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corpsman89

Bill proposal to allow NPs--AND PAs--independent practice

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Personally, I was pleased with the article until the end where the rep said that he will always see a doctor and so will his kids, and that he thinks autonomy for APPs will create a two-tier system of those who can access doctors and those who can't (unless I'm reading it wrong). Seems to me that he is asserting that he won't end up on the, "lesser," tier, of APPs, which really angers me. 

I do not think autonomy would have that affect, heck most patients that I've come across don't know the credentials of their PCP and don't really care, but it is something I have never considered. 

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It's an interesting strategy. I'm a little unclear- how exactly did PAs get included onto this bill? It sounds like it was an eleventh hour add on to a NP independence bill. This almost goes against OTP, but also would greatly level the playing field between PAs and NPs in Florida. does FAPA have an opinion at all? 

 

I just submitted a petition from my SP in support of California's OTP bill, so I'm eagerly watching how both of these turn out. 

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I am not sure why they added PAs to the bill, but it makes sense to me. I wish that when the very first state pushed for NP independence that PAs were included as well, because they would have set a precedent and we would likely had been included in all subsequent bills and proposals, and there fore would have the same success as NPs. 

While realistically this bill probably wont pass, if it did--and PAs actually gained independence in florida--it may be enough to start the domino train. 

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Sure hope Florida PA’s support this! Would be only way to actually even or level playing field.

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As a Florida PA, I’m encouraged by this direction. This bill has been all over commercials, but only for NPs. I’m curious as to what changed to put PAs on the bill as well, but I hope this goes somewhere. It would really be nice to actually be ahead of the curve here.

I don’t know if FAPA was involved, and I can see nothing about their involvement.

I am ticked that PAs make the bill “less appealing.”

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I hope FAPA takes the bill and runs with it.  Independent practice is not an awful thing, it is a beautiful thing.  

FAPA: Do not shoot yourselves in the foot.  Run with this, run, run, run to the finish line!

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“Pigman, an emergency room physician, offered a 153-page amendment to the measure that added physician assistants to the bill, a move that made doctors, and some lawmakers, more uncomfortable with the measure.”

Representative Pigman who introduced the bill and got it out of committee, and is also an EM physician, added us on. We should all write him a thank you letter.

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13 hours ago, LT_Oneal_PAC said:

“Pigman, an emergency room physician, offered a 153-page amendment to the measure that added physician assistants to the bill, a move that made doctors, and some lawmakers, more uncomfortable with the measure.”

Representative Pigman who introduced the bill and got it out of committee, and is also an EM physician, added us on. We should all write him a thank you letter.

 

I'm happy to hear that PAs are included, but any thoughts on why Rep. Pigman would have added PAs onto the bill? It doesn't sound like FAPA was pushing at all for inclusion here. If I'm feeling optimistic, I'd love to believe that someone just believes in midlevel equality (which would be a great goal, IMO), but I feel like I'm missing something here. 

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3 hours ago, spflynn4 said:

 

I'm happy to hear that PAs are included, but any thoughts on why Rep. Pigman would have added PAs onto the bill? It doesn't sound like FAPA was pushing at all for inclusion here. If I'm feeling optimistic, I'd love to believe that someone just believes in midlevel equality (which would be a great goal, IMO), but I feel like I'm missing something here. 

My first incredibly cynical thought was that he didn't want NP independence so he added us on as a way to make sure it didn't pass...then it backfired on him.

But reading the article maybe he actually is altruistic and honestly believes in it.

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Excluding arguments about bad actors what would change for most of us if a genie made us all independent practitioners today? For me the answer is pretty much nothing. I still have credentials. I still have departmental and regional medical directors. I still have to follow rules from insurance companies, the state and federal government. I'm still responsible and liable for my practice habits.

The only difference is I wouldn't be tied by law to a certain physician who does 10 meaningless chart reviews every month.

It is past time for some movement away from state mandated supervision.

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On 3/13/2019 at 1:01 PM, spflynn4 said:

It's an interesting strategy. I'm a little unclear- how exactly did PAs get included onto this bill? It sounds like it was an eleventh hour add on to a NP independence bill. This almost goes against OTP, but also would greatly level the playing field between PAs and NPs in Florida. does FAPA have an opinion at all? 

 

I just submitted a petition from my SP in support of California's OTP bill, so I'm eagerly watching how both of these turn out. 

 


I think you and PA's in California are WRONG about OTP. OTP is about leveling the playing field. OTP wants to nullify MANDATED collaboration between physicians and PA's. It is about collaboration but not MANDATORY. We want the law to allow things to be determined at the practice level without  our practicing medicine be tied to physicians. IF the practice wants to hire only PA's and NP's with no MD presence, it should be allowed. This is what OTP is all about. If you want your job to be tied  to physician supervision, go ahead but it is not what the rest of us want. We want to UNLINK ourselves from them, and not be  CHAINED LEGALLY collaborated with them.

 

California "OTP" bill is not really OTP. Some states like NJ and Michigan already give full authority to PA's and allow them to work solo/independently without SP presence or ever meeting them. Stop saying that MANDATED collboration is OTP. That is what Virginia and Texas state organization wanted OTP to be and are getting screwed now by physicians who want to limit and curtail their practices

 

 

Edited by ArmyVetDude
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1 hour ago, sas5814 said:

Excluding arguments about bad actors what would change for most of us if a genie made us all independent practitioners today? For me the answer is pretty much nothing. I still have credentials. I still have departmental and regional medical directors. I still have to follow rules from insurance companies, the state and federal government. I'm still responsible and liable for my practice habits.

The only difference is I wouldn't be tied by law to a certain physician who does 10 meaningless chart reviews every month.

It is past time for some movement away from state mandated supervision.

the BS wasted time of notifiy and reviewing shi%% with my doc for the mere purpose of record keeping. what a waste of both out times....

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4 hours ago, ArmyVetDude said:

 


I think you and PA's in California are WRONG about OTP. OTP is about leveling the playing field. OTP wants to nullify MANDATED collaboration between physicians and PA's. It is about collaboration but not MANDATORY. We want the law to allow things to be determined at the practice level without  our practicing medicine be tied to physicians. IF the practice wants to hire only PA's and NP's with no MD presence, it should be allowed. This is what OTP is all about. If you want your job to be tied  to physician supervision, go ahead but it is not what the rest of us want. We want to UNLINK ourselves from them, and not be  CHAINED LEGALLY collaborated with them.

 

California "OTP" bill is not really OTP. Some states like NJ and Michigan already give full authority to PA's and allow them to work solo/independently without SP presence or ever meeting them. Stop saying that MANDATED collboration is OTP. That is what Virginia and Texas state organization wanted OTP to be and are getting screwed now by physicians who want to limit and curtail their practices

 

 

It seems as though you're adding a certain spin to my post that wasn't in there. My point was that I don't think that the Florida bill will happen right now in California, because I"m still not sure how it happened in Florida. If it's altruism, that's great. However, we can't really count on altruism being what drives OTP forward.  I also agree with your overall point- the time is now to push for less restrictive PA practice laws. However, it's a good first step. Moving from supervision to collaboration is a good step, and having a practice level decision on the delegation of services is a modernization of largely archaic laws. 

I will be unhappy if this is the only OTP bill that is brought up or passes in California, but I also understand that it's a work in progress. It's up to us California PAs to make sure that we don't settle for a halfhearted attempt at OTP past this initial attempt. 

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On 3/13/2019 at 10:01 AM, spflynn4 said:

It's an interesting strategy. I'm a little unclear- how exactly did PAs get included onto this bill? It sounds like it was an eleventh hour add on to a NP independence bill. This almost goes against OTP, but also would greatly level the playing field between PAs and NPs in Florida. does FAPA have an opinion at all? 

 

I just submitted a petition from my SP in support of California's OTP bill, so I'm eagerly watching how both of these turn out. 

I just got the docs at my work signed the petition as well. Glad someone else is doing the same thing.  Lets go California PAs!

 

On 3/14/2019 at 2:37 PM, ArmyVetDude said:

 


I think you and PA's in California are WRONG about OTP. OTP is about leveling the playing field. OTP wants to nullify MANDATED collaboration between physicians and PA's. It is about collaboration but not MANDATORY. We want the law to allow things to be determined at the practice level without  our practicing medicine be tied to physicians. IF the practice wants to hire only PA's and NP's with no MD presence, it should be allowed. This is what OTP is all about. If you want your job to be tied  to physician supervision, go ahead but it is not what the rest of us want. We want to UNLINK ourselves from them, and not be  CHAINED LEGALLY collaborated with them.

 

California "OTP" bill is not really OTP. Some states like NJ and Michigan already give full authority to PA's and allow them to work solo/independently without SP presence or ever meeting them. Stop saying that MANDATED collboration is OTP. That is what Virginia and Texas state organization wanted OTP to be and are getting screwed now by physicians who want to limit and curtail their practices

 

 

This is not perfect, but it is a step moving forward. This is definitely not the end. California Medical Association is pretty strong, even NP's full practice authority got shot down in the past. There is also a strong Nursing lobby here. But California Academy of PA (CAPA) has some really progressive and young PAs leading the battle, we will see how it goes. But we are ready to fight!

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FAPA was involved in this process. I’m not speaking on behalf of them (FAPA) but the addendum process was felt to be the better method in this instance and the academy and board was definitely aware of the process/bill. 

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On 3/16/2019 at 9:45 AM, Gaijyn said:

FAPA was involved in this process. I’m not speaking on behalf of them (FAPA) but the addendum process was felt to be the better method in this instance and the academy and board was definitely aware of the process/bill. 

hmmm...All states that allow NP independence   should jump on what is already there and have some addendum for PA's and go from there. We need to be at least at the even playing field as NPs

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29 minutes ago, Gaijyn said:

The only state that has something like this is New Mexico (currently). 

Like an actual NP / PA bill proposing independent practice?

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This is what I support. not california's modified OTP that still mandates us to have collaboration. 

Whether or not we should have collaboration should be determined at the practice level. If a medical practice wants to hire only NP's or PA's and no physicians collaborating, it should still be allowed. This is already happening in some places where NP's have full authority. They have NP led teams that only hire NPs in minute clinics or pain management and stuff. They don't have to hire collaborating physicians and pay extra salary. This is not the case with PA's. We can't have PA led teams which makes us less valuable to everyone else. PA led services have to have some physicians and cost clinics HIGH SALARY= expensive cost

PA's are shunned because of this and will continue to be unless we put ourselves in equal footing if not better. CAPA needs to push for same rights as NP's. Not half ass OTP to appease physicians. They (CAPA PAs) act like cinderella trying to appease their abusive step mother (physicians). It is okay to push boundaries and seek more like nurses and NP's. SQUEAKY WHEELS Get the oil

NOT ACCEPTABLE!!!

Let the hiring decison be at the practice level. EVERYTHING  should be

Edited by ArmyVetDude

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