Dave's Blog from Clinician1.com

[EMEDPA]

Dave asked me to post this here:

Impossible For Some, Possible For Others
I am fascinated by the different socialization process between many NPs and PAs. Not all of us, but many of us.
I was at a PA conference speaking to a PA leader in a high position. This gentleman was a very nice fellow and clearly and honestly wanted to move the PA profession ahead but as we spoke I felt we were speaking different languages. As I would say something he would say, “That will never happen in my state”. Now let me tell you I have been a PA political being for almost 40 years. I was Vice-President of my PA class in 1973 and our program told us not to organize a student society. We took that threat on as a challenge. So here I am in this conversation and almost everything I say......partnership, working with NPs, increased autonomy, the word collaboration....all is met with the phrase “That will never happen in my state”. Now let me again make clear that this is not all PAs, nor all PA leaders. But it is too many. When I asked him why what I got was an answer that sounded something like “If we do these things, the medical society will destroy us”. I won’t say more about this discussion except to say I would like to think we parted as friends.
I recognize fear is still a huge part of the PA landscape. No doubt some fear is needed by not just PA leaders but all leaders. We should not be the Thelma and Louise of PA leadership running through the AMA House of Delegates knocking down tables. Some amount of fear or worry is healthy but if not put in it’s proper perspective, it will eventually neuter the PA profession.
If we worry about any other profession, TO THE DETRIMENT OF OUR OWN, we will destroy ourselves. It’s time we see that.
I know I will be disagreed with, but we can take a lesson from many other healthcare professions. Pharmacy. Physical Therapy. Psychology. Audiology. I will choose our NP colleagues as they are closest to us. NPs almost never stifle or minimize their profession to the detriment of any other. That’s not to say they don’t compromise or settle, they do. And not to say they don’t make mistakes, they do. But they have a clear sense of what they bring to the picture and will not budge from saying it. I have had PA leaders say to me, “well that’s because they are under the nursing board”. True, no argument there, but the vast majority of NPs still need a physician to be able to work and even in the states where NPs are gaining full practice authority (independence) many will need to practice with a physician for a number of years before gaining full practice. At any time, physicians can stop hiring NPs........ but somehow NPs know they won’t. Some PA don’t. That’s the disconnect between us. We PAs still believe that “the man” can crush us. NPs have given that one up. Hospital systems won’t stop hiring NPs or PAs unless one is clearly better than the other. In the almost 50 years of existence of both professions they hire both interchangeably. So does the VA, so do 50% of private physicians. It tells me something. Neither of us is going away. And “they” won’t make us disappear because we want to be able to have less barriers and less regulation on our practice. Most of these regulations may have made sense 50 years ago, but no longer work for either profession. The NPs get that also.
Where fear should come in for PAs is that it will soon be easier to just hire NPs as physicians will not want to be bothered with the burden of the rules and regs the PAs bring. The administrators will say why even worry our physicians? Hire NPs and make life simple. The physicians will say, I don’t want the hassles. If I was a PA leader that would be my major worry-not the medical society.
Clearly us “non-physicians” have much to offer the citizens of America. The idea of full practice authority rings clearer for all of us in family practice, peeds and women’s health. PAs and NPs in those fields can do most of what physicians do and do it well. Let’s work together to be able to go to the areas of need and provide care, with the least amount of barriers we can. Let’s work together to fund residencies that give us the training hours in certain specialties that America needs. Let’s work together to make sure insurance companies recognize the value of our work.
It is time for us to all say out loud that our professions are great and provide excellent care to our citizens and not look over our shoulder to see who is listening or reading our words.
It’s time for us PAs to not live in a world where “That will never happen in my state” changes to “It’s only a matter of time”.  Time to say “Anything is possible” and mean it.
Dave

[Guest Paula]

It is possible.  State chapters are starting to see the light.  When PAs get involved and start discussing with the naysayers and state our case, we will see change.  It will take time but I think it may not be as long as we think. 

[LKPAC]

Amen, brother!