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

[EMEDPA]

I think I would be more concerned with changing it from a professional certification to a license and increasing the scope of practice to at least the level of current NP's (not requiring direct supervision by a physician, being able to staff a facility solo and have full autonomy on treatment and Rx) would be a higher priority than the title one's called.

 

.

we receive a natl certification and are licensed by individual states to practice medicine.

pa's can already solo staff a primary care practice or emergency dept with full autonomy and no direct physician involvement and physician oversight after the fact(often days to weeks or even a month later). my sp has no real time input into my patient care decisions. maybe one a month I will find a note in my box at work with a suggestion(generally "don't give out so many narcs" as he and I differ a bit on tx of legitimate pain....)

[jdtpac]

I think I would be more concerned with changing it from a professional certification to a license and increasing the scope of practice to at least the level of current NP's (not requiring direct supervision by a physician, being able to staff a facility solo and have full autonomy on treatment and Rx) would be a higher priority than the title one's called.

 

Rich

 

ETA: Without the increase in scope of practice and removing the restrictions on autonomy, I can tell you one future PA that's going to be a physician instead....quickly.

 

Your almost got everything right except that a certificate to practice in most states constitutes a license. Example below is the statutes in Ohio. Many states have artery change their laws to reflect that a PA has a license to practice in the state. This was done to mainly clarify our ability to be reimbursed by some insurance companies that were denying payments to PAs because they say we were not license to practice medicine.

 

4730.081 Certificate to practice constitutes state licensure.

For purposes of the Revised Code and any rules adopted under it, a certificate to practice as a physician assistant issued under this chapter constitutes the state’s licensure of the certificate holder to practice as a physician assistant. The certificate holder may present the certificate as evidence of the state’s licensure of the holder to any health care insurer, accrediting body, or other entity that requires evidence of licensure by a government entity to be recognized or authorized to practice as a physician assistant.

Effective Date: 05-17-2006

[uscbigdawg]

I understand that in the real world, PA's can work autonomously. My PA's in the Army did it all the time. However, in the morning when the doctors showed up, the stack of charts signed off by the PA's needed to be over stamped by the doc's. The point I'm making is quite obvious (I think) and that PURE autonomy and the ability to purely own facilities, bill insurance, etc. is the what I would say a good amount of PA's want (including this future one). Without it, I don't see a big reason to stay in the PA world and WILL bridge out of it.

 

ETA: Got it on the licensing part, but I'm referring to the "C," in APA-C. If we're going to fret over names, I would sooner ditch the word certification than I would Assistant. Of course...I'm for ditching that too.

[EMEDPA]

. I hope you're negative attitudes towards the Academy, the profession and your personal experiences in practice are only conveyed in your responses on this forum and not in your professional life. Negativism and pessimism is the cancer that can grow and do more damage to our profession than a lack of title recognition or public education would ever do.

JDT- this came across as fairly insulting. of course we are all professional and deliver excellent care. just because we think the aapa isn't representing our interests doesn't mean we deliver poor care. your statement is like me saying" well, because you are a republican/democrat/libertarian I hope you don't deliver poor care". our stance on a purely political issue has nothing to do with how we practice.

my patients have no idea at all about the current state of pa politics or my stance on any pa related issue. most of them don't even know what a pa is and despite seeing me on multiple occassions (each with my intro as a pa, scripts that say pa, id tags, etc )they all say "hi dr. emedpa". there is no public awareness of what a pa is so the only frame of reference they have for someone seeing them in an er is the physician. most of them probably think a pa is some kind of physician.

in my 25 yrs involved with the pa profession I can remember only 2 pa related major pr exposures for the general american public.; steve hanson with obama and ann davis flubbing the recent npr interview. the aapa won't even advertise the name we have NOW. I might even be happy with that if folks on the st and in the er knew what I was talking about when I say I am a pa. I don't have 5 min to spend with each and every pt to educate them about the profession when I am working solo and have pts waiting 2 hrs to see me already most nights.

[ventana]

 

Ventana – “And yet you propose to know that is best for the profession and actually voted against it in spite of 6500 ESTABLISHED EXPERIENCED PA's thought”. 6500 pro title change PAs divided by 90,000 practicing PAs = 7.2% clearly not a majority, yet any measurable amount of concerned individuals whose concerns should rightfully trigger a signal to the leadership in the Academy. The response that individuals on this forum expected from leadership was to have each of those 6500 PAs receive some form of correspondence addressing their concerns. The result was that the Academy leadership and staff decided to develop a survey(results above), include the entire profession in that survey and share their conclusions of the survey with not only the general membership but the entire profession. Then prior to the HOD provide the delegates with a report that outlined the Academy's concerns and their findings of what the possible ramifications of a title change might entail. Based on this information the delegates voted as I mentioned above..

 

to point out the obvious

I only stated that 6500 signed

 

if you follow politics at all a 7.2% (6500/90,000) is not a % to be ignored - heck my local elections typically get about a 20% showing and sometimes are as low as 15%, the 2008 presidential election only had about a 60% showing so this statement by >7% of actively practicing PA's is a pretty impressive figure.

 

As well the "numbers" you so happily post on show that only about 14,000 PA's answered - what about the other 76,000? By no means are these numbers perfect.

 

Why would they not even allow the formation of a committee to study it? The only reason I can think honestly is a disconnect with the PA's in the field. Heck there now is not even the possibility of a debate on this issue - and I again ask WHY the AAPA released essentially a position statement on it BEFORE it was voted one, and one that by your own words only pointed out all the negative of the name change (cost expense, hassle - oh yeah and heaven forbid more work for the AAPA staff)

 

In my mind the tail is wagging the dog when stuff like this happens and it STINKS

[physasst]

JDT- this came across as fairly insulting. of course we are all professional and deliver excellent care. just because we think the aapa isn't representing our interests doesn't mean we deliver poor care.

my patients have no idea at all about the current state of pa politics or my stance on any pa related issue. most of them don't even know what a pa is and despite seeing me on multiple occassions (each with my intro as a pa )they all say "hi dr. emedpa". there is no public awareness of what a pa is so the only frame of reference they have for someone seeing them in an er is the physician. in my 25 yrs involved with the pa profession I can remember only 2 pa related major pr exposures for the general american public.; steve hanson with obama and ann davis flubbing the recent npr interview.

 

I would keep your eyes peeled for an article coming out on Monday or Tuesday in Business Insider and possibly the WSJ Blog about PA's, name change, and disruptive innovation......when you have a big bullhorn occasionally you have to use it.

[EMEDPA]

Why would they not even allow the formation of a committee to study it? The only reason I can think honestly is a disconnect with the PA's in the field. Heck there now is not even the possibility of a debate on this issue - and I again ask WHY the AAPA released essentially a position statement on it BEFORE it was voted one. In my mind the tail is wagging the dog when stuff like this happens.

they are afraid that any result showing it was feasible would result in a movement to then pursue it...and you can't do that...it might piss off physicians and the aapa of today is all about team care and the PHYSICIAN-pa care model of subservience....aren't we collaugues with physicians? isn't it time the aapa started saying publicly in forums other than their own newsletter that pa's practice medicine?

I am not asking for independence. I just want recognition for the important work I and other pa's do in the trenches. we are not assisting anyone, we are practicing medicine in affiliation with physician sponsors who remotely oversee our care and allow us a large amount of autonomy...to hear the aapa tell it(per the npr interview) we hand drs instruments and see colds and suture for doctors all day after the doctor has checked the patient already and said it is ok for us to proceed....

[EMEDPA]

I would keep your eyes peeled for an article coming out on Monday or Tuesday in Business Insider and possibly the WSJ Blog about PA's, name change, and disruptive innovation......when you have a big bullhorn occasionally you have to use it.

did you write it Dr. Physasst? if so ( or even if not) could you post it here when it comes out?

Thanks-e

ps: nice chatting with you the other night by phone.

[EMEDPA]

I understand that in the real world, PA's can work autonomously. My PA's in the Army did it all the time. However, in the morning when the doctors showed up, the stack of charts signed off by the PA's needed to be over stamped by the doc's. The point I'm making is quite obvious (I think) and that PURE autonomy and the ability to purely own facilities, bill insurance, etc. is the what I would say a good amount of PA's want (including this future one). Without it, I don't see a big reason to stay in the PA world and WILL bridge out of it.

 

ETA: Got it on the licensing part, but I'm referring to the "C," in APA-C. If we're going to fret over names, I would sooner ditch the word certification than I would Assistant. Of course...I'm for ditching that too.

you don't have to list the C. many folks just have john doe, pa on their name tags. (you have to have it but you don't have to display it to practice). when I finish my doctorate I am planning on changing my name tags from pa-c, emt-p to pa, dhsc.

[jdtpac]

JDT- this came across as fairly insulting. of course we are all professional and deliver excellent care. just because we think the aapa isn't representing our interests doesn't mean we deliver poor care. your statement is like me saying" well, because you are a republican/democrat/libertarian I hope you don't deliver poor care". our stance on a purely political issue has nothing to do with how we practice.

my patients have no idea at all about the current state of pa politics or my stance on any pa related issue. most of them don't even know what a pa is and despite seeing me on multiple occassions (each with my intro as a pa )they all say "hi dr. emedpa". there is no public awareness of what a pa is so the only frame of reference they have for someone seeing them in an er is the physician. in my 25 yrs involved with the pa profession I can remember only 2 pa related major pr exposures for the general american public.; steve hanson with obama and ann davis flubbing the recent npr interview.

 

EMEDPA ,

I have always respected your opinions but in this case I do not believe my comments are not anymore insulting than the comments by others on this forum who choose to always degrade and defame the Academy. I hear what you are saying and can sympathize with you because I have been in those same situation. I have constantly reminded my patients that I am not a physician but no matter what you say to them their response generally to me was always," I know that you're a PA but you're a doctor to me". I have even had situations where my patient has told the nurse they want to speak with the doctor and when my supervising physician comes in the room the patient responds by saying," I wanted to talk to Mr. Trimbath".

 

I can understand concerns about public relations but I think your opinion is very myopic. In my 35 years as a PA of which I have been involved in the Academy for almost 30 of those years I have much different opinion. The Academy has spent millions of dollars fighting for legislation that allowed you to have the scope of practice that you enjoyed today. The Academy has spent 100s of thousands of dollars over the years producing public education materials that was intended for individual PAs and the constituent organizations to share with their physicians, other health care providers and the public. They have made many public service announcements and provided them to the constituent organizations to be given to local TV and radio station. I cannot tell you how many times I have been asked by local newspapers, radio and TV stations to give comments about our profession. We have held all types of events around the state (like many other constituent organizations have) during PA week to promote the profession. I will give you an individual example: The Cleveland Clinic physicians and staff knows what a PA is thanks to Josanne Pagel. During one of the PA weeks she and her PAs did a wonderful job of setting up displays, holding daily events and even went as far as taking pictures of all the individual PAs and putting them on the walls of the walkways of the parking garages connecting to the hospital. There are over 350 PAs in this system who are a credit to the profession. The tools for the grassroots PAs to educate the public has always been developed with a high level of professionalism by the Academy, maybe we should be laying the blame on the individual PAs and constituent organizations for not doing a good enough job of profiling and promoting our profession. What more do you want the Academy to do for you(our profession) that we have been not doing for ourselves?

[EMEDPA]

how about paying for these public service announcements themselves instead of asking us to do it? I have never seen one and have worked as a pa in 3 states and was a pa student in 4 others. that's why we pay dues so that they will promote our profession both to the public and to legislators(which has been their focus in the past and something I do appreciate). I hang up potsers for pa week every year and they generally get taken down within the week by the nursing supervisors. ( I always choose ones that say "PA" not Physician assistant.)

the academy can tell me I am not an associate but they can't tell me I am not a PA. I don't have "assistant" on my cv or anything aside from my mandated hospital ID. everything says "emedpa, pa" . I have associations, etc listed in my cv as Society of em pa's, american academy of pa's, pa's for global health, etc

I strive to never say assistant again.

[physasst]

did you write it Dr. Physasst? if so ( or even if not) could you post it here when it comes out?

Thanks-e

ps: nice chatting with you the other night by phone.

 

Will do.....It's one of 3 articles I am writing this weekend (non research) the others are on rationing in health care, and an economic perspective on the historical relationship between successful businessmen becoming successful Presidents (hint: it doesn't work, at least not historically)....ALL will be on AngryBear...http://www.angrybearblog.com. From there, they tend to go viral. Business Insider picks up all of them, WSJ picks up many of them, and multiple other blogs will all link to it. Even Krugman via the NY Times occasionally picks up one of our articles. I'll send the links when it's done....

[EMEDPA]

I'll send the links when it's done....

Thanks.....-e

[physasst]

how about paying for these public service announcements themselves instead of asking us to do it? I have never seen one and have worked as a pa in 3 states and was a pa student in 4 others. that's why we pay dues so that they will promote our profession both to the public and to legislators(which has been their focus in the past and something I do appreciate). I hang up potsers for pa week every year and they generally get taken down within the week by the nursing supervisors.

 

I've never particularly cared for PA week, and never do anything for it. I'm not a rah-rah kind of person, and I also think that it makes us look silly to physicians and other serious people. Why should we celebrate doing our jobs? It's your job......I think we need to make our focus on getting more autonomy/independence for PAs, more PAs in higher administrative positions (we've done well in the VA and military, but need to focus on the civilian sector), and more PAs in full time research positions, leading research teams. I'll celebrate when we've accomplished all of that....

[EMEDPA]

I'm just hoping that my patients will read the poster and figure out what a pa is/does.

I always post the free ones for pa's in emergency medicine from bill@pa world, not the official aapa ones.

these:

http://healthcarecelebrations.com/

[EMEDPA]

I would seriously entertain the idea of a PA bridge program to DNP so that I can practice to the fullest extent of my training while having a national agency that will stand up and fight for my interests.

 

I am a member of the AAPA and have been for 10+ years but I am pretty frustrated that they would not even give consideration to 6500 PA's saying it needs to be looked at.....

 

ditto. won't happen without being an rn first though. have discussed this at length with contrarian(who is pa/np) and others.

just like you can't be an emt-p without being an emt-basic first.

a hypothetical fnp program that offered a 1 yr online 4 course pa to masters np bridge program would be swamped with applications. won't happen but it's an interesting discussion.

if I was an rn I would certainly do an online np program just for the freedom having an np in addition to the pa would grant in some settings. I know a few folks who have done this.

[EMEDPA]

let's keep on topic please....don't make me put my banning hat on.....:(

[EMEDPA]

Just replying to physassts bait.

fair enough.

now back to our regularly scheduled programming...

[EMEDPA]

Aaargh! Why should PAs have to wish they could get an NP cert?( I know why, I'm just asking the question rhetorically). Just the interest of PAs in such a thing should wake up the AAPA....

 

I bet there are NPs in their leadership that would love to set up a program like that and use it in their marketing.

won't happen because then they would have to admit that pa training is equivalent to rn+np. any pa to fnp bridge grad could practice as an rn, an np,or teach at a nursing school. it would undermine the np educational process(but it would make them tons of cash).

in both states in which I currently practice np's are "independent" and many practices (but not all) don't require them to have md oversight or cosignatures. the best er md group in my area only uses np's because they believe pa's increase their liability when they cosign a chart. I volunteer with one of the docs from this group in Haiti and he much prefers my approach and skill level but told me his group is too risk averse to conider adding pa's.

if I did a bridge I would keep both certs but at some jobs I would practice as an np and at others as a pa depending on local politics.

this is why I try to convince all rn's considering pa school to do the dual pa/np program at uc davis. some place like pa's, some like np's. being both is the ideal solution. work anywhere, anytime.

[EMEDPA]

Aaargh! Why should PAs have to wish they could get an NP cert?( I know why, I'm just asking the question rhetorically). .

for those who don't know the answer to your rhetorical question it is not because of the training, it is because of the support of an organization that actually promotes you to the general public, the institute of medicine, etc.....

[Contrarian]

... The point I'm making is quite obvious (I think) and that PURE autonomy and the ability to purely own facilities, bill insurance, etc. is the what I would say a good amount of PA's want (including this future one). Without it, I don't see a big reason to stay in the PA world and WILL bridge out of it.

 

But this is part and parcel to the "fret over names"...

 

You won't get any of the above as a "ASSISTANT"...

"Assistants" can't have "pure autonomy"... cause if they did... then they wouldn't be "supervised assistants"

"Assistants" don't need to independently bill insurances... the folks they assist already can.

 

If no one wants you to "assist" them... you are unemployed.

If you are completely "autonomous... you are no longer a "assistant"

The people you "assist" bills for the work they allow you to perform.

 

Seriously... think about that for a moment.

[andersenpa]

I have been following the debate on this forum regarding the title change issue for over a year and I am always concerned when I see individuals misquoted or misrepresenting the facts:

 

polarbebe - “Walk in the shoes of an experienced PA and you may change your mind... the majority of PAs favor name change” . Below are the results of the survey the Academy did on the title change issue. Although 45.5% is a plurality it is not a majority, however the voice of those individuals should be taken in consideration when this issue is debated. This is why I state that I am neutral on this issue and was of the 20.9% of the Unsure voters. I debated in favor of and voted for the resolution to create a task force to look into the ramifications of a title change at the HOD in Toronto. The debate was civil, collegial and in the end the vote was very close. The majority vote was cast by individuals that represented all the constituent organizations of the Academy. These individuals collectively are considered the voice of the profession. Therefore your statement is incorrect and only anecdotally based on your personal observation.

[TABLE]

[TR]

[TD]6735[/TD]

[TD]4982[/TD]

[TD]3091[/TD]

[TD]14808[/TD]

[/TR]

[TR]

[TD]45.5% [/TD]

[TD]33.6% [/TD]

[TD]20.9% [/TD]

[TD]100.0%[/TD]

[/TR]

[TR]

[TD]For[/TD]

[TD]Opposed[/TD]

[TD]Unsure[/TD]

[TD]Total[/TD]

[/TR]

[/TABLE]

 

 

In 16 states there was a mathematical majority. You could ask a statistician about the unsures, but if 20% of them voted in favor you are at a 50% pro vote. It's a debatable majority which I think a reasonable mind could accept.

 

 

Ventana – “And yet you propose to know that is best for the profession and actually voted against it in spite of 6500 ESTABLISHED EXPERIENCED PA's thought”. 6500 pro title change PAs divided by 90,000 practicing PAs = 7.2% clearly not a majority, yet any measurable amount of concerned individuals whose concerns should rightfully trigger a signal to the leadership in the Academy. The response that individuals on this forum expected from leadership was to have each of those 6500 PAs receive some form of correspondence addressing their concerns. The result was that the Academy leadership and staff decided to develop a survey(results above), include the entire profession in that survey and share their conclusions of the survey with not only the general membership but the entire profession. Then prior to the HOD provide the delegates with a report that outlined the Academy's concerns and their findings of what the possible ramifications of a title change might entail. Based on this information the delegates voted as I mentioned above.

 

2 things- first, the 6500 include students, to be completely accurate. Second, the 6500 should have been acknowledged. So no, a personally addressed letter was not the expectation. I was not in Toronto but I have heard that the 6500 were not adressed on the floor (anyone who can refute this claim???)...furthermore, no public announcement from the AAPA to say "yes, we have heard you, a significant portion of the constituency we declare ourselves to serve". Nothing came from the AAPA until the survey.

 

To the title change proponents on this forum:

If you're still dissatisfied with the outcome you need to come back to the HOD with another resolution that contains facts and not anecdotal information. Do not rely on leadership (Academy Board of Directors) to be able to change the title because that is not within their authority. I(We the delegates elected by our constituents) heard your concerns, and voted on the issues based on the facts. Unfortunately, we do not all practice in the same environment, we all don't enjoy total autonomy and we all don't gain equal respect and recognition from physicians, other health care providers or the public. This is not to say that the Academy isn't trying to do everything it can to make that happen. I hope you're negative attitudes towards the Academy, the profession and your personal experiences in practice are only conveyed in your responses on this forum and not in your professional life. Negativism and pessimism is the cancer that can grow and do more damage to our profession than a lack of title recognition or public education would ever do.

 

Does the AAPA president not have the authority to name an ad hoc committee to investigate the matter?

[EMEDPA]

Does the AAPA president not have the authority to name an ad hoc committee to investigate the matter?

he is afraid of the aapa staff. he feels that his job as president is not to rock the boat but continue business as usual.

[jdtpac]

he is afraid of the aapa staff. he feels that his job as president is not to rock the boat but continue business as usual.

 

You two have no idea of what you are saying!thesse last 2 posts are way out of line! You both haven't got a clue of what happens in the Academy.

[EMEDPA]

You two have no idea of what you are saying!thesse last 2 posts are way out of line! You both haven't got a clue of what happens in the Academy.

the next president of the aapa(herman) said he would support a committee to investigate name change while he was running for office. that is why many of us supported him.

let's see if he is true to his word when he takes office.

these are the folks who actually run the aapa. none of them were elected yet they set and enforce policy:

http://www.aapa.org/about_aapa/staff.aspx

only one of them is a pa.

this is listed on the same page. I laughed out loud:

 

"Listening is the foundation that drives all leadership decisions at AAPA. What are our members telling us? "