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Is there only one viable outcome for the profession?

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Now that I'm done this won't ultimately impact me yet I still care for those who are involved, or heaven forbid hoping to enter the profession.  With the NP's blowing past the PA profession, and frankly the numbers and money just isn't there for a viable fight with legislators as PA's (I know this because it never happened over the past 36 years, or that decade of PA's that preceded myself), is there only one saving option for those in the profession?  We have too many of us with training and experience to be allowed to go by the wayside I would think so what to do with us?  Will that option be to incorporate us into the healthcare field by allowing us to be grandfathered in and complete an additional 24 months of training and obtain an M.D., or else successfully complete the USMLE?  Maybe set aside 20% of an incoming class for experienced PA's for a couple of years until all have been given the opportunity to obtain said degree?  Without a residency you will be restricted to primary care only.  With the degree obtained you would now be eligible for specialty residencies just like the traditional medical student.  Discuss...

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I recently had an email conversation with a thinktank guy who doesn't understand why we have all these restrictions. He likened our training to the GP that is common in many other parts of the world. They graduate and go out into the wide world and practice medicine. He wondered if we, in the US, are so stupid we need 3 to 7 more years of training to do what the rest of the world does.

Maybe we should skip OTP and just go independent....period. If we are going to have to fight tooth and nail to get somewhere lets make it somewhere worth being.

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4 minutes ago, GetMeOuttaThisMess said:

Now that I'm done this won't ultimately impact me yet I still care for those who are involved, or heaven forbid hoping to enter the profession.  With the NP's blowing past the PA profession, and frankly the numbers and money just isn't there for a viable fight with legislators as PA's (I know this because it never happened over the past 36 years, or that decade of PA's that preceded myself), is there only one saving option for those in the profession?  We have too many of us with training and experience to be allowed to go by the wayside I would think so what to do with us?  Will that option be to incorporate us into the healthcare field by allowing us to be grandfathered in and complete an additional 24 months of training and obtain an M.D., or else successfully complete the USMLE?  Maybe set aside 20% of an incoming class for experienced PA's for a couple of years until all have been given the opportunity to obtain said degree?  Without a residency you will be restricted to primary care only.  With the degree obtained you would now be eligible for specialty residencies just like the traditional medical student.  Discuss...

From my limited understanding, the numbers, $$$ and progress hasn’t been there for PA’s because so many “happy as is PA’s” fought against those that wanted to change the title years ago and seek more independence years ago. Thus the development of PAFT, who have little control. Many just gave up trying. Even now with all the $$ spent on title change, I keep hearing rumors that it will not be  significant difference because going away from PA is just too difficult. I call BS!!!! anything worth while is difficult. There are folks that want to stay PA, assistant or associate, some because they are told it would take work. Not everyone will be happy, However, a show of real progressive thinking by becoming something other than Assistant or associate would likely grow members and $$$ from PA’s, rather than more giving up. Are AAPA and HOD so worried about making those who are “happy as is” upset that they are willing to compromise for a halfway change? 

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34 minutes ago, sas5814 said:

 

Maybe we should skip OTP and just go independent....period. If we are going to have to fight tooth and nail to get somewhere lets make it somewhere worth being.

Ding ding ding!  We have a winner!

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I posted this on May 4th,  2012 here on these boards.

If anyone ever questions my thoughts on our name....I've been saying the same thing for 8 years.

 

How long has AAPA been "considering" a name change.  The better part of a decade......pathetic.

 

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I know I'm in the minority here, but I've always favored M.P. <Medical Practitioner> behind our name. I get the whole "matching letters" of PA/Physician Associate thing, but I would rather just leave it Physician Assistant if that's what we end up with. M.P. or Medical Practitioner is EXACTLY what we are. Practitioners of medicine. 

 

practitioner |prakˈtiSHənər| nouna person actively engaged in an art, discipline, or profession, esp. medicine:

 

I know it will never change to this, but going from P.A.-C to M.P.-C is the real pivotal shift our profession needs if we are ever going to gain the respect from patients and colleagues that most feel our current name does not provide.

 

 

 

That and $4.06 will buy you a Starbucks.... 🙂

Edited by Cideous
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1 hour ago, GetMeOuttaThisMess said:

It all comes down to $$$, and as a whole, we didn't/don't have it.  Now if someone is related to Bill Gates, etc. .....

$$$ for what? My suspicion is that more would contribute $$$ to AAPA if it proved they really want to make the profession move forward in a BIG way. The first BIG way is a title that does not tie the profession to dependency. Law makers will not see that a physician associate as any more capable than an assistant. It is so hard to fight for more independence when your title says you are not. Guess I am that shallow, show me you really care or no Financial support. Tons of money will have been wasted if they make a half hearted effort. 

 

1 hour ago, GetMeOuttaThisMess said:

It all comes down to $$$, and as a whole, we didn't/don't have it.  Now if someone is related to Bill Gates, etc. .....

 

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2 minutes ago, Hope2PA said:

$$$ for what? My suspicion is that more would contribute $$$ to AAPA if it proved they really want to make the profession move forward in a BIG way. The first BIG way is a title that does not tie the profession to dependency. Law makers will not see that a physician associate as any more capable than an assistant. It is so hard to fight for more independence when your title says you are not. Guess I am that shallow, show me you really care or no Financial support. Tons of money will have been wasted if they make a half hearted effort. 

 

 

Yea I'm with you.  Not a dime until they show me they have something better than Associate.  I will not give AAPA money to go from Assistant to Associate....no way.

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Just so we are clear the HOD will vote on the title change before it goes to the board. The HOD is made up of YOUR STATE representatives. It is possible, but highly unlikely, the AAPA BOD could ignore the vote of the HOD.

If you want something done start letting your state society know. Tell them often and clearly what your thoughts are. The HOD delegates from your state are supposed to represent your interests and desires.

As an aside PAFT has been trying to get the HOD to count and register the individual votes and publish them so you know who voted for what and the delegates could be accountable for their votes. There has been anything from passive resistance to one delegate flat out stating he didn't want people to know how he voted. So tell the AAPA you want vote accountability!

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The problem with a 24 month training program to upgrade to MD or DO is the allopathic and osteopathic credentialing bodies have a minimum number of hours students must complete to be eligible to graduate.  Can't do that in 2 years.  The LECOM 3-year bridge accomplishes it by having no breaks and by having 2 months of clerkships b/w OMS I and OMS II years.  

But, I think that if demand is there, LECOM may make more bridge slots available each year and/or other schools may likewise open bridge programs.   I also understand this is not a path most PAs want to take.  It was a huge adjustment for me and family to move to the other side of the continent, give up all the cheddar I was making, buy a small crappy house in a crappy neighborhood, and live poor for 3 years, then middle class for at least another 3 years.  Plus it's pretty challenging academically...1 PA at our campus washed out last year.  Another took a year off to have a kid.  Also:  SO MUCH NEEDLESSLY COMPLEX information is taught expressly because it's needed for Step1/Level1......not because it's needed to practice medicine.   

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53 minutes ago, sas5814 said:

 

As an aside PAFT has been trying to get the HOD to count and register the individual votes and publish them so you know who voted for what and the delegates could be accountable for their votes. There has been anything from passive resistance to one delegate flat out stating he didn't want people to know how he voted. So tell the AAPA you want vote accountability!

I pushed for that transparency as PAFT president and cosponsored a bill that got shot down by the HOD. The cornerstone of democracy is knowing how your elected officials vote. This should be a no-brainer.....

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28 minutes ago, dfw6er said:

The problem with a 24 month training program to upgrade to MD or DO is the allopathic and osteopathic credentialing bodies have a minimum number of hours students must complete to be eligible to graduate.  Can't do that in 2 years.  The LECOM 3-year bridge accomplishes it by having no breaks and by having 2 months of clerkships b/w OMS I and OMS II years.  

But, I think that if demand is there, LECOM may make more bridge slots available each year and/or other schools may likewise open bridge programs.   I also understand this is not a path most PAs want to take.  It was a huge adjustment for me and family to move to the other side of the continent, give up all the cheddar I was making, buy a small crappy house in a crappy neighborhood, and live poor for 3 years, then middle class for at least another 3 years.  Plus it's pretty challenging academically...1 PA at our campus washed out last year.  Another took a year off to have a kid.  Also:  SO MUCH NEEDLESSLY COMPLEX information is taught expressly because it's needed for Step1/Level1......not because it's needed to practice medicine.   

Side bar: I wouldn’t be surprised if LECOM shut down their bridge. My communication with current students and people who interviewed there haven’t been good as of recently. The new chair/ who ever is in charge of APAP, is offering a lot of APAP candidates 4 year slots instead of seats in the APAP.

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3 minutes ago, PAtoMD said:

Side bar: I wouldn’t be surprised if LECOM shut down their bridge. My communication with current students and people who interviewed there haven’t been good as of recently. The new chair/ who ever is in charge of APAP, is offering a lot of APAP candidates 4 year slots instead of seats in the APAP.

doesn't this mean more good applicants than spots? this sounds to me like they need to expand the program....

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Just now, EMEDPA said:

doesn't this mean more good applicants than spots? this sounds to me like they need to expand the program....

From how it was conveyed to me from an interviewee was that he wasn’t interested in the program, didn’t speak highly of it or their 3 year primary care track for traditional students. Because if they’re offering 4 year slots to APAP why not offer them the 3 year primary care track as well? 
 

regardless this is all hearsay, no one knows exactly. But looking at expanding the program comes down to money. Which all things do. Why offer more 3 year slots when you can offer 4 year slots and generate more money?

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6 minutes ago, PAtoMD said:

Why offer more 3 year slots when you can offer 4 year slots and generate more money?

people don't want 4 yr slots. that defeats the purpose of attending the bridge.

Thanks for the update. I was almost in the first class with Prima. still regret my decision to opt out.

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31 minutes ago, EMEDPA said:

people don't want 4 yr slots. that defeats the purpose of attending the bridge.

Which is exactly why the interviee I know turned down their slot for the 4 year track. That’s the entire premise of it being appealing. Which is why I don’t understand why they offered 4 year slots and not 3 year primary care especially if the APAP applicant is interested in primary care. 
 

never too late to go back! But sounds like your gig right now is great! 

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41 minutes ago, PAtoMD said:

 

never too late to go back! But sounds like your gig right now is great! 

can't talk the wife into moving back there...if it was local I would still do it.

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1 hour ago, PAtoMD said:

Side bar: I wouldn’t be surprised if LECOM shut down their bridge. My communication with current students and people who interviewed there haven’t been good as of recently. The new chair/ who ever is in charge of APAP, is offering a lot of APAP candidates 4 year slots instead of seats in the APAP.

So I've been present for some of those remarks.  I don't think that's the implication.  He's stating this because he knows how difficult it is to try and set up auditions, deal with VSAS, then a couple of months later deal with ERAS, auditions, etc all while in the one year of your clinical rotations.  He's just saying it's much easier and less pressure if you convert to 4 years.   Also some of the folks who snagged a primary-care slot expressed dissatisfaction and were inquiring about any way of getting out of it so they can specialize.  The answer to that is a resounding "NO".  If you try to breach contract, LECOM reserves the right to take away your diploma which will automatically get you kicked out of residency.   So the only course of action if an APAP in the primary care tract wants to specialize is to convert to a 4 year tract.  I inferred that all you have to do is ask and they'll let you go to 4 year program.

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1 hour ago, EMEDPA said:

people don't want 4 yr slots. that defeats the purpose of attending the bridge.

Thanks for the update. I was almost in the first class with Prima. still regret my decision to opt out.

Yeah, most of us chose that program because 3 yrs school and 3 years of residency ain't too bad.  Especially if you're married with children.   But there are more than a few APAPs who are young, single, and only have 2 or so years of PA practice under their belts...so 4 years isn't too bad.  No MCAT necessary.  Easier to get selected as an APAP than if you applied to any other med school.  LECOM unofficially says they have around 60 candidates/year for 12 APAP slots.   The numbers are way worse if you're applying the traditional way for medical school.....there you're competing with thousands of kids with MCATs and strong undergrad GPAs.

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Interesting discussion about bridge programs but no one thus far seems to agree that there isn’t enough money from this profession to turn the political tide. It isn’t about dropping $50-100 to an organization with the numbers that this profession has. This is why I’m coming around to the fact that over the long term I think this is going to be a sinking ship if other alternatives aren’t realized. Some will be able to ride it out to retirement but for young grads now I’m not sure that the future 20-30 years from now looks promising.

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1 minute ago, GetMeOuttaThisMess said:

Interesting discussion about bridge programs but no one thus far seems to agree that there isn’t enough money from this profession to turn the political tide. It isn’t about dropping $50-100 to an organization with the numbers that this profession has. This is why I’m coming around to the fact that over the long term I think this is going to be a sinking ship if other alternatives aren’t realized. Some will be able to ride it out to retirement but for young grads now I’m not sure that the future 20-30 years from now looks promising.

Same conclusion I've come to over the past couple of years.   It played a minor part in my decision to go back to school, tbh.  Kinda hard not to see the writing on the wall. 

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42 minutes ago, dfw6er said:

Yeah, most of us chose that program because 3 yrs school and 3 years of residency ain't too bad.  Especially if you're married with children.   But there are more than a few APAPs who are young, single, and only have 2 or so years of PA practice under their belts...so 4 years isn't too bad.  No MCAT necessary.  Easier to get selected as an APAP than if you applied to any other med school.  LECOM unofficially says they have around 60 candidates/year for 12 APAP slots.   The numbers are way worse if you're applying the traditional way for medical school.....there you're competing with thousands of kids with MCATs and strong undergrad GPAs.

Right, it seems worth just applying to APAP and the traditional 3 year primary care track at the same time if the 4 year slots are being offered.

 

I appreciate your first hand knowledge and insight to the situation. 

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13 hours ago, Cideous said:

Yea I'm with you.  Not a dime until they show me they have something better than Associate.  I will not give AAPA money to go from Assistant to Associate....no way.

 

13 hours ago, Hope2PA said:

$$$ for what? My suspicion is that more would contribute $$$ to AAPA if it proved they really want to make the profession move forward in a BIG way. The first BIG way is a title that does not tie the profession to dependency. Law makers will not see that a physician associate as any more capable than an assistant. It is so hard to fight for more independence when your title says you are not. Guess I am that shallow, show me you really care or no Financial support. Tons of money will have been wasted if they make a half hearted effort. 

 

 

 

10 hours ago, GetMeOuttaThisMess said:

Interesting discussion about bridge programs but no one thus far seems to agree that there isn’t enough money from this profession to turn the political tide. It isn’t about dropping $50-100 to an organization with the numbers that this profession has. This is why I’m coming around to the fact that over the long term I think this is going to be a sinking ship if other alternatives aren’t realized. Some will be able to ride it out to retirement but for young grads now I’m not sure that the future 20-30 years from now looks promising.

 

 

 

Wow

 

Although I can see the percieved problem I think one needs to stop and look at their own situations....

 

We have > 130,000 PAs in this county

 

How many actively donate to the AAPA PAC (no one mentioned that the PAC is who is out there fighting for us)

Don't bother donating to AAPA if you don't like them, but the PAC (political action committee) is our official lobby

 

I dontate $25 a month (automatically from my CC bill)   Easy and never really feel it....

 

$25/month is $300/year

 

for those that say the $$ is not there

 

If we got 100,000 PA's (yes that means 3/4 of the PA's that are licensed - a huge percentage but if we are looking at our own extinction is it not worth it?) to do the same - 


 

100,0000
X      300

30,000,000

 

THIRTY MILLION dollars a year for Advocacy would sure go a long ways

 

Need PAFT to heal steer them

 

but it is possible!!  

 

BUT comments like " I am not going to give money till they prove it" just says you are not willing to risk anything and you want the pay off before the pay in.....

 

(I am not in any way affiliated with any national or state organization beyond being a member of AAPA and MAPA)

 

It is just simple math and finances, you want change, you need to pay for it..... that is politics

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I think history has clearly said that this isn’t going to happen regarding the donations to a PAC. Could things change? Yes, but you’re behind the eight ball with regard to the financial resources that you’re competing against for that slice of cheese.

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Vents a said....comments like " I am not going to give money till they prove it" just says you are not willing to risk anything and you want the pay off before the pay in.....

I Never said not going to give money until.... My issue is, I have spent a significant amount of time and energy along with finance over the past, 2-3 years because it appeared AAPA is/was trying to really finally do something. The title change has been an ignored topic for, what, 15-20 years now?  What I am saying is if after the past two years of investment is stays PA, whether Assistant or associate, for me personally, rather than giving more,  I will definitely do less.. Also, yes, there are some who are waiting  until they see a big change before they are willing financially support AAPA. They were burned years ago and have trouble trusting. Same for some younger PA’s who have heard about the past and difficulty of fighting for progress within their own profession. I realize everything has a price, not changing title significantly , keeping PA, will not be as expensive,. But not changing to a title that portrays more independence will cost more in legislative fights trying to explain how an assistant or associate could be anything but a helper, subservient . I may have posted this, if so, sorry. NP’s will continue to push the perception NP=physician, title physician assistant or associate is less than physician, therefore, physician assistant or associate is less than NP.  
Disclaimer, I in no way think NP or PA are equal to physicians, however, public and legislative perception is what will make or break your future.

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