surgblumm Posted September 2, 2020 Share Posted September 2, 2020 They never stop pushing and have a large PAC and lot's of money. Money talks and makes their cause walk. Most PAs do not contribute to their state PAC. 1 1 Quote Link to comment Share on other sites More sharing options...
Cideous Posted September 2, 2020 Share Posted September 2, 2020 I knew this was coming and I have been warning about it for years. Once California goes, we are hosed. All while AAPA postpones discussing a name change....Because for the love of god there is "no way" it could be done virtually...you know like everything else right now? <eyeroll> It would be comical if it wasn't so pathetic. Yes, I am angry. 1 2 Quote Link to comment Share on other sites More sharing options...
iconic Posted September 3, 2020 Share Posted September 3, 2020 (edited) Good for them, maybe we will finally become Associates this year *shrug* They will have independence in every state within the next 10 years. A lot of the old guard (and young) doesn't seem to care. Edited September 3, 2020 by iconic Quote Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted September 3, 2020 Moderator Share Posted September 3, 2020 On 1/29/2020 at 11:00 AM, JOhnny888 said: 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. PAs are not coming close to causing any measurable saturation. We are not pumping out near the numbers that medical schools and NPs are. We have about 10k graduates per year and NP has 30k with MD/DO combined producing about 30k. agree with @EMEDPA. It comes down to working where you want vs everything else. Have to go where others are not willing to go. There, you can get appropriate pay and autonomy. On 1/29/2020 at 10:04 AM, AbeTheBabe said: We just passed OTP in California. No more chart signature requirements, needing to put SP info on prescriptions, etc. California did not pass OTP if I recall. It got them on par (the previous par before this legislation) with NPs, but it did not remove physician responsibility, nor did it remove the need to have a agreement with a specific physician, nor did it allow for direct billing. IIRC 1 Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted September 3, 2020 Moderator Share Posted September 3, 2020 16 hours ago, surgblumm said: They never stop pushing and have a large PAC and lot's of money. Money talks and makes their cause walk. Most PAs do not contribute to their state PAC. This is a HUGE issue political gains cost $$$$ that is just the fact of our system Nursing has money due to huge #'s PA have been pretty frugal in contributions - no money = no real advocacay. In my state the Nursing loby outspends us about 10:1!! I give $25 a month to AAPA PAC - it is automatic on my CC - I never even realize it...... AAPA has said I am one of their most best donors, what ever that means. But if a $300/year gets any mention at a PAC it means that membership is not supporting it hardly at all. Come on folkds, throw a few bucks a month at AAPA PAC to fund this revolution - or we will always be an afterthought.... 2 2 Quote Link to comment Share on other sites More sharing options...
AbeTheBabe Posted September 3, 2020 Share Posted September 3, 2020 2 hours ago, LT_Oneal_PAC said: California did not pass OTP if I recall. It got them on par (the previous par before this legislation) with NPs, but it did not remove physician responsibility, nor did it remove the need to have a agreement with a specific physician, nor did it allow for direct billing. IIRC My understanding is that CA passed SB697 and the although it doesn't remove the need for a supervising physician, you can have a delegation agreement with the practice so that you don't need to have a separate agreement for each physician or surgeon you work with. There are other restrictions as well (like your SP name doesn't have to be on your RX). Here is the pamphlet given to us by CAPA regarding the changes. SB 697 Implementation Info.pdf 2 Quote Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted September 3, 2020 Moderator Share Posted September 3, 2020 1 hour ago, AbeTheBabe said: My understanding is that CA passed SB697 and the although it doesn't remove the need for a supervising physician, you can have a delegation agreement with the practice so that you don't need to have a separate agreement for each physician or surgeon you work with. There are other restrictions as well (like your SP name doesn't have to be on your RX). Here is the pamphlet given to us by CAPA regarding the changes. SB 697 Implementation Info.pdf 1.71 MB · 2 downloads It is good, very good in fact. But it is not OTP as there is still a supervising physician (practice agreement tether) and they retain ultimate responsibility for patient care/outcomes, no ability to direct bill (really this is a federal issue), does not establish a PA board (unless Cali already has one?) it seems to be a common misunderstanding of OTP. People often say Michigan has it, but they don’t. The only state to have it, minus the direct billing as that is a federal CMS issue, is North Dakota. Florida came SO close, but snatched away at the last second. 1 Quote Link to comment Share on other sites More sharing options...
MyNameWasUsed Posted September 8, 2020 Share Posted September 8, 2020 (edited) I've been job searching within the last month and I'm seeing way more NP listings than PAs. I don't think all hope is lost, but I'm going to start donating to whatever lobbyist group that pushes for PA independence. We need independence to match the NPs regardless if you agree with independence or not. Which advocate group in California do you guys recommend donating to? Edited September 8, 2020 by MyNameWasUsed Quote Link to comment Share on other sites More sharing options...
Joelseff Posted September 9, 2020 Share Posted September 9, 2020 I've been job searching within the last month and I'm seeing way more NP listings than PAs. I don't think all hope is lost, but I'm going to start donating to whatever lobbyist group that pushes for PA independence. We need independence to match the NPs regardless if you agree with independence or not. Which advocate group in California do you guys recommend donating to? Umm... CAPA!? that's the only "PA Lobbyist Group" in California. At least that can actually do anything. There are 12k PAs in California. I think ~2800 CAPA members and of those members only less than 10% give 25 bucks to the PAC. What gets me is that some of my PA friends here get an allowance from their jobs and won't even join because they never get around to it [emoji2359] no wonder we are losing! But for our little numbers in CAPA there is a fire in the guts of the members and its leadership...i recommend going to CAPA conferences (when the plague is no longer upon us) Sent from my SM-G975U using Tapatalk Quote Link to comment Share on other sites More sharing options...
Rose66 Posted September 13, 2020 Share Posted September 13, 2020 I will not be surprise if NP's end up supervising us in the near future if we don't do anything. Isn't this a bigger lost for MD's more than for us? If NP's are independent providers, they are still cheaper than MD's. Right? So companies will prefer to hire ( ej. A FP NP than a FP MD.) At the end I really thing it will be more lost to MD's, we are still Assistants, and many of us make less than NP w a Dr's degree. Your thoughts... 1 Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted September 13, 2020 Moderator Share Posted September 13, 2020 47 minutes ago, Rose66 said: I will not be surprise if NP's end up supervising us in the near future if we don't do anything. Isn't this a bigger lost for MD's more than for us? If NP's are independent providers, they are still cheaper than MD's. Right? So companies will prefer to hire ( ej. A FP NP than a FP MD.) At the end I really thing it will be more lost to MD's, we are still Assistants, and many of us make less than NP w a Dr's degree. Your thoughts... Won't happen. We practice medicine, they practice 'advanced nursing". Different boards and rules. I agree that the MDs should have been more vocal in supporting us and opposing NPs, but money talks... Most PAs I know make as much or more than NPs at the same jobs unless union contracts specify a step scale. 1 Quote Link to comment Share on other sites More sharing options...
PACali Posted September 13, 2020 Author Share Posted September 13, 2020 Senator Ling Ling Chang in my district. last year, I emailed her in regard of SB697 and She did not support it. Guess what, she supports the AB890 this year. What a joke. https://www.billtrack50.com/LegislatorDetail/19640 Quote Link to comment Share on other sites More sharing options...
Joelseff Posted September 13, 2020 Share Posted September 13, 2020 Senator Ling Ling Chang in my district. last year, I emailed her in regard of SB697 and She did not support it. Guess what, she supports the AB890 this year. What a joke. https://www.billtrack50.com/LegislatorDetail/19640 Prob means she got taken out to dinner by CNA and not CAPA [emoji2359] Sent from my SM-G975U using Tapatalk 1 Quote Link to comment Share on other sites More sharing options...
Cideous Posted September 13, 2020 Share Posted September 13, 2020 (edited) I will be officially letting my CA license go upon renewal at the end of this year. No reason for me to keep it up anymore. Once NP's get their independence in CA, I give us 24 months there before virtually all practices start to convert out of PA's and to NP's. This is going to hurt new/newer PA's more then the experienced ones, but if you find yourself between jobs in the next 24 months good luck. Edited September 13, 2020 by Cideous 1 Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted September 14, 2020 Moderator Share Posted September 14, 2020 to be an optimist If the NP's get full independence. we can and should make the case we are better trained, and should also be independent.... 2 1 Quote Link to comment Share on other sites More sharing options...
mgriffiths Posted September 16, 2020 Share Posted September 16, 2020 On 9/14/2020 at 1:46 PM, ventana said: to be an optimist If the NP's get full independence. we can and should make the case we are better trained, and should also be independent.... while I want to be an optimist and agree...but... to be a pessimist This is what we have been doing for decades and look where it's gotten us...maybe I'm being generous by saying "doing." 1 Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted September 16, 2020 Moderator Share Posted September 16, 2020 3 hours ago, mgriffiths said: while I want to be an optimist and agree...but... to be a pessimist This is what we have been doing for decades and look where it's gotten us...maybe I'm being generous by saying "doing." disagree with you on that last sentence we have not been trying to advance ourselves for more then about 1-2 years - prior to that it was "the doc's will take care of us" garabage - and AAPA not wanting to make waves...... those times are history BUT advocacy takes $$$ so everyone complaining about no help from AAPA should send them some money.... 3 Quote Link to comment Share on other sites More sharing options...
roundabout Posted September 20, 2020 Share Posted September 20, 2020 I feel like I’ve been seeing the same strategy of riding the coat tails of NP’s legislative victories for a while and then trying to use that to make a case for PA’s. But obviously it doesn’t seem to be working. In FL PA’s got kicked off the bill a day or two before it was voted on voila NP’s had independent practice and PA’s stayed the same. Maybe a different strategy is necessary. I feel like PA’s should reach out to the MD/DO leaders and combine efforts to put the kabash on the steady uprising of the NP’s. It’s widely understood by physicians that 1) PA’s are far better trained and much more competent 2) NP’s gaining legislative victories year after years hurts PA’s and Physicians. Time to realize that NP’s are not our friends, they are pumped out of these online degree programs to practice bad medicine and then at the end of the day we’ll just get lumped in with them as “Incompetent mid level providers” in the eyes of physicians. Got to pick a side in this fight. Quote Link to comment Share on other sites More sharing options...
Joelseff Posted September 20, 2020 Share Posted September 20, 2020 I feel like I’ve been seeing the same strategy of riding the coat tails of NP’s legislative victories for a while and then trying to use that to make a case for PA’s. But obviously it doesn’t seem to be working. In FL PA’s got kicked off the bill a day or two before it was voted on voila NP’s had independent practice and PA’s stayed the same. Maybe a different strategy is necessary. I feel like PA’s should reach out to the MD/DO leaders and combine efforts to put the kabash on the steady uprising of the NP’s. It’s widely understood by physicians that 1) PA’s are far better trained and much more competent 2) NP’s gaining legislative victories year after years hurts PA’s and Physicians. Time to realize that NP’s are not our friends, they are pumped out of these online degree programs to practice bad medicine and then at the end of the day we’ll just get lumped in with them as “Incompetent mid level providers” in the eyes of physicians. Got to pick a side in this fight. We've tried asking "big brother" (MD/DO) to fight the school yard bully before too... They held their own for the last several years but THIS YEAR... they got punched in the mowff! Who do you think has been fighting NPs In California the past few decades about their independence? It wasn't us. The docs don't want them to have independence but they don't want us to have it either. Just by the numbers in California: Physicians=60k NPs=23kPAs=12k BUT...NPs are backed by the CNA legislatively which includes 80k nurses and they have done an EXCELLENT job of selling to the public that they are the caring and competent one in the white coat. I think also the issue in California and likely the other 22+states is that many Physicians don't own their practice anymore. Up until the early 2000s, docs here preferred hiring PAs because they knew our training and they wanted us in their office to make more money for them. Now since most docs practice in system based care they are merely "employees" (not technically since it's illegal in California for a doc to be an employee of a hospital) of the system and really have not much say in preference of provider colleagues. These "newer" docs seem to think like you mentioned, that all APPs are "midlevel" and some think we are all incompetent. Who runs theses system based care corporations? Admins... Business folk. Some were Ex nurses... What's the answer... I dunno... I am not due to retire for at least another 20 years so I am here to fight. I think "riding the coat tails" of NPs in California got us SB697 passed and as I have posted it is a good FIRST start but we need more. I asked CAPA about AB890 but they say they have to wait for it to pass first to do something... I dunno if I like that answer but I think we have to wait and see because mounting our own offensive seems out of the question (no money). Remember, out of that 12k PAs in California only 2800 belong to CAPA and only less than 10% of the CAPA members give the 25 dollar or more PAC donation. Sent from my SM-G975U using Tapatalk Quote Link to comment Share on other sites More sharing options...
roundabout Posted September 20, 2020 Share Posted September 20, 2020 (edited) I don't really mean asking them to do the fighting. I mean us coming together to do it together. If both physicians and PA's can state their distaste with how things are regarding NP's something has got to give. I'm not naïve enough to think that at some point after pumping out 30k NP grads a year with high numbers of them doing their degree online or over the course of many many years that the care they deliver independently is going to result in sub-par patient outcomes. There is a reason medicine has grown to such strict standards. It's because its hard and takes diligent, long sacrifice to be competent. The sacrifice every one on here has given to become a competent clinician. They are bending the bar on those standards and it will result sooner or later in bad medicine. I just want to be on the correct side of the line when that happens. @Joelseff Edited December 14, 2020 by roundabout 1 Quote Link to comment Share on other sites More sharing options...
Joelseff Posted September 20, 2020 Share Posted September 20, 2020 I don't really mean asking them to do the fighting. I mean us coming together to do it together. If both physicians and PA's can state their distaste with how things are regarding NP's something has got to give. I'm not naïve enough to think that at some point after pumping out 30k NP grads a year with high numbers of them doing their degree online or over the course of many many years that the care they deliver independently is going to result in sub-par patient outcomes. There is a reason medicine has grown to such strict standards. It's because its hard and takes diligent, long sacrifice to be competent. The sacrifice every one on here has given to become a competent clinician. They are bending the bar on those standards and it will result sooner or later in bad medicine. I just want to be on the correct side of the line when that happens. @Joelseff I agree with much of what you said but I think the incentive to help us is low on the Physicians' list of concerns. I think we need to cozy up to the lawmakers. I agree with you that we don't need to water down our standards at all to keep us on the "right side" as you say because our training is and should always be our strength. Problem is, the NPs outpace us in proliferation of our profession. And I don't think application to PA school has gone down either. I think our model is attractive to those who do seek to become a Practitioner of medicine. I think the "fix" if there really is one, would be to 1. Change our name (like yesterday!!!) 2. Get on EVERY legislative move for independence that NPs are pushing and say "We need to be included in this as well!" then I think it'll be better for us and our patients. Sent from my SM-G975U using Tapatalk Quote Link to comment Share on other sites More sharing options...
Cideous Posted September 20, 2020 Share Posted September 20, 2020 4 hours ago, Joelseff said: I think the "fix" if there really is one, would be to 1. Change our name (like yesterday!!!) 2. Get on EVERY legislative move for independence that NPs are pushing and say "We need to be included in this as well!" then I think it'll be better for us and our patients. Sent from my SM-G975U using Tapatalk And yet...the dinosaurs out there still either want to keep Assistant or move to "Associate". lol By the time the field starts working for half of what NP's make, or just crumbles altogether, those PA's will be retired and think to themselves, "Hmmph, I guess I was wrong about that whole name thing....but my retirement accounts look great! So why would I care now..." Frustrating doesn't even begin to describe it... 1 Quote Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted September 21, 2020 Share Posted September 21, 2020 Sent from my iPhone using TapatalkA retired dinosaur. 3 Quote Link to comment Share on other sites More sharing options...
SedRate Posted September 29, 2020 Share Posted September 29, 2020 On 9/20/2020 at 8:57 AM, Joelseff said: Practitioner of medicine That has a nice ring to it. Quote Link to comment Share on other sites More sharing options...
SedRate Posted September 29, 2020 Share Posted September 29, 2020 (edited) On 9/20/2020 at 6:09 AM, johncfl said: It’s widely understood by physicians that 1) PA’s are far better trained and much more competent Sadly, this isn't always the case. Although a lot of surgeons I've met think highly of PAs, I can't tell you how many physicians I've also spoken to that didn't know the difference in training and practice laws of PAs and NPs. Hell, most didn't even know NPs can work independently. The look of surprise on their face when I broke some of this stuff down is concerning. Most just thought NPs are trying to be fake doctors and both PAs and NPs are just "mid-levels." I still remember one cardiologist who was trying to hire an NP because he thought PAs couldn't see patients on their own and always had to have the physician present. That's what he thought supervision meant. Edited September 29, 2020 by SedRate Quote Link to comment Share on other sites More sharing options...
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