Future excess of PAs? Anyone worried?

[LT_Oneal_PAC]

I agree that residencies and CAQ is the future, like it or not. Now that we have it, it's only going to get more prevalent.

 

So the question is: When the above happens, how can state legislatures possibly reconcile the notion in their head that NPs can practice independently (not saying they shouldn't) and we must be supervised with 10% chart review when we (in the future) have minimum two years grad school (true full-time didatic and over 2000 hours clinical), minimum one year residency, and CAQ certified? How can anybody in the profession think we should have these things and not at least move to collaboration?

[EMEDPA]

Depends on how the residency thing happens. If we do a rotating general internship like the do's do( and the md's used to do) you would still have flexibility.

If it was a specialty specific residency then you would lose flexibility but gain scope of practice.

[andersenpa]

The required residency thing kind of bums me out, but I admit I know very little about the subject at all, so if I'm wrong to be bummed, let me know. But to me, one of the appealing aspects of physician assistants is the generalist nature of the training. Seems like getting more committed to a certain zone sacrifices the ability to operate in different fields. Another thing that I think about when folks mention residencies is that I worry it will make PAs less independent because they are typecast into roles where they are more dependent upon physicians in specialties. Just seems dangerous to head that direction and give up one of the remarkable aspects of the Pa field, which is flexibility.

 

It's a non starter for many spec PAs since there is no role for an "independent" PA in neurosurgery, cardiac, nephrology, much of ortho, etc. This is not the NP model of individual silos. PAs have the generalist base to allow transitions. But they have the next level for specialties. Residency, CAQ, etc formalizes (and IMO legitimizes) the specialty training process. It's a necessity from what I've seen in my 12 yrs in surgery.

[EMEDPA]

So are PAs in those areas you mention generally there to stay anyway, and residencies shore them up?

yup. not too many em pa's decide to do ortho later in their careers...they would have to go back and take woodshop for that....:)

[EMEDPA]

nope. all pa's can always fall back on primary care as pance/panre focus on that.

my thought is that future pa's will all be able to do primary care but for anything in specialties they will require residency and caq.

[Mainer]

Am I understanding this correctly - that there are a very limited number of residency spots for PA's?

 

Further, i'm not sure how focusing on the improvement of PA specialty training fills projected market demands (which I interpreted to be mostly general medicine). Although I recognize that residents fill voids in healthcare....

[EMEDPA]

there is a demand for pa's in primary care as well as all specialties.

pa's right out of school can do primary care as our training focuses on that. physician specialty societies are wanting some objective measurement of proficiency to practice, thus residencies and caq's.

there are 19 residencies in em now with a new one every few months. there are also lots of surgical residencies and a few in lots of other specialties like ortho, der, nephrology, neuro and neuriosurg, ent, etc

to see all residencies check www.appap.org

[andersenpa]

Am I understanding this correctly - that there are a very limited number of residency spots for PA's?

 

Further, i'm not sure how focusing on the improvement of PA specialty training fills projected market demands (which I interpreted to be mostly general medicine). Although I recognize that residents fill voids in healthcare....

 

The number of residency seats is still much less than the spots needed to fill in the workforce. Specialty practice is a different animal and needs to be treated differently than the primary care gap. Emedpa stated the reasons why.

 

Sent from my DROID RAZR using Tapatalk 2

[Guest JMPA]

"physician specialty societies are wanting some objective measurement of proficiency to practice, thus residencies and caq's." who cares what "physician societies" want. So our certification is not enough of "objective measurement of proficiency to practice"? Residensidency and caqs? really? with all that forget PA and just go MD. that is too much requirement for minimal return and lifetime of "Assitant".

[EMEDPA]

physicians hire us. they often don't want to hire new grads or those without specialty specific experience.

pance says one is competent at practicing primary care only but 60% of pa's today go into specialties.

[andersenpa]

So our certification is not enough of "objective measurement of proficiency to practice"?

 

No, not completely, not for specialty practice. PA school training is generalist. There are no objective measures of competency for specialty PAs outside of maybe specialty specific CME.