Sterling684 Posted August 4, 2012 Share Posted August 4, 2012 Hi everyone, I am a prior service Air Force firefighter and am now at a crossroad. I have the prerequisites completed in order to apply for nursing school however; my interests lie with medicine and diagnosing patients. My second option would be to complete my B.S. in Emergency Health Science and work as a paramedic until I can get accepted into PA program… My dilemma is that I have lost some confidence in the longevity of the PA profession while searching through some of the posts on this forum. I would truly love to be a PA however; I can’t stand the thought of NP and DNP beating out PA’s for positions in the future or even worse the possibility of PA's being pushed out completely. Is this a foreseeable problem in the future? Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted August 4, 2012 Moderator Share Posted August 4, 2012 pa's will always exist. the impact of our role and accepatance by patients and regulatory bodies is still a question however. Link to comment Share on other sites More sharing options...
Sterling684 Posted August 4, 2012 Author Share Posted August 4, 2012 What changes do you feel need to take place in order to gain a wider acceptance and what role do you foresee PA’s filling in the future? Link to comment Share on other sites More sharing options...
Moderator ventana Posted August 4, 2012 Moderator Share Posted August 4, 2012 oh don't worry, we are not going anywhere!! the pains you are seeing are growing pains as we are one of the top 10 if not 5 professions out there according to most articles out there now (just read another one stating that we were on the top 10 list for the best master degrees) YEs we have to keep up with the NP's - but in many ways they are forging new ground that we would NEVER be able to do with out them doing it first - AMA might begrudingly let us be PCP's and sign all the papers if all the NP's already are doing it. Look at the brand new law in Massachusetts - PA's got amazing steps forward and I suspect MASS is now one of the most advanced PA friendly states out there - we don't even need to have a doc's names on our scripts anymore. BUT the NP's got a paragraph in the same 349 page law that says they can sign ANYTHING that a doc can sign that is within their practice - think about it - it says they can sign death cert, home health cert, admission, d/c, andd anything else - we (PA's) will likely follow, but in many ways we are not a mature enough national advocate (inspite of being about the same age as NP's) to get this type of stuff passed. I truly think that PA/NP will become the major delivery of primary care services in a team format in the next 10-20 years - their is just to many anging baby boomers and not enough providers to not have this happen, we are just having growing pains...... I for one would not want to be anything but a PA Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted August 4, 2012 Moderator Share Posted August 4, 2012 name change to physician associate to do away with confiusion with medical assistants. change terms like "supervision" to collaboration or sponsorship. CHANGE "MIDLEVEL" TO ADVANCED PRACTICE CLINICIAN OR AFFILIATED CLINICIAN. we don't give "midlevel care" why should we be called "midlevel providers". pa's do, and will continue to work in all specialties, all branches of govt, as pcp's, etc I believe the nccpa move to expand specialty certidfications will continue. with time employers and insurers will require them to work and be reimbursed in specialties. postgrad residencies will also increase in # and in importance, eventually becoming required.. Link to comment Share on other sites More sharing options...
jmj11 Posted August 4, 2012 Share Posted August 4, 2012 I've often been one of the strongest critics of the present state of PA-dom, with that said, I have great optimism in the future of our great profession. For one, things tend to cycle where enough people get fed up enough with how things are going and then changes happen. While slow to the table, eventually PA-dom will get it's **** together, especially if the younger PAs coming into the profession demand better and get involved in making changes. Link to comment Share on other sites More sharing options...
Guest Paula Posted August 4, 2012 Share Posted August 4, 2012 I heard a quote the other day: "Nothing will change if nothing changes." The PA profession is slowly changing. I agree we are grabbing on the coat tails of NP's. All newly certified PA's need to get involved in CHANGE. It is a wonderful profession, in spite of a few warts. Sterling684 go get your B.S. in the EHS and apply to PA school. You will be happier in medicine than in nursing, and you can one of the agents of change for PA-dom. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted August 4, 2012 Moderator Share Posted August 4, 2012 . But the np's got a paragraph in the same 349 page law that says they can sign anything that a doc can sign that is within their practice - think about it - it says they can sign death cert, home health cert, admission, d/c, andd anything else - we (pa's) will likely follow, but in many ways we are not a mature enough national advocate (inspite of being about the same age as np's) to get this type of stuff passed. pa's in wa can already do this. Link to comment Share on other sites More sharing options...
Sterling684 Posted August 4, 2012 Author Share Posted August 4, 2012 Thanks everyone for your responses, it’s nice to read some positive posts from those who are actively practicing. Paula, I believe you are correct; I think I will be happier as a PA and thanks for the vote of confidence. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted August 4, 2012 Moderator Share Posted August 4, 2012 maybe there's a paramedic job out there where you can do that, but i don't know of one. I had one in pa school. Low volume critical care transports. Link to comment Share on other sites More sharing options...
Moderator ventana Posted August 4, 2012 Moderator Share Posted August 4, 2012 pa's in wa can already do this. Maybe Medicare saws Doc has to certify face to face. And DME rules are changing to possibly requiring doc to sign face to face. states can not trump federal regs so it introduces an interesting wrinkle that will now get iron out by the NP. Honestly i see no reason why a highly experienced PA (sorry not a new grad-we need a primary care CAQ) with5 plus years experience should not be able to sign anything a doc signs. Right now PA can not sign admission oders, dc orders(we sign them but the doc has to be aware of them) death cet, dme certifications so there is issues what we can sign. Oh yeah we can not provide hospice care either. Honetly most these are medicare regs that need to get changed..... The point is the NP group will forge ahead and as long a we stay close behind in the rulings it will all get ironed out in the next the or so years. Now about that CAQ for pimary care..... Link to comment Share on other sites More sharing options...
Cideous Posted August 4, 2012 Share Posted August 4, 2012 If the new healthcare law does go into practice, it is going to throw a massive influx of patients into the system. The gov't will panic and look for ways to solve access......PA's are not going anywhere. Link to comment Share on other sites More sharing options...
Sterling684 Posted August 5, 2012 Author Share Posted August 5, 2012 Or, you could get your degree in nursing, and at the end of that time, you could have two options waiting for you.... PA school, or NP school. I like to have choices. It feels good to me knowing when I'm done with my nursing degree, that I would be able to choose either PA or NP, and have a really good shot at getting into either. Nothing says that you have to go to NP school after you become an RN, but you have some good options if you have RN tacked on. Nurses make good money, and if I wanted to pull a few shifts in Pa school here and there, they could make it worth my time. I know a nurse working on a masters that gets parked at a desk job and studies 9 hours when they pick up a shift. For 28 bucks an hour for 12 hours, that's a good deal. Maybe there's a paramedic job out there where you can do that, but I don't know of one. That’s my biggest problem, I don’t think I would make a good nurse (not that I feel that I’m above it) I just don’t think that it would fit what I want to do. I don’t want to go into nursing because it is safe; I want to go into my next profession because I want to be there. Paramedic fits who I am, and I feel the next natural step after that would be to become a physician assistant, I believe that becoming a PA will be the closest thing to kismet (on the side of my wife) that I can truly achieve. At the end of the day, I believe that I would be a better medical provider under the hat of a Physician Assistant than that of a nurse… I originally posted this because I had questions about the life of the profession and not due to financial support one degree would provide over the other. Link to comment Share on other sites More sharing options...
Contrarian Posted August 5, 2012 Share Posted August 5, 2012 Umm... Ventana, I think you misread what EMEDPA wrote. PAs in Washington State can ALREADY do these things and have been able to for quite some time. For yrs, we have had codified (written into the WA state law) that we can sign and attest to anything that our "sponsoring" physicians can in the normal course of our practice. This of course applies to state specific payers, courts, and processes... and not federal statues or regs. Who can sign Death Certificates and Medicaid papers are State specific. Here in WA. state, PAs can sign these with NO problems and have been able to for quite some time. Also, I don't think we have ever had a requirement for our SPs name on our scripts... and the only chart co-signature requirement is specifically for non-certified PAs. While its great to "keep hope alive," ... just because the NPs get some federal leaway doesn't mean that PAs are soon to follow... For instance, NPs can bill Medicare independently... and be paid directly by them and have been able to for quite some time. Not so PAs. So even if they (NPs) do make some headway on DME, and other medicare issues doesn't mean that PAs will be given consideration. Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted August 5, 2012 Moderator Share Posted August 5, 2012 Honestly i see no reason why a highly experienced PA (sorry not a new grad-we need a primary care CAQ)...brevity edit Now about that CAQ for pimary care..... I'm curious what you mean by a "primary care CAQ", and how this is different than the PANCE. Or the PANRE, for that matter. Link to comment Share on other sites More sharing options...
Joelseff Posted August 5, 2012 Share Posted August 5, 2012 While its great to "keep hope alive," ... just because the NPs get some federal leaway doesn't mean that PAs are soon to follow... For instance, NPs can bill Medicare independently... and be paid directly by them and have been able to for quite some time. Not so PAs. So even if they (NPs) do make some headway on DME, and other medicare issues doesn't mean that PAs will be given consideration. I have to agree. Just because NPs are blazing trails in medical policy does not mean we will follow suit. For one, NPs/Nursing cares about Nurses/NPs and can give a rat's a$$ about us. Despite what one may read on Clinician1-even there u can "feel" the division though not very obvious. For two, PA leadership has to want to take on advancing us out of our subserviant assistant status, which they don't seem too eager to want to do, or if a proposal to try to move us forward comes up, they find reasons to not do it because "it would cost too much" or "its too hard" or "because its raining outside." I dunno... I admire your optimism, Ventana, and I'm impressed with the moves in Mass. But I would not associate any headway that NPs make with possible inroads for us. I think in many ways PAs and NPs are still apples and oranges. Sent from my myTouch_4G_Slide using Tapatalk Link to comment Share on other sites More sharing options...
Contrarian Posted August 5, 2012 Share Posted August 5, 2012 I'm curious what you mean by a "primary care CAQ", and how this is different than the PANCE. Or the PANRE, for that matter. Yep... the PANCE/PANRE is the "primary care" CAQ... and it would make no sense to have to take two PANRE's, but where one simply had different acronym. If I remember correctly... you (Ventana) want a "Primary Care CAQ" that leads to Independent practice. I'd argue that the PANCE could/would fill this purpose coupled with a CME and verifiable minimum time in Practicing requirement. Link to comment Share on other sites More sharing options...
Contrarian Posted August 5, 2012 Share Posted August 5, 2012 Hi everyone, I am a prior service Air Force firefighter and am now at a crossroad... [brevity edit}.... My second option would be to complete my B.S. in Emergency Health Science and work as a paramedic until I can get accepted into PA program… Jump start at Nellis AFB: http://jtmlasvegas.com/emt-basic/ Link to comment Share on other sites More sharing options...
bradtPA Posted August 5, 2012 Share Posted August 5, 2012 In NC PAs can sign death certificates now with delegation statement signed by the SP authorizing it. It makes sense for my practice, which is essentially rural with the SP not on site and not familiar with the patient. The one DME requirement that blows me away is the inability to authorize diabetic shoes. I can write their meds, sign for the glucose meters, test strips, and lancets, but not a pair of shoes? Link to comment Share on other sites More sharing options...
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