California's AB 890 Signed Into Law

[PACali]

Congratulation to the California NPs passed AB890 to allow full practice authority through the state assembly. Next stop is the senate. 

https://a02.asmdc.org/press-releases/20200127-assembly-passes-ab-890-providing-full-practice-authority-nurse-practitioners?fbclid=IwAR3zZOdVW7ec54GcYuXK743FUlGcDr2VQXl-X16hUxk1LaaorRckzJyghas

Let's go California PAs. Get involved. Donate to California Academy of PA Political Action Committee. Even as little as $10 a month. I am sure everyone can donate 10 bucks a month,  rather than spending on Starbucks. I still have hope for the PAs (I have to, I have no choice. Still got 30 years LOL...hopefully). 

[mgriffiths]

I'm confused how this is a good thing.  In many instances (I don't know if this one included), NPs have actively fought to exclude PAs from any legislation like this and I don't see that this bill would include PAs in any way.  Please correct me if I am wrong.

NOW!!!  Does that mean we shouldn't be fighting or donating to our state's PA group helping them push forward?  OF COURSE NOT!!!  But, as I said, I don't see how this bill moving forward for NPs is good for PAs.

[sas5814]

To my observation they exclude us because they don't want us slowing them down. We are light years behind them in legislation and, for the most part, in professional culture. We, as a profession, have not demonstrated the drive and will they have. If I was them I'd exclude us too.

If I want to look at this sideways its good for us because every time this happens a few more PAs wake up to a new reality and want to get something done. Sadly I find that getting a bite in the ass is the only thing that seems to motivate most folks. (1st cuppa coffee. I may be a little more upbeat later.)

Edited January 29, 2020 by sas5814

[GetMeOuttaThisMess]

We've been whohaw'd since the get go by our own representatives.  We had our chance and blew it in the 70's/80's.

[AbeTheBabe]

We just passed OTP in California. No more chart signature requirements, needing to put SP info on prescriptions, etc.

[Cideous]

So this is the big One boys and girls, this is the legislation and the state that I have been warning about here on these boards for a decade. When nurse practitioners get full practice authority in California, stick a fork in us, we are done.

This came within a hairs breath of passing last year and if you go back to my older post you will see that I predicted that it was  going to pass this year. I really hate this for our profession but you can’t help but respect nurse practitioners for doing what our forbearers did not have the guts to do.

When this passes in California I think our next legislative move should be to merge our profession with nurse practitioners. Hopefully we can bring something to the table that they want.  After this passes, it will take less than three years before PA jobs almost completely dry up in California, and we are doomed to the wastebasket of history because those who have been running this profession refused to do what was needed 20 years ago.
 

This is not good news.

[JOhnny888]

This forum reminds me of a more grown up version of SDN... the sky isn't falling, all my PA friends somehow have 100k+ jobs right out of school, despite FPA for NPs here in MN. 

[Cideous]

7 minutes ago, JOhnny888 said:

This forum reminds me of a more grown up version of SDN... the sky isn't falling, all my PA friends somehow have 100k+ jobs right out of school, despite FPA for NPs here in MN. 

Just wait.  Professions who do not plan for the future are doomed to live in the past and for us that means NP’s steamrolling us for jobs. Just in the last five years I have absolutely seen a massive increase in NP only jobs in Texas. Give them better legislation laws? And your hundred K job is going to go bye-bye.  I’m sorry you might not believe it or want to believe it but it’s the truth.

 

it’s exactly this head in the sand mentality that has gotten us where we are today.

[JOhnny888]

Maybe you're right, but thats not what I have witnessed as a lowly MS3. I think the bigger issue that NPs and PAs will face in the future (due to pumping out so many new grads) is getting the level of acuity they seek. I think it'll come down to a choice between getting paid what you want vs seeing the acuity that you want. 

[EMEDPA]

1 hour ago, JOhnny888 said:

 I think it'll come down to a choice between getting paid what you want vs seeing the acuity that you want. 

I think it's actually living where you want(and having low acuity jobs) vs working rural/underserved area jobs for good pay and acuity. That has been my experience anyway. I used to work 2 minutes from home with a crappy scope of practice and didn't really get the jobs/acuity I wanted until I started driving 66, 115, and 150 miles to work into areas most physicians didn't want to live/work in. One of my rural jobs flies in an ER medical director from the east coast every other week. . 

[JOhnny888]

That's definitely true. I was thinking more in the future, especially if they don't limit the number of new grads for certain things (this could include EM residents as well tbh, given the % increase in the last 5 years). If the healthcare system doesn't change, then flooding the market isn't going to be good for any group. 

[ANESMCR]

2 hours ago, JOhnny888 said:

This forum reminds me of a more grown up version of SDN... the sky isn't falling, all my PA friends somehow have 100k+ jobs right out of school, despite FPA for NPs here in MN. 

I used to think the same thing. Until it happened to me. And witnessing 75% of my cohort and neighboring cohorts not achieving employment after 5/6 months. Every new grad PA will find a job, it’ll just take longer each year. 

[JOhnny888]

2 hours ago, ANESMCR said:

I used to think the same thing. Until it happened to me. And witnessing 75% of my cohort and neighboring cohorts not achieving employment after 5/6 months. Every new grad PA will find a job, it’ll just take longer each year. 

I think this is very location dependent.... if you "need" an EM job in Denver then yeah, it'll take some time. I don't think this is specific to the PA profession though. Could be wrong tho...

[sas5814]

It is multi-factorial. I have always said when you limit your options you limit your options.

 

That said I just saw a post by a PA who will, at some point in every post, tell you he has been a PA for 40 years. He explained how there are plenty of jobs in his area etc etc etc and said the preference for NPs over PAs has merely been anectdotal....while giving anecdotal evidence.

Yes it has mostly been anecdotal but, being in the business of PA legislation and policy for more than 20 years, I get the emails and I see the posts and at some point hundreds of anecdotes have to amount to proof.

 

Here is my "chicken little" opinion. If we don't maintain market parity with our NP colleagues this profession will become all but extinct within 10 years. I share this opinion with a number of PA leaders across the country. I'd be pleased to be wrong and hope I don't live long enough to be right. Doing nothing assuming we are ok is dangerous. Doing something can, at worst, keep us viable and, at best, make us preferred providers.

Edited January 29, 2020 by sas5814

[ANESMCR]

59 minutes ago, JOhnny888 said:

I think this is very location dependent.... if you "need" an EM job in Denver then yeah, it'll take some time. I don't think this is specific to the PA profession though. Could be wrong tho...

I applied to over 100 positions In rural northern and western CO, UT, WY, and MT. Across specialties. Never EM. Took me 5 months to get an offer. Many of my colleagues still do not have offers on the east coast, areas that are considered to have more jobs than my geographic location. It is specific to the PA profession, especially in the Midwest. NPs are not only preferred, but many of them run their own clinics here. It’s simply more fiscally responsible to hire NPs for larger hospital systems as well. 

[EMEDPA]

I am interviewing for a rural per diem position in EM at the end of next month. The facility only uses EM residents or PAs and they use them interchangeably. NPs not invited to apply. And this facility is affiliated with a major medical center, so I am hoping the tides are turning a bit in our favor. I know this is anecdote, but there are good jobs out there. They may not be as plentiful as they once were, but they are there.Back in the day (1996) I was offered 4 jobs even before taking PANCE. 

[sas5814]

I think we have areas where we are preferred and ER is one. The surgical specialties seem to be for us as well.

As you say back in the day... when I retired from the Army I had a recruiter line me up about 7 interviews in an area I wanted to be in a few days. They all offered me a position.

But time and tides stand still for no man and things are very different. I'm 60 and working in UC which I like. However if I lost this job I would probably have a difficult time finding another that didn't require me to move, didn't suck, or didn't pay much less than what I make now. I work in a town with 3 major medical centers and they are cranking out NP at a dizzying pace.

Edited January 29, 2020 by sas5814

[dfw6er]

33 minutes ago, MoneyDoctor said:

That is not OTP but that was the right that NP's had decades ago that We PA's are just sniffing at...

Expect PA's salaries in Kaiser to be less than <25K per year in calif if this passes and PA's are left stranded

F**K CAPA for not doing anything for Cali PA's

When I left California 1 1/2 years ago, NPs at Kaiser were already making considerably more than PAs with equivalent clinical work experience.....at least in the ER.  I was told that the nursing union was able to get the years the NPs worked as RNs counted as CLINICAL work experience......so a RN x 10 yrs with only 5 yrs of NP experience made more than a PA with 14 years OTJ as an EM PA.  

 

[EMEDPA]

6 minutes ago, dfw6er said:

When I left California 1 1/2 years ago, NPs at Kaiser were already making considerably more than PAs with equivalent clinical work experience.....at least in the ER.  I was told that the nursing union was able to get the years the NPs worked as RNs counted as CLINICAL work experience......so a RN x 10 yrs with only 5 yrs of NP experience made more than a PA with 14 years OTJ as an EM PA.  

 

When I started at KP as a new grad in em in 96 they counted my paramedic years on the salary scale. 

[dfw6er]

4 minutes ago, EMEDPA said:

When I started at KP as a new grad in em in 96 they counted my paramedic years on the salary scale. 

Nice.  

Several of our ER RNs pulled per diem or PT shifts at Kaiser's ER because it paid more than they made at my shop.  A few of the NPs did the same.  They suggested I consider it too,  but I found out I'd be making less than NPs with WAY less experience than me.  Just another example of how powerful the nursing lobby and nursing unions are.    The PAs really need to get their crap together ASAP or this will become the norm and the only remaining good paying-decent autonomy jobs will be in BFE regions of the country.

[GetMeOuttaThisMess]

We’re overreacting. I just got the NCCPA email and all is well they say.

[JOhnny888]

There may be specialties where it'll be harder, but there will also be specialties where it'll be easier... I sense a positive change for PAs in the coming 10 years as far as new physicians views on them vs NPs (at least this is the general feeling for me and my classmates who will be practicing within the next 4 years. We are much more aware of how much better you're training is and we work with your soon to be colleagues on rotations. 

[Cideous]

41 minutes ago, JOhnny888 said:

There may be specialties where it'll be harder, but there will also be specialties where it'll be easier... I sense a positive change for PAs in the coming 10 years as far as new physicians views on them vs NPs (at least this is the general feeling for me and my classmates who will be practicing within the next 4 years. We are much more aware of how much better you're training is and we work with your soon to be colleagues on rotations. 

 

 

 

I am at the tail end of my run, and reading posts like this make me glad I am.  I'm not trying to be disrespectful friend, but after 27 years as a PA, I can tell you without a shadow of a doubt that it is exactly this mentality that has put us behind the 8 ball vs NP's.  

In 10 years....we will either not exist or be making half of what NP's do.  Why?  legislative victories for them and apathy for us.  I have seen it go this way in state after state and like it or not, it will eventually catch up with you.  Do I hope I and the other experienced PA's here are wrong?  Sure.  

Are we......not a chance.

[Joelseff]

So this is the big One boys and girls, this is the legislation and the state that I have been warning about here on these boards for a decade. When nurse practitioners get full practice authority in California, stick a fork in us, we are done.
This came within a hairs breath of passing last year and if you go back to my older post you will see that I predicted that it was  going to pass this year. I really hate this for our profession but you can’t help but respect nurse practitioners for doing what our forbearers did not have the guts to do.
When this passes in California I think our next legislative move should be to merge our profession with nurse practitioners. Hopefully we can bring something to the table that they want.  After this passes, it will take less than three years before PA jobs almost completely dry up in California, and we are doomed to the wastebasket of history because those who have been running this profession refused to do what was needed 20 years ago.
 
This is not good news.

Well I look at it this way and I am sure CAPA is looking at this too. The modified OTP in Cali last year (SB697) was meant to position us "on parity" with NPs in the state. I think (hope and pray) that the next move is to get another bill in like this. Newsome seems to be in favor for APPs to have more independence (I frankly don't like or trust the guy but that's another post.) I agree with OP that we need to get on CAPA on this one and help out with the PAC. The state has 10,000 PAs in Cali and only 3000 CAPA members. Of those members only a small fraction give to the PAC.

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[SedRate]

Consider doing something surgical on the side to fall back on. It seems like surgical specialties are always looking for PAs. Surgical fields also allow you to fraternize with those of other areas such as internal med, critical care, trauma/vascular, etc, which can expand your network.

Oh, and did I say... Network, network, network! And keep in touch with your network! Word of mouth is powerful when it comes to getting a job. Consider socializing with medical professionals at your facility or hospital or nearby areas and/or doing things like softball, mountain biking, hiking, golfing, trivia night, etc. I have met and befriended physicians over some of these activities. If your hospital doesn't have much of a social life, get involved and start drumming up interest. I have found that it's easy to meet others in the physician lounge, so if you have access, start making friends! And hey, if the PA field does fizzle out, at least you've made some friends, had some good times, and hopefully met enough people who can get you a job as a rep or something similarly high-paying. Ha

Edited January 30, 2020 by Sed