With the restrictions of being a PA, have you thought you should have gone NP?

[EMEDPA]

Being that there is no other advancement/ bridge programs for the pa profession...

there is the PA to DO bridge at lecom....if I was younger I would do it.

[CoastalPalm]

Goes both ways and depends on what "microcosm" you belong to. Met a group of ER NPs at Pharm meeting the other night, 5 out of the 7 stated to numerous people they wish they had gone to PA school instead

 

I agree that it goes both ways. The difference though (in my limited experience of course) is in the reasons. It seems that NPs that wish they went to PA school instead/are envious of PAs are that way because of the educational model of PAs, who seem to have more of a basic/clinical science foundation, as well as what, double+ the amount of clinical hours than NP programs. In contrast, PAs certainly are not envious of NP education, but desire the advances in scope/full autonomy/etc available to NPs (state dependent of course). It seems as if PAFT is hoping to advance such things for PAs, and have PAs recognized as "full clinicians". In my limited opinion (and perhaps this is colored by my years of experience as a member of nursing staff, including as an ER tech), I think the NPs have it right with "collaboration". If I remember correctly, there is a bill in legislation here in NY that would require new grad NPs to have a collaborating physician for a certain time period (remember, even newly graduated physicians are not independent), after which they can be independent clinicians.

 

Ok, just looked it up-the Nurse Practitioners Modernization Act:

 

http://www.legislativegazette.com/Articles-Top-Stories-c-2013-04-15-83416.113122-Bill-gives-nurse-practitioners-more-responsibility-in-patient-care.html

 

Independent practice after 3 years and 3600 hours of NP practice. What with the superior educational model of PAs, PA residencies, CAQs, etc, I don't see why NPs would have such an opportunity available to them, except that they aren't under the Board of Medicine. Things like this do make me pause as I try to figure out the best route to continue my education and become an advanced practice clinician.

[CoastalPalm]

Goes both ways and depends on what "microcosm" you belong to. Met a group of ER NPs at Pharm meeting the other night, 5 out of the 7 stated to numerous people they wish they had gone to PA school instead

 

I agree that it goes both ways. The difference though (in my limited experience of course) is in the reasons. It seems that NPs that wish they went to PA school instead/are envious of PAs are that way because of the educational model of PAs, who seem to have more of a basic/clinical science foundation, as well as what, double+ the amount of clinical hours than NP programs. In contrast, PAs certainly are not envious of NP education, but desire the advances in scope/full autonomy/etc available to NPs (state dependent of course). It seems as if PAFT is hoping to advance such things for PAs, and have PAs recognized as "full clinicians". In my limited opinion (and perhaps this is colored by my years of experience as a member of nursing staff, including as an ER tech), I think the NPs have it right with "collaboration". If I remember correctly, there is a bill in legislation here in NY that would require new grad NPs to have a collaborating physician for a certain time period (remember, even newly graduated physicians are not independent), after which they can be independent clinicians.

 

Ok, just looked it up-the Nurse Practitioners Modernization Act:

 

http://www.legislativegazette.com/Articles-Top-Stories-c-2013-04-15-83416.113122-Bill-gives-nurse-practitioners-more-responsibility-in-patient-care.html

 

Independent practice after 3 years and 3600 hours of NP practice. What with the superior educational model of PAs, PA residencies, CAQs, etc, I don't see why NPs would have such an opportunity available to them, except that they aren't under the Board of Medicine. Things like this do make me pause as I try to figure out the best route to continue my education and become an advanced practice clinician.

[sartort]

I agree that it goes both ways. The difference though (in my limited experience of course) is in the reasons. It seems that NPs that wish they went to PA school instead/are envious of PAs are that way because of the educational model of PAs, who seem to have more of a basic/clinical science foundation, as well as what, double+ the amount of clinical hours than NP programs. In contrast, PAs certainly are not envious of NP education, but desire the advances in scope/full autonomy/etc available to NPs (state dependent of course). It seems as if PAFT is hoping to advance such things for PAs, and have PAs recognized as "full clinicians". In my limited opinion (and perhaps this is colored by my years of experience as a member of nursing staff, including as an ER tech), I think the NPs have it right with "collaboration". If I remember correctly, there is a bill in legislation here in NY that would require new grad NPs to have a collaborating physician for a certain time period (remember, even newly graduated physicians are not independent), after which they can be independent clinicians.

 

Ok, just looked it up-the Nurse Practitioners Modernization Act:

 

http://www.legislativegazette.com/Articles-Top-Stories-c-2013-04-15-83416.113122-Bill-gives-nurse-practitioners-more-responsibility-in-patient-care.html

 

Independent practice after 3 years and 3600 hours of NP practice. What with the superior educational model of PAs, PA residencies, CAQs, etc, I don't see why NPs would have such an opportunity available to them, except that they aren't under the Board of Medicine. Things like this do make me pause as I try to figure out the best route to continue my education and become an advanced practice clinician.

 

If you feel like the PA education is superior then why would you ever choose to get what you see as an inferior education? Maybe as an NP you would get more respect, independence, and people would know that you practice medicine but if you think you would be a better clinician and benefit your patients more as a PA shouldn't that be more important?

[sartort]

I agree that it goes both ways. The difference though (in my limited experience of course) is in the reasons. It seems that NPs that wish they went to PA school instead/are envious of PAs are that way because of the educational model of PAs, who seem to have more of a basic/clinical science foundation, as well as what, double+ the amount of clinical hours than NP programs. In contrast, PAs certainly are not envious of NP education, but desire the advances in scope/full autonomy/etc available to NPs (state dependent of course). It seems as if PAFT is hoping to advance such things for PAs, and have PAs recognized as "full clinicians". In my limited opinion (and perhaps this is colored by my years of experience as a member of nursing staff, including as an ER tech), I think the NPs have it right with "collaboration". If I remember correctly, there is a bill in legislation here in NY that would require new grad NPs to have a collaborating physician for a certain time period (remember, even newly graduated physicians are not independent), after which they can be independent clinicians.

 

Ok, just looked it up-the Nurse Practitioners Modernization Act:

 

http://www.legislativegazette.com/Articles-Top-Stories-c-2013-04-15-83416.113122-Bill-gives-nurse-practitioners-more-responsibility-in-patient-care.html

 

Independent practice after 3 years and 3600 hours of NP practice. What with the superior educational model of PAs, PA residencies, CAQs, etc, I don't see why NPs would have such an opportunity available to them, except that they aren't under the Board of Medicine. Things like this do make me pause as I try to figure out the best route to continue my education and become an advanced practice clinician.

 

If you feel like the PA education is superior then why would you ever choose to get what you see as an inferior education? Maybe as an NP you would get more respect, independence, and people would know that you practice medicine but if you think you would be a better clinician and benefit your patients more as a PA shouldn't that be more important?

[Guest JMPA]

If you feel like the PA education is superior then why would you ever choose to get what you see as an inferior education? Maybe as an NP you would get more respect, independence, and people would know that you practice medicine but if you think you would be a better clinician and benefit your patients more as a PA shouldn't that be more important?

 

Face it, independence, freedom of self employment and cash flow is what is important

[Guest JMPA]

If you feel like the PA education is superior then why would you ever choose to get what you see as an inferior education? Maybe as an NP you would get more respect, independence, and people would know that you practice medicine but if you think you would be a better clinician and benefit your patients more as a PA shouldn't that be more important?

 

Face it, independence, freedom of self employment and cash flow is what is important

[CoastalPalm]

If you feel like the PA education is superior then why would you ever choose to get what you see as an inferior education? Maybe as an NP you would get more respect, independence, and people would know that you practice medicine but if you think you would be a better clinician and benefit your patients more as a PA shouldn't that be more important?

 

I think the issue for me is whether I'll be able to put that better education to use (PAFT puts what I'm thinking about more articulately-"It has often been quoted by health policy experts, medical opinion leaders and others, that health professionals need to function at the "top of their license"; the highest level of their education and training." It seems that PAs often encounter various restrictive policies ("barriers to PA practice", again according to PAFT). Now, don't get me wrong, many great advances have been made in the PA profession, and I'm grateful that I'd be able to hypothetically enter it at a this time. I also have seen many great examples of PAs here on the forum, and in real life, that have great scopes of practice, and really function as autonomous clinicians at the "top of their license". Maybe I've been drinking the nursing Kool-Aid for too long. Yesterday I had a nurse tell me how PAs are getting left behind (this is something I've heard for YEARS in the two hospitals in two different cities I've worked in, so I'm assuming it's a common nursing view), how great NPs are, etc etc (the usual talking points). I don't know, I guess I get excited looking at PA curriculum, and I get excited hearing about NP advances. Weird?

 

And yeah, not interested in med school at all. ;)

[CoastalPalm]

If you feel like the PA education is superior then why would you ever choose to get what you see as an inferior education? Maybe as an NP you would get more respect, independence, and people would know that you practice medicine but if you think you would be a better clinician and benefit your patients more as a PA shouldn't that be more important?

 

I think the issue for me is whether I'll be able to put that better education to use (PAFT puts what I'm thinking about more articulately-"It has often been quoted by health policy experts, medical opinion leaders and others, that health professionals need to function at the "top of their license"; the highest level of their education and training." It seems that PAs often encounter various restrictive policies ("barriers to PA practice", again according to PAFT). Now, don't get me wrong, many great advances have been made in the PA profession, and I'm grateful that I'd be able to hypothetically enter it at a this time. I also have seen many great examples of PAs here on the forum, and in real life, that have great scopes of practice, and really function as autonomous clinicians at the "top of their license". Maybe I've been drinking the nursing Kool-Aid for too long. Yesterday I had a nurse tell me how PAs are getting left behind (this is something I've heard for YEARS in the two hospitals in two different cities I've worked in, so I'm assuming it's a common nursing view), how great NPs are, etc etc (the usual talking points). I don't know, I guess I get excited looking at PA curriculum, and I get excited hearing about NP advances. Weird?

 

And yeah, not interested in med school at all. ;)

[physasst]

Face it, independence, freedom of self employment and cash flow is what is important

 

Self employment in the era of ACO's is going the way of the whigs. Doesn't matter what degrees or credentials you have, unless you are practicing concierge medicine, which will remain a niche, everyone else will be an employee.

 

I wrote a paper back in the 90's (econ paper) about market consolidation in healthcare, and how eventually there would only be 15-20 regional health networks in the country, and how you would have regional masters (CCF, Hopkins, Baylor, Geisinger, Kaiser, Intermountain, etc.etc.) that will compete at the margins. With the advent of the ACO model, it would seem that some of my forecasting, although projected for different reasons, might come to fruition.

 

Independence and self employment are both myths. New payment models will dictate certain practice parameters to providers. For example, if you are not meeting certain quality targets and/or following established decision rules, using decision aids, and following guidelines, well, you are not going to be reimbursed very well. This is the model of the future and will be the future of healthcare. Acuity triangles will dictate provider utilization, etc.etc.etc.

[physasst]

Face it, independence, freedom of self employment and cash flow is what is important

 

Self employment in the era of ACO's is going the way of the whigs. Doesn't matter what degrees or credentials you have, unless you are practicing concierge medicine, which will remain a niche, everyone else will be an employee.

 

I wrote a paper back in the 90's (econ paper) about market consolidation in healthcare, and how eventually there would only be 15-20 regional health networks in the country, and how you would have regional masters (CCF, Hopkins, Baylor, Geisinger, Kaiser, Intermountain, etc.etc.) that will compete at the margins. With the advent of the ACO model, it would seem that some of my forecasting, although projected for different reasons, might come to fruition.

 

Independence and self employment are both myths. New payment models will dictate certain practice parameters to providers. For example, if you are not meeting certain quality targets and/or following established decision rules, using decision aids, and following guidelines, well, you are not going to be reimbursed very well. This is the model of the future and will be the future of healthcare. Acuity triangles will dictate provider utilization, etc.etc.etc.

[LESH]

Self employment in the era of ACO's is going the way of the whigs. Doesn't matter what degrees or credentials you have, unless you are practicing concierge medicine, which will remain a niche, everyone else will be an employee.

 

I wrote a paper back in the 90's (econ paper) about market consolidation in healthcare, and how eventually there would only be 15-20 regional health networks in the country, and how you would have regional masters (CCF, Hopkins, Baylor, Geisinger, Kaiser, Intermountain, etc.etc.) that will compete at the margins. With the advent of the ACO model, it would seem that some of my forecasting, although projected for different reasons, might come to fruition.

 

Independence and self employment are both myths. New payment models will dictate certain practice parameters to providers. For example, if you are not meeting certain quality targets and/or following established decision rules, using decision aids, and following guidelines, well, you are not going to be reimbursed very well. This is the model of the future and will be the future of healthcare. Acuity triangles will dictate provider utilization, etc.etc.etc.

Thank you. The game is changing. Don't hate the player...hate the game.

An old guy.

[LESH]

Self employment in the era of ACO's is going the way of the whigs. Doesn't matter what degrees or credentials you have, unless you are practicing concierge medicine, which will remain a niche, everyone else will be an employee.

 

I wrote a paper back in the 90's (econ paper) about market consolidation in healthcare, and how eventually there would only be 15-20 regional health networks in the country, and how you would have regional masters (CCF, Hopkins, Baylor, Geisinger, Kaiser, Intermountain, etc.etc.) that will compete at the margins. With the advent of the ACO model, it would seem that some of my forecasting, although projected for different reasons, might come to fruition.

 

Independence and self employment are both myths. New payment models will dictate certain practice parameters to providers. For example, if you are not meeting certain quality targets and/or following established decision rules, using decision aids, and following guidelines, well, you are not going to be reimbursed very well. This is the model of the future and will be the future of healthcare. Acuity triangles will dictate provider utilization, etc.etc.etc.

Thank you. The game is changing. Don't hate the player...hate the game.

An old guy.

[gducky5]

The future is in our hands. As an aspiring PA, I know why I've picked this route vs. NP. I've debated it internally and had my ups and down about my decision, but at the end of the day, my future profession is what I make of it. I'm not afraid to take a chance and lead in what I consider a completely badass profession. It won't be easy debating with our peers and standing up for what we believe is the right path for the future of PA practice, but it is the right and appropriate thing to do.

 

I've read a lot of cynicism on here lately pertaining the state of the profession and while I appreciate the thoughtful debate, its never enough to change my mind about going to PA school. Do what you will and don't seek answers from others and certain websites, even if they are helpful at times. Ultimately, only YOU have to answer to yourself about who YOU are and what YOU want to do with the little time you have on earth. Its all about attitude.

 

Maybe I sound a little naive and idealistic, but being idealistic has granted me more motivation than questioning myself every step of the way. Okay, I'm done. Hope that helps!

[gducky5]

The future is in our hands. As an aspiring PA, I know why I've picked this route vs. NP. I've debated it internally and had my ups and down about my decision, but at the end of the day, my future profession is what I make of it. I'm not afraid to take a chance and lead in what I consider a completely badass profession. It won't be easy debating with our peers and standing up for what we believe is the right path for the future of PA practice, but it is the right and appropriate thing to do.

 

I've read a lot of cynicism on here lately pertaining the state of the profession and while I appreciate the thoughtful debate, its never enough to change my mind about going to PA school. Do what you will and don't seek answers from others and certain websites, even if they are helpful at times. Ultimately, only YOU have to answer to yourself about who YOU are and what YOU want to do with the little time you have on earth. Its all about attitude.

 

Maybe I sound a little naive and idealistic, but being idealistic has granted me more motivation than questioning myself every step of the way. Okay, I'm done. Hope that helps!

[NAP1986]

Self employment in the era of ACO's is going the way of the whigs. Doesn't matter what degrees or credentials you have, unless you are practicing concierge medicine, which will remain a niche, everyone else will be an employee.

 

I wrote a paper back in the 90's (econ paper) about market consolidation in healthcare, and how eventually there would only be 15-20 regional health networks in the country, and how you would have regional masters (CCF, Hopkins, Baylor, Geisinger, Kaiser, Intermountain, etc.etc.) that will compete at the margins. With the advent of the ACO model, it would seem that some of my forecasting, although projected for different reasons, might come to fruition.

 

Independence and self employment are both myths. New payment models will dictate certain practice parameters to providers. For example, if you are not meeting certain quality targets and/or following established decision rules, using decision aids, and following guidelines, well, you are not going to be reimbursed very well. This is the model of the future and will be the future of healthcare. Acuity triangles will dictate provider utilization, etc.etc.etc.

 

I think there is a distinction this reply is missing regarding indepdence. It sounds perfectly logical from your analysis that free-standing clinics and self-employment are going the way of the dodo. However, when I think about "independence", it also means not having another healthcare provider having the final say about the treatment of your patient (who they may have never met) and having full scope of practice (no arbitrary restrictions) in your setting (probably likely only for primary care or other outpatient settings for PAs/NPs).

 

Perhaps one could step back and say that with evidence-based medicine guidelines and reimbursement being tied to outcomes and how well a provider is following the recommendations, physicians will not really have that much clinical decision making autonomy in the end and there will be no "independence" for anyone. If that is the case, the only difference between PAs/ supervised NPs and physicians will be an additional middleman (the doctor), who will not really be necessary or have much to contribute, if everyone is following cookbook medicine.

 

I don't know if it is the fundamental nature of the human spirit to desire to be self-employed, but having autonomy in decision making seems pretty fundamental for job satisfaction. I guess only time will tell how ACOs and evidence-based medicine will change things for all providers.

[NAP1986]

Self employment in the era of ACO's is going the way of the whigs. Doesn't matter what degrees or credentials you have, unless you are practicing concierge medicine, which will remain a niche, everyone else will be an employee.

 

I wrote a paper back in the 90's (econ paper) about market consolidation in healthcare, and how eventually there would only be 15-20 regional health networks in the country, and how you would have regional masters (CCF, Hopkins, Baylor, Geisinger, Kaiser, Intermountain, etc.etc.) that will compete at the margins. With the advent of the ACO model, it would seem that some of my forecasting, although projected for different reasons, might come to fruition.

 

Independence and self employment are both myths. New payment models will dictate certain practice parameters to providers. For example, if you are not meeting certain quality targets and/or following established decision rules, using decision aids, and following guidelines, well, you are not going to be reimbursed very well. This is the model of the future and will be the future of healthcare. Acuity triangles will dictate provider utilization, etc.etc.etc.

 

I think there is a distinction this reply is missing regarding indepdence. It sounds perfectly logical from your analysis that free-standing clinics and self-employment are going the way of the dodo. However, when I think about "independence", it also means not having another healthcare provider having the final say about the treatment of your patient (who they may have never met) and having full scope of practice (no arbitrary restrictions) in your setting (probably likely only for primary care or other outpatient settings for PAs/NPs).

 

Perhaps one could step back and say that with evidence-based medicine guidelines and reimbursement being tied to outcomes and how well a provider is following the recommendations, physicians will not really have that much clinical decision making autonomy in the end and there will be no "independence" for anyone. If that is the case, the only difference between PAs/ supervised NPs and physicians will be an additional middleman (the doctor), who will not really be necessary or have much to contribute, if everyone is following cookbook medicine.

 

I don't know if it is the fundamental nature of the human spirit to desire to be self-employed, but having autonomy in decision making seems pretty fundamental for job satisfaction. I guess only time will tell how ACOs and evidence-based medicine will change things for all providers.

[Guest JMPA]

Self employment in the era of ACO's is going the way of the whigs. Doesn't matter what degrees or credentials you have, unless you are practicing concierge medicine, which will remain a niche, everyone else will be an employee.

 

I wrote a paper back in the 90's (econ paper) about market consolidation in healthcare, and how eventually there would only be 15-20 regional health networks in the country, and how you would have regional masters (CCF, Hopkins, Baylor, Geisinger, Kaiser, Intermountain, etc.etc.) that will compete at the margins. With the advent of the ACO model, it would seem that some of my forecasting, although projected for different reasons, might come to fruition.

 

Independence and self employment are both myths. New payment models will dictate certain practice parameters to providers. For example, if you are not meeting certain quality targets and/or following established decision rules, using decision aids, and following guidelines, well, you are not going to be reimbursed very well. This is the model of the future and will be the future of healthcare. Acuity triangles will dictate provider utilization, etc.etc.etc.

Your ideas of social medicine are incorrect. Although it may be the "model" for the future, it is failure waiting to happen. Further more, yes independence and self employment are myths for PAS because of socialists like yourself. Compared to NP/MD, and yes i did just group them, we as a profession can obtain neither independence or self employment. And why? we cant even obtain a bridge program. And you also leave out the world of private payers. There are many practices that cater only to self pay, and they do quite well with not restrictions or mandatory "guidelines". It is people like you whom promote the destruction of this fine profession by promotion of comformity to socialistic/dependent medical practice. (how is it practice if it is dictated?)

[Guest JMPA]

Self employment in the era of ACO's is going the way of the whigs. Doesn't matter what degrees or credentials you have, unless you are practicing concierge medicine, which will remain a niche, everyone else will be an employee.

 

I wrote a paper back in the 90's (econ paper) about market consolidation in healthcare, and how eventually there would only be 15-20 regional health networks in the country, and how you would have regional masters (CCF, Hopkins, Baylor, Geisinger, Kaiser, Intermountain, etc.etc.) that will compete at the margins. With the advent of the ACO model, it would seem that some of my forecasting, although projected for different reasons, might come to fruition.

 

Independence and self employment are both myths. New payment models will dictate certain practice parameters to providers. For example, if you are not meeting certain quality targets and/or following established decision rules, using decision aids, and following guidelines, well, you are not going to be reimbursed very well. This is the model of the future and will be the future of healthcare. Acuity triangles will dictate provider utilization, etc.etc.etc.

Your ideas of social medicine are incorrect. Although it may be the "model" for the future, it is failure waiting to happen. Further more, yes independence and self employment are myths for PAS because of socialists like yourself. Compared to NP/MD, and yes i did just group them, we as a profession can obtain neither independence or self employment. And why? we cant even obtain a bridge program. And you also leave out the world of private payers. There are many practices that cater only to self pay, and they do quite well with not restrictions or mandatory "guidelines". It is people like you whom promote the destruction of this fine profession by promotion of comformity to socialistic/dependent medical practice. (how is it practice if it is dictated?)

[Super Duper]

<deleted due to lack of expertise in area of discussion>

[Super Duper]

<deleted due to lack of expertise in area of discussion>

[physasst]

Your ideas of social medicine are incorrect. Although it may be the "model" for the future, it is failure waiting to happen. Further more, yes independence and self employment are myths for PAS because of socialists like yourself. Compared to NP/MD, and yes i did just group them, we as a profession can obtain neither independence or self employment. And why? we cant even obtain a bridge program. And you also leave out the world of private payers. There are many practices that cater only to self pay, and they do quite well with not restrictions or mandatory "guidelines". It is people like you whom promote the destruction of this fine profession by promotion of comformity to socialistic/dependent medical practice. (how is it practice if it is dictated?)

 

Private insurers are moving into and experimenting with novel payment mechanisms like Prometheus, etc. Most of my intervenational research is now focused on audit and feedback (AF), where we assess how well providers are using evidence based guidelines (audit), and then create an intervention (feedback), and then re-assess provider compliance and practice afterwards (second audit) to determine if the feedback mechanism worked.

 

Providers don't like being told what to do. Which is why reimbursement will have to be tied to this. Ivers just completed the largest Cochrane review to date on AF and found that physicians only changed their behavior 4.7% of the time. Which is simply not acceptable. Much of our work (International Collaborative on AF) is now focused on experimenting with different feedback models to see which is more effective, and also experimenting in other provider groups (PAs, NPs, Nursing, PT, OT, etc.etc.etc.)

 

 

I would look up a lot of the work Naessens has done looking at acuity stratification and team dynamics in primary care (disclaimer-Jim works here and is a colleague with whom I work).

 

The fact is, whether you like it or not, healthcare delivery is being re-engineered using SE/OR techniques, and will change dramatically over the next 5-10 years.

[physasst]

Your ideas of social medicine are incorrect. Although it may be the "model" for the future, it is failure waiting to happen. Further more, yes independence and self employment are myths for PAS because of socialists like yourself. Compared to NP/MD, and yes i did just group them, we as a profession can obtain neither independence or self employment. And why? we cant even obtain a bridge program. And you also leave out the world of private payers. There are many practices that cater only to self pay, and they do quite well with not restrictions or mandatory "guidelines". It is people like you whom promote the destruction of this fine profession by promotion of comformity to socialistic/dependent medical practice. (how is it practice if it is dictated?)

 

Private insurers are moving into and experimenting with novel payment mechanisms like Prometheus, etc. Most of my intervenational research is now focused on audit and feedback (AF), where we assess how well providers are using evidence based guidelines (audit), and then create an intervention (feedback), and then re-assess provider compliance and practice afterwards (second audit) to determine if the feedback mechanism worked.

 

Providers don't like being told what to do. Which is why reimbursement will have to be tied to this. Ivers just completed the largest Cochrane review to date on AF and found that physicians only changed their behavior 4.7% of the time. Which is simply not acceptable. Much of our work (International Collaborative on AF) is now focused on experimenting with different feedback models to see which is more effective, and also experimenting in other provider groups (PAs, NPs, Nursing, PT, OT, etc.etc.etc.)

 

 

I would look up a lot of the work Naessens has done looking at acuity stratification and team dynamics in primary care (disclaimer-Jim works here and is a colleague with whom I work).

 

The fact is, whether you like it or not, healthcare delivery is being re-engineered using SE/OR techniques, and will change dramatically over the next 5-10 years.

[vpedpa]

Then just go if its on your mind that frequently. You sound somewhat obsessed

[vpedpa]

Then just go if its on your mind that frequently. You sound somewhat obsessed