underserved Posted July 20, 2012 Author Share Posted July 20, 2012 Be nice Anderson; I hate for you to get a warning for attacking me. Link to comment Share on other sites More sharing options...
underserved Posted July 20, 2012 Author Share Posted July 20, 2012 We will eventually change to associate huh? Apparently I'm not the only one with the crystal ball.... Link to comment Share on other sites More sharing options...
andersenpa Posted July 20, 2012 Share Posted July 20, 2012 Is the gameplan to include more autonomy along with the name change? Without that, it's just a name change. Not that Assistant to Associate isn't a good move, but I'm not sure it will provide any more leverage to negotiate better salary/bennies/etc. Edit: Andersenpa, the link to the website in your signature doesn't appear to be working. No the name change is an independent movement, not related to autonomy. It is about the appropriate title which defines ad brands our profession. It is also about avoiding persistent confusion with MAs who serve a VERY different role, and opening up for opportunities which are blocked by the term "assistant". Your salary and bennies are up to you and 1) how well you negotiate and/or 2) where you are willing to relocate And thanks for the heads up about the link...I will email the site owners (unless you know something, E).... Link to comment Share on other sites More sharing options...
andersenpa Posted July 20, 2012 Share Posted July 20, 2012 Be nice Anderson; I hate for you to get a warning for attacking me. Anderson is a different user who has never posted in this thread. (Attention to detail is critical) That being said, I am familiar with the forum rules and I didn't see an attack. Mods, let me know. Link to comment Share on other sites More sharing options...
andersenpa Posted July 20, 2012 Share Posted July 20, 2012 We will eventually change to associate huh? Apparently I'm not the only one with the crystal ball.... The name change is one of the dominant (if not the marquee) issue among PAs nationwide. There was a national write in campaign which generated >6000 signatures in favor. This is >200% the turnout of the last AAPA election. The issue was then featured in a special survey conducted by the AAPA. An overall plurality, and majority in many states, supported the change to Associate. These are facts which support the notion that the name will change. Link to comment Share on other sites More sharing options...
andersenpa Posted July 20, 2012 Share Posted July 20, 2012 Yep the DNP is about creating a body of administrators and execs, not clinicians. The former will have control over placement of the latter. Link to comment Share on other sites More sharing options...
treejay Posted July 20, 2012 Share Posted July 20, 2012 ^ the DNP to me is a great example of the foresight that exists among the prime movers in nursing. its an example of something they "got right" (at least in terms of their overall strategic advancement), I agree with a lot of what you're saying. But am I correct in interpreting you believe nurse leaders behind the push for DNP actually had unstated motives to elevate the nursing profession to higher NON-clinical heights (administration, managers, leaders, etc) even though they are touting their new doctorate as a CLINICAL doctorate, purportedly aimed at enhancing their clinical skills? Or is it not even unstated at all? Because how I interpret WHY they're advocating the DNP push, it's all about enhancing CLINICAL acumen. But, I'm well aware that there are usually unstated political motivations and incentives behind most things. I agree, the leaders of the nursing profession are vastly more visionary and bold than their counterparts in the PA profession I hope this was a coherent post at this late hour.... now back to the books. Link to comment Share on other sites More sharing options...
Joelseff Posted July 20, 2012 Share Posted July 20, 2012 Hey PAMAC, Great posts about the DNP, I totally agree with the admin vs clinical thing too. But I gotta ask you, why then would you, knowing you get better training and clinical skills through PA school vs NP, are you going NP? Do you intend to stick with admin? I think some of us here are betting you end up going PA ;) Sent from my myTouch_4G_Slide using Tapatalk Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted July 20, 2012 Moderator Share Posted July 20, 2012 Hey PAMAC, Great posts about the DNP, I totally agree with the admin vs clinical thing too. But I gotta ask you, why then would you, knowing you get better training and clinical skills through PA school vs NP, are you going NP? Do you intend to stick with admin? I think some of us here are betting you end up going PA ;) Sent from my myTouch_4G_Slide using Tapatalk Agreed....based on what I've seen on here, I'd love having you as a colleague Link to comment Share on other sites More sharing options...
andersenpa Posted July 20, 2012 Share Posted July 20, 2012 I agree with a lot of what you're saying. But am I correct in interpreting you believe nurse leaders behind the push for DNP actually had unstated motives to elevate the nursing profession to higher NON-clinical heights (administration, managers, leaders, etc) even though they are touting their new doctorate as a CLINICAL doctorate, purportedly aimed at enhancing their clinical skills? Yes....... Link to comment Share on other sites More sharing options...
jmiller Posted July 21, 2012 Share Posted July 21, 2012 can we keep this conversations going here? For somebody, who took the MCAT, filled out and send out all the supplements, and then decided this wasn't for me, these conversations is making me a little shaky about my decision. I have hoards of doctors in family, surgeons, ob/gyn etc, and seeing some go crazy was making me crazy. i still dont regret the decisions but yet i cant help wonder. Link to comment Share on other sites More sharing options...
mdebord Posted July 21, 2012 Share Posted July 21, 2012 The lack of respect from docs, staff and patients. Having to explain every single day of your working life that your not an assistant. Fighting amongst ourselves; we can't even agree on the name change. Being lowballed in re: to salary because we are "assistants". Employers wouldn't dare to pull that trick on docs. Having to fight for benefits, malpractice insurance, cme stipend, vacation time, etc... Oh yeah the aapa; let's not go there. Np are taking our jobs; you see them in many specialty and subspecialty because they are cheaper to hire. In the er I trained at pa are not hired because of the supervision requirement; the doc only take np. The specialty exam for Pa will eventually come into fruition and we be competing among ourselves for jobs; lateral mobility? Good luck with that. Need I say more Anderson? Ultimately, your decision is up to you, but I think it's in your own best interests to hold off on that decision until you at least give being a PA a fair shake. The concerns you mention are certainly valid, but depend largely upon your practice setting. The best advice to any new PA looking for a job (that I was told, and followed) is to look for a group/practice/doctor that values and respects PAs and has experience with employing them. You may find that you will be offered fair compensation and excellent bennies without even having to negotiate. In particular, the issues you mentioned I have not found to be "daily" at all. I may have to explain myself about once a week. My daily frustrations - time management, drug seekers, getting insurance to approve my imaging - are shared by docs as well. I am sure I will encounter more of the negativity as time goes on (I am new at this, after all); but I just want those of you out there who are questioning to know that there really are plenty of great opportunities. As usual though, it's up to you to find these and make the most of them. Certainly, this is not to say that MD isn't the better choice for some, but don't get scared off from what you really want - whichever way you decide. Link to comment Share on other sites More sharing options...
jsma Posted July 21, 2012 Share Posted July 21, 2012 I have looked at all the comments on this thread and I am surprised. I was recently admitted to a PA Program and will be beginning in January. I think that for anyone considering the field they have to understand the dynamics of the profession. A few comments have hinted at the fact that competency dictates trust and delegation of responsibilities and this is so true. I was on the fence about whether to pursue a medical degree or PA school and if you are young (under 30) you probably do want to pursue being an MD if the driving force is status. I have worked with MDs and PAs for years now and over time even MDs contend they would have to really think about their decision a little more closely. As a person who has been in the healthcare business for quite a while (I own a mobile ultrasound company) I can tell you the physician supervisor role is not something to be afraid of. I have to have a medical director, this person essentially functions in a role similar to what an SP would function. I see tremendous benefit in this from a business perspective. Many of the PAs on this forum that own practices have not really commented because they see the value in the relative autonomy that they have garnered by being exceptional practitioners. In a nutshell I am of the mindset that there will be some ignorance that you will have to contend with in any profession. It is, however, up to practicing PAs to be the biggest proponents of respect and not cowering under the current over exaggerated clinical experience and abilities of NPs or DNPs. Physicians have admittedly acknowledged they need PAs to extend their abilities and practice and be profitable. PAs are better suited to work with physicians and should act as such. One last note, as the ACA begins to be implemented (whether you are a proponent or not) there will be even more opportunities for the savvy healthcare professionals to expand their practice or find a niche that MDs don't want to or can't fill, the earning potential is not solely dictated by your SP or the circumstances in your immediate area. Additionally, although I agree with a title change similar to what is in other countries (i.e clinical officer) I think it is a rather shortsighted view of the profession to assume that the title will be the biggest thing to change perception, it is the responsibility of the advocacy organizations to be more proactive and have a valid vision like the Nursing Board. I know this is getting long winded but when I decided to make a huge change to become a PA it wasn't because of money or status it was because of people and when you are good at what you do, no nurse, physician or administrator can question you without feeling idiotic themselves. Link to comment Share on other sites More sharing options...
jmiller Posted July 21, 2012 Share Posted July 21, 2012 What are you and your acquaintances going crazy about? crazy in the sense of schedule and lifestyle. getting call 3am in the morning and then again, after going bed at 6, at 8am. having hard time scheduling your schedule with your kids schedule, games etc. not being able to spend enough time with them. Link to comment Share on other sites More sharing options...
andersenpa Posted July 22, 2012 Share Posted July 22, 2012 ^but it's not like every doctor has to take call (often they pick up a midlevel for just those kinds of things)? obviously obs and surgical aren't the most schedule friendly specialties, but they all knew that going in. You could do derm or family practice and never work after 5 pm. Call is not necessarily interchangable. In my group you have a surgeon (consults/cases) and a PA (ICU, inpatients, pt calls) on every day. Surgical and interventional practices work this way. Link to comment Share on other sites More sharing options...
Joelseff Posted July 22, 2012 Share Posted July 22, 2012 ^true. But my point it that outside of surgery or obs.... Or practices like yours (where obviously you can't pawn that off on someone), there are specialties and jobs where you can certainly lessen its impact. Ultimately, being plagued by call isn't a certainty that jmiller is doomed to suffer if he/she plans accordingly to take jobs that aren't tied to call. I don't see why call is often brought up in the PA vs MD discussion. I have had 4 PA jobs to date 2 including my current one, involves taking call. It's not that big of a deal for me, I know many of my colleagues hate it and yes at times it sucks like in Pain medicine for example, but I actually like knowing which of my pts ended up in the ED or admitted over the weekend so I can prepare for them (lately it involves dosing down BP meds after the ED and hospitalists dialed up their CCBs and betas to get them out of the hospital and out of hypertensive crisis-which was usually caused by not taking their meds regularly but i digress. Call though not pleasurable for the practitioner, is a necessary evil in the practice of medicine. In FP when you carry your own caseload its good because I hate getting a call from my SP about MY pt that he doesn't really see except for their initial "incident-to" visit and he takes care of it for me. Makes me feel like his assistant. Uknowhutahmeen? Sent from my myTouch_4G_Slide using Tapatalk Link to comment Share on other sites More sharing options...
Joelseff Posted July 22, 2012 Share Posted July 22, 2012 ^it was jmiller that was mentioning call and busy schedules driving his physician relatives crazy, not me. I was just telling him that it's not something that he neccessarily has to deal with if he goes to either med school or PA school.... If thats what concerns him/her. My wife and I both have call in our jobs. She has a lot more than me, but she absolutely hates it. I actually enjoy it when I'm on it. Get called in twice and it's like a full days wage for 3 or 4 hours work. But for what some of you PAs make for call pay, you can make bank, (others not so much). I think I could handle it because my life is boring and I don't drink. Oh didn't mean to point a e-finger at you bro. Sorry :o but yeah call is not that bad and it is,what it is. I think ppl make too much out of it. Now 24 hour call would really suck but in a rotation q 4 weeks within a call group, not too bad. Sent from my myTouch_4G_Slide using Tapatalk Link to comment Share on other sites More sharing options...
jmiller Posted July 24, 2012 Share Posted July 24, 2012 Oh didn't mean to point a e-finger at you bro. Sorry :o but yeah call is not that bad and it is,what it is. I think ppl make too much out of it. Now 24 hour call would really suck but in a rotation q 4 weeks within a call group, not too bad. Sent from my myTouch_4G_Slide using Tapatalk i should have been much clearer. When i said driving me crazy, i meant that seeing them go crazy was sort of confusing me in terms of deciding what to do. Seeing them go crazy wasn't literally driving me crazy. nonetheless, at the end of the day no matter what one does, MD/PA, it seems there always will be situations that will drive one crazy -- lets not over blow this again, lol. my FP uncle, even though not going crazy, is still paying his enormous 350k loans. He is 40+ years old, so there is the added perspective on having to decide what one should do. But, i have agree w/everybody that when MD vs PA comes, MD is the way to go. Everywhere in the forum, all i hear is how much it sucks to take the orders from their SP and the lack of autonomy. i haven't really heard much positive comments. When i asked everybody, "Are you happy" with what you do. 4/5 comments were all very discouraging. Dammit decisions decisions. Link to comment Share on other sites More sharing options...
physasst Posted July 24, 2012 Share Posted July 24, 2012 maybe thats why the NP world is pushing the DNP. couldnt see myself caring much for taking on the doctor title, but theres something to be said for the option to get the doctorate. it provides avenues for growth. a few of the upper echelons in the nursing admin at my facility are fininshing up on thier NP education. i dont see them using it a ton, but its nice to have that classification as a "provider" when they are making thier way up the corporate ladder. i see the DNP turning into something that gives them the edge in managing all the new primary care opportunities that are supposed to emerge out of the ACA, if it gets impemented.... hence all the practice management courses that the DNP consists of vs clinical training. they saw this day coming, and they wanted to be positioned to be the managers... the folks at the meetings with the organization's CEOs. the DNP was never about being doctors in the exam room, it was about being doctors in the boardroom. No, the DNP was Polly and Mary's creation. It was created with the sole purpose of making NPs the defacto primary care providers in the country. I know both of them and think highly of both of them. The DNP was created in order to try and create a situation whereby insurance companies would recognize the DNP as on par with an MD/DO (IN PRIMARY CARE...not specialties) with equal reimbursement and increased respect with patients. The DNP was solely a political move to try and corner the primary care market and increase renumeration. I have concerns about its effect on workforce supply and distribution (IE; decreased NP enrollment, decreased HRSA and CHC selection, etc.) but we will have to see how it plays out. Link to comment Share on other sites More sharing options...
andersenpa Posted July 24, 2012 Share Posted July 24, 2012 No, the DNP was Polly and Mary's creation. It was created with the sole purpose of making NPs the defacto primary care providers in the country. I know both of them and think highly of both of them. The DNP was created in order to try and create a situation whereby insurance companies would recognize the DNP as on par with an MD/DO (IN PRIMARY CARE...not specialties) with equal reimbursement and increased respect with patients. The DNP was solely a political move to try and corner the primary care market and increase renumeration. I have concerns about its effect on workforce supply and distribution (IE; decreased NP enrollment, decreased HRSA and CHC selection, etc.) but we will have to see how it plays out. Dropping first names of people that >90% members here don't know is a pretty poor way of communicating information (the point of this forum), especially from someone who is so desperate to show everyone how educated he is. The persistent name dropping screams of attention seeking. I usually don't comment on style points but this is glaring. Please continue though we're all impressed by all your "good friends" in high places....... Link to comment Share on other sites More sharing options...
physasst Posted July 24, 2012 Share Posted July 24, 2012 Dropping first names of people that >90% members here don't know is a pretty poor way of communicating information (the point of this forum), especially from someone who is so desperate to show everyone how educated he is.The persistent name dropping screams of attention seeking. I usually don't comment on style points but this is glaring. Please continue though we're all impressed by all your "good friends" in high places....... Actually, that wasn't my intent.....but I can see how it could be taken that way...typing too fast. It was Mary Mundinger and Polly Bednash, two leaders of the nursing profession. Mary has said repeatedly that in primary care, the NP should be thought of as an equivalent alternative to the primary care physician. She felt that the fact that NP's weren't recognized by insurance carriers as equivalents was a major problem. Hence the DNP and their claims (falsely I believe) of the degree being a "clinical" doctorate. Mary is retired now, but was advocating for this as recently as 2010. But don't take my word for it..here's hers.. http://www.forbes.com/2007/11/27/nurses-doctors-practice-oped-cx_mom_1128nurses.html Here's some snippets: The doctor of nursing practice (DNP) is a new level of clinical practice that is attracting a rapidly growing number of nursing professionals. This doctoral degree enables advanced-practice nurses to gain the knowledge and skills necessary to practice independently in every clinical setting. DNPs are the ideal candidates to fill the primary-care void and deliver a new, more comprehensive brand of care that starts with but goes well beyond conventional medical practice. In addition to expert diagnosis and treatment, DNP training places an emphasis on preventive care, risk reduction and promoting good health practices. These clinicians are peerless prevention specialists and coordinators of complex care. In other words, as a patient, you get the medical knowledge of a physician, with the added skills of a nursing professional. Once patients move beyond the common bias that only doctors of medicine can provide top-flight care, they typically come to appreciate these added benefits. Most important, research has demonstrated that DNPs, with their eight years of education and extensive clinical experience, can achieve clinical outcomes comparable to those of primary-care physicians. Along with a doctorate and the title of "doctor," the fact that a nurse practitioner has fulfilled this certification requirement will instill confidence in patients that DNPs have the expertise to serve as their health-care provider of choice. Nurse practitioners are reimbursed by Medicare and Medicaid in every state, but only variably by commercial insurance carriers. That is certain to change soon, as these DNP graduates prove they are the logical choice to become the new comprehensive-care clinicians. Her words not mine..... Link to comment Share on other sites More sharing options...
physasst Posted July 24, 2012 Share Posted July 24, 2012 To the OP, if there is ANY consideration of medical school....ANY.......go the medical school route. Like emedpa, I would have been much happier I think if I had done that. Of course, I tend to not ever be happy, so who knows.... Link to comment Share on other sites More sharing options...
PASHA Posted July 24, 2012 Share Posted July 24, 2012 No , not for me. I am pretty happy being PA-C. I love everything about it: pay , scope of practice, respect, schedule, lifestyle , etc. Link to comment Share on other sites More sharing options...
jmiller Posted July 25, 2012 Share Posted July 25, 2012 ^im still having a hard time understanding what you are getting at....but from what i can pick out, it sounds like you are deciding between MD and PA? if you dont ask clear questions, folks cant help you out much. maybe you are getting answers that discourage you because you need to change your approach when you do your research. dude i wasn't asking any questions. i was writing what i felt was the reasons i didn't wanted to go to medical school. Trust me i did enough research. Link to comment Share on other sites More sharing options...
Guest hubbardtim48 Posted July 25, 2012 Share Posted July 25, 2012 Ohhhh jmiller....guess you don't know PAMAC... just ignore him/her. He/she never has anything goo to say unless your talking about nursing or nursing theory....I hear you jmiller on the PA vs. Med school. I applied to med school, but with drew my applications because I knew I truly did not want to go that route and wanted a most simplistic life without all the dedication to resd, fellowships, etc... I knew I wanted to work primary care and knew that PA was the best route for ME and ME only. I can't say for anyone else, but it works for me and I think God, family, friends are more important than work so I will help my community out through primary care services, but will have time with my God, family, friends and STILL have extra time to be with family/friends when we are doing mission work and community activism. Good luck on your endeavor(s) in life and God bless you! P.S. scratch PAMACs comments....he/she seems like a debbie-downer...not my cup of tea... Link to comment Share on other sites More sharing options...
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