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| For PAs and NPs: Not In My Backyard (NIMBY) |
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by David Mittman, PA - February 28, 2011
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 Provided by Clinician 1
NIMBY, we have heard it before. Usually it was about a group of people that others did not want to live next to, or want to share the locker room with, or have sitting next to us at the school board meeting. Rarely justified, mostly not justified at all. Sometimes we ourselves even felt the same way and then things changed. What people usually realized later is that the change was needed and it made the town/school/team an even better place. So now we NPs and PAs find ourselves in “NIMBY land” and let me tell you it does not feel nice. Who does not want to share the neighborhood, the locker room or should we say (God forbid) the “Doctor’s Lounge?” You guessed it, organized medicine.
Of late, the national medical organizations have been actively looking for a way to have PAs and NPs become a revenue stream. In some cases their membership is declining and they see us as being able to fill the holes in their budgets, in other cases we attend their CMEs or conferences and they know we want to learn from them. So, they ask us to join their organizations as affiliate members. Clearly not full members. We will take your money, but please don’t consider yourselves “real” members.
Of late the PAs and NPs involved in the American Headache Society asked that organization to consider them for full membership. Rumor has it they were turned down with the excuse that if we do it for you we have to do it for everyone. That could mean chiropractors, naturopaths and all others who could treat headaches get in and my uneducated guess is they don’t want those people in. So, if they let in clinicians who prescribe and diagnose and treat in very much the same way they do (like NPs and PAs), I guess that opens up the Pandora’s Box to anyone who wants to come in? Maybe hypnotists? Give me a break. Not too long ago the osteopaths were treated the same way. How quickly we forget.
Over the last few years, many of the larger medical organizations have looked to position themselves to NPs and PAs. To their credit some smaller medical organizations, some state specialty societies and some local medical societies have given us full membership. They get it. But when it comes to the premier organizations, none will see us as full colleagues. The American College of Physicians will not, the AAFP will not, ACOG will not, the American College of Surgeons will not and even the American Academy of Pediatrics will not. NIMBY, they all say to us. Sure you can come to our meetings and take up some of those valuable hotel rooms but please........don’t ask to move across the street. Yes, we understand that some of you are really doing advanced work, that some of you really love the specialty we share with you, that some of you will make it your life’s work and would make wonderful members, but what will the rest of the family think?
I must say, I get it. But if this is the case, please do not also say your group represents “family practice” or “primary care”, represents “gynecology” or represents “women’s health”, represents “adult medicine”. Please tell the truth. The truth is your groups represents the interest of ONLY physicians who practice in that specialty and is actively out to exclude representation of the other clinicians who also practice in your specialty. You do not represent all people who give healthcare to children, just pediatric physicians. Cool.
To say your group does more than that would be quite misleading, especially because there are thousands, even tens of thousands of us NPs and PAs who also practice alongside you every day, but who many have concluded do not deserve a voice where it counts; in voting and on committees. If you believe we are all going to be a part of the future of healthcare, this is sad and unfair.
We get it.
Not in your backyard...
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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| TP (Texas) |
on 01 Mar 2011 at 4:46 pm |
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| Once the day comes when we all practice under the same rules and regs set in our laws, we may be considered equal by those who hold higher degrees, make these laws and develop the rules and regs. They have trained and practiced for many more years than the "MLP's", chiropractors, homeopaths, and colonic therapists, etc... Yes we all should have our say, however, there are "those rights and privileges" afforded to each academic degree obtained. If one wishes to be treated as an equal, then one should do the time, obtain further education and training so as to understand why these associations restrict membership. Do NP's practice under the SBME or the state Nursing Board? If MLP's are equal, why aren't we NP/PA's?? Till then, we should consider acting more like a partner in heathcare rather than an entitled subordinate. Ones passion must be guided by intellect and understanding of why things are the way they are. Hostility because doors are locked will usually yeild a greater number of locks on those doors ! |
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| dblack (Hershey PA) |
on 01 Mar 2011 at 2:05 pm |
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| I understand Dave's points and I applaud his initiative and stauch support of our profession. I would disagree however, that we somehow "deserve" to be admitted as full members of our parent organizations. I would point out that the organizations he referrences in his article are the American College of PHYSICIANS and the American Academy of Family PHYSICIANS. I would also point out that the AAPA does not admit physicians as full members, nor should it. I do agree that paraprofessional organizations, such as the American Headache Society, do not have as clear an arguement. Why not admit chiropractors, homeopaths, and colonic therapists? Perhaps we can all learn from each other and provide better care. |
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