Help! PA-C vs OPA-C

[MCHAD]

Alright, I am looking for some advice from those of you "Seasoned" PA's out there. I have had people ask me questions about "Physician Assistants" that they know that work in Ortho that were "Grandfathered in" so they didn't have to take the PANCE...I have figured out what i think these individuals are:

 

http://asopa.org/differencesopas.cfm

 

A classmate of mine also knows an OPA-C that refers to to himself as a PA and tells people he didn't have to go to PA school because his Brother-in-law was willing to train him on the job and he got certified by going to Florida and taking an unspecified "exam"... I guess my biggest issue is the fact that even on the website for this clinic they have rave reviews from patients saying how great the "Physician Assistant" is.

 

Have you encountered this and what do you do when someone tells you that they are a Physician Assistant and are leading people to believe that when they really aren't?

[LESH]

http://www.aapa.org/images/stories/IssueBriefs/Professional%20Issues/PA%20and%20OPA%20Distinctions%20-%202010.pdf

[rev ronin]

Interesting. I'd never heard of them before. Looks like they get full practice rights in TN, partial in NY, and some odd grandfathering in CA. There appear to be <600 total certified individuals--I wonder how many of them also hold some other actually effective credential like PA-C or RNFA.

[p911sc]

That article was very interesting and educational to me as well as I have never heard of them before.

[LESH]

Interesting. I'd never heard of them before. Looks like they get full practice rights in TN, partial in NY, and some odd grandfathering in CA. There appear to be <600 total certified individuals--I wonder how many of them also hold some other actually effective credential like PA-C or RNFA.

 

California had PA specialty training programs in the 70s to early 80s: Ortho, Emergency Medicine, Women's health and Allergy. I know one OPA, who later went through a Primary Care program, graduated and got her C. Others took the PANCE until the NCCPA made graduation from an accredited program a requirement. Most of these graduates were grandfathered in and given licenses but they could only practice in their specialty.

[just_me]

Is there something specificaly printer on their license that keeps them from enjoying the mobility of the profession?

 

California had PA specialty training programs in the 70s to early 80s: Ortho, Emergency Medicine, Women's health and Allergy. I know one OPA, who later went through a Primary Care program, graduated and got her C. Others took the PANCE until the NCCPA made graduation from an accredited program a requirement. Most of these graduates were grandfathered in and given licenses but they could only practice in their specialty.

[DSCLegend]

California had PA specialty training programs in the 70s to early 80s: Ortho, Emergency Medicine, Women's health and Allergy. I know one OPA, who later went through a Primary Care program, graduated and got her C. Others took the PANCE until the NCCPA made graduation from an accredited program a requirement. Most of these graduates were grandfathered in and given licenses but they could only practice in their specialty.

 

I was going to ask if there was something similar but with Women's Health. There's a PA that I know that says she was only trainned for Women's Health and that her license only says women's health. So is she "allowed" to see internal medicine/family medicine patients??

[MCHAD]

I was going to ask if there was something similar but with Women's Health. There's a PA that I know that says she was only trainned for Women's Health and that her license only says women's health. So is she "allowed" to see internal medicine/family medicine patients??

 

Huh...Sounds like a Nurse Midwife

[physasst]

There was a big program near here in Iowa, so Mayo has quite a few OPA's in Orthopedics. They started here in 1976. In fact, the Department of Orthopedics didn't hire it's first PA-C until 1992. They are slowly being phased out. AFAIK, there are no accredited programs anymore teaching it, but there is a movement in Tennessee, among some Orthopedists there to bring it back.

 

IN FACT, our PA-C affiliated program here at Mayo, is directed by an OPA.....BTW, OPA's ARE PA's, just in Orthopedics only. I would hesitate to ever challenge one of them to an Orthopedic specific exam. They can write orders here, and 1-2 of them can write orders for meds (grandfathered ones), but none of them can prescribe, at least here.

[LESH]

Huh...Sounds like a Nurse Midwife

Funny you should say that, after they stopped training PAs they started training NMW and still do today.

[LESH]

I was going to ask if there was something similar but with Women's Health. There's a PA that I know that says she was only trainned for Women's Health and that her license only says women's health. So is she "allowed" to see internal medicine/family medicine patients??

 

It would be outside her scope of practice based on education and training.

[LESH]

Is there something specificaly printer on their license that keeps them from enjoying the mobility of the profession?

 

That I don't know. I did see one of the Drew certificates recieved on graduation and it specified Emergency Medicine Physician Assistant, and I remember a state regulation giving Dr. Gail Anderson at LAC+USC authority to supervise all students in the program there or designate ER MDs/residents as SPs for training purposes. Considering how Ca. was/is about PA practice I am confident there was some type of designation. Mobility was the reason the one specialty trained PA I know went thru a Primary Care program.

[LESH]

BTW, OPA's ARE PA's, just in Orthopedics only. I would hesitate to ever challenge one of them to an Orthopedic specific exam. They can write orders here, and 1-2 of them can write orders for meds (grandfathered ones), but none of them can prescribe, at least here.

 

I totally agree my supervisor on my rotation in Ortho was one. She was good. She taught PA-S and the fifth years.

[coloradopa]

That I don't know. I did see one of the Drew certificates recieved on graduation and it specified Emergency Medicine Physician Assistant, and I remember a state regulation giving Dr. Gail Anderson at LAC+USC authority to supervise all students in the program there or designate ER MDs/residents as SPs for training purposes. Considering how Ca. was/is about PA practice I am confident there was some type of designation. Mobility was the reason the one specialty trained PA I know went thru a Primary Care program.

Drew used to have an EM post grad program. You may have been seeing one of those.

 

The biggest reason that OPA's don't have any movement or prospects is that they are unable to bill E/M or first assist from Medicare. They join a number of other positions that claim to be "just as good" as PAs. Medicare and the PA profession believes that like physicians you have to be able to take care of the entire spectrum of medical needs (whether or not Orthopedists choose to do this they can). This is the primary reason that the class C PA went away.

 

David Carpenter, PA-C

[clballin]

University of St. Augustine in St. Augustine, FL has been offering a masters in OPA since spring 2011. I have a few friends from my athletic training class who are attending in the fall. USA is amazing in ortho (their PT school is one of the best out there) so I'm sure the education would be great. OPA, however, isn't reimbursed for Medicare or Medicaid so someone would be rolling the dice with trying to get an ortho surgeon to hire them.

[Guest hubbardtim48]

http://www.aapa.org/uploadedFiles/content/The_PA_Profession/Federal_and_State_Affairs/Resource_Items/PA-OPA%20chart%204-2012%281%29.pdf

[Timon]

St. Augustine also opened up a OPA in San Diego, Ca.

[MEM-PATC]

I'm a PA Student in TN, and I brought this issue up to our state rep when they came on campus a few weeks ago. I really wish that TN would close new licensing for this profession. Obviously those still practicing should be able to continue to do so as they are grandfathered in, but they aren't PA's, and the whole idea of someone going to this school in florida (a state that doesn't even license OPA's) and then practicing in TN is crazy to me.

 

The OPA profession carries on and exacerbates many of the stereotypes that keep PA's back (undefined education guidelines, name confusion, etc.), and as long as we have open licensure for new OPA's, the problem is just further and further from going away by the extinction of this profession. Sounds harsh, and i don't really need it to be, but I think PA's need to protect their turf a little more. Again, I'm not trying to disrespect the knowledge of the people currently practice, but as someone who likely wants to work in ortho, and is an ATC also, I don't see how proclaiming these people as "specialty PA's" isn't a detriment to the PA profession.

[clballin]

I'm a PA Student in TN, and I brought this issue up to our state rep when they came on campus a few weeks ago. I really wish that TN would close new licensing for this profession. Obviously those still practicing should be able to continue to do so as they are grandfathered in, but they aren't PA's, and the whole idea of someone going to this school in florida (a state that doesn't even license OPA's) and then practicing in TN is crazy to me.

 

The OPA profession carries on and exacerbates many of the stereotypes that keep PA's back (undefined education guidelines, name confusion, etc.), and as long as we have open licensure for new OPA's, the problem is just further and further from going away by the extinction of this profession. Sounds harsh, and i don't really need it to be, but I think PA's need to protect their turf a little more. Again, I'm not trying to disrespect the knowledge of the people currently practice, but as someone who likely wants to work in ortho, and is an ATC also, I don't see how proclaiming these people as "specialty PA's" isn't a detriment to the PA profession.

 

From one ATC to another, I can totally understand your opinion on the subject. It's a tough decision for myself, since I truly appreciate the PA profession, to not want to look into a school like this. I thoroughly understand the differences and the name confusion. I have a few friends from my past athletic training class who will be attending this program and their reasoning is the fact that the training is all realms of ortho....the curriculum is very neat. Either way it does exist and from what I hear more states are looking to set licensing guidelines.

[discogenic]

From the orthopedic surgeon's perspective, why hire an OPA over a PA? From what I gather, OPAs do hit the ground running when it comes to orthopedics, which is a plus initially. But if I understand this correctly, OPAs can't write prescriptions, can't bill Medicare for services rendered (not sure about other insurance carriers), and can't work without the MD on-site. A PA, especially a PA with ortho experience, seems like such a better choice.

 

Are OPAs paid a lot less?

[MEM-PATC]

I think they make less, but I really don't know. As far as writing scripts go, I know some of them definitely "recommend" scripts and then MD signs off on it. It's fuzzy ground.

 

If more states sign of on them, that's the decision of those state governments. To me, however, that doesn't me PA's shouldn't be trying to prevent it. At the very least we should try to block the use of the term "Physician Assistant" as it muddies already unclear waters for patients. And does anyone doubt that the nursing world would put an end to "orthopaedic nurse practitioners" if such a thing existed and it threatened their "brand"?

[clballin]

http://www.healio.com/orthopedics/business-of-orthopedics/news/print/orthopedics-today/%7BFDCBAF09-7412-45D1-AACC-DA132BACD77C%7D/The-orthopaedic-physicians-assistant-Defining-our-value-in-anorthopedic-surgical-practice

 

 

Here's an article I found written by Jason Mazza, OPA-C. I've actually spoken to him before on the phone regarding the profession and his feelings on the St. Augustine program (he's an instructor there as well).

 

From what I remember hearing the pay isn't really set in stone since its very dependent on the ortho surgeon. Those in charge of the OPA program are hoping that offering a masters degree, OPAs will be recognized more for being specialists and that other schools adopt this curriculum.

 

I'm not particularly advocating this profession, I'm just interested in the response from others over the issue.

[rsterin]

I was initially interested in becoming an OPA (Ortho PA in the 80s).  There were only 5 or 6 programs; Cerritos JC in Norwalk, CA (LA County), Chattanooga, TN, Bismarck, ND, Staten Island, NY, Cedar Rapids, Iowa, and one more I think.  The one in LA County did not survive.  You were only train half a year to be an OR tech and Cast tech.  Luckily, I went to real PA school instead, but have spent half my career as a PA-Hospitalist in Orthopedic Surgery.  The young PAs do not care if they are called an Ortho PA or a PA in Ortho and don't see the big deal. 

It is a really big deal to me; testing every six years, 100-hour CME, etc.  They should no longer exist and now they have even added a "C" is more irritating. OPA-Certified.  But everyone, even medical assistants are now “certified”. 

I'm going to retire soon, after 35 years as a PA-C, so it's no longer my fight.  Nor is the Physician Associate vs Assistant.  I give up!

[Cideous]

1 hour ago, rsterin said:

I was initially interested in becoming an OPA (Ortho PA in the 80s).  There were only 5 or 6 programs; Cerritos JC in Norwalk, CA (LA County), Chattanooga, TN, Bismarck, ND, Staten Island, NY, Cedar Rapids, Iowa, and one more I think.  The one in LA County did not survive.  You were only train half a year to be an OR tech and Cast tech.  Luckily, I went to real PA school instead, but have spent half my career as a PA-Hospitalist in Orthopedic Surgery.  The young PAs do not care if they are called an Ortho PA or a PA in Ortho and don't see the big deal. 

It is a really big deal to me; testing every six years, 100-hour CME, etc.  They should no longer exist and now they have even added a "C" is more irritating. OPA-Certified.  But everyone, even medical assistants are now “certified”. 

I'm going to retire soon, after 35 years as a PA-C, so it's no longer my fight.  Nor is the Physician Associate vs Assistant.  I give up!

Certified Nurse Assistant?

 

CNA?  

 

Certified means nothing in the greater scheme of medicine.

[sas5814]

In Texas it is against the law to refer to yourself as a PA or Physician Assistant unless you are a graduate of an accredited PA program and have been initially certified by the NCCPA (continued certification not required). 

When I served on a hospital BOD and chaired the credentials committee we had a packet from an OPA pass through and I flagged it and killed it because he was credentialing as a PA. Nope. He can credential as something else but not a PA.

Sad thing was this was a re-credentialing and nobody in the hospital or the credentials office had a clue. I can't figure out how, with the Texas statutes, he was ever credentialed in the first place.