North Dakota Closer to OTP

[EMEDPA]

2 minutes ago, Boatswain2PA said:

I've ran into that before with ultrasound.  One place I worked for a while I asked ti get credentialed in FAST so I could bill (just trying to help them stay open) but no doc felt qualified.  I just did them anyway for patient care. 

 

I would imagine any doc losing their DEA license would be removed from ED supervision role.

if they told admin about it.... I am guessing many would not as it would likely result in suspension until they got it back.

One of my SPs now is family med, but he has worked in an ED 100% of the time since residency graduation and did EXTENSIVE rural ED moonlighting as a PGY2 and 3. he is a few years younger than me, but every bit as good as a residency trained and boarded doc.

[Boatswain2PA]

2 minutes ago, EMEDPA said:

One of my SPs now is family med, but he has worked in an ED 100% of the time since residency graduation and did EXTENSIVE rural ED moonlighting as a PGY2 and 3

Same here....and he is a former PA!!!

[LT_Oneal_PAC]

49 minutes ago, Boatswain2PA said:

Not with the Coast Guard who has enlisted in command of most of their operational units (both cutters and shore based rescue/law enforcement units).  

Most officers (in any branch) have no idea what true command looks like.

And if you dont care what your E8-E9s are telling you....you should reevaluate your military career.

I’ve met 6 total enlisted at the rank above E7 that garnered my respect as real leaders. Only one E8 and one E9. Only met a few O5 and above that had my respect too. Rank has no correlation with ability or skill other than knowing the instruction for every nit picky rule. Met lots of great E1-E6 and O1-O3. Military drives most of the good ones out.

As far as coasties go, I think this meme sums it up

 

[Boatswain2PA]

Never cared about nit-picky rules.  Cared a lot that my crews and boats were ready to launch in damn near any weather, for any mission, with the best chance of coming home in one piece.

Dont wanna bash you LT/PAC, but if you wanna go down that road...I doubt you have much operational experience, and that's ok cause your military job was (is?) to keep us operationally ready.  Can we just agree to disagree on whether PAs should have independence?

Agree with the meme 90%.  The 90% REMF non-operational part of the CG, most of which is made up of a bunch of candy-ass bureacratical officers tied to their desks as they send power point presentations to each other so they can pad their OERs to make O-4 in a f'n pathetic attempt to reach retirement rank.

The other 10% of us suited up for missions that would make you curl up in the fetal position and suck your thumb.

[EMEDPA]

relevant to the discussion at hand, copied from the huddle:

It is 1) nice to see that this is coming from the top (regardless of ones' own political leanings) and 2) it will be interesting to see if this opens up opportunities better for us.

https://www.medpagetoday.com/publichealthpolicy/healthpolicy/76678?xid=nl_mpt_DHE_2018-12-04&eun=g1079016d0r&pos=11&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily%20Headlines%202018-12-04&utm_term=NL_Daily_DHE_Active
 

 

[Boatswain2PA]

16 minutes ago, EMEDPA said:

relevant to the discussion at hand, copied from the huddle:

It is 1) nice to see that this is coming from the top (regardless of ones' own political leanings) and 2) it will be interesting to see if this opens up opportunities better for us.

https://www.medpagetoday.com/publichealthpolicy/healthpolicy/76678?xid=nl_mpt_DHE_2018-12-04&eun=g1079016d0r&pos=11&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily%20Headlines%202018-12-04&utm_term=NL_Daily_DHE_Active
 

 

Like everything in life, there is good and bad in this.  This encourages PAs to practice at the top of their license.  The truly bad side will be the leeches like naturopaths, etc.

[EMEDPA]

5 minutes ago, Boatswain2PA said:

Like everything in life, there is good and bad in this.  This encourages PAs to practice at the top of their license.  The truly bad side will be the leeches like naturopaths, etc.

They already can be independent "naturopathic physicians" in many states, including OR and WA.  the tricky move is attending a combined ND/FNP program(they are out there), then you can write for anything and are not restricted by either license. You can legally call yourself both a doctor and a physician.

[Boatswain2PA]

Just now, EMEDPA said:

They already can be independent "naturopathic physicians" in many states, including OR and WA.  the tricky move is attending a combined ND/FNP program(they are out there), then you can write for anything and are not restricted by either license. I know a guy who is an ND/PA/LAc who runs an alternative med clinic. he has an sp, but the guy leaves him alone for anything outside of allopathic ca

Can we just remove his PA-C?  Or somehow censure him as being a quack?  ACEP took the steps to censure Rosen for bullshit "expert testimony!"..

[EMEDPA]

2 minutes ago, Boatswain2PA said:

Can we just remove his PA-C?  Or somehow censure him as being a quack?  ACEP took the steps to censure Rosen for bullshit "expert testimony!"..

the guy works as part of a managed care system and gets referrals from pcps. most of what he does is acupuncture, but some folks want medicinal teas, etc and he can write for those too. Overall, I think he does pretty good work. there are some legitimate EBM-verified uses for acupuncture like n/v from chemo, etc

[Boatswain2PA]

Agreed.  Nobody has figured out acupuncture. But too many NDs are quacks ("You have a liver parasite from your well water, $300/month in my special water-soluble vitamins will cure you!)

[LT_Oneal_PAC]

11 hours ago, Boatswain2PA said:

Never cared about nit-picky rules.  Cared a lot that my crews and boats were ready to launch in damn near any weather, for any mission, with the best chance of coming home in one piece.

Dont wanna bash you LT/PAC, but if you wanna go down that road...I doubt you have much operational experience, and that's ok cause your military job was (is?) to keep us operationally ready.  Can we just agree to disagree on whether PAs should have independence?

Agree with the meme 90%.  The 90% REMF non-operational part of the CG, most of which is made up of a bunch of candy-ass bureacratical officers tied to their desks as they send power point presentations to each other so they can pad their OERs to make O-4 in a f'n pathetic attempt to reach retirement rank.

The other 10% of us suited up for missions that would make you curl up in the fetal position and suck your thumb.

I’m not going down any road. I’m stating my opinion of a select individuals of a certain rank during my time and my opinion that rank doesn’t not correlate with ability or skill, as you alluded to in mention officer trying to make O4. Some were great, most were not. I made no comment marginalizing a group. But if this topic triggers you I’ll avoid it in the future. My apologies.

I’ve agreed to disagree. I’ve derailed the thread a bit. Sorry everyone

[Kaepora]

On 12/6/2018 at 11:34 PM, EMEDPA said:

...a combined ND/FNP program(they are out there)...

Which schools have a program like this?

[corpsman89]

I am curious how the bill (HR 5506) is doing now that the government seems to be advocating direct billing for PAs.

https://www.aapa.org/news-central/2018/04/legislation-introduced-authorize-direct-pay-pas-medicare/

[VeryOldPA]

On 12/6/2018 at 11:34 PM, EMEDPA said:

They already can be independent "naturopathic physicians" in many states, including OR and WA.  the tricky move is attending a combined ND/FNP program(they are out there), then you can write for anything and are not restricted by either license. You can legally call yourself both a doctor and a physician.

There are only 5 Naturopathic Medical Schools in the US  If any of them have combined ND/NP programs they are not advertising them on their websites.  As far as being naturopaths being able to call themselves physicians they may be able to do that in some states but not all. Two stated specifically prohibit them from calling themselves physicians and from claiming to be primary care providerse

[EMEDPA]

Bastyr ND program and Seattle University FNP program have or at least had a joint program a few years ago.

Looks like they still have a dual Nurse midwife/ND program: http://bastyr.smartcatalogiq.com/en/2015-2016/2015-2016-Academic-Catalog/School-of-Naturopathic-Medicine/Doctor-of-Naturopathic-Medicine/Departments-within-the-Naturopathic-Medicine-Program/Naturopathic-Medicine-Dual-Degrees

[VeryOldPA]

3 hours ago, EMEDPA said:

Bastyr ND program and Seattle University FNP program have or at least had a joint program a few years ago.

Looks like they still have a dual Nurse midwife/ND program: http://bastyr.smartcatalogiq.com/en/2015-2016/2015-2016-Academic-Catalog/School-of-Naturopathic-Medicine/Doctor-of-Naturopathic-Medicine/Departments-within-the-Naturopathic-Medicine-Program/Naturopathic-Medicine-Dual-Degrees

The midwife program is a direct entry midwife program not a nurse midwife program.  No nursing degree needed to get in and no nursing degree awarded when you get out. Graduates are eligible for licensing in a number of states as midwives but not nurse midwives (I.e. APRNs). I believe that midwives in some states have limited prescribing but not 100% sure on that. 

[Kaepora]

On 12/9/2018 at 5:54 PM, VeryOldPA said:

The midwife program is a direct entry midwife program not a nurse midwife program.  No nursing degree needed to get in and no nursing degree awarded when you get out. Graduates are eligible for licensing in a number of states as midwives but not nurse midwives (I.e. APRNs). I believe that midwives in some states have limited prescribing but not 100% sure on that. 

You're correct.  Nurse Midwives are licensed and have prescriptive authority in 50 states plus DoC and US territories.  Certified midwives (not nurses) are licensed in Delaware, Maine, New Jersey, New York and Rhode Island and have prescriptive authority in New York, Rhode Island and Maine. 

 

[ArmyVetDude]

updates? what happened to them?