SUB-OPTIMAL TEAM PRACTICE PASSES IN ARIZONA
So Arizona has now passed legislation allowing physician assistants(PAs) to practice medicine independently after 8000 hours of clinical practice. Optimal Team Practice(OTP) is now in 4 states, including Colorado, Illinois & Iowa. This is what legislators refer to as “modernizing” the PA-Physician relationship.
As many of you know, I am a wordsmith. I’m also quite adept at interpreting spun bulls**t. “Modernizing” is a euphemism for removing restrictions that were designed to PROTECT THE PUBLIC. However, if legislators actually acknowledged that in their bills, the public would rightfully raise holy hell because they have no wish to be lab rats. I don’t know how Arizona legislators came to the 8000 hour cutoff, nor do I give a s**t. What it basically amounts to is that as long as a PA has practiced 8000 hours, they can go off to practice on their own. If employed, “practice level” means employers will call the shots. This is not a positive event. Allow me to elaborate…70% of physicians are now employed by pimps(hospitals/CMGs). These pimps like their ho’s(ie: all employed health care professionals) where they can control them. Even more preferable is if they can use cheaper ho’s to increase the profit-margin while forcing physicians under their employ to place their licenses on the line for these so-called “independent” non-physician practitioners(NPPs) who have no desire to be supervised, but still require a scapegoat on whom to dump their liability when they f**k up. “Independent” my a**.
Back to the 8000 hours. Clinical hour requirements for medical students are approximately 5000 hours. Residents are about 10,000 hours. Neither can practice independently. But PAs and NPs can, with less clinical hours. Mind you, the hours are not analogous because the training is not equivalent. To simplify, PAs/NPs are being allowed to practice, independently, without the same education or training as physicians and with less inequitable clinical hours. Yet, the most highly trained professionals in medicine have to wait a minimum of 11 years to practice independently. Mull that over…
The illegal corporate practice of medicine(CPOM) is directly antithetical to what is in the best interest of the patient. They will use PAs just like they use NPs in the hospital. Wrongly. Private physician groups who use non-physician practitioners ethically, will maintain appropriate supervision so that their patients remain safe and are properly cared for. Unethical private practices will continue to provide notional supervision, so their patients are f***ed.
These preposterous decisions are based on one thing: Appearance. Lamebrained legislators believe that because non-physicians appear functionally the same as physicians, they are competent to practice medicine–WITHOUT being held to a medical standard. However, the only health care professionals formally educated and trained in the practice of medicine cannot do the same, until they complete a residency. And what are our boards of medicine(BOM) and professional organizations doing? Not a f***ing thing. They sanction the passage of laws legalizing the illegal practice of medicine by looking the other way. Arizona has a separate PA board so they have no accountability to the BOM. It is egregious that not one of these POS will use a NPP for their kids, not even NPPs themselves. Nope. They want a Family Medicine doc or Pediatrician. Only the best. But for the marginalized, disenfranchised guinea pigs, their children will be fun to practice on until these ingrates can open up their own medspas, IV hydration, hormone clinics or whatever suits their fancy.
To the public, I assure you, there will be no follow up by any medical corporation, licensing board, legislative body, governmental entity or PA organization in 1, 5 or even 100 years to re-evaluate if the care being provided “independently” is sufficient or even safe. Because no one gives a s**t. Responsibility will be assigned after the fact, when a patient/family member who has been harmed(or killed) is seeking compensation, only to find out that PAs are not held to the same medical standard as physicians and never will be.
One last note to you f***ing, fumbling, blunderheaded, morally corrupt legislative dolts legalizing Optimal Team Practice, this is what the former president of the Physician Assistant Education Association( PAEA), the only national program that represents PA education, had to say about the initial proposal of OTP in 2017 and why the PAEA did not agree with eliminating the long-time professional relationship between PAs and physicians(the initial intent desired by the American Academy of Physician Assistants(AAPA)).
Bottom line: PA education has not changed or advanced in any way to justify them practicing medicine independently. With that, I will leave you with the quote from Dr. Eugene Stead, the creator of the PA profession. Those embracing OTP have accepted the former. Shame on them.
“The PA can have independence at a low level of performance or he can accept dependence and achieve a high level of performance.”–Eugene Stead, MD.
Seems like PAs and NPs are a LOT better at lobbying than physicians are. Maybe we could learn something from them.
A cracking word on the thesaurus dessert tray is ERSATZ. Synonyms like Butt4MD, bogus and faux don’t really resonate here. The message is – not at all what it claims to be, and markedly inferior. Germans have a term for ersatz coffee – the entirely innocent word Muckefuck, for things like roasting pistachio shells to make something not-coffee. You may try that word on for Muckefuck colleagues instead of bogus Joe. Carry on!
CAN SOMEONE PLEASE EXPLAIN WHY WE ARE ALL REIMBURSED AT THE SAME RATE BY INSURANCE COMPANIES……this makes no sense……like paralegals charging the same as attorneys….will that ever happen??????
Because, if we accept insurance, then we are no more than employees of the insurance companies. No point begging a profit-driven insurance company to increase your pay when no one is forcing them to do so. True, care by PA’s and NP’s almost certainly results in higher costs due to increased specialty referrals and poorer outcomes in the aggregate, but try convincing the insurance companies you’ve signed contracts with of that.