DANGEROUS TIMES
By Ron Pace, PA-C
FAPA President Elect

If you do not think or believe that these are dangerous times for our profession, just ask one of the 23 PAs working in Emergency Medicine in South Florida who one day had a job, and the next day found themselves replaced by a Nurse Practitioner. Fact, not fiction. It seems, as I understand the situation, that because of inequities in the way PAs are allowed to bill versus the way NPs can bill that it may be more advantageous in some situations to employ a NP versus an equally qualifed PA. The physician group that employed all these PAs decided to go with Nurse Practitioners vice PAs. So the inequities in the billing system plus the fact that NP salaries are generally considerably less than ours led to this decision it appears. It all boils down to the bottom line folks in business decisions like this one. So I am telling you, wake up out there! These are still dangerous times for our profession and will continue to be for the future. Want more proof? There is a group of dermatologists who are seeking to get legislation enacted that will limit us in our ability to perform certain office dermatological procedures, and require more supervision on a regular basis. Need more proof still? There are still those that would like to give FMGs a PA license without testing and following the state law. Are you scared or even concerned yet? I sure as hell am. Or are you feeling so secure in your job that you do not feel the need to be concerned? Talk to one of those 23 guys down South who one day had a job and the next day did not and then see how secure you feel.

Are we in a crisis now? No, not yet but it could be around the corner. FAPA and the AAPA are the only two groups fighting to protect our profession from those who would like nothing more than to see us go away. There was a bill introduced in the last session to establish an Anesthesia Assistant practice act. It was defeated. Why? Because the nursing lobby spent thousands of dollars in advertising and lobbying efforts to defeat it and they won the battle. And we are still fighting the FMG issue and will be for years to come most likely. That is why we have to be constantly vigilant in Tallahassee to make sure that nothing is done behind our backs to hurt our profession.

I warned of this type problem a little over a year ago in an article I wrote entitled, "Pathetic Apathy". You can read it online under the Current News Archives section. There are four words I hate to say now, but "I told you so." As a FAPA leader I spend hours on the phone, online, at meetings, traveling and doing everything I can, as do the other FAPA leaders, to protect our profession, and promote our profession to the public and the medical community. Your Board of Directors has a Task Force on Public Relations that is looking at our options and making plans to act when we need to do so. It is not going to be cheap but in the end, if it saves PA jobs in Florida; any cost is worth it in the long run. And we must learn to think long term and not short term.

At the recently concluded Board meeting, April 27th, in Jacksonville, I noted with great dismay our current membership numbers. In 2000 we had 1349 members, in 2001 we had 1561 members, and now in 2002 we have only 1421 members. We have 234 new members this year so far, but we have 360 non-renewals! Excuse me for being so blunt, but just what in the hell is happening to our profession in Florida? There are over 2000 practicing PAs in this state. Why aren't ALL of them members of FAPA? And the AAPA for that fact?

I am going to remind you of a few things I told you in the "Pathetic Apathy" article. It is our, yours and mine, responsibility to guard our rights and well-earned privileges. No one else. Ours alone. And that does not come cheap. The nursing profession outnumbers us by thousands and they spend thousands on lobbying and it shows. The physicians outnumber us also and have thousands more to spend than we do. We cannot match the doctors or nurses in numbers or money but we can do a lot better than we have to date. As a profession we have done well financially up to now but there are no guarantees that this will continue. Where would you and your family be financially if you were not a PA?

To get our message across to the public, the physician medical community and the legislature we need, no, we must have as many members as possible in FAPA. Every practicing PA should be with us on this. We are working to protect your profession, not just the FAPA members. To be frankly blunt, it really hypoexomicturates me to think that there are about a thousand PAs out there in Florida reaping the benefits of the hard work that FAPA leaders, current and past, are putting in on all these issues on a state and national level and not contributing a damned thing back to the profession. I do not care what your past experiences with FAPA have been that may have led you to not renew your membership or not join now. Every PA in Florida owes the FAPA organization a debt of gratitude for the hard work over the past 25 years plus that has us where we are now. The PA practice act, the prescriptive privileges, and all the other myriad of legislative successes would never have occurred without the FAPA organization, and if you believe otherwise you need to be on some serious medication. The reasons I hear by phone and email for not being a member are petty, mostly self-serving and not worth repeating or even considering. FAPA is not perfect and never will be but we are doing the best we can for you, our members and our profession. We are never going to please everyone on every issue and I am not going to try to do the impossible. So some FAPA leader along the way said or did something that you did not like. So what? Life is not fair, get over it. You need to look at the long-term big picture. Your memberships gets you a lot of bang for your buck.

So now the question I want to repeat to all of you is - what have YOU done for your profession? Are you a member of FAPA and the AAPA? If not, why not? Have you volunteered for any committee work? Have you worked on any local election campaigns of candidates who support PA issues? Have you done any volunteer work that promotes the PA profession and image? Have you donated to the Political Action Committee? To the FAPA Foundation? Do you attend FAPA state CME conferences at least once a year?

This is what we need from practicing PAs in Florida.