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Just got humiliated with the title PHYSICIAN ASSISTANT


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So today, some visiting nurses from Europe and Asia toured our hospital and many of the staff, including myself, was picked to answer their questions.  One of them wanted to know what was the difference between me, a PA, and another provider there, an NP. A nurse quickly shouted out that I am an assistant to physicians so I always get supervised by doctors but that the other provider is a nurse practitioner, thus she can practically independently and open up her own shop. So the next question from one of the visitors was, then why are you guys basically doing same tasks? Another nurse replied that I get supervised but the NP doesn't.  The visitors giggled and was saying something like  NP's must be higher in status and know more than PA's and how PA's are just assistants🤨

AAPA and we PA's must do something, or else we PA's will be looked down by the public as the inferior provider of the two.

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Guest Paula

What did you say to them?  Any defense?  It sounds as bad as when I invited my local Rep and Senator to visit our clinic to highlight PA's on PA day.  (This happened about 3 years ago).    The whole event got kicked up the admin stream and they decided to highlight the NP Hospitalist program.  The physician who developed it said that PAs can't work in hospital medicine.  I literally gasped out loud in front of the physician, senator, representative, hospital administrator and other administrators and said out loud "That;s not true".  It rattled the physician and afterward I pinned him down to clarify that PAs work in hospital medicine and ALONE in rural areas.  An outright war started that day and my new employer was the enemy.  So for 3 more years I have promoted the PAs, got telemedicine rules passed when the docs were going for it and we got PAs included, got my org to not limit some positions to NP ONLY positions, and now the WI Academy is soon to submit our legislation for OTP.  

The sad part of this all....for 3 years they keep calling me an NP, I got my credentialing letter with NP behind my name.  I have spent 3 years trying to correct this and now have a severe identity crises going on after today's provider meeting.  Gosh darn it, the slide they showed about the number of medicare annual visits we were behind on had NP behind my name.  Again I blurted out....".I am a PA, a PA please stop calling me an NP, I've been saying this for 3 years, you just tripped my trigger".  The clinic manager quickly corrected the slide, but in the end they don't really care.  And my last day of work there is in 3 weeks anyway.  

 

Dang it, who am I?????

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Guest Paula

The other sad thing about this is I and one other   PA in my system are actively promoting and advocating for new legislation and getting others involved was a failure.  The PAs are just in la la land and just put their heads down and work have no concept or awareness of the demise of PA profession.  

So Army Vet Dude: run for president of your state org and be the change.  you can do it.  I'll coach you. 

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Guest Paula

AAPA has funded our legislative efforts (via a grant we applied for) and sunk a lot of money in our state org, is helping us get Federal Trade commission opinion on our legislation, our AAPA liaison has come to our conferences and worked tirelessly on helping write our legislation, and has supported WI.  We asked, we got an answer and they came up to the plate. 

If you don't ask how will they help your state? 

Cideous, thanks for contributing to AAPA, your dues helped us.  

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Also name change (physcian assistant?  Whose assistant am I ?) could help - isn't there an AAPA survey soon that everyone can vote on it? Please do the survey!  If I read my email correctly, you don't have to be a paying member to do the survey, just create an account, to help your own profession

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I have a pretty high level of disdain for a lot of military nurses, having been under their fingernails for years as a medic prior to PA school...one of the reasons is many of them don't understand their arcs of fire and how to stay out of everyone else's.  It's fun to point it out in a public setting...even if it means being hauled up on the carpet.  

I was a corporal for many years because I have an issue with my verbal safety catch going from "S" to "A" rather easily.  It's happening more again as I deal with civilian RN's turned admin's that should have stayed as floor nurses where they may well have been useful - like some military counterparts, they've been promoted several ranks beyond than their highest levels of incompetence.

Nice to see things are no different either side of the border.

SK

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I am not usually on PA Forum so forgive me if this was already covered. A friend sent me this story.

What are people supposed to think when we call ourselves Assistants and tell people daily that we require supervision? BTW, the new Virgina law is collaborative for PAs so you could have pointed that out. We use words like "delegate", assistant" and "supervision" or supervising as part of our normal language and then are astonished when people throw those same words back at us. Words matter. Definitions matter. What do you refer to your SP as?  My partner? My supervisor? My colleague? How do we all define our profession? You need a 60-second elevator speech that defines us the way we want to be defined (and is still legally accurate). 

That's why the AAPA has a title change investigation going on now. It's vitally important we look closely and do it right. That's why we have OTP as POLICY of our profession and hope eventually all state laws adopt its principles. That's why we are looking to the future with hope for real change, but you have to join the AAPA now (it's not the AAPA of years ago) and join your state organization. We won't have too many chances. If I had 10 or more years left to practice (BTW, I have none) I would be involved in some way forwarding us all. I am not saying this because I drank the Cool-Aid, I am saying it because it's the only way we can change the landscape so stories like this do not become the norm. Your support gives us the support we need to change the landscape. 

Let's work together. 

Dave Mittman, PA, DFAAPA.

 

 

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2 hours ago, Joelseff said:

Aren't you the president of AAPA this year?

Did I read this wrong?

 

Dave Mittman is the current president-elect, meaning he will begin his 1-year term as president later this year in July. Jonathan Sobel is the current AAPA President.

Both appear to be pro-OTP and pro-title change, so I think we're in good hands for now. But it's still important for PAs to get involved wherever possible -- join the AAPA and state orgs, volunteer time to these organizations, donate to the AAPA PAC, and educate fellow PAs (as well as legislators, physicians, NPs, etc) about the changes that we need to keep moving our profession forward.

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Dave Mittman is the current president-elect, meaning he will begin his 1-year term as president later this year in July. Jonathan Sobel is the current AAPA President.
Both appear to be pro-OTP and pro-title change, so I think we're in good hands for now. But it's still important for PAs to get involved wherever possible -- join the AAPA and state orgs, volunteer time to these organizations, donate to the AAPA PAC, and educate fellow PAs (as well as legislators, physicians, NPs, etc) about the changes that we need to keep moving our profession forward.
I know but I was quoting his post where he stated "IF I had 10 more years... I would move the profession along..." and was wondering is he not doing that being the prez elect? Maybe his post was lost on me?

Sent from my SAMSUNG-SM-G891A using Tapatalk

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16 hours ago, sk732 said:

I have a pretty high level of disdain for a lot of military nurses, having been under their fingernails for years as a medic prior to PA school...one of the reasons is many of them don't understand their arcs of fire and how to stay out of everyone else's.  It's fun to point it out in a public setting...even if it means being hauled up on the carpet.  

I was a corporal for many years because I have an issue with my verbal safety catch going from "S" to "A" rather easily.  It's happening more again as I deal with civilian RN's turned admin's that should have stayed as floor nurses where they may well have been useful - like some military counterparts, they've been promoted several ranks beyond than their highest levels of incompetence.

Nice to see things are no different either side of the border.

SK

Been there done that too! I hear this tripe from many NPs and their lackeys with management titles far too often!! I invite them to step into my solo remote care practice site 700-1000 miles from a physician or hospital and somehow I don't get any takers!!! Nurses spend their careers trying to validate the chip on their shoulders and compensate for not being physicians and the "PA Profession" spends too much time trying to be liked and make others happy!!! I just do my job as best I can and to hell with the game players no matter their title or station!!

 

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On 3/8/2019 at 1:45 PM, ArmyVetDude said:

and another provider there, an NP. A nurse quickly shouted out that I am an assistant to physicians so I always get supervised by doctors but that the other provider is a nurse practitioner, thus she can practically independently and open up her own shop. So the next question from one of the visitors was, then why are you guys basically doing same tasks? Another nurse replied that I get supervised but the NP doesn't.  The visitors giggled and was saying something like  NP's must be higher in status and know more than PA's and how PA's are just assistants

My reply:  "In the US politics is everything.  The nursing lobby is incredibly powerful, so despite the vastly inferior education that NPs get that is often limited to 2 years of part time online education and 500 clinical hours in one specialty, in comparison to 2.5 years of intense full time medical education that requires at least 2000 clinical hours in general medicine, surgery, emergency medicine, pediatrics, geriatrics, and women's health, the NP lobby has managed to gain legal independent practice in most of our states.  However because of the inferior training and education, virtually every NP in the country still works for hospital or physician owned systems that require intense supervision.  Remember, there is a big difference between political power and competence."

 

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9 hours ago, Boatswain2PA said:

My reply:  "In the US politics is everything.  The nursing lobby is incredibly powerful, so despite the vastly inferior education that NPs get that is often limited to 2 years of part time online education and 500 clinical hours in one specialty, in comparison to 2.5 years of intense full time medical education that requires at least 2000 clinical hours in general medicine, surgery, emergency medicine, pediatrics, geriatrics, and women's health, the NP lobby has managed to gain legal independent practice in most of our states.  However because of the inferior training and education, virtually every NP in the country still works for hospital or physician owned systems that require intense supervision.  Remember, there is a big difference between political power and competence."

 

Who cares if YOU KNOW we have far more training and education. That is not what the public thinks or knows. Perception is reality and they believe NP's are superior because they don't need to be "supervised"

Also, with  a ton of new grad PA's and NP's being churned out to the work force each year, hospital positions that were readily available in the past are becoming more scarce. Many new grads from my city moved to other cities this year just to look for some positions in the hospital. Plus, more physicians are joining corporate medicine and less are opening their own clinics. NP's are trying to take advantage of it and have started opening more clinics. Make it worse, they are hiring PA's and acting as our bosses. This is already happening here. NP owned clinics hiring part time docs and PA's. 

 

Just because you are content with being someone's assistant forever does not mean everyone is okay with it. In fact, over 90% of PA's are not. It is okay. not everyone is okay being independent. You can always be someone's assistant. Let's just hope you do not do that for your future NP boss

 

P.S. you are in EM, right?  Go read SDN. EM docs think of PA's as meat movers. Many feel that MIDLEVELS should just tie and shine their shoes and fetch them some breakfast and lunch. And you are okay that we are tied to them? No, we shouldnt be. Let the hospital or practice level dictate how we practice. Not the state 

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If you are like me who thinks our title needs an "update" please participle in AAPA's survey coming up. It is run by an independent agency (WPP) hired by the AAPA.  The survey is for both AAPA and nonmembers. You can setup an account without join the AAPA. 

The link and the instruction is here. The survey will be send out on 3/19. It's time for change, time for action. 

 https://www.aapa.org/title-change-investigation-resources/

 

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Guest Paula

In regards to non-members, they absolutely are encouraged to participate.  They may or may not already have an account with AAPA.  If they know their login information, they can simply login and follow the instructions provided on the TCI web page  www.aapa.org/tci. If they aren't certain or know they do not have an account, they can call or email Customer Care.  That team is ready to assist as needed at customercare@aapa.org or 703-836-2272, option 1.


Thanks again!

------------------------------
Donna Nogay
American Academy of PAs
VP Marketing
AAPA Liaison to WPP
------------------------------

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I'm just saying a Marine PA would of had all those nurses lock their bodies in the attention then put them in their place.

Jk. Yeah, that blows you work in such an environment where the nurses don't respect PAs. Most of the nurses that work in my ER usually come to me rather than the physicians.

Sent from my SM-N950U using Tapatalk

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  • 2 weeks later...
On 3/11/2019 at 2:23 AM, Marinejiujitsu said:

I'm just saying a Marine PA would of had all those nurses lock their bodies in the attention then put them in their place.

Jk. Yeah, that blows you work in such an environment where the nurses don't respect PAs. Most of the nurses that work in my ER usually come to me rather than the physicians.

Sent from my SM-N950U using Tapatalk
 

Physicians look down on PA's more though. Best not to be legally tied down to those folks, so we dont get controlled

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Big difference between "looking down at someone" and understanding the difference between education.

PA:  4 years undergrad that includes some tough courses then 2.5 years if intense medical education.

MD:  4 years of science heavy undergrad, study for and pass the MCAT, 4 years of medical school (arguably 3.5 years), then 3-7 years of residency.

 

Understanding the differences there isnt "looking down at" someone.

However wanting what someone else has (independence) without working for it (going to medical school) kinda looks like the "everyone gets a trophy" mentality.

 

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On 3/22/2019 at 3:18 PM, sas5814 said:

Nope just everyone in their lane of traffic. If you have X amount of training you can do Y. However while doing Y nobody has to hold your hand or look over your shoulder.

 

On 3/22/2019 at 3:06 PM, Boatswain2PA said:

Big difference between "looking down at someone" and understanding the difference between education.

PA:  4 years undergrad that includes some tough courses then 2.5 years if intense medical education.

MD:  4 years of science heavy undergrad, study for and pass the MCAT, 4 years of medical school (arguably 3.5 years), then 3-7 years of residency.

 

I have masters in Biomedical Scicence. I took same courses as med students (was top 20%). I took pretty much 90% similar courses that  med students take their first two years.  The only two classes that I didnt take that they took were clinical reasoning and history and physical classes.Except for pathology, most of those courses won't make us more knowledgeable or better providers.  Yea, I still remember some diseases that result from malfunctioning lipid and gylocogen production from my medical biochem class but it does really nothing to make me a better provider.

Good physicians know where to look up resources and whom to refer and or consult, because they don't know everything.  Likewise for PA's or NP's. That is the art of medicine. What they learn in med school is not even 5% of medicine.

Residency I give them credit for that and maybe that is where they refine some skills. But PA who has been working in Primary care for 10 years  could better prepared than a residency grad FM or IM one year ago

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