Where are we going with the PA profession!!! seriously!!!

[EMEDPA]

Northern Cali, especially the San Francisco Bay area, is controlled by the nursing lobby. Good luck in finding a better place to work.

very true...come to the pacific nw where all that stuff goes away...PAs run ERs without a doc on site....

[Eventide]

Sad and surprising to hear. Never had this problem myself as a PA working in Mendocino county (Northern California), but I am at a small rural community health center, not a bureaucratic hospital. Sorry, ryan83. Bad situation.

[Eventide]

Sad and surprising to hear. Never had this problem myself as a PA working in Mendocino county (Northern California), but I am at a small rural community health center, not a bureaucratic hospital. Sorry, ryan83. Bad situation.

[jsfelder0417]

Time to go, if it was me.

[Joelseff]

I live in northern california ,

If you dont know , i researched it heavily , a hospitals policy overrides AAPA and CAPA , basically the hospital have the right to set up your scope of practice regardless what the law says.... but what pisses me off is that these hospitals put cuffs on PAs but never mess up with NPs.

 

Nurses run hospitals! When they strike, it's big news and shuts down the hospital, but they do it "for patient care." Yah...right! CNA is powerful here and I think there is an agenda to push us out and a push to have ALL the non-physician work for NPs. Just look at the SB352 bill that the CNA is fighting against. There have been multiple shots fired across our bow, some actually hit us, from the "nursing lobby" and some of us think its ok to snuggle up to them. I will say it again, NURSING IS NOT OUR FRIEND (notice I didn't say NURSES as most rank and file nurses and NPs I know don't have this mentality but nonetheless, they support CNA and ANA with their money)

[burnpac]

Wow. I feel your pain. However, this is not the norm in California. At our Central Valley hospital, the medical staff office has chosen to remove nearly all barriers to physician PA practice consistent with current law and regulation, and PAs, NPs and CRNAs have an excellent autonomous practice environment. I can confirm comments above that hospital practice is what the medical staff says it is, and they can implement any rules that they want. We have gone a different direction at our facility to attract PAs, adopting more permissive rules, and we are currently working on an initiative to make PAs, NPs and CRNAs full members of the medical staff. We have the support of the COS, and all department chairs, so I'm hopeful that we can get this done this year.

 

This is why providers other than physicians need to take an interest in facility governance to protect our rights and effect meaningful change in PA practice.

[LT_Oneal_PAC]

 

This is why providers other than physicians need to take an interest in facility governance to protect our rights and effect meaningful change in PA practice.

 

Quoted for truth.

[quirkymedic]

Ryan83,

 

I currently work in a rural hospital in northern california. Just north of Sac actually. This is my last week as a surgical PA in my hospital. This is the most unfriendly PA facility I have ever worked in. I was on vacation back in october and received a phone call that they told me basically the same thing. You cannot write orders. You cannot give verbal orders. Your SP must be on site if you round on patients. I was doing all of this with no issues for 10 months prior to this phone call. All because they are being visited by CMS and do not want to spend the time or energy reviewing our delegation of service agreement. I was promised that this would only be temporary (1-2 mos). It's been 6 months with no change, talk of change or even requesting a new delegation of service agreement. The admin doesn't care because there is only about 6 PA's that work in the hospital so it doesn't really affect anything from their point of view. I'm done. I literally follow my SP's around the hospital like a dog, doing clerical work like making copies and doing billing sheets. This is not what I spent years training and studying to become a PA.

 

Think of it as a blessing in disguise. It really is. You do not want to work under these circumstances. It sucks. I am moving on and not looking back.

[ryan83]

Ryan83,

 

I currently work in a rural hospital in northern california. Just north of Sac actually. This is my last week as a surgical PA in my hospital. This is the most unfriendly PA facility I have ever worked in. I was on vacation back in october and received a phone call that they told me basically the same thing. You cannot write orders. You cannot give verbal orders. Your SP must be on site if you round on patients. I was doing all of this with no issues for 10 months prior to this phone call. All because they are being visited by CMS and do not want to spend the time or energy reviewing our delegation of service agreement. I was promised that this would only be temporary (1-2 mos). It's been 6 months with no change, talk of change or even requesting a new delegation of service agreement. The admin doesn't care because there is only about 6 PA's that work in the hospital so it doesn't really affect anything from their point of view. I'm done. I literally follow my SP's around the hospital like a dog, doing clerical work like making copies and doing billing sheets. This is not what I spent years training and studying to become a PA.

 

Think of it as a blessing in disguise. It really is. You do not want to work under these circumstances. It sucks. I am moving on and not looking back.

 

 

 

Nps are taking over man accept the truth, everybody is worried about changing the name while its not the big deal, its not only california , its everywhere and its getting worse. i talked to many physicians and they literally told me " why would i take responsibility on PA and cosign charts while Nps are more autonomous and i dont have much of responsibility" i feel i wasted two years of my life and racked up loans to run after a physcian doing paperwork. go search on indeed.com put physician assistant and see how many jobs of medical assistant will pop up...

[SoCal_PA]

As a pre-PA starting my program in CA this Fall, this kind of news is extremely upsetting.

[Timon]

I am seriously thinking this is retaliation of SB 352 being passed. I'm also wondering if CAPA needs to lawyer up. From a business perspective it seems this is a violation of business conduct and opens them up to antitrust litigation since the definition of antitrust is the regulation of the conduct and organization of business corporations, generally to promote fair competition for the benefit of consumers. By removing PAs legal privileges resulting in the removal of our cost effective and high quality practitioners in order for NPs to take over the share of the market.

[EMEDPA]

move to a pa friendly state and you will be fine. northern ca is NOT pa friendly in any way and never has been. I left 14 years ago when they were posting jobs that said " PAs will only be consaidered if no NP applicants apply". seriously.

try WA, VT, NH, ME, MA, MT, WY, OK, etc...the more rural the better....

[UGoLong]

The more rural the better might be true, but it is something like the German army deciding to make a last stand in the Alps at the end of WWII. We need to find a better way. The problem exists in many places and is probably has many causes. I think our name is not the biggest concern.

 

I live in central Ohio, where NPs are quite strong. PAs are overseen by the Medical Board, while NPs are overseen by the Nursing Board. The Medical Board probably wants to keep us with limited roles as physicians are their primary constituency. The Nursing Board would like to see expanded NP roles. As an example, PAs here can work as long as their SP is within 60 minutes of their site in normal conditions (i.e., ignore the weather). NPs only have to have reasonable access (think telephone or text messages). My SP is very PA friendly, but he'd like to be able to take a trip with his family and let someone round for him. I can't, but an NP can.

 

I don't have that many more years to work, but I would like to see PAs prosper and be on equal footing with NPs. I know and work with many NPs and they are good people, like we are. If something is not done, I fear that PAs will be relegated to surgery only -- a specialty here that, thus far, is our version of the German Alps.

 

I'm going to the DC conference and will be interested to see if any of this comes up. It should.

[Swarley]

Are ID, NM, AZ, or NC part of that group of PA friendly states?

[quirkymedic]

Nurses run hospitals! When they strike, it's big news and shuts down the hospital, but they do it "for patient care." Yah...right! CNA is powerful here and I think there is an agenda to push us out and a push to have ALL the non-physician work for NPs. Just look at the SB352 bill that the CNA is fighting against. There have been multiple shots fired across our bow, some actually hit us, from the "nursing lobby" and some of us think its ok to snuggle up to them. I will say it again, NURSING IS NOT OUR FRIEND (notice I didn't say NURSES as most rank and file nurses and NPs I know don't have this mentality but nonetheless, they support CNA and ANA with their money)

 

 

Do you want to hear something funny? Not funny haha, but scary....

 

I just turned down a surgical PA job 10 min from my house with better pay because the PA's (almost all of the midlevels at this hospital are PA's) just voted in a NURSING union. They couldn't understand why I would be concerned about this... and was the main reason I turned down the job....

 

Also my hubby and I are seriously considering a transfer to either WA, TX, or AZ...

[EMEDPA]

Are ID, NM, AZ, or NC part of that group of PA friendly states?

AZ and NC are. don't know about ID and NM. also add ND and SD as good PA states. NY as well once you get out of nyc.

[TThielen]

Michigan??? It seems to be about equal with NPs here from what I can tell.

[Brotherman]

Nearly every physician I talk to in KY thinks (and rightfully so) that NP's are under trained in their clinicals. Yet, they admit they have so much power due to the strong nursing board in the state. Power = responsibility/privileges. I totally agree that the PA name is the least of our concerns...sure, associate sounds better...but laws, regulations, and professional respect are way more important. I agree with site-based governance and especially after reading about the stupid regulations on PAs in the Northern Cali, it is so vital for PAs to be involved with hospital leadership...in fact, I just emailed my medical director about getting involved. It would seem that after nearly 46yrs of our profession, the BS would become less and less. But with the nursing board acting in a delusional way, no wonder things are the way they are. This is an emotional rant, I know. Sorry Ryan that you got screwed. It pisses me off too. Thank you for sharing because it re-ignited my desire to be an active member of the Physician Assistant profession.

[Joelseff]

Nearly every physician I talk to in KY thinks (and rightfully so) that NP's are under trained in their clinicals. Yet, they admit they have so much power due to the strong nursing board in the state. Power = responsibility/privileges. I totally agree that the PA name is the least of our concerns...sure, associate sounds better...but laws, regulations, and professional respect are way more important. I agree with site-based governance and especially after reading about the stupid regulations on PAs in the Northern Cali, it is so vital for PAs to be involved with hospital leadership...in fact, I just emailed my medical director about getting involved. It would seem that after nearly 46yrs of our profession, the BS would become less and less. But with the nursing board acting in a delusional way, no wonder things are the way they are. This is an emotional rant, I know. Sorry Ryan that you got screwed. It pisses me off too. Thank you for sharing because it re-ignited my desire to be an active member of the Physician Assistant profession.

 

"Heed the words of the Brotherman!"

 

Sent from my myTouch_4G_Slide using Tapatalk 2

[CAdamsPAC]

AZ and NC are. don't know about ID and NM. also add ND and SD as good PA states. NY as well once you get out of nyc.

 

You forgot Alaska! PAs are loved and RESPECTED here!

[cupojava]

You forgot Alaska! PAs are loved and RESPECTED here!

 

Don't tell them that--it's the best kept secret ever!!!! LOL

[EMEDPA]

You forgot Alaska! PAs are loved and RESPECTED here!

very true. a glaring omission to be sure.

[Guest Paula]

The more rural the better might be true, but it is something like the German army deciding to make a last stand in the Alps at the end of WWII. We need to find a better way. The problem exists in many places and is probably has many causes. I think our name is not the biggest concern.

 

I live in central Ohio, where NPs are quite strong. PAs are overseen by the Medical Board, while NPs are overseen by the Nursing Board. The Medical Board probably wants to keep us with limited roles as physicians are their primary constituency. The Nursing Board would like to see expanded NP roles. As an example, PAs here can work as long as their SP is within 60 minutes of their site in normal conditions (i.e., ignore the weather). NPs only have to have reasonable access (think telephone or text messages). My SP is very PA friendly, but he'd like to be able to take a trip with his family and let someone round for him. I can't, but an NP can.

 

I don't have that many more years to work, but I would like to see PAs prosper and be on equal footing with NPs. I know and work with many NPs and they are good people, like we are. If something is not done, I fear that PAs will be relegated to surgery only -- a specialty here that, thus far, is our version of the German Alps.

 

I'm going to the DC conference and will be interested to see if any of this comes up. It should.

 

Let us know if it comes up and what the response is from AAPA. Please come visit the PAFT booth.

[Guest Paula]

Michigan??? It seems to be about equal with NPs here from what I can tell.

 

MI PAs are one of three professions in the state licensed to practice medicine. The other two are MD/DO. PAs are considered a sub-specialty of medicine. We have prescriptive rights for schedule II-V. NPs have independent practice but not independent prescribing and need a physician to get their DEA licenses. They are in the process of getting full independence and have a bill to get independent DEA licenses. That is why they withdrew from the PA bill for expanded scheduled drug rights...they decided to go for full independence.

 

It will be interesting to see what happens if they are successful. MI has been a good state for me to practice in....no chart co-sigs or prescription co-sigs required and chart review determined at practice level.

[FBIDoc]

Are ID, NM, AZ, or NC part of that group of PA friendly states?

 

Idaho is very PA friendly