pglaser01 Posted May 22, 2014 Author Share Posted May 22, 2014 One small positive that could possibly be taken from this ( I never even thought my OP would garnish this much of a response haha) I've already had several other Pre-PAs contact me about how they can monitor situations like this. I told them many state chapters allow Pre-PAs to join as non-voting members and get updates about the profession. I also directed many to PAFT as they also allow Pre-PAs to join. Perhaps with the increasing amount of PA programs and younger students out there that use social media (for just about damn near everything), we may get a stronger and more unified voice about what we are trying to become both as professionals and providers. Fingers crossed Link to comment Share on other sites More sharing options...
Keep your PANCE on Posted May 22, 2014 Share Posted May 22, 2014 I read several of these posts, and wonder how many people are ACTIVE members of MOAPA and AAPA? With a bill like this passing, it is going to take collaboration and concerted effort from everyone in the field, not just the leaders of MOAPA/AAPA to fight for the interests of PAs. How many PAs are practicing in Missouri? How many of those PAs are members of MOAPA? Link to comment Share on other sites More sharing options...
pglaser01 Posted May 22, 2014 Author Share Posted May 22, 2014 They only have 413 listed as members in their directory, but I doubt that's all of them Link to comment Share on other sites More sharing options...
Keep your PANCE on Posted May 22, 2014 Share Posted May 22, 2014 Just over half. Almost 800 in Missouri. Link to comment Share on other sites More sharing options...
CAAdmission Posted May 22, 2014 Share Posted May 22, 2014 re: court challenge after the fact, wouldn't that take years? Court challenge? Since all of our PA organizations like to cry poverty all the time, who exactly is going to pay for all this? These guys have it made. I bet they have no CME requirements, either. Certainly not the silly assed new ones that NCCPA dreamed up for us... Link to comment Share on other sites More sharing options...
PACdan Posted May 22, 2014 Share Posted May 22, 2014 I hope MOAPA sends a delegation to try and meet with the governor. Now would be the time to pull out all the stops, bring in the state nursing associations, anything... Sent from the Satellite of Love using Tapatalk Link to comment Share on other sites More sharing options...
andersenpa Posted May 22, 2014 Share Posted May 22, 2014 That's it? >6000 voted on the name change survey the issues that people care about will stir action Link to comment Share on other sites More sharing options...
polarbebe Posted May 22, 2014 Share Posted May 22, 2014 Great letter sent by PAFT president to the governor. Hopefully our voices will be at least heard before any potential bill signing. Once again, your PAFT Board of Directors has been active behalf of you and your profession. The legislature of Missouri recently passed a bill, now awaiting Governor Nixon's signature, that creates an "assistant physician." According to this bill, the position of "assistant physician" is a graduate of a medical school that did not get matched for residency. The bill also states that for CMS billing, these "assistant physicians" bill as a PA. PAFT sent the following letter to the Governor, after coordinating with Paul Winter, PA-C, President of the Missouri Academy. For more information on the underlying subject, see http://www.pasconnect.org/aapa-and-moapa-update-for-pas-on-missouri-legislation/?utm_content=05222014_story3_link2 and http://clinician1.com/posts/article/missouri_wants_to_create_new_profession_assistant_physician_shift_primary_c/ _______________________ The Honorable Governor Jay H. Nixon Post Office Box 720 Jefferson City, MO 65102 May 22, 2014 Subject: Senate Bill 716 PAs for Tomorrow (PAFT), a special interest group of the American Academy of PAs (AAPA), urges you to veto Senate Bill 716 establishing a new class of healthcare provider, an assistant physician. PAFT represents the national interests of our PA members. We believe that enactment of this law with provisions “authorizing the Board of Healing Arts to license physicians, unable to find a residency match, as assistant physicians, practicing within the confines of a collaboration agreement with a physician, and restricted to providing primary care services in rural and underserved areas”. Further, the language within SB 716 contains a provision that states “An assistant physician shall be considered a physician assistant for purposes of regulations of the Centers for Medicare and Medicaid Services (CMS).” Signing this into law would be a mistake. We believe that these provisions violate both federal and state laws and regulations. The Centers for Medicare Services states under US Department of Health and Human Services rules “A PA must be licensed by the State to practice as a PA and either: -Have graduated from a PA educational program accredited by the Accreditation Review Commission on Education for the Physician Assistant (its predecessor agencies, the Commission on Accreditation of Allied Health Education Programs, and the Committee on Allied Health Education and Accreditation); or -Have passed the national certification examination administered by the National Commission on Certification of Physician Assistants.” A collaborating physician or assistant physician requesting CMS reimbursement for PA fees may constitute Medicare fraud and also potentially defames the reputation of the entire PA profession. Your own state statutes (Chapter 334, Section 334.775, section 6) defines a “PA as a person who has graduated from a physician assistant program accredited by the American Medical Association's Committee on Allied Health Education and Accreditation or by its successor agency, who has passed the certifying examination administered by the National Commission on Certification of Physician Assistants (NCCPA) and has active certification by the NCCPA who provides health care services delegated by a licensed physician. A person who has been employed as a physician assistant for three years prior to August 28, 1989, who has passed the NCCPA examination, and has active certification of the NCCPA.” The NCCPA qualification rules are clear as to who may sit for the national certification and recertification examinations, these individuals masquerading as PAs with the protection of this law, are not eligible to sit for our examination. The Frequently Asked Questions section of the official NCCPA Web site, states that graduates of medical schools cannot be certified unless they graduate from an accredited PA program. The Web site also states, “NCCPA will not waive any eligibility requirements.” Ethically, use of the untrained providers is misleading to patients. As graduates of medical schools, they are entitled to introduce themselves to patients as “doctor,” thereby implying full qualifications as a practicing physician. This law does not require full disclosure of their legal status, which neither fits that of physician nor that of a PA. Our board is comprised of many veterans with over a half century of experience caring for our troops and their dependents as PA medical care providers. We believe implementation of this law will diminish the quality of medical care you seek to provide to the citizens of your great state; therefore, we urge you to veto Senate Bill 716. Sincerely David Mittman, PA, DFAAPA President Link to comment Share on other sites More sharing options...
Z PA-C Posted May 22, 2014 Share Posted May 22, 2014 Just got that email from PAFT today too! So happy to see they are on top of things. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted May 23, 2014 Moderator Share Posted May 23, 2014 just got off the phone with Dave. he has been in personal contact with several of the key movers and shakers on this issue. go PAFT! Link to comment Share on other sites More sharing options...
pglaser01 Posted May 23, 2014 Author Share Posted May 23, 2014 Well it must have done something, this has really become larger than I expected. Link to comment Share on other sites More sharing options...
Boatswain2PA Posted May 23, 2014 Share Posted May 23, 2014 Not trying to be a grammar nazi....but you might want to check that incomplete second sentence of the letter.BTW - to those of you complaining about the low numbers of AAPA members/PA voters....many of us do not believe the AAPA represents us. They are too busy pushing gun control measures, and censoring conservative speech, to do their damn job and stay on top of things like THIS. Link to comment Share on other sites More sharing options...
Timon Posted May 23, 2014 Share Posted May 23, 2014 Not trying to be a grammar nazi....but you might want to check that incomplete second sentence of the letter. BTW - to those of you complaining about the low numbers of AAPA members/PA voters....many of us do not believe the AAPA represents us. They are too busy pushing gun control measures, and censoring conservative speech, to do their damn job and stay on top of things like THIS. And do you think not being an AAPA member solves this problem? So you are correct in saying the AAPA doesn't represent you, you're not an AAPA member... Link to comment Share on other sites More sharing options...
cinntsp Posted May 23, 2014 Share Posted May 23, 2014 Not trying to be a grammar nazi....but you might want to check that incomplete second sentence of the letter. BTW - to those of you complaining about the low numbers of AAPA members/PA voters....many of us do not believe the AAPA represents us. They are too busy pushing gun control measures, and censoring conservative speech, to do their damn job and stay on top of things like THIS. Will you join and run for the BOD or try to get a delegate seat through a constituent organization? We need your common sense helping to move AAPA in the right direction. It can only represent the people that get off the couch and do something. It's like when people complain about an opposing political party but don't bother to go vote. Like it or not, AAPA is our national org and has the best capabilities to make change. Even those of us in PAFT realize that we should work with(and sometimes against) AAPA to make progress whether or not we support everything it does. Sent from my Nexus 5 using Tapatalk Link to comment Share on other sites More sharing options...
delco714 Posted May 23, 2014 Share Posted May 23, 2014 Ruh roh!! More competition!! Steve PA-C, Maine, urologic surgery Link to comment Share on other sites More sharing options...
LIPPER Posted May 23, 2014 Share Posted May 23, 2014 , Ethically use of the untrained providers is misleading to patients. As graduates of medical schools, they are entitled to introduce themselves to patients as “doctor,” thereby implying full qualifications as a practicing physician. This law does not require full disclosure of their legal status, which neither fits that of physician nor that of a PA. This statement is inaccurate. They are in fact doctors. They are qualified to act as doctors. They are not board certified. If they have completed USMLE-2 (which is harder than PANRE) then certainly they are more qualified than a Freshly graduated PA Sent from my iPhone using Tapatalk Link to comment Share on other sites More sharing options...
andersenpa Posted May 23, 2014 Share Posted May 23, 2014 This statement is inaccurate. They are in fact doctors. They are qualified to act as doctors. They are not board certified. If they have completed USMLE-2 (which is harder than PANRE) then certainly they are more qualified than a Freshly graduated PA Sent from my iPhone using Tapatalk This actually depends on the bylaws of the facility Just as a PA w/ a doctorate may not be allowed to introduce themselves as Dr Smith, the facility may have it written that only BC docs may use the title etc. Re qualifications no PA is "qualified" to introduce themselves as Dr but a med school grad doesn't hold universal qualifications over a new grad PA to practice. Link to comment Share on other sites More sharing options...
LIPPER Posted May 23, 2014 Share Posted May 23, 2014 This actually depends on the bylaws of the facility Just as a PA w/ a doctorate may not be allowed to introduce themselves as Dr Smith, the facility may have it written that only BC docs may use the title etc. Re qualifications no PA is "qualified" to introduce themselves as Dr but a med school grad doesn't hold universal qualifications over a new grad PA to practice. Law and hospital bylaws are two different beasts. Regardless a resident is not board certified, but is able (rightfully) to refer to themselves as "doctor". There is virtually no debate on this (I hope). USMLE overshadows PANRE. There is little debate there as well. . A PA w/ a doctorate and a MD (by definition, and the topic of debate in numerous other threads) is totally different. A graduated medical student is in fact a doctor qualified to introduce themselves as such, without reservation. So outside of a hospital setting, say in a rural setting can still call themselves doctor and treat patients with as much leeway and a PA/NP. Experience thereafter is another topic not germaine to or discussed in the law created above Furthermore I think the law as written above will be fixed simply by changing the term "as a Physician Assistant".... to "like a Physician Assistant". It's all symantics. Thus the new title "Assistant Physician"....Maybe now they'll form APFT!? Link to comment Share on other sites More sharing options...
andersenpa Posted May 23, 2014 Share Posted May 23, 2014 I am referring to the previous comment by "polarbebe". He states that this is misleading to patients and probably below the standard of care, as well as meeting the definition of qualification to practice unsupervised. It is just a fact that it may not be allowable or appropriate in the patient care context for an MD to present themselves as the established definition of a physician (BC) if they have not completed training. They can call themselves anything they want; it doesn't make it any less inaccurate. How they establish themselves in a patient care relationship is a contract- and that contract would not hold the same meaning to the patient and the unmatched IMG who had not completed resdiency. Rural or hospital that relationship carries the same weight. Even moreso in rural setting where there is less support. Link to comment Share on other sites More sharing options...
andersenpa Posted May 23, 2014 Share Posted May 23, 2014 Furthermore I think the law as written above will be fixed simply by changing the term "as a Physician Assistant".... to "like a Physician Assistant". It's all symantics. Thus the new title "Assistant Physician"....Maybe now they'll form APFT!? Well if that's the case then they need to change the collaborative/supervised issue. Practicing like a PA will mean they are supervised. Or they can make PAs collaborative. Link to comment Share on other sites More sharing options...
LIPPER Posted May 23, 2014 Share Posted May 23, 2014 I am referring to the previous comment by "polarbebe". He states that this is misleading to patients and probably below the standard of care, as well as meeting the definition of qualification to practice unsupervised. I am referring to PAFT's formal response. If properly defended by some MD group (whomever sponsored the legislation) the countering claim will be defeated. Again "standard of care'; is a misleading statement. There is no formal discussion regarding a freshly minted MD vs PA. I certainly agree with you; Especially in a rural setting where backup is harder to come by billy bob won't know the difference untill a big mistake happens. Also I do agree with you that there are instances of a new PA being better than a new MD. But that wouldn't be the norm. I would be very interested to see the pass rate for PA's taking USMLE2 vs 4thyr's taking PANRE Link to comment Share on other sites More sharing options...
LIPPER Posted May 23, 2014 Share Posted May 23, 2014 Well if that's the case then they need to change the collaborative/supervised issue. Practicing like a PA will mean they are supervised. Or they can make PAs collaborative. agreed Link to comment Share on other sites More sharing options...
andersenpa Posted May 23, 2014 Share Posted May 23, 2014 . I would be very interested to see the pass rate for PA's taking USMLE2 vs 4thyr's taking PANRE If that happened I too would be interested to see I used step 2 review for my PANCE/PANREs Link to comment Share on other sites More sharing options...
LIPPER Posted May 23, 2014 Share Posted May 23, 2014 I used step 2 review for my PANCE/PANREs the smart ones did! Link to comment Share on other sites More sharing options...
acc_pac Posted May 23, 2014 Share Posted May 23, 2014 Hmmm...here's a novel concept.... Did any of you who are bashing the situation, AAPA, MOAPA leadership, and lobbyist ever take just one moment to consider that perhaps there is more to the story (as there always is!), rather than go crazy with nothing but negativity??? I suspect the answer is an overwhelming "NO." Hateful, emotional comments are nonproductive. A better way to approach this news and situation would be to say, "wow, this is terrible for PAs in Missouri and potentially everywhere else. What can we do to help?" Perhaps MOAPA has a better idea of what would be helpful within their own state legislative issues and what kind of support they need, if any of you just reached out and asked. It is much easier to sit back and point fingers and point out faults than to channel a bad situation into positive, proactive energy, and that is what most of you are doing. In addressing the idea that there may be "more to the story," Mr. PAFT President--are you oppossed to increasing Medicaid prenatal funding and funding for hospitalized seniors' influenza vaccines? I certainly hope not. If you have Gov. Nixon completely veto this bill, you are saying you and all of the PAFT members do not support these causes, thus you do not support preventative patient care. To pglaser01--while I commend you for being a member of your state chapter, my comments to you are: 1. if you are so passionate about PA legislation in your state, at least get your organization's name right--it's the Missouri Academy of Physician Assistants, not the Missouri PA Society. 2. are you an active member, meaning have you ever actually attended a meeting? Better yet, before you decided to take it upon yourself to be the one to publish the letter sent out by MOAPA's president, did you take the time to try to contact him or any other BOD members to get more information? If the answer to either of these questions is "no," it would probably be helpful for you to take a moment to reflect on how "heroic" your actions are. While I am, by no means, defending even the idea of an assistant physician, seeing all of these hot-headed, ignorant comments are even more upsetting to me than the original issue at hand. Link to comment Share on other sites More sharing options...
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