Contrarian Posted July 28, 2011 Share Posted July 28, 2011 ... [brevity edit]... The problem arises in the more common circumstances where the SP doesn't have much to offer you except for license requirements. They don't look at your charts because they know that you chart much better than they do, you perform better than they do and they simply have nothing to offer. So sponsoring makes more sense. They meet the legal requirements. YEP...!!! My current 3 SPs (2 jobs) are all psychiatrist that graduated residency as late as 1983... They freely and readily admit that they have retained very little internal medicine... or just enough to be dangerous and afraid. Prior to my arrival... they were VERY quick to turf the inpatients for ANYTHING... and did often. They had a strained relationship with the surrounding EDs who were often pissed because they felt like they were being misused as primary/urgent ... non-emergent care. Now these Involuntary In-patients get a ED trip if its appropriate but most things are taken care of in-house. Even the physicians call ME at home to ask me what to do about most of the internal medicine stuff or defer it until I arrive. When the nurses approach them with a non-psych medical issue... I'm told that they usually hold up their hand to interrupt and say, "Call Contrarian" or... "Get Contrarian on the phone, I want to ask him what he thinks." So I'm sort of "Supervised" 20% of the time when I'm wearing my "psychiatry" hat... and "Sponsored" 80% of the time when I'm doing internal medicine/PsychoSomatic medicine. Link to comment Share on other sites More sharing options...
Contrarian Posted July 28, 2011 Share Posted July 28, 2011 ... [brevity edit]... The problem arises in the more common circumstances where the SP doesn't have much to offer you except for license requirements. They don't look at your charts because they know that you chart much better than they do, you perform better than they do and they simply have nothing to offer. So sponsoring makes more sense. They meet the legal requirements. YEP...!!! My current 3 SPs (2 jobs) are all psychiatrist that graduated residency as late as 1983... They freely and readily admit that they have retained very little internal medicine... or just enough to be dangerous and afraid. Prior to my arrival... they were VERY quick to turf the inpatients for ANYTHING... and did often. They had a strained relationship with the surrounding EDs who were often pissed because they felt like they were being misused as primary/urgent ... non-emergent care. Now these Involuntary In-patients get a ED trip if its appropriate but most things are taken care of in-house. Even the physicians call ME at home to ask me what to do about most of the internal medicine stuff or defer it until I arrive. When the nurses approach them with a non-psych medical issue... I'm told that they usually hold up their hand to interrupt and say, "Call Contrarian" or... "Get Contrarian on the phone, I want to ask him what he thinks." So I'm sort of "Supervised" 20% of the time when I'm wearing my "psychiatry" hat... and "Sponsored" 80% of the time when I'm doing internal medicine/PsychoSomatic medicine. Link to comment Share on other sites More sharing options...
rcdavis Posted July 28, 2011 Share Posted July 28, 2011 Well put, c. Link to comment Share on other sites More sharing options...
rcdavis Posted July 28, 2011 Share Posted July 28, 2011 Well put, c. Link to comment Share on other sites More sharing options...
archerry Posted July 29, 2011 Share Posted July 29, 2011 Well for one we keep the initials SP. Two....we do our own thing. We're not NPs. Why do we need to preserve the initials "SP"? Preserving"PA" I get. NPs, to their credit, have been quite successful in defining their role, in part via their nomenclature. For the record, I am not an advocate for NP-like independent practice, but rather a hybrid dependent/independent role as an affiliate with an MD/DO or as part of a group containing MD/DOs, who at a minimum, and per agreement, acts as consulting liaison with the authority to define and authorize scope of practice based on the PA's prior experience, skill sets, and overall quality of care. Link to comment Share on other sites More sharing options...
archerry Posted July 29, 2011 Share Posted July 29, 2011 Well for one we keep the initials SP. Two....we do our own thing. We're not NPs. Why do we need to preserve the initials "SP"? Preserving"PA" I get. NPs, to their credit, have been quite successful in defining their role, in part via their nomenclature. For the record, I am not an advocate for NP-like independent practice, but rather a hybrid dependent/independent role as an affiliate with an MD/DO or as part of a group containing MD/DOs, who at a minimum, and per agreement, acts as consulting liaison with the authority to define and authorize scope of practice based on the PA's prior experience, skill sets, and overall quality of care. Link to comment Share on other sites More sharing options...
andersenpa Posted July 30, 2011 Author Share Posted July 30, 2011 Why do we need to preserve the initials "SP"? Preserving"PA" I get. NPs, to their credit, have been quite successful in defining their role, in part via their nomenclature. For the record, I am not an advocate for NP-like independent practice, but rather a hybrid dependent/independent role as an affiliate with an MD/DO or as part of a group containing MD/DOs, who at a minimum, and per agreement, acts as consulting liaison with the authority to define and authorize scope of practice based on the PA's prior experience, skill sets, and overall quality of care. Preserve SP because sponsoring physician is more descriptive and unless PAs become independent (unlikely), we need that relationship. Re NPs they have not been successful because of their name. It ALL has to do with creating a legal framework which skirts the oversight of physicians. Link to comment Share on other sites More sharing options...
andersenpa Posted July 30, 2011 Author Share Posted July 30, 2011 Why do we need to preserve the initials "SP"? Preserving"PA" I get. NPs, to their credit, have been quite successful in defining their role, in part via their nomenclature. For the record, I am not an advocate for NP-like independent practice, but rather a hybrid dependent/independent role as an affiliate with an MD/DO or as part of a group containing MD/DOs, who at a minimum, and per agreement, acts as consulting liaison with the authority to define and authorize scope of practice based on the PA's prior experience, skill sets, and overall quality of care. Preserve SP because sponsoring physician is more descriptive and unless PAs become independent (unlikely), we need that relationship. Re NPs they have not been successful because of their name. It ALL has to do with creating a legal framework which skirts the oversight of physicians. Link to comment Share on other sites More sharing options...
primadonna22274 Posted August 2, 2011 Share Posted August 2, 2011 I also like "sponsoring physician" along the same lines as WA state rules. I also agree this is a topic that we should ONLY broach AFTER the Physician Associate brand is approved. ;) Lisa Link to comment Share on other sites More sharing options...
andersenpa Posted August 2, 2011 Author Share Posted August 2, 2011 I also like "sponsoring physician" along the same lines as WA state rules. I also agree this is a topic that we should ONLY broach AFTER the Physician Associate brand is approved.;) Lisa Only if you (primadonna, DO) get to be the first sponsoring physician after the laws are rewritten.... Link to comment Share on other sites More sharing options...
primadonna22274 Posted August 3, 2011 Share Posted August 3, 2011 Ok, I will volunteer to be the guinea pig ;) Did I mention I'm the lone lady in this group of 7 PAs? I really didn't expect that! Link to comment Share on other sites More sharing options...
greenmood Posted August 4, 2011 Share Posted August 4, 2011 I'm not going to vote because I haven't finished PA school or passed anything but anatomy and ethics so don't feel I've quite earned it yet. But if I *was* to vote right now, I'd stick with supervising. Why? Because I am still a PA embryo and have no idea what I'm doing. Many of the words my profs use I still have to look up in a dictionary. I cannot fathom a time when this will not be the case (although I believe you all when you say it will happen), and feel like when I get out of school I will probably need more of a supervisor than a sponsor, at least in the beginning. Maybe when I've been out practicing for a few years I'll change my mind - probably, I'll change my mind. So I guess I'm more about that sliding system of supervision/sponsorship that was mentioned. Link to comment Share on other sites More sharing options...
Joelseff Posted August 4, 2011 Share Posted August 4, 2011 I'm not going to vote because I haven't finished PA school or passed anything but anatomy and ethics so don't feel I've quite earned it yet. But if I *was* to vote right now, I'd stick with supervising. Why? Because I am still a PA embryo and have no idea what I'm doing. Many of the words my profs use I still have to look up in a dictionary. I cannot fathom a time when this will not be the case (although I believe you all when you say it will happen), and feel like when I get out of school I will probably need more of a supervisor than a sponsor, at least in the beginning. Maybe when I've been out practicing for a few years I'll change my mind - probably, I'll change my mind. So I guess I'm more about that sliding system of supervision/sponsorship that was mentioned. I am a new (7 mos) PA and don't see why Sponsoring is a problem even though I am being supervised. My SP never sees my patients unless I ask him to. Even if he saw EVERY patient and came up and wrote my A&P's, I STILL don't see how "sponsoring" is problematic. I voted for "Sponsoring" because supervising is not an ENTIRELY accurate descriptor of what my attending does. My call is MY call with my patients. If that warrants me consulting with my SP it is STILL MY call. Link to comment Share on other sites More sharing options...
amyg Posted August 4, 2011 Share Posted August 4, 2011 I am not even in PA school yet , just wanted to say in Alaska collaborate is used. From their website "To practice as a Physician Assistant - Certified, or to use the title, a person must be licensed under regulation 12 AAC 40.400 and authorized to practice under 12 AAC 40.408 by the State Medical Board. An approved Collaborative Plan must be on file with the State Medical Board in order to be authorized to practice" " An approved plan of collaboration with a physician licensed to practice in the State of Alaska" Link to comment Share on other sites More sharing options...
andersenpa Posted September 13, 2011 Author Share Posted September 13, 2011 Well there are nine responses in support of Supervising but none gave any strong support for why. Please, speak up! Link to comment Share on other sites More sharing options...
burnpac Posted September 14, 2011 Share Posted September 14, 2011 When I looked up the definition of "sponsor," it didn't really fit. PAs practice medicine in physician led teams, so to me, supervise is more closely aligned with my practice arrangement, and the practice arrangement of most PAs that I know. It is also "supervising" in Ca Business and Professions Code, and this is not likely to change in California ever. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted September 14, 2011 Moderator Share Posted September 14, 2011 fortunately some states like wa and alaska recognize that many pa's work under the sponsorship or in collaboration with physicians. it's a great model for what individual states can do.... surgical pa's are supervised. no argument there. I would argue that a pa working without an md on site in a family medicine or em setting is not "supervised" but still works as part of a team overseen or sponsored by a physician. they receive input into their care but it is along the lines of Quality improvement not "supervision" as it does not occur in real time. I almost never work with or see my primary sponsoring physician. maybe once a month I find a note in my box that says "maybe try this next time" regarding a pt I saw a week ago who has already completed the tx I set out for them. all my charts are reviewed per hospital(not state) requirements and I appreciate the feedback but when I am running a code or intubating without a doc around it's hard to argue that I am being supervised. at the same time I am not independent(nor would I want to be) as I am subject to the appropriate oversight of folks smarter than me and that's ok. Link to comment Share on other sites More sharing options...
burnpac Posted September 14, 2011 Share Posted September 14, 2011 About the only place that I work directly with my SP is the OR. 90% of the time, I'm on my own in the SICU, ED, Floor, and clinic, just like PAs who are more focused on outpatient care. All PAs exercise a significant level of autonomy, especially PAs who are highly experienced. That doesn't negate the fact that the buck stops with the SP in every situation, and that the SP is responsible for every patient you treat. Link to comment Share on other sites More sharing options...
alleycat Posted September 14, 2011 Share Posted September 14, 2011 " probably med student trolls. we still have a few. " we have TROLLS in the forum! ! ? ? ? Can we shoot them????:O_O: Link to comment Share on other sites More sharing options...
alleycat Posted September 14, 2011 Share Posted September 14, 2011 Ok, I will volunteer to be the guinea pig ;) Did I mention I'm the lone lady in this group of 7 PAs? I really didn't expect that! WAIT ! ! ! I'm a lady too!! and a Grandma. of two. boy-girl. Link to comment Share on other sites More sharing options...
Contrarian Posted September 14, 2011 Share Posted September 14, 2011 Yeah but she is referring to the PA-C to DO physician pseudo-bridge program that she is in... Link to comment Share on other sites More sharing options...
alleycat Posted September 14, 2011 Share Posted September 14, 2011 Yeah but she is referring to the PA-C to DO physician pseudo-bridge program that she is in... oh. (rereading threads...). oh, I get it. thanks C. Link to comment Share on other sites More sharing options...
haeriphos Posted September 20, 2011 Share Posted September 20, 2011 Sounds like a lot of work for a name change that doesn't really accomplish anything. I can understand the change to "associate" as it helps to prevent patient confusion, but an SP already knows their role and our capabilities (generally speaking). What's the advantage for a name change of SP, other than to make us feel warm and tingly? Would there be different privileges for a PA with a sponsoring physician as opposed to a supervising? Link to comment Share on other sites More sharing options...
Contrarian Posted September 20, 2011 Share Posted September 20, 2011 Umm... That was already covered... Here in WA state... there already IS a difference. "Supervised" PAs can not work in remote sites and ALL of their charting MUST be co-signed within 2 days. "Sponsored" PAs can work in remote sites and there is NO chart co-signature requirement. So there already IS a difference and I think the point of the discussions was that the change could "flesh-out" differences and later used to increase autonomy/independence of "Sponsored" versus "Supervised" PA-Cs. YMMV Contrarian Link to comment Share on other sites More sharing options...
andersenpa Posted September 20, 2011 Author Share Posted September 20, 2011 Sounds like a lot of work for a name change that doesn't really accomplish anything. I can understand the change to "associate" as it helps to prevent patient confusion, but an SP already knows their role and our capabilities (generally speaking). What's the advantage for a name change of SP, other than to make us feel warm and tingly? Would there be different privileges for a PA with a sponsoring physician as opposed to a supervising? To external groups....compare NP and PA. Who is perceived as more competent/autonomous - one who works with supervision or one who works with sponsorship/collaboration? Some argue we don't compete with NPs but stories here differ. Link to comment Share on other sites More sharing options...
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