cxr89 Posted May 15, 2012 Share Posted May 15, 2012 Hi guys, I didnt know wether or not to post this here or in the pre PA forum but anyways here i go. So for the last year or so, Ive been volunteering at my local ER just to give back some time to community. However, I never thought the heath profession would be my thing and I am always enjoying my time that I put in at the ER. I am about to graduate college with my BA in psychology, so I know I would want to get some HCE as an emt or MA after college and go back to community college to take my science prereqs, as the only thing close to a science class I took was psychopharmocology and biopsychology, which are not close to the prereqs I need. My concern at the moment is the future of the profession. I know the BLS websites says somewhere around a 30% increase in the proffesion. However, I know with the recent economic troubles and uncertainty in the US economy have a big impact on this number. For example, I know nursing where I live (souther california area around LA), the market is horrible but according to the BLS website, there is a huge demand. Even other areas in the US have the same situation I hear. Some nursing friends I know say they are worried to find a job after school as many new grads cant find a job, and even at my hospital where I volunteered, they recently had nurses voluntarily leave or else lay off would occur. I also know that the nursing market is also becoming heavily saturated, as many new nursing schools have poped up in recent years putting out more students than jobs apparently. My big question is, is it possible that what is currently occuring with the nursing market will eventually hit the PA profession? Any feedback is greatly aprreciated and thank you for your time tp read this post in your guys busy day. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted May 15, 2012 Moderator Share Posted May 15, 2012 as the economy gets worse opportunities for both pa's and np's increase. hospital systems realize they can hire a pa or an np for 1/3 the cost of a doc. solo docs realize that they can ad a pa/np instead of a physician partner and keep more money for themselves. the federal govt loves us because we are cheap labor. the # of pa's in practice has doubled in the last 10 years. the number of pa programs has tripled in the last 15 years. pa's and np's will always have a job. my concern is will these be quality jobs or triage, niche jobs and not full scope opportunities? Link to comment Share on other sites More sharing options...
sunny2spot Posted May 16, 2012 Share Posted May 16, 2012 Agreed. If you think about it -- and yes it's counterintuitive -- if the economy was great and hospitals had an abundance of funding, that could actually be bad for us. They'd hire as many doctors as they needed, force others to do the same by advertizing their prestigious roster, and midlevels would get pushed out. There is hardly a job out there that isn't dealing with the same tough market as healthcare workers. The beauty of being a PA is that you have the freedom to explore and apply to work in whatever specialty you can see yourself enjoying. I'm on the other side of the country, but I'm a new grad and got 3 job offers within 2 months of graduating -- 2 primary care, 1 ER (chosen). Nearly all my classmates had job offers by that time as well. Link to comment Share on other sites More sharing options...
physasst Posted May 16, 2012 Share Posted May 16, 2012 The future is incredibly bright. I'm at a systems engineering/research meeting right now, and the discussion about PA/NP providers is incredible. I just did the projections here, revised, and we are projecting a need of 1000 PA/NP providers by 2015, which we won't likely be able to meet..... Link to comment Share on other sites More sharing options...
Moderator ventana Posted May 16, 2012 Moderator Share Posted May 16, 2012 as the economy gets worse opportunities for both pa's and np's increase. hospital systems realize they can hire a pa or an np for 1/3 the cost of a doc. solo docs realize that they can ad a pa/np instead of a physician partner and keep more money for themselves. the federal govt loves us because we are cheap labor.the # of pa's in practice has doubled in the last 10 years. the number of pa programs has tripled in the last 15 years. pa's and np's will always have a job. my concern is will these be quality jobs or triage, niche jobs and not full scope opportunities? this touches on an interesting topic locally probably 2/3 of the doc's are with in 10 years of retirement the local monopoly hospital system is unable to hire MD/DO as they just are not around, they were thinking that PA/NP will fill the voids, but they are quickly finding out they are just as hard to hire as doc's (course they are about 20% below in pay - starting pay in the 80k with top of scale in the 110k) but they need to be in the 90-130k to really get people. was just talking to one of the HR people and they are starting to realize they have a very real problem on their hands in that they seem to be facing a dire shortage of doc's in the next 10 years as old doc's retire...... tough economy and lack of Doc's make's our job market look great Link to comment Share on other sites More sharing options...
physasst Posted May 17, 2012 Share Posted May 17, 2012 this touches on an interesting topic locally probably 2/3 of the doc's are with in 10 years of retirement the local monopoly hospital system is unable to hire MD/DO as they just are not around, they were thinking that PA/NP will fill the voids, but they are quickly finding out they are just as hard to hire as doc's (course they are about 20% below in pay - starting pay in the 80k with top of scale in the 110k) but they need to be in the 90-130k to really get people. was just talking to one of the HR people and they are starting to realize they have a very real problem on their hands in that they seem to be facing a dire shortage of doc's in the next 10 years as old doc's retire...... tough economy and lack of Doc's make's our job market look great Yep, and it's not just here. I had a 45 minute discussion at this meeting with the Swiss Secretary of State for Health. He's very interested in PA's and NP's as they are facing a massive physician shortage soon. Great discussion about allowing all members of the team to practice to the top of their abilities and training. Changing the cultural paradigm to enable teamwork, thinking of a circle with the patient at the center, rather than a heirarchal top-down structure. Somethings will be difficult. With a complicated wound, perhaps the physician or PA/NP SHOULD NOT be the one in charge. Perhaps the wound nurse should be giving the orders and managing the case. Using our expertise rather than worrying about egos. Great meeting. OH, also had a discussion with someone from the ACGME about PI-CME (CQI projects) and it was interesting. ALL physicians will have to complete this in the future. Additionally, it will likely be rolled out to RN's as well. This is an ACROSS THE BOARD push..... Link to comment Share on other sites More sharing options...
primadonna22274 Posted May 17, 2012 Share Posted May 17, 2012 Mike: Can you read the tea leaves and project top 3 specialty picks for me as a physician entering residency match in 2013? At the top of my list now is IM, neuro and FM. If I did FM it would be with an adult med focus (really great program 10 min from my house in SC and I like my house and my husband). I like the opportunities for geriatrics in any of these 3. Not to hijack the thread--I think the future IS bright for PAs. I find it hard to commit to one specialty (arguably the best part of being a PA is flexibility). Thanks :) Lisa Link to comment Share on other sites More sharing options...
surgblumm Posted May 17, 2012 Share Posted May 17, 2012 CMS Expands Medical Staff Definition. Now Includes NPs and PAs. CMS expands medical staff definition to include APRNs, PAs Among a raft of changes the Centers for Medicare & Medicaid Services issued this week, the agency controversially expanded its definition of the medical staff, allowing nonphysician practitioners to have privileges like other medical staff members. In an effort to cut some outdated requirements, CMS changed rules about medical staff oversight and roles. “We have broadened the concept of ‘medical staff’ and have allowed hospitals the flexibility to include other practitioners as eligible candidates for the medical staff with hospital privileges to practice in accordance with state law,” CMS said in the final rule. The explicit change now allows hospitals to give nonphysician practitioners, such as advanced practice nurses, physician assistants and pharmacists, the power to perform duties that they are trained for and allowed to do within their scope of practice and state law. If hospitals choose to do so, nonphysician practitioners could free up physicians to work on more medically complex patients, CMS said. The practitioners still must gain approval by the governing body that grants privileges. CMS said there was overwhelming support to broaden the concept of the medical staff to include all types of healthcare professionals. But critics worried that the rule would allow certain practitioners to circumvent medical staff bylaws, risking patient safety. CMS responded to comments and said the goal of the final rule is to allow hospitals to explore new approaches to care, thereby increasing the number and the types of practitioners granted hospital privileges. “We encourage physicians and hospitals to enlist qualified nonphysician practitioners to fully assist them in taking on the work of overseeing and protecting the health and safety of patients. This applies not only to the ‘work’ of the medical staff--such as quality innovation and improvement, best practices application and establishment of professional standards--but also to the everyday duties of caring for patients,” CMS said in the final rule. “We also believe that an interdisciplinary team approach to patient care is the best model for patients. However, we also agree that physicians, owing to their training and expertise, must be the leaders in overall care delivery for hospital patients.” CMS also eased up on rules for medical staff leadership, in which podiatrists can now be responsible for the medical staff. Also included in the rule, one governing board now can set the policy for the entire health system rather than the previous requirement that one body oversee each hospital. It thereby increases flexibility for the health system, CMS said. The U.S. Department of Health & Human Services (HHS), it said, is cutting the “red tape,” HHS Secretary Kathleen Sebelius and CMS Acting Administrator Marilyn Tavenner both called it in Wednesday’s announcement. Eliminating obsolete or burdensome regulations will save $1.1 billion across the healthcare system in the first year and more than $5 billion over five years. To learn more:http://www.cms.gov/apps/media/press/release.asp?Counter=4362&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&keywordType=All&chkNewsType=1%2C+2%2C+3%2C+4%2C+5&intPage=&showAll=&pYear=&year=&desc=&cboOrder=date http://www.ofr.gov/OFRUpload/OFRData/2012-11548_PI.pdf 14 Link to comment Share on other sites More sharing options...
physasst Posted May 17, 2012 Share Posted May 17, 2012 Mike: Can you read the tea leaves and project top 3 specialty picks for me as a physician entering residency match in 2013? At the top of my list now is IM, neuro and FM. If I did FM it would be with an adult med focus (really great program 10 min from my house in SC and I like my house and my husband). I like the opportunities for geriatrics in any of these 3. Not to hijack the thread--I think the future IS bright for PAs. I find it hard to commit to one specialty (arguably the best part of being a PA is flexibility). Thanks :) Lisa HA...Lisa, I wish I could. From a demand perspective, the demand will be highest for PCIM and FM. Personally, I would probably choose IM, as I have no desire to do OB or Peds. IM would allow flexibility to specialize in geriatrics, geriatric infectious disease, etc. etc. Also, it would allow you to move into a fellowship such as GI or Cards if you change your mind down the road. Neurology is awesome as a specialty, and there will certainly be jobs, but the demand won't be as high as in PC. I'm so happy for you Lisa....Go get 'em..... (BTW, I also had a long discussion with leadership here about establishing an "Office for Health Workforce Analysis" and possibly moving into a role as a "director" of said office working on workforce research projects full time.....they are very interested, but need to still push them (slowly, politically) over the line.... Link to comment Share on other sites More sharing options...
dkuhns1 Posted May 17, 2012 Share Posted May 17, 2012 Yep, and it's not just here. I had a 45 minute discussion at this meeting with the Swiss Secretary of State for Health. He's very interested in PA's and NP's as they are facing a massive physician shortage soon. Great discussion about allowing all members of the team to practice to the top of their abilities and training. Changing the cultural paradigm to enable teamwork, thinking of a circle with the patient at the center, rather than a heirarchal top-down structure. Somethings will be difficult. With a complicated wound, perhaps the physician or PA/NP SHOULD NOT be the one in charge. Perhaps the wound nurse should be giving the orders and managing the case. Using our expertise rather than worrying about egos. Great meeting. OH, also had a discussion with someone from the ACGME about PI-CME (CQI projects) and it was interesting. ALL physicians will have to complete this in the future. Additionally, it will likely be rolled out to RN's as well. This is an ACROSS THE BOARD push..... might i suggest that you have your Swiss contact get in touch with Professor jim Parle, j.v.parle@bham.ac.uk. Jim is the recently elected chair of the European PA Collaboration, a group of educators and clinicians from The Netherlands, Germany, Malta, England, and Scotland who are working together to develop EU wide standards for the PA profession to allow for 'professional portability'. (even though the Swiss are not part of the EU, EuroPAC will serve them well.) Link to comment Share on other sites More sharing options...
physasst Posted May 17, 2012 Share Posted May 17, 2012 might i suggest that you have your Swiss contact get in touch with Professor jim Parle, j.v.parle@bham.ac.uk. Jim is the recently elected chair of the European PA Collaboration, a group of educators and clinicians from The Netherlands, Germany, Malta, England, and Scotland who are working together to develop EU wide standards for the PA profession to allow for 'professional portability'. (even though the Swiss are not part of the EU, EuroPAC will serve them well.) Will do, BTW, how are you? When did you return? Mike Link to comment Share on other sites More sharing options...
dkuhns1 Posted May 17, 2012 Share Posted May 17, 2012 Hey Mike, I have been back since last year when the #%^** at the university closed our program. But since then I have been back and forth as still had students in the pipeline tlll this Jan. Now awaiting final word as adviser role for the program in Aberdeen with plans to go there a couple of times a year. Off to Dublin next month forthe ICEM conference (http://www.icem2012.org) where I will be speaking on the role of PAs in EM. From there over to the Netherlands to do some lectures for the program in Utrecht. Link to comment Share on other sites More sharing options...
physasst Posted May 17, 2012 Share Posted May 17, 2012 Hey Mike, I have been back since last year when the #%^** at the university closed our program. But since then I have been back and forth as still had students in the pipeline tlll this Jan. Now awaiting final word as adviser role for the program in Aberdeen with plans to go there a couple of times a year. Off to Dublin next month forthe ICEM conference (www.icem2012.org) where I will be speaking on the role of PAs in EM. From there over to the Netherlands to do some lectures for the program in Utrecht. What happened to the Saudi program? Are they still moving ahead? Good to see you around. Mike Link to comment Share on other sites More sharing options...
dkuhns1 Posted May 17, 2012 Share Posted May 17, 2012 Saudi program should be close to graduating their first cohort---i think. aafter two years there has been a total turn over in faculty. not unexpected given the challenges hardships that were faced. I dont know any of the new folks there. Meanwhile there is also a program underway in Afghanistan, again for their military but this time they are admitting women to the course. There is apparently some interest in getting something going for the civilain side eventually. See you in toronto? Link to comment Share on other sites More sharing options...
surgblumm Posted May 18, 2012 Share Posted May 18, 2012 Seems strange that they will allow females to touch males in the Mid East as I know the opposite is true but then, I'm not a Mid East expert. I'll be in Toronto and will sit in the HOD for the AFPPAs on Sat and Sun and will be working one of the exhibitors booths during the conference. I already have over two hundred CMEs this year. See you in Toronto Dave. Bob Link to comment Share on other sites More sharing options...
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