PACali Posted January 26, 2021 Share Posted January 26, 2021 I noticed there are more jobs for psychiatric NPs than PAs. At least in California, that is where I noticed. There is really no difference in term of supervision yet in California. Why is that? Quote Link to comment Share on other sites More sharing options...
Cideous Posted January 26, 2021 Share Posted January 26, 2021 Pretty sure NP's are now independent in California? They passed it in 2020. Quote Link to comment Share on other sites More sharing options...
PACali Posted January 26, 2021 Author Share Posted January 26, 2021 Just now, Cideous said: Pretty sure NP's are now independent in California? They passed it in 2020. They passed, but it won't start until 2023 1 Quote Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted January 26, 2021 Administrator Share Posted January 26, 2021 There have been more Psychiatric NPs. I believe it's a specialty board for them, and was before we had our CAQ available. Which, BTW, I'm considering working towards, now that my week consists of pain, eating disorders, and sleep.... 1 Quote Link to comment Share on other sites More sharing options...
DizzyJ Posted January 26, 2021 Share Posted January 26, 2021 PMHNP for sure have the psych market. Not impossible to practice in psych as a PA, just harder to find a job. I did outpatient psych in Sacramento for a couple years. At the time it was myself and 2 other PAs....since then it has been overtaken by PMHNPs Quote Link to comment Share on other sites More sharing options...
CAAdmission Posted January 26, 2021 Share Posted January 26, 2021 3 hours ago, rev ronin said: my week consists of pain, eating disorders, and sleep.... Sounds like my typical week, too. (My personal week, not my patients') Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted January 26, 2021 Moderator Share Posted January 26, 2021 3 hours ago, rev ronin said: , now that my week consists of pain, eating disorders, and sleep.... 42 minutes ago, CJAadmission said: Sounds like my typical week, too. (My personal week, not my patients') CJ do you mean personally or professionally ?? (sounds like my personal week plus day care to young kids.....) 1 Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted January 26, 2021 Moderator Share Posted January 26, 2021 Why no psych PA I have spoken to some Psych NP that think we can not do it - WHATTTT the 400 hour on line course they take some how prepares them BETTER then 4000 hours of education with mandatory rotations is psych and medicine (which is a lot of psych) and PCP(which is also a lot of psych) Honestly it comes down to this - up to this point not a lot of psych PA' - the psych NP's have a somewhat corner on the market and keep gaslighting everyone else that PA's can't possibly do it..... I thought of doing pych and was more then comfortable having managed 95% of the mental health in 200 bed jail for almost 5 years, but I enjoy IM to much. But I had a few enlightening conversations with PSych NP's (where I agreed with some of their thoughts on medical management, but pointed out a few instances where they were sort of practicing crappy medicine outside what was reasonable - yet they are "independent" and can "own their own practices" and "direct bill" - all of these were brought up as reasons they were "better then PA's" forehead slap as NONE of these have anything to do with proficiency nor education..... enough already..... what it takes is PA's moving into psych, getting CAQ, then becoming MCP and independence and showing the world we rock!!! 2 1 Quote Link to comment Share on other sites More sharing options...
Cideous Posted January 27, 2021 Share Posted January 27, 2021 We are Assistants. Why would anyone think we could do this.... 1 Quote Link to comment Share on other sites More sharing options...
PACali Posted January 27, 2021 Author Share Posted January 27, 2021 12 hours ago, DizzyJ said: PMHNP for sure have the psych market. Not impossible to practice in psych as a PA, just harder to find a job. I did outpatient psych in Sacramento for a couple years. At the time it was myself and 2 other PAs....since then it has been overtaken by PMHNPs That is basically what the recruiter said. They only hire PMHNP because it is required for reimbursement purpose. After a quick research, I realized you can get PMHNP certified in one year after an NP degree or 2 two years from the start. https://nursing.ucsf.edu/PMHNP-postmasters-certificate Don't get me wrong, I am not into more certificates/courses/degrees, but if it is required for us to work and compete with the NP, I am all for it. PA programs such as Lynchburg should start making certificates like PMHNP for post graduate training. I mean how are you going to get CAQ in psychiatry when you can't even get hire? I am not even in psy, I am in EM, but when I see my company only hire NPs for their psychiatric practice, I start to get worried. There is absolutely no reason PA can't practice in psych. Quote Link to comment Share on other sites More sharing options...
DizzyJ Posted January 27, 2021 Share Posted January 27, 2021 A PMHNP is not required for reimbursement. PAs can treat and bill for mental health services. Most PMHNP and PAs in psych are seeing patients for medication management, but can also bill for psychotherapy (unless something has changed since I was in CA practicing in psych). 2 Quote Link to comment Share on other sites More sharing options...
Lexapro Posted January 28, 2021 Share Posted January 28, 2021 (edited) Can a PA bill for psychotherapy? How is that ethical? PMHNPs need more therapy training, but at least they receive both didactic coursework and clinical hours performing therapy, as well as are tested on it in their licensing exam. From what I understand, PAs receive no formal therapy training whatsoever. This is something that really bothers me. There are already enough bad therapists out there. We don't need more under trained clinicians offering "therapy." Now if the PA is also an MFT or LCSW or gets residency training that includes psychotherapy training...have at it. Edited January 28, 2021 by Lexapro Quote Link to comment Share on other sites More sharing options...
iconic Posted January 28, 2021 Share Posted January 28, 2021 (edited) 1 hour ago, Lexapro said: Can a PA bill for psychotherapy? How is that ethical? PMHNPs need more therapy training, but at least they receive both didactic coursework and clinical hours performing therapy, as well as are tested on it in their licensing exam. From what I understand, PAs receive no formal therapy training whatsoever. This is something that really bothers me. There are already enough bad therapists out there. We don't need more under trained clinicians offering "therapy." Now if the PA is also an MFT or LCSW or gets residency training that includes psychotherapy training...have at it. I've looked at some PMHNP programs that have no therapy in the curriculum at all. Also where is this clinical supervision of therapy occurring? I've rotated with PMHNP student on my psych rotation and there was definitely no clinical supervision of therapy there for us. Counselors have to get 2000+ hours of supervised practice after they graduate. It's just not possible to receive this kind of therapy supervision the way NP programs are structured. It's bad enough that one is supposed to learn about medication management over 500 hours of clinicals. As far as billing for therapy, it varies by state but most commercial insurance would allow it. I do not support billing for services one is not qualified for, however, let's not act like all PMHNPs receive good therapy training, as most I suspect do not. PMHNPs make more than Psych PAs for no other reason that they are independent and do not require supervision Edited January 28, 2021 by iconic 1 1 Quote Link to comment Share on other sites More sharing options...
PsychiatricPA Posted January 29, 2021 Share Posted January 29, 2021 It's all about credentialing. PMHNPs can easily get credentialed by most insurance companies while PAs, FNP, CNS, etc can't. Quote Link to comment Share on other sites More sharing options...
Avalon Posted January 31, 2021 Share Posted January 31, 2021 As I understand it, a PA cannot bill for psychotherapy in many states without specific approval from the licensing board, and only after meeting additional specified criteria. For example, this is the statute governing such in the State of Maryland: A physician assistant (PA) may practice psychotherapy if the PA has the required additional education, training and experience to practice psychotherapy. Performing psychotherapy would be considered an advanced duty and therefore would require documentation of additional education, training and experience. When the Board licensed psychiatrist assistants, the minimum requirements were: Master’s degree from an accredited college or university; AND Completion of a graduate program accepted by the Board in a behavioral science that included 1, 000 hours of supervised clinical psychotherapy; OR Bachelor’s degree from an accredited college or university; AND 4,000 hours of supervised clinical experience that is approved by the Board. A PA should have similar education, training and experience before seeking Board approval to practice psychotherapy. 1 Quote Link to comment Share on other sites More sharing options...
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