jmj11 Posted January 26, 2012 Share Posted January 26, 2012 APCoPhobia (pronounced ap-co-phobia) This post is in response to a conversation I had recently with a malpractice insurer. The malpractice insurer (whom I've dealt with before and are very anti-PA) is the insurer of a neurologist whom has agreed to be my alternate supervision physician. I will need him about 1 week per year. The malpractice insurer's underwriters put a premium increase of $3,000/year on this physician (which I would have to pay for if I took it) for that one week of supervision or about 75 patient encounters. So I figured it this way. I've had 100.000 patient encounters during my 30-year career. I've never been sued or threatened to be sued. The worse outcome in my career was a medication side effect (mirtazepine causing severe bone marrow suppression) and that patient is still one of my most loyal, and a dear friend. So, based on the underwriters thoughts, if the typical settlement is for $3,000,000 and they want to make $500,000 profit (so 3,500,000 potential expense) for 75 patient encounters (during that one week per year), means that they would anticipate a successful suit every 17,500 patient encounters. Now if I was sued successfully tomorrow (worse case scenario) that would be, in reality, that I'm sued every 100,000 patient encounters. So this means that the underwriters have over-estimated the risk by a factor of 5.7 (or 570%). This is so far out of the realm of reality that it warrants to be classified as a from of an anxiety disorder (in the insurer's underwriters). This same attitude is reflected by other bodies which discriminate against NPs and PAs, such as the Kentucky Medical Association, AMA . . . maybe others. Because this is a definable mental illness or irrational fear, it would be appropriate to name it. Now, I'm dead serious about this. What brought this to mind was the fact that I was at a recent international headache meeting where the term "cephalgiaphobia" was coined (meaning the fear of having a headache). That term already has a Wikipedia site ( http://en.wikipedia.org/wiki/Cephalgiaphobia ), which, btw, was created by my first SP Joel Saper, MD. I've chose APC for "Advanced Practice Clinician" to cover both PAs and NPs. Again, I am dead serious about this. I think we should use this term and in the coming weeks I hope to create a Wikipedia site for it. Now if you have a better name, feel free to share it. I think this will shine a light on the rhetoric which we hear all the time that has nothing to do with reality. Mike Link to comment Share on other sites More sharing options...
jmj11 Posted January 26, 2012 Author Share Posted January 26, 2012 APCoPhobia (pronounced ap-co-phobia) This post is in response to a conversation I had recently with a malpractice insurer. The malpractice insurer (whom I've dealt with before and are very anti-PA) is the insurer of a neurologist whom has agreed to be my alternate supervision physician. I will need him about 1 week per year. The malpractice insurer's underwriters put a premium increase of $3,000/year on this physician (which I would have to pay for if I took it) for that one week of supervision or about 75 patient encounters. So I figured it this way. I've had 100.000 patient encounters during my 30-year career. I've never been sued or threatened to be sued. The worse outcome in my career was a medication side effect (mirtazepine causing severe bone marrow suppression) and that patient is still one of my most loyal, and a dear friend. So, based on the underwriters thoughts, if the typical settlement is for $3,000,000 and they want to make $500,000 profit (so 3,500,000 potential expense) for 75 patient encounters (during that one week per year), means that they would anticipate a successful suit every 17,500 patient encounters. Now if I was sued successfully tomorrow (worse case scenario) that would be, in reality, that I'm sued every 100,000 patient encounters. So this means that the underwriters have over-estimated the risk by a factor of 5.7 (or 570%). This is so far out of the realm of reality that it warrants to be classified as a from of an anxiety disorder (in the insurer's underwriters). This same attitude is reflected by other bodies which discriminate against NPs and PAs, such as the Kentucky Medical Association, AMA . . . maybe others. Because this is a definable mental illness or irrational fear, it would be appropriate to name it. Now, I'm dead serious about this. What brought this to mind was the fact that I was at a recent international headache meeting where the term "cephalgiaphobia" was coined (meaning the fear of having a headache). That term already has a Wikipedia site ( http://en.wikipedia.org/wiki/Cephalgiaphobia ), which, btw, was created by my first SP Joel Saper, MD. I've chose APC for "Advanced Practice Clinician" to cover both PAs and NPs. Again, I am dead serious about this. I think we should use this term and in the coming weeks I hope to create a Wikipedia site for it. Now if you have a better name, feel free to share it. I think this will shine a light on the rhetoric which we hear all the time that has nothing to do with reality. Mike Link to comment Share on other sites More sharing options...
Contrarian Posted January 26, 2012 Share Posted January 26, 2012 Sounds GREAT..!!! I look forward to reading your Wiki entry... Link to comment Share on other sites More sharing options...
Contrarian Posted January 26, 2012 Share Posted January 26, 2012 Sounds GREAT..!!! I look forward to reading your Wiki entry... Link to comment Share on other sites More sharing options...
cinntsp Posted January 26, 2012 Share Posted January 26, 2012 You should lobby to have it put in the DSM-V. Link to comment Share on other sites More sharing options...
cinntsp Posted January 26, 2012 Share Posted January 26, 2012 You should lobby to have it put in the DSM-V. Link to comment Share on other sites More sharing options...
Moderator ventana Posted January 26, 2012 Moderator Share Posted January 26, 2012 the trail blazers have some amazing stories..... on the insurance issue I got a quote for $4500 for myself in a home call business but the malpractice carrier said that if I was an NP it would only be about 1k. Seems the NP rates are FAR below PA's across the board...... have heard that this is because the NP national agencies subsidize it, but this just seems crazy....... maybe it is all those non-practicing NP's that keep the rates low?? Honestly $4500 for a panel of 200 patients, 10 years of never being sued or even have a reportable event, seems excessive compared to the NP rate..... then the Doc rate is the same at 4500-5000 so I guess they rate us equal to a doc for risk but some 5x's more risky then a NP???? no real logic to it.... Link to comment Share on other sites More sharing options...
Moderator ventana Posted January 26, 2012 Moderator Share Posted January 26, 2012 the trail blazers have some amazing stories..... on the insurance issue I got a quote for $4500 for myself in a home call business but the malpractice carrier said that if I was an NP it would only be about 1k. Seems the NP rates are FAR below PA's across the board...... have heard that this is because the NP national agencies subsidize it, but this just seems crazy....... maybe it is all those non-practicing NP's that keep the rates low?? Honestly $4500 for a panel of 200 patients, 10 years of never being sued or even have a reportable event, seems excessive compared to the NP rate..... then the Doc rate is the same at 4500-5000 so I guess they rate us equal to a doc for risk but some 5x's more risky then a NP???? no real logic to it.... Link to comment Share on other sites More sharing options...
Contrarian Posted January 26, 2012 Share Posted January 26, 2012 It has always been my understanding that their rates are low across the board because All nurses are "pooled." I was told that they don't distinguish between ARNPs and regular bedside nurses but simply pool them as RNs/nurses. So with over a million "nurses"... it doesn't take a degree in acturarial sciences to see why their rates are low... Link to comment Share on other sites More sharing options...
Contrarian Posted January 26, 2012 Share Posted January 26, 2012 It has always been my understanding that their rates are low across the board because All nurses are "pooled." I was told that they don't distinguish between ARNPs and regular bedside nurses but simply pool them as RNs/nurses. So with over a million "nurses"... it doesn't take a degree in acturarial sciences to see why their rates are low... Link to comment Share on other sites More sharing options...
jdtpac Posted January 26, 2012 Share Posted January 26, 2012 You began this thread discussing malpractice insurance and somehow ended up addressing our professional title. “Advanced Practice Clinician”, I understand why NP’s incorporated the word advanced into their title, Advanced Practice Registered Nurse because they are practicing at a greater level of responsibility than they did as a registered nurse. However, when we began our training and practice as physician assistants what advanced practice are we performing? I would still prefer Physician Associate over what you have suggested as an alternative to our current professional title. Unless you are suggesting that there should not be NP’s or PA’s and their be one clinician trained to provide the types of services these two practitioners provide and give those individuals a title of APC. Link to comment Share on other sites More sharing options...
jdtpac Posted January 26, 2012 Share Posted January 26, 2012 You began this thread discussing malpractice insurance and somehow ended up addressing our professional title. “Advanced Practice Clinician”, I understand why NP’s incorporated the word advanced into their title, Advanced Practice Registered Nurse because they are practicing at a greater level of responsibility than they did as a registered nurse. However, when we began our training and practice as physician assistants what advanced practice are we performing? I would still prefer Physician Associate over what you have suggested as an alternative to our current professional title. Unless you are suggesting that there should not be NP’s or PA’s and their be one clinician trained to provide the types of services these two practitioners provide and give those individuals a title of APC. Link to comment Share on other sites More sharing options...
jmj11 Posted January 26, 2012 Author Share Posted January 26, 2012 Regarding the whole issue, the fear of the irrational fear of NPs and PAs, (without getting bogged down in the name issue) so the new term is NPAphobia (pronounced "Nap ah fo bee ah" Link to comment Share on other sites More sharing options...
jmj11 Posted January 26, 2012 Author Share Posted January 26, 2012 Regarding the whole issue, the fear of the irrational fear of NPs and PAs, (without getting bogged down in the name issue) so the new term is NPAphobia (pronounced "Nap ah fo bee ah" Link to comment Share on other sites More sharing options...
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