Myth Busting Common Misconceptions Regarding PAs

Posted By: Ron Stavale Advocacy, Membership,

An anonymous survey of first year PA students was completed at a recent MAPA Professional Issues talk at Lawrence Technical University. Here are the questions, responses and comments.

PAs and NPs are Independent Providers? Myth

The idea that Michigan NPs are independent providers is a common misconception. Neither PAs nor NPs practice medicine independently. Since March 2017 PAs have been independent prescribers. The same year NPs became independent prescribers on non-controlled substances, but are still delegated and supervised by physicians in their ability to write or prescribe controlled medications.

Michigan Public Act 379 of 2016 eliminated the term ‘supervision and delegation’ for Michigan PAs to practice medicine. PAs work within any limitations outlined by their practice agreement with a participating physician or physicians licensed in Michigan. Michigan NPs, when practicing outside of their education and training as an RN, are required to practice under the supervision and delegation of a Michigan physician. Nurse Practitioners currently have a bill in the Michigan Senate (SB 279) that, if passed, would allow for them to practice independently.

International Medical Students who do not match for a residency should be licensed to practice medicine in Michigan?

80% of respondents felt that International Medical students who do not match should not be licensed to practice medicine in Michigan. While Michigan Physicians are allowed to supervise and delegate their practice of medicine to licensed or unlicensed individuals. These individuals are still required to have education and training. The supervising physician is then liable for the individuals actions. . There is a bill recently introduced in the Michigan Legislature that would allow for unmatched medical school graduates, even foreign medical school graduates, to practice medicine with a limited license – House Bill 5613.

MAPA is made up of a Board of Directors consisting of 13 PAs who receive a stipend for their work on behalf of Michigan PAs? Myth

80% of students felt that MAPA’s BOD are paid a stipend in order to support Michigan PAs. MAPA’s BOD, Committee Chairs and numerous Committee Members volunteer their time advocating on behalf of all Michigan PAs. It is clearly a labor of love. At a minimum Michigan PAs should support those efforts by being a member of MAPA.

In 1995, the Michigan Senate voted unanimously to allow all Registered Nurses in Michigan to prescribe medications? Fact

76% of respondents did not believe this to be true. In 1995 Michigan PAs were not allowed to accept and sign for pharmaceutical samples from pharmaceutical representatives because official forms stated ‘Physician Signature’. MAPA was able to submit a bill allowing for PAs to have that ability but since there was no MAPA representation in Lansing the Michigan Nurse Association amended MAPA’s bill thus allowing all RN’s to prescribe medication and it was passed unanimously by the Senate! Fortunately when MAPA became aware of this we were able to withdraw the bill before it went to the House of Representatives and re-introduce the bill, which then passed, under the guidance of our then newly hired Executive Director and lobbyist, Mike DeGrow.

If MAPA failed due to lack of membership then AAPA would come to Michigan and take over the role of MAPA, supporting over 8,000 Michigan PAs. Myth

82% of respondents thought that AAPA would come to Michigan and take over the role that MAPA has held for almost 50 years now. AAPA advocates for PAs nationally, especially Federal government including U.S. Congress and CMS. Almost all of your ability to practice medicine is actually decided by the State of Michigan not the U.S. Government. Even CMS typically points to state laws to determine provider eligibility. If MAPA failed due to lack of membership then what AAPA would do is come into Michigan and help organize Michigan PAs to create an organizational structure made up of concerned PAs and they would then have to come up with membership dues, hire appropriate professional staff and come up with a name…………hmmmm….I think we would then call it the Michigan Academy of Physician Associates (MAPA)!

Most health care organizations & employers grant time off from clinical practice for PAs to continue working for their professional organization? Myth

76% of respondents felt that institutions and practices grant PAs time away from their clinical practice to work with their professional organizations. While we are now seeing more PAs in leadership roles in institutions generally speaking, most practices focus on patient care and billing and any time taken away from their practice, other than the granted CME time, is solely the personal time of the PA. MAPA’s BOD, Committee Chairs & Members all give up their personal time when attending to efforts to better the PA profession in Michigan.