[NPInfo] An editorial From Dave

Pat Camillo looking-glass at worldnet.att.net
Thu Feb 8 17:11:56 PST 2007 

Well said Mike.....thanks!

Pat

Pat Camillo PhD,RN,APN,C
Certified Nurse Practitioner in Women's Health,
Gerontology and Menopause
Carmenta Health
1 Kalisa Way Suite 103
Paramus, New Jersey 07652
(201) 265-9042

Manhattan Menopause Center
225 East 64th Street Suite C-2
New York, New York 10021
(212) 308-4988
----- Original Message ----- 
From: "Michael E. Zychowicz" <mzychowicz at hvc.rr.com>
To: "'NP Info'" <npinfo at nurse.net>
Sent: Thursday, February 08, 2007 12:09 AM
Subject: RE: [NPInfo] An editorial From Dave


> Dave: I think you are a bright guy and I respect your ideas and thoughts 
> but
> I don't agree with all of your ideas and won't apologize for that. I don't
> think Pat or I are suggesting PAs or NPs are better than one or another. 
> I
> am not attempting to lecture you on politics (as you said in your prior
> e-mail); I am sharing my experience and ideas just as you are.  I think
> these have been relatively legitimate questions and thoughts about NPs/PAs
> that have been posed to you, the only PA I know of on this NP Info list
> serve.
>
> I totally agree with Pat's earlier statements.  I too have no disrespect
> toward PAs, as I have said blatantly in prior e-mails.  I agree that we 
> have
> many professional similarities and common legislative needs but IN MY
> OPINION to ignore our differences, unique identities, and political 
> agendas
> is absolutely unrealistic.
>
> I am also very tired of having to worry about expressing my NP opinion on
> this NP info list serve.  I feel like I can't even express an opinion, a
> thought or ask a legitimate question on this list serve without it being
> distorted and misrepresented.  GOD FORBID one has an opinion on this list 
> OR
> one has a legitimate question - you get slammed.
>
> I joined this NP list serve many years ago as a NP student to understand 
> my
> NP profession a little better through discussion of ideas with other NPs. 
> I
> agree with Pat that there are NP students on this list and we should
> remember that "people are watching".  I think we should remember to keep
> this list to intelligent/professional discussion and exchange of ideas. I
> have stopped requiring my NP students to join this list due to the
> dysfunctional communication I have seen over the past few years.
>
> Very disappointed.
>
> Mike
>
> Michael E. Zychowicz, DNP, RNFA, NP-C
> Assistant Professor of Nursing
> Nurse Practitioner
> Mount Saint Mary College
> Newburgh, NY 12550
>
>
>
> -----Original Message-----
> From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On Behalf
> Of Pat Camillo
> Sent: Wednesday, February 07, 2007 8:43 PM
> To: NP Info
> Subject: Re: [NPInfo] An editorial From Dave
>
> Dave, please understand that I mean no disrespect or harm. I am simply
> responding to YOUR posts.......statements that we should merge and become
> one "health care profession", statements that we are basically the same in
> terms of our history, our practice, our roles, etc. I feel compelled to
> respond to these posts to correct some inaccuracies. There are NP students
> on this list and I feel it's important that they are not socialized to
> believe they have no identity separate from medicine.....because, in fact,
> they do. I think I would know that since I've been an NP for over 25 years
> :).
>
> I have absolutely no agenda related to demonstrating that NP's are better
> than PA's. However, we ARE different. And that is what I am trying to
> clarify. Please do not misrepresent what I am saying by rephrasing my
> words.....I have NEVER stated that NP's are better than PA's......and 
> never
> would! Nor do I have any interest in doing so.......in fact, I would never
> even be posting anything comparing NP's to PA's except in response to your
> posts.
>
> Dave, I am impressed by your passion and clearly you are an outstanding
> member of your profession in so many ways. I have no ill will towards
> you......my postings are not a personal attack. As I mentioned in an 
> earlier
>
> post, we can agree to disagree and still be friends :)........I will not 
> try
>
> and define what a PA is and hopefully, you will cease trying to define 
> what
> an NP is........we can learn from each other by asking questions about 
> each
> other's profession.........I think you might agree that you are in the 
> best
> position to define what a PA is and is not and ........after 25 yrs as an
> NP, I am in a better position than you to define the NP role, history,
> clinical practice etc. Let's respect each other's knowledge and 
> experience.
>
> Peace
>
> Pat
>
> Pat Camillo PhD,RN,APN,C
> Certified Nurse Practitioner in Women's Health,
> Gerontology and Menopause
> Carmenta Health
> 1 Kalisa Way Suite 103
> Paramus, New Jersey 07652
> (201) 265-9042
>
> Manhattan Menopause Center
> 225 East 64th Street Suite C-2
> New York, New York 10021
> (212) 308-4988
>
>
> ----- Original Message ----- 
> From: "David Mittman" <dave at mittman.us>
> To: "NPinfo" <npinfo at nurse.net>
> Sent: Tuesday, February 06, 2007 10:14 PM
> Subject: Re: [NPInfo] An editorial From Dave
>
>
>> Sorry Pat:
>> You are still into LET ME SHOW YOU WHY NPs ARE BETTER THAN PAs.  As I 
>> said
>
>> I
>> gave that up. You remind me of the way physicians think about their
>> profession, no one could ever do what they do. I believe we all have the
>> capacity to care, to treat, to cure to feel for the patient and each
>> other.
>> What more is there?
>> Some of the things you said show a total lack of respect for my
>> profession.
>> I gave this game up as did many NPs and PAs. If you want to do this dance
>> find another partner..............I can not and will not do this anymore.
>> Always much respect,
>> Dave
>>
>>
>>
>>
>> On 2/6/07 9:30 PM, "Pat Camillo" <looking-glass at worldnet.att.net> wrote:
>>
>>>
>>>
>>>
>>>> Michael: I answered the other questions for Pat. If there are any more 
>>>> I
>>>> am
>>>> at your service.
>>>> I think your observation that what we have in common is that we both
>>>> deliver
>>>> healthcare is true but misses a point many NPs and PAs have accepted.
>>>> THAT
>>>> OUR SIMILARITIES ARE SO OBVIOUS, AND OUR DIFFERENCES SO FEW, THAT WE
>>>> HAVE
>>>> TO
>>>> WORK TOGETHER FOR THE BENEFIT OF US AND OUR PATIENTS.
>>>
>>> THEN JOIN US DAVE! WE'VE COME ALONG WAY OVER THE YEARS,
>>> YOU DON;T HAVE TO REINVENT THE WHEEL!
>>>
>>> The fact that we are 2
>>>> professions that require two year post graduate training to practice.
>>> Do ALL PA programs now require that?
>>>
>>> The
>>>> fact and frustration that  we do what doctors do without being doctors.
>>> Sorry Dave, I do many things that docs would never do :)
>>>
>>> The
>>>> fact that the SAME groups hate us both,
>>> I don't feel that hated! Threatening yes, but not hated.
>>>
>>> the fact that people who see us
>>>> generally love us, the fact that insurance companies will not reimburse
>>>> us,
>>> I have been directly reimbursed by many different insurances......is 
>>> that
>>> not the same for PA's?
>>>
>>>> the fact that we have the same  postgraduate educational needs,
>>> Really? In order to maintain my certification as a women's health NP, I
>>> need
>>> quite a few continuing ed
>>> hours in women's health - is that similar for you? Or do you have the
>>> option
>>> to get your continuing ed
>>> in any area of medicine? I honestly don;t know this........
>>>
>>> the fact
>>>> that many of us work together and have the same issues at the 
>>>> workplace,
>>> Not sure what you mean by this........Many professionals share similar
>>> issues in the workplace
>>> but doesn't mean we do the same thing
>>>
>>> the
>>>> fact that the public does not know much about either profession,
>>> I can;t speak for PA's, but today I saw about 20 women and in each
>>> instance
>>> I introduced
>>> myself as an NP.....years ago, at least half would ask me what that was
>>> and
>>> weren't they going to
>>> see a doctor.......today, no one asked me to clarify what an NP
>>> was........
>>>
>>>> that we are interchangeable at most workplaces,
>>> That would not be correct in my case......and there is opportunity in my
>>> New
>>> York office where there is a same day
>>> surgi center......to tell me to go into the back and help out. But no 
>>> one
>>> would ever dream of asking me to do that - I am
>>> certain!
>>>
>>> the fact that we started the
>>>> same year and over 42 years have shown the public we are great,
>>> It's my understanding that the AMA wanted nursing to do this with them
>>> back
>>> then and we turned them down
>>> and I am sure that we would turn them down again today.......so I think
>>> our
>>> histories are different.
>>>
>>> the fact
>>>> that both professions had a heavy RN involvement in their development,
>>>> the
>>>> only your doctor commercials, lack of hospital priviliges,
>>> Do PA's have difficulty getting hospital privledges?
>>>
>>> NOT TO MENTION
>>>> THE DAY TO DAY FRUSTRATIONS OF OUR PRACTICE WHICH WE DO BOTH
>>>> SHARE...............
>>> Actually Dave, even after this incredibly long day (after a viscious
>>> night
>>> with arthritis issues :),
>>> I felt far more energized than I do after a day of meetings at the
>>> university. My frustrations are not
>>> great because I make sure to define my role and my practice - no on else
>>> does.
>>>
>>>> I think what I believe is that we will get farther as 2 professions not
>>>> trying to point out the differences that separate us, but the power we
>>>> can
>>>> yield if we do not WASTE our energy trying to figure out how one group
>>>> is
>>>> better than the other group-whomever that may be.
>>> For me it's never a matter of better Dave - just different! I don;t see
>>> it
>>> as a waste of energy to
>>> hold on to the one thing that clearly distinguishes me from medicine -
>>> that
>>> is, nursing! There are SO
>>> many benefits - not the least of which is being identified as the most
>>> trusted professionals in survey after
>>> survey, year after year! Ask a marketing expert how valuable that is!!!
>>>
>>>>
>>>> Michael and Pat-serious question- have you ever worked arm and arm for 
>>>> a
>>>> length of time with PAs?
>>> Dave, this is not a personal issue. In my career, I have worked with 
>>> many
>>> PA's and really enjoyed them both in
>>> and out of the office,,,,,,,
>>>
>>> Not in the same institution, but members of the
>>>> same close knit team? Have you really seen how we practice?
>>>> Anyway, thanks for asking these questions and giving me the opportunity
>>>> to
>>>> answer them (and re-think them myself).
>>>
>>> I too appreciate this dialogue....although at times it gets old......we
>>> may
>>> just have to agree to disagree and still be friends :)
>>>
>>> Pat
>>>
>>> Pat Camillo PhD,RN,APN,C
>>> Certified Nurse Practitioner in Women's Health,
>>> Gerontology and Menopause
>>> Carmenta Health
>>> 1 Kalisa Way Suite 103
>>> Paramus, New Jersey 07652
>>> (201) 265-9042
>>>
>>> Manhattan Menopause Center
>>> 225 East 64th Street Suite C-2
>>> New York, New York 10021
>>> (212) 308-4988
>>>> Dave
>>>>
>>>>
>>>>
>>>>
>>>>  On 2/6/07 1:28 PM, "Michael E. Zychowicz" <mzychowicz at hvc.rr.com>
>>>> wrote:
>>>>
>>>>> Pat (and everyone),
>>>>>
>>>>>
>>>>>
>>>>> That is a great question about the independent practice of PAs and
>>>>> their
>>>>> global exposure.  I was wondering that also.  I think there are 13
>>>>> states
>>>>> in
>>>>> the US that allow completely independent practice for NPs and many 
>>>>> more
>>>>> that
>>>>> are actively looking to or moving forward with eliminating the 
>>>>> required
>>>>> collaborative/ supervisory requirement.  There are MANY countries
>>>>> across
>>>>> the
>>>>> globe that have NPs and/or are considering the development of the
>>>>> profession.  I am wondering also if the PA profession is looking at
>>>>> eliminating the statutory requirement of mandatory supervision.
>>>>>
>>>>>
>>>>>
>>>>> The PA and NP profession have a great deal in common (i.e. that we
>>>>> deliver
>>>>> health care) but I think this also opens the obvious discussion of
>>>>> where
>>>>> our
>>>>> two professions are with regard to legislative authority, ability,
>>>>> autonomy,
>>>>> etc.  Although we have a great deal in common, I would presume that 
>>>>> our
>>>>> two
>>>>> professions have moderately different legislative agendas on the
>>>>> federal
>>>>> and
>>>>> state level. Although we do very similar things with patients - we 
>>>>> have
>>>>> distinctly different education, philosophy and professional 
>>>>> identities.
>>>>> I
>>>>> could not have a conversation with Dave, PA about what it is like to 
>>>>> be
>
>>>>> a
>>>>> PA
>>>>> and he certainly could not have a conversation with me about what it 
>>>>> is
>>>>> like
>>>>> to be a RN/NP.  We could however talk about what it is like to take
>>>>> care
>>>>> of
>>>>> a patient which is our common ground.
>>>>>
>>>>>
>>>>>
>>>>> I generally like Dave's "Editorial", however I am not sure I agree 
>>>>> with
>>>>> all
>>>>> of his comments and conclusions.  I agree with Dave that many of the 
>>>>> so
>>>>> called "non-physician" professions (I hate that term) would benefit on
>>>>> occasion from joining forces to advance policy and legislation; there
>>>>> is
>>>>> however a huge political side of the equation that frequently gets in
>>>>> the
>>>>> way of professions working together.  I know that my NY state
>>>>> professional
>>>>> organization has a legislative team and professional lobbying team 
>>>>> that
>>>>> frequently meet with legislators.  These state legislators absolutely
>>>>> know
>>>>> who NPs are and what we do and what our agenda is.
>>>>>
>>>>>
>>>>>
>>>>> I don't like his idea that we should all be called "health care
>>>>> providers";
>>>>> I actually like my professional identity of registered nurse/ nurse
>>>>> practitioner.  I agree with Dave about this lack of primary care
>>>>> physicians
>>>>> being an opportunity for our professions.  I don't agree with his
>>>>> statements
>>>>> that there will be more medical schools built.  I would like to know
>>>>> his
>>>>> source for that or if that is sheer speculation on his behalf.
>>>>>
>>>>>
>>>>>
>>>>> This lack of primary care physicians is part of a bigger concept
>>>>> written
>>>>> about by Dr Clayton Christensen, a Harvard Business Professor.  Dr.
>>>>> Christensen has argued that Nurse Practitioners are a "disruptive
>>>>> innovation" in health care.  Physicians are becoming increasingly
>>>>> specialized and sub-specialized, with fewer physicians going into
>>>>> primary
>>>>> care. Physicians are being trained in medical schools, residency, and
>>>>> fellowship programs to care for extremely complicated medical 
>>>>> problems.
>>>>> This leaves an increasingly available market share for Nurse
>>>>> Practitioners.
>>>>> Although physicians have increasingly specialized training, most don't
>>>>> utilize the extent of their training in their day to day practice.  As
>>>>> an
>>>>> example, at my clinical practice an orthopedic spine surgeon with more
>>>>> than
>>>>> 10 years of graduate medical education might frequently treat patients
>>>>> with
>>>>> uncomplicated low back strains.  For such a highly trained surgeon to
>>>>> treat
>>>>> such a relatively simple patient problem is not a good utilization of
>>>>> resources and certainly uses only a small fraction of his training.
>>>>> The
>>>>> answer is the utilization of more nurse practitioners to care for
>>>>> primary
>>>>> care and primary care specialty patient problems.
>>>>>
>>>>>
>>>>>
>>>>> Just my 2 cents.
>>>>>
>>>>>
>>>>>
>>>>> Mike
>>>>>
>>>>>
>>>>>
>>>>>
>>>>>
>>>>> Michael E. Zychowicz, DNP, RNFA, NP-C
>>>>>
>>>>> Associate Professor of Nursing
>>>>>
>>>>> Mount Saint Mary College
>>>>>
>>>>> 330 Powell Avenue
>>>>>
>>>>> Newburgh, NY 12550
>>>>>
>>>>> 845-569-3144
>>>>>
>>>>>
>>>>>
>>>>> Orthopedics & Sports Medicine, PC
>>>>>
>>>>> 219 Blooming Grove Turnpike
>>>>>
>>>>> New Windsor, NY 12553
>>>>>
>>>>> 845-561-8060
>>>>>
>>>>>
>>>>>
>>>>>
>>>>>
>>>>> -----Original Message-----
>>>>> From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On
>>>>> Behalf
>>>>> Of Pat Camillo
>>>>> Sent: Tuesday, February 06, 2007 8:23 AM
>>>>> To: NP Info
>>>>> Subject: Re: [NPInfo] An editorial From Dave
>>>>>
>>>>>
>>>>>
>>>>> I have a few questions about PA's that perhaps you can answer Dave:
>>>>>
>>>>> 1. Are there any states where a PA can practice completely indepently
>>>>> of
>>>>> a
>>>>>
>>>>> physician? In other words, are there states where PA's do NOT have
>>>>>
>>>>> compulsory supervision?
>>>>>
>>>>> 2. Do you know of any countries where the PA as we generally know this
>>>>> role
>>>>>
>>>>> in the US, is being implemented? If so, where?
>>>>>
>>>>>
>>>>>
>>>>> Thanks
>>>>>
>>>>>
>>>>>
>>>>> Pat......on her way to one of two clinical practices while still
>>>>> teaching.
>>>>>
>>>>>
>>>>>
>>>>> Pat Camillo PhD,RN,APN,C
>>>>>
>>>>> Certified Nurse Practitioner in Women's Health,
>>>>>
>>>>> Gerontology and Menopause
>>>>>
>>>>> Carmenta Health
>>>>>
>>>>> 1 Kalisa Way Suite 103
>>>>>
>>>>> Paramus, New Jersey 07652
>>>>>
>>>>> (201) 265-9042
>>>>>
>>>>>
>>>>>
>>>>> Manhattan Menopause Center
>>>>>
>>>>> 225 East 64th Street Suite C-2
>>>>>
>>>>> New York, New York 10021
>>>>>
>>>>> (212) 308-4988
>>>>>
>>>>> ----- Original Message -----
>>>>>
>>>>> From: "Carla Anderson" <carla_rayne at yahoo.com>
>>>>>
>>>>> To: "NP Info" <npinfo at nurse.net>
>>>>>
>>>>> Sent: Monday, February 05, 2007 9:36 PM
>>>>>
>>>>> Subject: Re: [NPInfo] An editorial From Dave
>>>>>
>>>>>
>>>>>
>>>>>
>>>>>
>>>>>> While I have not known Dave as Peg does, I am speaking objectively to
>>>>>> the
>>>>>
>>>>>> words.  I think of "healthcare" as all encompassing, and it HAS
>>>>>> evolved,
>>>>>
>>>>>> to mean much more than "medical care" to me, and I believe to the
>>>>>> public
>>>>>
>>>>>> and people in general. In addition, in every speech I have heard from
>>>>>> the
>>>>>
>>>>>> White House press conferences, when there is a debate regarding this
>>>>>
>>>>>> topic, it is called "healthcare" reform, or reform of "healthcare"
>>>>>
>>>>>> policy.. Never have I heard current or former or future presidential
>>>>>
>>>>>> candidates refer to it as "medical care"..I am sorry but I have not.
>>>>>> I
>>>>>
>>>>>> also do not feel that doctors are going to say "if there is a
>>>>>> physician
>>>>>
>>>>>> shortage, we need to build more medical schools".. that does not make
>>>>>
>>>>>> sense, and I do not think that the Governmental powers that be, would
>>>>>> take
>>>>>
>>>>>
>>>>>> that literally anyway, should it be said, because the shortage or
>>>>>
>>>>>> perceived shortage of phsyicians is not from a lack of medical
>>>>>> schools...
>>>>>
>>>>>> I have NEVER heard a doctor say "we need more medical
>>>>>
>>>>>> schools"....The main shortage of MDs is in Primary Care, (and we have
>>>>>> an
>>>>>
>>>>>> answer for that)  and regarding the general shortage of physicians, 
>>>>>> it
>>>>>> is
>>>>>
>>>>>> partly because less are going into medical school, not because there
>>>>>> is
>>>>>> a
>>>>>
>>>>>> shortage of schools.. And as we have discussed before, the governing
>>>>>
>>>>>> bodies, are clearly looking at economics, and primary care, etc, and
>>>>>> they
>>>>>
>>>>>> are taking a CLOSER LOOK at NPs and PAs as the solution on a more
>>>>>> global
>>>>>
>>>>>> nature.   One thing does have to be addressed however. Arnold
>>>>>
>>>>>> Schwarznegger as Governor of California did apparently state he was
>>>>>> going
>>>>>
>>>>>> to contribute funds to the NP/PA program at UC Davis for these
>>>>>
>>>>>> practitioners.. However, I do not believe he is aware that as this is
>>>>>> a
>>>>>
>>>>>> school of Medicine,  it may not actually benefit the very
>>>>>> practitioners
>>>>>> he
>>>>>
>>>>>
>>>>>> wishes it to, because of the way the school program is set up. The
>>>>>> funds
>>>>>
>>>>>> may go into the Medical School, and not into the NPs, and PAs 
>>>>>> programs
>>>>>
>>>>>> directly.  This is my opinion, but I honestly have never
>>>>>
>>>>>> heard people use the term "medical care" intead of healthcare, and I
>>>>>> do
>>>>>
>>>>>> not think anyone is going to be proposing or considering a proposal
>>>>>> about
>>>>>
>>>>>> building more medical schools as a viable solution for our current
>>>>>
>>>>>> healthcare issues.  My opinion only/ Carla Anderson FNP/Portland, OR
>>>>>
>>>>>>
>>>>>
>>>>>> David Mittman <dave at mittman.us> wrote:  Peg:
>>>>>
>>>>>> I do not disagree. Want to get people thinking a bit. Just saying out
>>>>>> loud
>>>>>
>>>>>> that people are going to start to look for APCs who can provide
>>>>>> medical
>>>>>
>>>>>> care
>>>>>
>>>>>> (I could be wrong also!) and if they think NPs do some sort of
>>>>>
>>>>>> "nursing"-more medical schools will be built. If they think PAs are
>>>>>> really
>>>>>
>>>>>> "assistants", same for us.
>>>>>
>>>>>> Let's change all our names to HCPs (Healthcare Practitioners) then 
>>>>>> and
>>>>>
>>>>>> educate people we can provide healthcare and medical/advanced nursing
>>>>>> care
>>>>>
>>>>>> also.
>>>>>
>>>>>> Dave
>>>>>
>>>>>>
>>>>>
>>>>>>
>>>>>
>>>>>> On 2/5/07 12:41 PM, "Margaret A. Fitzgerald, DNP, NP-C, APRN, BC,
>>>>>> FAANP,
>>>>>
>>>>>> CSP"
>>>>>
>>>>>> wrote:
>>>>>
>>>>>>
>>>>>
>>>>>>> David, You and I have known one another for decades and respect one
>>>>>
>>>>>>> another's work. We are usually on the same page as well. While I
>>>>>>> agree
>>>>>
>>>>>>> with
>>>>>
>>>>>>> most of your editorial, I disagree with you on the medicine practice
>>>>>
>>>>>>> part.
>>>>>
>>>>>>> What we all practice is healthcare, not medicine, a word I believe
>>>>>>> puts
>>>>>
>>>>>>> one
>>>>>
>>>>>>> discipline in the driver's seat. Healthcare should be patient, not
>>>>>
>>>>>>> provider,
>>>>>
>>>>>>> focused.
>>>>>
>>>>>>>
>>>>>
>>>>>>> Peg Fitzgerald (who sends this note with a big hug to my buddy David
>>>>>
>>>>>>> Mittman
>>>>>
>>>>>>> and is a healthcare practitioner, FNP, in family practice)
>>>>>
>>>>>>>
>>>>>
>>>>>>>
>>>>>
>>>>>>>
>>>>>
>>>>>>> Dr. Margaret A. Fitzgerald, DNP, APRN, BC, NP-C, FAANP, CSP
>>>>>
>>>>>>> President, Fitzgerald Health Education Associates, Inc.
>>>>>
>>>>>>> 85 Flagship Drive
>>>>>
>>>>>>> North Andover, MA 01845-6154
>>>>>
>>>>>>> 978.794.8366
>>>>>
>>>>>>> FNP, Adjunct Faculty, Family Practice Residency
>>>>>
>>>>>>> Greater Lawrence (MA) Family Health Center, Inc.
>>>>>
>>>>>>> FHEA website www.fhea.com
>>>>>
>>>>>>> FHEA on line store www.fhea.biz
>>>>>
>>>>>>> Proud member of "Team Mimi", Leukemia and Lymphoma Team in Training
>>>>>
>>>>>>> http://www.active.com/donate/tntma/tntmaMFitzge
>>>>>
>>>>>>>
>>>>>
>>>>>>>
>>>>>
>>>>>>>
>>>>>
>>>>>>>
>>>>>
>>>>>>>
>>>>>
>>>>>>>> From: David Mittman
>>>>>
>>>>>>>> Reply-To: NP Info
>>>>>
>>>>>>>> To: ACC-Circle , NPinfo ,
>>>>>
>>>>>>>>
>>>>>
>>>>>>
>>>>>
>>>>>>>> Subject: [NPInfo] An editorial From Dave
>>>>>
>>>>>>>> Date: Sun, 04 Feb 2007 19:38:20 -0500
>>>>>
>>>>>>>>
>>>>>
>>>>>>>> Let¹s Redefine Medical Care, Quickly
>>>>>
>>>>>>>> By Dave Mittman, PA
>>>>>
>>>>>>>>
>>>>>
>>>>>>>> We will have mandatory national health insurance. Every week one
>>>>>>>> state
>>>>>
>>>>>>>> or
>>>>>
>>>>>>>> another talks about the fact that many of its citizens are not
>>>>>>>> covered
>>>>>
>>>>>>>> by
>>>>>
>>>>>>>> medical insurance. A number of states have come up with plans to
>>>>>>>> address
>>>>>
>>>>>>>> this and if California can pull it off successfully, they will
>>>>>>>> certainly
>>>>>
>>>>>>>> be
>>>>>
>>>>>>>> looked at as a model for the other larger states.
>>>>>
>>>>>>>> On top of this, we have a physician shortage. A recent article
>>>>>>>> stated
>>>>>
>>>>>>>> that
>>>>>
>>>>>>>> the Council on Graduate Medical Education predicted a shortage of
>>>>>>>> close
>>>>>
>>>>>>>> to
>>>>>
>>>>>>>> 100,000 physicians by the year 2020. That¹s a huge number of
>>>>>>>> physicians
>>>>>
>>>>>>>> to
>>>>>
>>>>>>>> be short of. Add to that the fact that there are almost 200,000 NPs
>>>>>>>> and
>>>>>
>>>>>>>> PAs
>>>>>
>>>>>>>> already delivering of healthcare in this country and you know we
>>>>>>>> have
>>>>>>>> a
>>>>>
>>>>>>>> problem.
>>>>>
>>>>>>>> Business will demand national healthcare coverage because it has to
>>>>>>>> for
>>>>>
>>>>>>>> its
>>>>>
>>>>>>>> own survival. Not because business people are experts in medical
>>>>>>>> care
>>>>>
>>>>>>>> but
>>>>>
>>>>>>>> because they cannot compete on a world level anymore because of the
>>>>>
>>>>>>>> burden
>>>>>
>>>>>>>> of healthcare costs. A small business in the U.S. that has six
>>>>>>>> employees
>>>>>
>>>>>>>> has
>>>>>
>>>>>>>> to start out budgeting $75,000 for health insurance before they 
>>>>>>>> even
>>>>>
>>>>>>>> open
>>>>>
>>>>>>>> their doors. The same business in Western Europe, Canada, India,
>>>>>>>> Mexico
>>>>>
>>>>>>>> or
>>>>>
>>>>>>>> the UK does not have to worry about this cost. What a deterrent to
>>>>>
>>>>>>>> opening
>>>>>
>>>>>>>> new businesses and competing on the world level. So, not if but 
>>>>>>>> when
>>>>>
>>>>>>>> national insurance comes, how many more providers will we need?
>>>>>
>>>>>>>> And, how can we ever begin to figure out what the medical care 
>>>>>>>> needs
>>>>>
>>>>>>>> will
>>>>>
>>>>>>>> be
>>>>>
>>>>>>>> of the baby boomers as they age into their 60s, 70s, 80s and 
>>>>>>>> beyond?
>>>>>
>>>>>>>> What does this all tell us? That the powers that be; medical
>>>>>>>> schools,
>>>>>
>>>>>>>> organized medicine (read AMA, AAFP, ACOG, etc), public health
>>>>>>>> officials,
>>>>>
>>>>>>>> big
>>>>>
>>>>>>>> business, and others will be called in by Congress and asked to
>>>>>>>> develop
>>>>>
>>>>>>>> a
>>>>>
>>>>>>>> plan to provide more medical care to our citizens. Their logical
>>>>>>>> answer
>>>>>
>>>>>>>> to
>>>>>
>>>>>>>> this challenge will be to create many more medical schools and many
>>>>>>>> more
>>>>>
>>>>>>>> doctors. What else could they say?
>>>>>
>>>>>>>> What else would anyone expect them to say? This is a no brainer.
>>>>>
>>>>>>>>
>>>>>
>>>>>>>> That¹s where I get worried. For years there has been a debate as to
>>>>>>>> what
>>>>>
>>>>>>>> kind of ³care² PAs and NPs provide. Look at most literature from 
>>>>>>>> the
>>>>>>>> NP
>>>>>
>>>>>>>> movement and you will see that NPs provide ³healthcare² or 
>>>>>>>> ³advanced
>>>>>
>>>>>>>> practice nursing care². Rarely does the ³organized² NP world admit
>>>>>>>> to
>>>>>
>>>>>>>> providing medical care, although individual NPs certainly do and
>>>>>>>> always
>>>>>
>>>>>>>> have.
>>>>>
>>>>>>>> Now I understand this healthcare/medicine distinction fully and
>>>>>>>> actually
>>>>>
>>>>>>>> agree with it. But it should change. Now let¹s look at the PA 
>>>>>>>> world.
>>>>>
>>>>>>>> They
>>>>>
>>>>>>>> do
>>>>>
>>>>>>>> provide medical care but always seem to officially say that in a
>>>>>>>> humble
>>>>>
>>>>>>>> way,
>>>>>
>>>>>>>> as in ³we do it, but we do not want to say it as loud as we can².
>>>>>>>> That
>>>>>
>>>>>>>> will
>>>>>
>>>>>>>> wind up hurting PAs if they keep it at that level, because when it
>>>>>>>> comes
>>>>>
>>>>>>>> time for all of the different medical care groups to chime in and
>>>>>>>> look
>>>>>
>>>>>>>> at
>>>>>
>>>>>>>> JUST WHO CAN PROVIDE MEDICAL CARE and whom to give the money for 
>>>>>>>> the
>>>>>
>>>>>>>> future
>>>>>
>>>>>>>> provision of such, where do you think it will go? Thirty more
>>>>>>>> medical
>>>>>
>>>>>>>> schools will be built and many others expanded.
>>>>>
>>>>>>>>
>>>>>
>>>>>>>> I say let¹s step up to the table now and have both our fine
>>>>>>>> professions
>>>>>
>>>>>>>> start educating the powers that be that we provide ³medical care² 
>>>>>>>> to
>>>>>
>>>>>>>> over a
>>>>>
>>>>>>>> million people every day and want to expand our delivery of it in
>>>>>>>> the
>>>>>
>>>>>>>> future. Yes, I am sure we also provide more than that. Maybe it¹s
>>>>>
>>>>>>>> holistic
>>>>>
>>>>>>>> care. Maybe it¹s more patient oriented care? But in this context
>>>>>>>> will
>>>>>
>>>>>>>> Congress or your state legislature even understand the nuances? We
>>>>>>>> have
>>>>>
>>>>>>>> to
>>>>>
>>>>>>>> tell the world that yes, we do medicine, and we do it well! We also
>>>>>>>> must
>>>>>
>>>>>>>> not
>>>>>
>>>>>>>> be afraid to ask for a seat at the table when this new healthcare
>>>>>
>>>>>>>> delivery
>>>>>
>>>>>>>> system is being carved out and to lobby to make sure both
>>>>>>>> professions
>>>>>
>>>>>>>> are
>>>>>
>>>>>>>> involved. If the country needs medical care, let us answer the call
>>>>>>>> and
>>>>>
>>>>>>>> give
>>>>>
>>>>>>>> it to them.
>>>>>
>>>>>>>>
>>>>>
>>>>>>>>
>>>>>
>>>>>>>> _______________________________________________
>>>>>
>>>>>>>> NPInfo mailing list
>>>>>
>>>>>>>> NPInfo at nurse.net
>>>>>
>>>>>>>> http://lists.nurse.net/mailman/listinfo/npinfo
>>>>>
>>>>>>>> *****************************
>>>>>
>>>>>>>
>>>>>
>>>>>>>
>>>>>
>>>>>>> _______________________________________________
>>>>>
>>>>>>> NPInfo mailing list
>>>>>
>>>>>>> NPInfo at nurse.net
>>>>>
>>>>>>> http://lists.nurse.net/mailman/listinfo/npinfo
>>>>>
>>>>>>> *****************************
>>>>>
>>>>>>
>>>>>
>>>>>>
>>>>>
>>>>>> _______________________________________________
>>>>>
>>>>>> NPInfo mailing list
>>>>>
>>>>>> NPInfo at nurse.net
>>>>>
>>>>>> http://lists.nurse.net/mailman/listinfo/npinfo
>>>>>
>>>>>> *****************************
>>>>>
>>>>>>
>>>>>
>>>>>> _______________________________________________
>>>>>
>>>>>> NPInfo mailing list
>>>>>
>>>>>> NPInfo at nurse.net
>>>>>
>>>>>> http://lists.nurse.net/mailman/listinfo/npinfo
>>>>>
>>>>>> *****************************
>>>>>
>>>>>
>>>>>
>>>>>
>>>>>
>>>>> _______________________________________________
>>>>>
>>>>> NPInfo mailing list
>>>>>
>>>>> NPInfo at nurse.net
>>>>>
>>>>> http://lists.nurse.net/mailman/listinfo/npinfo
>>>>>
>>>>> *****************************
>>>>>
>>>>> _______________________________________________
>>>>> NPInfo mailing list
>>>>> NPInfo at nurse.net
>>>>> http://lists.nurse.net/mailman/listinfo/npinfo
>>>>> *****************************
>>>>>
>>>>
>>>>
>>>> _______________________________________________
>>>> NPInfo mailing list
>>>> NPInfo at nurse.net
>>>> http://lists.nurse.net/mailman/listinfo/npinfo
>>>> *****************************
>>>
>>>
>>> _______________________________________________
>>> NPInfo mailing list
>>> NPInfo at nurse.net
>>> http://lists.nurse.net/mailman/listinfo/npinfo
>>> *****************************
>>
>>
>> _______________________________________________
>> NPInfo mailing list
>> NPInfo at nurse.net
>> http://lists.nurse.net/mailman/listinfo/npinfo
>> *****************************
>
>
> _______________________________________________
> NPInfo mailing list
> NPInfo at nurse.net
> http://lists.nurse.net/mailman/listinfo/npinfo
> *****************************
>
>
> _______________________________________________
> NPInfo mailing list
> NPInfo at nurse.net
> http://lists.nurse.net/mailman/listinfo/npinfo
> *****************************
>

More information about the NPInfo mailing list