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Wondering why NP's are blowing past us? Look at this map...


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https://www.aanp.org/advocacy/state/state-practice-environment

 

This was posted on another thread, but it deserves it's own.  Look at that map.  Put the Green and Yellow together.....Green being full practice authority and yellow having some restriction.  Only red requires doc supervision according to the AANP.

Honestly, I had no idea it was that many states.  This visual representation of this map leaves me speechless.  How long before California chimes in with full practice authority?  And we can't even move forward on a name change????????

Welp, I am officially changing  my recommendation for kids asking what they should go into.  PA or NP.  Looking at that map, how could anyone in good conscience recommend becoming a PA when you could have full practice authority in all those states as an NP?

I wonder how our AAPA funded "focus group" firm is doing.......

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2 hours ago, Cideous said:
https://www.aanp.org/advocacy/state/state-practice-environment
 
This was posted on another thread, but it deserves it's own.  Look at that map.  Put the Green and Yellow together.....Green being full practice authority and yellow having some restriction.  Only red requires doc supervision according to the AANP.
Honestly, I had no idea it was that many states.  This visual representation of this map leaves me speechless.  How long before California chimes in with full practice authority?  And we can't even move forward on a name change????????
Welp, I am officially changing  my recommendation for kids asking what they should go into.  PA or NP.  Looking at that map, how could anyone in good conscience recommend becoming a PA when you could have full practice authority in all those states as an NP?
I wonder how our AAPA funded "focus group" firm is doing.......

I wouldn't say this is "why" they are blowing past us... This is the RESULT of the true reason why they are blowing past us.

That reason is, unlike us, they never went under another profession except their own (nursing) which happens to also be one of, if not the most powerful political lobby/union in America.

Bloody brilliant move on their part if you ask me.

We can tote our "better training" but at the end of the day they hold the cards at the negotiation table.

Doctors (who clearly have the best and most thorough training) who have great numbers and are a quite powerful lobby in their own right can't even slow NPs/Nursing down.

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Edited by Joelseff
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I understand why NPs have progressed so far in the healthcare field. What I don't understand is why PAs aren't using the success NPs have achieved to our advantage. Obviously we have limitations they don't (namely, that we're regulated by the medical board and they aren't), but it still seems that we could slowly chip away at some of the useless legislative red-tape that is holding PAs back if we simply focused our lobbying efforts on gaining parity with NPs by highlighting our better (or more standardized) training. Functionally, NPs and PAs do the same things in many settings, and yet we are restricted in areas where they aren't -- this seems like a relatively easy case for lobbyists to make to legislators. 

A good start would be to focus on the VA, which is the largest single employer of PAs and yet has granted full-practice to NPs while PAs are still required to work under a supervising physician. 

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I wanted to add to my post.

Having said what I said, I for one still think PA is a better path for a non physician medical practitioner than NP. Lobby be damned, the training I have vs my NP colleagues (at least those I have met and worked with thus far) was vastly more in depth and it shows.

I have made a great career, though still in my first decade of practice and though I wish for a better bridge to MD/DO or a bridge pathway for parity with physicians, I don't regret being a PA. My life unfolded the way it did and PA was the only feasible path for me.

So I just wanted to add to my rather gloomy sounding post and the gloomy overall theme of this thread and remind my fellow PAs and those who aspire to be a PA (and I have said this before. Check the record lol) once we get OTP (or independence) and we grow in number the PA lobby will have a stronger presence and offer a BETTER product. Hang in there PAs and PA wannabes! Lots of exciting things in PAdom left to come.

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Edited by Joelseff
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1 hour ago, Joelseff said:

So I just wanted to add to my rather gloomy sounding post and the gloomy overall theme of this thread and remind my fellow PAs and those who aspire to be a PA (and I have said this before. Check the record lol) once we get OTP (or independence) and we grow in number the PA lobby will have a stronger presence and offer a BETTER product. Hang in there PAs and PA wannabes! Lots of exciting things in PAdom left to come.

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Hope springs eternal, and it's never a bad thing.  My point is, was and always has been, we need to stop F'ing around and get it done.  Name change and OTP.  It's time....period, full stop.

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I have rarely had an NP "blow past me" in regards to knowledge, ability, thoroughness, or speed.  Actually...I have only met 4-5 that I would say are as good as me, and perhaps 1-2 that I would say are better than me.

I know several who have opened, or are opening, their own clinic.  I feel sorry for their patients, but then again, I'm sure I'll be seeing lots of their patients in the ED.  

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Can we not put this into proper perspective? Our national leaders have been about as efficient as the Cowboys red zone offense this year. There, ‘nuff said.
 
Yeah but at least they made the playoffs... My Niners have a terrible Red Zone Offense and are in the cellar of the league [emoji17]

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3 hours ago, GetMeOuttaThisMess said:

Can we not put this into proper perspective? Our national leaders have been about as efficient as the Cowboys red zone offense this year. There, ‘nuff said.

 

Ok, you are quickly becoming my favorite poster here just below EMEDPA who of course we all bow down to in awe....lol 😄 

Edited by Cideous
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Folks

 

about 2 years AAPA has done a 180

 

not long ago they were still drinking the AMA cool aid

 

PLEASE don't think that AAPA is not progressive now - they are finally getting it - look at what they did with NCCPA to FORCE certification issues - proposed looking into a new certification body, look at OTP

 

AAPA is getting it - and we need to financially support them as they need money to get change to happen in DC

 

 

 

 

 

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2 hours ago, ventana said:

Folks

 

about 2 years AAPA has done a 180

 

not long ago they were still drinking the AMA cool aid

 

PLEASE don't think that AAPA is not progressive now - they are finally getting it - look at what they did with NCCPA to FORCE certification issues - proposed looking into a new certification body, look at OTP

 

AAPA is getting it - and we need to financially support them as they need money to get change to happen in DC

 

 

 

 

 

Agreed- rejoined AAPA this year. And going to the conference in May!

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On 12/22/2018 at 9:23 PM, Boatswain2PA said:

I have rarely had an NP "blow past me" in regards to knowledge, ability, thoroughness, or speed.  Actually...I have only met 4-5 that I would say are as good as me, and perhaps 1-2 that I would say are better than me.

I know several who have opened, or are opening, their own clinic.  I feel sorry for their patients, but then again, I'm sure I'll be seeing lots of their patients in the ED.  

And away we go with the "we have better training and knowledge" argument.

The general public sees it like this--MD/DO, and everyone else. They don't care that we are better trained than most NPs. It is obvious that most physicians and health care organizations don't either.

The sooner we are free from the shackles holding us back, the better off we will be. If not, we are most likely going to fade away as NPs take over health care.

 

 

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3 hours ago, mmiller3 said:

And away we go with the "we have better training and knowledge" argument.

The general public sees it like this--MD/DO, and everyone else. They don't care that we are better trained than most NPs. It is obvious that most physicians and health care organizations don't either.

The sooner we are free from the shackles holding us back, the better off we will be. If not, we are most likely going to fade away as NPs take over health care.

 

 

Exactly!  ^^^

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  • 2 weeks later...

Np’s are blowing past us because THEY HAVE THE BIGGEST POLITICAL action committee and have built themselves and governed themselves. This is why they do not recert  like a pa or other board certified physician.  When you make the rules it is easy to play the game. I am not saying that the pa’s should follow I am saying someone should stop the “nursey  doc” in their tracks. Make the rules universal for all advanced practice providers,  mid levels or whatever you want to call them. At least have them all fall under the board of medicine not the nursing board

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You guys don't get it...

The one and only reason why NPs are so far ahead is the fact that NPs are regulated by nursing boards, not medical boards.  Nursing boards can declare that NPs can do neurosurgery solo and there's not a damn thing the medical boards can do about it.

If PAs want to catch up to NPs, we need our own INDEPENDENT PA BOARD.  That's the ONLY way we can catch up to them.

Calling ourselves associates instead of assistants isnt going to do a damn thing

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How many of you are actively working with your state organization to bring a bill to your state legislators to modernize PA practice laws and to implement OTP? 

I'm deeply into year 6 with the first 3 years making noise to the then state PA academy leaders (who thought I was way off base) of why we needed change, and the last 3 years working on our legislation as the old state guard got voted out.

People:  start the process, stop discussing why NPs are so far ahead 'cuz as you discuss they move forward, and we sit here on the forum wondering why NPs are so far ahead and the never ending circle continues.

Run for president, regional rep, advocacy committee, executive council of your state PA board, HOD  and let's start shaking up that state map for PA  OTP states!!!!

 

 

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@Gordon

"The one and only reason why NPs are so far ahead is the fact that NPs are regulated by nursing boards, not medical boards.  Nursing boards can declare that NPs can do neurosurgery solo and there's not a damn thing the medical boards can do about it."

Actually, this is dependent on the individual state's medical practice acts.  At least in Ohio, this limits certain practices to physicians only.  The NP's can only do things that are specifically permitted in the nursing practice acts.  This includes things like ordering and interpreting medical testing, prescribing medications, and performing some procedures.  It is not a blanket authorization to perform surgery or other procedures, just like the PA practice acts.  While there are often some differences between the two, there are mostly similarities about what an NP and PA can do.  The primary differences are in the "supervision" vs "collaboration" vs "independence" requirements.

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14 hours ago, EMEDPA said:

Yup, and no hospital board is going to credential anyone other than a residency trained/boarded neurosurgeon to run NSG cases. first assist, sure, but not work as primary surgeon.

It seems like this point is lost on all the people making the slippery slope argument against modernizing supervision requirements.

"Without supervision, what's to stop a PA from doing neurosurgery solo?"

Answer: the same things that keep FM/IM/EM/OB/derm/peds/ortho MDs from doing it. 

Edited by fishbum
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