queenofhearts Posted May 21, 2011 Share Posted May 21, 2011 Forgive me, but please direct me to the thread if this question has been asked. I am pretty much looking for a straightforward answer, and i understand there may be technicalities in the wording and relationship between a PA or NP and their SP (or "collaborating) In the state of CA (one where I understand an NP is not independent), is there any difference between the diagnostic, treating, prescribing, etc abilities of a PA and NP who work in the same outpatient or inpatient setting? (Aside from the specialty itself) Link to comment Share on other sites More sharing options...
LESH Posted May 21, 2011 Share Posted May 21, 2011 Not to my knowledge, and I have worked with NPs. Link to comment Share on other sites More sharing options...
uscbigdawg Posted July 21, 2011 Share Posted July 21, 2011 Nope, but they sure will try to tell you there is. Rich Link to comment Share on other sites More sharing options...
uscbigdawg Posted July 21, 2011 Share Posted July 21, 2011 Nope, but they sure will try to tell you there is. Rich Link to comment Share on other sites More sharing options...
queenofhearts Posted July 3, 2012 Author Share Posted July 3, 2012 bump...... Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 3, 2012 Moderator Share Posted July 3, 2012 only the educational differences.... Link to comment Share on other sites More sharing options...
Zeus Posted July 4, 2012 Share Posted July 4, 2012 Agree with the above. NPs in their frist 6 months after getting their license have to run all of their RXs through someone else (M.D., D.O. ,PA, Ect), but their is legislation at this time to remove that 6 month requirement. Link to comment Share on other sites More sharing options...
Contrarian Posted July 4, 2012 Share Posted July 4, 2012 only the educational differences.... Again... This discussion is about CALIFORNIA. You know, the home of the DUAL NP/PA programs. So depending on what program the NP graduated from... there may or may not be any "educational differences." For the benefit of the newbies: To meet their workforce shortage needs, and out of the idea that in real world practice, there is NO functional distinction that separates a NP from a PA in clinical practice... Many years ago, there were a few dual NP/PA programs established in California. UC-Davis, Stanford and maybe another one. These were PA programs with all the same didactic and clinical standards of every other PA program out there. The only difference was that folks who happened to be RNs who entered these programs graduated with BOTH Family Nurse Practitioner & Physician Assistant Certificates/degrees/credentials. This enabled them to register as FNPs in California without taking the national NP boards and/or sit for the NP boards and license in other states that required it. This changed when the NP profession went to the mandatory Masters degree and the board exams started requiring a MSN degree to sit for the board tests. I'd venture to say that for decades, the "FNPs" who graduated from these dual programs were probably amoung the best trained "FNPs" in the US. Why...??? Because they were trained as PAs...:wink: Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 4, 2012 Moderator Share Posted July 4, 2012 I would hazard a guess that most practicing np's in ca today(2012) are not grads of davis or stanford. the original question was: " is there any difference between the diagnostic, treating, prescribing, etc abilities of a PA and NP " aside from those np's trained as pa's I would argue that the clinical abilities of a typical new grad pa are better given 3x the clinical hrs of the typical np. Link to comment Share on other sites More sharing options...
Contrarian Posted July 4, 2012 Share Posted July 4, 2012 I would hazard a guess that most practicing np's in ca today(2012) are not grads of davis or stanford.the original question was: " is there any difference between the diagnostic, treating, prescribing, etc abilities of a PA and NP " aside from those np's trained as pa's I would argue that the clinical abilities of a typical new grad pa are better given 3x the clinical hrs of the typical np. I would hazard a guess that most practicing NP's in CA today (2012) are not NEW grads. I would even go a step further and argue that a significant number of the experienced and established NPs that the OP will encounter in CALIFORNIA today (2012) will be from these prolific dualNP/PA programs that were around a LONG time (25-30+ yrs). As a matter of fact... these graduates are spread up and down the west coast from San Diego to the Canadian border, cause if I'm not mistaken... YOU even work with one of them in SW washington. Therefore, when the OP asked the general question about abilities of a PA and NP, in CALIFORNIA, I would argue this includes any NP or PA that the OP encounters in CALIFORNIA... whether it be a brand spankin new grad or old experienced 30 yr NP/PA. So if the OP is working in healthcare in CALIFORNIA, the OP WILL encounter many NPs who are graduates of these dual programs from the long ago and recent past because each of these programs graduated a handful of these Hybrid NP/PAs every 16-24 months for decades and many/most of those graduates work IN CALIFORNIA. Contrarian P.S... Simply spouting the tired line about how average PA clinical hrs make all PAs better trained than all NPs IN CALIFORNIA (where the OP was asking about) is misleading, biased, inaccurate and a disengenous disservice. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 4, 2012 Moderator Share Posted July 4, 2012 my point is this. notwithstanding grads of dual programs, if you take 2 identical rn's and send 1 to an fnp program and 1 to a pa program the pa prepared rn will be better prepared day 1 out of school than the fnp prepared rn. better didactics + better/longer clinicals+ identical candidates= pa wins. there are what, 20+ np programs in ca at this point and only 1 dual program. so in 5 yrs these 20 programs graduate as many np's as would have gone to the dual programs in 100 yrs. I don't have #s for you but I would wager the avg np today in ca has been in practice for less than 5 years and did not attend a dual program. I could be wrong. Lesh would know. I will concede that there are many dual pa/np grads in ca but I think it is safe to say the OP was not asking about them but avg np's.. interesting stat re: pa's: 50% of pa's in practice today have less then 5 years of experience due to the rapid proliferation of pa programs between 2000-2010. I imagine a similar fact is true for np's as they have many new programs as well. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 4, 2012 Moderator Share Posted July 4, 2012 . YOU even work with one of them in SW washington.. we had one on the hospitalist service for awhile. don't know if she is still there as I haven't seen her in over a yr. she is the only one I have ever met in person in oreon or wa who attended a dual program. I did have an old partner who was an rn, went to pa school, and then went back to do 2 more courses( in ca in the early 80's) and was given his fnp so he was a dual but under weird rules. he did it for rx rights then pa's got them. Link to comment Share on other sites More sharing options...
Hemegroup Posted July 17, 2012 Share Posted July 17, 2012 Huh??? I was just denied certifying disability to the EDD for my patient who I diagnosed, who I took off lithium, who is now better because of my recommended treatment, but they won't allow my certification of his diability because I'm not a "practitioner" ... but a NP is?????? WTF. I immediately sent a letter requesting a platform to discuss this asap, who knows if I'll hear anything. This is infuriating and insulting. I'll contact the CA board in hopes that they can do something but why hasn't someone taken care of this before now?? I think actually it might have been recently put into effect, because last year I wrote hundreds of these disability certifications with no issue. I'm livid. Link to comment Share on other sites More sharing options...
Joelseff Posted July 17, 2012 Share Posted July 17, 2012 Yah bro, I went through that same thing last year....edd has a NP form we can't even sign the regular one but our SPs who have never seen the pt except for the initial visit so we can bill incident to, can certify the pt for disability but we who have followed the pt and is the treating provider can't. WeakSauce..... Sent from my myTouch_4G_Slide using Tapatalk Link to comment Share on other sites More sharing options...
Hemegroup Posted July 17, 2012 Share Posted July 17, 2012 Ridiculous. I've already written a letter to the EDD requesting a platform for discussing the issue. Whether anything comes of it remains to be seen. Link to comment Share on other sites More sharing options...
Joelseff Posted July 18, 2012 Share Posted July 18, 2012 Ridiculous. I've already written a letter to the EDD requesting a platform for discussing the issue. Whether anything comes of it remains to be seen. Maybe we can contact CAPA about this. I'll shoot them an email.... Sent from my myTouch_4G_Slide using Tapatalk Link to comment Share on other sites More sharing options...
Hemegroup Posted July 18, 2012 Share Posted July 18, 2012 Great, let me know what they say. I'm going to seek legal counsel. Link to comment Share on other sites More sharing options...
Hemegroup Posted July 24, 2012 Share Posted July 24, 2012 I got a call today from the Medical Director of the EDD. She said that I needed to contact my state organization, to which I replied that I would be contacting CAPA as well as a lawyer. She scoffed at me so I (oddly) had to teach her that a PA is not a legal professional but a medical one. She then was a little nicer until she said the Doctor should be the first one to see all patients. At that point I realized I was dealing with a character and excused myself from the situation. She ended by saying that the NP form still has to be signed by a Physician ... I haven't even read it yet, I have to be honest. But the bottom line of the conversation was that it has to happen in legislature. I think. Any news from CAPA? Who should I write to? Link to comment Share on other sites More sharing options...
Hemegroup Posted July 24, 2012 Share Posted July 24, 2012 Nope, they only have to have conferred. This is but one more example of stronger NP political action. Link to comment Share on other sites More sharing options...
Joelseff Posted July 24, 2012 Share Posted July 24, 2012 No reply yet. I sent an email to capa@capanet.org I couldn't find a specific email. I may have an email list of delegates. I'll dig it up and pm u. Sent from my myTouch_4G_Slide using Tapatalk Link to comment Share on other sites More sharing options...
Joelseff Posted July 30, 2012 Share Posted July 30, 2012 Got a reply today: Hello Joel, PAs cannot certify disability as yet. CAPA had legislation in 2011 to allow PAs to certify but that section of the bill was amended out at the last minute. We were not able to save it although the bill (SB 1069) did provide for PAs ordering durable medical equipment, ordering of some home health services (not Medicare) and signing many documents and forms (attestations). The disability certification is still a priority issue for us and we need to find the best way to obtain that authority. We will let the membership know our progress - watch the CAPAnews. Regards, Bob Robert Miller, PA-C Past President, Chair, Professional Practice Committee Treasurer California Academy of Physician Assistants (CAPA) SO hopefully we are still in the fight! Link to comment Share on other sites More sharing options...
Hemegroup Posted July 31, 2012 Share Posted July 31, 2012 Thanks Joel, I'll write to Mr. Miller and include the rest of the constituents and let them know of the letter I wrote and the reply I got from the EDD director. I can order morphine but not diapers? Ridiculous. Link to comment Share on other sites More sharing options...
Joelseff Posted July 31, 2012 Share Posted July 31, 2012 Thanks Joel, I'll write to Mr. Miller and include the rest of the constituents and let them know of the letter I wrote and the reply I got from the EDD director. I can order morphine but not diapers? Ridiculous. Sure thing heme...I know. We also can't write home nursing orders on Medicare pts. I wish they could pass blanket legislation to allow us to do all the things MD/DOs can, as far as forms, certs, etc.,in accordance with our scopes and DSAs. That way only our SP can limit what we cam do. I don't see the logic in some of our limitations. Sent from my myTouch_4G_Slide using Tapatalk Link to comment Share on other sites More sharing options...
Contrarian Posted August 1, 2012 Share Posted August 1, 2012 I don't see the logic in some of our limitations. Ummm... because there often wasn't any used or required when the limitations were codified. Lots of them were simply "Turf-Protectionistic" in orgin. Link to comment Share on other sites More sharing options...
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