More good news for NPs...

[Guest Paula]

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.....

 

We need money....lots of it.  Does anyone know of any kickstart projects?  Not sure if Kickstart is for films only?  Will have to check it out.  Otherwise we need AAPA members to all join PAFT and divert funds to us....LOL!

[Guest Paula]

We need money....lots of it.  Does anyone know of any kickstart projects?  Not sure if Kickstart is for films only?  Will have to check it out.  Otherwise we need AAPA members to all join PAFT and divert funds to us....LOL!

Nope, Kickstarter for creative arts funding only.  That leaves PAFT and a PAC and we are not a PAC.

[KMD16]

Here are my predictions. If we (PAs) as a profession doesn't act fast. We'll be face out by the NPs. The new PCP in town are NPs. The numbers of med students going into primary care hasn't change that much. Though there was a bump per AAMC report. There's talk/survey right now on quantiaMD whether MDs should only specialize leaving primary care for PAs and NPs. The NPs are setting the stage for the future while we fold our hands. I'm afraid for the future of the profession. Join PAFT.

[EMEDPA]

Here are my predictions. If we (PAs) as a profession doesn't act fast. We'll be face out by the NPs. The new PCP in town are NPs. The numbers of med students going into primary care hasn't change that much. Though there was a bump per AAMC report. There's talk/survey right now on quantiaMD whether MDs should only specialize leaving primary care for PAs and NPs. The NPs are setting the stage for the future while we fold our hands. I'm afraid for the future of the profession. Join PAFT.

I'm thinking NPs will get the primary care market and PAs will get hospital based medicine and specialties.....

[Joelseff]

I'm thinking NPs will get the primary care market and PAs will get hospital based medicine and specialties.....

Sadly, it looks that way. I wont go without a fight though.

 

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[CoastalPalm]

I'm thinking NPs will get the primary care market and PAs will get hospital based medicine and specialties.....

 

Something tells me the adult and peds acute care NPs, and the neonatal NPs, who don't/aren't allowed to practice in primary care (and aren't trained in it), would have a field day with that. 

[KMD16]

I'm thinking NPs will get the primary care market and PAs will get hospital based medicine and specialties.....

The core foundation of the profession were solely base on primary care. I wonder if PA programs would change it core foundation with specialty/subspecialty in mind. Maybe this would result to a push for mandatory post graduate training. As per PA dominating hospital medicine. I think it's a split. It also depend on area of the country or whether the hospital is affiliated with a major academic that house NPs program. The reverse is the case.

[EMEDPA]

The core foundation of the profession were solely base on primary care. I wonder if PA programs would change it core foundation with specialty/subspecialty in mind. Maybe this would result to a push for mandatory post graduate training. As per PA dominating hospital medicine. I think it's a split. It also depend on area of the country or whether the hospital is affiliated with a major academic that house NPs program. The reverse is the case.

PAs pretty much already own the EM and surgery markets. other specialties are even splits(critical care, cards, etc).

[Lexapro]

PAs pretty much already own the EM and surgery markets. other specialties are even splits(critical care, cards, etc).

 

Hmm. I think this is really, really location dependent. I see lots of NPs, (especially ACNPs) in the ER. Less so in surgery, but it's not unheard of.

[KMD16]

^ true. However, if you take a census of MLP in the ED across the country, PAs > NPs.

[Woody85]

I'm thinking NPs will get the primary care market and PAs will get hospital based medicine and specialties.....

 

Why are we not embracing this? This could be the PA’s niche in the future…Specialty!

 

Why not change the purpose of a PA to be a highly specialized advanced practice provider.

 

Keep our generalist training as it is to enable us to choose from any specialty we want with the completion of a REQUIRED postgrad residency directly after graduation from PA school.

 

Now we have become residency/fellowship trained providers, which is something the NP’s don’t have.

 

Not to mention the fact that this is something we can change ON OUR OWN without fighting massive lobbyist groups.

Let the NP’s get their fluff “Doctorates”, Give me true clinical experience any day!

[seekingtruths]

Why are we not embracing this? This could be the PA’s niche in the future…Specialty!

 

Why not change the purpose of a PA to be a highly specialized advanced practice provider.

 

Keep our generalist training as it is to enable us to choose from any specialty we want with the completion of a REQUIRED postgrad residency directly after graduation from PA school.

 

Now we have become residency/fellowship trained providers, which is something the NP’s don’t have.

 

Not to mention the fact that this is something we can change ON OUR OWN without fighting massive lobbyist groups.

Let the NP’s get their fluff “Doctorates”, Give me true clinical experience any day!

 

Wouldn't that significantly reduce our job options? Ouch. Less jobs available for PAs.

[Woody85]

Wouldn't that significantly reduce our job options? Ouch. Less jobs available for PAs.

Why would it? your specialty could still be PC or IM

[blueridge]

Now we have become residency/fellowship trained providers, which is something the NP’s don’t have.

 

 

 

NPs are aggressively seeking and receiving funding from Congress for residencies (two links to same article) - today $$ for primary care residencies, tomorrow??:

 

http://www.sfexaminer.com/sanfrancisco/common-sense-solutions-can-resolve-primary-care-shortage/Content?oid=2760170

 

https://uaprn.enpnetwork.com/nurse-practitioner-news/47701-common-sense-solutions-can-resolve-primary-care-shortages-

[Woody85]

NPs are aggressively seeking and receiving funding from Congress for residencies (two links to same article) - today $$ for primary care residencies, tomorrow??:

 

http://www.sfexaminer.com/sanfrancisco/common-sense-solutions-can-resolve-primary-care-shortage/Content?oid=2760170

 

https://uaprn.enpnetwork.com/nurse-practitioner-news/47701-common-sense-solutions-can-resolve-primary-care-shortages-

Sure we can't block them from entering a residency, but will it be required for them? If we require it the SP will know he/she will be getting a fellowship/residency trained provider. The NP's will be a mixed bag.

[UGoLong]

I like the fact that there are PA residencies, if you want to take one. I would not want residencies to be required (unless an employer wants you to have one, which is their right). My SP was willing to train me and, thanks to my efforts and his, I'm getting there.

 

More hoops to jump through do not automatically lead to more opportunities. For example, does taking the PANRE every x years (something NPs do not have a similar process for) lead to more opportunities, even though you can say that we are tested more often, like physicians? Not around where I live.

 

The trick, if there is one, probably does not involve increasing barriers to entry to become a PA. It's already a fairly rigorous process in my view. 

[Mainer]

I don't believe PA's are going to give up any of the primary care market, at least looking at the big picture.

 

We're the preferred provider clinically due to the strength of our training.  The demand for PA's in primary care is very high and very much a growing profession.

NP's may have some advantages politically in some states.  My sense is, we're going to start holding our ground, especially with PAFT growing stronger everyday.  (signing up myself today)

 

I work in an "NP independent state".  Ironically, I know of a few PA owned practices in my state (both primary care and specialty) and only one NP owned practice, and she practices acupuncture/alternative medicine. 

 

The number of MD owned practices is dwindling very quickly..... being bought out by hospitals and other organizations.  The affordable care act and similar legislation is making it nearly financially impossible to open a viable practice today.  An MD told me that if you want to own a practice, become a PT, dentist, DPM or some other ancillary provider, not an MD.  I don't have data, but from my own observation, MD private practices are selling out.  NP's and PA's will likely have fewer options for self-employment in medicine regardless of "independent" status.  The requirements, just from an EMR and IT standpoint, make it cost prohibitive. 

 

My understanding is that NP (and I guess PA) on some level, are vying for payment at physician rates.  This could result in a pay increase, but PA and NP have to remain cost effective or one will win over the other simply through economics. It seems that employers will hire whomever is most cost effective.  It's simply a dollar & cents thing today. 

 

On a similar, in my area, we've seen the benefit of PA schools opening within the region.  The midlevel market was once dominated by NP's in my area simply due to a supply and demand.  I'm rural and PA's are slamming the markets around here.  A local CEO told me that it used to make sense to send and RN to school to get their NP qualification in exchange for 2-4 yrs of service, but that no longer makes sense fiscally because their are well qualified PA's available, and folks are much happier with the quality.  We have PA students doing rotations in nearly every department around here.  The clinical staff and administration love that we have such a broad education compared to the limited educational program of NP's. 

 

I think it's time for the PA profession to start playing the game better politically. 

 

One state simply needs to get the momentum going.  I also think that state legislation that outlines collaborative agreements with hospitals should replace individual supervising physicians in the future.  Both our careers and patient deserve something more stable than the vulnerability of the current PA-physician agreements. 

[EMEDPA]

 

One state simply needs to get the momentum going.  I also think that state legislation that outlines collaborative agreements with hospitals should replace individual supervising physicians in the future.  Both our careers and patient deserve something more stable than the vulnerability of the current PA-physician agreements. 

this^^^^^^

totally agree

[GetMeOuttaThisMess]

I concur with the collaboration statement in scenarios where the volume of providers is next to impossible to manage.  This would include university medical centers affiliated with medical school attendings/faculty and large EM groups where you might see one of the physicians one or two shifts per year where you're not sure that they even remember your name.

[EMEDPA]

I concur with the collaboration statement in scenarios where the volume of providers is next to impossible to manage.  This would include university medical centers affiliated with medical school attendings/faculty and large EM groups where you might see one of the physicians one or two shifts per year where you're not sure that they even remember your name.

at my primary job I have not worked with my sp of record in > 3 years. don't know if he is even aware that he is my sp. all docs in the group are alternate sps of record.

[Iain1028]

The problem lies in the fact that there is ZERO advertising for the PA profession.  I live in Phoenix, AZ.  I have yet to see ONE billboard advertising the PA profession.  Its essentially crickets for advertising our profession and that falls directly on the shoulders of the NCCPA and the AAPA.

 

What do our dues monies go to?  Administrator salaries?  I want billboards, advertising.  Its a joke......

[LIPPER]

The problem lies in the fact that there is ZERO advertising for the PA profession. I live in Phoenix, AZ. I have yet to see ONE billboard advertising the PA profession. Its essentially crickets for advertising our profession and that falls directly on the shoulders of the NCCPA and the AAPA.

 

What do our dues monies go to? Administrator salaries? I want billboards, advertising. Its a joke......

No doubt I'll get flamed here; given the dues/roll of PAFT, what is that money being spent on?

 

 

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[Guest Paula]

Lipper: PAFT money being spent on developing a research project and survey and I cannot disclose the topic right now.  We discuss it at our board meeting tomorrow night.  Stay tuned.  Also, we sent two representatives to the AAPA advocacy training in February and were successful in leading and contributing to the discussion that the nomenclature for PAs (assistant) is not a relevant title or descriptive of what we do.  Look at AAPA website and you will see they are not using the word assistant as much and are changing the documents.  They are using just PA and a goal of theirs is to amend all of their educational pieces....a work in progress.  This is largely due to PAFTs involvement in February and prior to that when I was part of a teleconference on marketing the PA profession.  That took place in October or November if I recall it right. 

 

While all of us wish we could wave the magic wand and have instant changes to our marketing and restrictions lifted it just does not happen overnight.

 

What would you like to see us spend our (your) money on?   Are you a member?  Remember, all of us at PAFT volunteer all of our hours and none of us are paid.  We all spent our own money for travel and expenses when we had our annual board meeting in Atlanta in February.  While we may be small we are mighty and willing to put our money where our mouth is.  (P.S.  we helped our student rep with expenses however).

[LIPPER]

:) I won't contribute to the fight for a title change. No need to rehash

 

 

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[Guest Paula]

I should have also mentioned that we and AAPA are moving toward collaboration practice language and that was a big piece of the advocacy training too.  Much more than the nomenclature change.  There was a compromise to think about how we describe ourselves and PA was settled on to just say PA, like an MD says MD, and an NP says NP and a DO says DO.  

 

Not ideal.  LIpper: see the new topic I posted about PAFT and dues.