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Enough! It's time to SPLIT from the Physician Assistant profession....


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***Mark this post.  You heard it here first.***

 

Tired of waiting for a name change that will never come?  

This conversation has been going on for over 20 years now and I for one am sick of waiting.  I can not sit around anymore waiting for the leadership of this profession to do the right thing.  They never will because many PA's are still willfully ignorant to the fact that our name affects everything, not the least of which is our ability to pass ANY widespread meaningful legislation.  Florida just put out a cry for help with the president there saying, "PA's in Florida are in crisis!".  Not slumping, not backsliding.....CRISIS.

So, my proposal would include the following points:

1.  Current PA's:  After PA school, attend an extended training/residency/fellowing program 6-12 months depending on years of practice.  For instance new PA grads would do 12 months and PA's with 5-10 years of practice could do 6 months etc.  After which they would awarded the title of "Medical Care Practitioner".  A legal title allowing the participant to use in clinical practice.

2.  IMMEDIATELY BEGIN LOBBYING STATES FOR FULL PARITY WITH NP'S TO INCLUDE TARGETED practice independence commiserate with NP laws.

3.  LOBBY WITH NP'S, NOT AGAINST THEM AND FINALLY LEAVE BEHIND THE UNHEALTHY RELATIONSHIP PHYSICIAN ASSISTANTS HAVE HAD WITH DOCS.

4.  IN THE SHORT TERM THE MCP FELLOWSHIP/RESIDENCY WOULD BE FOR CURRENT PA'S, BUT WITH AN EYE TOWARDS THE FUTURE OF CREATING  START TO FINISH MCP PROGRAMS.

 

I know what a lot of you will be thinking.....wow that's just too big of an idea.  Well so was creating the field of PA's to begin with, but it happened because it was a good idea at the time.  We have however outgrown the name "Assistant" and "Associate" will be no better.  Now we have HARD consultant data to prove that we NEED Practitioner in our title.  The one thing I give AAPA credit for is finally doing this study.

If current PA's want to stay Assistants with the restrictions levied on them, so be it.  But those of us wanting to move on and actually form the future of targeted independent practice, like NP's have done, need to move on from this field and its horrible name.

 

I am going to be working on a power point presentation very soon and begin soliciting state conferences for a speaking slot.  Change is never easy, but we have all worked too hard to watch it slip away due to laziness and lack of foresight.   

Edited by Cideous
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agree something must be done

but trying to cleave off is the hard path

 

every single insurance company would (state, federal, private, workers comp.....) would have to recognize an entirely new field - talk to the radiology "super techs" on how hard this is - they have been working for a over a decade trying to get medicare to recognize them.  With out medicare, no payment, with out payment no jobs...

 

volunteer on you state agency, donate, shake the very foundation of AAPA and NCCPA

scream it from the roof tops to change PA to MCP....

 

 

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Perhaps those who don’t want independence practice or FPA can sign a “waiver” form and stay as “assistant”. I’m just concerned that those who wish to remain in that role will ruin for the rest of us who wanted to progress. We need to get legislatively on par with NPs one way or another, or else....

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On 1/21/2021 at 2:14 PM, Cideous said:

3.  LOBBY WITH NP'S, NOT AGAINST THEM

There's no reason to expect them to be on your side in all this. Unless they would do it for the pure fun of further antagonizing physicians. 

Edited by CJAadmission
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1 hour ago, ventana said:

agree something must be done

....but trying to cleave off is the hard path....

 

 

It may be the hard path, but it is rapidly becoming the only path.  Where do we stand with the name change?  A six month post consultant results cooling off period?  Give me a break.  Where is the urgency???  Where do we stand with targeted independence legislation?  Little to none unlike NP's who have moved AGGRESSIVELY on their legislative agenda even more so during the pandemic.  What have we done?  Nothing.

The lack of urgency in this field will be the end of it one legislative loss at a time.

 

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Dude, if you want to be a doctor, go to MD or DO school. Do a 3 to 5 year residency. Then go independent

Just like me, the PA-C, my ARNP colleague gets regular, weekly supervision. She has 22 years' experience and I have 28 years.

You're a PA by choice, get over yourself.

Have a nice day.

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15 hours ago, Cideous said:

It may be the hard path, but it is rapidly becoming the only path.  Where do we stand with the name change?  A six month post consultant results cooling off period?  Give me a break.  Where is the urgency???  Where do we stand with targeted independence legislation?  Little to none unlike NP's who have moved AGGRESSIVELY on their legislative agenda even more so during the pandemic.  What have we done?  Nothing.

The lack of urgency in this field will be the end of it one legislative loss at a time.

 

AAPA has reached out the state PA boards and asking for feedback.  State PA boards are meeting and working out how to ask and asking membership.  It all takes time.....

11 hours ago, EastCoastPA said:

Do NP's do a 12 month residency for independence?

nope, most commonly after 1-2 years of supervised experience they are independent (in those states they have independence - is is over 50% of the states and growing)

9 hours ago, Carl1 said:

Dude, if you want to be a doctor, go to MD or DO school. Do a 3 to 5 year residency. Then go independent

Just like me, the PA-C, my ARNP colleague gets regular, weekly supervision. She has 22 years' experience and I have 28 years.

You're a PA by choice, get over yourself.

Have a nice day.

So entirely misses the mark - politically we are being left behind.  This is not debatable, it is fact.  We are the only professional profession that I am aware of that does not have control over our own profession.  It is an experiment which was tried and shown to fail.  What value does you weekly meeting bring?  what happens if you don't have them?  in my case there is a few areas I exceed the knowledge base of the SP - insane 

let me be clear on this - if you want to be the "Assistant"  for ever and have a profession with unlimited control over yours then great stay and assistant, but the more you learn about the business of medicine, the politics of medicine, the future outlooks, the barriers we face that are no fault of the individual PA, and the bias against us as "Assistants" you realize we need to change.  

Please don't stand in the way of progress because "we always did it this way"  or  "it is fine the way it is"  because it is not fine.  We are losing standing rapidly to NP's and it is only going to get worse if we do not do something. 

41 minutes ago, iconic said:

Argh just let me take a couple nurse theory classes and give me that NP degree

yeah, love this idea, but never gonna happen....

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So why fight for PAs to be unemployable until after a 1 year residency / force a pay cut and delay paying off $100k loans when NPs don't have to? I was with it until that point. If we're fighting for parity, let's go for parity. Anything less is an admission that we are poorly trained compared to them to uninformed admins/hiring managers...

Edited by EastCoastPA
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11 hours ago, Carl1 said:

Dude, if you want to be a doctor, go to MD or DO school. Do a 3 to 5 year residency. Then go independent

Just like me, the PA-C, my ARNP colleague gets regular, weekly supervision. She has 22 years' experience and I have 28 years.

You're a PA by choice, get over yourself.

Have a nice day.

Where in the post did he say he wanted to be a doctor???  After 28 years in practice why do you need weekly supervision?  You can be an independent provider and still practice at your comfort level asking a physician colleague to check your work.  I personally don't understand the fear some PAs have gaining equal independence to NPs.  Do you just not want to accept full responsibility for your actions?  Do you feel incompetent to practice unless you have supervision?  What is your personal reason for not wanting independence?  How will your job change if you became independent? 

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19 hours ago, kang1208 said:

Perhaps those who don’t want independence practice or FPA can sign a “waiver” form and stay as “assistant”. I’m just concerned that those who wish to remain in that role will ruin for the rest of us who wanted to progress. We need to get legislatively on par with NPs one way or another, or else....

The thing is if you want a close supervisory relationship (or however you would describe it) you are still free to seek that out even if we had full independence. However, under the current rules there is no option for someone who is well trained and experienced to seek a position with independence.

I understand the arguments. I haven't had a position where someone was really watching over me closely in many years but the rules are still their to be used against me if someone chooses to do that.

At its most basic level all our efforts need to be based on achieving continued market parity. I think the future of the profession depends on it.

 

oh and Carl joined about 12 hours ago. He is a troll. Don't feed the trolls

Edited by sas5814
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The plan is simple... OTP + MCP.  We just have to follow through with OTP (eventually could be FPAR) and change the title to Medical Care Practitioner. 

OTP/FPAR and MCP go together 

Physician supervision and Physician associate go together.

The truth is physicians do not want to supervise PA anymore. I predict give a few more years, we will see a push back from physician organizations from supervising PAs. Associate/assistant physician will be on the rise,  because of increase medical student graduates and lack of residencies.  

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1 hour ago, PACali said:

 

The truth is physicians do not want to supervise PA anymore. I predict give a few more years, we will see a push back from physician organizations from supervising PAs.

This is exactly right.  They are employees and resent everyone and everything because of it.  They are becoming extremely adverse to "supervising" PA's.  To them we are simply a liability with all cost and no return and to put it quite frankly...I don't blame them.

But...what will Assistants do with no one to assist?  

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36 minutes ago, Cideous said:

This is exactly right.  They are employees and resent everyone and everything because of it.  They are becoming extremely adverse to "supervising" PA's.  To them we are simply a liability with all cost and no return and to put it quite frankly...I don't blame them.

But...what will Assistants do with no one to assist?  

Or what will Physician's associates do when Physicians don't think we are their associates?

Wake up people, when was last time AMA called us their associates?

The pandemic will change a lot of things. Hospital closing, physician hours are cut, and the increase use of telemedicine. Who wants to see an assistant, or a doctor's associate when they can get the physician on the screen?

We have to be our own profession and control our fate. 

For the PA students who are reading this, PA school does not tell you physicians are not always your friend. I have worked with many great physicians, but there are also really horrible ones that could care less about you. You will  be doing their job with 25% of the pay and respect. You have to support OTP and title change (Medical Care Practitioner). If not, good luck paying off your student loan because NPs are taking over. 

Edited by PACali
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On 1/22/2021 at 7:51 AM, sas5814 said:

oh and Carl joined about 12 hours ago. He is a troll. Don't feed the trolls

Entirely likely, but I checked and he's not clearly a returning banned person, so he might just have a very divergent opinion, so we're giving him the benefit of the doubt.

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  • 3 months later...

Wholeheartedly agree. I'm a healthcare marketing consultant and my wife is a PA. I've had the conversation with her several times... as an industry/organization, the title needs to change. It's a horrible label within the profession, and externally sends the wrong impression to the consumer. A "PA" outside of healthcare (read: to your patients) is a "personal assistant"... not exactly a vote of confidence or respect. And it's far too close to "medical assistant," which is a wildly different skill set, of course.

>> For the PA students who are reading this ... You will  be doing [the doctor's] job with 25% of the pay and respect.

This, absolutely. Words matter. Half the respect comes from the title. PAs should lose the diminutive A.

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Thank you for bumping this older thread.  The predicted rejection of MCP is exactly why I wrote this piece.  PA's can not get out of their own way, but what they just don't get is that this profession has a shelf life which is rapidly reaching its expiration date.  Every time NP's win another state with independence....we lose.  We lose jobs, we lose ground trying to keep parity and we lose the respect and standing with the general public.

Now more than ever like minded providers in this profession need to split from the PA field.  Let them stay assistants or associates if they want and be swept into the dust bin of history while we ascend to where NP's are and where we should all be.

I predict if we did this, within 3 years you would see an AVALANCHE of PA's joining us in the MCP field.

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It is interesting to see this thread come back around again. Time changes the perspective. 

I think Rev pointed out this board and the Huddle are small bubbles in the opinion pool. I have to remind myself, with some help from colleagues, that it is a microcosm and may not represent the greater will. 

I'm waiting to see what the HOD does or doesn't do before I decide what I am going to do next. My intention was to, basically, resign from PA politics once my PAFT time is up in a few weeks. My wife says I'm incapable.

The Sisyphean task of trying to change opinion has worn me down to the nub. Particularly vexing are the retired PAs who either wax romantic about the old days or recite their resume every time they speak and then tell everyone how they have a "bigger view" than people who disagree with them. They don't....they can't see outside the box or around the corner.

I predicted we would need to cleave from the physicians and create an identity unique from the NPs 20 years ago when I ran for TAPA president (twice). I got stomped because I was "radical" and "would alienate our friends the nurses". I wasn't wrong then and I'm not wrong now. We are in trouble and I'm not terribly interested in some gasbag who has no skin in the game pontificating about his bigger vision and how smart he is.  Screw him.

Ok I'm tired and went down the rabbit hole for a minute.

This isn't the time to do the same old thing. This isn't the time to take baby steps. Genteel diplomacy has a place but if you aren't willing to actually fight diplomacy has no teeth.

It is the time to see far into the future. It is the time for bold idea and bold steps. It is time for leaders to lead and if they have to step on some old egos in the process.....sorry.

Here is the real sad part. It isn't going to happen because not enough people have felt the pain yet. There is a tipping point where the profession will be driven from its historical apathy and torpor into action. That has to happen BEFORE we are so damaged we have no political or bargaining power at all. I'm not convinced it will.

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“Particularly vexing are the retired PAs who either wax romantic about the old days or recite their resume every time they speak and then tell everyone how they have a "bigger view" than people who disagree with them. They don't....they can't see outside the box or around the corner.”  

I never found it to be romantic and I don’t mention my background unless asked.  I don’t even identify myself as a PA if asked what I did.  I just say that I was a...wait for it...MEDICAL PROVIDER.  It was a PITA to break new ground in specialty IM and EM in Dallas.  Hope it made life easier for those who followed.  

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Too broad a generalization I suppose. I'm thinking of a select few and nobody here among them. Really one in particular who flat out tells people he knows better than WPP regarding title change. 

We all stand on the shoulders of those that came before us. I think was grinds my gears is when that gets transmuted into some perceived wisdom about the current state of affairs or gets used as a weapon to stifle differing opinions. I really think it stops younger PAs in their tracks and they just don't participate. If everyone voted instead of just the HOD it's conceivable a silent majority would move things in a different direction. I could be wrong.

Heaven knows I've been wrong about things. I would be happy to be wrong about this

I haven't had much sleep in the last few weeks after falling and breaking a couple of ribs. I am particularly crabby. I think I'd feel better if I just disconnected from the whole issue(s) and let them play out.

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I emailed two of our state's HOD reps today regarding the proposed name change and describing my concerns with the status quo. Both thanked me for my input and one added that 7 of our 8 delegates are in favor of a name change. I didn't ask to what name but I was pleasantly surprised.

Edited by UGoLong
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3 hours ago, sas5814 said:

Too broad a generalization I suppose. I'm thinking of a select few and nobody here among them. Really one in particular who flat out tells people he knows better than WPP regarding title change. 

We all stand on the shoulders of those that came before us. I think was grinds my gears is when that gets transmuted into some perceived wisdom about the current state of affairs or gets used as a weapon to stifle differing opinions. I really think it stops younger PAs in their tracks and they just don't participate. If everyone voted instead of just the HOD it's conceivable a silent majority would move things in a different direction. I could be wrong.

Heaven knows I've been wrong about things. I would be happy to be wrong about this

I haven't had much sleep in the last few weeks after falling and breaking a couple of ribs. I am particularly crabby. I think I'd feel better if I just disconnected from the whole issue(s) and let them play out.

Damn Scott?  I hope you're ok man.  Rib fractures suuuuuck.  Hang in there, that pain with breathing will go away.....in 4-6 weeks LOL, sorry!

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Great idea and a plan for implementation. The conferences will be difficult because they need to be approved by the AAPA and this is not clinical but I have gotten a few of these on the agenda. Good luck. BTW - it's been 25 years and I think I still have some of the original articles that I wrote. Too many leaders were too busy shining the buttocks of the AMA.

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