As all PAs and NPs know, there is never a dull week! Our readers were buzzing across social media and our homepage as the latest news in healthcare came out.

On Facebook, one reader gave practical advice to our blogger who recently lost a supervisor. After forming a strong relationship with her collaborating physician, our blogger Beverly missed the advice and guidance given in her first year as an NP. Reader Lisa reacted, "'Sugar coat it' and ‘not take it personally' goes a long way in the real world." Do you have any advice for our blogger? How do you deal with losing a mentor?

We also posted the article, "Why Nurses Need More Authority," encouraging NPs to work as primary care providers and close the gap in primary care. Our readers supported the article, with one reader adding, "And PAs!"

On Twitter, we shared an article from Des Moines University calling PAs "pretty awesome." We completely agree! We also shared the breakthrough joining of medicine and technology: a live-tweet brain surgery from Houston Hospital. Check out all the tweets from the surgery and let us know if you would participate in a surgery broadcast to the world. The risks are heavy, but we must admit: the result is astonishing!

"'Assistant' No More," a call for a change to the PA title, appeared on our site last week. Said one commenter, "I'm only a student but I've read a lot about the movement to change the PA title. The 'assistant' part is certainly a misnomer. Great article and nice explanation of confusion with non-clinicians!" 

Our NP and PA Salary by Academic Degree results got a lot of clinicians talking this week. One of our readers responded, "Cost benefit ratio has narrowed and employers, unfortunately, can obtain a MSN plus graduate with equal clinical for the same salary. How does one pay the loan off with a dicey job market and health care is in a major state of flux." Another frustrated reader expressed disdain with the hiring process. "Who has the time or the money to pursue a PhD in nursing when you're working full-time???? Who ???? When you have kids to put through college???? WHO???? Are you kidding???? Who can even afford to remain unemployed another 3-5 years in order to obtain the degree??? Are you people kidding me?? Is the profession of health care that much in love with themselves????" reader Rickae said. Do you think the current salary for each academic degree is fair? Let us know below!

Always a great source for professional advancement, our LinkedIn page provided some new job openings this week. Are you hunting for a job? Make sure to check back frequently for all the latest opportunities around the country and for advice on nailing your resume, landing an interview and wowing your potential new boss!

Comments are reposted here verbatim, without editing. We love to get feedback from our readers. If you're not chatting with us on Facebook, Twitter and LinkedIn, "like", "follow" and "connect" with us and start sharing in the conversations! If you are, keep following and spread the word!

If there's something you think we should be discussing, let us know! As always, thanks for following!

This week, readers of ADVANCE for NPs & PAs let us know their opinions on many posts, comments and articles.

On Facebook, our readers liked career development tips, the newest practices in skincare, NP certification information and the latest posts from our various bloggers. We also posted an article discussing the growing need for primary care physicians. It suggests that a fast-track medical program can offer schooling to more professionals at a lesser cost than a traditional medical program. One reader weighed in, "Great idea. Let's see how difficult the application & admission process will be. Theory sounds ideal." What do you think? Would you go back to school for the chance to be an MD in only 3 years?

Over on LinkedIn, reader Barbara asked, "Has anyone worked for an insurance company as a clinician, helping patients get the services they require?" Check out our community page now to give your feedback and see what other issues are generating discussion between fellow PAs and NPs!

On Twitter, we took a PA poll. "Poll: #Physicianassistants, are you a member of a nat'l or state PA org.? Click ‘home' to vote on RH side of page. http://bit.ly/KlB8hc" If you didn't vote yet, make sure to do so now! Reader @CharlesLehman also included us in his daily newspaper Public Education. "Public Education Today is out! http://bit.ly/eixwVS ▸ Top stories today via @mattryan2000 @wobblyneil @guswhyte @jeffbcdm @advancefornppa," he tweeted. If you have any great PA or NP news to share, make sure to follow us on Twitter and mention us to spread the news!

Heated discussion continued as PAs debated the 10-year recertification cycle change. Reader Paul commented, "I am pleased with a 10 year recert, and my next test will be in 2016. It will be my last as I will be retired by 2026.The interesting thing is that I will now be required to do more than my SP regarding PI-CME since my SP is not board certified. We will probably retire at about the same time, and I'm pretty sure my SP will not be engaged in my process of the new rules."

Adding to the discussion, James wrote, "When are the leaders of our profession going to start listening to the PA's in the ‘trenches'? A survey was done prior to the passage of this change and the OVERWHELMING majority of PA's were against this. The only change that needs to be done is to administer an initial exam following graduation of an accredited program. Subsequent CME's every two years after that is fine. Can ANYONE tell me how the current system makes any of us more competent to practice? Maybe the changes that need to take place are the people who are in leadership positions!!!"

In our Front & Center news section, we discussed some of the latest laws effecting NPs and PAs. Following news that NPs and PAs in Florida will now have access to Medicaid, reader Keischa wrote, "Thank you, Thank you, Thank you!!! One small step may lead to many!!"

In our blog community, blogger Elizabeth wowed readers by sharing her journey through personal and professional loss and triumph. One commenter noted, "Wow you have such strength, confidence and resilience it really is conveyed in your blog. While not understanding the actions of others, at least you are you are taking the time for yourself and you are starting a wonderful life in your new career. Stay strong focused and successful!" Do you agree with Elizabeth's take on work?

Comments are reposted here verbatim, without editing. We love to get feedback from our readers. If you're not chatting with us on Facebook, Twitter and LinkedIn, "like", "follow" and "connect" with us and start sharing in the conversations! If you are, keep following and spread the word! Is there something we should be discussing? Let us know!

Readers of ADVANCE for NPs & PAs are getting involved by making their voices heard on our site and via social media. This week, several readers commented on articles and on blog posts. On the article, "What NP Graduates Need to Know About Certification," questions are coming in about maintaining certification. Author Susan Hellier responded with, "It is my understanding that phased out certifications will continue to be honored as long as certification requirements are maintained."

Debate continues in the comments at the "National Salary Report 2011" article, which details the overall results of our 2011 national salary survey. One reader adds the following about the gender disparities between male and female NPs and PAs:

"Kelly, in many cases males devote more hours on the job than females, hence their receiving more pay. This is not always true, of course. But to assume sexism is too simplistic. Furthermore, females that choose to have children often remove themselves from the workforce for months at a time (or even years), which causes them to miss opportunities for advancement, and, in fact, can even open up opportunities for the males that continue working to take on leadership roles in the absense of the woman due to his being the only person then having a certain knowledge set. Of course, there are other times men are just viewed as less emotional and thereby supposed to be more worthy of elevated positions. Of course, we know that women that lack emotion and compassion are often viewed as harsh and abrasive, so there can exist hypocritical interpretations at times."

The ADVANCE for NPs & PAs blogs were active with comments this week, including a very honest and encouraging remark from a new nurse practitioner on the NP & PA Student Blog post, "Like Nailing Jell-O to a Wall":

"As a recent FNP graduate (December 2011) who is married with two small children and who worked full time as an RN while going through school let me assure you that you CAN DO THIS!!

I am very type A but had to realize that I could not do it all. Like you I have a very supportive husband and family and would not have made it without them. I would study only at night once my children were in bed and my husband had left for work. Of course by then I was tired from whatever had gone on that day.

Take time for yourself and family. Hire a housekeeper (as I did) if you can afford it. If your program is like mine was there is no way humanly possible to read every page of every book so don't even try!!

I wish you the best of luck and don't forget you will survive and one day be an FNP and it will all have been worth it!"

This week on Facebook, we shared "Improving Healthcare for Veterans and Military Families," with photos and audio of an event featuring first lady Michelle Obama as as well as Jill Biden supporting nurses as providers for veterans with PTSD. AANP representatives were in attendance at the event as well.

And we would like to thank Twitter followers who retweeted us in the last week: @BushDrDawn, @pomeranian1, @Kamododragoon, @avasearchgroup, @MarjorieShanks, @Principled_HC, @Nanciaguilera, @wiz_liller, @salixpharma, @MedEdgeforPAs, @Mkulcz and @carolinepilgrim.

Comments are reposted here verbatim, without editing. If you're not chatting with us on Facebook, Twitter and LinkedIn, "like", "follow" and "connect" with us and start sharing in the conversations! If you are, keep following and spread the word! Is there something you'd like to see on our social media sites? Let us know in the comments below. Thanks for following!

If you're not chatting with us on Facebook, Twitter and LinkedIn, "like", "follow" and "connect" with us and start sharing in the conversations! If you are, keep following and spread the word!

This week, our social media sites exploded with great comments from our readers. Here are some of the highlights, copied verbatim and without editing.

This week on Facebook, we shared photos from the 2012 NAPNAP conference in San Antonio, Texas. The photos show the many speakers and attendees at the conference, as well as some of the exhibitor booths and entertainment those NPs at the conference enjoyed. Check out the slideshow to meet some of our staff, an adorable dog and many of your colleagues!

We also shared the incredible story of one PA student who used her training to save the life of a drowning 6-year-old boy. The post was enjoyed by many readers, garnering a "Well done!" from one proud reader. Do you know any heroic PAs? "Like" us on Facebook to share your stories!

Over on LinkedIn, our web editor, Jennifer Ford, shared the YouTube video "Physician Assistants: A Fast-Growing Profession." The video, with over 2,500 views, describes the PA profession, its impact on patients and its goal in healthcare. Head over to LinkedIn to share your opinion on the video and discuss the profession with your colleagues!

On Twitter, we shared our latest "New Grad NP" blog post, "The Power of 'No'". In the post, our blogger Beverly describes the cost-saving benefits of denying some patient requests, specifically in the corrections facility in which she works. One reader commented, "It is up to us, as providers, to weed out the wants from the true needs of our patients and provide quality care that is cost-effective. It does not take long to change behavior if one is consistent and fair with all. I too had to learn ‘just say no' on a different scale." Do you deny some patient requests for the benefit of your practice? Let us know in the comments section of our blog!

Following the news of a huge change in the PA profession, we posted a summary of the PA recertification changes. In response to the post, Twitter follower @KPottsPA asked, "What's the cycle for #NP?" To find out, check out our New Grad Guide article, "What NP Graduates Need to Know About Certification." Do you think NP certification needs to be modified? What are your thoughts on the recent PA recertification changes? Let us know on our Twitter board!

Is there something you'd like to see on our social media sites? Let us know in the comments below. Thanks for following!

If you're not chatting with us on Facebook, Twitter and LinkedIn, "like", "follow" and "connect" with us and start sharing in the conversations! If you are, keep following and spread the word!

This week, our social media sites exploded with great comments from our readers. Here are some of the highlights, copied verbatim and without editing.

Many of our fans were sad to see "Adventures of a New PA" blogger Timothy Loerke submit his final post. Tim has shared the last four years of his life with us, while his schooling, clinicals, and eventual first two jobs as a PA changed his life. "Congrats on your new ED gig! I just stumbled on your page today and see you are ending your posts. I am a PA with one year of ED experience and could relate with so much of what you shared about jobs and being new. Thanks for the honesty! Good luck," one of our readers posted.

As Tim left, NPs and PAs greeted our newest NP & PA Student Blog writer, Olga Trouskova, with her post, "Ceviche and Salsa for This Russian!" One reader asked, "Thanks for those thoughts, Olga. Question, how can we best be prepared to be culturally sensitive if, like you, we stumble across unexpected situations? How can we learn about diversity? Reading? Only experience? Conversations with other practitioners?" How do you practice cultural awareness? Add to the conversation by clicking the link above!

We also shared the naming of PAs as one of the top rated jobs according to the Wall Street Journal in its article "Not All Jobs Are Created Equal." While calling out PAs for their great work, the article left out NPs. Our readers sounded off. One Facebook fan reacted, "PA's can have their rating!!! I prefer the NP pay!!! nuff said!!!" Another, in a heated discussion on PA and NP jobs, stated, "I disagree with the individual who posted this article. I will take a stab and say that NPs can be equated with PAs in this article. The NP role is much more similar to the PA role than a RN role, no? That's why this Facebook site is dedicated to both NPs and PAs equally, right? I prefer to simply believe the writer just isn't all knowing re: job classifications and mistakenly left the NPs out." What do you think of the rating? Let us know on our Facebook page!

If you're not following us on Facebook, "like" us and start sharing in the conversations! If you are, keep following and spread the word!

This week, we posted the article "Organizing and Investing to Expand Primary Care Availability with Nurse Practitioners" by Peter J. Levin and Rick Bateman from Journal of Community Health to our Facebook page and asked fans for their opinions.

The article, focusing on the growing shortage of primary care physicians, proposes an organized practice expansion of nurse practitioners. It additionally summons the support of business-oriented management organizations to assist NPs in opening practices.

We asked Facebook fans what they thought of the proposed business model.

Here are selected responses, copied verbatim without editing:

• Why not PAs???
• I believe PAs can't practice without constant physician oversite
• PA's are required to have on site supervision! Where in I believe 23 states NP's can already practise independently (Put out their shingle) and other states with MD collaboration.
• Correction!!! On site I didn't mean physically!! But they practise together!! An NP can practise in many states with out that controlled supervision! However they can by choice collaborate with an MD (specifically Specialists)! Or to add can even have an MD on their payroll if they want them to just sign off every two weeks or call them if they need further direction!
• I would rather have a NP and/or PA treating me than a physician. For me, personally, they seem to take more time, actually listen, and care about getting us well. Chase, specifically is the best pediatric provider I have ever taken my child to see.

The article received a lot of great feedback from our readership, but the conversation isn't over! What is your opinion on the article? Please share with us in the comments below or on our Facebook page!

Recently a reader commented on an ADVANCE for NPs & PAs news story, Mississippi NPs Seek Removal of Collaborative Agreement. She mentioned that the rural Mississippi clinic where she worked had to close when they lost their collaborating physician. I contacted Cari McDonald, MN, FNP-C, MPH&TM, who recounted her story:

We started with an acute care clinic about 2 years ago, in a growing rural community in southern Mississippi. We were one MD and 2 FNPs. The practice grew into family practice as we 2 NPs had been working in this community several years. The MD worked about one day week because he was busy in another clinic outside of town. The other NP and I switched frequently as I often work out of state and abroad. At the end of 2011 my NP counterpart was forced to stop working suddenly because of a medical emergency and a week later our MD was hospitalized for open heart surgery. This left me alone with no backup. I worked the clinic for a few weeks, while urging other local MDs to collaborate or consider renting clinic space in our building. Our MD did not want to return as he would be recovering for a very long time and didn't agree that NPs should have a DEA license without direct supervision (this was a confusing statement after our history together, yet I left it alone).

Other physicians' reasons for not wanting to collaborate were, "I just don't want the liability," "I'm already at the maximum number of NPs I can collaborate with," or "There's already twice as many NPs as MDs in this community." One MD said her husband (a nurse practitioner) wouldn't allow it. At that point, I was required to send notices out to patients, refer those who would need further evaluation in their continuum of care and close the doors. I found myself feeling like I was asking for someone to "be my mommy" on my quest for a collaborator.

I was hired immediately at a family practice in the same town, which happened to be one of the clinics I had appealed to previously for help with collaboration. It is important to practice with peer communication/collaboration, but I think this can be accomplished by maintaining good relationships with other providers in your area. Even a modification to the collaboration agreement would be helpful. Mississippi doesn't even call it collaboration, they call it "protocols," and it limits the locations an NP can practice. For instance, if your protocol states that you practice at such and such address and the high school asks if you can come over and do sports physicals at the school, you cannot without first getting approval from the board.

Collaboration is still often being misunderstood to mean "supervision." But when it is clearly understood, does it often mean "competition?"

These are the kinds of stories healthcare providers wish they no longer had to hear. Patient access to care decreased in this rural area at a time when the healthcare system should be ramping up for a huge influx of patients. The time has come for collaboration to work for patients, not against them.

The task force, developed in October 2010, was charged with addressing future opportunities and challenges associated with expansion and growth of the field.

After holding two in-person meetings in Washington, D.C., the task force created a specified list of recommendations with detailed rationales, implementation suggestions and desired outcomes.

Specifically, the recommendations involve identifying core values related to diversity, primary care, and competition, and specific strategies for bolstering training, workforce, and collaboration.

By focusing on diversity, quality, infrastructure and distribution, the task force hopes to expand the profession by 2020 to meet a growing demand for qualified healthcare professionals across the nation.

The joint task force's final report notes that a shortage of 45,000 primary care physicians and 46,000 specialist physicians will be needed in the next 8 years - a problem to be solved by developing a stronger PA presence nation-wide.

By targeting the field in multiple stages, including pre-application to a PA program and admission process, didactic curriculum within PA programs, clinical education curriculum, and post-graduate or practicing PA work, the task force hopes to strengthen the profession in its primary role in healthcare delivery.

As Kevin C. Lohenry, PhD, PA-C, president of PAEA, and Robert L. Wooten, PA-C, president of AAPA noted in their pre-report address, "We feel that the recommendations outlined in this report are critical in providing quality healthcare to all Americans."

A full description of each recommendation will be detailed in a forthcoming article by ADVANCE for NPs and PAs.

ADVANCE for NPs & PAs caught up with Rodney Fox, PhD, NP, of Pride Medical in Atlanta, to ask him about the "Occupy ANCC" page he created on Facebook. Here are his responses to a few of our questions.

Jennifer Ford (JF): Tell me about why you chose to take up the torch for this cause.

Rodney Fox (RF): Yes, I have started a campaign that provides a forum for currently credentialed nurse practitioners to object to ANCC’s policy of retiring respected credentials. The site is Occupy ANCC, say no to retiring your NP credential. The National Organization of Nurse Practitioner Faculty found that broadly trained family and adult NPs are the most marketable APRN credentials. It seems ridiculous to retire these highly esteemed credentials. I am attempting to bring a unified voice to others who may feel the same. First, allow me to state that I believe that ANCC has made this move in good faith, and that those involved have the best intentions. This move is in response to the LACE Consensus Model for APRN Regulation, a model with the intent to align the relationship among licensure, accreditation, certification, and education that creates uniform practice among APRNs. A major goal of the model is to advance advanced practice nursing to the next level, while benefiting individual APRNs and enhancing patient care. The radical step of retiring the current credential of practicing NPs, and developing a new credential without providing a bridge, misses the mark on multiple levels.

First, it is nearly impossible to move the profession to the next level when the process serves to segregate those now practicing from those who will continue to practice. The new certification introduces a new and, by definition, different class of NP. I recently completed a study where stigma was a measure, and stigma by definition arises from the notion that others are different from us. Who knew that nurses were capable of producing stigma, but on a professional scale? Nursing is already the laughing stock of health with multiple certifications and letters following our names: alphabet soup. This shiny new certification will only serve to muddy the water and confuse our colleagues, our patients, the community and us.

This process assumes that the current adult and acute curriculum is, and has been, inadequate in providing elderly content. By any measure of logic, geriatric patients are adults and make up a majority of the patients admitted to hospitals. This is the very population that adult NPs (ANPs) are trained to treat as outpatients, and acute care nurse practitioners (ACNPs) are trained to treat within healthcare facilities. The response I received from ANCC was that there are rogue NP programs that are not providing geriatric content, and ANCC’s response is to scrap the whole system. One cannot open any nursing or health-related journal without coming across the term evidence-based practice. I must ask, if our current training and nomenclature is so inadequate, where is the evidence?

I do not disagree that geriatrics is an important issue. Geriatric concepts should be taught and tested in future credentialing exams. However, I have not read any research that suggests ANPs or ACNPs are providing geriatric patients with incompetent care. In fact, the research suggests otherwise, NPs provide high-quality care, offer high patient satisfaction and achieve excellent health outcomes. Any perceived gap in competency exists in the minds of a few individuals. Any ANP or ACNP graduating from a reputable program had geriatrics as part of their curriculum. This change is not supported by evidence and is really a change in semantics.

Finally, this change does not benefit individual APRNs currently in practice. In fact, this could produce a nightmare situation for individual NPs going forward. The fine print to this deal is that NPs need only renew their credentials through professional development and continuing education. Well, I agree this is something we should do and are doing. However, if a person for any reason allows his or her certification to expire, that individual will not be able to sit for boards. Their board exam will not be available, and if they were educated prior to around 2013, their education will not be adequate to sit for the new exam. In fact, it is not clear if current NP programs will meet the new credentialing requirements, or if the new test will be psychometrically sound.

The fact is that many unforeseen events can arise that may prevent a person from recertifying, such as raising a family, doing research, caring for an aging parent or personal and family illness. If this situation arises, then the person must find an academic program, apply for admission, hope they are accepted, and then complete formal academic coursework that may take one to two semesters, or longer. This also assumes you are near a program that will accept you, you have adequate faculty and mentors to teach you, and you can afford both the real cost and opportunity cost to meet this new requirement. This whole process may take 1 to 2 years, and all this to receive content that was arguably previously provided, or could have been provided through alternative and more efficient methods. Many states require certification to practice as an NP, so we are discussing a person’s livelihood.

JF: What made you decide to create the Facebook page?

RF: I decided to go with Facebook because it is free, and searchable through Google. Anyone can join, and the only limitation is for those without a Facebook page. I felt it would have the greatest impact.

JF: What kind of response have you had to the page and the campaign?

RF: There are just over 50 members. This is not an adequate number because ANCC told me that only 150 certified NPs called to object to this move. Obviously we need more involved. That said, I did receive a call from ANCC’s executive director of credentialing, who was very kind and receptive to my thoughts. We simply disagree on this issue.

JF: What would be the ideal outcome of your efforts? What has happened so far?

RF: I am in favor of maintaining the adult and acute care NP certification, or at least provide a mechanism for currently credentialed ANPs and ACNPs (and others) to move into this new certification. I am not suggesting that credentialing and certification content should remain stagnant; far from it! Nursing should continue to evolve along with the scientific body of knowledge. If any rogue NP programs are deficient in proving adolescent through geriatric content within its adult and acute care curriculum, those programs should be dealt with individually. That is the purpose of our educational credentialing bodies whose objective is to maintain educational standards.

Any deficiencies, perceived or real, of currently practicing adult and acute care NPs can be addressed through educational modules, seminars and/or case studies. A 2- to 3-day seminar structure could provide this content, or for those unable to travel, through completion of online modules, just as continuing education is now provided. Mandating completion of a geriatric-specific educational module prior to the next recertification cycle would ensure everyone is up to date with geriatric content. NPs need continuing education to recertify anyhow. The development of such a module would be a perfect project for researchers at organizations such as the American Academy of Nursing's “Building Academic Geriatric Nursing Capacity,” or the Robert Wood Johnson Foundation. This module would meet the need of almost every APRN, except geriatric NPs who would need an adolescent to geriatric module. An adequate template likely already exists on some nurse faculty’s laptop.

A process that provides a mechanism to move all APRNs together is best for APRNs and the community in need of their services. APRNs are on the cusp of something great, and nursing, in general, has a real opportunity to provide leadership in the future of healthcare. We do not do this by chopping off our base – all currently certified NPs. The educational modality that I propose would be beneficial for several reasons. First, those who need the content receive it, and can immediately apply the knowledge. Secondly, everyone’s competency is up to date and standardized. Thirdly, each APRN receives continuing education credits, a necessary requirement. Fourthly, through fees, the program will pay for itself, and knowledge will be broadly disseminated. Finally, the nursing profession moves forward together, united as one. The current plan to change our profession, by drawing a line in the sand on certification, does more than its initial intent and I believe is not the intent of the consensus model. The current plan cuts a gorge between currently practicing NPs and the newly certified NPs. The proposed changes are not grounded in evidence-based knowledge. There is a real risk of ostracizing all currently certified NPs. The risk to our professional image and opening ourselves to unintended consequences is too great. I support the consensus model and believe the demand for gerontology services will grow, but this is not a favorable way forward.

I believe a petition should be started at Change.org. Verizon dropped a proposed $2 monthly convenience charge, and we might have the same effect on ANCC. If someone does start a petition, that person can borrow any of my objections to formulate their argument. And, naturally, I would sign it.

As most of you already know, ADVANCE for NPs & PAs operates a well-trafficked blog community featuring conversations about everything from the DNP movement to technology in healthcare to trends in dermatology and aesthetics. We also operate two very popular blogs written by NPs and PAs who have recently entered practice. We'd like to create a blog focused on student experiences. That's where you come in.

If you are a current NP or PA student, I hope you'll consider joining our blog environment. Before pressing "send" on an email to me, however, please reflect on the following questions: 

• Do you have an established track record of meeting deadlines? 
• Do you realistically have time to write a brief conversational blog post (a few paragraphs) about once or twice a month?
• Do you think you have interesting opinions to share?
• Are you comfortable being in the "public" eye, with your photo and full name posted on our website? 

If you answered "yes" to all these questions, this opportunity might be a good fit for you. To throw your hat in the ring for consideration, send me an email describing yourself (background, interests, anticipated graduation date) and suggesting topics for your first three blog posts. My address is mpronsati@advanceweb.com.

I look forward to hearing from many great students out there. Thank you!

Forbes.com columnist Merrill Matthews is on the money when he predicts a bright and bountiful future for NPs and PAs. His column posted yesterday, headlined "Healthcare Future Bright for Nurses, Stinks for Doctors," focuses on physicians' increasing malcontent with falling reimbursement rates and overall income potential. He notes that NPs and PAs are being used in expanded ways as a result of this trend coupled with incentives in the Patient Protection and Affordable Care Act.

In the column, Matthews compares average salaries for physicians and NPs (don't know why he didn't look at PA salaries, too) and quotes from the 2010 National Salary Survey of NPs & PAs, conducted by our journal. We are finalizing data tabulation for the 2011 National Salary Survey of NPs & PAs right now, and we will publish these important results in February. Sign up for our free enewsletter so that you'll be notified when these results are posted. Find the enewsletter signup on our homepage.

The article, “Parental Knowledge Regarding Lifelong Congenital Cardiac Care,” was published online on Nov. 28 in the American Academy of Pediatrics publication.

Among Fernandes’s coauthors, all writing on behalf of the Adult Congenital Heart Association and the Adult Congenital Cardiac Care Associate Research Network, were Petar Breitinger, PA-C, MPAS, in the departments of pediatrics and internal medicine at the University of Florida, Gainesville; Stephen Crumb, MSN, ACNP-BC, in the cardiology department at Nationwide Children’s Hospital in Columbus, Ohio; and Jo Ann Nieves, MSN, ARNP, PNP-BC, in the pediatric cardiology division of Miami Children’s Hospital in Miami, Florida.

In the multicenter study, Fernandes and colleagues administered a questionnaire to parents of children with moderate and complex congenital heart disease to assess their knowledge of lifelong congenital cardiac care (LLCCC). While national guidelines recommend that nearly 50% of adult survivors with congenital heart disease receive LLCCC, the number of adults who receive such care seems to be far less. Inadequate parental knowledge of LLCCC might contribute to care interruption, the authors reasoned.

From the article’s abstract:

Results: A total of 500 parents participated; the median age of their children was 10 years (range: 2–18 years). Most parents (81%) understood that their child would need LLCCC, but only 44% recognized that their child's cardiology care should be guided by an adult congenital heart specialist in adulthood. More than half (59%) of the parents stated that their current cardiology team had never spoken to them about LLCCC, but 96% wished to learn more. Variables associated with parental LLCCC knowledge included previous discussions regarding LLCCC, underlying cardiac surgical diagnosis, and level of parental education.

The PA-led researchers conclude that a substantial number of parents of children with moderate and complex congenital heart disease lack knowledge about LLCCC, but almost all of them have a desire to learn more about the care their child will need as an adult.

We are proud and excited to announce that ADVANCE for NPs & PAs is an official journal of the National Academy of Dermatology Nurse Practitioners (NADNP). This organization formed in late June and already has more than 1,300 members. We have dedicated a section of our recently launched dermatology and aesthetics specialty site to NADNP, where its leaders and members will provide clinical articles and other updates on a regular basis. The first article calls attention to the need for better skin cancer screening in primary care.  Also look for NADNP to become involved in our print edition and webinar programming in 2012.

Debra Shelby, DNP, FNP-BC, DNC, is the founder and president of NADNP. Her devotion to excellence in dermatology practice and to the advancement of NPs in dermatology led her to create the DNP dermatology residency program at the University of South Florida in Tampa. Through this important work, Shelby's commitment to provide education and support to NPs in all settings and specialties expanded, leading to the formation of NADNP. NADNP's mission is "dedicated to setting the standards in dermatology practice, education, research and professional development. It is our mission to serve as a resource and to support all NPs with an interest in dermatology."

I encourage you to visit the NADNP website at http://nadnp.net for more information. I also hope you will register for the organization's inaugural conference, to be held May 2-5 in Clearwater Beach Fla. Registration is open now, and spots are filling quickly. I look forward to meeting you at the conference!

The bill had been introduced on July 8, 2011 and approved by the House Committee on Education and the Workforce later that month. The full House passed it without objection yesterday. FECA was passed before the existence of the PA profession and as such needs to be updated to include PAs’ role in today’s healthcare system. Although the overwhelming majority of state workers’ comp programs recognize PAs, the federal program does not. That means that unless a physician is on site to sign a form, a PA must either punt the injured worker to an ED or provide care that will not be reimbursed.

The AAPA is calling on PAs to contact their senators and ask them to support the legislation and to thank their representatives for passing the House bill. The academy has editable form emails to representatives and senators at its website specifically regarding this legislation.

In its coverage of the Occupy Wall Street protest yesterday, the TV/radio program "Democracy Now!" featured a segment in which a self-described PA reports on conditions in Zuccotti Park. See the video and read the accompanying transcript here: http://www.democracynow.org/seo/2011/11/16/occupy_wall_street_protesters_return_to

From the transcript:

BRIAN FREUD: My name is Brian Freud. I’m a physician assistant. Since we lost so much yesterday, we are afraid to lose more. Our resources are limited now. So right now we’re making sure that if we need to pack up and leave in a hurry, we can. What we’re doing is we make sure we have our emergency necessary supplies in case things get out of hand, people get pepper-sprayed. We have solution, plus basic essentials, bandages, ice packs, thermal blankets, all the necessary things for bumps, bruises, cuts, sprains, dehydration, and just making sure people take care of themselves.