AAPA candidates afraid of name change and independent PA rights

[MakePAprofessionGreat]

they need to go. Lets get rid of these losers. Some actually thinks we should ALWAYS be under supervised physicians. They need to go. Lets do it. LEts vote

[sas5814]

As has been stated previously it is a bit like triage. It is unlikely any candidate, much less several of them, will check every box on your wish list. Choose the ones who do the most for where you think the profession should be...but VOTE! No vote...no complaining.

[LT_Oneal_PAC]

actually I think this is the only election I didn’t have to regretfully vote for a “least worst” option. I think I have a minor disagreement with one candidate I’m voting for.

[camoman1234]

I'd like to hear from you all about who you think is for OTP/name change so I can research more about these potential new leaders that will bring our profession into the 2000's...

[sas5814]

I don't think any of the candidates are against OTP though some keep talking about our precious and valuable relationships with physicians. I think we have to have relationships with the physicians at the political level but let us not consider them as valuable or even beneficial just necessary.

There is a bit of mix and match on name change and what that name will be but I think that issue will be more or less settled at the AAPA conference.

My personal issue is the NCCPA and a new certifying agency. There is a lot of disagreement on this and most are in the "wait and see" mode while the studies are being conducted about the best way of testing and certifying. Mittman is the only one I know of who clearly wants another certifying body. James Cannon served on the NCCPA board for years and has total faith in them. He is, otherwise, a well established capable PA leader. I think as long as the NCCPA is the 800 pound gorilla they can do whatever they want... they may not even misbehave again but why have a system that permits them to?

I voted at 0600 this morning when I got up.I don't think there is a bad choice in the bunch.....just some that fit my wishes a little better than others.

[Boatswain2PA]

1 hour ago, MakePAprofessionGreat said:

they need to go. Lets get rid of these losers. Some actually thinks we should ALWAYS be under supervised physicians. They need to go. Lets do it. LEts vote

You think I'm a "loser" because I think some 25 year old kid with two years of medical training should be supervised?

If you think said 25 year old should be able to see patients unsupervised, then that simply makes you an idiot.

[LT_Oneal_PAC]

14 minutes ago, Boatswain2PA said:

You think I'm a "loser" because I think some 25 year old kid with two years of medical training should be supervised?

If you think said 25 year old should be able to see patients unsupervised, then that simply makes you an idiot.

Boatswain is pretty justifiably irritated here. Let’s not turn our AAPA elections into the circus our national politics have become. We all want what is best and just disagree on what is best. Name calling and vitriol will only galvanize people into their current position thus decreasing healthy debate. Not saying I’m never guilty, just happen to have a voice of reason today. 

[sas5814]

Isn't it funny how that works? I'm often shaking my fist and screaming and yelling but sometimes I'm the voice of reason. Makes me wonder if the world started spinning backwards or not.

[LT_Oneal_PAC]

2 minutes ago, sas5814 said:

Isn't it funny how that works? I'm often shaking my fist and screaming and yelling but sometimes I'm the voice of reason. Makes me wonder if the world started spinning backwards or not.

I’ve found I’ve been better after reading “The Righteous Mind”. Helped me look more carefully at why we disagree.

[sas5814]

I may give that a read. I just finished up a jury trial (see my newest post) where a 21 year old man was having sex with and pimping a 14 year old girl. 3 started wanting to give him probation.....kind of like the probation agreement he signed for his last crime 3 days before being arrested for this one. My mind was boggled.

[Joelseff]

You think I'm a "loser" because I think some 25 year old kid with two years of medical training should be supervised?
If you think said 25 year old should be able to see patients unsupervised, then that simply makes you an idiot.

Hmm. I think OP meant that the "losers" are those who think we should "ALWAYS" be under supervision. At least that's how I read it. I agree that new grads (they can 25 yrs old and up lol) need some form of supervision/collaboration. But someone with considerable (arbitrarily 5 years or more?) experience should be able to shed some (or all?) supervision by a MD/DO (who may be 28 yrs old, just saying).

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[sas5814]

That is how I read it as well... The limitations of written communication.

[pafrankc]

On 4/6/2018 at 9:37 AM, sas5814 said:

I don't think any of the candidates are against OTP though some keep talking about our precious and valuable relationships with physicians. I think we have to have relationships with the physicians at the political level but let us not consider them as valuable or even beneficial just necessary.

There is a bit of mix and match on name change and what that name will be but I think that issue will be more or less settled at the AAPA conference.

My personal issue is the NCCPA and a new certifying agency. There is a lot of disagreement on this and most are in the "wait and see" mode while the studies are being conducted about the best way of testing and certifying. Mittman is the only one I know of who clearly wants another certifying body. James Cannon served on the NCCPA board for years and has total faith in them. He is, otherwise, a well established capable PA leader. I think as long as the NCCPA is the 800 pound gorilla they can do whatever they want... they may not even misbehave again but why have a system that permits them to?

I voted at 0600 this morning when I got up.I don't think there is a bad choice in the bunch.....just some that fit my wishes a little better than others.

When NCCPA goes to a state (think WV last year) and lobbies for PANRE as a condition of licensure--thus making the PANRE a "high stakes exam," does anyone think that maybe they are in violation of federal anti-trust laws?  

Antitrust Violations. Violations of laws designed to protect trade and commerce from abusive practices such as price-fixing, restraints, price discrimination, and monopolization. The principal federal antitrust laws are the Sherman Act (15 U.S.C. §§ 1-7) and the Clayton Act (15 U.S.C. §§ 12-27).

[Joelseff]

When NCCPA goes to a state (think WV last year) and lobbies for PANRE as a condition of licensure--thus making the PANRE a "high stakes exam," does anyone think that maybe they are in violation of federal anti-trust laws?  

Antitrust Violations. Violations of laws designed to protect trade and commerce from abusive practices such as price-fixing, restraints, price discrimination, and monopolization. The principal federal antitrust laws are the Sherman Act (15 U.S.C. §§ 1-7) and the Clayton Act (15 U.S.C. §§ 12-27).

IF they were violating existing laws protecting us but I wonder if NCCPA is under some other law or regulation being they are our certifying body? Maybe they avoided violating antitrust this way somehow.

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[Boatswain2PA]

22 hours ago, Joelseff said:

But someone with considerable (arbitrarily 5 years or more?) experience should be able to shed some (or all?) supervision by a MD/DO (who may be 28 yrs old, just saying).

So, since I've been practicing for >5 years in emergency medicine, and working VERY independently, I should be able to get an independent license?

With an independent license would I be able to start doing fluoroscopy or total knee replacements tomorrow?  What about neonatology...sounds like that pays very well.

I get the frustration of being tied to the docs....I really do.  Makes me frustrated too!  But the push for independent practice rights just doesn't fly with reality.  

I'm ALL for getting rid of the restrictive laws (# of PAs a doc can supervise, legal requirements for chart review, cosignature, etc), but I just can't see "independent practice rights" (and let's be honest, that's the goal of many who push OTP) being a good thing for the entire PA profession (remember, PAs do more than FP and EM).

[corpsman89]

It's political. 

I don't think even most NPs think *actual* full practice authority is a good thing. It's not like all the NPs in Virginia are all of a sudden performing cardiothoracic surgery today. Its just a statement that puts hospital administrators at ease knowing that these NPs don't need anyone signing off their charts, they don't need to pay physicians extra to supervise or collaborate with NPs. Its simply political. It makes patients believe that NPs are better qualified because they are allowed to work independently, while PAs need their hands held. 

In a perfect world I wish NPs never jumped for full autonomy. I wish they were in the same place as us. I feel that the push for OTP and the push for more independence is not because we want to be independent, but its because we want to be on equal term with our competition. And since there is no point in trying to stop the nursing lobby we might as well fight with them and try to gain equal footing. Sad but true. politics. 

 

[rev ronin]

3 minutes ago, corpsman89 said:

In a perfect world I wish NPs never jumped for full autonomy. I wish they were in the same place as us. I feel that the push for OTP and the push for more independence is not because we want to be independent, but its because we want to be on equal term with our competition. And since there is no point in trying to stop the nursing lobby we might as well fight with them and try to gain equal footing. Sad but true. politics. 

 

Like a lot of things in politics, what ends up getting lost is the middle ground.  I wish there was something between what we have know (you don't have an SP or backup? No practice for you!) and no safety net, but for those of us who work in a state where NDs have prescriptive rights, to be shut out without that direct, active linkage to a single doc is scary.

[CAAdmission]

NDs have prescriptive rights? For what?

[sas5814]

The "I can do anything if I am independent" trope has pretty much been beat to death. OTP isn't independence but let us imagine it is. 

Can a FP physician perform cardio thoracic surgical procedure? Can  general surgeon perform inter-cranial surgery? Can an orthopedist take out an appendix? Of course not. So the independence argument is a straw man argument.

OTP isn't independence.

Even if it was it doesn't mean we could all just suddenly run wild.

[Joelseff]

So, since I've been practicing for >5 years in emergency medicine, and working VERY independently, I should be able to get an independent license?

With an independent license would I be able to start doing fluoroscopy or total knee replacements tomorrow?  What about neonatology...sounds like that pays very well.

I get the frustration of being tied to the docs....I really do.  Makes me frustrated too!  But the push for independent practice rights just doesn't fly with reality.  

I'm ALL for getting rid of the restrictive laws (# of PAs a doc can supervise, legal requirements for chart review, cosignature, etc), but I just can't see "independent practice rights" (and let's be honest, that's the goal of many who push OTP) being a good thing for the entire PA profession (remember, PAs do more than FP and EM).

Nah boats that's not what i meant or said... I said that perhaps after a few years (5 was suggested) supervision can be partially or fully shed. This does not mean we are loose cannons doing EVERYTHING in medicine but get real, I should be able to do all the things I was trained to do without supervision If I am proficient in that skill right? Or, I'll ride a backwards slippery slope here, do you think we are so inept that we need to be supervised at all times?

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[Joelseff]

The "I can do anything if I am independent" trope has pretty much been beat to death. OTP isn't independence but let us imagine it is. 
Can a FP physician perform cardio thoracic surgical procedure? Can  general surgeon perform inter-cranial surgery? Can an orthopedist take out an appendix? Of course not. So the independence argument is a straw man argument.
OTP isn't independence.
Even if it was it doesn't mean we could all just suddenly run wild.

This!

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[EMEDPA]

OTP means supervision is determined at the practice level. A hospital that hired a PA OR NP always has the ability to say "all of your charts will be reviewed within 48 hours" or "all abdominal pains" or "all charts for the first 5 years then none thereafter", etc. Physicians as noted above are only credentialed for what they can do by specialty. same would be true for us. an em pa would have full em privileges, but no GI endoscopy privileges, etc

[CAAdmission]

7 hours ago, sas5814 said:

Can an orthopedist take out an appendix? Of course not.

I'm not even sure an orthopod could identify an appendix.

[Reality Check 2]

What’s the definition of a double blind study? Two Orthopods reading an EKG.

 

[Boatswain2PA]

3 hours ago, EMEDPA said:

OTP means supervision is determined at the practice level.

It's more than that.  The AAPA's position is also to create PA boards separate from the medical boards.

7 hours ago, Joelseff said:

I said that perhaps after a few years (5 was suggested) supervision can be partially or fully shed.

I wasn't trying to infer you said that, just taking the argument the next step.

Now, let's reverse that.  After working in general surgery for 7 years, would you get an "independent licensure" from the PA board?    Could you then go do family practice unsupervised?  How about work urgent care unsupervised?

We are talking about taking a position to change the laws.  By LAW, an surgeon could, indeed, go work family practice or urgent care (I work with a surgeon who covers the ED occasionally).  Yes, organizational regulation could prevent this, but they could also continue to require co-signature for us....so then why change the law?