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PA's and DO's
Started by rwebster23
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Seems like an interesting idea. I posed this question over in the osteopathic forum--I wonder if it's a topic they discuss in osteopathic school as they prepare the DOs for residency and clinical practice.
Something tells me that from a "practice of medicine" standpoint, this would be fine (as long as the PA has read the same texts as the DO and done a certain amount of training with the supervising DO to learn the craft).... But, from a financial standpoint, I'm not sure if a PA can get reimbursed for doing OMM, as the laws are currently written, whether or not they are deemed "capable" by their supervising Doc.
Maybe someone over there (or here; EMedPA?) will know the dilly-yo.
Something tells me that from a "practice of medicine" standpoint, this would be fine (as long as the PA has read the same texts as the DO and done a certain amount of training with the supervising DO to learn the craft).... But, from a financial standpoint, I'm not sure if a PA can get reimbursed for doing OMM, as the laws are currently written, whether or not they are deemed "capable" by their supervising Doc.
Maybe someone over there (or here; EMedPA?) will know the dilly-yo.
Didn't "Suggest" anything. PA's have always trained with, and mirrored the practice of their respective docs. That is what we do. If a DO doesn't want to increase his/her productivity, have more time to him/herself, and enjoy this fruitful partnership, that is their call. One way or the other. No "Suggesting".
My ambivalence comes from a economic angle, not a patient care one. I was actually in PA school for a few semesters, and personally feel that PAs are more than capable of developing the same tactile procedural/surgical skills as a physician as well as most of the critical thinking skills necessary to practice medicine within the first 4-5 years of their first job.
But the whole point of PAs is to extend the capabilities of a physician's practice to more patients--making healthcare more accessable to the masses who need it, while not sacrificing efficiency or good quality patient care. If a DO can train a PA to do OMM with the same efficiency and reimbursement rate (or 85+% of it), I think it's a great idea. I think OMM is a fantastic modality of care in the current depersonalized system of American medicine. The fact is that it's a very difficult modality to learn--it takes a lot of book studying to gain proficiency with the anatomy, and even more clinical practice to feel the normal and abnormal resiliency/tension of the different tissues in different patients and pathologic states. Of course PAs could do it. I'm sure nurses and physical therapists develop similar tactile "intelligence" (when it comes to normal/pathologic tissue) over the years in their careers.
I'm just asking if it's economically feasible.
If medicare won't reimburse my PA for OMM, but will pay us well for every skin biopsy, I'd rather train the PA to take off horns and third nipples. That way we can all go play golf after work, and drink Guinness instead of Bud Light. And isn't that REALLY better for all concerned? 😉
But the whole point of PAs is to extend the capabilities of a physician's practice to more patients--making healthcare more accessable to the masses who need it, while not sacrificing efficiency or good quality patient care. If a DO can train a PA to do OMM with the same efficiency and reimbursement rate (or 85+% of it), I think it's a great idea. I think OMM is a fantastic modality of care in the current depersonalized system of American medicine. The fact is that it's a very difficult modality to learn--it takes a lot of book studying to gain proficiency with the anatomy, and even more clinical practice to feel the normal and abnormal resiliency/tension of the different tissues in different patients and pathologic states. Of course PAs could do it. I'm sure nurses and physical therapists develop similar tactile "intelligence" (when it comes to normal/pathologic tissue) over the years in their careers.
I'm just asking if it's economically feasible.
If medicare won't reimburse my PA for OMM, but will pay us well for every skin biopsy, I'd rather train the PA to take off horns and third nipples. That way we can all go play golf after work, and drink Guinness instead of Bud Light. And isn't that REALLY better for all concerned? 😉
We do in house billing. The issue of can the PA "do" it vs can the PA get payed for it are different, yet, you can ask that same question of any procedure. Unless there is legislation stating the PA cannot perform, doubtful the PA cannot get reimbursement. The only way to know is call and 'ask'. Personally, I "KNOW" an NP who's done just that 🙂
guetzow said:
Yeah, but OMM isn't like a procedure where you can take an x-ray and verify placement of a line, or listen to the lung fields and see if they're intubated properly, or stick a a needle in something and get tissue out. In all those cases, it's clear-cut, done, done, done, bill, bill, bill.
With OMM, it's more subjective--more operator dependent. That's the whole controversy with OMM in the first place--how do you separate out physiologic/anatomic effects from the "placebo effect" of a patient who really just likes being touched by their physician? That can be a very powerful thing. "Ahhh... I feel so much better since the OMM treatments started [insert: '...since you've been spending ten extra minutes with me and making me feel like I really matter and you really care']..." 😉
D
deleted6669
I know pa's who do omt. I don't know if they get paid extra for it......
in theory an md/do can delegate any skill/procedure they can perform to their pa if they feel they can do it safely and to the standard of care. it must be a skill the md/do can do, however so a pediatrician can not delegate facial skin grafts to a pa unless they can do it themselves.
in theory an md/do can delegate any skill/procedure they can perform to their pa if they feel they can do it safely and to the standard of care. it must be a skill the md/do can do, however so a pediatrician can not delegate facial skin grafts to a pa unless they can do it themselves.
group_theory
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In Pennsylvania, a PA who is under direct supervision of a DO does not have any script priviledges.
http://www.aapa.org/gandp/statelaw.html
PENNSYLVANIA
Scope of practice: Medical procedures delegated by supervising physician, within normal scope of physician's practice and within the training and expertise of the PA.
Prescribing/dispensing: PAs may prescribe and dispense drugs from formulary that excludes schedules I-II and parenterals except insulin and allergy kits. PAs who prescribe controlled medications must register with the DEA. PAs supervised by osteopathic physicians may not prescribe.
http://www.aapa.org/gandp/statelaw.html
PENNSYLVANIA
Scope of practice: Medical procedures delegated by supervising physician, within normal scope of physician's practice and within the training and expertise of the PA.
Prescribing/dispensing: PAs may prescribe and dispense drugs from formulary that excludes schedules I-II and parenterals except insulin and allergy kits. PAs who prescribe controlled medications must register with the DEA. PAs supervised by osteopathic physicians may not prescribe.
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D
deleted6669
it is a silly rule and one most docs there don't follow to the letter. when I was there I was given a presigned blank script pad every morning....so much for no prescribing as a pa.....group_theory said:
<sits back and waits for the firestorm to follow>
I am not sure about the PA doing OMT, but they are licensed to work under a DO. That is a term that must be used loosely as state laws vary with their role under the DO. In some states it is equal to the PA under ane MD. In other states there is more supervision required of the PAs. For example, as stated earlier, in Pennsylvania the PA sees the pt and writes the script, they have to have the DO cosign the script. They are trying to change this, but for now that is the case. This seems like a big deal, but in some practices the supervising physician must sign their chart to my understanding, so they have to have the doc review everything anyhow. I'm not really sure how much of a burden this poses if any.
billydoc said:
I'm looking at this route also since I do Asian Bodywork. I'm also looking at training in Zero Balancing which was created by a physician. I'd like to do some clinical with a DO but lacking that will just incorporate the bodywork I know into my practice. 😎
zenman said:
Yup! ZB is great. I took elective at my acupuncture school taught by Jim McCormick, and later got certified by the org of Dr. F. Smith and his followers. I'm also certified in Tui Na. But OMM is owned by AOA. Therefore I'm not sure that I, as an NP (to be), and a L.Ac could legally call it OMM. It'd be nice, because I have some great associations with D.Os who actualy practice OMM. But even if they allowed OMM to be performed by non-D.O...could I get paid for it? I mean is it a billable procedure? I don't think it will fly. But I'll look into it.
🙂 😀
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