The PA Trojan Horse Has Been Built, Loaded, And It Is On Its Way!
I have sparred with certain PAs on this website who claim they are different than NPs in that they do NOT want independent practice. We all knew this was bullsh#t because we have seen this movie before with NPs. Here’s a prior post. First, the Physician Assistants change their name to Physician Associates.
Then the AAPA (see image at top) says modernized laws need to change in order to help the healthcare shortages. Interesting, what do they mean? They reference this article. Here are some highlights:
- In a time where patients in our state are dissatisfied with the health care system, it’s important we do all we can to maximize Kentucky’s health care workforce.
- Fortunately, PAs stand ready with commonsense solutions that can make a lasting impact over time, while also helping to keep newly trained PAs in the state after graduation.
- There is a real need to update several outdated, unnecessary regulations that can hinder a health care team’s ability to fully utilize PAs. With modernized laws, PAs could do more to help address the health care shortages in Kentucky.
The author never says Full Practice Authority (FPA) but that’s the beauty of a Trojan Horse. And that has been the PA plan all along. A Master’s Degree after college and you can be any specialist you want to be. Hell, you can change yearly from ortho to plastics to derm and they now want to do it independently.
For the patients’ sake, please do not open the gates!
I had an N.P. that worked in my office as the “gubbermint” said they would pay the group practice more money. She was older than me and worked as an oncology nurse for 8 years before she got her master’s degree/N.P.
She asked the oncology group for support while she got her masters but they said, “No”. So she quit and her school teacher husband was able to support her through her N.P. degree. She was free after graduation, was hired and paired with me. Wasn’t a better working relationship ever had. Still see her and her husband every now and then socially.
We had fun at work.
Debbie would grab me when I came out of an exam room and discuss a difficult medical problem with a patient she was seeing. The N.P.’s were “supposed” to get simple stuff but that didn’t always happen with scheduling. More often than not it led to a direct admission under my care in the hospital with a difficult situation.
Had other N.P.’s and actually P.A.’s circulate through my area who said they like helping out but would not want to do
what I do in a million years without the med school/residency training I had.
N.P.’s wanting to be independent are ignorant fools and the malpractice insurance requirements will put them out of business in a few years if it’s ever instituted. Yeah and if they’re smart with “weird” stuff they’ll refer to the local E.R.
anyways so the “chit” will roll down hill to the doctors anyways if they’re lucky.
An N.P. working in a group medical practice and associated with a supervising physician they can grab at anytime for a tough case discussion is the ideal situation. I was involved with that and had a nice working relationship with the N.P. assigned with me. It’s stupid to argue for independence as I was the guy on the line for my N.P.’s actions. She was very good and there wasn’t any legal repercussions from her work. If the N.P.’s get independent, the malpractice insurance will put them out of business.
We have long since passed the point where a bright, enterprising individual should sincerely ask “Why bother going to medical school?” The NP-PA political efforts (propaganda) have deceitfully changed the premise to a false standard too many lay idiots, corrupt administrators, and corrupt politicians have accepted. Why kill yourself for a minimum of 7 years when a slick-ad LELT can claim to compete with you on equal footing, with far less investment, far less risk, and far less debt? Honest individuals aside, the wave of phony non-physicians bleating about increased access to care is being swallowed by a society that increasingly reflects the intellect of the average “Today Show” viewer. It’s funny, and depressing.
Sure… “modernize the statues”…
We are fighting a bill in New Hampshire, that wants to “modernize” one little word- from “…SHALL collaborate…” to “…MAY collaborate…” ie. Full Practice Authority.
https://legiscan.com/NH/text/HB1222/2024
Thanks for that link!
Medical care is defined by performing a CPT code and attaching it to a diagnosis. Nobody cares what actually happened or who did what, but the CPT needs to billed by someone who is accredited by the payer. And last but not least, the provider needs to meet the state guidelines in which the service was provided. In medical school. I remember hearing many times that you can teach an ape to do surgery. If that ape can (with some help) fill out a provider application and get an NPI number, then we can open the local zoo to provide medical care to all of the huddled masses that are suffering due to lack of adequate staffing.
Mary Shelley wrote a story which may have been more profound than even the author herself grasped. She wrote of revivified clusters of dead human remains and their new, invented nature. We see the other side of the equation long present in our field-commodification. As we measure assembly-line production in dollars, and define the nature of the desired product, we turn human beings into simplistic and horrible things. We speak of “burnout” of those whose predetermined value as a commodity depends only on two eyes and an arm, with nothing else valued, the rest left to wither and be wasted. Of course, if that’s all the assembly line requires, then having much less training and ability satisfies equally. In this way, PA’s, and next, EMT’s, are interchangeable. A blindness sets in, where each step involves processing patients at a pay station, then passing them on to the next. I realized that I stopped caring in a way in my third year of medical school, when I was being trained for the line. Great wealth is yours to be had higher up in management. But that begs the uttermost question.
Hospitals have a fit credentialing MDs. Please provide proof you have been trained and done this procedure.
Yet the same hospitals put new grad NP and PA in the ER. The hospitals let them switch from Ortho to Hospitalist to Neurology.
And dozens will help serve Louisville and Lexington with cash Botox clinics.
And remember to call to boot!
I respectively request you examine the credentialing process for PAs at your institution.
The Joint Commission mandates a PAs (and APRNs) be credentialed by the medical staff office or equivalent, with both FPPE & OPPE processes in place.
https://www.jointcommission.org/standards/standard-faqs/hospital-and-hospital-clinics/medical-staff-ms/000002124/
In the private practice setting, PAs are required to have an identified supervising physician who determines the PA’s scope of practice. If a P.A. is operating a “Botox clinic” or MediSpa that includes administration of pharmaceuticals or invasive procedure, there is a physician who has signed off on this.
Most PAs, yes there are outliers in every profession, value our relationship with physicians. I have had some truly great physician mentors over my 40+ yr career. Recognize most state P.A. laws haven’t been “modernized” in decades….. and don’t accurately reflect current P.A. practice. So rather than complain on social media, insist your state’s medical society and regulatory board sit down and have a civil discussion about P.A. practice and how to update our practice acts. Unfortunately, the rhetoric from both sides has divided 2 professions who historically worked together to provide safe, effective health care to our patients.
You never addressed the Trojan Horse and the attempt to get FPA.
Trojan horse: “a person or thing intended secretly to undermine or bring about the downfall of an enemy or opponent:”….. Where is the “trojan horse”? The AAPA has been transparent about the meaning and goal of Optimal Team Practice (OTP), and has been since adopted in 2017. No secrets.
OTP differs from FPA in that PAs will to work collaboratively with physicians, emphasizing the importance of teamwork. While it does eliminate the requirement for an Identified supervising physician and detailed supervisory agreement, it emphasizes collaboration. This more accurately reflects modern PA practice. As a PA with 40 yrs experience, I discuss cases with my supervising physician rarfely, but an assured he is always available and trusts my judgement.
We also feel that removing supervision, it will lessen liability associated with supervision. That is born out by a recent study in the Journal of Medical Regulation.
Finally, we have to remain competative. Would you rather have a profession that embraces collaboration, teamwork with physicians and other health care professionals, with a proven track record of the same? Or a profession with FPA who declares they are “just as good, if not better” and physicians?
Thanks for answering with 100% bullshit. Your Trojan Horse is to get FPA. Stop lying and at least admit it. And you will have the same advertisements as the NPs.
Amazing to me how hospitals will plug in a mid level, any mid level into the ER or hospitalist services. In our hospital the pulmonologist successfully lobbied to require all the FP ICU admissions to have an “Intensivist consult” Guess who saw those patients? A parade of midlevels since he could never keep one very long. By the time I retired, medical patients could be in the hospital for days and never been seen by a physican at all. Glad to be retired, and hoping like heck to stay out of the hospital. Especially that one.