Missiles launched at NCCPA

[CAdamsPAC]

So, yeah...update on the on-line reviews and transparency:

 

NCCPA has totally taken down all rating, feedback postings on their facebook site as well as the fact that Google reviews / rating is "magically" completely unavailable now.. hmmm....  It's hard to imagine that they're not spending the money WE give them to have Google shut it down.  ...just an other level they're spending money they get from US to their own cause--AGAINST us. 

 

The NCCPA were SUPPOSED to be more transparent, (not that they were at all in any way before).  This was discussed at the recent big pow-wow (the NCCPA, AAPA, ARC-PA meeting couple months ago).  The NCCPA apparently agreed to be more transparent.  So, they're not only not keeping up with their end of the deal but going in the opposite direction.

 

This is yet an other level of unacceptable behavior of the NCCPA and only more clearly shows that they're in this all for themselves, and by shutting down all feedback, posts from PAs, (even perfectly professional posts/reviews/feedback), is only continuing to fool the public and, basically, being deceitful.  The ONLY posts on their FB site they don't delete are those, who drink the Kool-aid and leave fluffy NCCPA-nicy-nice posts.

 

C'mon AAPA.....  where are you??!!!! 

Gee, who here is surprised to learn of this action by NCCPA? They are in the " open self preservation mode" , now that their true colors have been exposed and validly challenged. It's time for someone to start a campaign to specifically disconnect us from involuntary servitude to the NCCPA. I don't know who but I'll write the checks to support them!!

[Reality Check 2]

So, my questions are - What is the legal tie to NCCPA and between whom? How do we disconnect from NCCPA on a national level?

 

I am sure that AAPA has a team of lawyers trying to figure this out but since AAPA membership is voluntary - how do we represent ourselves against NCCPA which requires all of us to be certified through them?

 

There are 1000 questions about how to disconnect, how to maintain certification for state requirements, how to grandfather folks in, etc etc etc.

 

Pretty sure NCCPA isn't going to voluntarily give up the personal info on all 108000 PAs in its books right now - how do we get a hold of everyone?

 

Do we have a leader of this movement or is it even a movement -- yet?

[ventana]

In today's email from AAPA

Add your voice to the discussion on PA recertification at AAPA 2017 
AAPA 
The AAPA Board of Directors continues to explore the feasibility of starting a new certifying organization. This is your chance to make your voice heard! All AAPA members are invited to attend The Future of PA Recertification: Information and Feedback Session at AAPA 2017, May 15-19, in Las Vegas. Register now and sign up to save your spot at this session — space is limited! Already registered? Sign up when you add The Future of PA Recertification: Information and Feedback Session to your conference schedule. 

 

 

 

Folks now is the time to address this.  Honestly NCCPA needs to wake up and realize how dire straights they are in and hopefully "come to their senses"

 

speak up!!

 

 

 

as for a leader - does PAFT have a thought on this???

[Noreaster]

I'm an AAPA member; I did not get the email. 

 

I'm completely in...with creating a new re-cert process.  Let the NCCPA have the PANCE but a new re-cert process is one really great way to get out of that stronghold over my throat, as so eloquently articulated above. 

 

I would totally donate $$ to the AAPA, if I find out they're moving forward with this.  I know they can't accept any $ for anything specific but I think they can if generic. 

 

I'm in !!! 

 

One thing that I feel perplexed about is when I talk with PAs and they don't see it... they don't see how corrupt and self-serving the NCCPA is and just have that Zoloft look in their eyes and that Stepford wives look in their eyes and happily robot-along with the NCCPA's manipulations and, well, pure oppression really. 

[Reality Check 2]

I didn't get an AAPA email either and am paid up membership-wise.

[GreatChecko]

By the looks of the cut and paste, that is from the daily "Members Community Digest." Might have to check your email settings on the website or your spam folder for it, especially if it gets deleted on a regular basis.

[CAdamsPAC]

I'm an AAPA member; I did not get the email. 

 

I'm completely in...with creating a new re-cert process.  Let the NCCPA have the PANCE but a new re-cert process is one really great way to get out of that stronghold over my throat, as so eloquently articulated above. 

 

I would totally donate $$ to the AAPA, if I find out they're moving forward with this.  I know they can't accept any $ for anything specific but I think they can if generic. 

 

I'm in !!! 

 

One thing that I feel perplexed about is when I talk with PAs and they don't see it... they don't see how corrupt and self-serving the NCCPA is and just have that Zoloft look in their eyes and that Stepford wives look in their eyes and happily robot-along with the NCCPA's manipulations and, well, pure oppression really. 

 

"One thing that I feel perplexed about is when I talk with PAs and they don't see it... they don't see how corrupt and self-serving the NCCPA is and just have that Zoloft look in their eyes and that Stepford wives look in their eyes and happily robot-along with the NCCPA's manipulations and, well, pure oppression really. "

This is why our profession is where it is today....far too many "Go along and get along" PA Bots afraid of their shadows out there, concerned about upsetting or offending someone if they speak up on an issue that threatens their profession!!

[PA2B2017]

In my program, it's learned in PA school! Lots of 'do what we SAY, not what we DO', and 'we know what is best for each and every one of you; don't question or argue, or we will make life worse for you' (which they have proceeded to demonstrate to reinforce the lesson), and so on.

[CAdamsPAC]

In my program, it's learned in PA school! Lots of 'do what we SAY, not what we DO', and 'we know what is best for each and every one of you; don't question or argue, or we will make life worse for you' (which they have proceeded to demonstrate to reinforce the lesson), and so on.

Don't get me started on PA Schools faculty's need to control students!! That a whole other thread!!!

[Ollivander]

Can I get a TLDR as a pre-PA?

[BruceBanner]

In my program, it's learned in PA school! Lots of 'do what we SAY, not what we DO', and 'we know what is best for each and every one of you; don't question or argue, or we will make life worse for you' (which they have proceeded to demonstrate to reinforce the lesson), and so on.

 

It was the exact same in my program back in 2010 - 2012. Very punitive, fear-based environment.

[PA2B2017]

It was the exact same in my program back in 2010 - 2012. Very punitive, fear-based environment.

And then consider how it might be reinforced in a practice setting where the "dependent practioner" (who DOES need the OJT to learn how to actually practice what they swallowed from the 'fire hose') is treated the same way ... I imagine it takes some eye-opening event to see the issues.

[BruceBanner]

Can I get a TLDR as a pre-PA?

 

The NCCPA is a very suspicious, self-serving organization with little explanation as to where our 16+ million dollars are going each year. They have made lobbying efforts that have blocked legislation that would result in broader scope and greater independence for us, mainly because such legislation would not require re-boarding to maintain licensure. The most recent was in west Virginia, where they succeeded. Curiously, the NCCPAs lobbyist is also a lobbyist for a private holding of the WV governor. None of this was voted on by PA constituency.

 

Basically, their overarching goal is to make certification and re-certification mandatory to practice everywhere, without any input from the PA community or AAPA. They are blocking otherwise really progressive legislation that would move the PA profession forward. The AAPA is starting to pick up speed and actively oppose this.

[Lyndhurst]

As a current student I can echo the authoritarian do as we say nature of my program. They are not very interested in dialogue.

 

Also I am surprised at how many of the practising PAs I meet on rotation are aware of the NCCPAs recent actions. Most admit to not paying attention too much but are surprised when I tell them about the WVa actions.

 

Is there a way to spread that story amongst PAs? How I don't know maybe advertisement in journals. Perhaps PAFT could take action on this at the conference. Increasing awareness amongst practising PAs could only help

 

Sent from my SAMSUNG-SM-G920A using Tapatalk

[BruceBanner]

And then consider how it might be reinforced in a practice setting where the "dependent practioner" (who DOES need the OJT to learn how to actually practice what they swallowed from the 'fire hose') is treated the same way ... I imagine it takes some eye-opening event to see the issues.

 

I'm not really sure why this culture exists. I've heard from students I have that it is similar in their programs. Like what is the benefit? I get the 'professionalism' thing but they go over the top letting you know how much power they have.

[marktheshark89]

^my program was the exact opposite of this. Perhaps some do need that type of structure but I would not have thrived in such an environment.

[Reality Check 2]

I went to school so long ago - the profession was only 20something years old then.

 

My program concentrated on skills. We really weren't treated any differently than med students and expectations were the same on clinical rotations.

 

PAs worked in our teaching hospitals and we saw what they did. 

 

Back in Texas in the 90s - NO Rx privileges, we didn't even have licenses then.

 

But we were treated fairly, high expectations, good interactions with the majority of attendings, residents, clinics.

 

It makes me sad to hear about oppressive or less than realistic teachings.

[Ollivander]

The NCCPA is a very suspicious, self-serving organization with little explanation as to where our 16+ million dollars are going each year. They have made lobbying efforts that have blocked legislation that would result in broader scope and greater independence for us, mainly because such legislation would not require re-boarding to maintain licensure. The most recent was in west Virginia, where they succeeded. Curiously, the NCCPAs lobbyist is also a lobbyist for a private holding of the WV governor. None of this was voted on by PA constituency.

 

Basically, their overarching goal is to make certification and re-certification mandatory to practice everywhere, without any input from the PA community or AAPA. They are blocking otherwise really progressive legislation that would move the PA profession forward. The AAPA is starting to pick up speed and actively oppose this.

Thank you so much for explaining this in great detail! I assume the outlook that re-boarding to maintain licensure won't change over the next decade then by the looks of half of the replies in this thread?

[AliB]

Thank you so much for explaining this in great detail! I assume the outlook that re-boarding to maintain licensure won't change over the next decade then by the looks of half of the replies in this thread?

 

FYI

 

·       Only 18 of the United States require re-certification for license renewal;

33 (with D.C.) do NOT require PAs to re-certify in order to maintain their license; these jurisdictions have no issues with patient safety

·       CMS (Centers for Medicare and Medicaid Services) does not require PAs enrolled as providers to recertify^[1]

[1] https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/Medicare-Information-for-APRNs-AAs-PAs-Booklet-ICN-901623.pdf

 

However, many private insurers and many corporate owned facilities DO require maintenance of certification as a condition of credentialing or of employment, so the majority of PAs (>90%) are compelled to, or choose to.

[BruceBanner]

^ Correct. Even if the state does not require it, that VAST majority of corporate/university employers do.

[Reality Check 2]

I have a job pending at the VA

Looks like VA and all government agencies require certification.

The VA requires certification as a condition of employment - thus, PANRE after PANCE:

 

 

 

a. A PA is a health care professional trained at the graduate level and credentialed to provide medical services to patients within a defined Scope of Practice. PAs receive over 2,000 hours of didactic training in the medical sciences and over 2,000 hours of supervised clinical training. PA training programs are nationally accredited by the Accreditation Review Commission on Education of the Physician Assistant (ARC-PA). PAs must receive a passing score on the Physician Assistant National Certifying Examination (PANCE) for initial board certification by the National Commission on Certification of Physician Assistants (NCCPA). Maintenance of certification requires Continuing Medical Education (CME) from a provider accredited by the American Academy of Continuing Medical Education (AACME), and completion of a selfassessment and Practice Improvement activities approved by NCCPA biennially. In addition, recertification requires a passing score on the Physician Assistant National Recertifying Examination (PANRE). Initial NCCPA certification is required for PA practice in all 50 States and maintenance of certification is a condition of employment for all Federal Agencies employing PAs. NOTE: PAs who were on VA employment rolls prior to the implementation of the VA Physician Assistant Qualification Standards (March 12, 1993) and were not certified by NCCPA on that date are exempt from the certification requirement for employment.

[south]

Yeah, I have looked at / applied to / interviewed with "x" many jobs since last fall and don't remember a single one NOT requiring it.  I DO know one PA who had not renewed his at his date a few years past and his employer had no problem.  However that hospital was bought out a couple years ago, so...

 

Classic political argument, by the way.  Legislating a requirement best left to the private employer's choice...

[CAdamsPAC]

We are not completely alone gang! ; 

This pediatrician declined to do MOC. See what happened to her.

MEG EDISON, MD | PHYSICIAN | MAY 17, 2016

The American Board of Medical Specialties says “board certification is a voluntary process, and one that is very different from medical licensure.” This is echoed by my board, the American Board of Pediatrics, who says, “Board certification is a voluntary process that goes above and beyond state licensing requirements for practicing medicine.”

Over the past few years, the definition of “board certified” has changed from a one-time test to an ongoing series of tests, hoops, and fees to maintain certification through the MOC program. Not participating in any portion of the convoluted and expensive MOC program results in loss of board certification, but so what? Board certification, either as initial certification or 20 years into maintaining certification is voluntary, so what’s the big deal?

 

 

Well, it turns out, not complying with MOC is a big deal. Not only has the definition of “board certified” changed, apparently so has the definition of “voluntary.”

 

 

 

On December 17, with the blessing of my partners, I decided to test how “voluntary” board certification is.  Over the past 13 years, I’ve passed my board examination twice, completed multiple proprietary online tests, and completed three ABP research projects on my patients. But when the American Board of Pediatrics threatened to revoke my certification and nullify 13 years of testing and research projects if I didn’t pay $1,300 to “maintain certification,” I had enough. I didn’t pay, and voluntarily gave up my board certification.

I wrote a letter explaining why, so there wouldn’t be any confusion. To date, that letter has been read 100,000 times. Clearly, I hit a nerve among my colleagues. But what would happen to me professionally? What happens to doctors who stop doing MOC?

 

 

First off, after many threatening emails, the American Board of Pediatrics erases the name of any doctor who fails to complete any of the four parts of MOC from their website. Erases.

December 17, there I am.

And now, I don’t exist.

Grandfathered doctors, like ABP president David Nichols,  are listed as “Board certified, not participating in MOC,” but those of us who have passed multiple board exams and a decade of MOC? Erased.

Obviously, they have the technical ability to list us as, “Board certified, not participating in MOC,” but they don’t. They erase our names, as if we’d never passed our boards to begin with. The only way to find out that I’ve passed two board exams is to write the ABP and pay $40 for a release of information. Why would they do such a thing, why make this so difficult for us? Because their website has the power to destroy our careers, that’s why.

 

 

Four weeks after my Open Letter to the American Board of Pediatrics was published, my name was erased from the ABP website and the threats began. On an insanely busy Friday afternoon in February, I was called by Blue Cross Blue Shield of Michigan/Blue Care Network, and informed that I had to immediately cease from seeing any of my BCBS/BCN patients. Immediately. They checked the ABP website, my name was no longer listed, and I was therefore no longer allowed to see my patients.

I asked if I could have a colleague co-sign my notes, and that was not allowed. I asked it I could see my patients and not be paid. They said I was forbidden from seeing my patients. I submitted my board certification through the National Board of Physicians and Surgeons, and was told only ABMS boards were allowed. I asked if I asked if I could see the credentialing policy I was being held to, and was told, “it was proprietary.” All this stress and harassment in Michigan,  because I didn’t pay $1,300 to the American Board of Pediatrics, a multi-million certification corporation out of North Carolina. Unbelievable.

I pushed back and asked for a departicipation notice in writing, and they backed off. I now have until December 31, 2016, to comply and pay the American Board of Pediatrics $1,500 (with the added $200 late fee, of course), or I will be banned from seeing my patients at that point.

 

 

Next up were the hospitals. My hospital privileges were due for renewal this month, and imagine my surprise when I had to sign a contract confirming that I would enroll in ABP MOC! This was nowhere to be found in my med staff requirements, which only requires me to have initial board certification. When I asked the hospital credentialers, they assured me this was a glitch. No one knew how this language made its way on to the computer-generated contract or how to change it.  After much anxiety, I signed the contract as there was no alternate way to get my privileges renewed. Time will tell if I lose my hospital privileges over a computer “glitch.”

So far, six months after dropping my board certification, I’m still standing, but not without a ridiculous amount of harassment and bullying. My scenario repeats itself thousands and thousands of times across the country. Usually, most doctors back down and pay the money, they stop doing CME of their own choosing and complete the education modules decreed by the boards, they stop doing their own novel medical research and instead complete the  busywork research for the boards, they give up family time to travel to review courses, they shut down their offices to take secure examinations.  Doctors do this out of fear. The ABMS has long banked on fear and intimidation as a business model.

That model is coming into question as more and more doctors fight back. Rather than fear, I’m banking on the strength of my fellow physicians to return board certification to its rightful place as a voluntary process: one that is not tied to licensure, hospital privileges, insurance participation. Oklahoma has shown us this is possible.

Michigan will take the first step towards freeing our doctors from overreach of the ABMS, as House Bills 5090 and 5091 finally go to testimony before the House Health Policy Committee.  I will be there testifying, alongside an incredibly diverse group of physicians finding common ground on this issue.  The powerful insurance and hospital lobbies will oppose us, as anticipated. Maybe the ABMS will send someone to plead their case.

I remain optimistic that Michigan lawmakers will see MOC for the money-making sham it is, and act on behalf of Michigan doctors and our right to care for our patients without interference by these unaccountable outside board certifying corporations. My hope is that this will be the beginning for other states to follow in our footsteps and return board certification and MOC to a voluntary process, free of fear and intimidation.

Meg Edison is a pediatrician and can be reached on Twitter @megedison.  This article originally appeared in Rebel.MD.

Image credit: Shutterstock.com

 

[Noreaster]

CAdamsPAC,

Good illustration of the realities out there!

As I've said in prior posts, there's good reason that the AMA is strongly against high stakes re-cert testing.  This is also why I was strongly against the NCCPA getting into specialty testing.  The evolution is obvious.   A multi-million dollar company creating more and more tests.. hmm.. more money for them and more restrictions on us.  How do more PAs not see how this hurts us?  I'm perplexed actually.  In like, there's good reason the AAPA is opposed to high stakes re-cert testing.

 

​I have a friend, who's a surgeon in a sub-specialty, who's exceptionally good, strong, talented, and yet, came extremely close to losing his job and livelihood over high-stakes re-cert testing.  When he didn't pass a test, he had to cancel a very busy clinic and actually fly out to the site of the test creators.  Of course MOC companies make a sh**-ton of money and, of course they're HIGHLY motivated by that huge income.  Of course they'll do just about anything to maintain and even increase their millions.  These companies all claim the same thing as the NCCPA.. that we're "safer" by their re-cert high stakes testing. 

 

Pretty much the only people who I hear things like, "having a re-cert test isn't a big deal" are those, who work in ER/Fam practice/hospitalist, or PA students/new grads, and I WISH these PAs would see the bigger picture.  I saw on this forum in a different thread a PA said something to the effect of, (paraphrased), [...if a PA can't pass a PANRE, well, should they be practicing?]  I mean, I say with all due respect, that's just drinking the Kool Aid.  Last I looked, I think over 74% of PAs are in specialties.  The PANRE is 'supposed' to be a family practice/generalist text. (apart from surgery test)  I don't actually even see how a generalist exam supports us moving from one area of medicine to an other, yet, I never hear anybody arguing that...those PAs, who say we should be taking the re-cert test.  So, those, who work in ER/Hospitalist/Fam practice, um... IT'S WHAT THEY DO DAY IN AND DAY OUT...of course it's not a big deal to you guys.  Ok, that was a bit off subject.. oops.

 

​I just strongly hope that PAs' eyes are widely opening as the recent deplorable acts by the NCCPA in West Virginia and how this exposed their obvious corrupt, extremely biased, selfish, greedy, and self-seeking ways. 

[south]

I expect the PANCE, PANRE and maintenance certification fees to increase every year.  If I read the forums here correctly, the PANCE fee increased about $40 since last year.  I assume it's been like that for years.

 

Money in the bank!  GIve me a single reason why they would decline this cash flow.

 

My classmates were surprised and pissed when our school suddenly required about $1000 in brand new "graduation fees" midway through our last semester. Someone complained, pointing out that the fees exceeded costs they could get from loans and were mysteriously absent from the website.  We were tersely informed that we were certainly welcome to decline the fee and not graduate or receive a degree.  

 

They could have demanded $10,000 and we would have paid it.  If you listen closely, on a quiet night, you can them (and the NCCPA) laughing.