Ontario Nurses Organization: The AMA Would Be Proud
 

Most PA and NPs pay lip service to being “different”, even regarding playing the game of medical politics which I believe most of us would rather not play. Also most NPs and PAs in professional leadership positions believe we would act differently than organized medicine does towards other professions if we were in their position. We believe we would not protect our turf solely for economic reasons, that we would look at the situation and act accordingly. Most of us constantly wonder how physicians could believe that “we don’t know what we are doing”. Or how they constantly say to the press that “NPs and PAs don’t know what they will miss” or we are a “danger” or even the tried and true; “When your rash is really cancer, will they be able to tell?” It upsets me every time I hear organized medicine say such things. I don’t expect them to like us, but as people of science, I very much expect them to look at the evidence and even more. Look at the track record and the studies. Look at the number of hospitals we all work in. Look at the military, Kaiser, the Public Health Service and the over 200,000 of us in practice. We have a track record to look at.

Is it possible or even plausable that if we had the power, we might just act in the very same way as the medical society? I think we might.
I am particularly bothered by the recent press release of the RN Association of Ontario. They are the equivalent of the Ontario Nurses Association. To make a long story short, Ontario has been using US trained PAs in pilot projects for years. The PAs did so well and impressed the other professionals they worked with that Ontario decided to start a PA training program (Master degree level, modeled after the best U.S. PA programs) and decided find a place for them in their healthcare system. Ontario and Canada in general have also started to really also look at NPs as providers of care, which also is fantastic. Why not try PAs also? Seems after what we have seen in the States, and what Canada has seen in it’s military PAs for 30 years, it should be a consideration.

A number of months ago, the RN Association of Ontario came out against PAs. That in itself is O.K. I would hope that they would not, but I was not surprised. For some reason, they just did again in a press release this week http://www.rnao.org/Page.asp?PageID=122&ContentID=3152&SiteNodeID=509&BL_ExpandID&AA_PrintFriendlyMode=True and for the life of me I can’t understand why they made so significant an attack. If it’s turf protection, I get it. As most PAs are women, I presume it’s not gender based. If it’s economic, I get that also. There are multiple reasons for them not to want PAs. Heck, I don’t know if I would want a competitor. So what did they do? They went and picked the same reason the medical society has used on NPs and PAs for years. That it’s because PAs are poorly trained and are a danger the public. Wow.

How do they know that? There are few PAs in Ontario and the pilot project was in all respect a success. The PAs even had many more barriers than we have in the States and did really well. They also know PAs in the U.S. are a resounding success and remember Ontario borders NY and other states where PAs have also been around for almost 40 years providing care. Ontario PAs do not yet have a law, so it’s not the particulars in the legislation that bother them. And that’s just what irks me, there is no reason to say what they said. The RNAO starts out it’s position and press release by saying this...“"Members of the public will not be well served if the provincial government pursues a plan to allow physician assistants (PAs) to work in hospitals, family health teams, community health centres, and family physician offices”. Organized medicine could not have said it better.

The Association goes on to say also say PAs are poorly trained and that they will JEOPARDIZE patients.  “The board of directors of the Registered Nurses’ Association of Ontario (RNAO) has unanimously endorsed a position statement, which raises serious questions about the level of education and regulatory oversight physician assistants have and how these could jeopardize patients.”

The argument that public health will suffer if (fill in the blank) gets to do (fill in the blank) is always the lowest common denominator response. When you don’t have a rational point to make, just shout “quality of care”.  That’s why I question whether we really would be different? I am glad we have not been really put to that test here in the U.S. Relations between NPs and PAs have become so much better. People still try to divide us but I think most of us would agree that both professions are good, here to stay, have much in common, and should try to work together. But I still wonder, if we were put in the position of a new profession wanting to do some of what we did, would we look at the facts, look at the evidence, use critical thinking and read the studies? Or would we do the same and go right to “protection of the public” and the “they are inappropriately schooled to be anything but a danger” as the reason?

Sure beats admitting the truth.

 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”.

RECOMMEND THIS ARTICLE

You must be logged in
to recommend articles

Average (Not Rated)

» Recommended Articles