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PACali

Federally funded NP residency program

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https://theaggie.org/2019/11/18/nurse-practitioner-residency-program-launched-by-uc-davis-health/?fbclid=IwAR0cCOs9hLo7J5KsMaa31XbCX8oU4pLHMEZriL5Ysax4zRHq9DuIDsfhhqM

"The new residency program for nurse practitioners at the Betty Irene Moore School of Nursing has opened its applications. While nurse practitioner residency programs exist at other institutions, this is the first one to be funded by the Health Resources and Services Administration, according to Debra Bakerjian, a School of Nursing clinical professor and principal investigator. The $3.5 million grant is monumental for the nursing community since it depicts federal recognition of the importance of nurse practitioners in primary care. "

Are there any federally funded PA residency program out there? If not, why not? 

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If you don’t count the military, which of note doesn’t offer NP residency, then I don’t know of any.

looking at the SON page, the residency looks pretty watered down to me. A few “short specialty rotations” per the website and no mention of resident pay or benefits. The real winner here is UC Davis who is going to bill for NP resident services and get federal aid. 

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4 hours ago, LT_Oneal_PAC said:

If you don’t count the military, which of note doesn’t offer NP residency, then I don’t know of any.

looking at the SON page, the residency looks pretty watered down to me. A few “short specialty rotations” per the website and no mention of resident pay or benefits. The real winner here is UC Davis who is going to bill for NP resident services and get federal aid. 

The majority of their time will be primary care, with off service rotations as well.  Sounds pretty standard for a 1 year primary care residency.  They will be compensated, however, the amount has not yet been announced.  

"...who is going to bill for resident services and get federal aid."  So like every hospital system with a physician residency...?

Sounds like sour grapes to me...

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3 hours ago, Kaepora said:

The majority of their time will be primary care, with off service rotations as well.  Sounds pretty standard for a 1 year primary care residency.  They will be compensated, however, the amount has not yet been announced.  

"...who is going to bill for resident services and get federal aid."  So like every hospital system with a physician residency...?

Sounds like sour grapes to me...

I’m not sour. We had NP residents where I trained and happy to have them. Some of the best I’ve ever worked with. They are welcome to have it federally funded as well. I have no qualms with this. Same with PAs I worry about places starting a “residency” that is actually cheap labor and a way to make money. The few off service rotations don’t appear to cover any OB-GYN, inpatient, or procedural rotation. They specifically note that the rotations are short. So, for the benefit of the resident, I would qualify all these things.

If you don’t know how billing works, please keep the snide comments to yourself. You can keep on thinking I have something against NPs or nurses, but I don’t, so taking jabs at me will continue to be fruitless. Residents do not get paid the way the rest of us who get paid:
 

“When hospitalists work in academic centers, medical and surgical services are furnished, in part, by a resident within the scope of the hospitalists’ training program. A resident is “an individual who participates in an approved graduate medical education (GME) program or a physician who is not in an approved GME program but who is authorized to practice only in a hospital setting.”1 Resident services are covered by Centers for Medicare & Medicaid Services (CMS) and paid by the Fiscal Intermediary through direct GME and Indirect Medical Education (IME) payments. These services are not billed or paid using the Medicare Physician Fee Schedule.“

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Why would an NP want to do this?

Get paid a resident salary of 50k per year instead of making 100k?  That's a stupid decision and doesnt advance your career.

Show me where NP or PA jobs require a primary care "residency"

 

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Its not a requirement now but with the saturated market it will be “Understood requirement” very soon. They may not explicitly post it under job description but who do you think will get interviewed: someone brand new out of school or someone who states on resume they did a residency? Plus residency gets your foot in the door with hospital system you may be interested in working

 

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32 minutes ago, TexasPA28 said:

Why would an NP want to do this?

Get paid a resident salary of 50k per year instead of making 100k?  That's a stupid decision and doesnt advance your career.

Show me where NP or PA jobs require a primary care "residency"

 

Well, we don’t know what the salary is. Personally I think there is only one good primary care residency that gives proper time in off service rotations, inpatient service, and procedural rotation so that one can be a fully functioning FM provider, and it pays 70k for some odd reason.

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2 hours ago, LT_Oneal_PAC said:

Well, we don’t know what the salary is. Personally I think there is only one good primary care residency that gives proper time in off service rotations, inpatient service, and procedural rotation so that one can be a fully functioning FM provider, and it pays 70k for some odd reason.

FM docs have no choice but to do a residency.  But if you gave them the "option" of doing a residency for 70k per year vs starting practice at 200k per year, there's not a soul who would choose to do the residency

Primary care residencies for PAs and NPs are worthless.  Hell I'd argue they are also worthless for MDs

A primary care NP/PA can do 100% of the job that the MD can do with no residency.  Think about that.

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On 12/1/2019 at 1:20 AM, TexasPA28 said:

FM docs have no choice but to do a residency.  But if you gave them the "option" of doing a residency for 70k per year vs starting practice at 200k per year, there's not a soul who would choose to do the residency

Primary care residencies for PAs and NPs are worthless.  Hell I'd argue they are also worthless for MDs

A primary care NP/PA can do 100% of the job that the MD can do with no residency.  Think about that.

One can do family medicine without a residency, but not well. I’ve done family medicine without a residency and it took me 3 years of dedication and using my own vacation to learn all the procedures that the residents learn in intern year. This isn’t to say all MDs retain this knowledge, or perhaps they went to a terrible residency because I’ve seen them know jack-all about anything as well.

family medicine is the easiest specialty to do poorly and still get maintain a practice, but it’s the hardest to do really well give it’s broad nature. 

I think 100% of the job is a completely false statement. Few graduate from school knowing how to do vasectomies and endometrial biopsies. Same goes for admitting patients to the hospital and managing them on the floor. Now is a full 3, or God forbid 4, year residency necessary for all this, I don’t believe so. But I think a one year internship in all specialties, including family medicine, would benefit any provider. I think those that care about being the best, rather than thinking about money, would choose it. I chose 50k over the 140k I make now to do a residency in EM. 

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11 hours ago, TexasPA28 said:

A primary care NP/PA can do 100% of the job that the MD can do with no residency.  Think about that.

A primary care NP/PA with multiple years of experience and a strong collaborative team...yeah. Probably. Maybe.

Making the assertion that a new grad PA/NP can walk in the door of a practice and perform at the same level as a residency trained MD is pretty disingenuous. O'Neal nailed it above with "easy to do, hard to do well".

Could you shuffle patients through the day? Sure. Could you see 20 - 30, follow up on all the labs and calls and make sure that the vague symptoms your patient is showing up with isn't a sign of some zebra? Or a result of the polypharmacy inherited from the last provider? How about managing the complex social situations you run into? Let alone managing the inpatient if your group follows their own.

Primary Care is hard.

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I love when people think they can do someone else's job without actually doing it. Maybe a solution to this is pay by efficiency and mandatory charting/clinical reviews to see how they did. Let those who want to try either sink or swim financially, legally, and with their license. Bet that would change some minds real quick. 

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3 hours ago, JOhnny888 said:

Let those who want to try either sink or swim financially, legally, and with their license. Bet that would change some minds real quick. 

I'm pretty sure that NPs in independent practice states who own their practice do just this.

Edited by Lexapro
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5 hours ago, JOhnny888 said:

I love when people think they can do someone else's job without actually doing it. Maybe a solution to this is pay by efficiency and mandatory charting/clinical reviews to see how they did. Let those who want to try either sink or swim financially, legally, and with their license. Bet that would change some minds real quick. 

I’m not sure the point of your post? Lots of people both do this and many more want this. Is it about pay, since you bring that up? Is it that no APP does equal work to a physician? Are you saying we are big talkers? All bark and no bite? None of that hives with reality.

First many places don’t have the volume to pay by “efficiency,” but there are plenty of places where the APP is expected to see the same volume and acuity. In fact, when I work in a FM residency clinic, the expectations was higher for the APPs because the physicians had to ha w “admin” time for education of at least 50%. Meaning the APPs had a panel of about 1250 minimum and the docs would have 400 patient panels max. We all had the same 20 min appointment. 
 

urgent care is a prime example where physicians and APPs have the same scope and expectations. Many APPs own their own urgent care or FM clinic as well. JMJ here owned his owned headache specialty clinic. 
 

our license is always on the line. One could make the false assumption the physician will be involved in a lawsuit as well for your mistake, but there isn’t a case to back this up. Even if it were true, it doesn’t absolve the PA. So yes, our license is always out there.

plenty of APPs are paid by revenue generation.

almost all APPs inpatient have there charts reviewed, unless you are suggesting that physicians aren’t actually reading the notes, just signing them off, and actually have no concern for patient safety.

I’ve done the nearly the entire job of a FM physician (they wouldn’t let me break into OB), I’ve done the exact job as a EM physician resident, and I’m doing the job of a EM physician in a CAH solo coverage. 

 

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On 12/2/2019 at 11:31 PM, LT_Oneal_PAC said:

I’m not sure the point of your post? Lots of people both do this and many more want this. Is it about pay, since you bring that up? Is it that no APP does equal work to a physician? Are you saying we are big talkers? All bark and no bite? None of that hives with reality.

First many places don’t have the volume to pay by “efficiency,” but there are plenty of places where the APP is expected to see the same volume and acuity. In fact, when I work in a FM residency clinic, the expectations was higher for the APPs because the physicians had to ha w “admin” time for education of at least 50%. Meaning the APPs had a panel of about 1250 minimum and the docs would have 400 patient panels max. We all had the same 20 min appointment. 
 

urgent care is a prime example where physicians and APPs have the same scope and expectations. Many APPs own their own urgent care or FM clinic as well. JMJ here owned his owned headache specialty clinic. 
 

our license is always on the line. One could make the false assumption the physician will be involved in a lawsuit as well for your mistake, but there isn’t a case to back this up. Even if it were true, it doesn’t absolve the PA. So yes, our license is always out there.

plenty of APPs are paid by revenue generation.

almost all APPs inpatient have there charts reviewed, unless you are suggesting that physicians aren’t actually reading the notes, just signing them off, and actually have no concern for patient safety.

I’ve done the nearly the entire job of a FM physician (they wouldn’t let me break into OB), I’ve done the exact job as a EM physician resident, and I’m doing the job of a EM physician in a CAH solo coverage. 

 

Yeah.... that wasn't the point of my post at all lol. I'm sick of people in one specialty saying how easy another specialty is. "PA's and NP's can do 100% the job of a FM physician without residency" lol... OK lets have the 26 year old girl fresh outta PA school come and manage complex patients, do C-sections, vasectomies, cover the ER and hospital, and see good volume.... Those are the crazy quotes that need to be absolute roasted into reality, idc who says them. 

But to address your PA vs physician post, I have heard surgical PA's say they could basically do the surgery (which is crazy to say when you've never done it). Also, in many instances a physicians license is ultimately on the line, sometimes even if they weren't involved in the care. 

Charting review goes for everyone... midlevels and physicians. I'm not trying to make this another turf war, simply stating what should be obvious... and as a side note, I think anyone who takes care non-sick patients can do a decent job (including my MS3 self), especially after a month of on the job training. 

Edited by JOhnny888

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Does anyone know where the funding came from for this NP residency ? I know it’s from the federal gov but specifically which organization, grant, ect. ?

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52 minutes ago, BirdDogPA said:

Does anyone know where the funding came from for this NP residency ? I know it’s from the federal gov but specifically which organization, grant, ect. ?

"The new residency program for nurse practitioners at the Betty Irene Moore School of Nursing has opened its applications. While nurse practitioner residency programs exist at other institutions, this is the first one to be funded by the Health Resources and Services Administration, according to Debra Bakerjian, a School of Nursing clinical professor and principal investigator. The $3.5 million grant is monumental for the nursing community since it depicts federal recognition of the importance of nurse practitioners in primary care. "

 

https://www.hrsa.gov/

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6 hours ago, PACali said:

I am just wondering why these aren't available to PAs? 

Probably took one look at the user base and modding on this forum to "yeaa nope" PA's off that list.

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2 hours ago, mcclane said:

Probably took one look at the user base and modding on this forum to "yeaa nope" PA's off that list.

Regardless of our other disagreements...this is pretty funny.

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