PA's no longer wanted at VAMC

[Hope2PA]

Looking into jobs at VAMC, it appears majority, appeared at least 3-4 times more, are for NP or APRN vs PA.  The requirements do not even mention PA education, strictly Nurse Practitioner or APRN degree.  Even saw a few that will consider RN working on NP.  Very few PA job listings. When i entered Physician assistant, few popped up, but then majority of posts were for other type assistants. Have PA's lost or loosing the opportunities at VAMC now?  

[ventana]

yes they are

 

if you search "Nurse Practitioner" 129 jobs come up - granted not all these are NP jobs but most are

If you search "Physician assistant" 54 jobs come up

 

True story

I just was not hired on a job I was qualified for, instead a new grad NP who wa on VA scholarship for NP was hired.

Fine, except for the fact I am USAF VEt with a disability rating... so much for hiring Vets over civilians. 

 

 

Many Many times I am seeing Admin jobs being posted as NP only, when they are clearly in the PA/NP realm....

 

We need PAs to get promoted and make hiring decisions in the VA

 

I am trying to get hired.........

 

 

[kang1208]

We will not be able to compete with NPs in the job market very very soon...I don’t care if “your area” “his area” or “her area” is still very “PA friendly” or not.

I’ve been hearing more and more PAs are having trouble finding jobs and was suggested to move across the country just to find one (which can soon saturate the market for “PA friendly states”) where NPs can be just about anywhere and still have a job market. It’s concerning...

On the side note- I’ve always wonder if we post these topics into the “PA student” section of this forum, curious as to what kind of responses will we get...

Edited November 17, 2020 by kang1208

[Hope2PA]

I looked at the VA Gov/Jobs website for USA jobs, although it pulled up a list of over 100 under Physician Assistant title, there were a total of 18.  The rest were predominately Advanced Medical Assistant (office secretary type), Physician (Assistant director of something) and various other "assistant" or associate type positions.  The Nurse Practitioner had around 70 positions, the majority were primary care, only one PA primary care. I did not keep counting as they gradually became dispersed in various nursing jobs, so possibly around 85 is my guess. Private medical for profit want easy, which means independent NP and the VA, government also appears to be heading toward same mindset.  

[sas5814]

In the VA PAs and NPs were offered, essentially, independent practice several years ago. The NPs jumped on it and our leadership declined. Here we are.

I had an interesting talk with a VA doc a couple of months ago who didn't know NPs didn't require an SP anymore. She seemed pretty distressed by the news.

I just was accepted for a primary care position at my local VA clinic about 10 minutes from the house. I have provisionally accepted. I say provisionally because they have a review board that looks at your experience and plugs you into the salary scale so I don't have a number yet. Its an arcane process I can't untwist. If someone who works at the VA has some insight on what I'm likely to be offered in primary care with 31 years experience I'd appreciate it.

BTW I blasted through the interview process quickly. They had several NPs apply (I'm told) and they couldn't come close to matching my resume. From closure of the announcement to my offer was about 3 weeks which is stunningly fast for any government agency.

[GetMeOuttaThisMess]

When at Dallas with similar years of experience and a primary care position (IM), I went in at 12/10 as I recall.  This was at the actual hospital and not a community clinic.

BS, and not MS, as well.

Went back and looked at IRS documents and last paystub says “12/10” at just under $100K/annually.  They were receiving a pay increase to match NP’s at the time that I left which was going to put them in the mid $110K’s.

Edited November 17, 2020 by GetMeOuttaThisMess

[Cideous]

Kaiser on the west coast is starting to move hard towards NP's as well.  With NP's winning California legislatively I would expect this trend to rapidly accelerate over the next 24 months.  Congrats, our profession's fealty to docs which screwed us out of a chance to advance like NP's, and our sick obsession with keeping the letters P.A. at any cost has killed us.  We are a dead man walking profession.

[EMEDPA]

6 minutes ago, Cideous said:

Kaiser on the west coast is starting to move hard towards NP's as well.  With NP's winning California legislatively I would expect this trend to rapidly accelerate over the next 24 months.  

This has been the case in NorCal for years. Their union there has pushed through a rule that PAs are hired only if no NP(even a new grad) can be found. I worked my first job in SoCal for KP in the 90s and was treated well. 

[Cideous]

4 minutes ago, EMEDPA said:

This has been the case in NorCal for years. Their union there has pushed through a rule that PAs are hired only if no NP(even a new grad) can be found. I worked my first job in SoCal for KP in the 90s and was treated well. 

We were all treated well in the 90's.  When I graduated in the early 90's there was 14 jobs for every PA and 95% of my class was hired 6 months BEFORE we graduated.  Miss those days.

Edited November 17, 2020 by Cideous

[NWAPA]

Hi all, I am a current PA student graduating in December. I am a recipient of the VA HPSP (scholarship). As such I have a service commitment to the VA following graduation.

 

Like mentioned above I do feel there is a large disparity between PA and NP opportunities at the VA. I check the USAJobs site regularly. At the time of writing there are 19 PA positions. NP is much higher. This is distressing for several reasons, not the least of which being I am REQUIRED to work at the VA, graduating in less than a month, and have had 0 success with being offered an interview as of yet. While I have no doubt I will eventually be placed....(how long after graduation though?) I have done 2 clinical rotations at 2 different VA sites. At each site my attempts at networking and finding a possible job have been met with, "Well we really only hire/have experience with NPs." 

 

Discouraging to say the least. Off topic but the way the scholarship was presented to me before accepting has not turned out to be reality regarding how placement will work. Thankful to have a job (eventually) in this pandemic though. 

[MSPAC2]

6 minutes ago, NWAPA said:

"Well we really only hire/have experience with NPs."

I hope you took the time to educate them. 

[NWAPA]

3 minutes ago, MSPAC2 said:

I hope you took the time to educate them. 

Oh absolutely, these were even rotations that I had set up myself in attempts to network and be able to stay close to home during my service obligation. Unfortunately have not been able to turn those into job opportunities, but they are precepting other students from my class now. 

 

Still blows my mind that an orthopedic surgery service can have 4 NPs (no OR time), and not have a PA or real interest in hiring one. Speaks to the strength of NP lobby and # of opportunities in the VA for NPs vs PAs. 

[Cideous]

2 hours ago, NWAPA said:

 

 

Still blows my mind that an orthopedic surgery service can have 4 NPs (no OR time), and not have a PA or real interest in hiring one. Speaks to the strength of NP lobby and # of opportunities in the VA for NPs vs PAs. 

It speaks to the fact that they are "Practitioners" and we are just "Assistants"...

[MSPAC2]

https://www.aapa.org/news-central/2020/11/va-establishes-path-to-adopt-full-practice-authority-for-pas/?utm_source=facebook&utm_medium=aapa_post&utm_campaign=news_central&fbclid=IwAR099bVSTqjojjp3gnwNFA3DOyQO7A22z3dJwHxjgvmyX1Wc5HMz1A0AALE
 

It looks like AAPA is working on it. 
 

We should encourage everyone to submit a formal comment to support this rule: 

https://www.federalregister.gov/documents/2020/11/12/2020-24817/authority-of-va-professionals-to-practice-health-care

[ventana]

I honestly think that AAPA and AMA needs to aggressively go after NP's working outside their area of training.

 

A FNP should not be hospital based, a CCNP can not be out patients, a peds NP can not see adults....

 

They need to restict the NP to the area of their training

 

 

 

As for pay in the VA

 

Just had a big pay redo and now there is 1-5 steps

1-3 is new, somewhat experience and experienced - these are front line jobs

4 and 5 are leadership roles, now we just have to fill them

 

 

As for getting hired - I am a veteran with a disability rating and NP are getting hired before me..... very discouraging ....

[thinkertdm]

Is it because NPs are seen as clinicians and pa’s are seen as licensing, credentialing and supervision nightmares?  My new Chief sent me a document that stated PAs are prohibited from prescribing controlled substances as per some cfr; I looked it up, and the cfr referenced stated that prescribing was limited to professions who’s license allowed for controlled substance prescribing, ie any pa in 49 states.  I told her this, and she hemmed and hawed. 
 

if what I said doesn’t make any sense, it’s because I’m busy moving.  Join VAPAA.  

[Hope2PA]

4 hours ago, MSPAC2 said:

https://www.aapa.org/news-central/2020/11/va-establishes-path-to-adopt-full-practice-authority-for-pas/?utm_source=facebook&utm_medium=aapa_post&utm_campaign=news_central&fbclid=IwAR099bVSTqjojjp3gnwNFA3DOyQO7A22z3dJwHxjgvmyX1Wc5HMz1A0AALE
 

It looks like AAPA is working on it. 
 

We should encourage everyone to submit a formal comment to support this rule: 

https://www.federalregister.gov/documents/2020/11/12/2020-24817/authority-of-va-professionals-to-practice-health-care

Let hope this is not a repeat of Florida. Did any0ne notice comments are submitted to Chief Nursing Officer. There is nothing stopping family and friends from commenting.  If PA's lose this, they really are screwed!

[Hope2PA]

 VA's authority to establish national standards of practice for health care professionals which will standardize a health care professional's practice in all VA medical facilities.

Sorry to be so ignorant on the wording of proposal, Can someone tell me how, if this "authority to practice health care" is passed, would guarantee PA's would gain FPA in the VA?  I want to be optimistic, but what is to prevent physicians from saying PA's cant be included because they are our Assistants/associates and  not licensed practitioners. Then the CNO, who appears to be highly involved, from saying NP's are fulfilling the need and PA's should remain in assistant role? 

[kidpresentable]

13 hours ago, Cideous said:

Congrats, our profession's fealty to docs which screwed us out of a chance to advance like NP's, and our sick obsession with keeping the letters P.A. at any cost has killed us.  We are a dead man walking profession.

Maybe we can still wake up to our impending doom and pull off a Manhattan Project/COVID vaccine-like effort to prevent the profession’s imminent demise

[MSPAC2]

4 hours ago, Hope2PA said:

Sorry to be so ignorant on the wording of proposal, Can someone tell me how, if this "authority to practice health care" is passed, would guarantee PA's would gain FPA in the VA?  I want to be optimistic, but what is to prevent physicians from saying PA's cant be included because they are our Assistants/associates and  not licensed practitioners. Then the CNO, who appears to be highly involved, from saying NP's are fulfilling the need and PA's should remain in assistant role? 

IDK. But that sounds like a terrific question for the AAPA. I've read some of the comments and they were all physicians who oppose this because NPs and PAs are not qualified to practice without them. Where is the cavalry? We should be flooding the comments section.

[Hope2PA]

8 hours ago, MSPAC2 said:

IDK. But that sounds like a terrific question for the AAPA. I've read some of the comments and they were all physicians who oppose this because NPs and PAs are not qualified to practice without them. Where is the cavalry? We should be flooding the comments section.

Doesn’t matter what physicians  say about NP, they already have FPA as of 2016 or 2017(same time PA’s turned down the opportunity) However, even if the proposal is passed, it will be not be easy for for PA’s because physicians and NP’s  can always point to the fact PA’s can’t have FPA because they are, by their own choice of title, a physical assistant or physician associate, not a practitioner of any sort.

I also read posts, a lot appeared to be same general letter, passed along for providers to send and attach their name. I saw pages of those from CRNA. I didn’t see such letter available through AAPA. Additionally, Each state should send out letter sample to all members who should then share with family and friends. Maybe rather than general, this is good for all health care providers, AAPA could forget about every other profession for a moment and write specifically about PA’s and their education and quality of service. 
Gaining this federally would help individual states in their quest. NP have the ability to say, we have FPA in VA and x number of states, when addressing legislators, PA’s currently have very little.

[ventana]

We should encourage everyone to submit a formal comment to support this rule: 

https://www.federalregister.gov/documents/2020/11/12/2020-24817/authority-of-va-professionals-to-practice-health-care

 

 

PLEASE post comments in support!!1

[MediMike]

"One example that impacts multiple health care professions throughout the VA system is the ability to administer medication without a provider (physician or advanced practice nurse practitioner) co-signature."

Sigh.

 

[Joelseff]

I was offered a job at my local VA (I'm a disabled vet also) 2 years ago in the Neuro dept. Pay kinda sucked so I declined. Payscales at the VA heavily favor NPs but recently a pay equality policy was adopted by the VA to pay both PAs and NPs the same (it's still pretty low in my opinion) but I was told by their HR that "it is up to each VA facility to adopt the policy" but by 2021 (IIRC) all facilities should have it adopted. With the news of possible FPA for us at the VA, I might look into a job there again. 

Edited November 19, 2020 by Joelseff

[ventana]

I think that was just implemented nationwide.