How Do We Best Fight for Our Professional Causes?

[jmj11]

I'm asking one of my philosophical questions.

 

Background: I'm not a confrontational type of guy. I grew in a Pollyanna type of world where my mother always taught us, "Be kind to people and they will always be kind to you in return." Of course everyone has heard the adage, "It is easier to attack flies with honey that vinegar."

 

As a business owner, and a PA-Practice owner, I've been involved with several huge fights over the past year and a half. I will have to say that some of them got very, very ugly . . . we are talking name calling threats and the like.

 

Now, I was recently involved with another big fight (and I'm not done with it yet). I threw down a hateful gauntlet from the begining and it went nasty quickly. Yesterday I was almost banned from the American Headache Society. When I started my crusade (bad choice of words) I had a crowd of NPs and PAs supporting me, but as it got uglier, I found myself out on a limb alone.

 

But this isn't about me. This far more general. So, us take it back to the name change issue. I confess, it got a little ugly at the end but I wasn't at the center of that fight.

 

So here is my question. While I got plenty of supporting e-mail in my last fight (which was pretty public with e-mails being copied and sent to everyone on both sides) I did have one personal e-mail from an NP. I had deeply embarrassed her. My harsh tone was unprofessional and she thought our best advances come from submitting and playing along and changing things over time. I have to admit, NPs tend to be in-your-face far more than us PAs and she was the exception.

 

I felt a little guilty after I read her e-mail. But then, I went back and reviewed this past 1 1/2 years. I was able to win several major battles, like getting Allergan to allow PAs and NPs to order Botox for the first time in history and them listing me as a headache specialist on their web site. But that fight got very ugly all the way to the CEO of Allergan, which I ended up meeting face to face in a verbal fight.

 

So, here is my question. Are we served better by in-your-face tactics? Have we as a profession been too passive? I honestly don't know the answer right now, but I'm just reflecting on this past few months. What's your thoughts?

[andersenpa]

As nonphysicians in a physician world, we are not in the power position. Discretion is the better part of valor.....saving the big guns for when you have no other options.

 

The more objective and neutral we remain, for as long as we can, is always the safest (most effective) route. Remember the response you got in that letter you posted?

 

Coming in with accusations will always meet a hostile return.

[rcdavis]

Yeah mike, agree generally you on the above.. But remaining passive didn't get mike to where he is today.. By fighting for himself, he has elevated us all.

Same thing for your and Eric's recent new PA association.. Do you intend on being passive about that subject we are all passionate about ( name change and defined pathways towards less administrative supervision)?

 

Mike's quandary is that he is fighting for a definition of PA-Dom which pushes the envelope.. A lot. All he wants to be is a provider which owns te business.. And to do that, he is having to buck the (PRE) conceptions of the payers and the physicians only can be owners philosophy of several physician groups. (how can you be an assistant to an employee?)

 

The military PAs fought this fight when it came to commissioning PAs from warrant officer status.. It wasn't pretty, and took several careers flushed down the toilet to fight that concept - how could a PA outrank the doctor and still be subordinate to that dr?) the battle was won.. But many were bloodied ( myself included).

 

Mike is on point here, and treading through uncharted jungles.

 

If we accept slights, if we remain passive to ignorance about our roles, then we have no one to blame but ourselves when those slights and misconceptions become ingrained.

 

SOMEONE has to speak up.

 

Mike jones has been Ferlinghetti-like: howling and fighting for us all.

 

Sometimes a little sugar works, and when mike gets his back up, he comes out blazing.. A-la the letter to the headache group... But Their response was inordinate also, and raised empty threats ( or what should be empty threats).

 

When it comes right down to it, jones has little to lose.. Being expelled from the headache society? First I doubt he has done anything aggregious enough to warrant that, secondarily ..big whoop. So what? His current position and reputation are being self made, in no way dependent on referrals from that society.

 

My answer to mike jones is, take 24, let the situatio(s) simmer, then respond less from the heart and more from the mind.

State accurate facts neutrally, them claim your position regarding these facts passionately.

 

I admire you for it

 

rc

[physasst]

So, here is my question. Are we served better by in-your-face tactics? Have we as a profession been too passive? I honestly don't know the answer right now, but I'm just reflecting on this past few months. What's your thoughts?

 

It depends greatly on the fight in question. All fights, be they for power, recognition, salary, benefits, respect, etc. require a plan of action. This can vary greatly depending on:

 

1. Your position in the dispute

2. Your opponents position and tactics

3. Timeline

4. Other individuals involved

5. Desired outcomes

6. Long term consequences/benefits

7. etc.etc.etc.etc.

 

You have to know your enemy, know the rules, know the battlefield, and have a strategy....Sometimes blunt force is required, sometimes tact is required, sometimes a retreat and regroup is required. There is no one answer to that question, because it is too subjective.

 

I have lighter from my time in the service....on it is inscribed a favorite saying of mine. "If you know the rules and can pay the price, then you can play the game".

 

Good luck, when are you coming back to visit? Would love to see you again.

[LIPPER]

I guess one question I have is why is your support from PA's erroding? They should be your biggest supporters. Maybe toning down some of your demands, in exchange for broader support would advance your cause, maybe not all the way...but baby-steps?

 

I'll certainly admit I haven't followed any of your story

[Contrarian]

Those that know me can pretty much guess my answer... but I'll just say:

 

There is a reason why EVERY effective fighting force in the history of man has been staffed with Negotiators/Diplomats/Emissaries , Clandestine operators, Surgical Strike Forces, and Blunt indiscriminate (kill everything in a set perimeter) forces or methods/tools.

 

These are all tools to be used when appropriate... to accomplish whatever the mission is.

 

"You gotta know when to hold em, know when to fold em, know when to walk away, know when to run... and when to just kill every MotherFer in the room, empty their pockets of all valuables, take their jewelry and calmly stroll away"...

 

 

Different situations require different tactics, techniques and procedures to prevail...

[LT_Oneal_PAC]

No one tactic is useful in all situations, but force is the only language some understand. I think being assertive is always appropriate in this type of debated though.

[jmj11]

I guess one question I have is why is your support from PA's erroding? /QUOTE]

 

Honestly, in my most recent situation, now that I think about it, while our mailing listed of 60 included several PAs I only heard from one, who was and is in my camp. However, the 10 or so other, NPs all went silent when the powers to be threaten us if we didn't remain quiet. I kept talking and will continue. So when people threaten you many people fade into the woodwork.

[Contrarian]

Yep...

Learned a long time ago that there is a striking difference between those who "run from," versus those who "run towards" gun fire...

Its as striking as the difference between "sheep(le)" and "Sheep-dogs" or prey and predators.

[Hemegroup]

Hey, don't forget it's National PA Week Oct 6th to 12th ... Good Job, Sir and perfect timing. Like was stated, we are an institution so on that there is no worry however standing up for the work we have done is something else entirely. I like the 'relax now and approach from the mind' bit a lot. Not to forget reminding people we are here ... Horton Hears a Who? So much work that you've done ... hat off to you (did you know that one of the JW Presidents, Rutherford, wrote that tipping a hat to a lady is placing males in a subordinate role and is from Satan? Interesting bit of trivia there ... hmm). I'm ready to jump in the fight as well, if I can just get the charts done from the past 120 patients I've seen in the past 3-4 days. Why does it always happen that when all 7 rooms are filled, the 1st one I go into has 9 issues to take care of? It's like asking how socks disappear from the dryer. I asked my Physiology Prof that once, she got a kick out of it but in the end acknowledged that she really didn't have the answer.

[TWR]

JMJ, I have watched you fight your battles over the past 1 1/2 years and have admired your tenacity. All of the above comments have great merit and a 24 hour time out (figuratively) is probably good at this time. What I find very disheartening is that "our" AAPA has not taken an interest in your journey which although is personal, affects all of us in a positive professional way. I would like to think that the new group forming to represent us will be a more involved and not passive or worse ignore.

[andersenpa]

Yeah mike, agree generally you on the above.. But remaining passive didn't get mike to where he is today.. By fighting for himself, he has elevated us all.

Same thing for your and Eric's recent new PA association.. Do you intend on being passive about that subject we are all passionate about ( name change and defined pathways towards less administrative supervision)?

 

Sorry my earlier post was form my phone and thus brief.

 

I don't recommend being passive, but rather being measured in how we react to professional issues.

Case in point, we often post media articles here which protray PAs negatively. Often forum members will post their responses or emails. some of these are downright hostile and aggressive. I'm NOT accusing Mike of this but this is an example of how approaching an issue with hostility will generally get a similar (and nonproductive) response.

 

There is a way to be objective, clam, AND PASSIONATE at the same time.

[jmj11]

Sorry my earlier post was form my phone and thus brief.

 

I don't recommend being passive, but rather being measured in how we react to professional issues.

Case in point, we often post media articles here which protray PAs negatively. Often forum members will post their responses or emails. some of these are downright hostile and aggressive. I'm NOT accusing Mike of this but this is an example of how approaching an issue with hostility will generally get a similar (and nonproductive) response.

 

There is a way to be objective, clam, AND PASSIONATE at the same time.

 

No apologies needed. Yes, mine really was hostile and aggressive. I'm not justifying my tone, as that is why I brought up this whole question, but the person I wrote my letter to, had a colleague who made statements last year in a public forum including, "if we let PAs and NPs be members then we might as well let the horse doctors in" and "If we let them in, then we will be overtaken by chiropractors." So there was some history there.