But my point is that if you have to jump through those hoops to be a competitive PA, and that becomes the norm, you’ve already lost the battle. Look at Utah. You guys should be thrilled that there is a path to some form of independence. But then the NPs just literally were provided with full independence. The only reason psyche NPs weren’t pulled in was because they are covered by a different set of laws for mental health practice. But regular NPs there are now set free. They don’t even need to do their first 1000 hours under the watchful eye of a physician. A Pa there needs to have 5 years of supervision... IN WHATEVER SPECIALTY THEY WANT TO PRACTICE IN! A doctorate to compete? Who is competing? OTP... all that did was get docs off the hook for liability. Under OTP, you can come work for my practice, and I, as the practice owner, would be providing the supervision, because supervision takes place at the practice level. Could PAs own their own places? Nope, that’s not what OTP is about.
The structural barriers to PAs (which are really the only things I have a problem with regarding the PA field, and it’s not all their fault) are thus...
-Cost of education (including the undergrad degree that usually doesn’t come with an income to fall back on unless you are a nurse).
-status as a dependent provider (which is only being scaled back a little bit).
-Time investment (which on the whole is tantalizingly close to what goes into undergrad and med school proper).
The time investment becomes even more of an issue with any tacked on fluff course. And yes, it would be fluff akin to what everyone says about the DNP. And the DNP has applications that appeal to practice management, and is beneficial to getting into leadership roles in health care as a whole. Every hospital has a CNO, who is an executive who moves policy. Every entity with nurses involved has a director of nursing. We are automatically invited to the party. A PA with a Dhsc is a novelty without a compelling role, especially since I know nurses with health science degrees, albeit fewer with doctorates.
Whats the difference between an NP and a PA.... NPs are more common, cheaper to obtain, most have health care experience, saavy skills from dealing with people, many more options, a great fallback (that leads to less desperation in the job search), and avenue to seamlessly advance professionally along a degree path....
I recommend PA to almost no one. Not because they aren’t competent providers, but because if these structural inequities. The time to fix them was 10 years ago. Doing it now is quite a bit late. Literally the entire western United States (and all of New England), including Hawaii and Alaska, are either independent to the full extent, or else now have minimal and easily obtainable accommodations that must be met prior to independent practice. It’s all wrapping up. PAs take one step forward, NPs take 3. That means you guys still lose ground.
And like you said... anyone can get a Dhsc. So it may become the standard for PAs, but it doesn’t set them apart. That HR person who doesn’t know what they are choosing from among will certainly know what a doctor nurse is, and it will still stand out over the PA (or MCP) with a DHSC.
Another self inflicted wound? Rebranding PAs into “Medcial Care Practitioners”, or “medical practitioners for short”, which really means you guys want to be called “MPs” to piggyback NPs in the hopes of using our title as your springboard. That’s going to obscure things for PAs even further. You can copy our name, but you can’t effectively get word out. And I can call myself a Medical Practitioner too. Patients will be like “what’s an MCP?”, and people will say “they used to be physicians’ assistants but changed their name”. The name thing would have been saavy 15 years ago, but it’s a distraction right now when PAs can’t afford it. It will be another one step forward when the NPs are still taking three.
What I’m seeing right now is a tight job market, and lower pay for non physician provides. I’m seeing NP grads waiting in the wings making $90k+ while they wait for jobs to open up, and PA grads sounding like pharmacy grads, with time ticking. Fine time to push rebranding, minimal team practice, degree creep, and flooding the market. Nurses did all this too... decades ago, when it was to our benefit.
It’s all structural, and not fair, but that’s the PA vs NP take that I have. Doctorates will be the death of PAs. Name piggybacking won’t kill the career field, but it’s the wrong moment to further obscure the profession. OTP is the wrong battle to be fighting.
