Why not "Associate Physician" instead of "Physician associate"?

[andersenpa]

the delegates in the HOD did not circumvent anything. Were you there to observe the debate, I was? IMO, the issues were debated in open forum, both sides presented there cases in a collegial and civil manner and in the end the vote was very close.100 individual signing and supporting a petition is admirable and there is a lot of information in that petition that could be debated. However, a well-developed factual policy statement from one or more of the officially recognized specialty organizations would be more creditable. And not just a statement stating that they support a title change. I would like to see several of the specialty organization unite, develop policy/position statement and then create a resolution to be submitted at the 2013 HOD. Just because the issue failed to achieve your desire results at the 2012 HOD does not mean you should continue to pursue your goal. However eventually we must put this issue to rest and focus on the more important things that face our profession. I still don't believe that a title change is in any way going to change our future potential increase in scope of practice.

 

I'm not clear why "we must" put this issue to rest. And with all due respect what you personally "believe" has little bearing on the matter. The issue is the collective voice and desires of the nation's PAs. It sounds like you are more interested in driving the decision rather than let it play out by its own merits.

I am merely echoing EMEDPAs comments, but the fact remains that >6000 PAs and PA students signed a supportive write in campaign to the AAPA (which went unanswered), the AAPA released a survey in which 37 states had more supportive votes than not, and in 16 of those states there was an outright majority.

 

You seem to accuse us of using our personal agenda to drive the debate yet you do that very thing in trying to dismiss the issue or its advocates. The name change group written in quotes as a way to deligitimize it? Already several organizations have voiced support, but now we need "more" groups to unite? Will the goal line be moved again after that is achieved?

 

 

One of the hallmarks of a good leader is to not dismiss the concerns of others. If you are a PA leader then the first step would be to listen and respect what others support without attempting to dismiss it based on your own agenda.

[andersenpa]

if it gets put to rest without name change, the i would bet that marks an accelerated decline of the aapa. you have over 40 percent of PAs that indicated that as an important issue.

 

what i see happening if this gets benched is that it will highlight how mickey mouse things have become, and PAs wont be making advances down the line. youll see PAs going more to the specialties, and NPs taking over general practice with thier DNPs. more and more, PAs will identify as "cardiology PA", or "emergency PA", or "surgical PA", because they will be marginalized to either niches, or be practicing under conditions that always trail NPs.

 

jdtpac, you are the poster boy for someone choosing NP vs PA... it in how you advocate for a timid approach to advancing PAs.

 

The failure or success of this measure has nothing to do with PAs entering PC vs specialties.

[andersenpa]

Implying a representative rolled over and didn't support a stand for title change completely, totally and in whole discounts the constituency that supports the status quo and that EXPECTS the vote to reflect that....

 

They are there to represent us, Which it appears they did as retold by those that attended.... It was debated. There was a vote, and ruled out.

 

If this isn't what happened, then there must be official minutes kept.. Perhaps get them and post them online... To add some clarity to what happen

 

I've tried. There is no official tally of each delegate vote so I cannot take my state delegates to task. Nor am I able to get official minutes depsite requests to the AAPA. Transparent, huh?

 

Nothing about this could lead you to say that we were represented. The delegates represented thier internal interested. There is no way they could have represented their constituents given the results of the census. Read my above post. 37 states pro associate. 16 of those an outright majority.

 

The status quo is not something to be defended but rather something to be consttantly challenged. A principle that this COUTRY was founded on and a good lesson for our national body to follow. The constituency should expect their representatives to represent the PAs of their state or organization, NOT their personal politics.

[ventana]

I don't believe there is such a program and if there was you couldn't get into it if you were not first a nurse, then an NP....they aren't going to let PA's into a nurse practitioner led program without being an NP....also...what makes you think they have more privileges than you do now? Just because they hold the DNP degree doesn't let them practice medicine any different than you do. That would be their desire, but state legislation regulates that and you can be sure physician led organizations are NOT going to give those privileges to anyone who has not graduated from a bona-fide medical school.

 

 

Nurses control their own fate - if they want to create a new PA -- > DNP program I would not put it past them if they think it will benefit them (and I am starting to think it would ba a great idea)

 

As for PA and NP being the same - wow that is just not true in the business sense - and it is scary to think that you as one of the senior PA's and AAPA member is so entirely clueless about this

 

PA's can NEVER direct bill

PA's have exactly ZERO states where they do not need an SP (I think NP's have independent practice is something like 16 or 18 states)

PA's can not own 100% of a corporation and bill medicare (1% owned by other person but in most states with laws preventing the corporate practice of medicine that means that the 1% has to be owned by a MD/DO)

NP's can own their own practice, bill directly, can sign off on somethings that I can't (can't remember but think they can sign LTC or something else)

 

 

and their National agencies are actually advancing their career field

 

 

 

 

know your facts before you make statements that are lies...

[ToppDog]

true. i just think that name change would contribute to less ground being ceded. i dont think its a good idea to neglect a focus on PC.

 

Agree, A big part of the problem that has PA's focusing less on PC is the fact that MDs increasingly are abandoning it, so there are fewer of them to be supervising providers; plus the additional costs of going to higher degrees has many new PAs seeking out specialties to make more money to pay off these larger loans. It's sad really. Having greater autonomy could fix this, & it all begins with the name change.

[andersenpa]

Nurses control their own fate - if they want to create a new PA -- > DNP program I would not put it past them if they think it will benefit them (and I am starting to think it would ba a great idea)

 

As for PA and NP being the same - wow that is just not true in the business sense - and it is scary to think that you as one of the senior PA's and AAPA member is so entirely clueless about this

 

PA's can NEVER direct bill

PA's have exactly ZERO states where they do not need an SP (I think NP's have independent practice is something like 16 or 18 states)

PA's can not own 100% of a corporation and bill medicare (1% owned by other person but in most states with laws preventing the corporate practice of medicine that means that the 1% has to be owned by a MD/DO)

NP's can own their own practice, bill directly, can sign off on somethings that I can't (can't remember but think they can sign LTC or something else)

 

 

and their National agencies are actually advancing their career field

 

 

 

 

know your facts before you make statements that are lies...

 

Is it true that pas cant direct bill? I thought i have heard contract surg pas that bill on their own.

 

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[jdtpac]

One of the hallmarks of a good leader is to not dismiss the concerns of others. If you are a PA leader then the first step would be to listen and respect what others support without attempting to dismiss it based on your own agenda.

 

Your opinion of my dismissing others concerns is completely off base. I have listened and respected everything that everyone on this forum has stated without throwing disrespectful remarks at them personally. I was at the house of delegates and supported/voted for the formation of a task force which unfortunately did not pass. I also spent many weeks behind the scenes prior to the HOD functioning as an arbitrator between the 2 camps that finally decided to pull the 2 resolutions on the title change and concentrate on the issue of developing the task force. In my last post, I think am encouraging those who are dissatisfied with the outcome at the last house of delegates to continue to pursue your objectives and resubmit them at the next HOD. And I'm sure those who know me well will admit that my personal opinion has never overshadowed my desire to see the profession prosper.

 

As far as saying that 37 states had a larger number of PAs in favor of a title change may in fact be true but in most instances they were less than a majority(40-45% in most instances) and there was a large number that were undecided (20-25% on average per state). It was those undecided votes which convince me to support the formation of a task force. In another post you mentioned that there is no tally of how each delegate voted, that would be a roll call vote, which in my 28 years as a delegate never saw that happen. You also state that because of this there is no way for you to take your state delegate to task. If you feel that strongly about knowing how you're delegation voted you should be able to go to them directly. We have been bantering this issue for as long as I can remember and the outcome has always been the same. I think the majority of PAs are not convinced that expanding the resources to address a title change has any impact on expanding our scope of practice. Personal provide aside, the reality is our branding has been established and what we need to do is expend the resources to market us better.

 

Always enjoy discussing the issues and sharing differing opinions.

[LIPPER]

 

Nothing about this could lead you to say that we were represented. The delegates represented thier internal interested..

Again;

Was their discussion on the floor or not? According to those who attended, there was.

Was there a vote or not? According to those who attended, there was.

The Delegates represented "we"....they represented the platforms on which they were elected by "we"...if we elected enough representatives that ran on a platform of change, then a legitimate arguement could be made. Is this the case?

I've tried. There is no official tally of each delegate vote so I cannot take my state delegates to task. Nor am I able to get official minutes depsite requests to the AAPA. Transparent, huh?..

On this I definitely agree with you...There should be an official transcript, vote count etc....

 

Look, I'm just not willing to ceede to an arguement of conspiracy and laziness just because. I just refuse to believe that our leadership is so insane as to believe that only they know whats best. without copnsideration for the future..... Quite simply because I agree with the decision.. and I'm not lazy, or naive *Keep your comments to yourself* ;)

[LIPPER]

I think the majority of PAs are not convinced that expanding the resources to address a title change has any impact on expanding our scope of practice. Personal provide aside, the reality is our branding has been established and what we need to do is expend the resources to market us better.

.

 

That is it in a nutshell.

[Hemegroup]

That is it in a nutshell.

 

Tell that to the patient who applied for his own clinic and received a notice from the Association of Medical Assistants. Give it up, you're losing this one.

[coloradopa]

I've tried. There is no official tally of each delegate vote so I cannot take my state delegates to task. Nor am I able to get official minutes depsite requests to the AAPA. Transparent, huh?

 

Nothing about this could lead you to say that we were represented. The delegates represented thier internal interested. There is no way they could have represented their constituents given the results of the census. Read my above post. 37 states pro associate. 16 of those an outright majority.

 

The status quo is not something to be defended but rather something to be consttantly challenged. A principle that this COUTRY was founded on and a good lesson for our national body to follow. The constituency should expect their representatives to represent the PAs of their state or organization, NOT their personal politics.

There are no minutes as such. The action on each bill is available on the website under the HOD.

 

As far as representative, each state has a different process for delegates but for most the delegates are elected by the members of the state chapter. Just like members of congress delegates are free to vote as they wish. The expectation is what the members that elected them want and communicate.

 

I can tell you what I saw from the podium. Most of the yes votes for the studies were from the specialty organizations. The no votes were overwhelmingly from the state delegates. They are the ones that you have to convince. They are the ones that know the cost and effort that would go into a name change. They are almost universally uninterested. If you want to change the vote, you would need to elect delegates that agree with you. That's the only way that there will be change.

[ventana]

Is it true that pas cant direct bill? I thought i have heard contract surg pas that bill on their own.

 

Sent from my DROID RAZR using Tapatalk 2

 

PA are specifically banned from direct billing - the only way to bill for PA services is by signing an Assignment of Benefits to either you SP, a corp or your employer.

 

NP's on the other hand can direct bill...... meaning then can set up a practice, own it 100% and bill directly and only with their PIN

 

HUGE DIFFERENCE -- the NP's were much more succesfull at protecting and expanding then the PA's

[jdtpac]

Tell that to the patient who applied for his own clinic and received a notice from the Association of Medical Assistants. Give it up, you're losing this one.

 

 

This statement makes absolutely no sense! what do you mean by "applied for his own clinic"? *who did he apply to for what and what does this have to do with medical assistants?

[Hemegroup]

This statement makes absolutely no sense! what do you mean by "applied for his own clinic"? *who did he apply to for what and what does this have to do with medical assistants?

 

Sorry, yes, my mistake, I meant the PA who applied for his own clinic and was contacted by the Medical Assistant association. I was writing in the middle of seeing a slew of patients, sorry.

[jdtpac]

And that's a good point.... It's jm11... Starting his own headache clinic. He's given us all front row seats to his struggles. Were he an NP, he'd be set.

 

 

*it must be the state he practices in. I know of a few PAs in Ohio that own their practice. Leased a bldg., hired a SP and started practicing. Realistically, there are a relatively small group of either PAs or NPs who own or operate a clinic.

[EMEDPA]

*it must be the state he practices in. I know of a few PAs in Ohio that own their practice. Leased a bldg., hired a SP and started practicing. Realistically, there are a relatively small group of either PAs or NPs who own or operate a clinic.

if I am not mistaken it is 4-5% of pa's. the same as the # of np's who own/operate.

David carpenter would know. he has posted the stats in the past.

[LT_Oneal_PAC]

A good question would be how many more PAs would own if it were easier to get loans and not mistaken for assistants by the bank, as has been demonstrated twice on this forum, amongst numerous other problems relating to be seen as an assistant.

[Contrarian]

HemeGroup is probably referring to JmJ11... who like me and several others here, owns his own practice.

I believe, Mike (JmJ11) had been "initially" denied several insurance contracts, bank loans, etc... due to the confusion the word "ASSISTANT" causes MOST of the lay public (consumers).

 

People just can't wrap their minds around the notion that ... as "assistants"... there MUST be someone present for us to "Assist."

 

 

For example..

As was in my original business plan, we are adding pain management to our "lines of service." In my opinion, to do this correctly, this means that we must add small and large joint injections.

 

So to accomplish this... over the last 2 months, I've been shopping for some Ultrasound equipment.

I called several US manufacturers and explained what my goal is then left contact info for reps to do demos.

Each and every one of them has either asked to speak with "the doctor I work for," or has given me info and basically instructed me to tell the physician I ASSIST what the benefits of their products were.

 

One even told me that they would pay for/subsidize a mini ultrasound internship for the physicians in the practice. When I told her that it would be a non-physician using the equipment and doing the injections, she said that the internship was only for physicians... and that the company would only pay for physicians. I then explained that I am the business/clinic owner and therefore decide WHAT machine from which company we would use and the sole clinician onsite and would be doing the US guided injections. She didn't know how to respond to that so had her supervisor call me.

 

 

Supervisor called and asked to speak with the DOCTOR that I worked for...:heheh:

[jdtpac]

Hire an SP....

 

NPs find a physician to collaborate with (in places where they aren't independent)

 

It's not the notion of opening my own clinic that appeals to me, it's me being able to not be tied at the feet of doctors.... To take my license elsewhere if I want. To not have to have to answer questions like they ask in pa school interviews like "what would you do if your supervising physician/boss is making a medical decision after having a several stiff drinks?"

 

Collaborate or SP, it does not make any diff! Some physician is still getting paid for back up. PAMAC sounds like you need to go to med school!

[andersenpa]

Again;

Was their discussion on the floor or not? According to those who attended, there was.

Was there a vote or not? According to those who attended, there was.

The Delegates represented "we"....they represented the platforms on which they were elected by "we"...if we elected enough representatives that ran on a platform of change, then a legitimate arguement could be made. Is this the case?

On this I definitely agree with you...There should be an official transcript, vote count etc....

 

Look, I'm just not willing to ceede to an arguement of conspiracy and laziness just because. I just refuse to believe that our leadership is so insane as to believe that only they know whats best. without copnsideration for the future..... Quite simply because I agree with the decision.. and I'm not lazy, or naive *Keep your comments to yourself* ;)

 

 

My contention is that the discussion was based on unfounded claims of cost and risk. I say this based on the reports of friends who were there and the public statements released from the AAPA and delegates. So, debated or not, the issue was confounded from the beginning. Look at how the led the questioning with cost in the initial survey. Unacceptable. I expected a lot more from my professional society, and was deeply let down. The AAPA failed me and thousands of other PAs with their agenda.

 

Re delegates, none of these individuals ran on the item of the name change in their platform. It wasn't an issue when they ran. So their constituents would have no expectation to know how they would vote on it. Like myself and others, state chapter PAs expect their delegates to follow the consensus of their members on a specific item such as this.

 

I believe the next election will play out with more delegates questioned on this.

 

Look, I'm just not willing to ceede to an arguement of conspiracy and laziness just because. I just refuse to believe that our leadership is so insane as to believe that only they know whats best. without copnsideration for the future..... Quite simply because I agree with the decision.. and I'm not lazy, or naive *Keep your comments to yourself* ;)

 

This is exactly what they've done. In their words, the issue had no merit. An issue with survey data to support its merit. An issue with a write in campaign that doubled the numbers of the last AAPA election. I don't think it's laziness; actually the contrary. An active movement from our hemorrhaging national society which defies the will of thousands of its members who merely ask the AAPA to STUDY the matter. Effete leadership from an organization who IMO is not seeing the real future and potential of this fine profession.

[andersenpa]

Collaborate or SP, it does not make any diff! Some physician is still getting paid for back up. PAMAC sounds like you need to go to med school!

 

The unfortunate fact is that a functioning licensed SP is lynchpin of PA practice. SP quits, dies, moves, loses his license, etc, PA is hosed. Not all NPs suffer this fate.

[andersenpa]

And that's a good point.... It's jm11... Starting his own headache clinic. He's given us all front row seats to his struggles. Were he an NP, he'd be set.

 

It's Ventana I think that we're referring to. Mike had his struggles as well.

 

http://www.physicianassistantforum.com/forums/showthread.php/36166-Nah-we-don-t-need-a-name-change!!!!!!!!!!!!!!!!-WHAT

[andersenpa]

This statement makes absolutely no sense! what do you mean by "applied for his own clinic"? *who did he apply to for what and what does this have to do with medical assistants?

 

See above.

[physasst]

Right now is THE best time to do this because of the dialogue about cost containment. Yet business as usual is going to throw this game too. Need 40000 new physicians? Give PAs more independence and we'll make up more than a quarter of that number for you at half the cost of what a quarter of those physicians would be. But the condition is that they need parity with NPs.

 

I really don't need to go to med school to satisfy my goals Jdtpac, because NPs pretty much could provide it (or are on the track to at least fighting for it).What I'd like is for PAs to have even half as much the difference as NPs do, and even that would be fine. But I think it's unfortunate that you respond to that desire by suggesting med school is the answer instead of Pa? You should have just said that A DNP is the answer.

 

This is inaccurate. An NP cannot provide the same services that a physician does...neither can a PA. We can provide the same services in certain patients, but you are showing your inexperience if you think that you can see all of the same patients as a physician can. This is dangerous ground. NP's have independence sure, but less than 2% of them practice independently based on the last numbers I saw. Why? Cause it's not the same. No matter what the NP leadership has said in the past, a DNP does not grant equivalence to an MD/DO in primary care....neither does a PA degree.

 

I am currently working in a PM&R spine practice and am completing the same training program the fellows go through. I had to take a pre-test, which I scored decently on, but was extremely difficult (and I have 7 years of Orthopedic experience, and 2 years of Neurosurgical Spine training already) This group wants me to have my own "independent" practice, but I already know, after being a PA for a long time, that there will ALWAYS be patients that I need some physician help with. Even if it's just a "Hey, can I run something by you.....should I be thinking of anything else?"

 

Don't fall into the trap of thinking that PA or NP training provides equivalence. I have 4 friends that were PA's that went back to med school....everyone of them said it was much more difficult than PA school and they learned things that they never learned in PA school. The biggest thing about being a PA (or an NP I would argue)....know your limitations....

[physasst]

Th above was just a long way of saying that it isn't 1:1.....

 

So, when we do workforce research, and run analysis and projections. We currently are looking at a projected shortage of about 140,000 physicians by 2025. 65,000 of which are in primary care. But we can't simply say...."Hey, if we train 65,000 PA's and NP's we can eliminate the shortage".....It doesn't work like that. It's not a 1:1 replacement. We don't know what it is, but let's assume 90%. We can fill 90% of the shortage, that would mean a need of 58,500 PA's and NP's.......and still have a physician shortage, also, we don't make enough PA's and NP's to fill that many spots. Especially considering the shortage in other specialties......Cardiac Surgery for example is going to have a REAL problem in about 10 years.