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If you are a member of the Bexar County PA Society, feel free to read and comment here on our news page regarding PA related issues.  Members only may comment. 
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  • 08 Oct 2014 4:52 PM | Reginald L. Smith

    Good afternoon to all,

    I would like to thank and appreciate all those who have assisted and worked hard for Bexar County PA Society. As a former Board of Director member, I do know the work you have to put in to make this Society to function and stay financially stable.

    I will be working as Civil Service at Womack AMC starting December 1. I hope to see some of you at Oct 16 CME dinner. I will NOT be attending our PA conference due to my recert PA Boards that weekend. Again, I thank all those who supported Bexar County PA Society for so many years.

    Reginald L. Smith, PA-C

    Former Vice-President and Director at Large BCPAS.


  • 30 Sep 2014 1:38 PM | monique Ochoa (Administrator)

    Today, Board members Chuck Moxin, Barbara Dauerty, Reggie Miller and a student speaker Ms. Marianne Mell,  PA-S 1  from at UTHSCSA asked Bexar County to please recognize PAs in Bexar County and all they do for the community.  Ms. Mell made a presentation about Physician Assistants and Bexar County awarded a proclamation to President, Charles Moxin stating October 6 - 13, 2014 will be recognized as PA week in Bexar County.  See photo on website page "About BCPAS".  

  • 22 May 2014 8:08 AM | Blaine Carmichael

    I want to express my opposition to using “collaborative: to define our relationship with physicians. When I say to the pt, I am working in collaboration with Dr X, which I do on occasion to test their response, I usually hear something to the effect “What does that mean?” Is the doctor a Nazi?” When I say, “I work in Association with Dr X” The response is, something like, “OK”

    I  support “in association with” rather than “in collaboration with” as our working relationship description with physicians. Here are some of the other reasons I do not like the word “collaboration” to describe the PA/Physician relationship.

    To cooperate as a traitor, esp. with an enemy occupying one's own country.

    To give help to an enemy who has invaded your country during a war.

    He was suspected of collaborating with the occupying army.

    Trials for war crimes, collaboration, and genocide continued in several countries for many years after the war.

    Any cooperation with Israel would be seen by many Palestinians as collaboration with the enemy.

    The betrayal of others by working with an enemy.

    Since the Second World War the term "Collaboration" acquired a very negative meaning as referring to persons and groups working with the enemy.

    The more specific term Collaborationism is often used for this phenomenon of collaboration with an enemy. However, there is no water-tight distinction; "Collaboration" and "Collaborator", as well as "Collaborationism" and "Collaborationist", are often used in this pejorative sense.

    The term collaborate dates from 1871, and is a back-formation from collaborator (1802), from the French collaborateur as used during the Napoleonic Wars against smugglers trading with England and assisting in the escape of monarchists, and is itself derived from the Latin collaboratus, past participle of collaborare "work with", from com- "with" + labore "to work." The meaning of "traitorous cooperation with the enemy” dates from 1940, originally in reference to the Vichy Government of Frenchmen who cooperated with the Germans, 1940-44.

    Collaboration, to conspire, cooperate, collude, fraternize “He was accused of having collaborated with the secret police.”

    Warm Regards

    Blaine P. Carmichael, PA-C. MPAS, DFAAPA

    President Elect, BCPAS

  • 27 Mar 2014 7:48 AM | monique Ochoa (Administrator)

    In recent months, some PAs in Texas have met resistance with their patients getting CIII-V prescriptions filled.  This issue has been on TAPA’s radar since the beginning, and we have been working toward a resolution.  Some of you may not have noticed any change in the way your scripts were being managed, but for those of you who have had scripts mishandled, there is now a clarification on the matter.

    First, for historical background, the original legislation that allowed for controlled substance prescribing to be delegated was passed in 1995.  Its intent was to allow for no more than a 90-day equivalent of the med, whether it be 30 days with 2 refills, or 90 days in one fill.  

    With rising concerns about controlled substance diversion, pill mills, and regulation of these prescriptions, pharmacies across the country have taken a harder look at policies regarding these scripts.  In Texas, the Pharmacy Board arrived at a different interpretation of the long-standing legislation.  Some pharmacists, mostly from larger chains, began to interpret the law as meaning something different than originally intended.  

    TAPA asked the TMB to offer clarification to the Pharmacy Board as to the original intent of the legislation.  As a result, the Texas Pharmacy Board has issued an update on their website.  Please see below:

    Information on Controlled Substance Prescriptions from Advanced Practice Registered Nurses and Physician Assistants

    At their December meeting, the Texas Medical Board reviewed Section 157.0511 (b)(2) [see below] of the Medical Practices Act and determined to interpret this portion of their Act to mean that, if delegated by the physician, an APRN or PA may issue prescriptions for a total of 90-days’ supply of a controlled substance including refills.  The intent of the section is to allow 90-days’ supply and not to limit the patient to one refill. This means the APRN or PA could issue a prescription with more than one refill provided the total quantity does not exceed more than a 90-day supply. Further discussions with staff of the Medical Board have also resulted in the interpretation that essentially a controlled substance prescription issued by an APRN or PA, expires 90-days after issuance.

    Sec. 157.0511.  PRESCRIPTION DRUG ORDERS. 

    (a)  A physician's authority to delegate the carrying out or signing 

         of a prescription drug order under this subchapter is limited to: 

              (1)  dangerous drugs;  and

              (2)  controlled substances to the extent provided by             

                    Subsection (b).

    (b)  A physician may delegate the carrying out or signing of a prescription drug order for a controlled substance only if:

             (1)  the prescription is for a controlled substance listed in Schedule III, IV, or V as established by the commissioner of public health under Chapter 481, Health and Safety Code;

              (2)  the prescription, including a refill of the prescription, is for a period not to exceed 90 days;

              (3)  with regard to the refill of a prescription, the refill is authorized after consultation with the delegating physician and the consultation is noted in the patient's chart; and

              (4)  with regard to a prescription for a child less than two years of age, the prescription is made after consultation with the delegating physician and the consultation is noted in the patient's chart.

    When encountering any future road blocks with controlled substance prescribing, having this link (www.tsbp.state.tx.us) available will be vital in communicating with pharmacists.  If you continue to meet resistance, please let TAPA know.  It is imperative that we be able to practice at the fullest extent of our license, and that our patients have access to the care they need in a timely fashion without delay.  Advocacy works, PAs in Texas do have a voice.  Please share this info with your fellow PAs. 

    Karrie Lynn Crosby, MPAS, PA-C

    TAPA President 2013-2014

  • 14 Mar 2014 12:12 AM | Blaine Carmichael

    Dear Mr. O'Reilly,

     

    On behalf of the Association of Family Practice Physician Assistant/Associate (AFPPA) organization, we were thoroughly dismayed and assuredly disappointed by your comments about the PA profession during "The O'Reilly Factor" broadcast on March 4, 2014. We know that by the time you read this letter you will have been contacted by a multitude of our colleagues and other graduates who probably listened to and respected your views in the past. Not only did you disparage our profession, your innuendo about community college insults every graduate of these institutions of higher learning.

     

    Comparing PA's and our training to "Lenny, who just came out of the community college" grossly misrepresents our education and the quality medicine that PAs practice in every medical setting and specialty in America. That includes caring for our military service members, both home and abroad, and even serving on the white house medical staff. The misleading information you expressed does a great disservice to the millions of viewers who trust the information and opinions you provide.

     

    Maybe you were unaware of what a physician assistant is/does or maybe your staffers/researchers confused our profession with "medical assistants". What you need to know is that the majority of today's PAs are educated through intense, graduate-level medical programs wherein we are trained to diagnose, treat and prescribe. In contrast to your comment, 94 percent of PAs hold bachelors, masters or higher degrees. We are often trained right alongside physicians in medical schools, academic medical centers and residencies. These programs are modeled on the medical school curriculum with a combination of classroom instruction and a minimum of 2,000 hours of clinical rotations. That means we share diagnostic and therapeutic reasoning with that of physicians.

     

    PAs are nationally certified and licensed to practice medicine and prescribe medication in all 50 states, the District of Columbia and all U.S. territories with the exception of Puerto Rico. PAs are authorized by the State Medical Boards to practice medicine, meaning we can perform physical examinations, diagnose and treat illnesses, order and interpret lab tests, assist in surgery, perform procedures, provide patient education and counseling, and make rounds in hospitals and nursing homes among many other medical services.

     

    There are more than 95,000 PAs in the workforce today, increasing access to high-quality healthcare. More than 7,000 PAs graduate from 181 accredited programs each year. We would encourage you to learn more about the PA profession before your next healthcare segment. The proper thing to do in this instance would be to do a story on our profession with details of our educational process. Your viewers deserve to know they can count on us for the care they need, when they need it.

     

    Sincerely,

     

    The Board of Directors

    Association of Family Practice Physician Assistants
  • 26 Jan 2014 5:15 PM | monique Ochoa (Administrator)
    Below are two articles on the flu for your review if interested.  
  • 13 Jan 2014 9:10 AM | monique Ochoa (Administrator)

    The Primary Care Crisis: Where Should PAs Go?


    Vic Germino, PA-C one of the first three PAs trained recently said in an interview, "I feel that every PA should go into family medicine first, and then branch out". He thought this was the way we as a profession would be the best we could be, the way we would "pay our dues" and lamented the fact that so many PAs went directly into the specialties first.

    Ladies and Gentlemen, we are in a family practice, primary care crisis in our country. The reasons are vastly different than they were in 1965 when the first PA program was created at Duke but the upcoming decisions that shape HOW and WHICH clinicians will provide primary care will shape healthcare and the way it is delivered for the next decade.

    Vic is spot on. We need to go into the family medicine policy debate and not just stick out toes into it. We need to jump into the pool with both feet and when the whistle blows be one of the top finalists for the gold medal. If not, I fear, part of the soul of the PA profession may die.

    Please allow me the few minutes of reading to elaborate.

    America does not have the physicians it needs to provide basic primary care services. It will not have them in the foreseeable future. Physicians do not see primary are as a viable specialty to enter. They will not be going into primary care and those that are already practicing in it will be closing their practices with increased frequency. The reasons for this exodus are multifaceted, and if NPs and PAs could triple their primary care numbers tomorrow these problems would still exist. To review, Medicare reimbursement is too low. The primary care clinician must run interference between the insurance companies and the patient, which ultimately is a losing proposition. Malpractice keeps going up and consumers look at their clinician as part of the problem. These problems will not disappear if PAs and NPs take on a greater primary care role.


    If PAs want to be left out of the new primary care delivery paradigm in the future, we can easily have that happen. We can just continue on as we are today. If we want to be included, we can also make that option come to life.

    How? For PAs to take a leadership role as a profession that sees itself as a leader in the delivery of primary care services, we must start to act. This action must take place as soon as we can make it happen.

    Firstly, we must come out publicly as a profession saying that we can provide primary care services as autonomous clinicians. NOT as independent practice clinicians, but as clinicians who can provide the broad spectrum of primary care services not as "assistants", but as providers in our own right. We must let the national and state primary healthcare policy leaders know we have earned the right to be included in the mix along with the NP/MD/DO clinicians that already have a seat at the "primary care delivery" table. We have the studies to back us up. Let us accelerate our education of others regarding our worth.

    How To Start

    Let's call in a few chips. For 45 years, PAs have worked long and hard under conditions which would have killed off any other profession. Our name mislabels us and has since we changed it from Physician Associate, the name Dr. Stead at Duke picked for our profession. As PAs, the barriers we have had to face just to practice medicine would have crippled any other profession. For years, organized medicine has chosen to minimize or negate our contributions while organized nursing has generally declared us invisible. My friends, we have not had an easy time proving our worth. But prove it we did. The examples are too numerous to detail here but the fact that there are now 85,000 of us in practice and the fact that we can prescribe, diagnose and treat at the level of a physician in all 50 states affirms the track record we have amassed. There is currently no doubt that we provide primary care and that we do it as well as any other group of clinicians.


    Today PAs are not looked at as an answer to the primary care crisis by a significant number of policy makers. How do we increase the number of policy makers that will include us in their future plans?

    Here are some ways;

    -Educate the policy makers of the USA that PAs WANT and DESERVE to be included. Our professional societies should come out and say we are a cost effective deliverer of primary care services; that we will match our record of providing care with any other group. That we have excelled in the provision of care in undeserved and rural areas and that we want those who can shape future policy to take notice of this history and allow us to participate.

    -The PA profession should call for a "National Conference on the Delivery of Primary Care” with representatives from any organization (PA/NP/MD/DO) that has clinicians who currently deliver primary care. We should then advocate for our equal status among these clinicians to create primary care policy in the future.

    -Regarding education, we should do two things. One is to reimburse one year tuition to any new graduate who agrees to practice in an underserved area providing primary care for 2 years. For experienced graduates we endorse and ask for funding for one year residency in family medicine for PAs (and possibly NPs) funded by the federal government in as many hospitals that want to start them. If our government can give billions to the financial companies that were (by and large) failures, they can give us millions to see if PAs are a significant resource to solve this healthcare crisis. Create residency programs for PAs and NPs entering with a Master's level education. Twelve months in length awarding a doctorate upon graduation. These programs would also grant the graduate the status of "Primary Care Provider" and if the new PCP agreed to practice in an under served area their tuition would be repaid, along with a stipend. These new graduates would be designated a PA-PCP or NP-PCP.

    Even with this increased schooling it will take us much less time and cost the system much less money and resources to educate us than it will to educate a physician, especially when we know they will not enter primary care. Along with this would be the request for funding of studies to see how good the graduates of this program were. If deemed worthy, the program could be expanded so that any family practice residency that gets federal funding would have to take a number of PAs and NPs in them, or lose their funding. Let's really start to cement our place in the system.

    Lastly, let's have our state organizations start to lobby their respective state legislators to remove the barriers that prevent us from providing care in the areas that need primary care. Let's do away with chart counter signatures, decrease MD to PA ratios, scrutinize other regulations that are decades old and that have shown no evidence to insure quality care, but have clearly been a detriment to NPs and PAs providing care where it's needed. If we can show that these possible barriers enhance quality care, let's keep them and refine them to make them even more useful. My guess is that many of these "barriers" hinder the ability of good clinicians to practice in areas where we are needed. Let the evidence dictate the practice.

    In Review

    Primary care will be re-defined over the next two years. It is time for the PA profession to work with the NP profession and others to make sure we are all recognized as primary care providers and to highlight our profession as leaders in the delivery of primary care services. It is time we took a proactive rather than a reactive posture regarding the provision of these services. We call upon the state organizations and well as the family practice PAs to lead the way for us as a profession into this new era. Primary care residencies should be formed, new strategies put into place and barriers to practice scrutinized to allow PAs and NPs to further expand the provision of primary care to the people and communities that need them.

    Blaine P. Carmichael, MPAS, PA-C, DFAAPA

  • 26 Nov 2013 4:00 PM | monique Ochoa (Administrator)
    Hello BCPAS members,

    If you received a notice via email recently welcoming you as a member to the BCPAS it is because we have new management that is imputing our membership data into this online system.  Please know that you have not been charged an additional year of membership.  This email is just to bring notice to our new website, system and will notify you when your dues are ready for renewal.  You may edit your own profile online.  Please take notice of our new forum which is available for members only to communicate with your peers.  You will be notified of events as they approach and any news in the industry or our association.  Please stay in touch!  
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