keccers
@keccers.eth
In Washington state, legislation is on the table to be able to bill advanced practice RNs and physician assistants at the same rate as doctors https://app.leg.wa.gov/BillSummary/?BillNumber=1430&Year=2025&Initiative=false This does not mean that a PA makes more money or achieves pay parity with a doctor— only that his or her employer makes more $$
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✿ ZACH HARRIS ✿
@zachharris.eth
Have you considered the proportionate amount of time the doctors work on a patient versus nurses. It is super asymmetrical. There’s also a huge labor shortage after the pandemic with nurses so as a way to incentivize supply, I would imagine they tried to make salaries on par.
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keccers
@keccers.eth
They didn’t try anything. There is nothing in the bill requiring pay parity, just billing parity This doesn’t apply to your garden variety nurse either — only to APRNs and PAs — they have prescribing authority, more advanced education and sometimes more autonomy — they are often being used in lieu of doctors now too It suggests to me that basically we as patients should get used to a lot less educated practitioners. To me here they are angling to punt more and more cases to the APRNs and PAs who they can pay less but bill same as doctor
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✿ ZACH HARRIS ✿
@zachharris.eth
Ah, I misunderstood… so it’s from a medical coding POV. Same arc outcome but with lower cost to service it. I think doctors need to swipe right on PA but not RNs. Are they fully autonomous or is the and MD / DO that needs to sign off before scripts can be deployed? I mean this is already happening all the time with in-network psychiatrist services because 99% of them are overbooked and have waitlists months out.
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Omar
@dromar.eth
Depends on state regulations and specialty. Some states allow NPs to practice independently, the share increased significantly after Covid. Most PAs need a signing physician. But lots can be missed in between. I would rather have an AI see the patient and sign off on that (something I already have tried and worked well). Have much more faith in it and patient is receiving better care tbh. For psychiatry the main divide is in controlled substances as many psych medications are scheduled. DEA allowed NPs to prescribe scheduled meds during Covid but recently rescinded that. Especially after the emergence of numerous ADHD startups that prescribed to those that didnt meet criteria. Now NPs (having tasted the freedom) are lobbying heavily for this, along with those new companies and health systems that stand to benefit from the higher margins.
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