I realize I always comment but this is too big an issue. The ONLY thing affecting, and will effect PAs forever is the issue of collaboration and this was number one on the UMA quick list in their attack on the Bill

This is the single thing that will drive the future of PAs. We have to have collaborative status just like the NPs do so we can compete in a market that they have us down 4:1 We love them, and it’s not against NPs just leveling the field so we can compete and get the GOOD jobs too. All of the other things in the Bill are wonderful but not vital to PA longevity (as a viable strong professionals not relegated to the jobs only where a doc really thinks were the “assistant” in the literal way. I really got this vibe from the UMA doctor.

Jonathan did a great job with what little time they gave him and it’s through for now, but they made it clear at the UMA they were going to fight

My measly advice is that we be honest. We DO NOT think we are equal to doctors. We LOVE working with and for our doctors. BUT our profession is struggling mightily (please, I beg, do not rely on INDEED as an indicator)You can IF you know how to read it properly as there are many duplicates and phony jobs listed in the numbers) but I am talking to PAs all over and agencies. PAs are hurting. NPs are not, simply due, especially out west, to their “collaborative vs supervisor” stipulation. THEY can work for the telemedicine companies- we cannot. They don’t want to find us supervisors. I know because I speak with them.

If it gets hot we need to make clear this is about survival and job viability. I’d be happy to gather statistics It is not about independence and striking out on our own. Let’s be real though, we likely can’t “fool” the UMA or skip it by them. They’re doctors for a reason.

So we appeal to the reality 1. We’re losing jobs at an incredible rate due to NPs ability to just be “hired” or open their practice and 2 we could not work telemedicine companies in the covid crisis, but NPs could, BECAUSE we are handcuffed by the supervisor rule.

Look, we’ve proven ourselves and we WANT to still have a doctor / PA relationship forever and they need to know this. This is not about ego ....but about economics and our survival (not literally but as a viable profession and not the afterthought.)

Great work all

So, Dale, what can we all do to prepare for the next step? I appreciate all the work that has been done on our behalf. I agree with your statements as I recently have switched employment and had to tackle some of these issues of finding a supervising physician. Thank you all for your work!

Carol, this is a tough one. From my little desk and computer chair over the years I have noted some issues with our former leadership in AAPA, who are, really, our only national voice that seem to have impacted our profession and have us - I should say "the future PA's" in deep hole. Were down 4:1 to our only competition AND they can be, like here in our state a simple 1:1 hire while we are always a 2:1 find a supervisor hire.

I am not sure if my colleagues realize that NP's and PA's both had their first classes in 1965. We started the same year. Yet they, the NP's, show incredible ambition as a profession while our profession seemed to be so tentative and apprehensive at every step, and then nearly apologetic, on everything we accomplished or attempted to accomplish. It is noble and "not wrong" to want to work closely with our physician supervisors and the physician profession as a whole, but at what cost ultimately? We have NEVER upheld to the public our superior training over the NP, I believe it is in most cases anyway, or advertised this or anything really. We don't want to "offend" anyone as a profession so we are now struggling from behind. So many PAs are FORCED into jobs or specialties they don't want because NP's have gobbled up the good jobs and present themselves, I have actually watched this in the workplace in Utah, as "independent" providers and they don't "need" a supervisor like the PA over there does. So I feel as if we really have 2 avenues we pursue at the same time and prepare for.

One is the ideal path, that we PAs make clear to the AMA and others we are not "cheap" doctors" and we do not consider ourselves on the level of the physicians (I understand there are PA's whose skill level can rise to physician level - but we don't view ourselves in that sense) and we are not trying to "take" physician jobs, but to fill gaps and serve where we are needed. We "want" to work as a team, not as as single entity competing for healthcare jobs.
BUT.....we are caught in the middle. When we view the 3 legal clinicians in the US who have overarching prescriptive authority (and it is really only 3), the Physicians, the NP's and then we PA's, we are the only "dependent" provider being pushed down in a job market simply due the finesse and foresight(?) maybe of the NP profession at positioning themselves in an "independent" or in a very simple "collaborative" licensure position, wherein to hire an NP over a PA in Utah is a simple answer for many HRs and clinics and hospitals because they are just "hired" outright - no doctor has to be found to "supervise" and no doctor has to be paid to supervise or babysit a PA. The NP's as I said above already outnumber us 4:1 so they have that edge and we will never catch up. More concerning to me, if one reads the briefs on their national site, is they want them all the get doctorates AND be able to use the moniker in the workplace. And then they want independent practice in all states and territories eventually AND they actually DO feel they are at the physician level- they say it. I think we need to just say that for economic and job viability and competition WE NEED collaborative or independent status just to simply stay strong in a market we're down 4:1 already.

And the second path means we may have to put on our big boy and girl pants and be ambitious and just let them know, IF they try to maintain control over us PA's since they have lost it with the nurses, who even skirt around the medical boards in every state, that this collaborative change or independent practitioner movement is about our survival, period. We can't have 3 US prescribers, the physicians who are top dog and rightly so in a way, then these NP's who have flooded the market, and are demanding independence, angling to use the "doctor" title, and outnumber us significantly because they now whip them out with online course and 500 hours in any doctors office they can find (this is only partly an exaggeration as I have stories of NP's getting jobs in urgent care and emergency medicine after spending their 500 hours with an uncles internal medicine practice and was easily hired, as they needed no supervisor to work, and because the place could not hire any more PA's because they had 2 (and 4 NP's) and only one retired doctor to supervise (and he can only sup 2 FTE) and they were NEVER going to pay another doctor to be on staff.)

This is what we're up against. But it can be done. The nicest, quietest way is best of course, and here's hoping we can get it passed.

And so what does this mean? When is the official vote?