[NPInfo] My Reply........To Shelby

[David Mittman]

Meg: 
What point did pointing out that PAs must have a physician available on the
phone make? There are TONS of PAs practicing in satellite clinics all across
America. To be truthful 75% of NPs must have the same. And in the states
where NPs can practice alone, few do, most are still with physicians. The
public's physician "perception" problem and being the "captain" of the ship
problem is something common to both professions and is not going away.
NOT SAYING WE ARE THE SAME but there is little difference between
supervision and collaboration in most states. There is also little
difference between how an NP in GYN and a PA in GYN practices.
That being said I agree with you. What makes us different?
I am not sure of everything that does, but I AM VERY SURE that patients
constantly tell us we are different and better. We care more. It is palpable
for both professions. We also are turned on by primary care, most docs are
not. PAs and NPs ARE different in a way we need to describe. The question is
who will care? Insurance companies don't. They only care about paying us the
least possible.
Health planners don't, they want to have the same quality as docs at a
lesser cost.
The government does and does not as they are faced with the same problems
that the insurance industry faces. How to get most from a buck.
And WE hold ourselves up to providing the same level of care that physicians
do (remember the NP article in JAMA). On one hand we strive to show we are
as good and on the other hand we ARE different. Either we are trying to be
them or we are not. A central question for both professions.
So that leaves most of us needing to do what most have trouble doing,
keeping up with the day to day advances in medicine. We need to do that to
be as good. We do that with less journals and many less resources than
physicians have, and we do it well.
Do we both want to do what physicians do? Yes.
Do we both want to be different? Yes.
Do we want to document that difference? Yes.
Do we both want to be different in the SAME WAY? I think so but who really
knows?
All interesting questions.
Thank you for bringing them up.
Love and peace,
Dave






On 9/4/07 10:49 PM, "mmhelgert46 at comcast.net" <mmhelgert46 at comcast.net>
wrote:

> OK.....we need to have this dialogue ....Physician Assistants must have a
> physician at arms length( either by phone or in the building) So says the
> Board of Medicine in each and every state ....I don't see any other way around
> this one....NP's in various states need a variety of similar settings called
> preceptors, physician consultants...and other combinations of these types of
> practices. Some states are very independent...such as Oregon (my state)
> 
> My question will always be...what are we doing that makes us different, unique
> and stand apart ?...what's the niche we fill?  and what we are doing about
> making this happen. It still makes little difference if physicians are "at the
> top of the food chain"...this is not my concern...my concern is what are we
> doing to set ourselves apart from this? this is the task that faces us right
> now...this point in history when health care is in shambles...it is a perfect
> opportunity to make it happen for all of us.......not continue discussing
> physicians.......what makes us different then they are?...if we can't even
> figure this out...we're doomed. The dialogue cannot continue along the lines
> of "we are cheaper"...that's old  and it doesn't quite describe us....money
> should never be in the description........
> 
> This is the part...where it gets really tough...'cuz I'm describing a
> professional...and that brings up the DNP program and  that whole
> issue..........which is the future......and this is where we take our rightful
> place shoulder to shoulder with all other professionals....such as lawyers,
> physicians, CPA...to name a few......we set the standards, describe
> educationally what we need, we provide the statements that the public must
> see...and this must happen so we don't go the way of the dinosaurs...Meg
> 
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