Call to action: AA's in Texas

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NC does not allow AA's at present, thanks in large part to your friends and mine, the AANA, NCANA, and numerous individual CRNA's.

Several legislators in NC are under scrutiny or investigation for possible ethics or campaign finance violations after the AA bill was held up by the committee chairman despite it's being passed by an overwhelming vote of the healthcare committee, and despite it already passing the full senate.

http://www.journalnow.com/servlet/S...SJ_BasicArticle&c=MGArticle&cid=1173350599729


Is the ASA aware of this story? You should send them the link to give them ammunition against the CRNAs. Yet more proof of the corruption the AANA is likely full of.

Ideally, they should pursue legal action against the corrupt politicians that derailed this bill even though it looked it had already been approved.
 
Members don't see this ad :)
I think you will be pleasantly surprised with the reply.:)
 
http://www.asahq.org/Newsletters/2007/05-07/stateBeat05_07.html

Texas Introduces Anesthesiologist Assistant Licensure Legislation

Lisa Percy, J.D., Manager
State Legislative and Regulatory Affairs

Legislation has been introduced into the Texas Legislature that would require a person to obtain a license in order to practice as an anesthesiologist assistant (AA). Although AAs in Texas currently practice pursuant to the delegatory authority of anesthesiologists as set forth in the medical board's guidelines, licensure more clearly defines and anchors the practice of AAs in a state than delegatory authority. AAs are currently licensed in 10 states* and practice pursuant to a physician's delegatory authority in six.†

Under H.B. 3313, an AA would be authorized to assist the supervising anesthesiologist in developing and implementing an anesthesia care plan for a patient. AAs would practice only under the direct supervision of a board-certified anesthesiologist who is physically present or immediately available. The supervising anesthesiologist may supervise no more than four AAs; an AA may have more than one supervising anesthesiologist.

In providing assistance, an AA's scope of practice could include:

• obtaining a comprehensive patient history, performing relevant elements of the physical examination and presenting the information to the anesthesiologist;

• pretesting and calibrating anesthesia delivery systems and interpreting such information from the monitors in consultation with the anesthesiologist;

• initiating multiparameter monitoring before anesthesia or in other acute care settings under anesthesiologist supervision;

• establishing basic and advanced airway interventions, including intubation and the performance of ventilatory support;

• administering intermittent vasoactive drugs and starting and adjusting vasoactive infusions;

• administering anesthetic, adjuvant and accessory drugs;

• assisting and initiating with the supervising anesthesiologist the performance of epidural anesthetic procedures, spinal anesthetic procedures and other regional anesthetic techniques;

• providing initial CPR in response to a life-threatening situation as directed by a physician or protocol until the supervising anesthesiologist arrives;

• participating in research and clinical teaching activities as authorized by the supervising anesthesiologist; or

• performing other tasks delegated by an anesthesiologist and that the AA has been trained and proficient to perform.

Conversely AAs would be prohibited from prescribing medication or controlled substances. AAs would practice only under the supervision of an anesthesiologist or in any location where the supervising anesthesiologist is immediately available for consultation, assistance and intervention.

H.B. 3313 creates the Texas Anesthesiologist Assistant Board, which would be an advisory board to the medical board. The AA board would consist of six members, including a physician, AA, two anesthesiologists and two members from the public who are not licensed or trained in a health care profession. The board also would adopt rules that establish continuing education requirements for AAs, licensure fees, procedures for disciplinary actions and procedures to review licensure applications. The medical board would adopt rules to regulate AAs and the supervising anesthesiologists.

Lastly H.B. 3313 protects patients from misrepresentation. AAs would be prohibited from referring to a license as "board-certified" or any other terminology that implies that the AA is a physician. Student AAs would not be permitted to use the terms "intern," "resident" or "fellow."

*Alabama, District of Columbia, Florida, Georgia, Kentucky, Missouri, New Mexico, Ohio, South Carolina, Vermont.

†Colorado, Michigan, New Hampshire, Texas, West Virginia, Wisconsin.
 
We will see if the AANA loses this fight. The odds are against the AANA in Texas because the shortage of providers is pretty severe there and Texas believes in the free market.

Blade
 
The bill is scheduled for public hearing!!! :clap: :clap: :clap:

http://www.legis.state.tx.us/tlodocs/80R/analysis/html/SB01314I.htm

AUTHOR'S / SPONSOR'S STATEMENT OF INTENT

Anesthesiologist assistants (AAs) are allied health care providers who work under the direction of licensed anesthesiologists to develop and implement anesthesia care plans. AAs are licensed and regulated in 15 states and the District of Columbia, are recognized for compensation as approved health care providers by Medicare, Medicaid, and Tricare, and are employed in the Veterans Administration hospital system. Currently, there is a shortage of AAs practicing in Texas. This bill will ensure patient safety and promote AA practice in Texas.

Effective date: September 1, 2007, except as provided by Subsection (b) of this section.


Next step: Scheduled for public hearing on . . . . .
http://www.legis.state.tx.us/BillLookup/History.aspx?LegSess=80R&Bill=SB1314

Hopefully Texas will soon be the 11th state to license AA's!!!
 
Can someone explain (I apologize if this has been addressed, but in my following of this forum I have seen this question posed and not satisfactorily addressed) why backing AAs does anything except postpone the problem?

I mean, I guess we do need to postpone the problem since it is already upon us. That's fine... I just wanted to make sure that's all it did, and that we are still looking for all of the other avenues of correcting the underlying problem.

Great news, though!
 
Can someone explain (I apologize if this has been addressed, but in my following of this forum I have seen this question posed and not satisfactorily addressed) why backing AAs does anything except postpone the problem?

I mean, I guess we do need to postpone the problem since it is already upon us. That's fine... I just wanted to make sure that's all it did, and that we are still looking for all of the other avenues of correcting the underlying problem.

Great news, though!

CRNA's fall under the Board of Nursing whereas AA's fall under the Board of Medicine. AA's are specifically required to work under an anesthesiologist as CRNA's once were too.

The benefit of AA's is that they give anesthesiologists more choices. They are no longer dependent on CRNA's. However, I think AA's are just a band-aid. Once their numbers grow large enough, they too will seek independence since their scope and role is exactly that of a CRNA. At least, AA's will give anesthesiology more time (20 years?) and control to formulate a future for the profession. The future probably will mean more supervision and less hands on delivery of gas by anesthesiologists. Maybe more perioperative work and rounding. With 36k CRNA's, the genie can't be put back in the bottle. It's unlikely we can roll back CRNA independence either. We can't deny that the profession is changing, but we should be taking the lead in shaping that transformation, not the CRNA's.
 
The benefit of AA's is that they give anesthesiologists more choices. They are no longer dependent on CRNA's. However, I think AA's are just a band-aid. Once their numbers grow large enough, they too will seek independence since their scope and role is exactly that of a CRNA. At least, AA's will give anesthesiology more time (20 years?) and control to formulate a future for the profession. The future probably will mean more supervision and less hands on delivery of gas by anesthesiologists. Maybe more perioperative work and rounding. With 36k CRNA's, the genie can't be put back in the bottle. It's unlikely we can roll back CRNA independence either. We can't deny that the profession is changing, but we should be taking the lead in shaping that transformation, not the CRNA's.

Again - and again - AA's are NOT interested in independent practice. We have already been here more than 35 years. It simply isn't in the cards. We are and always have been committed to the anesthesia care team concept with an anesthesiologist heading up the team. We believe that each patient deserves the involvement of an anesthesiologist with their surgical procedure. The AAAA and ASA work very well together and will continue to do so for many years to come.

There is a shortage of anesthesia providers nationwide - severely so in some areas. There aren't enough anesthesiologists (never will be) and there aren't enough CRNA's (never will be) to make up for the attrition of current providers and increase in demand from an aging population. AA's are an excellent, time-proven option to increasing available anesthesia services while at the same time making sure that an anesthesiologist is participating in the care of every patient in the practices that we work with.
 
Members don't see this ad :)
Again - and again - AA's are NOT interested in independent practice. We have already been here more than 35 years. It simply isn't in the cards. We are and always have been committed to the anesthesia care team concept with an anesthesiologist heading up the team. We believe that each patient deserves the involvement of an anesthesiologist with their surgical procedure. The AAAA and ASA work very well together and will continue to do so for many years to come.

There is a shortage of anesthesia providers nationwide - severely so in some areas. There aren't enough anesthesiologists (never will be) and there aren't enough CRNA's (never will be) to make up for the attrition of current providers and increase in demand from an aging population. AA's are an excellent, time-proven option to increasing available anesthesia services while at the same time making sure that an anesthesiologist is participating in the care of every patient in the practices that we work with.

Taurus,

You are correct about the CRNA issue. But, you are wrong about the AAAA.
The AAAA is committed to the ACT model. If the AANA gets its way our profession won't last 20 years. With the AAAA you get a quality professional without the competition. As for 20 years from now, you argument about the AAAA is theoretical while the AANA's drive for 100% Independence is all but a foregone conclusion. Which organization do you back TODAY?

Blade
 
The AAAA is committed to the ACT model.

You won't know for sure until their numbers reach in the thousands. Using history and human nature as my guide, I stick with my original claim. To me, it's not a question of if but when it will happen. I still support AA's over CRNA's though because it gives us more choices.
 
You won't know for sure until their numbers reach in the thousands. Using history and human nature as my guide, I stick with my original claim. To me, it's not a question of if but when it will happen. I still support AA's over CRNA's though because it gives us more choices.

AA's are not even licensed in the majority of the USA. Yet, you have them practicing Independently in twenty years. I am sure the AANA wouldn't mind competing against TWO groups for jobs. :rolleyes: In my opinion, it will take at least ten years or more to get AA's licensed in the majority of states.

In addition, how many years until the AAAA gets 10,000 members? With only 5 schools in existence a very long time. It is human nature to fear the unkown. It is also foolish to ignore history. The ASA has learned this lesson well and the mistakes made with the AANA are unlikely to be repeated with another organization.

Unfortunately, we need Mid-Level Providers in the USA. Our only option is to decide which Mid-Level Provider to support. I believe the AANA's agenda has left us with no alternative other than the AA. I suggest we act accordingly while there is still time.

Blade
 
Oh how funny this is to watch.

EtherMD and jwk would have us all believe that there is any difference in "intent" from the AAs or CRNAs. Truth is, its all about money. How long before the AAs seperate and become another type of CRNA? EtherMD and jwk will long be gone from the profession by then and we will be holding the ball.

The right way to fight is to stop wasting resources and money on AA programs and put the money into MD/DO Residency programs which are failing (per the ASA itself). Why isnt the answer MORE MD/DOs as opposed to another midlevel?
 
Well, there you go a CRNA telling us not to back the AA's. So that must be what we should do:smuggrin: . Listen, it has been stated many times on here that AA's are controlled by the medical board (physicians) so there will never be a chance of independent practice. There may however be a push for extended scope of practice which we will have to monitor. That just tells me that the push for more AA's is working and making the CRNA's nervous. Lets keep up the push. Some colleagues of mine from CO just lost a couple of CRNA's and replaced them with AA's :) . They said it was a mild uproar but quickly subsided when they seen how qualified they were.
 
Well, there you go a CRNA telling us not to back the AA's. So that must be what we should do:smuggrin: . Listen, it has been stated many times on here that AA's are controlled by the medical board (physicians) so there will never be a chance of independent practice. There may however be a push for extended scope of practice which we will have to monitor. That just tells me that the push for more AA's is working and making the CRNA's nervous. Lets keep up the push. Some colleagues of mine from CO just lost a couple of CRNA's and replaced them with AA's :) . They said it was a mild uproar but quickly subsided when they seen how qualified they were.

I agree wholeheartedly. The AANA uses misinformation to slander the AA profession. Our only option at this point is to replace CRNA's whenever possible with AA's. The ASA leadership supports the AAAA but a REAL effort must be made to start a dozen new programs.

Blade
 
Oh how funny this is to watch.

EtherMD and jwk would have us all believe that there is any difference in "intent" from the AAs or CRNAs. Truth is, its all about money. How long before the AAs seperate and become another type of CRNA? EtherMD and jwk will long be gone from the profession by then and we will be holding the ball.

The right way to fight is to stop wasting resources and money on AA programs and put the money into MD/DO Residency programs which are failing (per the ASA itself). Why isnt the answer MORE MD/DOs as opposed to another midlevel?

There will never be enough anesthesiologists, plain and simple. Many of the anesthesia residency systems are in deep doodoo now (don't forget to thank the AANA) and is not likely to change significantly for a while. You could double the number of residencies (not that anyone could pay for them) and still not produce enough new anesthesiologists to fill every chair at the head of the OR table. You're right - it IS all about the money, and for whatever reason, anesthesiology has NEVER gotten it's fair share from CMS and insurors. I remember many years ago when insurors considered the "standard" reasonable fee for anesthesia to be 20% of the surgical fee.

The AANA has never supported anesthesiologists and the ASA. Contrast that to the AAAA and AA's who are committed to working with the ASA.
 
Some colleagues of mine from CO just lost a couple of CRNA's and replaced them with AA's :) . They said it was a mild uproar but quickly subsided when they seen how qualified they were.

Sweet! :thumbup:

I agree. Because AA's are under the BOM, physicians will have greater control than over nurses. "Monitor" is the operative word.
 
Some colleagues of mine from CO just lost a couple of CRNA's and replaced them with AA's :) . They said it was a mild uproar but quickly subsided when they seen how qualified they were.
That's what we're always pointing out. Once someone actually meets or works with an AA, they quickly realize we're not the incompetent uneducated idiots that the AANA would have you believe that we are. One reason the Florida legislation passed on the third attempt several years ago was that several of the Florida legislators that initially voted against us finally realized that they had been flat-out lied to by CRNA's and their assorted "professional" organizations.
 
Listen fool.

If i was a CRNA why would i promote more MD/DO programs? Are you daft?

Im sick of being labeled something im not just because I dont agree with the rhetoric you people blindly spit out. My mother is a former CRNA who became an anesthesiologist, my dad is a surgeon. I was a Nurse who when to med school. Believe me, i know the politics here very well since i grew up on them.

Regardless of what jwk says, AA = another person doing your job. PAs were also "under the medical board" and are pushing yearly for more independence, and are getting it. AA = the PA of anesthesia. To be so short sighted as to believe that the medical board will have dominion over a midlevel for ever and ever is akin to believing in fairy tales when the proof is all around you that it dosent happen that way. Id rather see more DOCTORS put out than more COMPETITORS regardless of their pretty names. Take a bit of a loss now to have more MD/DOs to solidify the profession 10 yrs form now.

If residency programs are in "doodoo" now, how will they be 10 years from now when we have ignored them, spent all our money creating AA programs and they have decreased by 50% since CRNA and AAs can do the job and there is little need for the anesthesiologist? Come now, are you all that short sighted?

Well, there you go a CRNA telling us not to back the AA's. So that must be what we should do:smuggrin: . Listen, it has been stated many times on here that AA's are controlled by the medical board (physicians) so there will never be a chance of independent practice. There may however be a push for extended scope of practice which we will have to monitor. That just tells me that the push for more AA's is working and making the CRNA's nervous. Lets keep up the push. Some colleagues of mine from CO just lost a couple of CRNA's and replaced them with AA's :) . They said it was a mild uproar but quickly subsided when they seen how qualified they were.
 
My preference would be no midlevels at all. All anesthesia should be given by a anesthesiologist. However, that's not the case because we allowed midlevels into the game. It's too late to turn back the clock.

There aren't enough anesthesiologist so we need help from midlevels. If we have to have a midlevel in the OR, I would choose an AA over a CRNA.
 
Listen fool.

If i was a CRNA why would i promote more MD/DO programs? Are you daft?

Im sick of being labeled something im not just because I dont agree with the rhetoric you people blindly spit out. My mother is a former CRNA who became an anesthesiologist, my dad is a surgeon. I was a Nurse who when to med school. Believe me, i know the politics here very well since i grew up on them.

Regardless of what jwk says, AA = another person doing your job. PAs were also "under the medical board" and are pushing yearly for more independence, and are getting it. AA = the PA of anesthesia. To be so short sighted as to believe that the medical board will have dominion over a midlevel for ever and ever is akin to believing in fairy tales when the proof is all around you that it dosent happen that way. Id rather see more DOCTORS put out than more COMPETITORS regardless of their pretty names. Take a bit of a loss now to have more MD/DOs to solidify the profession 10 yrs form now.

If residency programs are in "doodoo" now, how will they be 10 years from now when we have ignored them, spent all our money creating AA programs and they have decreased by 50% since CRNA and AAs can do the job and there is little need for the anesthesiologist? Come now, are you all that short sighted?

Can you give an example of PA's pushing yearly for independence and getting it. More rhetoric. Yes there is a very small dissatisfied minority that really should have gone to medical school. Most of the push for "independence" is to remove barriers that frankly make the supervising physician's job more difficult. You claim to understand the politics then spit out this garbage.

David Carpenter, PA-C
 
My preference would be no midlevels at all. All anesthesia should be given by a anesthesiologist. However, that's not the case because we allowed midlevels into the game. It's too late to turn back the clock.

There aren't enough anesthesiologist so we need help from midlevels. If we have to have a midlevel in the OR, I would choose an AA over a CRNA.

Do you really want to be the MD who does anesthesia for cataract surgery all day every day?
 
Listen fool.

If i was a CRNA why would i promote more MD/DO programs? Are you daft?

Im sick of being labeled something im not just because I dont agree with the rhetoric you people blindly spit out. My mother is a former CRNA who became an anesthesiologist, my dad is a surgeon. I was a Nurse who when to med school. Believe me, i know the politics here very well since i grew up on them.

Regardless of what jwk says, AA = another person doing your job. PAs were also "under the medical board" and are pushing yearly for more independence, and are getting it. AA = the PA of anesthesia. To be so short sighted as to believe that the medical board will have dominion over a midlevel for ever and ever is akin to believing in fairy tales when the proof is all around you that it dosent happen that way. Id rather see more DOCTORS put out than more COMPETITORS regardless of their pretty names. Take a bit of a loss now to have more MD/DOs to solidify the profession 10 yrs form now.

If residency programs are in "doodoo" now, how will they be 10 years from now when we have ignored them, spent all our money creating AA programs and they have decreased by 50% since CRNA and AAs can do the job and there is little need for the anesthesiologist? Come now, are you all that short sighted?

You seem to be the one that lacks insight into this problem. Your denial of the AANA's CONSTANT push for more independence shows Naivety or foolishness.

AA Programs mean more labor for the Academic Chairs. Thus, these programs MAKE money for academia and help support the Residency Programs.
Mid-Levels are a fact of life in the USA. An AA is a good alternative to a CRNA which results in hurting the AANA's agenda.

Your "blindness" is due in part to lack of education and experience despite your parents' backgrounds. Fortunately, the majority of the ASA and experienced attendings realize the threat the AANA posses to our specialty in the future. While we may disagree on the solution there is no denying the problem. Just open this month's ASA Newsletter and read about the AANA's latest push for more practice rights.
 
Hey Dave


Well this quote:

Most of the push for "independence" is to remove barriers that frankly make the supervising physician's job more difficult. You claim to understand the politics then spit out this garbage.

Is a perfect example of rhetoric. I could post the PA stuff but why bother? You just confirmed it for me.


Can you give an example of PA's pushing yearly for independence and getting it. More rhetoric. Yes there is a very small dissatisfied minority that really should have gone to medical school. Most of the push for "independence" is to remove barriers that frankly make the supervising physician's job more difficult. You claim to understand the politics then spit out this garbage.

David Carpenter, PA-C
 
Hey Dave


Well this quote:



Is a perfect example of rhetoric. I could post the PA stuff but why bother? You just confirmed it for me.

Nice ad hominen attack. In my state 100% chart consignature requirement within two weeks. Doc's went to the state board and said lets get rid of this. Not the PA's the Doc's. PA's among others not sure if this was a good idea. End result a change where the signature requirement goes down as the PA gains more experience. Doc's are happy (doesn't really affect the PA's). I'm sure you would label this a press for "independence". The physicians that are affected by it saw it as affecting their business and practice of medicine. Once again proof?

David Carpenter, PA-C
 
Nice ad hominen attack. In my state 100% chart consignature requirement within two weeks. Doc's went to the state board and said lets get rid of this. Not the PA's the Doc's. PA's among others not sure if this was a good idea. End result a change where the signature requirement goes down as the PA gains more experience. Doc's are happy (doesn't really affect the PA's). I'm sure you would label this a press for "independence". The physicians that are affected by it saw it as affecting their business and practice of medicine. Once again proof?

David Carpenter, PA-C

David,

The Same Group of militant CRNA's that wants "Independence" at any cost also despises the very concept of "AA." Thus, the AANA is fighting to keep AA's from practicing their field wherever possible. The AANA is run by these militant CRNA's and has been for at least the past twenty years.

When they can't win an argument with logic they use fear/scare tactics on Anesthesiologists and the Public. In this case it is the bogus "they will want Independence too" without knowing all the facts (or even caring about the facts).

Blade
 
David,

The Same Group of militant CRNA's that wants "Independence" at any cost also despises the very concept of "AA." Thus, the AANA is fighting to keep AA's from practicing their field wherever possible. The AANA is run by these militant CRNA's and has been for at least the past twenty years.

When they can't win an argument with logic they use fear/scare tactics on Anesthesiologists and the Public. In this case it is the bogus "they will want Independence too" without knowing all the facts (or even caring about the facts).

Blade

I would agree. Not just in the CRNA field either. Speaking for PA's we now have a almost 40 year history of practicing medicine under physician supervision. There are members of the AMA, AOA, ACP, ACS as well as three other physician organizations on our certifying board. We are under the BME in all 50 states. We have a representative at the AMA and they have one in our house of delegates. All in all it has been a very productive relationship which is defined by our practicing medicine in partnership with physicians. I have seen a lot of interest recently in Colorado with the AA profession and hopefully anesthesiologists have a similar relationship with AA's. What some people describe as lackeyism is what I describe as knowing your limitations.

David Carpenter, PA-C
 
*sigh*

Physician assistants in a battle regarding supervision
They are fighting against regulations requiring a certain amount of physician supervision:

The osteopathic group maintained at the hearing that patients do not get quality health care from a PA if the supervising physician does not initially see the patient and have on-site supervision.

The opposition groups say the two-year PA training, master’s level degrees and prior medical work does not qualify them to see patients alone, without the doctor being in the building.

Here are some Physician comments on the story.

I think it's money-grubbing on the part of PAs, who want to maintain or increase hours on the job, and the doctors, who want to keep the office open and generating income when they aren't around. This has nothing to do with patient access to care.

I've heard about PAs working by themselves under the license of a doctor. The doctor may be allowing several PAs to work under him/her and collecting revenue from all of them.

How can we require a doctor to be educated for minimum 7 years, a PA 2 years, and allow them to do the same job? Why do we require so much from doctors, or so little from PAs? I think that primary care providers learn the bulk of "how to do it" on the job. So a PA who has been working for a while probably has a really good grasp on everything primary care. So should they be able to practice without a doctor in the office? Are they the same as a doctor?

If I was a PA I'd want more autonomy so I could demand more money for increased responsibility, and then I could eventually push for laws allowing me to open my own primary care clinic without physician supervision.

As a doctor, I'd want to allow more PA autonomy to an extent. Just enough so I could keep PAs under me so that they couldn't go out on their own, but enough autonomy so they could see all my patients and I could simply pull my income off their backs.

The News-Leader of Springfield, Mo., has an article about the state's new PA supervision legislation .

A Missouri bill passed late Monday will ensure that patients will still have access to physician assistants in rural health clinics.

The bill, which affects rural and inner-city sites across the state, awaits the governor's signature.

The bill allows physician assistants, or PAs, to treat patients unsupervised 34 percent of the time as long as their supervising doctor is on site 66 percent of the time.

When not on site, the doctor must be readily available for consultation by telecommunication and be within 30 miles of the PA's facility.

It's passage is being hailed by the Missouri Academy of Physician Assistants.

“This is a true victory for Missouri patients and for our profession,” said Paul Winter, president of Missouri Academy of Physician Assistants. “Without a change in law, some health clinics would have been forced to reduce operating hours or close completely, leaving thousands of Missourians to travel greater distances for medical treatment or go without.”

here are a couple of many. Eventually, every 'midlevel' wants to usurp the parent. Its common and not a personal condemnation, as you suggest.
 
In that last one, the PA claims that it's a victory for the patients but also for PAs. A victory over what/whom? We assume AMA? But yeah, I don't generally buy-in to the whole "AA permanently solves the problem", but I certainly do think it's one way to postpone it.
 
Well, its a victory of some sort. The local medical establishment there actually supported it (i believe) which is interesting. It is certainly a degradation of the supervision rule b/t PAs/physicians.

To me they local medical board was 'ok' with it b/c it means they make more money bot being there.... always back to money.
 
Well, its a victory of some sort. The local medical establishment there actually supported it (i believe) which is interesting. It is certainly a degradation of the supervision rule b/t PAs/physicians.

To me they local medical board was 'ok' with it b/c it means they make more money bot being there.... always back to money.

Unfortunately, if you are correct, then long-term we're screwed, no? :eek: :thumbdown:
 
*sigh*



Here are some Physician comments on the story.





here are a couple of many. Eventually, every 'midlevel' wants to usurp the parent. Its common and not a personal condemnation, as you suggest.

Umm could you actually provide links to those "comments". I know the Missouri story is taken out of context. If you had researched this a little more you would understand this. Your entire article is from a problem with the Missouri practice act. The act is poorly written over what is required for supervision. Almost every state requires that physician be available either in person or telephonically for any questions the PA has. Missouri seems to require that the physician be physically present. Despite the testimony on this there are very few states that require the physician to be present. In an effort to actually allow care for rural residents the BME in Missouri allows remote supervision of PA's in rural HPSA's. The Osteopathy association sued the BME over this last year. This would have had the effect of closing most rural health clinics in Missouri. For a different slant (I won't say more balanced) look here:
http://www.prnewswire.com/cgi-bin/stories.pl?ACCT=104&STORY=/www/story/01-29-2007/0004515497&EDATE=

Here is the follow up:
http://www.prnewswire.com/cgi-bin/s...07/0004578860&EDATE=WED+May+02+2007,+08:01+AM

So you managed to find some political hacks to support your theory. The more common way of looking at this would be since in almost all cases PA's are the employees of the physicians, the physician should determine how much supervision is needed. This is a functional part of almost every PA practice act. The act describes the upper limit of what a PA can do. The physician can always limit what the PA can do. Once again you have not demonstrated any desire for independence. Insteady you have pulled up a bunch of political commentary against providing healthcare to rural patients instead of a desire for independence.

David Carpenter, PA-C
 
Well, its a victory of some sort. The local medical establishment there actually supported it (i believe) which is interesting. It is certainly a degradation of the supervision rule b/t PAs/physicians.

To me they local medical board was 'ok' with it b/c it means they make more money bot being there.... always back to money.

The reason that the medical establishment supported it is they understand how supervision works. They also understand the problem of delivering health care in rural Missouri. It is about money. You can't get a physician to go to these towns for the money they offer. If you want to head out to rural Missouri and make 70-90k then go ahead. Most of these PA's have been doing this for some time and are making less than that.

David Carpenter, PA-C
 
David,

Thank You for your response. Again, you showed the facts to a big AANA (BON) supporter. The CRNA vs. AA issue is a "no-brainer". If Mid-Levels are needed as "assistants" in the operating room (and they are) our leadership should support the AA over the CRNA. Anyone who can't see this needs a retinal transplant.

Blade
 
David.

With all due respect, lets call a spade a spade. The outcome in both these examples is the same, an interest by PAs in weakening supervision. I was right and evidenced it. (and more is out there)

I wont waste time arguing it further on the Anesthesiology forum. The point is made.


EtherMD: Please, put on a new record the one your playing is broken.
 
Creme,

Did you read this month's ASA Newsletter about proposed legislation by your beloved AANA? If you decide to look at the facts and not at "opinion" it is quite clear which Group of Mid-Levels posses an immediate threat to the specialty of Anesthesiology.

As for my "broken record" your beloved AANA hopes by playing the same tune over and over again at the State level the legislators will eventually start singing their song.

Blade
 
For those interested in avoiding Noyac's ban on politics, the AANA and CRNA's our colleagues in the Pain Forum have an excellent debate going on.

"Bloated CRNA salaries" is a heated discussion and a very active thread.
Apparently, the moderator at that forum has no problems with open discussion.

Blade
 
For those interested in avoiding Noyac's ban on politics, the AANA and CRNA's our colleagues in the Pain Forum have an excellent debate going on.

"Bloated CRNA salaries" is a heated discussion and a very active thread.
Apparently, the moderator at that forum has no problems with open discussion.

Blade

Not yet, he doesn't.

Good Bye
 
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