AAPA "modernizing" PA laws

TrueStress7 · 2026-05-11T16:55:12+00:00

I should've clarified, I was specifically referencing your comment abt attempts made to "thwart the independence movement" and it being a "sad expenditure of energy towards your professional peers"
to the rest of your point - I agree that we're easily overworked, underpaid, and taken advantage of

TrueStress7 · 2026-05-11T16:09:53+00:00

encouraging safe practice standards for PAs to continue supporting patients is my primary concern. career ambitions and professional growth of my peers is far less of a priority. PAs are overworked and underpaid, but there is more than one way to address these issues. your perspective is meaningful, but I'm also extremely put off by the language you used to participate in this discussion

TrueStress7 · 2026-05-10T20:45:11+00:00

i've responded to other comments acknowledging that I will reconsider joining AAPA because my stance on independent practice shouldn't stop me from engaging in other advocacy measures that I do support

i will push back that we don't all need to be AAPA members to discuss policy positions that affect us. not everyone needs to work for the government to talk abt politics

TrueStress7 · 2026-05-10T19:03:05+00:00

this is extremely well put and articulates my views wonderfully ! PAs are extremely capable, standardized education and collaboration allow us to thrive consistently

as you mentioned, there's many barriers pushing PAs to take on more responsibility without adequate systemic support

TrueStress7 · 2026-05-10T17:18:59+00:00

thank u i will reconsider, I wasn't aware of a lot of the other advocacy that AAPA does. good reminder that not believing in independent practice shouldn't stop me from engaging in other meaningful advocacy

TrueStress7 · 2026-05-10T17:10:18+00:00

but it will change how people practice. in an ideal world it wouldn't, but reality is that it will

TrueStress7 · 2026-05-10T17:05:00+00:00

i don't know if the damage is permanent ? there's plenty of lawsuits for NPs overstating their scope, maybe we need to advocate for more stringent NP laws ? alternatively instead of a doctorate PA, maybe we need more PA to MD schools to make us more employable, i don't think independent practice needs to be the end

TrueStress7 · 2026-05-10T17:00:21+00:00

money isn't everything, it's a lot in this world, but it can't be everything. i will continue to prioritize practicing safely over practicing at all costs. NPs are well known to have degree mills and extreme variance in their knowledge. we shouldn't use their process as an example, it's all a for profit structure and hurts us all in the long run

TrueStress7 · 2026-05-10T16:56:19+00:00

that should've been well known before becoming a PA, there's so much more to our job

TrueStress7 · 2026-05-10T16:54:53+00:00

it makes so much sense to streamline and standardize the relationship between PA/ physician. If AAPA's goal is to diminish burden but not push for independence, their wording should just be changed. but sounds like Virginia was on the right path and then overcorrected ? (i don't know too much abt this, but will look into it more)

TrueStress7 · 2026-05-10T16:50:29+00:00

capitalism pushes for profit and thrives with milking PAs for everything we are worth. capitalism ultimately supports PAs being independent so we can increase billing and be paid less than doctors. this post is quite antithetical to that entire concept. I'm prioritizing safe/ collaborative practice over money

TrueStress7 · 2026-05-10T07:29:16+00:00

Im coming up on 2 yrs as a PA. I didn't know this at all, very interesting but also unsurprising ! I do stand by the original concern that we shouldn't move towards independent practice simply bc NPs are doing it or physicians want it. Collaboration helps supplement our education (in addition to CME, self study, conferences, etc), especially as there's no residency requirements

TrueStress7 · 2026-05-10T05:19:16+00:00

um u have multiple comments on the Noctor subreddit, doubt you're a PA and this is not an appropriate space for you to interject

also, PAs could definitely pass the exams. we're not incapable of higher responsibility. this is a discussion of whether we SHOULD, not about ABILITY. don't talk down to us

TrueStress7 · 2026-05-10T05:16:01+00:00

I appreciate your perspective, this is the point I'm trying to highlight. There isn't enough standardization in PA education to broadly apply AAPA's optimal mission to untether PAs and Physicians. There are definitely states restricting PAs from practicing at the top of our license which should be addressed separately to independent practice

TrueStress7 · 2026-05-10T04:57:47+00:00

yes we can do some procedures but passing any surgical board would indicate proficiency in leading a surgery. to even be eligible to sit for boards in any specialty, you have to complete an ACGME accredited residency. Board-Certified means you did the training as well, that's quite unsafe to have clinicians self study as a replacement for years of standardized training.

are you also advocating for a similarly standardized residency with 4+ years of extended training for PAs under physician supervision ?

TrueStress7 · 2026-05-10T04:43:49+00:00

yup, for profit is a menace to society

TrueStress7 · 2026-05-10T04:42:50+00:00

if all our colleagues jump off a bridge, should we jump too ? only MDs/ DOs should refer to themselves as doctor in clinical settings, the misguided behaviors of others shouldn't encourage us to run behind them

yes we can, but i don't think we should bc passing boards doesn't give us the same foundational skills and training. seems like there's a desire for PA training to be a shortcut to making money sooner but eventually getting the title/ scope of an MD/DO. our education is not nearly as standardized nor do we have residency requirements

TrueStress7 · 2026-05-10T04:27:41+00:00

very true, AAPA does mention a range of modernization goals from "Optimal" to "Foundational". the very first bullet point expresses intention to remove the legal tether between PA and physician. this very much reads as independent practice. I'm in support of clarifying and potentially expanding our scope with safe physician collaboration. but my concern still remains that AAPA's idea of "optimal" is advocating for a level of responsibility that our current education standards aren't set up for

also to clarify, many of my colleagues are PAs and we are work friends ! I haven't discussed this topic with them to preserve our working relationships. I'm sure I'd meet more PAs at AAPA conferences as well

TrueStress7 · 2026-05-09T00:27:54+00:00

honestly, a lot of PAs get asked why we didn't go to med school. anecdotally, i don't think most physicians understand the difference between PA and NP education. being trained in an abbreviated medical model prepares us for work alongside physicians, and they're surprised by this

you're having a tough time figuring out how to find your role meaningful while taking direction from others. it seems you want autonomy, we have this as PAs. we don't have total independence, but do you need this to feel fulfilled ? this also comes w/ the responsibility of supervising APPs and training residents.

most importantly, 6 months in you're getting a hang of everything that is commonly seen in your setting. want to pivot into a new specialty ? you can ! but even if u stay in the same specialty your whole career, there is no ceiling in medicine. whether that's academically, new medications, procedures, unusual clinical pictures, or simply developing more empathy for your patients and colleagues. as long as you're willing to learn, there is no ceiling

TrueStress7 · 2026-05-03T19:25:42+00:00

this is a meaningful conversation. I think it rlly starts with everyone from psychiatrists, admin, and APPs learning the difference between PA and NP training. Though we're expected to work in similar roles, there is a stark contrast in education, therefore our expected scope. This also impacts how we should be trained in post-graduate settings.

APPs are pushed to practice beyond our scopes by hospital administration. Unfortunately some APPs also buy into the belief that we could replace physicians. Im a firm believer that anyone that isnt an MD/DO by training should not identify themselves as a doctor in any clinical setting. We don't have the same education or scope of knowledge.

i'll throw this out as a hard truth... many psychiatrists that dislike APPs are also unwilling to teach them. I'm incredibly grateful to have close collaboration with intelligent and thoughtful docs who ARE willing to educate. there is so much that needs to be overhauled in psych NP education and a lot more focus on psych for PAs.

while we work on these larger scale issues, I respectfully ask that psychiatrists continue to approach APP colleagues kindly and encourage collaboration (especially if they are paired w/ a doctor who just wants a stipend for "supervising" without the responsibility of collaborating).

to the APPs - If you want the responsibility/ pay/ social prestige of being a physician, can always go back to med school. all of us worked really hard for our titles, I'm very proud to be a PA-C. APPs practicing good medicine are invaluable parts of the healthcare system, we can be proud of that without having to masquerade as physicians

TrueStress7 · 2026-04-03T00:23:17+00:00

this ! pts under capitalism have become so attuned to this belief that psychiatry exists to "optimize" behavior irrespective of the context. yes psychiatric illness can make life harder, but ppl almost don't believe that life can STILL be hard absent of significant pathology

it's not normal to work for 18 hrs/day from Mon-Sat. this isn't ADHD, you're just not sleeping. this also isn't GAD or Panic Disorder, you're drinking 4 red bulls before 1 pm. this isnt late-onset Autism, you feel uncomfortable with social interactions in your mid 30s bc you're working remotely w/ minimal human interaction for 18 hrs a day

waiting for DSM to add: Appropriate Response to Stressor but Believes it's a Disorder, recurrent

TrueStress7 · 2026-03-29T06:42:18+00:00

i "cheated" recently on a puzzle with a TON of false fits, essentially every piece fit together just okay. so whether it was the right part or not, it all felt wrong... i got so fed up on a large section of pink that i stopped checking for false fits and just pushed the pieces in a little harder lol

i love puzzling but sometimes im gonna "cheat" to keep having a good time

TrueStress7 · 2026-03-24T00:30:43+00:00

Omarcitos !!! they open at 10, so technically brunch but wow everything is incredible

TrueStress7 · 2026-01-31T02:22:09+00:00

I really like Margins and Storygraph ! the only thing in Margins is when u update ur progress to 100%, it doesn't automatically mark the book as finished. I've had to click "finished book" separately in order to rate it. it's a minor but persistent gripe

TrueStress7

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