How is AAPA working with state legistlatures to change legislation for independent practice

[overthehorizen]

Just took a look at the Nurse Practitioner web site and saw how organized they are. No wonder the AAPA is completely unaware of what our profession is facing. The PA profession is being overrun by the NPs . AAPA is like the old purchasing manager who insists on buying IBM mainframes when every organization uses networked PCs. 

 

https://www.aanp.org/legislation-regulation/state-legislation/state-legislation-tracking-center

 

 

[overthehorizen]

Wonder if the AAPA has ever seen this map? PAs....say goodbye to your profession.

 

https://www.aanp.org/images/documents/state-leg-reg/stateregulatorymap.pdf

[CAAdmission]

Wonder if the AAPA has ever seen this map? PAs....say goodbye to your profession.

 

https://www.aanp.org/images/documents/state-leg-reg/stateregulatorymap.pdf

 

Yep. The only thing we have going for us is that NPs suck at taking care of sick people. If it was not for that, I would be very worried.

[mandrew1]

Where is all this hysteria coming from? Seriously, am I missing something? NPs certainly aren't overtaking Connecticut! 

[overthehorizen]

The VA is a leading indicator for our profession. They are the single largest employer of PAs in the country. They have longest history of PA utilization. Now, they have said that NPs are superior to PAs and PAs shall be subordinated to NPs. It is only a matter of time before the rest of the country and private sector takes notice. Some 2000 PAs were essentially derailed by the move to exclude PAs from independent practice at the VA. The most important influence in the VA on this issue is a Senior Executive employee, Denni Woodmansee PA-C. Mr Woodmansee, Director of PA Services at the VA, has been stone cold silent on the issue. He is however actively engaged in advancing the profitability of the NCCPA with continued PANRE testing. (See his listing as a Board Member). PAs wonder why they donate to the AAPA and nothing happens. It's because the people who have the influence are acting in their own self-interest rather than the interest of those they represent. The VA announcement portends an ominous future for the PA profession. Other hospitals will soon follow the same path and you will be reporting to the NP in your office. 

[ventana]

I would have to seriously disagree with the VA being the leading indicator of our profession.  They are so far behind the times in our area for PA utilization it is not funny.  They pay something like 40% less and truly do not understand the value of PA.

 

That being said - the NP lobby looks for weak spots to leverage to their advantage and the VA is one of the them.  They are organized and methodical and they have been going after their goals for man y many years.  Many of those years AAPA sat on the sideline and figure "the doc's have our back".   Well that was a seriously BAD decision!  Ultimately their lack of vision cost us $44,000 PER PA by not being allowed to do HiTech funds......

 

BUT the times are a changing....

 

AAPA has had a fair amount of staff turn over as the members stood up and demanded it - new members on the board, new directions are being taken

 

ie eliminating the Physician Assistant verbiage from teh web site,  now only PA, considering Full Practice Responsiblity, (and more things that I can not remember at 5am as I try to thaw out pipes)

 

 

 

My point is - AAPA was asleep at the wheel for a number of years - BUT they are not now.  As well - as a PA you MUST be advocating for the profession - I will not get into the NP/PA debate but I can say PAs are great providers and an asset to our health care delivery system.  

 

 

BUT you must be contributing $$$$ to a PAC (Political Action Committee) in order to have any right to gripe or B****   No one else but PAs are going to advocate for our profession so those that come on boards and gripe about the current state of affairs - WHAT ARE YOU DOING TO CHANGE IT?

 

 

I donate the equivalent of a cup of coffee a week to PAC with AAPA - not a lot - but I am doing something.

[SHU-CH]

Many state societies have very low levels of PA membership and participation. I also know of at least a couple that have had trouble filling board positions due to a lack of interest.

 

If the PAs within a state are not interested, there is little an outside organization can do to come in and improve the situation.

[BruceBanner]

Many state societies have very low levels of PA membership and participation. I also know of at least a couple that have had trouble filling board positions due to a lack of interest.

 

If the PAs within a state are not interested, there is little an outside organization can do to come in and improve the situation.

 

I think this is the crux of the whole problem. There is not enough interest and involvement at the grassroots, state/local level, which is reflective of our profession as a whole.

 

A while back I posited that PAs will never achieve full independence simply because the vast majority of PAs are OK with their dependent role. Most of us are or were smart enough to go to medical school, so it's not like we took a consolation prize in going to PA school. We chose this, and knew on some level what were getting into. The majority of PAs I have known in my career are 25-40, mostly females, with young families at home who just want to do their job without too much interference and go home on time.

 

This forum represents a vocal minority.

[True Anomaly]

I think this is the crux of the whole problem. There is not enough interest and involvement at the grassroots, state/local level, which is reflective of our profession as a whole.

 

A while back I posited that PAs will never achieve full independence simply because the vast majority of PAs are OK with their dependent role. Most of us are or were smart enough to go to medical school, so it's not like we took a consolation prize in going to PA school. We chose this, and knew on some level what were getting into. The majority of PAs I have known in my career are 25-40, mostly females, with young families at home who just want to do their job without too much interference and go home on time.

 

This forum represents a vocal minority.

 

This can't be said enough.  Absolutely true

[overthehorizen]

the majority of PAs I have known in my career are 25-40, mostly females, with young families at home who just want to do their job without too much interference and go home on time.

 

This forum represents a vocal minority.

This is an interesting argument worth exploring further. We do have to understand the heterogeneity of our membership and appreciate their diverse motivations. The question in my mind is this. If we can't effect change because we are majority is comprised of female PAs with children who don't care about the future, then how did the NPs achieve 22 state independence. The proportion of women in NP ranks is far greater than in the PAs ranks. The real answer is that the PA has a iron chain around his neck where the Physician master yanks whenever the wind blows. Nurses are not tied to Physicians and were easily able to extricate themselves from the dangerous reach of Physicians. 

[Boatswain2PA]

I think this is the crux of the whole problem. There is not enough interest and involvement at the grassroots, state/local level, which is reflective of our profession as a whole.

 

 

I can't join my state PA organization because I'm not a member of the AAPA.

 

If they changed that, then I would join, and offer to help in any way.

[MedicinePower]

This is an interesting argument worth exploring further. We do have to understand the heterogeneity of our membership and appreciate their diverse motivations. The question in my mind is this. If we can't effect change because we are majority is comprised of female PAs with children who don't care about the future, then how did the NPs achieve 22 state independence. The proportion of women in NP ranks is far greater than in the PAs ranks. The real answer is that the PA has a iron chain around his neck where the Physician master yanks whenever the wind blows. Nurses are not tied to Physicians and were easily able to extricate themselves from the dangerous reach of Physicians. 

The far higher number of NPs, many of them childless, permitted their more involvement in the political process. I imagine things for PAs will be very different in 10 years especially since there is a near exponential growth of graduating PAs due to the dozens upon dozens of new PA schools opening.

[ventana]

I think this is the crux of the whole problem. There is not enough interest and involvement at the grassroots, state/local level, which is reflective of our profession as a whole.

 

A while back I posited that PAs will never achieve full independence simply because the vast majority of PAs are OK with their dependent role. Most of us are or were smart enough to go to medical school, so it's not like we took a consolation prize in going to PA school. We chose this, and knew on some level what were getting into. The majority of PAs I have known in my career are 25-40, mostly females, with young families at home who just want to do their job without too much interference and go home on time.

 

This forum represents a vocal minority.

 

 

Many state societies have very low levels of PA membership and participation. I also know of at least a couple that have had trouble filling board positions due to a lack of interest.

 

If the PAs within a state are not interested, there is little an outside organization can do to come in and improve the situation.

 

 

 

seems like 'some' PA like to gripe and B*****

 

BUT 

 

When it comes time to actually put up some good old hard cash - and realize that AAPA is not perfect - but it is the best we have and it is getting better (a lot) - that people would rather sit back and complain - instead of being proactive and donating some money, and making their voices heard in DC - really it is not that hard now with EMAIL and the like.....

 

yup we get a butts handed to us by nursing because they understand the value of political advocacy, and that money talks, and BS walks....

[overthehorizen]

For the people here to want to eliminate senseless Panre testing and obtain independent practice, the idea of sending money to support the AAPA sounds foolish. I would characterize it this way.  Pretend a new political candidate from outside the mainstream decides to run for President. Nobody takes him seriously. The mainstream candidates with the power laugh at the guy. The new guy starts gaining ground even against the power and momentum of the mainstream candidate. In the primary though, the new entrant loses. The mainstream candidate who opposed everything the new entrant had campaigned on says "Come join my mainstream campaign and we will incorporate your idea. IT's better to work with us."  Tell me the ending to that story. 

[AliB]

I can't join my state PA organization because I'm not a member of the AAPA.

 

If they changed that, then I would join, and offer to help in any way.

 

What state (or states) require AAPA membership in order to join the state organization?

[Boatswain2PA]

What state (or states) require AAPA membership in order to join the state organization?

PM sent.

[RuralER/Ortho]

What state (or states) require AAPA membership in order to join the state organization?

I believe my state does as well...

[EMEDPA]

OR and WA do not. I am an aapa member , but not a member of WAPA or OSPA

[overthehorizen]

Many here are suggesting that contrarians should join the AAPA and be the change you want. I can't understand why I cannot look at the website for AAPA and find a section that says "Action plan to win practice independence" or "Action plan to eliminate PANRE testing." In the business world, orders don't come into the firm mysteriously from outer space with large checks to deposit at the bank. Every year, before the fiscal year begins, the President lays out the objectives. Various department heads tell the President how they can accomplish those objectives and what they will need. Each team creates a strategic and tactical plan. In the sales group, territories are carved out, major accounts are selected, product mixes are forecast, organizational charts of buying influences are created, swot plans are made for every product line, every product, every territory, every major account, sales funnels are created, weekly and  monthly numbers throughout the year predict how far above target the team is headed, resources are reallocated as needed to win major opportunities. The amount of planning and execution that goes into running a firm is mind boggling( I haven't even talked about manufacturing, engineering, accounting). Yet, I look at AAPA and the only thing I see is a letter expressing disapproval. For that effort, they ask for a sum of $295. I can't bring myself to pay that kind of money for a group that hasn't shown any plan, any action, any success, any strategy, any tactics, any leadership. I know it is harsh but I have worked with some winning firms and the AAPA is not a winner.

[FingersCrossed]

AAPA and state chapters:

http://www.nxtbook.com/nxtbooks/aapa/paprofessional_201612/#/8

[Guest Paula]

I can't join my state PA organization because I'm not a member of the AAPA.

 

If they changed that, then I would join, and offer to help in any way.

 

 

Wow, your state has that restriction?  Wisconsin allows PAs to join our chapter without being an AAPA member.  To fill some board positions you must be an AAPA member and of course to fill HOD position, must be an AAPA member.  You need to ask your state to change their policy.

 

I was a regional representative and on the WI board without AAPA membership, then re-joined AAPA at a later date.  To be president one must belong to AAPA and I am now president.   Boatswain: Start petitioning your state....what state do you live in ?  

[Boatswain2PA]

Wow, your state has that restriction?  Wisconsin allows PAs to join our chapter without being an AAPA member.  To fill some board positions you must be an AAPA member and of course to fill HOD position, must be an AAPA member.  You need to ask your state to change their policy.

 

I was a regional representative and on the WI board without AAPA membership, then re-joined AAPA at a later date.  To be president one must belong to AAPA and I am now president.   Boatswain: Start petitioning your state....what state do you live in ?  

Yup, my state APA requires AAPA membership to become a fellow.  I could pay he same dues as a fellow, but become a "sustaining member"...but not be able to vote or hold office.

 

My state APA also has low membership percentage.  I got an email from state president about a year ago asking me to join.  I wrote him back explaining why I wouldn't join AAPA.  He wrote me back a lengthy letter saying he understood my reasons, explained how the state APA has little influence over the AAPA, and then asked me to join as a sustaining member instead.

 

Yeah....I think I'll pass.

[sillycibin]

They're not pushing independent practice.  They have settled on "Optimal Team Practice."  Typical compromise type position that solves none of our problems and is doomed to fail.  I think OPT is a mistake and going to just waste years of our time and money with all the lobbying required to put it into place.  OPT is something we should have tried pushing 10 years ago, but the NPs are way too far ahead of us now.  And it is having ramifications in the job market now for NPs vs PAs in states with independent practice.  Our leadership is failing us with OTP.