OTP is a must if we're to catch up to our NP colleagues

[Guest HanSolo]

11 minutes ago, deltawave said:

New grad PAs are also settling for lower compensation packages. It doesn’t take long for corporations to recognize this. There ought to be a class on salary negotiations in every PA program. It only takes a couple people to accept a low-ball offer before everyone loses traction. 
 

Ultimately, the responsibility and workload held by a PA/NP demands a salary above board. 

I agree, but we also hear about new grads struggling to get work. What leverage do they have if they're worried that is the only opportunity they will get? 

[deltawave]

7 hours ago, HanSolo said:

I agree, but we also hear about new grads struggling to get work. What leverage do they have if they're worried that is the only opportunity they will get? 

Move...

I know people will come up with reasons why not to and all that, but you’ve got to go where the market is good. This is a good career we’re talking about. 
 

Rule of 3’s. 

[ANESMCR]

44 minutes ago, deltawave said:

Move...

I know people will come up with reasons why not to and all that, but you’ve got to go where the market is good. This is a good career we’re talking about. 
 

Rule of 3’s. 

That’s just it. The rule of 3’s these days. More like the rule of 0’s. Give up location (1). Okay...move to the dwindling number of states with more jobs so you can achieve employment in a specialty you’re not interested in, just for the sake of getting experience (2). As mentioned above, accept lower salary (3). It’s not that easy. Case in point, the appealing aspect of becoming a physician assistant is that you will have all three. New graduates are now faced with exactly the opposite. 

[deltawave]

7 minutes ago, ANESMCR said:

That’s just it. The rule of 3’s these days. More like the rule of 0’s. Give up location (1). Okay...move to the dwindling number of states with more jobs so you can achieve employment in a specialty you’re not interested in, just for the sake of getting experience (2). As mentioned above, accept lower salary (3). It’s not that easy. Case in point, the appealing aspect of becoming a physician assistant is that you will have all three. New graduates are now faced with exactly the opposite. 

Well that’s one way to look at it. 
Are you always this optimistic? 

[ANESMCR]

11 hours ago, deltawave said:

Well that’s one way to look at it. 
Are you always this optimistic? 

Optimistic, sure. Pragmatic, absolutely. 

[Guest Paula]

We need OTP and then independence, we need residencies or fellowships to compete with the NP's. (who are developing fellowships for NPs...my friends newly graduated DNP daugther is in an ER fellowship in Cali).  They are looking at FP fellowships to further align with PA training.  So we need independenct and fellowships/residency/ or true bridge program to physician for all PAs now certified and let us all grandfather into physician and phase out the PA profession. 

[Guest HanSolo]

22 hours ago, deltawave said:

Move...

I know people will come up with reasons why not to and all that, but you’ve got to go where the market is good. This is a good career we’re talking about. 
 

Rule of 3’s. 

Moving isn't exactly what I would call leverage...

[deltawave]

30 minutes ago, HanSolo said:

Moving isn't exactly what I would call leverage...

Sure it is. If people don’t accept crappy contracts and leave for places that offer better options, the laws of supply and demand will kick in. 

[RadAssPA]

Name change, OTP, residencies and CAQ's appear to likely be the future for the PA profession. CAQ's should be expanded. What specialties do you think should be added?

Current NCCPA CAQ's:

1) CT Surgery 2) EM 3) Hospital Medicine 4) Nephrology 5) Orthopaedic Surgery

6) Pediatrics 7) Psychiatry

Possible CAQ options??:

1) Cardiology 2) Gastroenterology 3) Urology 4) General Surgery

5) Neurosurgery 6) Transplant surgery 7) Radiology 8)Internal Medicine

9) Pulmonary/Critical Care 10) Pain Management 11) Allergy/Immunology

12) Infectious disease 13) ENT 14) Rheumatology 15) Neurology

Thoughts??

 

 

 

 

 

Edited November 25, 2019 by RadAssPA

[EMEDPA]

48 minutes ago, RadAssPA said:

Name change, OTP, residencies and CAQ's appear to likely be the future for the PA profession.

 

 

 

 

and doctorates...folks may have differing opinions on this, but when all the NPs have DNPs, we need to have them too, at least in tight markets. Probably less important if you want to work rural, Indian health, prisons, underserved areas, etc

[WeBuyAndSellJunk]

I think the problem is that you have no leverage at all when there are 5 NPs waiting to step up next in line for any job. They aren't coming out of school riddled with debt and going from making $25 an hour to $40 an hour is a big gain for evening courses, hanging out with friends for clinical rotations, and an ability to continue working over a 2 year period. I have some leverage with my work history, but a new grad PA can't prove themselves any better than a new grad NP. The reality is that this is happening right now also. The PA program that I attended has had several new graduates really struggling to land jobs months after graduation. These are excellent students, several who have been clear that they are willing to go anywhere for a position. 

I am not sure how we compete when it is so easy for NPs to just flood the market and drown us out of existence. We need to prove that we are more valuable to a system. I suspect that some sort of residency will soon be the expectation for the primary medicine fields. 

[Cideous]

15 minutes ago, printer2100 said:

 

I am not sure how we compete when it is so easy for NPs to just flood the market and drown us out of existence. We need to prove that we are more valuable to a system. I suspect that some sort of residency will soon be the expectation for the primary medicine fields. 

and those here who know me, know I have been screaming this from the rooftops for over 10 years here on these boards......yet here we still are.  I feel bad for you guys, I really do.  

[ANESMCR]

5 hours ago, printer2100 said:

The PA program that I attended has had several new graduates really struggling to land jobs months after graduation. These are excellent students, several who have been clear that they are willing to go anywhere for a position. 

I am not sure how we compete when it is so easy for NPs to just flood the market and drown us out of existence. We need to prove that we are more valuable to a system. I suspect that some sort of residency will soon be the expectation for the primary medicine fields. 

Sounds familiar. My cohort graduated/passed the boards x4 months ago. 6/30 of them have been able to land a job. Agree about residency. However, as someone stated here previously, there aren’t enough of them and it’s just as competitive to get accepted into a program. That’s a lot to risk/ask of prospective students. Work your tail off and maybe you get accepted to PA school, then after that...jump hurdles to maybe get accepted into a residency program. After that, you still face stiff the prospective difficulty of finding a job. I know some already do but all PA schools should just incorporate an entire additional year to their curriculum, whether it be counting as said residency or giving the option to specialize etc. 

[EMEDPA]

21 minutes ago, ANESMCR said:

 I know some already do but all PA schools should just incorporate an entire additional year to their curriculum, whether it be counting as said residency or giving the option to specialize etc. 

I think this is where PA education is headed. 3 year programs, awarding a doctorate, followed by a one year internship in specialty of choice.

[LT_Oneal_PAC]

23 hours ago, ANESMCR said:

Sounds familiar. My cohort graduated/passed the boards x4 months ago. 6/30 of them have been able to land a job. Agree about residency. However, as someone stated here previously, there aren’t enough of them and it’s just as competitive to get accepted into a program. That’s a lot to risk/ask of prospective students. Work your tail off and maybe you get accepted to PA school, then after that...jump hurdles to maybe get accepted into a residency program. After that, you still face stiff the prospective difficulty of finding a job. I know some already do but all PA schools should just incorporate an entire additional year to their curriculum, whether it be counting as said residency or giving the option to specialize etc. 

I disagree wholeheartedly that another year should be added, at least for the purpose of residency. Honestly I think no more than 6 months could be added, but thats just opinion. I understand why you think that might be a good idea, to incorporate residency to skip having a second application cycle, but here’s why it’s not:

- residency is about graduated independence. A student cannot be independent. It works the way it does because the law allows you to be fully functioning, but you voluntarily restrict your scope and salary in EXCHANGE, and this is how it’s different from just going straight into practice, for being able to move slower, study each case, and have on shift teaching at whatever speed you require. Teachers are also much more willing to take the risk on a resident doing a procedure, but they are not keen on a letting a student drive the wheel. It’s a matter of mental perception. I intubated almost 1000 people before PA school and handled lots of difficult airways, but no one would let me intubate while I was a student. 

- you can quit a residency and still have your license intact, debt not stacked up, and income earning power increased. There are jerk people in medicine that may try to sink you. I’ve seen it happen to others. No reason to make people take that risk any longer than they have to while incurring the level of debt we are.

-schools are teaching you to the test. In residency, all tests are done and you get to focus on learning that matters. Not high yield questions and answers for PANCE, but how to actually save lives and work in the system.

- many residents are unionized because they can be treated like indentured servants. My residency wasn’t unionized and boy could you tell between how we were treated vs other residencies. All I wanted was better damn parking and some dental insurance! When you are a student, nothing you can do to improve your situation. Debt without a license holds you hostage.

In short, schools should not be in charge of residency.

There isn’t a reason we cant exponentially increase residency slots. Unlike physician interns, we have a license to practice medicine day one, and bill normally. So by taking a salary cut to physician resident levels but billing at 100% incident to rules since every patient a resident sees has to be seen by an attending, we are making the hospital a crap ton of money. 

[ANESMCR]

12 minutes ago, LT_Oneal_PAC said:

In short, schools should not be in charge of residency. 

I see your point. Well said, all of that makes sense. I suppose the better solution would be to push for more residency positions then. The idea I was getting at originated in seeing preference for graduates from PA schools that boast specialized training. Off the top of my head-UC Denver (Peds) and Witchita State (Rural med), and others.   

Edited November 25, 2019 by ANESMCR

[Hope2PA]

On 11/25/2019 at 10:30 AM, printer2100 said:

I think the problem is that you have no leverage at all when there are 5 NPs waiting to step up next in line for any job. They aren't coming out of school riddled with debt and going from making $25 an hour to $40 an hour is a big gain for evening courses, hanging out with friends for clinical rotations, and an ability to continue working over a 2 year period. I have some leverage with my work history, but a new grad PA can't prove themselves any better than a new grad NP. The reality is that this is happening right now also. The PA program that I attended has had several new graduates really struggling to land jobs months after graduation. These are excellent students, several who have been clear that they are willing to go anywhere for a position. 

I am not sure how we compete when it is so easy for NPs to just flood the market and drown us out of existence. We need to prove that we are more valuable to a system. I suspect that some sort of residency will soon be the expectation for the primary medicine fields. 

The only way to PROVE how valuable PA’s are is to actually be considered for positions. Administrators do not always care about your education, In nearly half the states, NP’s are easier to deal with, and could cost less, because physicians are not required to supervise or collaborate with them. Support AAPA, PAFT and state association. Then demand they work toward OTP and potentially independence similar to NP.

[Cideous]

*** And they don't have "assistant" in their names....

[deltawave]

20 hours ago, EMEDPA said:

I think this is where PA education is headed. 3 year programs, awarding a doctorate, followed by a one year internship in specialty of choice.

Then I should have just went to medical school. 

BS, MS, and then what you propose is just not what PAs were geared towards. There has to be a better alternative; otherwise prospects could (read should) just become a physician. Likely, the cost of such programs will soar making it as economically difficult to manage as medical school. Why go through all of that just to have to fight for work placement, practice rights, and to be titled “assistant” or “associate?” 
 

It works for NPs for reasons other have stated; they can work while in school, they get cushy placements, and they have a super lobby backing them up. It doesn’t work like that for PAs. 

[deltawave]

19 hours ago, LT_Oneal_PAC said:

Your residency post. 

Bravo.

I wish I could like your post twice.

[ventana]

solution

make all new grad PA DMSc

make one year post grad intership MADATORY and have hard standards to get a resideny program licensed

offer more career counseling to the new grads

 

in about 5 years this is what it looks like

EVERY new pa is a DMSc 

Every new grad then goes to residency and is functionally independent day 1 after residency

Every new grad from residency is told of their value and job offers start at $125k (because we are worth at least that)

 

 

TADA  

Then the politicians realize we are truly what we are and give us fully independent practice

 

And while I am at it, I find the pot o gold at the end of the rainbow, see a  unicorn, can order VNA and sign for diabetic shoes.....

[Hope2PA]

Didn’t President Trump sign some executive order early October to take away required supervision for NP and PA, and have Medicare payments go to job done not title held. I don’t know what else has happened with this except AAFP and I think AMA are fighting against and Nurses are fighting for. Scary thought is NP can push the fact that they already have independence in half of US, PA’s on the other hand do not. Legislation will likely agree PA’s are Assistants, or even Associates, but definitely not worthy of independence or equal pay because they are tied to physician’s. AAFP and AMA will settle because at least they win half the battle.

[Avalon]

Ventana,

I'm not disagreeing here, but I am wondering what your solution means for currently practicing PAs who do not hold a doctoral degree and/or have not completed a residency. 

[ohiovolffemtp]

Multiple physician organizations, I believe about 30+, sent a letter in opposition to this.  I don't believe it has actually gone into effect.

[CookiePA]

It is a scary thought that we may be left behind. I agree with Residencies and do think that it will make us stand out.

Did anyone catch the recent news circulating about Edward Elmhurst Health, Naperville, fired or I guess laid off 11-15 doctors and plan on replacing them with sounds like most likely APPs?
 

I have issues with this whole scenario. And I get Medicine is a business To some extent. Bottom line being we better work fast with our local and state chapters if this is what it is going to look like.

Edit: edited my sentences to avoid confusion 

Edited November 27, 2019 by CookiePA