PA's and NP's vs the AOA

[ebola95]

ok, what is the official AOA stance on PA's and NP's now? I recently read that the AOA will/does recognize the abilities and usefulness of these "middle level practitioners" in the health care field, but that they only agree to recognize thier ability to practice under direct in-house supervision of an DO....is that correct?

To make matters worse, a PA-student has shown me a recent article about hospitals creating more post-graduate residencies for PA's exclusivley while decreasing the number of medical-residencies availible at the same hospital....what's going on with that? anyone got the inside scoop or whould i not believe everything that i am reading?

---

Members don't see this ad.

 

[turtleboard]

PAs are popular, but they won't replace physicians with medical degrees. I wouldn't read everything out there, especially if what you're reading is handed to you by one of "them."

Tim of New York City.

 

[UHS03]

I know that in Missouri, the MSMA is opposing a bill that would allow PA's to practice without direct in-house physician supervision. The kicker is that they want to remain on the physicians malpractice insurance. So, basically, they get all the practice rights, a quarter of the schooling, and the physician still is held accountable (or their insurance is anyway.) I don't have a problem with PA's pursuing expanded or independent pratice rights, but make them carry their own insurance for it. The general public recognizes the training physicians get and just by knowing what "PA" stands for, recognize that they are not physicians, so I'm not worried about competition. Am I understanding the legislation properly? I get a newsletter from the MSMA and this is how I interpreted the bill they were describing. Unfortunately I threw that newsletter away so I can't quote the actual wording to you.

Of interest is another bill in Missouri that seeks to allow Naturopaths to "diagnose and treat diseases, injuries, ailments, infirmities, and other conditions of the human mind and body, including but not limited to natural means or the prescribing or dispensing of substances" The newletter says that these "substances" include schedule IV and V controlled substances. This bill somehow gives these rights to chiropracters as well and is being pushed heavily be a segment of the chiropractic community that have retained lobbyists. For reference this is HB 1253. I assume this is only being presented right now in Missouri. I haven't read it, and only know what the newsletter told me, but obviously the MSMA is opposing it.

 

[ebola95]

ok, thanks for your reply, both of you.....i just read another article (Central Michigan University has a PA program and several students rotate through the ER where i work) mentioning that PA's in Kansas can now perscribe schedule I and II meds without "direct" supervision...i understand that with the changing health care situation here in the US and the need for middle level providers; however, what kind of impact is that going to have on our future practices? Are we going to be reduced to reviewing charts all the time and not seeing any more patients? just a bit confused

 

[Joe]

The reason why the PAs and NPs need a physician supervision is because they don't have the level of trainings the physicians get, i.e. 4 yrs med school and 3+ GME.
Now if they want to have unsupervised practice rights, let them go through 3 yrs of residency and calls q4. Also, make them carry their own malpractice insurance (as mentioned above), because after couple of lawsuits, they would think twice about having the autonomy without the adequate trainings.
I think it's important for everyone to know where his position is in the health care team.

 

[merchpa]

Whoa Fellas,
The official position of the American Academy of Physician Assistants has been, is now, and always will be that Pa's and Physician's work together as a team. (NP's on the other hand want complete autonomy.) As a PA in orthopedic surgery, I carry $1,000,000/$5,000,000 in malpractice insurance as do most PA's. The Doc's I work with pay for my malpractice as part of my benefit plan. And I don't mean to be petty, but NOBODY can prescribe schedule I drugs as the FDA does not allow PA's, MD's, or DO's to prescribe Heroin.
As Mr.Rodney King once said "Can't we all just get along?"

merch

 

[ebola95]

thanks for the input merchapa....i wasn;t trying to be beligerant or insinuate that it is "us" vs "them" at all; rather, i am trying to understand the roles that we will have in the near future realting to each other....let's face, healthcare is a very dynamic and volitile situation right now....trying to understand what the hell is going on is important......

ok, i'm ignorant here, why do NP's want complete autonomy? what is the purpose or the reasoning behind it? i am concerned because i don't want to spend 7+ years of my life getting an advanced medical degree so i can practice if i am going to be a chart pusher when i could have done 2 years of graduate work and had all the practice rights that i could ever want....

anyone else understand what i am saying or am i all alone here?

 

[merchpa]

ebola95,
I spend several hours each week explaining to physicians in my community what I do as a surgical PA. What it comes down to is I make my 2 doc's more efficient. (ie. they earn more money and have more time with their families.) I'm not sure if I would go to medical school if I couldn't be in a surgical sub-specialty, but whether it's worth the time to you to do something you love, who knows.
As far as NP's and there drive for autonomy, let me share my somewhat biased opinion. Most NP's work in family practice and do an excellent job for the most part. I have read that up to 80% of all patients seen in a FP clinic do not require the advanced knowledge of a Doc. Having spent 6 months during my training in a community health clinic, I feel that is an accurate number. PA's like the fact that for the 20% they can't handle, they have a close relationship with the physician down the hall. Most NP's seem to call a specialist when they get stuck with that 20%. State nursing Associations have a very powerful lobby and have obtained some very liberal Practice Acts. Schedule 2-5 prescribing rights, ordering diagnostics and most importantly, independent medical practice.
My opinion is that PA's enhance a physician's practice where as NP's compete against it. Many NP's work in physician offices and obviously don't compete with the doc, but the laguage in their State Practice act clears the way for them to "hang out their own shingle".
Just my two cents...