Are we heading towards a "mid-level heavy" healthcare system

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rathman26

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We have Physician Assistants and Nurse Practitioners. We have Radiologist Assistants, whom all extend the physician, and provide cost effective services to patients. I believe 29 states currently recognize Radiologist Assistants. To my knowledge, I don't believe RA's can actually read images though as apart of their practice

Now we even have Respiratory Therapists who will be pushing hard not only to make their time and services billable by medicare, but to also eventually create a mid level in their field as well. I assume it will be to extend the pulmonologist and do things such as make their own vent changes, and order meds.

Minnesota currently is the only state I believe that has the Advanced Practice Dental Hygenist, but more states could follow in coming years.

Radiation Therapists could also try to get in on the fun: http://www.asrt.org/docs/default-source/whitepapers/acad07whtpprrttadvpractice.pdf?sfvrsn=2

With a looming physician shortage at hand in the coming years, it seems like we are going to turn more and more to "mid-level" providers to fill the voids. Im not convinced though that the current needs cannot be filled by NP's and PA's and that basically every specialty needs to have a specialty. This degree creep is getting a little out of hand now.

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We have Physician Assistants and Nurse Practitioners. We have Radiologist Assistants, whom all extend the physician, and provide cost effective services to patients. I believe 29 states currently recognize Radiologist Assistants. To my knowledge, I don't believe RA's can actually read images though as apart of their practice

Now we even have Respiratory Therapists who will be pushing hard not only to make their time and services billable by medicare, but to also eventually create a mid level in their field as well. I assume it will be to extend the pulmonologist and do things such as make their own vent changes, and order meds.

Minnesota currently is the only state I believe that has the Advanced Practice Dental Hygenist, but more states could follow in coming years.

Radiation Therapists could also try to get in on the fun: http://www.asrt.org/docs/default-source/whitepapers/acad07whtpprrttadvpractice.pdf?sfvrsn=2

With a looming physician shortage at hand in the coming years, it seems like we are going to turn more and more to "mid-level" providers to fill the voids. Im not convinced though that the current needs cannot be filled by NP's and PA's and that basically every specialty needs to have a specialty. This degree creep is getting a little out of hand now.
Midlevel RRTs will never happen. There's no need for them, as they'd have less of a scope than a physician assistant and likely just as long of a training period. There's nothing special a midlevel RT could do that a PA couldn't, it would just be silly. What scope would they add, bronchoscopies? Central lines maybe? The ability to change their own ventilator orders and order their own therapies? I just can't see much added utility. Just my two cents as a respiratory therapist.

Colorado and Alaska, I believe, recognize Dental Assistants as a midlevel dental provider.

Yeah, we're looking at a flood of midlevel providers in the future, and a country in which only the wealthy get real medical care, unlike every other country in the world, where it's a given that people deserve care provided and overseen by a physician.
 
Midlevel RRTs will never happen. There's no need for them, as they'd have less of a scope than a physician assistant and likely just as long of a training period. There's nothing special a midlevel RT could do that a PA couldn't, it would just be silly. What scope would they add, bronchoscopies? Central lines maybe? The ability to change their own ventilator orders and order their own therapies? I just can't see much added utility. Just my two cents as a respiratory therapist.

Colorado and Alaska, I believe, recognize Dental Assistants as a midlevel dental provider.

Yeah, we're looking at a flood of midlevel providers in the future, and a country in which only the wealthy get real medical care, unlike every other country in the world, where it's a given that people deserve care provided and overseen by a physician.

I think it will happen to an extent, but they'll be rare/sparsely used. Like only a few states allowing them to practice and only a handful of jobs and opportunities being available to them. RCP's I believe already have the skills and training to do a lot of those things to my knowledge (vent changes, some places I believe let them insert a-lines). They are already a very capable provider, and it's not that they are not capable of taking on that role, but more so that....I don't think with RCP's in particular that any more training will help them. I think in their particular case, they need to focus on making their services and time billable by medicare so they can work outside the hospital walls, and the opportunities will come for that profession. But that's a long fight in it's own right.

But this seems like the growing trend now, where specialties have specialties.

And I also could foresee a flood of mid-levels in the future, especially with the NP's. This combined with a shortage of MD's

There seem to be new NP schools popping up all over the place. Some NP programs can even be done online via distance learning. Not knocking the DL route, distance learning is becoming more and more of the norm today, but the more convenience, and easier access to schools, combined with more schools popping up, and with an increased ability to accept more students and hold more seats, can lead to a flood of professionals in a field.

Any healthcare program to a college is a cash cow. But I think we're definitely looking at a mid-level heavy healthcare system going forward.
 
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I think it will happen to an extent, but they'll be rare/sparsely used. Like only a few states allowing them to practice and only a handful of jobs and opportunities being available to them. RCP's I believe already have the skills and training to do a lot of those things to my knowledge (vent changes, some places I believe let them insert a-lines). They are already a very capable provider, and it's not that they are not capable of taking on that role, but more so that....I don't think with RCP's in particular that any more training will help them. I think in their particular case, they need to focus on making their services and time billable by medicare so they can work outside the hospital walls, and the opportunities will come for that profession. But that's a long fight in it's own right.

But this seems like the growing trend now, where specialties have specialties.

And I also could foresee a flood of mid-levels in the future, especially with the NP's. This combined with a shortage of MD's

There seem to be new NP schools popping up all over the place. Some NP programs can even be done online via distance learning. Not knocking the DL route, distance learning is becoming more and more of the norm today, but the more convenience, and easier access to schools, combined with more schools popping up, and with an increased ability to accept more students and hold more seats, can lead to a flood of professionals in a field.

Any healthcare program to a college is a cash cow. But I think we're definitely looking at a mid-level heavy healthcare system going forward.
Yale just decided to start the first online PA program as well. Standards are falling across the board, and the ones who stand to suffer the most are the public.
 
Yale just decided to start the first online PA program as well. Standards are falling across the board, and the ones who stand to suffer the most are the public.
the yale distance learning program was NOT credentialed by the physician assistant educational association earlier this month. it will not be operating anytime soon, although yale says it will reapply. if this ever happens it is still years in the future.
 
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the yale distance learning program was NOT credentialed by the physician assistant educational association earlier this month. it will not be operating anytime soon, although yale says it will reapply. if this ever happens it is still years in the future.
Thank god. This is an excellent development toward protecting the integrity of the PA profession.
 
We pushed very hard against the online program.
 
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We pushed very hard against the online program.
yes we did. many Yale grads sent letters stating this would tarnish their prior degrees and many folks(myself included) sent letters to PAEA saying this would set a bad precedent for the profession.
 
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