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Anyone else feel AAPA is doing nothing to help advance PA profession?


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No name change... no independent rights like NP's.... administrative hurdles that hold us back...

so fed up... I am applying DO and not waiting for NP's to take over. I will become a real doctor and try to suppress NP advancements -who are not real doctors and don't even have clinical skills that can match PA's --- myself, lol.

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1 hour ago, EMfuturePA said:

No name change... no independent rights like NP's.... administrative hurdles that hold us back...

so fed up... I am applying DO and not waiting for NP's to take over. I will become a real doctor and try to suppress NP advancements -who are not real doctors and don't even have clinical skills that can match PA's --- myself, lol.

I get your frustration. But c’mon man. I know plenty of NPs who are solid clinicians and have skills identical to PAs. Do PAs have better schooling? Yes. Are most who come out of school better prepared? Yes. However, I know plenty of PAs with little real life medical experience and nurses who go to NP school with lots of RN experience. When I finish NP school I will be fighting for PAs. If you become a DO, you should be fighting for PAs, not tearing down/fighting NPs. If you choose to do the latter you won’t get far. The wheel is already in motion and there won’t be much that can be done to reverse these independent policies. 

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Optimal Team Practice has been approved and some efforts to water it down were defeated at the HOD this year. It is a change that has to be made state by state and the wheels have started turning. This is not a process that can  be accomplished quickly.

 Somewhere around a million dollars were allocated by the AAPA to hire a consulting firm to make recommendation on the best title to change to and the best way to make that happen. Once a title and method has been settled on the actual change, again, has to be done state by state but is fairly simple in that it just requires amendment to existing enabling legislation that essentially says "everywhere the term physician assistant appears is now amended/changed to *title."

If you have some ideas on how to do more faster I am sure the folks leading this charge would love to hear your thoughts and have your shoulder to the wheel helping make it happen.

Yes we are behind the legislative and PR curve compared to the NPs. As has been stated they are reaping the rewards of years and years of hard work on the legislative front and it isn't going to go backwards. Our best bet is to learn from their success and emulate it before we become irrelevant in the marketplace.

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1 hour ago, 2234leej said:

I get your frustration. But c’mon man. I know plenty of NPs who are solid clinicians and have skills identical to PAs. Do PAs have better schooling? Yes. Are most who come out of school better prepared? Yes. However, I know plenty of PAs with little real life medical experience and nurses who go to NP school with lots of RN experience. When I finish NP school I will be fighting for PAs. If you become a DO, you should be fighting for PAs, not tearing down/fighting NPs. If you choose to do the latter you won’t get far. The wheel is already in motion and there won’t be much that can be done to reverse these independent policies. 

I don't necessarily like to "tear down" another profession but NPs have legitimately pushed their authority, clout, and power too far. The very fact that PAs have far superior, standardized and verifiably higher quality training, yet are restricted legislatively compared to NPs proves this point. 

I feel like many PAs are being sort of 'forced' into the idea of independence from Physicians, not because we believe it is best for patient care, but because of competition from NPs. Really it's the only way for us to survive, because the current trends and signs show that PAs are being outpaced by NPs due to their full practice authority and other legislative wins.  

In a perfect world, NPs and PAs would both operate in an OTP type environment. 

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3 hours ago, EMfuturePA said:

so fed up... I am applying DO and not waiting for NP's to take over. I will become a real doctor and try to suppress NP advancements -who are not real doctors and don't even have clinical skills that can match PA's --- myself, lol.

Very mature perspective OP, sounds like you'll make a great team member.

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4 hours ago, EMfuturePA said:

No name change... no independent rights like NP's.... administrative hurdles that hold us back...

so fed up... I am applying DO and not waiting for NP's to take over. I will become a real doctor and try to suppress NP advancements -who are not real doctors and don't even have clinical skills that can match PA's --- myself, lol.

 

1 hour ago, ApolloPA said:

Very mature perspective OP, sounds like you'll make a great team member.

LMAO... yea EMfuturePA would definitely do well in an OTP environment with that attitude

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Perhaps you are being a bit hasty Newbie.I have had a love/hate relationship with the AAPA for at least thirty years but I have seen a change in the manner in which they are operating. they are no longer staff driven---this is a plus because those who you bother to elect are making the decisions and charting the course.I am not quick to point at NPs as there are many great NPs as there are great PAs. Remember, when you point at someone, three fingers are pointing back at yourself. Finally, you may need to reassess the reason s that you became a PA, it's not supposed to be a second or third choice. We need PAs who are willing to fight for change.

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We have been fighting for change for 30 years....and we are exactly right where we started, but hey keep at it.  I'm sure things will change soon............

 

I will circle back around a year from now to this thread and see where we are.  Kinda like I did last year on a similar thread....oh wait....nothing has changed.  Well, there is always next year...or the year after at.....

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When I started 10 years ago AAPA literally did nothing for us. There was no support, we were restricted as providers like crazy, and no leadership.

Fast forward to now, we have come a long way with the beginning of OTP, consideration of name change, diminished barriers with laws etc. It's a slow process, yes, but things are taking shape. If you look at the NP profession, they too have had a long battle.. Its only now that they have taken bigger strides. 

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In addition to the above, the AAPA helped introduce into Congress this April a bill to finally allow PAs to be able to directly bill and be reimbursed for their services in the Medicare system.  If that passes, you can bet that third-party private payers will follow suit.  And once we control our financial destiny, everything else will follow.

 

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23 hours ago, corpsman89 said:

I don't necessarily like to "tear down" another profession but NPs have legitimately pushed their authority, clout, and power too far. The very fact that PAs have far superior, standardized and verifiably higher quality training, yet are restricted legislatively compared to NPs proves this point. 

I feel like many PAs are being sort of 'forced' into the idea of independence from Physicians, not because we believe it is best for patient care, but because of competition from NPs. Really it's the only way for us to survive, because the current trends and signs show that PAs are being outpaced by NPs due to their full practice authority and other legislative wins.  

In a perfect world, NPs and PAs would both operate in an OTP type environment. 

I agree and disagree. It really depends on what field you enter. PAs are thriving and are still much preferred over NPs in cardiothoracic and orthopedics (which is unfortunate for me, because my specialty is orthopedics/sports medicine). NPs are usually preferred in psych and women's health from what I have seen. Primary care is still split 50/50 in my opinion. 

As I said earlier, in regards to curriculum and training, PAs have it better than NPs. No question. However, from what I have seen, the vast majority of PA students now do not have a significant amount of healthcare experience. Many do the minimal patient experience requirement to get their clinical hours (ex. PT tech) and go straight to PA school. How is that better than someone who is an RN for 2-3 years and then becomes an NP? Even with the superior PA training, it'd probably balance out (or be in favor of the NP). Again, this isn't even a fair comparison because their previous experience is apples to oranges. Do I believe they should raise the standards for NP school? ABSOLUTELY. Unfortunately for the profession, it is money driven. I HOPE that bad patient outcomes are shown in research for under qualified NPs. Maybe then the credentialing institutions will take notice (I don't want anyone getting hurt of course). 

How have NPs pushed their power too far? Isn't it the profession's responsibility to practice to their maximum capability? Wouldn't you do the same thing? The advanced practice nursing profession has proven through research (albeit, it isn't flawless research) that they can effectively and efficiently practice in primary care comparable to that of physicians for common medical conditions (Hughes et al., 2015; Mafi et al., 2016; Salmdone, 2015). It's not like the numbers are showing that primary care physicians are vastly superior in these research articles in regards to safe care, cost effectiveness, patient satisfaction. 

I feel for you guys. I was accepted to PA school at Rosalind but chose not to go for these very reasons. I figured that my PT background would help offset the inferior NP training (and it has). I still enjoy coming to this forum because these professions fight very similar battles in different states. 

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2234leej-

Respectfully, I don't think anyone has a problem with the long time nurse who attends a solid NP program and becomes a provider. That is a great path with a proven track record of safety and excellent outcomes. I have worked with some great former ER and ICU nurses who attended solid programs and to a person they are all rock stars. . What alarms many of us are direct entry programs, both for np and pa. Someone who was a history major grad last month can take a few science prereqs and if they apply to selected pa and np programs , and apply to enough of them, they can get in and be a provider in 2-3 years. In my town there are something like 3-5 of these direct entry np programs for folks with a prior bs in anything. 1 year to rn/bsn then 2 more to np with much of the np coursework done online and 500 hrs of clinicals or so, often at sites they arrange themselves, which may be of variable quuality. I feel the same way about direct entry pa, or even worse the very few hybrid online programs like the atrocity that is the new yale program. Regarding these NPs- In an independent state like mine, one of these folks with a total of maybe 1200 hrs of clinical time between rn and np can get independent practice rights day 1 while a pa practicing in the same office in the same specialty with the same group for 40 years requires oversight and supervision. clearly you can see the inequity in this.

 

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54 minutes ago, True Anomaly said:

In addition to the above, the AAPA helped introduce into Congress this April a bill to finally allow PAs to be able to directly bill and be reimbursed for their services in the Medicare system.  If that passes, you can bet that third-party private payers will follow suit.  And once we control our financial destiny, everything else will follow.

 

That bill (HR 5506) is a really big deal, and I sincerely hope PAs are writing their legislators about it and encouraging their colleagues to do the same. We can't afford to forget about it and let it die on house floor. I wrote mine around the time that it was announced, and may do so again (I got a canned and likely automated response back, but that's probably the best you can hope for). 

For those who are interested, AAPA has a form-letter that you can edit/personalize that automatically sends to your legislator. Here is more info: https://www.aapa.org/news-central/2018/04/legislation-introduced-authorize-direct-pay-pas-medicare/ 

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1 hour ago, True Anomaly said:

In addition to the above, the AAPA helped introduce into Congress this April a bill to finally allow PAs to be able to directly bill and be reimbursed for their services in the Medicare system.  If that passes, you can bet that third-party private payers will follow suit.  And once we control our financial destiny, everything else will follow.

 

Agreed. However, AAPA has practically done nothing to promote this other than their initial social media post. They should pin this to the top of their Facebook page. It should be on the front page of their website, and most importantly they should send a major email out to all members advocating for this bills passage. I have serious doubts that it will get passed, either through superior opposition or through no one advocating for the bill. 

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1 hour ago, 2234leej said:

I agree and disagree. It really depends on what field you enter. PAs are thriving and are still much preferred over NPs in cardiothoracic and orthopedics (which is unfortunate for me, because my specialty is orthopedics/sports medicine). NPs are usually preferred in psych and women's health from what I have seen. Primary care is still split 50/50 in my opinion. 

As I said earlier, in regards to curriculum and training, PAs have it better than NPs. No question. However, from what I have seen, the vast majority of PA students now do not have a significant amount of healthcare experience. Many do the minimal patient experience requirement to get their clinical hours (ex. PT tech) and go straight to PA school. How is that better than someone who is an RN for 2-3 years and then becomes an NP? Even with the superior PA training, it'd probably balance out (or be in favor of the NP). Again, this isn't even a fair comparison because their previous experience is apples to oranges. Do I believe they should raise the standards for NP school? ABSOLUTELY. Unfortunately for the profession, it is money driven. I HOPE that bad patient outcomes are shown in research for under qualified NPs. Maybe then the credentialing institutions will take notice (I don't want anyone getting hurt of course). 

How have NPs pushed their power too far? Isn't it the profession's responsibility to practice to their maximum capability? Wouldn't you do the same thing? The advanced practice nursing profession has proven through research (albeit, it isn't flawless research) that they can effectively and efficiently practice in primary care comparable to that of physicians for common medical conditions (Hughes et al., 2015; Mafi et al., 2016; Salmdone, 2015). It's not like the numbers are showing that primary care physicians are vastly superior in these research articles in regards to safe care, cost effectiveness, patient satisfaction. 

I feel for you guys. I was accepted to PA school at Rosalind but chose not to go for these very reasons. I figured that my PT background would help offset the inferior NP training (and it has). I still enjoy coming to this forum because these professions fight very similar battles in different states. 

I'm mainly referring to direct entry DNP programs and the like. NPs in many states that graduate from programs like these with basically no real nursing experience are allowed to practice at the top of their scope, with zero oversight. THAT'S SCARY! 

And yes, I have a major problem with PA programs admitting students with hardly any experience. I believe that PA programs should only accept applicants with a MINIMUM of 2000 hours of QUALITY experience. But in the end at least we have some oversight. 

I think the perfect model would be oversight for ALL new PA/NPs (regardless of experience) (2-3 years), and then given a pseudo OTP/independence type situation there after. 

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6 minutes ago, corpsman89 said:

Agreed. However, AAPA has practically done nothing to promote this other than their initial social media post. They should pin this to the top of their Facebook page. It should be on the front page of their website, and most importantly they should send a major email out to all members advocating for this bills passage. I have serious doubts that it will get passed, either through superior opposition or through no one advocating for the bill. 

Actually I spoke to one of AAPAs legislative folks and they are advocating for it and there seems to be no major opposition from anyone so the chances of it passing is quite good (as much as that can be measured in anything political).

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11 minutes ago, corpsman89 said:

I'm mainly referring to direct entry DNP programs and the like. NPs in many states that graduate from programs like these with basically no real nursing experience are allowed to practice at the top of their scope, with zero oversight. THAT'S SCARY! 

And yes, I have a major problem with PA programs admitting students with hardly any experience. I believe that PA programs should only accept applicants with a MINIMUM of 2000 hours of QUALITY experience. But in the end at least we have some oversight. 

I think the perfect model would be oversight for ALL new PA/NPs (regardless of experience) (2-3 years), and then given a pseudo OTP/independence type situation there after. 

Could not have written a better post if I tried...

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33 minutes ago, sas5814 said:

Actually I spoke to one of AAPAs legislative folks and they are advocating for it and there seems to be no major opposition from anyone so the chances of it passing is quite good (as much as that can be measured in anything political).

Well that is great news for sure! I just wish they would promote it to everyday PAs a little better. I have heard absolutely nothing about it other when it was first introduced. Nothing from my school, social media, their website, emails from them. 

One big difference (in my opinion) is that many NPs seem to be very involved and informed in their legislative endeavors. I imagine the reason is that their professional organizations makes sure they know what is going on and how important it is.

With that being said, it is apparent that AAPA has changed and is now charging hard for PAs and our advancement in the marketplace and our ability to treat more patients. 

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1 hour ago, EMEDPA said:

2234leej-

Respectfully, I don't think anyone has a problem with the long time nurse who attends a solid NP program and becomes a provider. That is a great path with a proven track record of safety and excellent outcomes. I have worked with some great former ER and ICU nurses who attended solid programs and to a person they are all rock stars. . What alarms many of us are direct entry programs, both for np and pa. Someone who was a history major grad last month can take a few science prereqs and if they apply to selected pa and np programs , and apply to enough of them, they can get in and be a provider in 2-3 years. In my town there are something like 3-5 of these direct entry np programs for folks with a prior bs in anything. 1 year to rn/bsn then 2 more to np with much of the np coursework done online and 500 hrs of clinicals or so, often at sites they arrange themselves, which may be of variable quuality. I feel the same way about direct entry pa, or even worse the very few hybrid online programs like the atrocity that is the new yale program. Regarding these NPs- In an independent state like mine, one of these folks with a total of maybe 1200 hrs of clinical time between rn and np can get independent practice rights day 1 while a pa practicing in the same office in the same specialty with the same group for 40 years requires oversight and supervision. clearly you can see the inequity in this.

 

In my mind "it's all about the Benjamins" PA & NP Schools are out to milk as much money out of aspirants  into the school's coffers as possible!! The only thing not being lowered to enter either profession is tuition! Nothing else matters to NCCPA, every PA program and physicians and practice administrators but the money they can make in this entire process!! Independent practice by PAs or NPs= the money not going into the physician's/practice pockets!!!!Call me a cynic but prove my points as wrong if you can?

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2 hours ago, EMEDPA said:

2234leej-

Respectfully, I don't think anyone has a problem with the long time nurse who attends a solid NP program and becomes a provider. That is a great path with a proven track record of safety and excellent outcomes. I have worked with some great former ER and ICU nurses who attended solid programs and to a person they are all rock stars. . What alarms many of us are direct entry programs, both for np and pa. Someone who was a history major grad last month can take a few science prereqs and if they apply to selected pa and np programs , and apply to enough of them, they can get in and be a provider in 2-3 years. In my town there are something like 3-5 of these direct entry np programs for folks with a prior bs in anything. 1 year to rn/bsn then 2 more to np with much of the np coursework done online and 500 hrs of clinicals or so, often at sites they arrange themselves, which may be of variable quuality. I feel the same way about direct entry pa, or even worse the very few hybrid online programs like the atrocity that is the new yale program. Regarding these NPs- In an independent state like mine, one of these folks with a total of maybe 1200 hrs of clinical time between rn and np can get independent practice rights day 1 while a pa practicing in the same office in the same specialty with the same group for 40 years requires oversight and supervision. clearly you can see the inequity in this.

 

That is an atrocity. Your level of experience surpasses the vast majority of us. I know you (and others) are more than qualified to be independent practitioners. It is unfortunate that the profession is hitched to physicians when it shouldn't be. 

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