sas5814 Posted February 11, 2019 Share Posted February 11, 2019 I just returned from the TAPA conference in Houston and I got to have some great talks with current TAPA leadership and a lot of the old goats like me who served "back when." For now the x-ray issue has been tabled so there can be more discussion and stakeholders can be involved and give input. I am pretty confident it will die a quiet death. The key people are still watching. Just a bit of history on title change and OTP. The discussion of title change has been around almost since there was a title. A few years back (6?) a group of experienced PAs were concerned that it was getting a lot of talk but no action. PAs For Tomorrow was initially formed to create some movement on the issue. Now AAPA is investing a million dollars to pay a 3rd party disinterested company to investigate what title might be best and how to best roll it out and in May those results will be discusses at the AAPA conference and a plan made. OTP started when a board member of PAFT wrote a white paper on the concept then known as Full Practice Authority and Responsibility. The Name was changed to OTP but the initial idea went forward almost unchanged and now is changing the face of the profession nationally. It is the single most important issue facing the profession today. When 3 states who opposed OTP tried to amend it and water it down at last year's AAPA HOD PAFT was there testifying and working with other groups to make sure we kept moving in the right direction. The AAPA is moving along in the right direction and I am pleased to see what they are doing and how they are doing it. There are plenty of former PAFT leaders among the current leadership and I hope to see more in the upcoming election. So at the end of this shameless plug for PAFT, of which I am a board memeber, I invite any of you who feel like what we have done and what we are doing to join and ask your friends to join. Join PAFT Link to comment Share on other sites More sharing options...
NeoTrion Posted February 16, 2019 Share Posted February 16, 2019 When this issue has not been tabled by the TMB. The can was merely kicked down the road, at least this was the latest information on the legislation committee. TAPA sent the call to action for Texas PAs and SPs to email, snail male, etc... the TMB concerning this rule change. Believe it or not Scott Freshour (TMB cousel) admitted on a government relations call that "it was poorly written rule targeting independent clinic practices with no physician or radiologist over read at any point, but was not intended to change normal workflow in hospital or clinic practices." I have heard in the back channels that he and the president of TMA were responsible for writing this "poorly written rule," but honestly that is just back channel communication. He went on to say he had been overwhelmed with negative responses. So now they are actually willing to talk and have a stakeholder meeting to try and develop consensus before moving forward. This matches with what some of us that are connected to back channel in the TMB are hearing. We had requested a stale holders meeting before the wave of opposition hit, and at that time they weren't responsive. Now they want to talk about this and have been open to a stake holders meeting. Some members that should be invited to the stakeholders meeting have yet to be invited, and were politely told there is not plans to invite them. They were told they could attend as a member of the general public. Next meeting with TMB is March 1st, but I doubt they can get a re-write done and approved by that time. It will probably end up being in the summer. This update was sent out to members over email. TMB is still concerned that this radiology interpretation is not something that can be delegated to us by a physician. As I see this it is just to let the fire cool down a bit, and hope we get distracted by other pursuits on the legislative agenda. I am still encouraging members and non members alike to at least still send their opposition points to the TMB to keep the pressure on. We are also asking Texas PAs to send a copy of what they send to TAPA. We all know government has a habit of misrepresenting the numbers, and this serves as a possible point of contention for TAPA to challenge the number of dissenting emails TMB received. I have heard that TMB will take this up anytime between March - July. Mind you TAPA proposed a rule change for this (rule 185) before the TMB and TMA proposed their restrictive rule (193). TAPA's states this is decided at the clinic site with the SP. Ours was approved and recommended by the PA board and sent to TMB for review. At that point that is when TMA countered with their rule. We pushed our rule through the proper channels due to hearing rumors that TMA was going to introduce restrictive legislation on this. It is also hasn't helped that the push for straight independence by Texas Nurse Practitioners has finally awaken TMA and TMB. They have sent out multiple position statements basically calling out NPs. In this link we are not mentioned at all, but they are definitely going after Texas Nurse Practitioners. https://www.texmed.org/Template.aspx?id=49527. It looks like TMA finally said enough is enough. We are essentially getting hit by the splash damage used to go after them, even though we are not named in the above article. I have also been told that Texas Nurse Practitioners have also tried to go for a Nurse Practitioner Compact like the RNs have. It is looked upon as a backdoor method for independence. If an NP is independent and licensed in a state within the compact, then they want to be able to work in Texas, but be governed by the restrictions in the state were they are actually licensed. This would effectively give them backdoor independence in Texas, even though they have gone for independence in Texas for multiple years. There bill has never made it out of committee. I don't know how true that it is, but I have heard some of the doctors talk about and are concerned. This could be simply fear mongering. At any rate the American Academy of Emergency Medicine has also voiced their opposition to PA's in medicine in the following link. https://www.aaem.org/current-news/aaem-takes-a-stand-on-the-use-of-apps-in-ed . There was a PA that was invited to speak at the Texas College of Emergency Physicians conference this year. His invitation was withdrawn after the AAEM published their opinion. The topic was "of PA utilization in the emergency department. They stated they wanted a "Physician Perspective." SAS if you haven't seen Eva's response to TMB, I think you would be proud of how it was written. As a member of both PAFT and TAPA I was happy to see the language. Has PAFT sent anything to TMB concerning this rule? As a member of PAFT I would like to know if they are planning anything on their end to support TAPAs efforts or if they plan to attend the TMB meeting as well. Link to comment Share on other sites More sharing options...
sas5814 Posted February 18, 2019 Share Posted February 18, 2019 I did in fact see it and it was strong work. This was a rule boondoggle and whomever is responsible for writing it should be ashamed of the lack of thought that went into it along with the utter failure to include stakeholders. PAFT has written a letter to the medical board and it is available on our web site. We continue to watch and wait to see how this will play out and we are in touch with TAPA leadership waiting to see how we can be of further assistance. Link to comment Share on other sites More sharing options...
Cideous Posted February 18, 2019 Share Posted February 18, 2019 lol good grief this freaking state. I swear. No bad enough we are dead ass last in the country for health insurance coverage...and not by a small margin....Now the TMB is continuing their assault on access. Welcome to Texas. Link to comment Share on other sites More sharing options...
sas5814 Posted February 18, 2019 Share Posted February 18, 2019 8 minutes ago, Cideous said: lol good grief this freaking state. I swear. No bad enough we are dead ass last in the country for health insurance coverage...and not by a small margin....Now the TMB is continuing their assault on access. Welcome to Texas. well in "fairness" they aren't worried about access....just control over health care. Link to comment Share on other sites More sharing options...
kargiver Posted February 28, 2019 Share Posted February 28, 2019 Why doesn't TAPA retain legal representation and send a "Cease and Desist" order for Restraint of Trade to the TMA? They are clearly not friends of the profession and what they are trying to do is tantamount to a restraint of trade. G Link to comment Share on other sites More sharing options...
sas5814 Posted February 28, 2019 Share Posted February 28, 2019 Oh that would be a long conversation. Lets just say they aren't renowned for making bold moves. For now this issue is being tabled and I suspect what will come out in the end will be nothing that looks like this proposed rule. Lots of people are watching it and it won't get any traction in its current form Link to comment Share on other sites More sharing options...
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