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Future of PA's in ED


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I hadn't heard this? What does it mean they can practice without the "supervision" of a MD/DO? They don't need to be affiliated with a supervising physician?

 

I believe their state regs say "sponsoring" vs supervising and I think collaborative vs supervisory I could be wrong about the latter.

 

I believe also NO chart review requirement.

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in wa you need a sponsoring physician of record who is "aware of your practice patterns". most hospitals still require 100% chart md cosignature so it is a moot point. the advantage is in private practice and/or clinic ownership, not hospital settings.

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The legislation on PAs, has always used the word supervision. That supervision does not or is not compelled to be on site but reached by other forms of communication. I have covered our surgery practice for decades, followed state law and my partner was in another country. There are always rumors that surface and that is why every PA should be a member of their state organization regardless of how lame some are. Remember, the way to change is to position yourself as an officer so that you can effect change for the better in your state and nation. We need to discern who is looking for a title versus who is dedicated to fight for the profession.

My ER had 100,000 visits per year and desperately needed and utilizes PAs. I think this is rumor or a very ancient administration. The one problem that Doc's have with us is that they must sign charts sometime in the week for PAs and they have not seen the patient. THis makes them responsible for a patient that they did not eyeball. You can see why they have that feeling and why the physician/PA role is built on trust.

Bob Blumm

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I agree that PAs are and willcontinue to be utilizwed in the ED and UC.

 

The thing I keep noticing is that the term "LIP' Licensed Independent Provider, keeps coming up all along with Nursing Staff that oversees most inspections. It is a repeated fight to keep our status without this official designation. It has been addressed on a peripheral level and for all intrents and purposes it can be negated. However the term LIP is counterintuitive to someone who has to be "supervised". T

This designation needs to be eliminated...period.

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I agree wholeheartedly and wish the AAPA did also. LIP is becoming a standard and we need to change our standard which means become unsupervised and have collaborative agreements like most NPs had in the past. It's a step in the right direction.

Bob

 

This. Doctors no longer having to arbitrarily sign charts days later and being held liable for actions they likely never had control over will result in much more respect in the clinical setting.

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It's nice to see that PAMAC has placed so much thought into this issue. I love some of the quotes such as the one related to lack of bladder control. Name change will happen, agreed. It is only after this happens that we will need to have ovarian and testicular fortitude and go for the real gold and that will be some type of collaborative practice. PAs are happy to practice in primary care and all of the specialties whereas NPs are more content in Women's Health, Pediatrics, Cardiology, Endocrinology and Primary Care.

There will be more than enough patients for the physicians, PAs and the NPs and we will be in a physician led team in institutions but not in private practice. We will all learn to work and play well in the same sandbox because our reflections will be fairly the same. Keep the faith as life isn't fair, but it's still good. Life is too short to fret over these things and we need to concentrate on one step at a time and take the next small step.

Bob

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if they see PAs having eyes toward independent practice in specialties, its on. then all your training beyond NP programs wont mean a thing, because PAs will just be another non-doctor trying to pull the wool over peoples eyes.

 

Any discussion about PAs being independent really only applies to settings where PA autonomy is indecipherable against a doc colleague- FP, OP Med, general peds, occ med, etc. PAs will not be independent in specialties. The credentialing and competitive forces won't allow it. PAs have a much stronger case for being a "LIP" in the aforementioned areas.

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  • 1 month later...

I've seen PAs utilized in a number of ways in various EDs. Some places I used to transport out of with my CCT team had the PAs in fast track while others had solo PA coverage overnight.

 

This is EMEDPA's dream job: http://www.healthecareers.com/aapa/job/emergency-medicine-pa-unique-opportunity/1332079

I've transported out of this hospital before, great EMED environment.

 

EMED groups like this, in my opinion, only help strengthen the argument for PAs to be utilized more in the ED setting.

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