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PAs Phased Out Of My Current Hospital - Cautionary Tale


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Long story short, the hospital I work for in Virginia has decided to move towards only interviewing/hiring NPs. The rationale: NPs don't require supervision or co-signature. State law says PAs need 5% of their charts co-signed, hospital policy is 100% and have in turn used that policy to change the status quo. 

 

Cautionary tale comes in two forms, the first being the obvious that the time for a name change is upon us. As long as the name assistant is associated with our profession, this will continue to happen across the country. The second cautionary tale is the need for a pile of 'F-U money' on hand. When I precept soon-to-be PA graduates, I tell them to tuck away $10,000 in a high yield savings account and never touch it. Start this with your very first paycheck. This is your "hell no, I'm not doing that" fund for piece of mind that you can leave any toxic position without worry because you'll likely be able to find another gig while you live off of that money.  Fortunately I practice what I preach and had the flexibility to walk away without being forced to stay with a team heading in a direction I don’t agree with. 

Edited by beattie228
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While I wholeheartedly agree with everything you said, I do not see where having any other name would have changed the requirements of chart co-signatures, or the requirement of "supervision".  You would still need the FU money, because the hospital would have still thrown the people requiring "supervision" off of the bus.

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1 hour ago, thinkertdm said:

While I wholeheartedly agree with everything you said, I do not see where having any other name would have changed the requirements of chart co-signatures, or the requirement of "supervision".  You would still need the FU money, because the hospital would have still thrown the people requiring "supervision" off of the bus.

We need OTP and name change SIMULTANEOUSLY. Both are holding us back. We are seen as inferior. I was humiliated in front of touring nurses today with the assumption that NP's are superior to PA's because they dont need to be supervised

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What hospital system in VA? Did they lay off PA's?  I heard, second hand, of system, who apparently "downsized" all AAP's then gradually re hired only NP..  

BTW, I put time and $$$ where my mouth is. Written, called and paid to promote at state and national level. im old in years, not in PA years, but really feel like giving up. I have volunteered to help promoting OTP and gotten no email responses. 

My main reason for not giving up is tha I am really concerned that when I get much older an unexperienced, direct entry online NP who doesn't know squat will be my provider!!! 

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1 hour ago, VeryOldPA said:

According to the AAPA co-signature requirements in VA are determined at the practice level and have been for several years.  (see https://www.aapa.org/wp-content/uploads/2017/05/6_KE_Chart_5-5-17.pdf

 

I've reviewed the VA BOM rules/regulations for PA and can't find anywhere anything stipulating a 5% chart review either.

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Wasnt VA one of the few states that wanted the wordings on OTP modified to include collaboration with physicians. They seem to let physicians and other medical team members dictate how PA's practice. First tell your state delegates to get their act together. Everyone in VA should be advocating for NO MANDATORY physician collaboration and PA's being able to hang their own shingles. Collaboration or not, it should all be determined at the practice level. If the practice wants all PA and NP team with no hiring additional "supervising" docs, it should be allowed. Waste of salary to have collaborating doc drives our income down and patients medical cost up. NOT GOOD!

Edited by ArmyVetDude
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I have tried to find old legislative bill that had suggested more leniency on PA scope of practice in Virginia. It was'2017 or 2018 same time NP were proposing and got their new agreement. it appeared PA"s were given a cracked door, it seams like some PA's are shutting it or only barely peaking in rather than pushing open. I am not in VA, was just looking in the area at the time and recall it was  disappointing occurrence.  And yes, VA was one that wanted to change OTP, to the bad as I recall. 

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1 hour ago, Hope2PA said:

I have tried to find old legislative bill that had suggested more leniency on PA scope of practice in Virginia. It was'2017 or 2018 same time NP were proposing and got their new agreement. it appeared PA"s were given a cracked door, it seams like some PA's are shutting it or only barely peaking in rather than pushing open. I am not in VA, was just looking in the area at the time and recall it was  disappointing occurrence.  And yes, VA was one that wanted to change OTP, to the bad as I recall. 

What exactly is your point with this?  What does it have to do with the subject of this post or the fact that VA succeeded in getting an outstanding bill passed? 

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20 hours ago, VeryOldPA said:

 

What exactly is your point with this?  What does it have to do with the subject of this post or the fact that VA succeeded in getting an outstanding bill passed? 

They pretty much got what they deserved/

Virginia delegates tried opposing OTP, because they thought we should ALWAYS have collaboration with physicians. Look what is happening there now. 

Texas delegates also tried opposing OTP, and look what PA's there have to deal with now. Some docs in Texas wanted to take away their prescribing authority, ability to read x-ray, and so on.

We need OTP and get rid of mandatory collaboration. We can't let physicians and other medical field dictate it anymore, if we want to survive. We can't compromise in our current OTP negotiation. NO MANDATORY COLLABORATION or bust!

Edited by ArmyVetDude
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  • 2 weeks later...

My point was, 2-3years ago when NP’s were legislating for indipendent practice in VA, I’m pretty sure, not positive, I saw that PA’s were initially linked in with them some how. But then a statement was put out that PA’s did not want this, they were dedicated to the team. Yes a nice bill has passed. However, if memory serves, it could have been more like what Florida is proposing. Soon after, VA proposed change  to OTP, thankfully didn’t happen.

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12 minutes ago, Hope2PA said:

My point was, 2-3years ago when NP’s were legislating for indipendent practice in VA, I’m pretty sure, not positive, I saw that PA’s were initially linked in with them some how. But then a statement was put out that PA’s did not want this, they were dedicated to the team. Yes a nice bill has passed. However, if memory serves, it could have been more like what Florida is proposing. Soon after, VA proposed change  to OTP, thankfully didn’t happen.

Tough break. They should have joined forces with the NP's. Those delegates should be fired!

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