Opinion, advise,.....

[ERgirl]

I have been PA for 24 years and have been proud to be PA.  Since last week, I have been feeling ashamed and incompetent. This my story: In the last 8 plus years,  I have been practicing in a private clinic with a physician who is also the owner and NP.  Each of us has our panel of patients and dedicated MA. The practice is very busy but flexible (as a mother with a young child, this is very important to me). In additon,  I am always allowed to practice to the full extent of my education and training. To make my story short,  our physician’s license was put on  restrictions ( because of some legal issues that I can not discuss here). Therefore, he can not act as my SP. He temporarily delegate the responsibility  to one of his physician friends, but,  this temporary delegation is only good for four weeks per our state regulation.

On the other hand, the NP who is less educated than me MS vs. DMSc and less experience than me 15 vs. 24ys can continue seeing her patients because of her autonomous license. Here I am telling my patient there is a chance I might not be able to see them anymore and explaining difference between NP and PA  practices. I feel like l am telling them  NPs are more competent than PAs.  Don’t get me, I have nothing against my NP coworker.  We are realy get along  very well. 

I understand the management is working hard to find me a SP, it is business at end of the day.  Why would they pay me and a SP when they can hire a NP who needs no SP?   

 I am considering just  leaving there to pursue a nonclinical  position where I will not need a SP.  I am really worried about  PAs’ future.  I know some of my PA colleagues fought hard for “OTP” but I do not understand what is  the benefit of “OTP” and how is it comparable to the NPs’ autonomous practice?

 

Thanks for reading.

[thinkertdm]

From a business perspective there is no benefit from hiring a pa who requires multiple levels of beaurocratic baloney over an np who needs none.  OTP just adds confusion to office managers who’s sole purpose is to make money.

[iconic]

39 minutes ago, thinkertdm said:

From a business perspective there is no benefit from hiring a pa who requires multiple levels of beaurocratic baloney over an np who needs none.  OTP just adds confusion to office managers who’s sole purpose is to make money.

Not to mention OTP does not waive supervision altogether 

[thinkertdm]

28 minutes ago, iconic said:

Not to mention OTP does not waive supervision altogether 

Not.At.All.  If I’m running a business, why would I go with the more expensive (to me) option?  I want to make money, and the profit margin in health care is razor thin.

[camoman1234]

but if we educate on why we are a better trained and legally safer (IMO) clinician then that would get gears running. I do not have any evidence on legal issues and lawsuits between NPs and PAs, I am strictly speaking of training. That also looks bad on PAs as we think we are better, blah blah blah. So basically we need a name change and a very strong support from AAPA and NCCPA to advance this profession. 

[thinkertdm]

15 minutes ago, camoman1234 said:

but if we educate on why we are a better trained and legally safer (IMO) clinician then that would get gears running. I do not have any evidence on legal issues and lawsuits between NPs and PAs, I am strictly speaking of training. That also looks bad on PAs as we think we are better, blah blah blah. So basically we need a name change and a very strong support from AAPA and NCCPA to advance this profession. 

Absolutely, sure.  But medicine is a retail business.  Administration doesn’t care-and I’m not being facetious- about what’s best for the patient.  They care about the bottom line, which is what happens after income meets expenses. If it looks the same, and costs less, then it is an improvement.  
NP- poorly trained, but no oversight required, no extra administration required, no funny business about signatures or other jazz.  
 

PA- excellently trained, but a physician is needed, time is needed periodically for chart reviews and other miscellany; these are hours not bringing in cash.  Some mds bring up getting sued.  I don’t know, the admins say.  The PA comes in with a “team practice “ ...sounds expensive, admins say.  
 

I can’t stress this enough.  Medicine is a business.  You think those big buildings are cheap?  
 

NP is a much better business decision.

[Cideous]

 

She is a Practitioner and you are an Assistant.....

 

 

I'm not trying to be a jerk, but this is what our national leadership has clung to....dependence on Physicians and the name "Assistant".

If you have been doing this 24 years, you know that you are no one's "Assistant" or "Associate", you are a Practitioner.  Remember this when the war over our name really starts to heat up.

Edited November 22, 2020 by Cideous

[PACali]

50 minutes ago, Cideous said:

 

She is a Practitioner and you are an Assistant.....

 

 

I'm not trying to be a jerk, but this is what our national leadership has clung to....dependence on Physicians and the name "Assistant".

If you have been doing this 24 years, you know that you are no one's "Assistant" or "Associate", you are a Practitioner.  Remember this when the war over our name really starts to heat up.

Associate also sounds like an apprentice.

[PACali]

We do need more than OTP. What we need is OTP with 'practice parity' with the NPs. There is no reason for not being equal with the NPs. 

[ventana]

 

back to the OP

 

so very sorry you are going through this - yup it is seriously not fair.... down right stupid actually

 

Do you have any friends/docs that you can reach out to?

 

hang in there - these situations usually work out in the end.  

The NP owner needs to hustle to get you an SP - I am sure you are supporting a large part of her overhead and staff turnover runs somewhere between 1/3 and 1/2 years salary in costs (but this cost never actually shows up on the balance sheet)

 

Maybe someone here has a friend if you state the state your in (other then feeling annoyed and pissed that is...)

[ERgirl]

5 hours ago, thinkertdm said:

Absolutely, sure.  But medicine is a retail business.  Administration doesn’t care-and I’m not being facetious- about what’s best for the patient.  They care about the bottom line, which is what happens after income meets expenses. If it looks the same, and costs less, then it is an improvement.  
NP- poorly trained, but no oversight required, no extra administration required, no funny business about signatures or other jazz.  
 

PA- excellently trained, but a physician is needed, time is needed periodically for chart reviews and other miscellany; these are hours not bringing in cash.  Some mds bring up getting sued.  I don’t know, the admins say.  The PA comes in with a “team practice “ ...sounds expensive, admins say.  
 

I can’t stress this enough.  Medicine is a business.  You think those big buildings are cheap?  
 

NP is a much better business decision.

“Medicine is a retail business,” you are right. Now, the admin is working hard to find me an SP because 300+ of their patients urgently need a provider.   Eventually, they will realize hiring an NP is better for the business.  It is sad, but I don’t blame them.

[ERgirl]

2 hours ago, ventana said:

 

back to the OP

 

so very sorry you are going through this - yup it is seriously not fair.... down right stupid actually

 

Do you have any friends/docs that you can reach out to?

 

hang in there - these situations usually work out in the end.  

The NP owner needs to hustle to get you an SP - I am sure you are supporting a large part of her overhead and staff turnover runs somewhere between 1/3 and 1/2 years salary in costs (but this cost never actually shows up on the balance sheet)

 

Maybe someone here has a friend if you state the state your in (other then feeling annoyed and pissed that is...)

The physician is the owner not the NP.  I am in Virginia.

[ERgirl]

5 hours ago, Cideous said:

 

She is a Practitioner and you are an Assistant.....

 

 

I'm not trying to be a jerk, but this is what our national leadership has clung to....dependence on Physicians and the name "Assistant".

If you have been doing this 24 years, you know that you are no one's "Assistant" or "Associate", you are a Practitioner.  Remember this when the war over our name really starts to heat up.

"She is a Practitioner and you are an Assistant," You nailed it!

[Joelseff]

Our title is "Assistant" so we can't get legislation to give us independence... We need to change our title then go after independence. 

Some ppl in the huddle hanging onto "Associate" and some are still saying we don't need the title change at all and just push OTP... They still don't see why we need to detach from physicians or any other profession. 

To the OP... Sorry this is happening to you. I've thought about this scenario many times. One of my best friend's SP died a few years ago and she was unable to work until another SP picked her up and he was terrible to her. We are "property" not "Associates" 

Edited November 23, 2020 by Joelseff

[Cideous]

3 minutes ago, Joelseff said:

One of my best friend's SP died a few years ago and she was unable to work until another SP picked her up and he was terrible to her. We are "property" not "Associates" 

This is very very very accurate.

[Aunt Val]

I'm in the process of applying for jobs, and I just got a rejection email from a health center basically because I'm a PA and not an NP.  The position would be pretty much my dream job, working in underserved areas of my city, including with refugees.  The website only advertised NP openings, but I thought I'd try anyway.  However, I "do not meet the minimum requirements for the position," according to the rejection email.  Sigh.  I'm disappointed.

[CAAdmission]

This is why I would never have worked with a solo practitioner - all your eggs are in one basket. Groups always appeared safer to me. But I guess now if they are not hiring PAs, that's the end of that. 

[Cideous]

2 hours ago, Aunt Val said:

I'm in the process of applying for jobs, and I just got a rejection email from a health center basically because I'm a PA and not an NP.  The position would be pretty much my dream job, working in underserved areas of my city, including with refugees.  The website only advertised NP openings, but I thought I'd try anyway.  However, I "do not meet the minimum requirements for the position," according to the rejection email.  Sigh.  I'm disappointed.

The new normal.

[CAdamsPAC]

On 11/22/2020 at 3:22 PM, thinkertdm said:

Not.At.All.  If I’m running a business, why would I go with the more expensive (to me) option?  I want to make money, and the profit margin in health care is razor thin.

You get what you pay for. 

[ventana]

4 hours ago, Aunt Val said:

I'm in the process of applying for jobs, and I just got a rejection email from a health center basically because I'm a PA and not an NP.  The position would be pretty much my dream job, working in underserved areas of my city, including with refugees.  The website only advertised NP openings, but I thought I'd try anyway.  However, I "do not meet the minimum requirements for the position," according to the rejection email.  Sigh.  I'm disappointed.

Never have I got one of these......  till last month.   
 

times are changing not for the better