An alternative to the PANRE?

[mmiller3]

11 minutes ago, ral said:

They need to add one more answer to the sample test question (I just now went and read it):

Which of the following is the most appropriate next step?

(A) Anteroposterior and lateral x-ray studies of the skull (B) CT scan
(C) Discharge and observation by family or friends
(D) Hospital admission for observation

(E) MRI 

(F) Look over at the patient's mother/father/sister/husband/friend.  Explain each of the previous options, and what the consensus of the best experts and current research states, while carefully observing their facial expressions and/or body position/language.  Quickly refer back in your mind to the current quarterly satisfaction surveys, which are sent out by the folks in the 4th floor offices, with the private bathrooms and espresso machines, and consider how this will impact your next performance review.  If the patient and significant other smilingly nod in agreement with your assessment and explanation, thank you for being so kind, and ask if you have a private practice where they can establish you as their PCP, then move forward with option (C), and discharge the patient appropriately.  If you pick up on any hesitation, a subtle raise of the eyebrow, a teenage type "duck face", a roll of the eyes, a comment about a relative in the healthcare or lawyer business, a smug "Hmmph", or any other flag, then quickly offer to get them a coffee and danish to pass the time while you order the CT or MRI, and put in a consult for neurology.  Go home and sleep well, knowing that you were able to provide the highest level of customer service in the industry.  For the next week, refer to Yelp or Facebook, to see if the patient left at least a four star review, thereby ensuring that your job remains secure.

I'd say it's funny 'cause it's true, but it's not funny (not your comment, but the state of medicine these days). Just true.

[delco714]

I emailed them asking what it takes to pass

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[Ollivander]

Do you guys think they'll ever get rid of this re-certification process of re-testing and move towards re-certifying via clinical practice hours and continuing education credits?

[delco714]

Do you guys think they'll ever get rid of this re-certification process of re-testing and move towards re-certifying via clinical practice hours and continuing education credits?

Doubtful.. Our physician colleagues need to pass boards, so why shouldn't we? We are not NPs after all..you want to keep SOME ability to move specialties or to primary care, right? Need to keep specialty PA at least somewhat broadened to do so..somehow.. At least that's my take

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[Guest Paula]

There is  no point to the PANRE.  PANCE should be permanent certification that allows us to get a permanent license, just like physicians never have to retake their USMLE.  

If you are in  a specialty and take the CAQ then take it for your job protection and if you go to a specialty and need to take a CAQ, then do it. CAQ does not necessarily need to be through NCCPA.  For example: Certified Diabetes Educator for endocrinology practice where the PA focuses on diabetes suffices for a CAQ.  Headache specialty allows a test for PAs....voila...a CAQ.  

Family practice  and general internal med doesn't need the PANRE, just CME in the area of FP/IM.

Let's work towards full OTP in each state and put in our rules that there is no requirement for  recertification for licensure and the the initial PANCE is sufficient to qualify us as permanent certification. Each state PA board determines the amount of CME required for license renewal.  The NCCPA eventually becomes only a body that provides the PANCE and CAQs, but become obsolete for PANRE, as it is not their function anymore.  Let's squeeze them out of PANRE business. 

 

 

 

[mrieger]

“Paula”...thank you for your thoughts.  I share the same desire as you.  PANRE is an unneccessary stress that proves nothing in regards to our capability of treating patients in the clinical setting ?

[GetMeOuttaThisMess]

On 10/3/2017 at 8:39 PM, Paula said:

I'm breathing another sigh of relief.  I took PANRE in 2016 and am on the 10 year cycle.  Will be retired by 2026.  No More PANRE for me!!!!!  I dodged the bullet. 

I'm like Paula, any further questions I see in the future will be answered "retirement".  BTW, I didn't see it in the thread, what was the scenario regarding the imaging study choice/observation posed?  I'm going to guess that Jack fell down and broke his crown but had no LOC, event amnesia, focal neuro sx., or recurrent barfing.  If so, save them money and send them home, AND DON'T TELL THEM TO KEEP THE DARN PATIENT AWAKE!  Do they really think that keeping them awake makes a difference if you're developing increased ICP?  If you're going to do anything have someone go and attempt to wake them once overnight and if not an appropriate response then go back and scan.  Back to Airstreams, vacation condos, Medicare supplemental policies, etc..

[BruceBanner]

I could see how specialty PAs would not be thrilled about another iteration of primary care standardized testing.

The way I see it, though, it's a win-win. I get to take 25 general medical questions every 3 months for 2 years, and if I fail (I have a feeling they will probably 'pass' everyone this being a pilot), I get an extra year to take the PANRE, for which I've been doing NCCPA-authored practice questions for 2 years anyway.

To me that's a lot less "high stakes" than a massive half-day pass/fail general knowledge exam.

And who knows, maybe by 2021 there will be a new certification paradigm anyway.

 

[sas5814]

I think where we are going to end up is anyone's guess. This is a step in an evolution. In answer to Ollivander... I don't think we will see a CME only option anywhere in the visible future. There is a strong opinion that it lacks credibility. Opinions vary. We just have to keep moving forward.

[Guest UVAPAC]

I work with several APRN's, and I know that to re-certify they can either "take a test" or "write an essay."  I was told they basically all choose to submit their CME's with an Essay because "why risk failing the test."

 

I am due for the PANRE in 2021, so hoping that this pilot study is a success, and we have additional options.

[Noreaster]

I do like the fact that they're doing something to evolve things and it's cool to be able to have options.  I do not like, however, that this pilot test is still a high stakes test. 

What I'm honestly confused about is: the NCCPA is saying "no preparation needed" and the NCCPA told me that this is testing "walk around knowledge" and no prep needed.  Sooo.... like 75% or over of us are in specialties and we're going to be tested without prep???  and expected to have a "walk around knowledge" of general medicine??  This just does not make a lot of sense to me.  If I were to put on my critical thinking hat, knowing that if fail the pilot, one can take the PANRE, well, if the pilot costs the same of the PANRE and there is so much less overhead costs for the pilot, (no test center charges, etc), then well, the NCCPA is making a lot of money when the specialty PAs fail the pilot b/c they didn't prep and were tested on the fly.  I really just don't get certain aspects of this.  My main concern is that I advocate for doing away with high stakes re-cert testing.  The pilot, so far, does not fulfill that...thus far.

[gbrothers98]

On 10/7/2017 at 2:36 PM, Ollivander said:

Do you guys think they'll ever get rid of this re-certification process of re-testing and move towards re-certifying via clinical practice hours and continuing education credits?

Never.

PANRE is about 2 things, money and providing the public with a sense of protection based upon establishing a standard  to be met.

NCCPA will not provide alternatives that lead to their existence being threatened or revenue being reduced. They were smart in retrenching and choosing a more collaborative course of action. They will always be able to play the card that they are the gatekeeper to ensure a standard and protect the public from a PA that does not meet the mark.

Could they move towards a model of PANRE via clinical hours and CME? Sure. But you would have to practice in primary care and particularly the CME would be very specific concerning topic and provider. Otherwise, they will use the CAQ to establish competency in specialty. PANRE process for job hoppers or require for reentry into primary care.

At least the pilot project offers an alternative and removes the testing center from equation. Those that partake will realize that the odds are even more stacked in their favor for success.

George

 

[welkins]

I agree we need an alternative to PANRE.  I am not sure that NCCPA is the answer to that alternative.  While they are the only choice currently, they are in it for NCCPA under the guise of 'improving pt care and the PA profession".  Remember what happened to the last NCCPA mandates and the backlash.   They backed off when PAs and the AAPA started discussions about alternatives to NCCPA. 

I believe we are all professionals and adult learners working in a competitive marketplace.  CME should be enough after initial certification to maintain continued learning and re certification.  I have not read a study that says patient outcomes are better because of re certification exams.  It only fills the pockets of NCCPA.  If re certification exams made for better pt outcomes then NPs would have pts dropping all over the place and they would have their own version of PANRE instead of just CEs and re licensing fees.  We need to continue PANRE with the least amt of change as possible until we can develop other avenues of maintaining certification other than NCCPA re cert exams. 

I am not convinced the majority of employers choose a PA because they don't want an NP or vice versa.  Healthcare is a business and they use the "we care" crap to stay in business and make money.  Its not an altruistic organization that gathers in a circle every morning to sing, We Are The World.  Healthcare groups choose a person to do the work that makes them the most money for the least cost without getting them sued.  If its a PA at the time, then a PA gets the job.  If its an NP at the time, then the NP gets it.  The preference is making the most money for the least cost to the company not an NP or a PA. 

I think we compete with NPs for jobs and they have a much easier path to maintain their licensure than we do.  We should be working diligently to level the playing field rather than disucssing how to keep NCCPA in business and in control of our profession with their certification process.  What do do with PANRE should be a short term goal, not discuss how to extend its life or extend the life of NCCPA.

[mrieger]

Welkins...well said.  My thought exactly.  Thanks!

[loveforbooks]

PANRE is not needed in California to practice. Take PANCE and done except if your employer insist on it.

[Cideous]

4 hours ago, loveforbooks said:

PANRE is not needed in California to practice. Take PANCE and done except if your employer insist on it.

I did not know that.  Go Go Cali!

 

Having said that, I am doing the Alt pathway.  If I blow it, they give me another year to take the PANRE.  Once I pass that I am finally on that damn 10 year cycle....yet....that will be my LAST PANRE because I am going to retire before that stupid thing comes up again.  I've taken that damn thing 4x already going on 5th.  How many F'ing times do I have to prove I can pass that thing?  Sorry, I just get pissed off thinking about it.....again.   All because the NCCPA is trying to stay relevant.  This is the same organization that OPPOSED PA's in a recent state law upgrade.  Actually lobbied against us.  The thought of sending them $350 just ticks me the heck off.

[Boatswain2PA]

Just took the PANRE for the first time.  It is a terrible test.

20 years in the military, have taken thousands of tests covering material that YOU SHOULD KNOW.   

If the PANRE tests things we should know, then why is (something like) 62% correct passing?  It's not a test of things we SHOULD know, it's a terribly designed test from the get-go.

So many esoteric bullshit questions.  So many questions with multiple right answers (ie: interventions that, in real practice, would all be getting done at the same time).  Many questions I didn't even care about (and I work EM).  Too many subspecialty questions.

I did a board review course and it was pretty good for dusting off some cobwebbs for primary care stuff (diabetes medicines, chronic asthma management, psyc, rheumatology, etc), but I don't think I would know HOW to study for this test if I have to take it again.  I just felt much of it was random CRAP.

We should follow in the footsteps of physicians and certify/recertify in our specialty.  There are already 26 PA specialty organizations, and I'm sure many more would quickly pop-up (like a family practice specialty) if we did this.

I would love to take an EM based specialty recertification exam that pushed me to improve my actual practice instead of the trivial pursuit style PANRE.

Rant over....2 weeks till I see if I guessed enough right.

[loveforbooks]

For more info. on licence renewal in California. Here you go http://www.pac.ca.gov/licensees/renewals.shtml

I called them to make sure this is correct. They said I either take CME (50 credit) or go with NCCPA(PANRE). Thank God I live in California. Even if I have to take that exam every 30 years, I still will not want to take it.

[EMEDPA]

18 minutes ago, loveforbooks said:

For more info. on licence renewal in California. Here you go http://www.pac.ca.gov/licensees/renewals.shtml

I called them to make sure this is correct. They said I either take CME (50 credit) or go with NCCPA(PANRE). Thank God I live in California. Even if I have to take that exam every 30 years, I still will not want to take it.

if you live in a state that allows you to recertify by cme and you let your nccpa lapse you limit your options for ever moving as most states require current nccpa cert at time of initial licensure.

[EMEDPA]

11 hours ago, Boatswain2PA said:

Just took the PANRE for the first time.  It is a terrible test.

20 years in the military, have taken thousands of tests covering material that YOU SHOULD KNOW.   

If the PANRE tests things we should know, then why is (something like) 62% correct passing?  It's not a test of things we SHOULD know, it's a terribly designed test from the get-go.

So many esoteric bullshit questions.  So many questions with multiple right answers (ie: interventions that, in real practice, would all be getting done at the same time).  Many questions I didn't even care about (and I work EM).  Too many subspecialty questions.

I did a board review course and it was pretty good for dusting off some cobwebbs for primary care stuff (diabetes medicines, chronic asthma management, psyc, rheumatology, etc), but I don't think I would know HOW to study for this test if I have to take it again.  I just felt much of it was random CRAP.

We should follow in the footsteps of physicians and certify/recertify in our specialty.  There are already 26 PA specialty organizations, and I'm sure many more would quickly pop-up (like a family practice specialty) if we did this.

I would love to take an EM based specialty recertification exam that pushed me to improve my actual practice instead of the trivial pursuit style PANRE.

Rant over....2 weeks till I see if I guessed enough right.

you should hear next week. I am sure you did fine.

[EMEDPA]

11 hours ago, Boatswain2PA said:

Just took the PANRE for the first time.  It is a terrible test.

20 years in the military, have taken thousands of tests covering material that YOU SHOULD KNOW.   

If the PANRE tests things we should know, then why is (something like) 62% correct passing?  It's not a test of things we SHOULD know, it's a terribly designed test from the get-go.

So many esoteric bullshit questions.  So many questions with multiple right answers (ie: interventions that, in real practice, would all be getting done at the same time).  Many questions I didn't even care about (and I work EM).  Too many subspecialty questions.

I did a board review course and it was pretty good for dusting off some cobwebbs for primary care stuff (diabetes medicines, chronic asthma management, psyc, rheumatology, etc), but I don't think I would know HOW to study for this test if I have to take it again.  I just felt much of it was random CRAP.

We should follow in the footsteps of physicians and certify/recertify in our specialty.  There are already 26 PA specialty organizations, and I'm sure many more would quickly pop-up (like a family practice specialty) if we did this.

I would love to take an EM based specialty recertification exam that pushed me to improve my actual practice instead of the trivial pursuit style PANRE.

Rant over....2 weeks till I see if I guessed enough right.

you should hear next week. I am sure you did fine.

[cdcd67]

1 hour ago, loveforbooks said:

For more info. on licence renewal in California. Here you go http://www.pac.ca.gov/licensees/renewals.shtml

I called them to make sure this is correct. They said I either take CME (50 credit) or go with NCCPA(PANRE). Thank God I live in California. Even if I have to take that exam every 30 years, I still will not want to take it.

Wait, what??

I never knew that. :O

[Marinejiujitsu]

Wait, what??
I never knew that. :O

Yep but employers usually require it, at least in the ER.

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[sk732]

So glad I just had to go through all my conferences and courses for the last year to ensure I had enough credits to get my certifying body off my case for another year - took me about an hour to enter the stuff into the database.  They had considered doing an national recert exam up here, but decided to go with CME credits like our physician colleagues do.

SK

[Cideous]

Most people are trying to get to Cali, not out.