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| First Thoughts: On Healthcare Reform Passing |
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by David Mittman, PA - March 26, 2010
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 Provided by Clinician1
Regarding the passing of healthcare reform so much is going through my head............
- I am glad that we passed healthcare reform. WHY? Because we elected a man as President who promised that he would do something about the problem we have regarding Americans and our healthcare. I did not attach any more to it than that. Not Democratic or Republican victories. Not Conservative or Liberal values, but only that this is the American way.
This is the way democracy works. The person who wins is elected because of what he promises. And now we should all hope it works for all Americans. If it does not, he and his party will pay the price. It is a place I hope more of us get to about this problem.
- One thing that I do worry about is that the insurance companies, who I feel, ultimately, have the most to lose, will just keep raising rates. And they will say it is because “we have to absorb the costs of reform”. I wonder about them, as I have wondered before. We really passed insurance reform, not healthcare reform.
- I am sorry that the AMA backed healthcare reform. They should not have, as I think they have much to lose also. After all of the years of the AMA putting PAs and NPs down, I still do not trust they are out for the common good. Maybe they know something we do not know, or have they really figured this all out and realized, as many did, that people need care? Maybe it was just time? Still, I worry about the fact that they were staunchly behind this. I need to be more forgiving sometimes, but still??
- I really hope and trust that the NP and PA professions will use this opportunity to stand together and lead to benefit both our patients and our professions. We have so much to give. Should I have this trust? We have a golden opportunity here. Let all of these new PA and NP students coordinate at least a part of their research and study just how good both professions are. If we are as good as we think (and I know) we are, we have a golden opportunity to prove it. NPs and PAs are needed now more than we ever have been. There is no solution to the primary care crisis except using us. NONE. We should realize it and ask for some of the things both our professions need. More autonomy, name changes, postgraduate residencies; whatever it is, now is the time.
- When I asked in a blog a few weeks ago that NPs and PAs be more “out there” in their communities as leaders in healthcare reform, I actually got hate mail. I do not think it was from Clinician 1 members but from non-member NPs and PAs, as we sent an email blast to try to get people to join. I worried that all I did was ask people to get involved and did not endorse any specific plan, and I got hate mail. From my own colleagues! WOW.
Time to come together and for all of us to move forward. There should always be room for debate.
Have a wonderful week. Keep checking all of the news on Clinician 1.
Dave
Dave has been a PA, and later NP, leader for thirty years. He strongly believes that NPs and PAs must work together to insure a better future for both professions. Most recently Dave has been busy launching another dream; Clinician 1, the first internet community for PAs and NPs. In October 2008, Dave was honored by the New Jersey State society of PAs with its “Lifetime Achievement Award”.
The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
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| Jessica (Pittsburgh) |
on 01 Apr 2010 at 4:10 pm |
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| American way? Sure Americans elected a president who promised reform in the healthcare arena. HOWEVER this was a general statement and when it came to the details of the legislation presented and passed, EVERY major poll showed that the majority of Americans did NOT want that bill passed. Yet the American people are steam-rolled over by a congress and a president with their own agenda. This is tyrany, not democracy, and this did not used to be the American way. This bill will not provide universal healthcare. |
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| Gary Cripe, PA-C (Orem, Utah) |
on 31 Mar 2010 at 2:40 pm |
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Dave,
I have been a PA for almost 26 years, 24 of those in Family Practice. I agree pretty much with all of what you say. I did not support this health bill, but agree that it will do nothing but benefit those in our profession. I've heard rumors of name changes since getting out of school, but regarding this; at the AFPPA conference in Orlando 2 weeks ago a comment by one of the speakers was his belief that we will see "PA" & "NP" go away and all of us lumped together as "APC's" (Advanced Practice Clinicians). What do you think?
Gary |
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| Betty (Alabama) |
on 30 Mar 2010 at 10:53 pm |
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Dave, I do agree that PA's and NP's need to pool our efforts to help promote our profession as Advanced Practitioner's. I work in a Family Practice in Rural Al, where jobs are few and health care is lacking due to lack of insurance or in some cases lack of funds to even pay co-pays. Most seek care only when needed, and often too late to be a quick fix, then comes the extended use of costly medications (that is a whole other can of worms to me), but point being if they could not afford to stay well how can they afford to get out of a major illness to achieve wellness. These are the people who really need us! Now the really HUGH thing is that because I am in Al, I am limited in many things I can do, by our laws. The AMA in the deep south is like the "Good ol' Boys club", I still encounter physicians who refuse to discuss a patient with me, they want to talk to the Doctor!. There is power in numbers, and our numbers are growing, but everyone needs to get involved and be part of the progress.
Just being, isn't enough anymore. |
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| Greg Wilkinson (Spokane, WA) |
on 30 Mar 2010 at 7:53 pm |
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| I am doubtful that democracy actually occurred, Dave. I feel that my vote, opinion, and those millions of others who did not want "this" reform to take place were nor honorably represented. Nevertheless, this is the fine kettle of fish I find myself. Will a name change make a difference? I've asked my patients this question, and their usual response is something like, "Well Dr. Greg, what are you called again? Your a PA, right?" I've been a PA for 15 years, and I've been called a lot of things by a lot of people. There is a familiar smell of political correctness stinking up the area. But I digress. We can make a change for good, just as we always have. As far as the health care over hall socialism bill goes: I don't know the consequences, except for change somewhere, some how, by some one. I'm just going to keep on taking care of people. Hopefully my new tax burden will not overwhelm my lowered reimbursement. |
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| Mark Green (Georgia) |
on 30 Mar 2010 at 3:51 pm |
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Dave,
I am with you!!!!!!!! I really think greed and the desire to be the one-in- charge is the main factors behind the AMA fears and intense grip on the power to not allow the NPs & PAs to do what we were trained to do. We can all go back in forth or up and down all day, but the truth is, after working three years in a GP practice I (and any educated person of at least two year of college ) can do the same thing the MD/DO can do. Hey, if it don't look right.... PUNT IT to the the specs.
Come on.... how many times do you have to see the same thing before you know what to do.......If you can not catch on you should not have finish NP or PA school / pass the national Board.
By-the-way........... what ido they do difference in FP resident training? You see one..... You do one...... You teach one.
Mark (20 years as a PA-C) |
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| Monica (Texas) |
on 30 Mar 2010 at 2:32 pm |
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| I'm glad to see someone who thinks like I do- NP's and PA's working together to complement each other and forward the purpose of advanced practice. I propose we all call ourselves Advanced Practitioners. One could then add a dash and place your respective area behind that ex. FNP, PA, etc. The title should serve the patient, not our political or personal turf. Patients need one name (much like doctor) to know the person they are dealing with is competent to diagnose and prescribe, and if they are even interested, then they can pursue the many and varied initials representing philosophical and practice backgrounds. I am disappointed in the lack of ingenuity in the reform-legislators seem a bit lazy to ensure that. |
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| Dave Mittman, PA (Livingston, NJ) |
on 30 Mar 2010 at 12:54 pm |
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Darlene:
Less and less it will be about the money for physicians. For physicians in primary care, those days are gone. For NPs and PAs those days are still coming.
For insurance companies, there will be money but they will have to show more than ever before.
Have a bit of faith and be willing to keep speaking out.
Dave |
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| Darlene Fludd (South Carolina) |
on 30 Mar 2010 at 9:17 am |
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| As healthcare reform evolves it will become as every other thing has, all about profit. I too stressed to everyone I meet the importance of healthcare reform. But my friend it will not be too long that it will be about money and profit. You can not make money off of patients if they are healthy. |
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