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Interesting discussion on Medscape. Are we ready to become independent?


Are PAs ready to become independent?   

76 members have voted

  1. 1. Should PAs become independent? If so, when?

    • No
      15
    • Yes, soon after finishing PA school and passing the boards.
      3
    • Yes, but only after completing residency
      7
    • Yes, after x years of experience in a certain specialty
      51


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I would much prefer the "earned clinical doctorate" as a marker for independence:

* Everyone understands what a doctorate is.

* There are dozens to scores of residency spots per year; there is no way we can put many/most PAs through them without a huge explosion in residency spots--we are already seeing programs implode without enough rotation sites, and this might just damage that further.

Independence, as I want to see it, is primarily administrative, not clinical. I still want to keep working with specialty boarded docs, either in my same clinic, or if I go DPC, as the consultants to whom I refer. Once I know what I know well enough to be safe, that means I know when to refer, NOT when I can be my own medical island, dependent on no-one else.

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I voted after completion of residency, but I feel it could be residency or years in practice. I do think there should be some type of quality assurance if it's years in practice. You can't just do telemedicine for 3 years then be autonomous in anything other than telemed, and I hesitate you should do telemed at all without a lot of concrete training. 

Also believe that period of supervision/training could be under a senior PA. Maybe after 10 years you can start to certify others.

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12 minutes ago, rev ronin said:

Eureka!  All we have to do is make it based on a CAQ, and all of NCCPA's big dollars will be behind independence.

That may have been meant as sort of a joke, however, combination of CAQ, which requires certain amount of experience is actually a good idea. You need the support and $$$. Got to play the political game to progress as a profession.

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43 minutes ago, rev ronin said:

Eureka!  All we have to do is make it based on a CAQ, and all of NCCPA's big dollars will be behind independence.

While having all that money behind it would be awesome, I’m not saying a CAQ. I’m not sure what quality assurance I would want, just want to skip the whole white paper thing physicians had to go through

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I think the idea of a "board certification" in a specialty for PA's is a good idea.  However, that board certification should come from a PA organization that's accountable to the PA's practicing in that area.  For example, the EM certification should come from SEMPA; other certifications from the equivalent PA organizations.   That way each organizations could set the standards both for new PA's entering their 1st specialty and potentially different standards for experienced PA's entering from other fields.

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1 hour ago, ohiovolffemtp said:

I think the idea of a "board certification" in a specialty for PA's is a good idea.  However, that board certification should come from a PA organization that's accountable to the PA's practicing in that area.  For example, the EM certification should come from SEMPA; other certifications from the equivalent PA organizations.   That way each organizations could set the standards both for new PA's entering their 1st specialty and potentially different standards for experienced PA's entering from other fields.

A Dermatology PA tried and nearly got eaten alive from within and without.

also I believe the board should be separate from the advocacy organization. Sounds like there might be some conflict of interest 

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Right now we have a situation where the "board" is separate from the advocacy organizations.  That board is very insulary, appoints its own members, and advocates for its own goals at the expense of the overall PA profession.  That's why I believe that professional organizations should be the ones that grant the certification.   The AAPA could set or coordinate overall standards. I'm not familiar with the dermatology experience but I'll try to find out about it.

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1 hour ago, ohiovolffemtp said:

Right now we have a situation where the "board" is separate from the advocacy organizations.  That board is very insulary, appoints its own members, and advocates for its own goals at the expense of the overall PA profession.  That's why I believe that professional organizations should be the ones that grant the certification.   The AAPA could set or coordinate overall standards. I'm not familiar with the dermatology experience but I'll try to find out about it.

Certainly the ABMS has become greedy. I just worry the advocacy organization might become equally greedy and then who do you have to speak out for you. I wouldn’t totally oppose it, but I would like to see a good game plan to prevent such issues.

 

https://www.mdedge.com/dermatology/article/210902/business-medicine/dermatologist-who-organized-pa-group-faces-backlash

I guess they couldn’t do anything to the PA involved, so they just trashed the physician associated with it and took away his board status.

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38 minutes ago, TexasPA28 said:

If PAs are to seek board certification, it will have to be from PA organizations.  There's zero percent chance any of the ABMS boards are going to give board certification status to a PA, even if we pass the same exams the physicians do.

 

Unless forced to by an external factor, such as an antitrust court decision...

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2 hours ago, ventana said:

so today

25 patients 

full service primary care and occ health clinic - I got to cover both.  busy busy day

doc not around, and  never once did I think "geez I wish my doc was here"

 

Supervision is highly over rated

 

independence is the future

I'm sure you were a new grad when your greatness was manifested?

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On 12/8/2020 at 4:49 PM, rev ronin said:

Unless forced to by an external factor, such as an antitrust court decision...

Antitrust would only come into play if the ABMS was the only way to become "board certified"

But the ABMS is just one pathway of many, so there's no antitrust issue here.  

The NPs have their own specialty boards that declare their members as "board certified" and it has nothing to do with ABMS.

 

 

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On 12/9/2020 at 4:12 PM, ventana said:

so today

25 patients 

full service primary care and occ health clinic - I got to cover both.  busy busy day

doc not around, and  never once did I think "geez I wish my doc was here"

 

Supervision is highly over rated

 

independence is the future

Someone please tell me how is that a physician's associate? 

An experience PA like you should have FPAR in primary care, outpt clinics.  

Edited by PACali
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