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Decisions and Destiny: Thoughts for PAs for 2019

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How often do we take the things that life has to offer and fail to recognize that they are good fortune or gifts? We observe special things such as the health of our family members, our dwelling, our two cars, the fact that we are healthy and fortunate enough to have employment and that some of us can choose to operate today, consult tomorrow, or care for patients in our office the following day. There is always food on our tables, a place for our heads at night, a trusty CPAP (continuous positive airway pressure) machine that makes me sound like Darth Vader, parents, children, and grandchildren. Both my son and daughter are employed, my son as an RN and an actor, and my daughter as vice president of a company in New York City.

Life is not as rewarding for everyone. What if you lived in a town in the Midwest hit by a tornado? What if your home was washed away or destroyed by torrential rain? Consider the individuals who get into their car, drive to work, and are suddenly hit by a truck or SUV. They wake up in an intensive care unit fighting for their lives.

Life is always in flux and situations can change from minute to minute; you or a family member could undergo a complete change in destiny.

Destiny is not a matter of chance; it is a matter of choice! We must choose a path that will lead us to a place of security, for both the present and the future. It requires involvement today, not tomorrow. To justify your decision to become a PA or an NP, it was necessary to make a choice. For many of us, that choice was made based upon our past involvement in medicine or nursing. Many PAs were former medics and corpsmen or perhaps EMT’s or paramedics, and realized they could do so much more as a PA. Many NPs were former nurses or specialty nurses in fields like emergency medicine, critical care, pediatrics and psychiatry and therefore decided  that they could accomplish more as a NP. Upon making this decision it was required that we follow the educational path that would lead to a licensed medical professional designation. We all paid a price to gain the prize of calling ourselves PA or NP.

When thinking of security, it involves not only your choice of profession but also how to maintain that professional designation and how to have appropriate defense in the real world of patient care. Our decisions are often life saving and yet we need to be able to justify those decisions with our peers and medical and nursing societies. Security comes from being able to point to proper medical care references and also by having malpractice insurance. Most institutions provide that insurance but its liability protection is extremely limited. Locum Tenums insurance is not provided, neither are curbside consultations or per diem jobs or moonlighting. This requires a company that writes professional liability insurance policies and not all of these are created equal. I use CM&F because I have personally heard of disasters with some other companies. Research is mandatory in making this decision as your destiny is involved.

You and I share the responsibility of being vigilant and staying informed. Knowledge is the key to understanding the issues, and that knowledge cannot be attained by existing in a vacuum. The issues that we face, we face together, and there is no room for bystanders. If you look back at the accomplishments that have been made this year, they would not have been successful without joint effort and the desire to improve. Your career decisions are shared, thoughtful decisions and are best learned from your colleagues. As we enter a new year, 2019, let us strive to recommit ourselves to our patients, to patient care, to our professions and to ourselves and our families by rethinking our security and how to improve it.

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