone. 

 

I find the concern about NPs lacking physician supervision to be reactionary. Is there evidence that PAs have lost jobs? Couldn't physician's say the same concerning PAs? I work solo in an ED and my SP makes no bones that the standard he holds me to is that of a board certified MD in EM, which is what he is. Since I strive on a regular basis to reach this standard, shouldn't all the area ABEM certified physicians view me as a threat since I am paid less than half their median salary but actually work more hours and probably see more patients? Couldn't they say the 5 full time and one part time PA at my shop took jobs that should go to doctors?

 

So what are we really concerned about here? More likely somebody else has beaten us to what we desire for ourselves? But what is this desire worth, if anything? How many PAs would really hang out a sign and start seeing patients on their own? A great ED nurse I worked with for years became a NP, then obtained his Doctorate and started his own practice. It is a daily struggle because he is not only a clinician but now a business owner and has to worry about paying the bills and keeping the lights on. He faces disregard from the local MD community on a regular basis but he sees the patients they refuse or dont want to see and he is a great clinician. Will there be NP clinics popping up all over CT in the next several months that will serve the same purpose? Is it that easy?

 

Lets look at CT. According to the AAPA, there are 1900 PAs in CT. Only 22% are in areas considered primary care, the remainder are in specialties, subspecialties, surgery and EM. Since that primary care % seems a bit on the lower side, maybe CT needs NPs to fill the void that physicians and PAs are not?

 

Let's say you want that ability to practice without supervision. I think you would be hard pressed to get a job in my ED. The hospital, the board of trustees, the credentialing committee, the medical staff and it's bylaws would place many obstacles in the way. Eventually, there would be a QA and QI process in place that would amount to collaboration and supervision under a different name. And if you are an orthopedic PA or a CT surgery PA, do you really think you are going to replace a hip or crack a chest on your own?

 

So this will really only work for PAs in primary care areas and only if they are willing and brash enough to go out and establish their own practice. This could be what provides the incentive to push more PAs into primary care and into areas that truly need. It could also help PAs that are in small practices seeking ownership or running into SP successor issues. This could be a legitimate issue for the AAPA and state chapters to pursue but it would have to be directed along that venue of alleviating a real problem and not a tit for tat situation with NPs.

 

For my personal practice in the ED? I want supervision. I desire the legal guarantee I have someone to review my care, someone that has to take my call when I have a concern and seek advice or direction. Someone that will stand with me before the medical staff and support me, someone that will support me when ridiculousness is brought to the state medical board, someone that respects me as much as I respect him or her.

 

George Brothers PA-C

Well said.  

[Guest Paula]

The "independent" thing applies to physicians, too. 

[PACProvider]

PAs will never achieve practice independence as long as the are governed and represented by the AAPA and NCCPA. If you look at the history of the DOs, you will learn that the AMA utilized every tactic to destroy the DO profession. Some were illegal; others simply unethical. The MD credential and "Doctor" title is a powerful brand that is being protected by the AMA and Physician class at any and all costs. Any physician who collaborates or influences or votes on matters of the AAPA or NCCPA will always act in his or her own self-interest and NEVER act in the best interest of the PA. DOs won the respect and independence they enjoy today by recognizing that the MD/AMA/Allopathic medicine machine was anathema to their very exisitence and mounting legal and professional battles AGAINST the MD/AMA/Allopathic medicine machine. PAs don't understand this history and how the MD/AMA/Allopathic medicine machine is working against the PA profession to marginalize us and profit in perpetuity from our labor. 

 

PAs need representation from individuals who act ONLY in the best interest of PAs. PAs need to mount legal battles for our rights. PAs need to influence public opinion to show the evil behavior of the MD/AMA/Allopathic medicine machine. PAs must learn the Physicians are not our friends; they are our slave masters. Just because they let us sleep and eat in the basement of their plantation homes instead of the fields doesn't mean we are part of their Physician class. 

[Guest Paula]

Department of Commerce Restraint of Trade suit might be an avenue to gain PAs the ability to manage their own profession.  

[KMD16]

PAs will never achieve practice independence as long as the are governed and represented by the AAPA and NCCPA. If you look at the history of the DOs, you will learn that the AMA utilized every tactic to destroy the DO profession. Some were illegal; others simply unethical. The MD credential and "Doctor" title is a powerful brand that is being protected by the AMA and Physician class at any and all costs. Any physician who collaborates or influences or votes on matters of the AAPA or NCCPA will always act in his or her own self-interest and NEVER act in the best interest of the PA. DOs won the respect and independence they enjoy today by recognizing that the MD/AMA/Allopathic medicine machine was anathema to their very exisitence and mounting legal and professional battles AGAINST the MD/AMA/Allopathic medicine machine. PAs don't understand this history and how the MD/AMA/Allopathic medicine machine is working against the PA profession to marginalize us and profit in perpetuity from our labor.

 

PAs need representation from individuals who act ONLY in the best interest of PAs. PAs need to mount legal battles for our rights. PAs need to influence public opinion to show the evil behavior of the MD/AMA/Allopathic medicine machine. PAs must learn the Physicians are not our friends; they are our slave masters. Just because they let us sleep and eat in the basement of their plantation homes instead of the fields doesn't mean we are part of their Physician class.

Well said!

[ventana]

Department of Commerce Restraint of Trade suit might be an avenue to gain PAs the ability to manage their own profession.  

 

 

I truly believe that if we are not going to be forgotten as a whole - AAPA or some grouping of PAs is going to need to stand up and legally fight - forget the politicians who are paid off by AMA, or other interest groups - go to the courts to fight for the ability to do things (FORCE medicare to change it's regulations) more on the national level - then go after it in the states.

 

Will be a hard battle but one that is worth fighting....

 

OR

 

PA-->DNP in one year part time (watch all the primary care PAs jump ship)

 

OR

 

PA-->DO/MD in a more reasonable time (prima - thoughts?  could you do it in less then 3 years?)

 

 

 

Otherwise we are just going to regulated right out of the primary care world, specializing will still be okay but PCP will go away.....