Are Physicians Our Friends?

[sas5814]

I posted this in the AAPA forum where I have been following and participating in a lot of conversations about the upcoming AAPA elections, OTP, name change, and others. There are several, mostly much older, PAs who keep carrying on about our valuable relationships with physician groups and how we have to maintain them. I was particularly weary of the subject today and went on a bit of a rant which will probably get deleted. I'm interested in opinions. Thanks. Rant as follows:

 

I'm going to step in the dogma because I have listened to our wise elders (and I'm no spring chicken) wax poetic about maintaining precious relationships with physician groups and disagreeing with them starts a great hue and cry.
Physician groups are not our friends politically...period. I have great relationships with many physicians and know many who understand and support OTP. I have yet to hear about a major physician group who has worked on our behalf in our attempts to advance the profession. Quite the opposite seems to be a near daily report from one place and another. Here in Texas for many years (and it may still be) TMAs legislative agenda included stopping the expansion of privileges of any non-physician health care providers....period. Doesn't matter if it is good for patients or good for health care or if it is a PA, NP, PT, podiatrist (sorry...foot and ankle surgeon), or anyone else. This is emblematic of our valuable relationship with physician groups. last legislative session we were asked by 2 anesthesiologists who are in the state legislature to open our practice act to anesthesia assistants in return for some nickle and dime concessions on our privileges....and TAPA agreed! This resulted in the biggest groundswell of negative opinions and push-back from PAs I have ever seen. One of the anesthesiologists/legislators said he was withdrawing support for our, frankly inconsequential, modifications to our practice act stating "I thought we had you under control but it seems we don't." THAT ladies and gentlemen is what we are dealing with everywhere.

I don't advocate going rogue or being unnecessarily provocative. I do advocate for "this is what we are going to do and we don't care if you like it or it makes you happy" perhaps stated in a warm gentle voice with a smile on our face. It is past time we stood up and acted like a grown up profession. We can be polite and diplomatic and prosecute our agenda DESPITE physician groups if necessary. Will it be easy? Certainly not. Will it be any harder than standing around with our hat in our hands waiting to be blessed with permission? Nope....

and now the gentle politicians and diplomats may begin explaining why I am wrong....

:-)

[EMEDPA]

saw that. Some physicians are quietly supportive, but I have yet to ever hear one go to bat actively for us. Closest I ever head was the president of acep say PAs are the preferred non-physician provider in em to a lecture hall full of PAs at the sempa conference a few years ago. would have been more impressed if she said it to a group of docs.

[LT_Oneal_PAC]

5 minutes ago, EMEDPA said:

saw that. Some physicians are quietly supportive, but I have yet to ever hear one go to bat actively for us. Closest I ever head was the president of acep say PAs are the preferred non-physician provider in em to a lecture hall full of PAs at the sempa conference a few years ago. would have been more impressed if she said it to a group of docs.

That doc at every other conference they were paid to lecture at ;)

[Joelseff]

Honestly, in the medical political arena we have NO friends... We need to stand on our own politically and not rely on other groups because those groups serve themselves alone. Look at NPs and Nursing... They could give two squats about PAs. If we disappeared I doubt any other profession would protest or push for a "bring PAs back campaign."

 

Now I don't mean this at a grassroots level... Many of my friends are Docs and NPs [emoji6]

 

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[lemurcatta]

Quote

Are docs our friends?

Judging by the rhetoric over at SDN... That would be a big no. Qualifier here that I have many MD and soon to be MD friends, but organized medicine is not going to advocate for PAs, and at least on anonymous message boards, there seems to be a lot of resentment. 

[Miaow]

On ‎3‎/‎30‎/‎2018 at 11:51 PM, lemurcatta said:

Judging by the rhetoric over at SDN... That would be a big no. Qualifier here that I have many MD and soon to be MD friends, but organized medicine is not going to advocate for PAs, and at least on anonymous message boards, there seems to be a lot of resentment. 

I'm grumpy today (home from Maui after 10 days) so here's the nicest thing I can say about SDN: That place is the distilled, toxic essence of every twat who ever got into medical school and drank the self-aggrandizing Kool Aid at the White Coat Ceremony.

(Too harsh? LOL).

Edited to add: The actual really cool doctors and med students are never the ones who post all the hateful stuff there.

[mgriffiths]

I would say that MDs feel like they are our friends because most prefer to hire PAs over NPs from an experience/education/attitude perspective (but it seems this is changing with NPs requiring less and less oversight by law - it's just convenience and malpractice).  Whether they truly are our friends depends on perspective.  If we are content being saddled to them, then overall they are our friends; but if we are wanting independence the vast majority are our enemies.

[MidwesternTexan]

RIGHT ON!

I'm now 24yrs as a PA-C, and getting really tired of the 'anti-PA' rhetoric that often abounds.

The time for Revolution is NOW!- how's that?

We needed a title change 25 yrs ago!  AND equal to or above privileges that those of our NP/lesser trained counterparts.

My 2 cents.

[MidwesternTexan]

AND, If the person that came up with the term OTP- what's that, optimal team practice?

If it was you, I don't mean any disrespect, BUT- it's kind of oxymoronic- NO?

I don't feel the term OTP is going to get us anywhere.

I could be wrong.

I'm always right though.

I thought I was wrong once---- I was mistaken. ;-)

[BruceBanner]

On 3/31/2018 at 1:51 AM, lemurcatta said:

Judging by the rhetoric over at SDN... That would be a big no. Qualifier here that I have many MD and soon to be MD friends, but organized medicine is not going to advocate for PAs, and at least on anonymous message boards, there seems to be a lot of resentment. 

SDN...you'll never find a more wretched hive of scum and villany.

[MidwesternTexan]

SDN?  Wt....?

Student Doctor Network?

 

[PAtoMD]

41 minutes ago, MidwesternTexan said:

SDN?  Wt....?

Student Doctor Network

DONT SAY ITS WHOLE NAME  but yes Student Doctor Network

[CAAdmission]

19 hours ago, SR0525 said:

DONT SAY ITS WHOLE NAME  but yes Student Doctor Network

[EMEDPA]

1 hour ago, CJAdmission said:

QFT!

[sas5814]

See this news article for the Texas Medical Association from last year. TMA has had, for 20 years I am aware of, a high priority legislative priority of stopping any expansion of non physician provider privileges.

[SinkingShip]

People who think there exists an important Physician-PA relationship are generally those of the "old timers" era. I have found that the people who hold back the profession most strongly are the PAs who entered 40 years ago. At that time, the PA was a certificate program and some had an associate degree. One has to ask why someone would pursue a "certificate" instead of a four year competitive university education in the 1970s. At that time, tuition was rather inexpensive. The issue is lack of intellectual rigor. Many (or most) of our top PA leadership today were not bright enough to gain admission to competitive universities. Thus, they have always been hamstrung by lack of intellect that kept them "depending" on the Physician Supervisor to be the intelligence they themselves didn't have. Today, a graduate of a PA program is as bright or brighter than every primary care PA resident. After three years of practice, a new graduate PA has equilibrated his intellect and knowledge with that of his new minted resident. Thus, todays PAs don't require any supervision or collaboration for that matter. Unfortunately, the old timers are choking the young PAs to death by blocking action at the AAPA and NCCPA. Eliminate any one who opposed independent practice. Understand your political enemies today are the same kind of kids that typically drop out of high school today. Not bright. Not motivated. If you doubt me on this, just ask yourself if you would be bragging to you neighbor that your kid just got accepted into the certificate program for Microsoft Office Professional at the local Devry University. Well, that is what the old time PA did forty years ago but the names changed to PA certificate and many of the schools are out of business now. 

[sas5814]

One of the old guys (of which I am one) actually said in another forum the physicians created us and nurtured us for 50 years and now we want to turn our backs on them.

I just threw up in the back of my throat.

[EMEDPA]

just posted on the huddle:

physicians and physician groups will not be burning the midnight oil to advance PA practice. They never have. We need to do this ourselves. If some of them want to come along for the ride, great. If not, it's time to plow forward with title change and implementation of reasonable state by state legislative advances. I like the MI model. I think this is a great start and would love to see those changes implemented nationwide. What physician would have a problem with decreased liability?
Most Americans still don't know what a PA is (this was shown in an AAPA survey a few years ago) and our assistant title kills us in the eyes of these folks who have no idea who we are: HR/admin folks, legislators, and worst of all, patients. We have been asking for a REAL PR campaign as long as I have been a PA and have yet to see it happen. One patient at a time is not going to cut it. It never has.
 

[corpsman89]

I just wish physician groups would fight for us. 

[CAAdmission]

20 hours ago, sas5814 said:

Funny looking guy. Beady little eyes, too close together. Looks like Satan.

[sas5814]

I think that is a requirement to rise in TMA

[Joelseff]

People who think there exists an important Physician-PA relationship are generally those of the "old timers" era. I have found that the people who hold back the profession most strongly are the PAs who entered 40 years ago. At that time, the PA was a certificate program and some had an associate degree. One has to ask why someone would pursue a "certificate" instead of a four year competitive university education in the 1970s. At that time, tuition was rather inexpensive. The issue is lack of intellectual rigor. Many (or most) of our top PA leadership today were not bright enough to gain admission to competitive universities. Thus, they have always been hamstrung by lack of intellect that kept them "depending" on the Physician Supervisor to be the intelligence they themselves didn't have. Today, a graduate of a PA program is as bright or brighter than every primary care PA resident. After three years of practice, a new graduate PA has equilibrated his intellect and knowledge with that of his new minted resident. Thus, todays PAs don't require any supervision or collaboration for that matter. Unfortunately, the old timers are choking the young PAs to death by blocking action at the AAPA and NCCPA. Eliminate any one who opposed independent practice. Understand your political enemies today are the same kind of kids that typically drop out of high school today. Not bright. Not motivated. If you doubt me on this, just ask yourself if you would be bragging to you neighbor that your kid just got accepted into the certificate program for Microsoft Office Professional at the local Devry University. Well, that is what the old time PA did forty years ago but the names changed to PA certificate and many of the schools are out of business now. 

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[katieo]

[pafrankc]

I am one of those old timers mentioned frequently in this thread.  I've been in practice for 36 years and am retiring from clinical practice this summer.  While I do not consider physicians (read that as physician groups) as our friend, they must be recognized for what they really are to the PA profession--part of a symbiotic relationship.  We can't survive without them, they can't survive without us. 

We can't survive without them.  After 50+ years as a profession, we are not going away.  BUT: They control the medical boards, they control state medical societies, and they have more control over legislators than we do.  We have neither the numbers, nor the political clout to move toward "independence."  Consider Tennessee and West Virginia.  Both states put forth legislation and got it into committees with calls for more "independence."  The WV legislation was cosponsored by the committee chair (a physician), a lawyer, a nurse, and a lawyer!.  It was on the agenda for a meeting, and was pulled from the agenda at the last minute.  The TN legislation actually called for a new profession (Doctor of Medical Science) with significant independence, and the writers actually used "comparable to MD/DO" in the wording.  In both cases, the physicians gathered together, used their communication network, and put enough pressure on the legislators to keep the bill from moving forward.  That will happen again and again, even with millennials trying to make the changes.  It has nothing to do with being a dinosaur as a PA, it has to do with medical politics.

They can't survive without us?  Perhaps, and perhaps not.  Again, age doesn't matter--it's the political reality, and in this case, a financial reality.  Like us, most physicians go into medicine wanting to make a difference and practice altruistic medicine.  They soon realize that student loans and current income level take precedence over the altruism.  They now want to maximize income, and the two best ways to do that are to hire a PA, or hire a NP.  They hire us because of what we bring to the bottom line.  Despite their massive amounts of education and training, they refuse to be educated on what we bring to the table medically.  How many physicians know about our training?  Even those that serve on medical boards do not know our training or education.  They do not know that our clinical rotations are as close to the MD/DO internship as possible, without being an intern.  Because they lack that knowledge, they automatically compare us to another profession with a similar job description. 

             

 

[mmiller3]

On 4/8/2018 at 1:00 PM, SinkingShip said:

People who think there exists an important Physician-PA relationship are generally those of the "old timers" era. I have found that the people who hold back the profession most strongly are the PAs who entered 40 years ago. At that time, the PA was a certificate program and some had an associate degree. One has to ask why someone would pursue a "certificate" instead of a four year competitive university education in the 1970s. At that time, tuition was rather inexpensive. The issue is lack of intellectual rigor. Many (or most) of our top PA leadership today were not bright enough to gain admission to competitive universities. Thus, they have always been hamstrung by lack of intellect that kept them "depending" on the Physician Supervisor to be the intelligence they themselves didn't have. Today, a graduate of a PA program is as bright or brighter than every primary care PA resident. After three years of practice, a new graduate PA has equilibrated his intellect and knowledge with that of his new minted resident. Thus, todays PAs don't require any supervision or collaboration for that matter. Unfortunately, the old timers are choking the young PAs to death by blocking action at the AAPA and NCCPA. Eliminate any one who opposed independent practice. Understand your political enemies today are the same kind of kids that typically drop out of high school today. Not bright. Not motivated. If you doubt me on this, just ask yourself if you would be bragging to you neighbor that your kid just got accepted into the certificate program for Microsoft Office Professional at the local Devry University. Well, that is what the old time PA did forty years ago but the names changed to PA certificate and many of the schools are out of business now. 

Well-played. This post has a little bit of everything--offensive comments with no purpose, grandiose claims regarding newly-minted PAs, statements designed to further drive a wedge between PAs and MD/DOs, "historical" facts with no evidence, all while offering no facts and disappearing without any follow up.

This is the kind of constructive posting that gets things done...