AAPA's Push for Full Practice Authority

[doctalaughs]

What's your background Fox800? Have you worked in a small hospital like this? Ever looked at the budget of a hospital in a town of 8000 people?

Even if they COULD afford BCEP (and the vast majority couldn't), there aren't NEARLY enough of you to go around.

I have a solution for all the problems in this thread. Since you think independent practice is inevitable, and PAs are supposed to "self-regulate" who need more help and who is not ready, I propose that we have all doctors abolish the need for formal residency. As soon as you graduate medical school you can independently run an emergency room, do surgery, be a hospitalist or pediatrician with zero formal requirement for someone supervising.

After all, these will be doctors with more training than a newly graduated PA so all patients will surely benefit. Of course, some will not be ready yet for neurosurgery, but they will "self-regulate" and make sure that they "get a second set of eyes" until they are up to speed in a few years. This will also solve the rural problem because those grads will work for 125/hour instead of 250, commensurate with their training level between a PA and a fully boarded doc.

See what I did there?


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[doctalaughs]

M
If your EM PAs don't know Nexus criteria then fire them. Today. They should be working derm, not EM. Hell, they shouldn't even be working Derm because I'm 99% sure the Nexus criteria is on the PAEA/NCCPA blueprint for the PANCE/PANRE (the PA national certification/recertifcation examination).


It sounds like you have realllly crappy mid-levels.

Right, send the PAs over to derm because you actually don't need to know anything to practice dermatology.

I actually spent my 4 years of residency in dermatology playing candy crush on my phone and learning how to pluck eyebrows.


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[deleted109597]

You're correct in that I occasionally ask for a second set of MD/DO eyes to look over a situation. That's generally a good idea.

Your argument of "relegate that PA to the snot hall" doesn't hold water in the real world, and is incongruent with the "push for independence".

Relegation doesn't work when the PA/NP is too busy arguing with you as to why "you're wrong and they're right".

Just last night. 10pm. Quittin' time for one of our PAs. I look thru his 28 year old with vertigo chart before he leaves. Guy notoriously sucks at charting. When he presents the case to me, he tells me of right-sided nystagmus and classic BPPV symptoms.
<snip>

It's the same problem we have with nurses. Their authority structure goes to the head midlevel. Not to you. After that, I think it might go to the medical director, but most of those are wet noodle CMG pawns, so it ends there. This is the real cause of burnout. We are responsible for everything, but have no authority. Nurses suck? Sorry, the hospital employs them and won't fire them. Lab takes too long? Sorry doc, you'll have to see them in the lobby now. Patient complains about the transporters? C suite sits the group down for a talking to about press ganey scores.
Private practice is where it's at. Even the SDGs, with whatever stability they think they have, don't employ the nurses, techs, and lab.

 

[Boatswain2PA]

I have a solution for all the problems in this thread. Since you think....PAs are supposed to "self-regulate" who need more help and who is not ready.....

I never said that. I said I think independence is inevitable because physician groups have lost the political battle with the NPs allowing them to become "independent", thus opening the doors for others.

 

[GandalfTheWhite]

I never said that. I said I think independence is inevitable because physician groups have lost the political battle with the NPs allowing them to become "independent", thus opening the doors for others.

until politicians and hospital admins realize that NPs order 25% more tests and obtain consults/specialist referrals 42% more than physicians which drives up both healthcare costs for the public and operating costs for the hospital.

 

[RustedFox]

until politicians and hospital admins realize that NPs order 25% more tests and obtain consults/specialist referrals 42% more than physicians which drives up both healthcare costs for the public and operating costs for the hospital.

You haven't heard? The public likes unnecessary testing. Makes them feel better. So does the hospital. More to charge for.

I seriously ordered a flu swab on a nonfebrile, non-sick at all six year old at one am last shift. Why? Parents insisted on it. Easier to just give in than deal with the patient complaint.

 

[GandalfTheWhite]

You haven't heard? The public likes unnecessary testing. Makes them feel better. So does the hospital. More to charge for.

I seriously ordered a flu swab on a nonfebrile, non-sick at all six year old at one am last shift. Why? Parents insisted on it. Easier to just give in than deal with the patient complaint.

Well hopefully, this new bill about malpractice restrictions should help cut down on defensive medicine and CYAs, but the complaints/satisfaction surveys is something I cant even being to think up a solution for.

 

[67552931811]

Well hopefully, this new bill about malpractice restrictions should help cut down on defensive medicine and CYAs, but the complaints/satisfaction surveys is something I cant even being to think up a solution for.

Don't have them?

 

[RustedFox]

Well hopefully, this new bill about malpractice restrictions should help cut down on defensive medicine and CYAs, but the complaints/satisfaction surveys is something I cant even being to think up a solution for.

New bill about malpractice restrictions? Share, please.

 

[GandalfTheWhite]

New bill about malpractice restrictions? Share, please.

https://www.nytimes.com/2017/04/15/...alth-care-bill-medical-malpractice-suits.html
House GOP quietly advances key elements of tort reform

Its a bill, not a law... yet.

Don't have them?

LOL why make things easier and allow us to focus on the medicine instead of placating people? No fun in that