paprospect24 Posted September 11, 2011 Share Posted September 11, 2011 Sure is... and fairly typical. It the "bombshelter" mentality. Back in the 50s and early 60s... lots of folks spent substantial sums of their income on elaborate, hearty bombshelters. They generally thought of themselves as smarter than everyone else, and therefore arrived at the notion of a bombshelter before the average citizen. To cognitively and socially justify this expenditure, lots of them pushed their local, state, regional, and even federal officials to "Paternally" mandate bombshelters for everyone. Seems they figured that folks would stop snickering, laughing and deriding them about their expensive backyard mass burial sites, if everyone was REQUIRED to do as they had already done. Fortunately, bombshelters were not mandated as most of them simply caved in, or flooded from groundwater, became unsustainable/surviveable and were either dug up or simply filled in. Point: There is a tendency to decide that one's personal course of action is the exact and correct course/route for all to take... Beware as it USUALLY isn't so. YMMV Contrarian Hi. I think your smart. :smile: Link to comment Share on other sites More sharing options...
andersenpa Posted September 11, 2011 Share Posted September 11, 2011 Yep but at this point I think it's come to "play the game before the game plays you".... Link to comment Share on other sites More sharing options...
LESH Posted September 11, 2011 Share Posted September 11, 2011 Yep but at this point I think it's come to "play the game before the game plays you".... True very true... Link to comment Share on other sites More sharing options...
Contrarian Posted September 11, 2011 Share Posted September 11, 2011 Yep but at this point I think it's come to "play the game before the game plays you".... Yeah... I agree 100% The million dollar question seems to be: What is "the game"...??? Is it simply adding more letters to your signature by spending more in tuitiion and further enriching academic institutions...? Or Is it about added ability, skill, knowledge, value...?? I ask because... "To Me"... spending $50k-$70k on a doctorate that will add NO translate-able value, tangable marketable skill, or more importantly INDEPENDENCE in DAILY practice is just plain DUMB/Silly... unless its just a "hobby." Personal "hobbies" are great but I'm of the opinion that they shouldn't be mandated across a entire profession. Nor should they be used as barriers to entry into a profession... or barriers to "parity" amongst professionals within a given profession. Because as was stated earlier in this thread... the OP seems to suggest that a doctorate will somehow equate PAs to the NPs... and missing the point about their ability to practice WITHOUT outside influence/interference... which is basically their ability to guide and control their own destiny. If it was the "doctorate" and NOT the independence... then PAs should be able to get a "doctorate" in ANYTHING (Theology, Business, Ecology, etc.) and be equal to NPs. The reality is that it really doesn't matter what PAs get a doctorate in... NPs will still lead the way and be a bit ahead of the "power-curve" unless those PA doctorates are in self-determination and professional/clinical independence. As a CCRN with training from a "diploma program"... we (me and the ASN and BSN CCRNs) used to laugh and snicker at the CCRNs on the unit that would flaunt their MSNs. We would then remind them that they simply spent much more money to do what we ALL were equally doing for the same pay. Point: Spending money on another PA degree means nothing if you still have to show up with your "hat-in-hand" and kiss a physician's a$$ to see a patient. Nothing has changed except for the deficit in your bank account and the increase in debt load. Oh... and the peice of paper in a folder or on a wall somewhere, cause you still won't be called "doctor" in clinical practice, they will still require "supervision," the reimbursement rate is still 85%, you still re-test every 6 yrs but cooool... you can tell people that you hold a "doctorate" degree. :heheh: Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted September 11, 2011 Moderator Share Posted September 11, 2011 Is it about added ability, skill, knowledge, value...?? . I would argue(as above) that a RESIDENCY(not an entry level doctorate) would impart more ability, skill, and knowledge and "value" to medical practices and if it happened to grant a doctorate along the way to put us on even ground with dnp's then all the better. I am for residencies whether or not they grant an additional degree but if someone enters with a masters and spends 12-18 months doing clinical work and clinical research what is the next appropriate degree or certificate to grant? I wasn't for the degree creep to ms but it cost me nothing to get one so why not? I certainly would still( and have) hired folks with other degrees and will continue to do so. my interest in pursuing an academic doctorate at this point is mostly self interest in the topic and thoughts about a future in teaching. I don't harbor any secret thoughts that I am earning a clinical doctorate. Link to comment Share on other sites More sharing options...
burnpac Posted September 11, 2011 Share Posted September 11, 2011 A Modest Proposal For parity with the NPs (for whatever purpose) then the currently accepted terminal degree is not going to be adequate is it? It’s only a Masters. We need a doctorate and we need to make it mandatory for practice. We should be gearing up (just like the DNPs) to have every entry level PA program confer a doctorial degree. That would cut down the number of programs considerably at the entry level; wouldn’t have to worry about oversaturation anymore. However, we may be able to convert some of the programs to specialty post grad programs that can award a doctorate. If the NCCPA requires a doctorial degree as part of the eligibility to take the PANCE that may help with the state licensure issue, because the regulatory committees usually defer to NCCPA. The NCCPA would also help get the word out about the profession to the public, payers and credentialing committees. They have a vested interest being the sole owner of the “C”. I like it! And keep those specialty exams coming. Can’t have enough of them! We need more formative and summative data on the workforce. Think of the opportunities at Academic Health Centers for doctorial prepared PAs to start branching out into specialty board preps. Just like our colleagues in Nursing, PA academia should start increasing the on line opportunities for the Doctorate. We should set a ten year plan for every PA practicing to earn their doctorate. Every BOM or PA regulatory committee should require a doctorate for licensure (like Mississippi and Ohio require a Masters now). AAPA has experience helping craft such state legislation Exciting times for our Brave new PA world are ahead my friends. I am seeing the error of my ways. Terminal Degrees are the way to go. What do you all think? :;;D: LesH Lesh: This is counterproductive to the needs of the health care system. We are not in competition with NPs in any way, shape or form. Neither schools of nursing of schools or medicine can possibly train enough practitioners to meet the need into the foreseeable future, especially given the coming realities of the Affordable Care Act. We need to train PAs faster, and not longer and more expensively. If schools of nursing want to make NP training longer, more expensive and more difficult, all the more power to them. This hurts them in ways that can't possibly be offset by the added prestige of a doctoral degree. Meanwhile, we will crank out 6000 to 7000 PAs a year who are ready to hit the ground running in serving the needs of the health care system, and we will fill the available jobs with PAs. That will impress the health care policy makers, and solve access to care problems, in a way that no degree can. I'm also against creating any barriers to lateral mobility of PAs. I'm all for post graduate education and experience. I'm just against giving the system a reason to latch onto some dubious credential and using it to deny otherwise qualified PAs from taking specialty positions. I have been successful in multiple specialties over my career, and I want to maintain this flexibility for all PAs. It is good for the system that PAs can be readily and easily deployed in multiple health care settings. Link to comment Share on other sites More sharing options...
Contrarian Posted September 11, 2011 Share Posted September 11, 2011 Umm... I THINK Lesh was being facetious... Link to comment Share on other sites More sharing options...
burnpac Posted September 11, 2011 Share Posted September 11, 2011 I have been struggling for some time to understand why the PA profession is so stubborn. The nursing lobby has made a strategic move to the DNP. The PA is now the ONLY allied health profession without a doctoral degree. We are behind the curve...as usual...thanks AAPA. The substance of the DNP is irrelevant. What is relevant is that in the arena of public perception, the DNP appears more qualified than a PA with a Master's degree. When the nursing lobby goes before congress, who do you think the lay congress people will automatically believe are more qualified? A Doctoral NP or a Master's PA? We are losing the fight in the arena of public perception and ultimately because of that will lose in the arena of congressional favor, licensing and priveleges. Grinder: Exactly why is the AAPA to blame for this? The AAPA, and the PAEA, NCCPA and ARC-PA did have a doctoral summit, bringing together multiple stakeholders (not just leadership people), and collectively decided that at the present time, the masters degree was the appropriate degree for PAs. Largely, this issue is under the control of PA schools. If there is demand for PAs with doctorates, and there is a ready pool of students willing to pay the premium, the schools will offer this. Economics has driven degree creep more than any other issue. AAPA doesn't train PAs, and aside from some policies regarding PA education set by the HOD, leaves the PA education policy issues to PAEA. We do have a dog in this fight because we need to ensure that our new grad PA colleagues are trained and ready to meet the needs of the health care system. Show me one shredlette of objective evidence that DNPs are perceived to be more qualified than licensed PAs by anyone. As someone who has spent significant amounts of time on Capitol Hill over the past two decades lobbying PA issues, I can assure you that lay congressional representatives could care less about this issue. All they care about in this environment is how quickly you can train and deploy PAs and other qualified health care providers. This is where PAs have a decided advantage over physicians and NPs. Let's not lose our competitive advantage to the dubious notion that a doctoral degree is going to provide any tangible benefit to the profession. That said, I have no problems with post graduate clinical training in improving the skills and abilities of PAs in practice. I just do not want to see this same training serve as a barrier to the current excellent lateral mobility of the profession. Link to comment Share on other sites More sharing options...
physasst Posted September 11, 2011 Share Posted September 11, 2011 Umm... I THINK Lesh was being facetious... Good lord I hope so....or the scotch is really having some significant long term neurologic effects....:( Link to comment Share on other sites More sharing options...
winterallsummer Posted September 11, 2011 Share Posted September 11, 2011 I believe you mis-interpreted my point in saying if PA is 4 years just to head to med school. I am not ill-informed, greedy nor do I want a shortcut into medicine, or to be a doctor. If you need proof feel free to read many of my other posts. One point of the profession is that PAs were created to help fill the shortage of medical professionals. They act in most ways like a doctor yet do not require the decade of formal training. The point is to get efficent practicioners out there who can practice across a wide spectrum and learn new skills on the job, with the added bonus of being able to change specialties as well. The role of the PA, IMO, is the most pragmatic approach to our health care system. So what will the extra PhD training include? More medical experience? Okay, but can this not be addressed by a residency or on the job training? Business and administrative duties? There is already the PA/MPA or you can get your MBA. Creating the PhD for political reasons - okay, fine, let those who want to go on for that go for it. But mandate all that extra time for PAs? Why fix what isn't broken? The problems you are discussing are of political merit, and a longer mandatory academic career is not necessarily the answer. Sincerely, The bad guy Link to comment Share on other sites More sharing options...
LESH Posted September 11, 2011 Share Posted September 11, 2011 Lesh: This is counterproductive to the needs of the health care system. We are not in competition with NPs in any way, shape or form. Neither schools of nursing of schools or medicine can possibly train enough practitioners to meet the need into the foreseeable future, especially given the coming realities of the Affordable Care Act. We need to train PAs faster, and not longer and more expensively. If schools of nursing want to make NP training longer, more expensive and more difficult, all the more power to them. This hurts them in ways that can't possibly be offset by the added prestige of a doctoral degree. Meanwhile, we will crank out 6000 to 7000 PAs a year who are ready to hit the ground running in serving the needs of the health care system, and we will fill the available jobs with PAs. That will impress the health care policy makers, and solve access to care problems, in a way that no degree can. I'm also against creating any barriers to lateral mobility of PAs. I'm all for post graduate education and experience. I'm just against giving the system a reason to latch onto some dubious credential and using it to deny otherwise qualified PAs from taking specialty positions. I have been successful in multiple specialties over my career, and I want to maintain this flexibility for all PAs. It is good for the system that PAs can be readily and easily deployed in multiple health care settings. Steve I haven't posted in a while so I guess my AARP sense of humor doesn't come accross very well. LOL, you have known me and what I have stood for a lot of years. Trust me I haven't changed. I do apologize for the confusing post. I thought the reference to "A Modest Proposal" http://art-bin.com/art/omodest.html would have been a clue. Guess it wasn't the best reference. I am one of the old dudes who complain about Degree Creep. Seems to have been my MO since 2005. Sorry to all didn't mean to be a troll. Lesson learned. Don't post before morning coffee. Then probably best not to post at all in my case. Sorry. And to my students concerning the degree, this is not how I feel, but you know that or should by now. Les Link to comment Share on other sites More sharing options...
burnpac Posted September 11, 2011 Share Posted September 11, 2011 SteveI haven't posted in a while so I guess my AARP sense of humor doesn't come accross very well. LOL, you have known me and what I have stood for a lot of years. Trust me I haven't changed. I do apologize for the confusing post. I thought the reference to "A Modest Proposal" http://art-bin.com/art/omodest.html would have been a clue. Guess it wasn't the best reference. I am one of the old dudes who complain about Degree Creep. Seems to have been my MO since 2005. Sorry to all didn't mean to be a troll. Lesson learned. Don't post before morning coffee. Then probably best not to post at all in my case. Sorry. And to my students concerning the degree, this is not how I feel, but you know that or should by now. Les Dear Les, Now I'm LOL and know that I'm preaching to the choir! All the best to my fellow AARP colleague.... Link to comment Share on other sites More sharing options...
physasst Posted September 11, 2011 Share Posted September 11, 2011 SteveI haven't posted in a while so I guess my AARP sense of humor doesn't come accross very well. LOL, you have known me and what I have stood for a lot of years. Trust me I haven't changed. I do apologize for the confusing post. I thought the reference to "A Modest Proposal" http://art-bin.com/art/omodest.html would have been a clue. Guess it wasn't the best reference. I am one of the old dudes who complain about Degree Creep. Seems to have been my MO since 2005. Sorry to all didn't mean to be a troll. Lesson learned. Don't post before morning coffee. Then probably best not to post at all in my case. Sorry. And to my students concerning the degree, this is not how I feel, but you know that or should by now. Les Thank the lord....now I can have another drink......GOD BLESS Lagavulin......especially after my &*%*(((% Cleveland Browns.......GRRRR. I'm so mad, I could literally punch a hole in the wall right now...Nothing like alcohol on a Sunday....LOL.... Link to comment Share on other sites More sharing options...
LESH Posted September 11, 2011 Share Posted September 11, 2011 Good lord I hope so....or the scotch is really having some significant long term neurologic effects....:( LOL Dude its all good. I haven't changed. It was just a post that feel flat on its face again sorry to all especially the OP. Physasst since about 2000 (and the begining of this evolution of our profession) the scotch has been replaced by LITs. LOL Link to comment Share on other sites More sharing options...
physasst Posted September 11, 2011 Share Posted September 11, 2011 LOL Dude its all good. I haven't changed. It was just a post that feel flat on its face again sorry to all especially the OP. Physasst since about 2000 (and the begining of this evolution of our profession) the scotch has been replaced by LITs. LOL One of the docs just bought me a Makers Mark 46.....not a huge bourbon fan, but might crack it open tonight and cry during the Jets/Dallas game. Hoping Dallas wins. So far I'm down 200 bucks today.....ugh. Link to comment Share on other sites More sharing options...
LESH Posted September 11, 2011 Share Posted September 11, 2011 Umm... I THINK Lesh was being facetious... Maybe a little. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted September 11, 2011 Moderator Share Posted September 11, 2011 Maybe a little. FWIW I knew you were kidding.... Link to comment Share on other sites More sharing options...
LESH Posted September 11, 2011 Share Posted September 11, 2011 FWIW I knew you were kidding.... Thanks EMED. I have a reputation (poor as it may be) to uphold. LOL Link to comment Share on other sites More sharing options...
medic25 Posted September 12, 2011 Share Posted September 12, 2011 I always appreciate a good Jonathan Swift reference :) And if we're voting on whiskey, I'll be having a Bushmills Black Bush; a true Irish classic. Link to comment Share on other sites More sharing options...
physasst Posted September 12, 2011 Share Posted September 12, 2011 I always appreciate a good Jonathan Swift reference :) And if we're voting on whiskey, I'll be having a Bushmills Black Bush; a true Irish classic. Hmmm. Bushmills. Link to comment Share on other sites More sharing options...
alleycat Posted September 12, 2011 Share Posted September 12, 2011 LESH, I'm relatively new to the Forum and haven't seen many of your posts , but I could read the 'tone' of your "modest" post....and having read the original Modest Proposal (hmmmm tasty long-pork) , found the humor refreshing. thanks hope " long-pork" doesn't offend anyone.:O_O: vitamin water here, acai and blueberry. hmmm. Link to comment Share on other sites More sharing options...
Contrarian Posted September 12, 2011 Share Posted September 12, 2011 Well yeah... "Long-Pig" is a aquired but succulent taste and delight...:;;D: Link to comment Share on other sites More sharing options...
taotaox1 Posted September 12, 2011 Share Posted September 12, 2011 Lol Lesh, This english major caught your reference :P Link to comment Share on other sites More sharing options...
paporzelt Posted September 13, 2011 Share Posted September 13, 2011 no o-chem, biochem, physics, upper level math and mcat are reasons(those were mine-they weren't very good ones then or now but they are reasons). no living on 40k/yr for 3-7 years as a resident is another. pa at 3+1=4 is still around half of md at 4+3(min)=7. some folks just want to get working and making $ and the difference of 3 years is a big deal. My program required Organic 1 and 2, physics, and gmats. and most 4 year science degrees require an upper level math anyway. I became a PA because I had no desire to be a MD, even though I easily could have become one, and was by no means very impressed with most of the medical students i've met and worked with while on rotations (from Columbia and NYU mind you). If I wanted my patients calling me "Doctor" I'd have gone to medical school. Link to comment Share on other sites More sharing options...
andersenpa Posted September 13, 2011 Share Posted September 13, 2011 My program required Organic 1 and 2, physics, and gmats. and most 4 year science degrees require an upper level math anyway. I became a PA because I had no desire to be a MD, even though I easily could have become one, and was by no means very impressed with most of the medical students i've met and worked with while on rotations (from Columbia and NYU mind you). If I wanted my patients calling me "Doctor" I'd have gone to medical school. Not sure when you went to PA school but those requirements seem to be a product of the modern age. Link to comment Share on other sites More sharing options...
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