Jump to content
Sign in to follow this  
Avalon

MedScape Family Medicine weighs in on NP care

Recommended Posts

H, All,

 

This concerned me as much for its content as for location of the article.  Has anyone else seen this?  Granted, I read it late last night, but once again, I recall no mention of PAs in this debate.  Looking forward to your thoughts.

 

 

http://www.medscape.com/viewarticle/851933?nlid=91822_429&src=wnl_edit_medp_fmed&uac=193235ST&spon=34&impID=900115&faf=1

Share this post


Link to post
Share on other sites

Just came off shift and read "home of the dnp movement" as "Home of the drip movement"...could be possible as well perhaps?

 

SK

Share this post


Link to post
Share on other sites

Just came off shift and read "home of the dnp movement" as "Home of the drip movement"...could be possible as well perhaps?

 

SK

I much prefer french press over drip. definitely also better than keurig.

  • Upvote 1

Share this post


Link to post
Share on other sites

A little off topic, but a necessary reminder, the more autonomy they gain, the more attractive they become to an employer over a PA that needs a supervising physician.  I see plenty of job postings now that say NP only.

Share this post


Link to post
Share on other sites

Without taking a position on the competence of NPs to move into the primary care shortage, my concern is simply this: Here we see yet another article (vetted apparently by key players in the inception of the DNP movement) that has reached mass public access, that (intentionally?) overlooks the mention of PAs as possible contributors to said shortage of providers.  Where is the similarly scholarly article showing comparable patients outcomes between physicians and PAs to at least keep us at the bargaining table?

  • Upvote 3

Share this post


Link to post
Share on other sites

I looked through the articles that were cited and they just go in circles citing other RCTs but it's hard to find actual studies - I did find one was 45 years ago in Canada, and another was diabetes care from a nurse specialized in diabetes (NSD) in the Netherlands which is literally not even a thing in the US. I did find a decent articlle that they cited as having higher patient satisfaction with NPs. However this is a direct quote "Of the patients who consulted a general practitioner, 73% (364) stated that they would consult a general practitioner for a similar illness in the future and only 8% (38) indicated that they would consult a nurse (table 5). Of those who saw a nurse practitioner, 48% (211) stated they would consult a general practitioner next time and 32% (139) that they would consult a nurse." Soooo I'm no expert but personally I wouldn't use that information to support patient satisfaction with NPs?

experimenter-bias.jpeg

Share this post


Link to post
Share on other sites

One of my jobs is experiencing financial cutbacks, the first suggestion by a staffing company was to get rid of me and and the once monthly visiting SP as we could be replaced by a much cheaper new grad NP.  This prompted management and other non-medical personnel to comment that they "did not realize I had lesser degree than a nurse".  Infuriating as I have several years here working independently.  This is also seen in all of the job listings, NP preferred, PA may apply but may not be considered. Where is our professional representation?

  • Upvote 3

Share this post


Link to post
Share on other sites

Someone somewhere planted the seed into the physician community that supervising PAs was cumbersome, full of legality and generally unappealing.

In the past 10 years I have seen a steady decline in the number of jobs for PAs and ads starting to say NP Only. 

Surgeons still want PAs for the most part - we actually have training in surgery and I have met my fair share of NPs who can't suture, cast or do procedures.

 

I find it disturbing that this has occurred and that our governing body has not seemed to do anything to retort or rebuttal or provide facts.

 

The VA in my city is NOT hiring PAs or really NPs for that matter. All their ads are for physician only and their HR department doesn't return calls, emails or direct presentation of resume by house staff physicians (my friend is there). And yet they are completely short on docs and their ER has been closed and they don't have enough in house docs or providers PERIOD. So much for serving our veterans…..

 

SOMETHING has to happen on a national level or all these gads of new grads we are producing will have ZERO jobs and start taking jobs at a cheaper rate than those of us who are seasoned (no offense new grads but I have to protect my wage too).

 

I can't see authorizing ANY more PA programs and seriously evaluating the number of new grads per year in comparison with the job markets and the whole NP Only movement. We are pushing ourselves out of jobs steadily.

 

My very old 2 cents…..

Share this post


Link to post
Share on other sites

OK, I get that publication of such articles is frustrating but do you really expect nursing schools to include PAs in their studies?  Why would they do that when their not-so-hidden agenda is to prove their superiority?  We have not had meaningful PA workforce research for years while the nurses have been churning this stuff out with great regularity.  You may not like their methods, you may find fault (as do I) with their research design and sources, but like it or not, it IS getting published.  If you want to fight back, defend PA practice at home and nationally, create greater autonomy and/or change your scope of practice, then there must be commensurate PA research demonstrating PA competence to do so.  Years ago family medicine created research rings with each ring generating a question for which data could be gathered over a set time period.  The data was collated and voila - a publishable paper.  As a matter of fact, one of the largest NIH grants for family medicine was granted on the basis of the research rings and its data generated.  Reach out to practices similar to yours and create a research collaborative in conjunction with a PA program.  The faculty need the research experience and they need your data to do so. 

  • Upvote 3

Share this post


Link to post
Share on other sites

^^^^ Many of us actively involved in PA issues locally and nationally have been calling for research similar to the IOM The Future of Nursing study.  So far, we have not been able to secure a national research organization to have any interest in such a study.  PAFT has looked into IOM and other research groups only to find out the cost is prohibitive for us as a small organization and we do not have the clout or backing from a university.  Your idea of joining with a university program and research arm is a good one.....food for thought.   

 

It will be a good topic of discussion for the Leadership and Advocacy summit coming up in February 2016.  I will be there. 

  • Upvote 1

Share this post


Link to post
Share on other sites

I have mentioned it before, as in real estate - location, location, location and with medical providers it is perception, perception, perception.  It seems to come back to the PA title with reclaiming the title of Physician Associate.  That's not all.  The doctorate will become a must for the survival of the profession though not necessary for all to practice medicine.  The elevation of the perception will lift the profession as a whole.  PA to MD or DO bridge programs will continue to be a desirable option for many.  The PA niche will remain as intended, producing a well-trained medical provider, in a timely fashion, able to practice medicine with collaboration.  However, once seasoned, there must be a option of pursuing a doctorate and the elimination of physician collaboration or tethering.  Consultation will always exist anyway.  The general public will accept a residency style doctorate embellished with classroom time (books, case studies, ...), stout tests, and lectures, etc. along the way.  The time is at hand to grow bold in advancing the profession or grow extinct in the manner by which the PA profession is historically known.  Being progressive is better that lagging.  Work it.  A stitch in time saves nine...

  • Upvote 3

Share this post


Link to post
Share on other sites

Someone somewhere planted the seed into the physician community that supervising PAs was cumbersome, full of legality and generally unappealing.

In the past 10 years I have seen a steady decline in the number of jobs for PAs and ads starting to say NP Only.

Surgeons still want PAs for the most part - we actually have training in surgery and I have met my fair share of NPs who can't suture, cast or do procedures.

 

I find it disturbing that this has occurred and that our governing body has not seemed to do anything to retort or rebuttal or provide facts.

 

The VA in my city is NOT hiring PAs or really NPs for that matter. All their ads are for physician only and their HR department doesn't return calls, emails or direct presentation of resume by house staff physicians (my friend is there). And yet they are completely short on docs and their ER has been closed and they don't have enough in house docs or providers PERIOD. So much for serving our veterans…..

 

 

They need the money for the sleep study they contract out for every single psych referred etc. Etc.

Share this post


Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Sign in to follow this  

×
×
  • Create New...

Important Information

Welcome to the Physician Assistant Forum! This website uses cookies to ensure you get the best experience on our website. Learn More