Who's Training Your PA to do Fluoro-Guided Procedures?

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drusso

drusso

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One of you Ballers in Georgia is trying to steal my PA and telling them they can do RFA, ESI's, and stim trials. Please stop...just stop.

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Let's not pretend to be surprised. Medicine is headed to a lowest common denominator mentality fast, moreso for PP pain. Though many will state it's for cost containment, I would argue the opposite. Follow the money.

Just like lazy anesthesiologists would salary CRNAs and pocket the difference on billings, some will use the same setup in pain. Maybe we will see some private equity companies running multiclinics with one doc and several burn churn fluoro rooms run by NPs and PAs
 
I cannot imagine a future where I don't have 3 PAs in the clinic doing shots while I telemed/direct clinic from the beach.
 
This is not legal in Georgia. We can all do our part in writing complaints to the Georgia Medical Board against any physician who is supervising a PA doing spinal procedures. It has been 15 years or so since the Georgia Medical Board last opined on this topic as non delegable tasks.
 
lobelsteve said:
This is not legal in Georgia. We can all do our part in writing complaints to the Georgia Medical Board against any physician who is supervising a PA doing spinal procedures. It has been 15 years or so since the Georgia Medical Board last opined on this topic as non delegable tasks.
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Can you back this up with references?
 
swamprat said:
Can you back this up with references?
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The order was on the CSBME website in 2005. The only reference I can find to the document was a 2009 case I reviewed for the CSBME and I discussed the document. Searching the Georgia Medical Board website (since the revision from CSBME) yields no document.
Still, file complaint as stated above and it will get investigated.

Would anyone here testify that a PA can perform ESI and RFA?
 
lobelsteve said:
The order was on the CSBME website in 2005. The only reference I can find to the document was a 2009 case I reviewed for the CSBME and I discussed the document. Searching the Georgia Medical Board website (since the revision from CSBME) yields no document.
Still, file complaint as stated above and it will get investigated.

Would anyone here testify that a PA can perform ESI and RFA?
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So are you saying PA's in Georgia don't do interventional Pain?
 
lobelsteve said:
The order was on the CSBME website in 2005. The only reference I can find to the document was a 2009 case I reviewed for the CSBME and I discussed the document. Searching the Georgia Medical Board website (since the revision from CSBME) yields no document.
Still, file complaint as stated above and it will get investigated.

Would anyone here testify that a PA can perform ESI and RFA?
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Hmm. All I see that would suggest that in the Georgia SOS site is a law delineating an AA vs a PA. Technically if they leave the local anesthetic out, they aren't doing epidural anesthesia if they're doing an epidural steroid injection, and even then, with appropriate training you could conceivably get "express" board approval. And then, if it's an AA, they could do pain stuff regardless...

Rule 360-5-.04 General Job Description​

(1)The job description is a document signed and dated by both the primary supervising physician and the physician assistant whom the physician is seeking to utilize or already has approval to utilize.
(a)A job description shall not be required to contain every activity the physician deems the physician assistant qualified to perform, but shall confine the activities of the physician assistant to those in the scope of practice of the primary supervising physician.
(b)The job description shall include a description of the medical acts to be performed by the physician assistant. For physician assistants who do not practice as an anesthesiologist assistant, attachment of the Job Description provided by the Board shall be deemed adequate compliance with this requirement. However, if the physician assistant is performing an act not covered in the Job Description, then a submission of these additional acts is necessary and express approval by the Board is required. The Job Description does not include the delivery of general, spinal or epidural anesthesia and a physician assistant performing these acts would require additional training and express Board approval.
 
Guys this is nuts!

I was recently getting credentialed for insurance companies. I don't have a Pa/NP. But thr insurance companies actually offered a contract tht would allow me to bill all the cpt but at a lower rate. I asked my rep about this. He said apparently people do that. I was shocked. I of course deferred it. We really ought to all complain to the medical board. Whomever is teaching this to them is causing an unsafe environment for patients...
 
just heard about a practice in the midwest that this is going on already...
 
around here it's only the private practice guys letting their midlevels do fluoro procedures
 
There is an ortho practice in NW indiana where the spine surgeon referred these to his CRNA to do. Patients were never told it was a crna doing the procedures and he introduced himself as a Doctor apparently. Something happened and they removed all traces of the CRNA from the practice and patients can't seem to get their records that involved the crna. This was about 6mo ago.
 
TheLoneWolf said:
Let's not pretend to be surprised. Medicine is headed to a lowest common denominator mentality fast, moreso for PP pain. Though many will state it's for cost containment, I would argue the opposite. Follow the money.

Just like lazy anesthesiologists would salary CRNAs and pocket the difference on billings, some will use the same setup in pain. Maybe we will see some private equity companies running multiclinics with one doc and several burn churn fluoro rooms run by NPs and PAs
Click to expand...

Spot on! Sad but true.
 
myrandom2003 said:
There is an ortho practice in NW indiana where the spine surgeon referred these to his CRNA to do. Patients were never told it was a crna doing the procedures and he introduced himself as a Doctor apparently. Something happened and they removed all traces of the CRNA from the practice and patients can't seem to get their records that involved the crna. This was about 6mo ago.
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The something that should've happened is that ortho practice should've shut down and the spine surgeon should have his license revoked for maleficence
 
buddababa said:
The something that should've happened is that ortho practice should've shut down and the spine surgeon should have his license revoked for maleficence
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Agreed, one thing to be delegating procedures under supervision, although we all seem to agree that a neuraxial procedure in people with stenosis and her notions should not be delegated.

It’s straight up deceptive to pass off a CRNA as a doctor.
 
dipriMAN said:
Agreed, one thing to be delighting procedures under supervision, although we all seem to agree that a neuraxial procedure in people with stenosis and her notions should not be delegated.

It’s straight up deceptive to pass off a CRNA as a doctor.
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Well, CRNA schools will require doctorate level education by 2025 for admission. This is so they can call themselves doctors. Already being done by NPs.
 
Did you see the job advertisement for a new grad at Phoebe Putney? According to the recruiter I talked with, the doc there who is retiring does >19,000 wRVU per year... of medication management.
 
PainApp2021 said:
Did you see the job advertisement for a new grad at Phoebe Putney? According to the recruiter I talked with, the doc there who is retiring does >19,000 wRVU per year... of medication management.
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Whaaaaaaat?
 
PainApp2021 said:
Did you see the job advertisement for a new grad at Phoebe Putney? According to the recruiter I talked with, the doc there who is retiring does >19,000 wRVU per year... of medication management.
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Straight up dealer.
 
PainApp2021 said:
Did you see the job advertisement for a new grad at Phoebe Putney? According to the recruiter I talked with, the doc there who is retiring does >19,000 wRVU per year... of medication management.
Click to expand...
My NP does 23000 wRVU… but it’s mostly discography, SCS, vertiflex, endoscopic rhizotomy and kypho that’s she’s doing.
 
“The Department Of Public Health says the next step after the Prescription Drug Monitoring Program is required in Georgia, is to work with other states to prevent addicts crossing state lines to doctor shop.”

The next step is for people like this Moree guy to retire and stop this nonsense. Gaurenteed a significant portion of the medications he’s prescribing are being sold on the street. If I were him I would not be able to sleep at night.
 
Not for nothing but I wouldn’t want to see
these patients back in follow and and have to deal with the “why am i not any better” bull****. To me that alone would make it a bad deal, aside from the blatant disregard for anything that is ethical or right
 
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