Stephen Hanson...President of American Academy of Physician Assistants
So a nurse and a PA. No actual physicians?
(no links)
Abusing nurses puts patients at risk State legislation is needed to protect both as staffing issues are highlighted at hearing for 10 who resigned
Newsday (Long Island, NY) - Monday, October 29, 2007
Author: BARBARA CRANE . Barbara Crane , a registered nurse, is president of the New York State Nurses Association Delegate Assembly.
Patients and their right to safe nursing care will be at the heart of a hearing today in Suffolk County Court for 10 immigrant nurses under indictment for patient endangerment.
But the issue should not be whether the nurses, employed by SentosaCare, were wrong for leaving their place of employment, the Avalon Nursing Home.
They clearly are not. The real question is whether poor nurse staffing practices at Avalon were putting patients at risk - and why New York State doesn’t have a law in place yet to ensure safe staffing standards are met.
The 10 nurses have been at the center of a controversy that began when they resigned from their jobs in April 2006. What’s gotten lost in all the attention is the fact that these registered nurses cared about their patients.
According to their personal accounts, the nursing home was understaffed. Nurses were literally dragged from their beds to work overtime. Equipment needed to care for patients was not available, and newly hired nurses were not properly oriented or trained to their responsibilities.
The nurses frequently complained to their employer to no avail. It was only after months of trying to provide nursing care under nearly impossible conditions that the nurses took the only avenue they believed open to them.
The nurses were not represented by a union, nor did they have the option to correct these problems through collective bargaining. All they had was a contract to work for SentosaCare, which they had signed with a recruiting agency before they left their homes in the Philippines.
The New York State Nurses Association was contacted by the nurses after they left SentosaCare. The Nurses Association was not trying to organize the nurses at this or any other Sentosa facility. But as the voice for nursing in New York State, with more than 35,000 members statewide, we are willing to speak up on behalf of RNs who are abused by their employers to the point that patient care is threatened.
These 10 were among 26 nurses who resigned from Sentosa-Care facilities 18 months ago. The employer filed a complaint with the State Board for Nursing, accusing them of unprofessional conduct and patient abandonment. The board investigated the charges and dismissed them.
Usually, that would be the end of the matter. But in this case, SentosaCare had the financial and political clout to take the unprecedented step of pursuing the case in court - despite the fact that no patient harm had occurred.
This brings us to today. As an organization of registered professional nurses, the Nurses Association empathizes with the families who believe their loved ones were put in danger. We ask them, however, to consider the real source of that danger - an unscrupulous employer who apparently believed he could abuse his nursing staff with little concern for the quality of patient care or basic human rights.
Instead of condemning these nurses, we encourage patients and their families to support our efforts to obtain state legislation that would help improve patient care conditions:
The Safe Staffing for Quality Care Act, sponsored by Sen. Kemp Hannon (R-Garden City) and Assemb. Richard Gottfried (D-Manhattan), would establish minimum nurse-to-patient ratios in health-care facilities. Research has proven that the fewer the patients assigned to an RN , the better the health outcomes for those patients.
Meanwhile, the bill to curtail the practice of mandatory overtime sponsored by Sen. Thomas Morahan (R-New City) and Assemb. Aileen Gunther (D-Forestburgh) would limit consecutive hours of work by nurses. Reliance on overtime increases the risk for injuries and accidents due to fatigue and stress, which ultimately diminish the quality of care and endangers patients.
It is notoriously difficult to get legislation through in Albany. These bills are too important to allow them to be stalled. The State Assembly has passed the bill on mandatory overtime. The State Senate, however, did not bring it to a vote as the legislative session ended in June. We urge our elected representatives to pass these pieces of legislation and hope their constituents will encourage them, too.
The better working conditions they’ll promote will be safer for both nurses and patients.
//
‘Make more of them’ isn’t the only solution - to America’s worsening physician shortage
Bakersfield Californian, The (CA) - Tuesday, November 24, 2009
In spite of the tremendous amount of time and money it will require to produce enough physicians to offer access to care for all Americans , federal and California state officials continue debating how to “make more of them” (”Salute efforts to educate new doctors,” Nov. 14).
In reality, the aging population, the limited access in rural and underserved communities and the promise of universal health care warrant the inclusion of all levels of providers in the medical workforce. Fortunately, a team-based approach, including all providers, such as physician assistants (PAs) and nurse practitioners (NPs), can help to bridge the gap while we await the genesis of more doctors.
PAs are amassing in the medical work force faster than physicians and are already playing a role in offsetting the physician shortage. This is in part because PAs are produced in about one-third the time of physicians . The PA profession has doubled in the past decade and tripled in the last 15 years. Currently in the U.S., there is approximately one PA in practice for every 10 physicians . In 2008, the American Academy of Physician Assistants reports that there were 73,893 PAs in clinical practice and more than 257 million visits to PAs.
The potential for continued growth in the profession remains high, with 88 percent of programs reporting an increase in applicants in 2008. The quality of PA students is also increasing as programs become more competitive. For instance, the New York Institute of Technology’s PA program has 1,500 applicants for 52 seats. That’s roughly a 3 percent acceptance rate — the equivalent of Harvard Medical School’s 2008 acceptance rate.
So are we turning out PAs in vain? Absolutely not; for now there is no such thing as too many PAs. The profession’s affordable salaries (averaging about $89,000 per year across all specialties) make it an attractive choice for increasing the volume of providers within the medical system at a fraction of the cost. Many planners are especially concerned about the future supply of primary care providers. PAs may offer the most savings when placed in specialties. In family practice, PAs make a little more than half of the physician ‘s $150,000 salary, while in orthopedics, PAs may make about $90,000 compared to physicians who make from $350,000 to $500,000. We also know that many PAs deliver or supplement primary and preventative care through their work in specialties. For example, PAs in oncology see survivors for years after their cancer has been treated and the diligent monitoring of the patients’ health often uncovers other issues.
We’re continuing to learn more about how PAs actually deliver care. Recently, Perri Morgan, Ph.D, PA-C, director of Physician Assistant Research at the Duke University Medical Center, examined the cost-efficiency of PAs using national data to study office visit resource use when PAs are in the provider mix. She and her colleagues asked whether PAs increase the availability of the services offered by physicians or whether they instead provide additional care that actually increases the number of visits that a patient uses. They concluded that, on average, PAs are replacing care that would be provided by physicians rather than offering additional or redundant services to patients. The research showed that when PAs provided 30 percent or more of a patient’s office visits in a year, there was no increase in the total number of office visits per year.
In my experience, patients not only accept, but also rely on the care they get from providers such as PAs and NPs. Numerous studies conducted in the last decade have found little or no difference in the patients’ perception of quality of care delivered by PAs, NPs or physicians . So, while PAs may not be the entire answer to a growing shortage of physicians , they clearly are a part of the solution. I believe a large part.
Stephen Hanson of Bakersfield is the president of the American Academy of PAs (AAPA), representing nearly 75,000 practicing PAs. He work as a physician assistant at the Grossman Burn Center at San Joaquin Community Hospital.
In spite of the tremendous amount of time and money it will require to produce enough physicians to offer access to care for all Americans , federal and California state officials continue debating how to “make more of them” (”Salute efforts to educate new doctors,” Nov. 14).
In reality, the aging population, the limited access in rural and underserved communities and the promise of universal health care warrant the inclusion of all levels of providers in the medical workforce. Fortunately, a team-based approach, including all providers, such as physician assistants (PAs) and nurse practitioners (NPs), can help to bridge the gap while we await the genesis of more doctors.
PAs are amassing in the medical work force faster than physicians and are already playing a role in offsetting the physician shortage. This is in part because PAs are produced in about one-third the time of physicians . The PA profession has doubled in the past decade and tripled in the last 15 years. Currently in the U.S., there is approximately one PA in practice for every 10 physicians . In 2008, the American Academy of Physician Assistants reports that there were 73,893 PAs in clinical practice and more than 257 million visits to PAs.
The potential for continued growth in the profession remains high, with 88 percent of programs reporting an increase in applicants in 2008. The quality of PA students is also increasing as programs become more competitive. For instance, the New York Institute of Technology’s PA program has 1,500 applicants for 52 seats. That’s roughly a 3 percent acceptance rate — the equivalent of Harvard Medical School’s 2008 acceptance rate.
So are we turning out PAs in vain? Absolutely not; for now there is no such thing as too many PAs. The profession’s affordable salaries (averaging about $89,000 per year across all specialties) make it an attractive choice for increasing the volume of providers within the medical system at a fraction of the cost. Many planners are especially concerned about the future supply of primary care providers. PAs may offer the most savings when placed in specialties. In family practice, PAs make a little more than half of the physician ‘s $150,000 salary, while in orthopedics, PAs may make about $90,000 compared to physicians who make from $350,000 to $500,000. We also know that many PAs deliver or supplement primary and preventative care through their work in specialties. For example, PAs in oncology see survivors for years after their cancer has been treated and the diligent monitoring of the patients’ health often uncovers other issues.
We’re continuing to learn more about how PAs actually deliver care. Recently, Perri Morgan, Ph.D, PA-C, director of Physician Assistant Research at the Duke University Medical Center, examined the cost-efficiency of PAs using national data to study office visit resource use when PAs are in the provider mix. She and her colleagues asked whether PAs increase the availability of the services offered by physicians or whether they instead provide additional care that actually increases the number of visits that a patient uses. They concluded that, on average, PAs are replacing care that would be provided by physicians rather than offering additional or redundant services to patients. The research showed that when PAs provided 30 percent or more of a patient’s office visits in a year, there was no increase in the total number of office visits per year.
In my experience, patients not only accept, but also rely on the care they get from providers such as PAs and NPs. Numerous studies conducted in the last decade have found little or no difference in the patients’ perception of quality of care delivered by PAs, NPs or physicians . So, while PAs may not be the entire answer to a growing shortage of physicians , they clearly are a part of the solution. I believe a large part.
Stephen Hanson of Bakersfield is the president of the American Academy of PAs (AAPA), representing nearly 75,000 practicing PAs. He work as a physician assistant at the Grossman Burn Center at San Joaquin Community Hospital.
Barbara Crane link in my post #47 didn’t work.
Hopefully, this is a better link to much source info:
http://www.zoominfo.com/Search/ReferencesView.aspx?PersonID=133650613