Healthcare Workforce Reform

[shirleysvorny]

With Michael Cannon, I've written a proposal for "Healthcare Workforce Reform." Instead of everyone doctoring up -- limiting access to professions and to care -- we propose an alternative. We propose allowing incremental levels of certification for all health clinicians. For example, individuals could be credentialed to perform cataract surgery or vasectomies. It would replace the current system of state licensing. Attached and online at: https://www.cato.org/publications/policy-analysis/health-care-workforce-reform-covid-19-spotlights-need-changes 

It would be great to hear what PAs think of this policy initiative. We plan an hour discussion on Sept. 15:  https://www.cato.org/events/right-skilling-health-professionals-replacing-government-licensing-third-party-certification

Let me know what you think!

Shirley Svorny, Ph.D

Professor of Economics Emeritus, Cal State Northridge
Adjunct Scholar, Cato Institute

https://academics.csun.edu/faculty/shirley.svorny

https://www.cato.org/people/shirley-svorny

pa-899-update.pdf

[LT_Oneal_PAC]

58 minutes ago, shirleysvorny said:

With Michael Cannon, I've written a proposal for "Healthcare Workforce Reform." Instead of everyone doctoring up -- limiting access to professions and to care -- we propose an alternative. We propose allowing incremental levels of certification for all health clinicians. For example, individuals could be credentialed to perform cataract surgery or vasectomies. It would replace the current system of state licensing. Attached and online at: https://www.cato.org/publications/policy-analysis/health-care-workforce-reform-covid-19-spotlights-need-changes 

It would be great to hear what PAs think of this policy initiative. We plan an hour discussion on Sept. 15:  https://www.cato.org/events/right-skilling-health-professionals-replacing-government-licensing-third-party-certification

Let me know what you think!

Shirley Svorny, Ph.D

Professor of Economics Emeritus, Cal State Northridge
Adjunct Scholar, Cato Institute

https://academics.csun.edu/faculty/shirley.svorny

https://www.cato.org/people/shirley-svorny

pa-899-update.pdf 255.51 kB · 0 downloads

I think this is excellent. My only problem is there will be incentives by any third party organization to overcharge for any skills they want to certify, or onerous recertification especially for rarely used skills that may be used once in a clinician’s career such as emergent thoracotomy or hysterotomy. 
 

I’ll put 9/15 in my calendar and try to be there. Thank you for asking our participation.

[shirleysvorny]

You may be thinking of the ABMS. Some specialty boards have infuriated physicians with MOC requirements that raise revenues for the specialty boards but that many physicians say are a poor use of their time and costly. But, if other third party credentialing organizations could offer credentials of value to employers and, therefore, to clinicians, that would diminish the importance of the ABMS certifications in the scheme of things.  

[LT_Oneal_PAC]

1 hour ago, shirleysvorny said:

You may be thinking of the ABMS. Some specialty boards have infuriated physicians with MOC requirements that raise revenues for the specialty boards but that many physicians say are a poor use of their time and costly. But, if other third party credentialing organizations could offer credentials of value to employers and, therefore, to clinicians, that would diminish the importance of the ABMS certifications in the scheme of things.  

That is kind of my point. ABMS is a third party that manages certifications. I imagine any third party would attempt the same and steps would have to be taken to ensure the same problem doesn’t reoccur.

[Joelseff]

This looks interesting but besides the caveat that O'Neal brought up about certain certifying bodies over charging for certificates etc, would this not also potentially INCREASE competition for PAs in the workforce? If there are for example, as in the website states, "primary care technicians" then what will happen to us primary care PAs? (along with the other specialties)

 

It's interesting and theoretically sounds like a good idea, I just don't know how it will play out in practice and concerned it may exacerbate some issues we already have (job competition, perceived legitimacy in the arena etc)

 

Sent from my SM-G975U using Tapatalk

 

 

 

 

 

 

 

 

 

 

[shirleysvorny]

This would open the market and I can see why you would be defensive, but it would also give you more options -- if you wanted to pursue them. It terms of legitimacy, political decision making would be taken out of the picture and that is where PAs face the most difficult challenges re scope of practice. This plan would allow clinicians to assume a scope of practice determined by their credential (and their liable employer), not by the state legislature. I found that 38 states already explicitly permit employers to determine the scope of practice for individual physician assistants based on the employer’s appraisal of each individual’s clinical knowledge and skills. Correct me if I'm wrong, but the National Commission on Certification of Physician Assistants already offers specialty certificates for physician assistants in the areas of cardiovascular and thoracic surgery, emergency medicine, hospital medicine, nephrology, orthopedic surgery, pediatrics, and psychiatry. This evolved organically, as we imagine would occur with other levels and types of certification if our proposal were adopted in a state. Our proposal would not change any of these things but it would take the politics out of determining scope of practice.  And it would take away some of the effective market power of the ABMS by allowing entry of competing specialist categories.

Edited August 31, 2020 by shirleysvorny