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So, I am a hospitalist PA with almost 5 years of experience at a large urban hospital in the Pacific Northwest. I have worked at the same hospital since graduating from PA school and have gained valuable skills and abilities and feel confident in my practice of hospital medicine. 

I was interested in potentially relocating to another city within the PNW, and so started looking into job opportunities. 

Providence Medical Group (PMG) is one of the largest healthcare providers in the Northwest and the largest healthcare provider in Washington. 

Unfortunately as I browsed their job postings, I realized that they have a strong bias towards nurse practitioners, particularly in the field of hospital medicine. As you can see from the following job postings, specifically listed for hospitalist NPs: 

 

Providence St. Vincent in Portland: 

https://jobs.psdconnect.org/partner/providence/jobs/?jobId=18757

Providence Medford 

https://jobs.psdconnect.org/partner/providence/jobs/?jobId=19011

Providence Sacred Heart Spokane 

https://jobs.psdconnect.org/jobs/?q=hospitalist&page=3&jobId=11101

 

I reached out to a recruiter about one of these jobs, highlighting my experience and asking if they would consider a PA for one of these positions. This is the response I received: 

Thank you for your interest in opportunities with Providence in ***. At this time, the group is only seeking ARNP candidates so they can function independently at the hospital. Please feel free to keep an eye on our website at www.psdrecruit.org for other opportunities of interest and best of luck in your search!

So now I'm feeling pretty frustrated and disappointed and wanted to reach out to the forum to see if anyone else had similar experiences or advice.

The irony is that they prefer NPs over PAs because of independent practice, however I honestly feel so confident in my current abilities and experience because of the collaboration I have had with physicians throughout the beginning of my career. At this point I feel confident practicing independently the majority of the time, however legally of course we do not have independent practice. 

Any thoughts or advice? 

welcome to the new reality where we are being replaced by NPs and our national organization is spending most of its time on whatever the PC flavor of the week is.

Full autonomy is the only thing that is going to let the profession survive but I think its too late even if we started now. We are too far behind to catch up....and we continue to dither and dawdle and half step.

I too have refused care from NPs for the same reason particularly in primary care. I'm sure there are some great ones but why take the chance? My recent experiences in primary care, urgent care, and even in the ER have been horrible.

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44 minutes ago, iconic said:

A big part of issue is we have surgical PAs (and others) or PAs in backwater states who think that these issues do not affect them 

We have a lot of PAs who are perfectly comfortable and participate in the HOD and other places where they effect policy. Combined with PAs who are already retired or semi retired who have an over sized voice and will be unaffected when they turn out to be wrong.

I got tired of being shouted down for gloom saying. I have (checks desk calendar) 1355 days until I pull the ripcord. I feel for the youngsters in the profession.

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28 minutes ago, sas5814 said:

We have a lot of PAs who are perfectly comfortable and participate in the HOD and other places where they effect policy. Combined with PAs who are already retired or semi retired who have an over sized voice and will be unaffected when they turn out to be wrong.

I got tired of being shouted down for gloom saying. I have (checks desk calendar) 1355 days until I pull the ripcord. I feel for the youngsters in the profession.

I feel like I will be ok. I am trying to stand out by pursuing unique training opportunities. I am in a niche specialty and speak 2 languages, however, I would have been better served by an NP degree legislatively. I def think our profession is headed in the wrong direction, but, alas there is nothing I can do about it. When I was venting about certain employment issues I was having to my surgical friends, some of them, snarky, suggested I seek out surgical employment.. 

I think it depends on how we define all right. I don't think we will blink out of existence. I believe the best short to mid term outlook sees our utilization shrink a great deal... maybe 70 to 80% in the next 10 years. Its just numbers as I have outlined before.

It is possible that after the crash we could rebound by achieving autonomous practice which would, once again, make us marketable and competitive. That will be a long process and the longer we wait to start the longer it will take and, because our numbers will be diminished, will be even harder to accomplish.

Until we have independence we are going to lose ground.

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I still think we must disassociate from NP. 
they have watered down their education to the point it is ineffective and dangerous for new grads. 
free market will catch up with crappy care in the way of lawsuits and insurance and employers getting burned.  
 

we need to stand apart from NP and be very clear we are entirely different.  

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(edited)
3 hours ago, ventana said:

I still think we must disassociate from NP. 
they have watered down their education to the point it is ineffective and dangerous for new grads. 
free market will catch up with crappy care in the way of lawsuits and insurance and employers getting burned.  
 

we need to stand apart from NP and be very clear we are entirely different.  

Tale as old as time.. yes many of them are bad.. they just go back to being bedside nurses. They are not being sued at any higher rate; and in fact nursing malpractice premiums are much lower than PAs 

But you are right, they are not jumping at the opportunity to associate with us. They have dissociated from us “assistants” in every legislation they have advanced 

Edited by iconic
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1 hour ago, iconic said:

 nursing malpractice premiums are much lower than PAs

Less than half.  Like $700/year vs. $1800ish.  Eventually that will normalize/rationalize... but until then, we pay more.

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