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PA Friendly/Unfriendly States


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I am looking to get a list going of PA friendly vs PA unfriendly states. Andersen tried getting a similar thread going a while back that had a rating system but unfortunately it never took off. I don't know if it was too much effort for people to rate different aspects of the job or what... so instead I was hoping people could just say what state they currently work in or have worked in and whether you consider it to be PA friendly. Side commentary is appreciated too.

 

From reading this forum I've gathered that places like Washington, New York, and Vermont seem PA friendly while Maine, Kentucky, and Tennessee aren't. Feel free to correct me if I'm wrong. Virginia and Hawaii are very NP friendly but I don't know if that also equates to being PA unfriendly.

 

Any and all contributions are welcome. Thanks!

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maine is fairly pa friendly. pa's can cover er's solo there although I understand pa's in the community have some issues.

mayo regional medical ctr in maine is almost entirely staffed in the er by pa's. I think there is 1 doc who works occasional shifts but the vast majority of the time it is solo pa staffed. I looked at a job there and would still consider it in the future.

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Disclaimer: I'm a pre-PA and this is all hearsay and anecdotes.

 

Not from experience, but I'm under the impression that North Carolina is a very PA-friendly state in regards to required physician supervision, Rx and practice operation and ownership. I am also under the impression that Florida is moderately un-friendly to PAs and moderately friendly to NPs in the categories listed previously.

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ND-PA friendly and lots of jobs...for now. Being taken over by DNP's. Several programs in our state and they are taking over rural hospitals and "letting go" the PA's that have supervising physicians in other cities. We have poor representation and are being pushed out of the scene slowly by DNP's.

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Disclaimer: I'm a pre-PA and this is all hearsay and anecdotes.

 

Not from experience, but I'm under the impression that North Carolina is a very PA-friendly state in regards to required physician supervision, Rx and practice operation and ownership. I am also under the impression that Florida is moderately un-friendly to PAs and moderately friendly to NPs in the categories listed previously.

 

Can anyone else provide input on Florida? - South Florida specifically. I thought the scope for PAs and Nps were pretty similar down here.

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Yeah I work in Florida and trained in the northeast. Very different. I like florida based on the beaches and relatively high salary compared with a lot of states. However different mindset of what PAs can do or should do. NE is very PA friendly and expect PAs to do a lot. Here in FL you have to FIND positions that know how to utilize you. Granted this is an over generalization and each hospital is very different. Some hospitals have mindset of any chart any person but those are few and far between. Also the narc thing is just ridiculous. I found up north the most PA friendly state I rotated through was Connecticut. But all of them were fairly good with regards to responsibility. However pay is a lot less in some of those states as well, especially PA.

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Our practice employs NPs and PAs. We can both prescribe class II drugs..NOW. Previously it was just NPs and they would complain that they spent their entire day dealing with drug seekers and hyper/drugged kids. Once we could prescribe class IIs my schedule has much less complicated stuff and more refill visits. I enjoy the freedom of having class IIs of course...but also enjoyed the NP having to do all the refill visits and dealing with all the drug seekers. :)

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The NJ practice statutes state that every "order" needs to be countersigned. The BME has decided to interpret this to mean that everything a PA writes (except, curiously, a script) has to be countersigned. See a HTN patient for a routine checkup, find him to be stable, make no med changes = get that note countersigned. The time frame for signature differs depending upon the nature of the interaction, but if you work in a satellite office, you will be trucking all of your charts over to be siged every couple of days.

 

The BME also has secret things that PAs are not allowed to do. You will find these secret procedures nowhere in writing. Most are related to dermatology. PAs cannot use laser, administer botox, or do just about any esthetic procedure (dermabrasion). The only way one will find this out is to contact the BME and ask if one can do it. You will then find that there is a "policy" that PAs can't do these things. (It's a lot like the double secret probation in Animal House.) My advice to all NJ PAs is to NEVER contact the BME to see if you are allowed to do something. It is better to seek forgiveness than ask permission.

 

The Derm Society in NJ recently tried to get the BME to pass regulations that would not allow PAs to treat any derm conditions at all unless they were working under a board certified dermatologist. Miraculously, the BME saw this was dumb - it would have made taking care of poison ivy in the ER legally interesting.

 

The NJ Medical Society is the nation's oldest. Also the most self-centered, narrow-minded and oppressive. Last year, Selective Insurance denied a claim for a PA who performed EMG. The insurance company went to court, claiming it did not want to pay because the procedure was out of a PAs scope of practice. Both the Medical Society and the AMA filed briefs on behalf of the insurance company. Isn't that special? How often do you see physician organizations siding with an insurance company to deny a claim? On appeal, the court found in favor of Selective and EMG has now been effectively removed from our practice.

 

Some day, I am going to law school and I am going to offer sttep discounts to anyone with a suit against an MSNJ member. In the meantime, I hope they all get pancreatic cancer (Selective Insurance included)...

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Ohio has a reputation of being a PA-unfriendly state, but that is changing somewhat. New legislation has been passed within the past 5 years that has expanded the practice of PAs in Ohio. Some parts of the state are certainly more "PA-friendly" than others. I am under the impression that the Toledo, Cleveland, and Columbus areas are fairly PA-friendly. PAs cannot currently prescribe schedule II drugs in Ohio, but a bill has been proposed to Ohio legislature to allow prescribing of schedule II drugs as well as expand PA practice in other areas (pronouncement of death, among others). Salary is again dependent of what area of Ohio you are practicing, and while it is not among the highest, it isn't the lowest either. We are making strides in Ohio for PAs.

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