Moderator ventana Posted October 27, 2022 Moderator Share Posted October 27, 2022 Thinking of working for the Feds - tired of the private game This is my question Utah and North Dakota have no supervision requirements for PA Fed employment mandates you have a PA license in a State, any state. What is stopping me from getting a ND or Utah license and never again having to worry about a SP?? Honestly is seems like EVERY federal PA that can do this should. As the dollars flow out of the home states there will be additional pressure to update the regs, and for a crusty old PA like me I would finally be able to just do my job and not worry about the sill regulations 1 Quote Link to comment Share on other sites More sharing options...
sas5814 Posted October 27, 2022 Share Posted October 27, 2022 Nothing stops you from getting a license in those states. The Fed, however, is a closed system and makes its own rules. So even if you were licensed in one of those states your would still have to have a SP to work at the VA. Internal rules. Quote Link to comment Share on other sites More sharing options...
Reality Check 2 Posted October 27, 2022 Share Posted October 27, 2022 I work for the VA. I have a Utah license. My doc is listed on paper as a collaborator. There is not a work plan. I work autonomously. The VA respects your highest license. Utah gives autonomy at 10000 hrs - I am WAY beyond that. 2 Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted October 27, 2022 Author Moderator Share Posted October 27, 2022 so do you feel you are "independent" do you ever have to justify your decisions for non-medical reasons? Are you treated fairly and as a independent practitioner? Are you in Utah??? Why Utah and not North Dakota? 1 Quote Link to comment Share on other sites More sharing options...
thinkertdm Posted October 30, 2022 Share Posted October 30, 2022 I have a license in N.Y. and il. I’ve worked in pact (primary care) in the va in Florida, Illinois, and Wisconsin. I think I have a cp listed on something but never needed anyone to co-sign anything. If I run into a tough situation I ask one of my specialist contacts. And honestly, these are situations to confirm my initial plan, not where I was clueless. For all intents and purposes I was independent. I was listed as pcp and my patients saw me as that. 1 Quote Link to comment Share on other sites More sharing options...
ifeeluncomfortable Posted October 30, 2022 Share Posted October 30, 2022 I am a new grad working at a VA to repay my HPSP scholarship commitment and am in a surgical subspecialty. Right now all my notes are co-signed. There was an email last week about how my VA system is doing away with requiring co-signing notes from PAs in the surgical departments. Hasn’t been implemented yet though. Doubt it will affect my department. I still see them wanting to co-sign my notes which I’m ok with at this point since I’m so new. 1 1 Quote Link to comment Share on other sites More sharing options...
sas5814 Posted October 31, 2022 Share Posted October 31, 2022 On 10/27/2022 at 11:20 AM, ventana said: so do you feel you are "independent" do you ever have to justify your decisions for non-medical reasons? Are you treated fairly and as a independent practitioner? I know the question wasn't directed to me but I feel totally independent. I manage a panel of 1100 very sick people and nobody is looking over my shoulder ever. Nobody has time to. When the chief of staff said I wasn't doing a physician's work because I have to have a SP I, literally, laughed in her face. My SP has consulted me 5x more than I have consulted her. It's a piece of paper that means nothing. I have no restriction on me that doesn't also apply to the physicians except for prescribing schedule II drugs which doesn't interest me anyway. I am, of course, in primary care. Specialty care would be very different and my sense is there are a lot on NPs doing scut work in specialty care. I don't see a lot of responses to referrals from specialty PAs or NPs. They get saddled with screening referrals and determining which ones get cancelled for whatever trivial reason they come up with. (Referrals are a never-ending source of misery.) 1 Quote Link to comment Share on other sites More sharing options...
NeoTrion Posted November 4, 2022 Share Posted November 4, 2022 Whatever happened to getting independent practice at the VA like the NPs have? Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted November 4, 2022 Author Moderator Share Posted November 4, 2022 2 hours ago, NeoTrion said: Whatever happened to getting independent practice at the VA like the NPs have? AAPA dropped the ball they are getting better then that now.... they should have pushed super hard but the old guard dragged their feet.... sad 1 Quote Link to comment Share on other sites More sharing options...
HMtoPA Posted November 8, 2022 Share Posted November 8, 2022 (edited) With regard to independent practice in the federal government, I am in the Navy, and I know your interest is geared more towards the VA. However, I will say that as a generalist PA, I was given wide latitude when I worked in family medicine, seeing my own panel of patients with no cosignature of notes and no prescribing restrictions. I work in the emergency department now, and with fellowship training I have supplementary EM privileges, see my own patients, and sign my own notes. Non-EM-trained PAs that I work with must staff their patients and get their notes cosigned. At all times, essentially, I have had either a supervising or collaborating physician on paper. I say essentially, because sometimes the ball was dropped administratively. However, this so-called supervisory relationship has never been anything other than a piece of paper, even if an onerous one. The only other sort of limitation on my practice I can think of is that when I was in family medicine, I was subject to a higher percentage of charts reviewed each month, I think like 10% versus the physicians’ 5%. In my current position, however, there is parity. I have a Washington state license, and I do not think that there would be a difference if I had a Utah or ND license. I think the biggest issue facing the PA profession right now is the idea of independent practice, because it just creates more red tape, and an extra hurdle in the hiring process. Physicians don’t want to be on the hook for our decisions, nor should they be. This should be job number one for the AAPA, in my opinion, more than any title change or PR campaign. Edited November 8, 2022 by HMtoPA 1 Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted November 8, 2022 Author Moderator Share Posted November 8, 2022 To all thanks for all the info I am encouraged with what I hear. I am 20 yrs out of school and 100% independent in all things (as much as anyone can be independent - we all defer to specialists some times) It looks like this might work well 26 days off a year 10 holidays 13 sick Bummer on no CME but seems like there is free CME out there for us I absolutely do not need or want a Doc thinking they are my "fearless leader" and in fact I am looking to be part of a great team - seems this comes at the CBOC level with the local staff. One more question - how many people work a non-40 hour week - I am honestly feeling the 3 day work week right now figure this is 27-30 hour based on variables One last question - What type of deductions do you see from you paycheck - tired of seeing mine shrink ($350/ health insurance, $550/m FSA due to high ded plan) rest of the deductions are okay like DCA, extra life and family life but the $7000 for FSA just annoys me 1 Quote Link to comment Share on other sites More sharing options...
sas5814 Posted November 8, 2022 Share Posted November 8, 2022 (edited) 12 hours ago, ventana said: One last question - What type of deductions do you see from you paycheck - tired of seeing mine shrink ($350/ health insurance, $550/m FSA due to high ded plan) rest of the deductions are okay like DCA, extra life and family life but the $7000 for FSA just annoys me Here it is strait off my current LES if you can figure the codes: FEGLIC0 $23.04 FEHB106 $289.61 FSA-HC$ 105.76$ MEDICARE$72.90 OASDI$311.7 ORG/UNIONVFUF$29.82 RETIRE, FERSKF$239.08 TAX, FEDERAL$758.70 TSP SAVINGS$380.35 DENTAL$36.11 FERS and TSP are the retirement plan and the pension plan. I am a dues paying union member. I max out my FSA based on my plan deductible because I can roll it over year to year and if I have a catastrophic health event I'd like the money in the bank. FEHB is my health insurance for me and my wife. FEGLI is, I think, my life insurance add on. OASDI Social Security. This is for 2 weeks. I buy the best health and dental plans I can. There are much less expensive ones out there are about 60% of my health insurance cost is my wife...who now works for the VA too and will have her own insurance reducing my premium significantly. Edited November 8, 2022 by sas5814 added info Quote Link to comment Share on other sites More sharing options...
BLM8867 Posted November 9, 2022 Share Posted November 9, 2022 (edited) I'm currently at the VA. Just got this in my email. This may be a helpful resource for anyone interested: Edit: added an additional file. Total Reward$ of a Allied Health Professions VA Career 11-4-2022.pdf Physician Assistant - Total Reward$ of a VA Career Flyer 11-3-2022.pdf Edited November 9, 2022 by BLM8867 Quote Link to comment Share on other sites More sharing options...
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