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Happy Thanksgiving!!

HAPPY THANKSGIVING!!

From the NCCPA

In the spirit of Thanksgiving and in honor and support of our veterans and active duty servicemen and women, for every PA and PA student who likes us on Facebook this month (up to the 10,000th), we'll split a $1 donation between the Wounded Warriors Project and the Fisher House Foundation.

Both charities support returning servicemen and women during difficult times in their lives. The Fisher House Foundation provides a "home away from home" for military families to be close to a loved one during hospitalization for an illness, disease or injury. The Wounded Warrior Project serves military service members who incurred service-connected wounds, injuries, or illnesses and their families as they adjust to their new life.

Thanks for helping us build this new online community on Facebook and for showing your support for these great organizations and those they serve.

LIKE THE NCCPA ON FACEBOOK!!!!

HURRICANE SANDY

HELP THOSE AFFECTED BY HURRICANE SANDY

DONATE TO RED CROSS

If you can't donate but would like to volunteer your time, please search google as there are various opportunities to help - especially in NY & NJ

picture found at www.nydailynews.com

HAVE ANYTHING TO SHARE?

Do you have any good websites or resources others can benefit from? 

Please share them. 

Email me at KPABLOG@gmail.com 

I'm a PA

Post-Graduate PA Residency

Thinking about a PA residency? 

Here is a link with the current residency offerings throughout the US: PA RESIDENCY

SUGGESTED ITEMS TO KEEP IN YOUR POCKETS

Are you about to start clinical rotations?!? Here are some suggested items to keep in your white coat. Having these will help get you through rotations successfully!

- 2-3 inexpensive black pens

- Pen light

- Stethoscope (which can also be used to test reflexes)

- Alcohol swabs to keep stethoscope clean

- Small 3x5 inch notebook to take notes and jot down information for patient logging

- Granola bar or small hard candies (especially for surgical rotation)

- Quickcards --> www.medquickcards.com (especially helpful during first rotations)

- Maxwells Quick Medical Reference (especially helpful during first rotations)

- Pharmacopoeia ISBN 9780763774394

- Pocket Medicine Book (especially during internal/primary/emergency medicine)

- For Ortho - goniometer and small tape measure

- For ER - trauma shears

National PA Week

A celebration of the PA profession

Yearly from October 6-12th

Increase awareness of the the profession!

Healthcare Reform and PAs

What Impact Will Healthcare Reform Have on Physician Assistant Jobs?  – 9/13/2012

September 13, 2012
By Joyce Routson, HEALTHeCAREERS.com 

Physician assistants can look forward to more jobs, pay with accountable care organizations. Under healthcare reform, team work, primary care emphasized. 

Experts who study healthcare workforce issues believe that midlevel practitioners are becoming more common because the medical system is looking for more efficient ways to use physicians, who can be in short supply. 

The new U.S. healthcare reform act is applying even more emphasis on the use of nurse practitioners and physician assistants. Two types of organizations the government is promoting under the act will impact the physician assistant marketplace and their compensation. 

One of the new team work models under the Patient Protection and Affordable Care Act is the patient-centered medical home. The second – known as accountable care organizations (ACOs) – is designed to trim spending for Medicare patients by tying reimbursements to quality standards and efficient care. 

An ACO is a group of providers and suppliers of services (for example, hospitals, nurses, physicians, and others involved in patient care) that work together to coordinate care for the Medicare beneficiaries they serve. To be eligible, the ACO must serve at least 5,000 Medicare patients and agree to participate in the program for three years. 

The goal of an ACO is to deliver seamless, high quality, patient-centered care for Medicare beneficiaries instead of the fragmented care that has so often been part of fee-for-service health care. The Affordable Care Act specifies the groups of providers and suppliers that can form an ACO. That list includes “ACO professionals,” who are defined as physicians, nurse practitioners (NPs), clinical nurse specialists (CNSs), and physician assistants. 

The Centers for Medicaid and Medicare Services (CMS) announced in July that more than 100 ACOs are up and running. 

“ACOs will require physicians and hospitals to be more deliberate about coordinating the total care of the patient in and out of the hospital with an emphasis on keeping them out of the hospital,” says Susan O’Hare, NP, a senior vice president with Integrated Healthcare Strategiescompensation consulting firm. “Primary care physicians and advanced practice clinicians (PAs, NPs, and midwives) will provide the absolute foundation of this model.” 

Employment

With the emphasis on primary care – not just in ACOs – more providers will be needed. Since there already is a shortage of primary care physicians – midlevel providers – who typically spend about six years in training compared to the more than 10 for MDs – will be in greater demand to fill that primary care gap. 

“We certainly think any time an organization decides to move an innovative model of care where there will be an increased need for efficiency this will benefit because PAs provide many of the same duties as physicians with lower salaries,” says Michael Powe, AAPA vice president of reimbursement and professional advocacy. 

The U.S. Bureau of Labor statistics predicts physician assistants will be the second-fastest growing health profession in the next decade (after home health aides). There are 84,000 certified PAs, according to the American Academy of Physician Assistants (AAPA). 

Today, slightly more physician assistants work in hospitals rather than with physician practices or in primary care, but that ratio could change. 

According to the AAPA, close to 30 percent work in family medicine and general internal medicine, with the remainder in surgery or surgical subspecialties, emergency medicine or other internal subspecialties. About 40 percent work in hospitals. 

There remains some reluctance among physicians to employ nurse practitioners or physician assistants. According to one survey, from healthcare staffing company Jackson Healthcare, only 36 percent of the physicians it asked used NPs and 25 percent used physician assistants. The AAPA reports that 29 percent of PAs nationwide work in group practices; only 11 percent work in solo practices. 

O’Hare believes this ratio will change over time, although nurse practitioners, who may have more varied and less technical training than PAs, “will be probably see greater utilization in the primary care setting. But that will shift over the next couple of years and you will see both of them grow.” 

Data released this year from the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics, found that 49% of office-based physicians worked with physician assistants, nurse practitioners and/or certified nurse midwives. 

However Powe said because many hospitals own physician practices or have ACOs in their network, there will be a more jobs offered by those employers as well. 

Compensation

The law of supply and demand would suggest that all midlevel provider salaries will rise in the coming years. Primary care PAs make about $75,000 a year, less than those in surgical subspecialties or emergency medicine, where the median is $90,000. Increases likely will be greater for those at the lower end of the scale than those at the higher, O’Hare says. 

“Midlevel providers are cost-effective in primary care settings, where they can relieve physicians of the necessity of providing routine care,” O’Hare wrote in an article in Becker’s Hospital Review in 2010. “Midlevel providers are also cost-effective in specialty practice settings, providing much of the medical care patients need while allowing physicians to focus more attention on the complex issues that make the best use of their knowledge and experience.” 

O’Hare also wrote that as PAs and nurse practitioners take on roles similar to physicians, they could expect incentive plans to become a standard component of reimbursement, in terms of awards for productivity, patient satisfaction, adherence to quality standards and achievement of other goals. 

Scope of practice

As to whether their duties will change under ACOs, Powe says that PAs likely will enjoy an expanded role. “I think that we’ll see added incentive for all healthcare systems utilize PAs to full extent of their education and expertise – it will be an all-hands-on-board mentality and they’ll be asked to do as much as possibly can,” he said. Organizations will utilize them to the full extent of their license to gain those cost-savings, he says. 

Both O’Hare and Powe said that PAs may likely also play an important role in transition care –caring for the patient after he or she leaves the hospital. ACOs have incentives to ensure patients follow instructions and improve at home and don’t end up back in the hospital for a visit that Medicare doesn’t pay for. 

“They are well-suited to be a care coordinator; there is great need to help transition care more efficiently,” says Powe. In the traditional model, PAs are used in a “billable by encounter” way where they get paid for certain treatments – not for advising patients to take their prescriptions. “I believe that they can play a key role in educating, phone triage and treatment, and even home visits that can hugely impact keeping a patient on a prescribed therapy and healthy enough to stay out of hospitals,” says O’Hare. 

“The use of NPs and PAs by primary care doctors can bridge that gap between the hospital and the next outpatient encounter.” 

obtained from: http://www.healthecareers.com/physician-assistant/article/what-impact-will-healthcare-reform-have-on-physician-assistant-jobs/171066?type=email&source=pa-091812 

Residency Programs Can Help Ease Doctor Shortage

Opinion: Residency programs can help ease doctor shortage

Originally published: August 24, 2012 12:26 PM
Updated: August 25, 2012 6:49 PM
By NORMAN H EDELMAN. AND EVONNE KAPLAN-LISS  

Photo credit: Janet Hamlin | "It is essential that the public come to understand that the rules of supply and demand apply to the health care workforce.," write Norman H. Edelman and Evonne Kaplan-Liss.

As medical educators and physicians practicing on Long Island, we hear frequent complaints from patients about how hard it is to see a doctor -- especially doctors practicing adult primary care.

It's a nationwide problem, and it's likely to get much worse in the near future. The availability of doctors will be affected by the result of the presidential election because, if it's not repealed, the Affordable Care Act will mean an estimated 15 million to 30 million additional Americans will get health insurance. Most experts predict a shortage of physicians in the United States ranging from 50,000 to 100,000 by the end of the decade, due to this rapidly increasing demand for health care, which will come with a slowly increasing supply of physicians.

We know why demand is increasing. In addition to the impending impact of Obamacare, the elderly population is growing rapidly and will require more medical services. At the same time, medical technology is advancing just as fast -- making many new desirable services available to all.

The origin of the short supply of physicians is more complex though. As a result of the great expansion of medical education in the 1960s and 1970s -- as well as the success of managed care in reducing the use of hospitals in California -- graduate medical education planners, beginning in the 1980s, feared that we would produce too many physicians. As a result, medical school expansion was brought to a virtual halt, and the output of students graduating with MD degrees stayed constant from 1980 to 2005. The error of this near-freeze of graduating physicians has been recognized, and since 2005 there has been a rapid expansion of medical schools in both size and number. On Long Island alone, Stony Brook University expanded its medical school class by 25 percent, and Hofstra University opened a new medical school just this year.

But increasing the output of medical students will do almost nothing to increase the number of practicing physicians. And understanding this is the key to understanding the problem of physician shortages.

Although many states will license a physician with only a few years of post-medical school training, as a practical matter virtually all doctors who wish to practice in the United States must complete an accredited U.S. residency program after medical school. So the only way to increase physician supply to any significant degree is to increase the output of fully trained medical residents.

The great majority of financial support for residency training in the United States is provided by the federal government through the Medicare program. And as a result of the worry about physician oversupply, this support was frozen in 1997. Despite strong urging by most medical education societies, there've been essentially no successful attempts in Congress to significantly increase the support of medical residency training. In fact, all current budget proposals call for reductions of support of resident training as one way to control the costs of the Medicare program.

Currently, there are about 20 percent more entry-level residency slots than graduates of U.S. medical schools each year -- the difference is made up by graduates of foreign schools. So the major effect of expanding the number of U.S. medical students will be that foreign students will be displaced in residency programs. It won't translate into more doctors.

Hospitals have increased resident training at their own expense, but these efforts have been modest and largely limited to the hospital-intensive specialties like orthopedics and radiology. A recent survey of New York State teaching hospitals conducted by Stony Brook Medicine, the medical school at Stony Brook University, found that only two of 20 hospitals without a family medicine residency program would establish one if provided additional Medicare support at current rates. Though they were interested in expanding internal medicine residencies, past research has shown that only about 30 percent of these residents go on to practice general internal medicine; instead, most sub-specialize in pursuit of greater income, prestige and better working conditions.

An increase in graduating medical students without an increase in residency slots will direct more U.S. medical school students to relatively fewer sought-after family medicine residencies. As the numbers equalize -- which is predicted by 2020 -- graduates will find they must take whatever entry-level residency spots they can get. So one approach to produce more doctors practicing adult primary care would be to provide current teaching hospitals more financial and other incentives to create residencies in family medicine over the more lucrative specialty residency programs. In the absence of new federal money, this may require a redistribution of current funds, ideally through Medicare -- clearly a contentious issue. Since virtually all teaching hospitals already have residencies in internal medicine, we might seek to establish these in current non-teaching hospitals. But it's unknown if they'd be willing or able to do this.

There is another approach. We might focus on producing more nurse practitioners and physician assistants. There's ample evidence that these clinicians can provide primary care equivalent to physicians in outpatient settings. New York should remove the demeaning restrictions to independent practice of nurse practitioners, such as the requirement that they subject themselves to superfluous "physician supervision." And, we should invest more in training them; there is ample demand for training programs, but inadequate access to them.

It is essential that the public come to understand that the rules of supply and demand apply to the health care workforce. We probably won't be able to increase the supply of primary care providers until the public realizes their importance and demands that insurance companies provide better access to them, just as patients now demand access to the technology-oriented specialists.

An adequate health care workforce -- one that is balanced with regard to physician specialists, primary care doctors and the increasingly, important non-physician clinicians -- is critical to the provision of high quality health care that we all expect and deserve.

Dr. Norman H Edelman, former medical school dean and vice president for health sciences at Stony Brook University, is professor of preventive and internal medicine at Stony Brook Medicine. Dr. Evonne Kaplan-Liss is director of advanced certificate in health communications and an assistant professor of preventive medicine at Stony Brook Medicine. The views expressed here are solely those of the authors.

http://www.newsday.com/opinion/oped/opinion-residency-programs-can-help-ease-doctor-shortage-1.3925137

NY MED

NYMED seems like an interesting series. Check it out. 

An Eight Part Series Inside New York's Top Hospitals: NYMED
10pm Tuesdays or full episodes available at: NYMED

"What do grandmothers, addicts and celebrities have in common? All of them seek care at Columbia and Weill Cornell Medical Centers the crown jewels of the prestigious New York-Presbyterian Hospital in New York City. For a full year ABC cameras had unprecedented access to document the mayhem and the miracles that occur daily in these world class facilities. Adding a Brooklyn dimension, Lutheran Medical Center also participated. The eight-part series, from the producers of HOPKINS and BOSTON MED, is a raw and intimate look at life inside these hospitals where doctors spend far more time with each other than with their families, developing complicated and intertwined personal relationships." - www.nymedshow.com

Best-Paying and Worst-Paying Master's Degrees

Best-Paying and Worst-Paying Master’s Degrees

• Print

By Charyn Pfeuffer, PayScale.com

If you’re looking for the most bang for your postgraduate educational buck, some master’s degrees yield bigger financial returns than others.  

More Resources from Monster:

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Katie Bardaro, lead analyst at online salary database PayScale.com, says that many of the top-paying master’s degrees are in technical fields such as engineering and computer science. “These are areas where it pays to get additional training and build upon the knowledge acquired in an undergraduate program,” Bardaro says.

Although Bardaro says any degree that allows you to increase your technical know-how is valuable when it comes to salary, she cautions that more education does not always result in higher income, especially when you factor in the cost of obtaining the degree. “Education is like any other investment, in that one needs to do some cost-benefit analysis before taking the plunge,” she says.

Below, we’ve ranked the 10 best-paying and five worst-paying master’s degrees and listed three top-paying, typical jobs for graduates and median, mid-career salary information. The master’s of business administration (MBA) is not included in this list.

To put the salaries in perspective, the median pay per master’s-degree category is:

• Engineering and technology degrees: $110,000
• Arts and sciences degrees: $83,300
• Pre-professional degrees: $84,100

10 Best-Paying Master’s Degrees
1. Master’s in Electrical Engineering 

• Median Pay: $121,000
• Possible Jobs: Senior systems engineer ($124,000), software developer ($112,000), senior electrical engineer ($108,000)

2. Master’s in Finance 

• Median Pay: $120,000
• Possible Jobs: Vice president of finance ($170,000), finance director ($154,000), senior financial analyst ($83,500)

3. Master’s in Chemical Engineering

• Median Pay: $117,000
• Possible Jobs: Process engineering manager ($148,000), senior chemical engineer ($124,000),chemical process engineer  ($102,000)

4. Master’s in Economics

• Median Pay: $114,000
• Possible Jobs: Marketing director ($150,000), economist ($107,000), senior financial analyst ($104,000)

5. Master’s in Physics 

• Median Pay: $113,000
• Possible Jobs: Senior software engineer ($112,000), physicist ($93,400), secondary school teacher ($70,000)

6. Master’s in Computer Science 

• Median Pay: $109,000
• Possible Jobs: Software architect ($124,000), IT project manager ($109,000), software developer ($96,100)

7. Master’s in Mechanical Engineering

• Median Pay: $105,000
• Possible Jobs: Senior mechanical engineer ($100,000), project engineer ($88,300), mechanical engineer ($86,800)

8. Master’s in Civil Engineering

• Median Pay: $97,100
• Possible Jobs: Construction project manager ($97,100), structural engineer ($86,600), civil engineer ($84,800)

9. Master’s in Physician Assistant Studies

• Median Pay: $96,200
• Possible Jobs: Physician assistant ($96,500)

10. Master’s in Management Information Systems 

• Median Pay: $95,000
• Possible Jobs: Senior software engineer ($105,000), IT manager ($92,600), systems analyst ($82,400)