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Discussion About Nurse Practitioner and Physician Assistant Titles and Roles
Discussion About Nurse Practitioner and Physician Assistant Titles and Roles
Discussion About Nurse Practitioner and Physician Assistant Titles and Roles
Discussion About Nurse Practitioner and Physician Assistant Titles and Roles
Discussion About Nurse Practitioner and Physician Assistant Titles and Roles
Discussion About Nurse Practitioner and Physician Assistant Titles and Roles
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Discussion About Nurse Practitioner and Physician Assistant Titles and Roles

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If you are looking to promote to or communicate with physician assistants and nurse practitioners, it is important for you to avoid language that is derogatory and understand how your goals may be …

If you are looking to promote to or communicate with physician assistants and nurse practitioners, it is important for you to avoid language that is derogatory and understand how your goals may be aligned with their roles. I saw this informative discussion about language to use (and avoid) to address these health care professionals the right way. Read this when you have a moment. I can also help you navigate some of these nuances and discover ways to engage these growing and highly-influential health care professional segments through education.

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  • 1. I know this topic was recently posted, but I just got a nasty email from a Provider for calli... Page 1 of 6 Account Type: Basic Ryan Cliche, CAE Add Connections Home Profile Contacts Groups Jobs Inbox 41 Companies News More Groups Search... Physician Assistant and Nurse Practitioner Network Discussions Members Promotions Jobs Search More... Start a discussion NEW Groups in the LinkedIn app for iPhone and Android. Latest Updates I know this topic was recently posted, but I just got a nasty email from a Provider for calling him an Advanced Practice Professional What do NPs and PAs want to be called these days??? 10 days ago Follow Derek Like Comment Follow Flag More 26 comments• Jump to most recent comments Jeff Jones • I cant speak for NPs but I can tell you PAs find it offensive to be called Physicians Assistants. We are not owned by Physicians and we are not slaves. We are Physician Assistants. Most also find it offensive to be called "Mid-levels". 10 days ago • Like Follow Jeff Tina Christian • What kind of career change are you offering? 10 days ago • Like Follow Tina Tina Christian • By the way, Im an NP. That is fine with me. I dont care for mid-level. 10 days ago • Like Follow Tina Top Influencers This Week Derek Sims • Tina, I have opportunities in 32 states, email me your information and what you are looking for. So Advanced Practitioner is ok, just not Midlevel correct? 10 days ago • Like Follow Derek Michael Porter • I couldnt agree more with Jeff. I work with nurses that still use the term physicians. PAs as professionals need to take the initiative to educate people when they observe others referring to our profession in thus manner. As far as opportunities, please let me know. I am in surgery in Dallas, Texas. Follow Michael 10 days ago • Like Matthew Andersen, PA-C, FAPACVS • There is no one acceptable term that anyone has agreed upon (that I have heard). But we do know which ones are out: Physicians Assistant Physician Extender Follow Matthew Midlevel I try to use "clinician" or "provider" depending on the setting. Some folks use "Non-physician provider" or "Non-physician clinician" but it seems odd to define something by what it is NOT. 9 days ago • Like Shelia Palmer, PA-C,MBA,MHA • I agree with Mr. Andersen 9 days ago • Likehttp://www.linkedin.com/groupItem?view=&srchtype=discussedNews&gid=3059010&ite... 9/30/2011
  • 2. I know this topic was recently posted, but I just got a nasty email from a Provider for calli... Page 2 of 6 Follow Shelia N Devonna Grover, PA-C, MPAS • Derek, You will never get it right for every provider. Certain titles are going to get under some peoples skin. If the founders of the professions had any idea where these two professions Follow N (PA and NP) were really headed they would have be much more thoughtful about the Devonna names that were chosen and made it all easier for those who have followed. I have had physicians get really irked to be called providers or clinicians because they are lumped in with the PAs and NPs. Again, you will never be able to make all of us happy. 9 days ago • Like 2 Matthew Andersen, PA-C, FAPACVS • " If the founders of the professions had any idea where these two professions (PA and NP) were really headed they would have be much more thoughtful about the names that were chosen and made it all easier for those who have followed. " Follow Matthew Funny thing is the preferred term by the founders of the PA profession was physician associate- they had a name in mind- and the AMA pushed for physician assistant. PAs were in no power position to argue and the name stuck. 9 days ago • Like 1 N Devonna Grover, PA-C, MPAS • My degree from the University of Oklahoma says "Physician Associate", but I graduated a long time ago. I dont think the issue will ever be resolved. I think the thing that is most difficult for PAs is that as the profession has matured the "assistant" moniker does not fit. I work right along side the physician Follow N providers, they see one patient I see the next. I havent "assisted" a physician in 25 years. Devonna That is not to say that I dont confer with them on occasion, I just dont assist them. 9 days ago • Like Matthew Andersen, PA-C, FAPACVS • http://www.associatenamechange.com/ 9 days ago • Like Follow Matthew Juanna H • I think that the term "mid-level" provider reassures the physicians that we are not trying to compete with their title, and I have also found it helpful to simplify the concept for patients sake. If I tell them "mid-level, means that our practice is in between the nurses role and the physicians role: right in the MIDdle". Although it may not be accurate, I dont intend to offend anyone by using this explanation, but just help patients be a little Follow Juanna less confused as to who does what. Does that make any sense? 9 days ago • Like Matthew Andersen, PA-C, FAPACVS • It doesnt make any sense as we are expected to practice the same gold standard medicine as physicians, assume liability, maintain CME and board certification, and answer to the same BOM/credentialing bodies/state licensing. Follow Matthew When we manage COPD, perform a infant well check, or assist in the OR, we are not performing differently than a physician would in that situation. Our training is different but the expectations on evlauation and management are the same. Theres no "mid" level, or 75% level, or 99.999% level about it. 8 days ago • Like 1 Matthew Andersen, PA-C, FAPACVS • Im speaking some specifics about PAs; as an NP you wont (likely) be under the BOM and have the same credential/recert issues. But the concept is the same (even though NPs claim to not practice medicine). 8 days ago • Like Follow Matthewhttp://www.linkedin.com/groupItem?view=&srchtype=discussedNews&gid=3059010&ite... 9/30/2011
  • 3. I know this topic was recently posted, but I just got a nasty email from a Provider for calli... Page 3 of 6 Mary Harkin • I agree with Juanna. I am a Advanced Practice Registered Nurse from a Family Nurse Practitioner masters level tract & I work in a Dermatology office with 2 MDs & 3PAs. Mid-level works because it is a generic term that is inclusive of NPs & PAs. I can understand PAs wanting a title that recognizes their profession as its own, but it may be a bit late in the game for a name change. If you ever knew someone as a child by a certain Follow Mary name, you tend to always think of them with that name even if they change it as an adult. I really think it is most important for the name mid-level, nurse practitioner, & physician assistant to be synonymous with quality health care. Remember New Coke, Madison Avenue couldnt sell it. 8 days ago • Like Matthew Andersen, PA-C, FAPACVS • Coke is one thing, but realize that there are several examples of medical professions changing their title successfully. podiatrists used to be called chiropidists. Chiropracters and naturopaths are now officially recognized as Doctor of Chiropractic Medicine and Naturopathic Physician. The only barrier to changing Follow Matthew a professional title is the external forces that have stake in it and the initiative of the professions members. Just because midlevel has been in place is no reason for it to remain. Furthermore the PA profession is actively working on formally changing the title to Physician Associate- not too late in the game at all. No one is doubting that PAs and NPs provide quality care. The greater issue is the obstacles to progress these professions face when the terms used to describe them fail to acknowledge the level at which we all practice. An ER PA doesnt manage an asthmatic up to the "mid point" and then hand off to a physician. An occ med PA doesnt evaluate an employee to the "mid point" and hand off either. 8 days ago • Like 2 Kristin A. Neal • I am old fashioned and I call Doctors-Doctors and PAs-PAs and NPs- NPs. If I want to group them together I say "Doctors, PAs and NPs." 8 days ago • Like 1 Follow Kristin A. Kristin A. Neal • I practice medicine and I practice to the full extent delegated to me by my Supervising Physician. Without him I would not be able to practice--I would know a lot but I could not practice without the Supervising Physician-PA relationship. This relationship should be celebrated instead of sidelined. Follow Kristin A. 7 days ago • Like 1 Michael Lemp • Kristen, I agree with what you are saying to an extent. But what about NP who hold a doctorates? The goal is to change to DNP for entry as an APN. We call physicians doctors simply because they hold a doctorates. Shouldnt the same courtesy be shown to anyone who holds a doctorates, especially if it is in the field they currently practice? I mean Martin Luther King Jr. was not a physician, yet is one example of Follow Michael someone addressed as doctor under all circumstances. 7 days ago • Like Matthew Andersen, PA-C, FAPACVS • "Well, lets see! You attended a PA program & you no longer feel as though the title on your graduation certicficate does you justice in your particular level of Practice. You no longer need any supervision & the physician or facility you work for does NOT Follow Matthew have supervisory capacity or liability over you. And you feel as though you are not respected by having the Title you chose whan you attended your particular PA program. Problem Solved! Go to back to School & Get your MD! " Never mentioned anything about the need for supervision or my professional relationship with my practice- perhaps you can enlighten us on that. Never mentioned that I dont feel respected either. I have a great practice. As a surgical PA the issue of the "name change" affects me very little. It has much greater impact on primary care PAs who are limited by insurers/HMOs/state and federal organizations becuase of their title. There are INNUMERABLE examples of this. See heres the thing- its not about ME, its about my PROFESSION. Becoming a Physician Associate wont make much difference at all for me. But it will for the thousandshttp://www.linkedin.com/groupItem?view=&srchtype=discussedNews&gid=3059010&ite... 9/30/2011
  • 4. I know this topic was recently posted, but I just got a nasty email from a Provider for calli... Page 4 of 6 of front line Primary Care PAs whose title affect their professional/industry relationships. So there the "problem" you are trying to solve doesnt exist. But thanks for commenting on something and someone that you clearly dont know much about. Rule of thumb- Read More, Post Less. 7 days ago • Like • Reply privately • Flag as inappropriate Matthew Andersen, PA-C, FAPACVS • "I practice medicine and I practice to the full extent delegated to me by my Supervising Physician. Without him I would not be able to practice--I would know a lot but I could not practice without the Supervising Physician-PA relationship. This relationship should be celebrated instead of sidelined." Follow Matthew it is not the name of the profession or how we define a group of professionals (non physican clinicians) thart sidelines the SP-PA relationship. The work PAs have done in demonstrating their competence has enabled legislation across the country which allows PAs, under the construct of their PA-SP relationship, to practice in models such as solo PAs in remote sites or those who carry their own patient panels, with no physician on site and periodic chart review every few months. we all realize that PAs are not independent but were certainly not assisting physicians the majority of the time. Redifining the title to a more modern, representative name does NOT undermine the PA- SP relationship, except perhaps in the paranoia of "turf battlers" 7 days ago • Like Ann Johnson • After 27 years of practicing as a PA, I have assisted, advised, taught and been taught by and worked alongside hundreds of physicians. I have also work alone in many settings. I am a highly professional clinician who has worked in many areas of medicine. I had never heard the term mid-level until 2006. I have no idea where it came Follow Ann from but I do not like it and I feel it is insulting. I tell patients and everyone else that I am a physician assistant because that is what my profession says I am. I would like that term to be modernized also because it does not accurately describe what we do. When physicians graduate from medical school they are called Dr. X, Y or Z. They are not addressed as Intern, Resident or Fellow by the patients and staff. I am not MIDLEVEL to anything. I am not a structure comparable to a highrise or a basement and am not a midlevel. If my clinical capability is midlevel I need to quit now and get myself up to speed so I do not hurt anyone. I have the highest respect for all the physicians I work with and am not trying to suggest I have a higher level of training. I may have a higher level of experience in some areas but that is irrelevant to this issue. I have decided not to respond to midlevel anymore, it is just inaccurate and as I said before,insulting. 7 days ago • Like Juanna H • Am I just lacking the pride necessary to understand this argument? Although I dont mind arguing for the sake of it, or even venting for the sake of being heard and understood, this particular discussion does not, in my opinion, shed light on your goals and expectations. Follow Juanna I think that we are getting stuck on words... It seems to be pure semantics, and I have yet to read what PAs want to be called (in place of midlevel providers), and what it is expected to achieve? If it is purely for the benefit of billing/payment and greater accessibility to a larger number of patients, I am all for it. But that has more to do with legislation and/or insurance policies than title. If it is for recognition, I think that PAs have a much better status in the general publics perception than NPs: The majority of the patients (or people out of the profession) that I encounter know exactly what a PA is, but cant make the difference between a NP, an RN and a LPN/LVN...A nurse is a nurse is a nurse.... If your job and responsibilities are fulfilling, and you feel that you are respected by your colleagues, why so much resentment? What is the real end-goal? 7 days ago • Like 1 N Devonna Grover, PA-C, MPAS • Juanna, I see from your profile that you might be rather new to the issue. The issue is that the services that we provide,both NP and PA, which are within the scope of our duties, should Follow N be exactly the same services that are provided by a physician in the same circumstances. Devonna The ability to evaluate and diagnose the symptoms that a patient presents with must behttp://www.linkedin.com/groupItem?view=&srchtype=discussedNews&gid=3059010&ite... 9/30/2011
  • 5. I know this topic was recently posted, but I just got a nasty email from a Provider for calli... Page 5 of 6 equal to our physician counterparts for each patient that we choose to treat. Now with that being said, there are many patients that are beyond our expertise and should be referred for physician management, but our ability to make that determination is not different if we are evaluating the patient or if a physician is evaluating the patient. If I evaluate a person with a sinus infection, the evaluation and treatment plan, should be no different that if a physician were treating that patient. If I work up a patient who has gall stones or the physician I work with comes to the same diagnosis, the patient still should be referred for surgical evaluation. The initial services rendered should be no different. Now the issue becomes evident when insurance companies and patients think that they somehow got services that were less appropriate or should be less expensive because they were only seen by a "mid level" provider, an "assistant" or just a "nurse." In the surgical specialties PAs do act in a "assisting" role, but if not for a PA or NP that role would need to be filled by a physician not only for technical experience and training, but for reimbursement. And while the PA is performing the exact services that a physician would as an assist in surgery, the reimbursement is less. However, because a PA is assisting the first surgeon, the second physician who would be filling that role as an assist is free to perform surgery instead of assisting another surgeon. The trend is the desire to change the Physician Assistant name back to Physician Associate, which was the original name of the profession, but was changed to appease physicians. The title of Nurse Practitioner is confusing by the inclusion of "nurse." NPs are no longer practicing "advanced nursing", they are practicing medicine just the same as physicians. The NP profession is moving to the doctorate level of training, however in the state that I am in, unless the law has changed recently, they cannot present themselves to their patients as Doctor X, Y, Z, because the law states that in a medical setting only listed professions, i.e. medical doctor, osteopathic doctor, podiatrist, chiropractor etc. can be called Doctor. It is not a matter of being prideful, it is a matter of a title that more accurately describes what we do in order to lessen confusion. 7 days ago • Like 1 Matthew Andersen, PA-C, FAPACVS • N Devonna Grover made great points that I agree with. This is not an argument for argument’s sake. But there are two issues here: what do we call PAs (assistant or associate) and what do we call PAs/NPs/CRNAs as a whole (non- Follow Matthew physicians who practice medicine). Despite what they may call it NPs are practicing medicine. The goals for the associate change are to better describe the way PAs function in the modern era. Assistant is clearly a relic of the profession’s foundation when the programs and oversight were heavily or completely run by physicians. If you took all the “work units” for PAs nationally a small percentage would be categorized as times “assisting physicians”- primarily surgical PAs as operative assistants and some clinical settings where PAs and MDs work alongside each other. In any other case PAs are simply practicing medicine and referring when necessary. Difference between that and physician practice is that docs refer out of their specialty only, whereas PAs will refer out and within. This, along with the fact that no other profession which has the level of training and autonomy that PAs have is called “assistant”....and PAs are often confused with medical assistants...is the main argument for using the term Associate. Removing the term assistant will have downstream benefits in legislation and billing, as those who write policy and law are the lay public or nonclinical folks who don’t associate “assistant” with any sort of professional medical practitioner. They think of the person who gives shots and takes the BP. Plenty of PA case examples being shut out of care or leadership opportunities based on the assistant title. The funny thing is PAs don’t like “assistant” and clearly some NPs feel the “nurse” portion doesn’t reflect that they are PCPs/independent providers and only reminds pts that they are nurses. I guess the professions do have something in common- name issues. Re: what we call the group, there isn’t a good term with any brand recognition. This is partly due to PAs and NPs strong push by some groups to stand alone, with each emphasizing the unique features of their profession rather than commonalities. NPs have worked hard at distancing themselves from physicians, and thus PAs as well. So outside of ”clinician” or “provider” (which can describe MD/DO as well), there is no good choice. As a previous poster said- call PAs “PAs” and NPs “NPs”. The only resentment I sense in the name change advocates is against those who somehow question the need or right of PAs to determine the name of their own profession. There are ways for PAs to better utilized, and for the profession to grow, that are hindered by the assistant title. And you use the term “recognition”, which is a COMPLETELY VAILD argument as well for PAs. It is when critics draw “recognition” into “vanity” or “pride” that the discussion breaks down- as they fail to see the situation from the PA perspective. 6 days ago • Likehttp://www.linkedin.com/groupItem?view=&srchtype=discussedNews&gid=3059010&ite... 9/30/2011
  • 6. I know this topic was recently posted, but I just got a nasty email from a Provider for calli... Page 6 of 6 Juanna H • @ Devonna and Matthew. I appreciate you both taking the time to spell it out for me. As Devonna pointed out, the issue you both feel so strongly about is still very new to me, and I am guessing that at this Follow Juanna point in time, I just feel grateful for being given the opportunity to learn and practice way beyond what would have been possible had I remained an RN. I trust that your arguments are grounded in your experience of the profession and years of practice. As for me, I still feel that I dont know much and I therefore dont feel entitled to wanting more recognition because I couldnt back it up (hopefully, this will change). The titles "Physician Assistant" and "medical assistant " do sound alike, and I can see how that would be both confusing and detrimental to your practice and career. I understand why you feel that you should be able to determine the name of your own profession. And if it were to indeed improve practice recognition and reimbursement, it would ultimately benefit the patients and their access to care, which I could only support... That being said, I cant help but wonder what impact the push for more recognition will have on our relationships with physicians. Is it wise to bring more attention to us when the Medical governing bodies are fighting so fiercely to put us "back in our place"? Are we not going to end up losing the "advanced practice" that drew us to our respective professions in the first place? Probably just a newbies concern? What are the feelings and thoughts of your MD/DO colleagues on the topic? 5 days ago • Like Add a comment... Send me an email for each new comment. Add Comment Ads by LinkedIn Members CRM for Higher Education Top Manager/Director Jobs Recruit and Retain More Students with Join TheLadders.com for access to SaaS CRM Built for Higher Ed thousands of relevant JobsHelp Center About Blog Careers Advertising Recruiting Solutions Tools Mobile Developers Publishers Language Upgrade Your AccountLinkedIn Corporation © 2011 User Agreement Privacy Policy Copyright Policy Send Feedbackhttp://www.linkedin.com/groupItem?view=&srchtype=discussedNews&gid=3059010&ite... 9/30/2011

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