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Happy APP Week!
4 Plays6 months ago
It's our favorite time of the year here at On Call: National APP Week! Sept. 22-27 is dedicated to recognizing advanced practice providers for the expertise, compassion, and care they bring to patients every day. To celebrate, April and Alicia—APPs themselves—are adding a little friendly competition into the mix with a fact or fiction all about their beloved profession. If you're an APP out there listening, we hope you play along with us and feel celebrated this week!
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Transcript
Introduction and APP Week
00:00:00
Speaker
This week is, do you know what this week is?
00:00:02
Speaker
APP week, maybe.
00:00:03
Speaker
That's right.
00:00:04
Speaker
National Advanced Practice Provider Week.
00:00:06
Speaker
So I've never stopped working.
00:00:08
Speaker
Exactly.
00:00:10
Speaker
I am technically on PTO, friends, but APPs are so important to us.
00:00:15
Speaker
And not just our sound APPs, but our APPs across the world.
00:00:21
Speaker
This is On Call.
00:00:23
Speaker
This would be really cool to just wear scrubs all the time.
00:00:25
Speaker
And you don't have to think about what you're going to wear to work.
00:00:27
Speaker
That is awesome.
00:00:28
Speaker
We're here to answer your questions.
00:00:30
Speaker
We can sit down and discuss them.
00:00:32
Speaker
Wait, I got to go.
00:00:33
Speaker
I'm on call.
00:00:34
Speaker
Wait, you're on call?
00:00:35
Speaker
I thought I was on call.
00:00:40
Speaker
Welcome back, everyone, to another episode of On Call with April and Alicia.
00:00:44
Speaker
I'm April.
00:00:45
Speaker
I'm Alicia, and we are back.
00:00:49
Speaker
Ladies and gentlemen, it's, guess what, April, it's not cold where I am.
00:00:54
Speaker
How is the weather where you are?
00:00:57
Speaker
You know, it's funny because we did our, you know, we did our fall episode and we're like, oh, fall's here.
00:01:02
Speaker
And I swear that like, I swear that since.
00:01:06
Speaker
Oh, fall's here.
00:01:07
Speaker
I was like, ugh.
00:01:08
Speaker
You said.
00:01:09
Speaker
Dread.
00:01:10
Speaker
It's fall, y'all.
00:01:11
Speaker
But I have been thinking about it because I think like the official day of the first day of fall is not yet.
00:01:17
Speaker
But also since we recorded that.
00:01:20
Speaker
It will be the Monday before this comes out will be the first day of fall.
00:01:24
Speaker
Yeah.
00:01:25
Speaker
22nd.
00:01:27
Speaker
But since we recorded that episode, it has been sunny and 80 every day.
00:01:33
Speaker
I remember when we recorded it, I was like, oh, it's like, you know, 60s.
00:01:37
Speaker
It's this cool fall weather.
00:01:39
Speaker
I can wear warm clothes.
00:01:40
Speaker
No, we're back to shorts and tank tops.
00:01:42
Speaker
That's what you get.
00:01:43
Speaker
And that's what happens when you drink a pumpkin chai latte too fast.
00:01:48
Speaker
Just let it be summer, guys.
00:01:50
Speaker
I did go get one after we recorded.
00:01:51
Speaker
Let the good Lord bless us with sunshine or something, you know?
Solo Travel Insights
00:01:55
Speaker
I am in Cabo, and I was just really, really wanting to do this bad boy in video.
00:02:01
Speaker
I was telling you before we started, just this landscape, just really to make April jealous.
00:02:06
Speaker
That's all.
00:02:07
Speaker
But it wasn't working out so well.
00:02:09
Speaker
So I'm back indoors staring at the water while I do this.
00:02:14
Speaker
But boy, do I have the biggest smile on my face.
00:02:17
Speaker
Oh, that's good.
00:02:18
Speaker
And again, there's like, really?
00:02:20
Speaker
I am.
00:02:21
Speaker
Well, you know what?
00:02:22
Speaker
I think that everybody...
00:02:26
Speaker
should take time, well, we all should take time for ourselves, and we've done those mental health conversations before, but I do think that one thing I was always scared to do was travel by myself or go to a restaurant by yourself, things where I was always like, that's creepy.
00:02:44
Speaker
I was just going to go sit at a booth by myself.
00:02:46
Speaker
I still don't think I do it locally, but I'm kind of moving into this era mission mode of my life where I'm becoming, not a hermit crab necessarily, but
00:02:57
Speaker
I'm just kind of learning to soak it up for me.
00:02:59
Speaker
And it doesn't like I don't need to be entertained by people.
00:03:02
Speaker
It's very interesting.
00:03:03
Speaker
So it's been an interesting journey for me.
00:03:07
Speaker
Yeah, especially in the area that I'm at.
00:03:08
Speaker
So, yeah, it's been cool.
00:03:11
Speaker
Weather's been awesome.
00:03:12
Speaker
I got a little bit of remnants of some tropical storm that was moving out in the Pacific.
00:03:17
Speaker
That's about as close as I'm probably going to get.
00:03:20
Speaker
This season.
00:03:21
Speaker
But it's been awesome.
00:03:23
Speaker
The weather channel still lives on.
00:03:24
Speaker
Guess what?
00:03:25
Speaker
My YouTube TV app works in Mexico.
00:03:27
Speaker
So when I woke up this morning.
00:03:29
Speaker
I just turned on YouTube TV.
00:03:30
Speaker
And was like doing my morning walk down the beach.
00:03:33
Speaker
Listening to the weather channel.
00:03:35
Speaker
But I got to tell you.
00:03:37
Speaker
Quicksand.
00:03:39
Speaker
Middle of the night.
00:03:41
Speaker
I was watching a How to Survive Quicksand.
00:03:43
Speaker
Have you ever thought about Quicksand before?
00:03:45
Speaker
Well I mean I've seen it.
00:03:47
Speaker
You know like in movies and stuff.
00:03:49
Speaker
Well, the never ending story that you're a child of the 80s.
00:03:52
Speaker
Not that I don't want to be exposed to quicksand.
00:03:55
Speaker
Yeah, I was watching.
00:03:57
Speaker
It was fascinating.
00:03:58
Speaker
First of all, I want to know where quicksand is.
00:03:59
Speaker
So I do like I never go there.
00:04:01
Speaker
But they're like how it's like how to quicksand and riptides for some reason have been my new focus on like, how do you survive that?
00:04:11
Speaker
To ask me why?
00:04:13
Speaker
I don't know.
00:04:13
Speaker
But well, the riptide I do.
00:04:15
Speaker
But quicksand.
00:04:17
Speaker
For everybody that wants to know, I'm going to help you save your life.
00:04:19
Speaker
If you drink quicksand, if you start sinking, the more you pull away, apparently, that's what makes it tighten up.
00:04:25
Speaker
It's almost like there's Chinese finger toy things.
00:04:28
Speaker
Yeah, you're supposed to not move.
00:04:30
Speaker
You're supposed to do tiny circular movements with one leg and then you get one leg out, but you don't go to pull the other leg up.
00:04:39
Speaker
You've got to lay back on your back with the one leg out and then it'll create a pocket.
00:04:44
Speaker
All you do is just try and create pockets so that water comes in.
00:04:48
Speaker
You're welcome.
00:04:50
Speaker
I saved everyone's life.
00:04:52
Speaker
I'm going to just try to avoid it.
00:04:55
Speaker
Well, that's my point.
00:04:56
Speaker
Like, where is it even anyway?
00:04:58
Speaker
I know.
00:04:58
Speaker
I wonder if it even really exists.
00:05:01
Speaker
I don't know.
00:05:01
Speaker
I'm sure it does.
00:05:02
Speaker
It was on the NeverEnding story.
00:05:03
Speaker
He lost his horse to it.
00:05:04
Speaker
Do you remember?
00:05:05
Speaker
It was the saddest part of the story.
00:05:06
Speaker
It's also on that show that I just watched with Kirsten.
00:05:08
Speaker
There was an episode with quicksand.
00:05:11
Speaker
Ugh.
00:05:12
Speaker
That's a scary way to... I mean, can you imagine?
00:05:15
Speaker
Okay, let's not be morbid.
00:05:16
Speaker
I'm looking at the water right
Medical Emergency on a Flight
00:05:18
Speaker
now.
00:05:18
Speaker
What are you doing, April?
00:05:19
Speaker
Jeez.
00:05:20
Speaker
You're the one that brought it up.
00:05:21
Speaker
Enough with the weather talk.
00:05:22
Speaker
You talk about the weather too much.
00:05:24
Speaker
let's talk about work.
00:05:25
Speaker
First of all, that was all you, but yeah, let's actually talk about work at this episode because this week is, do you know what this week is?
00:05:33
Speaker
APP week, maybe that's right.
00:05:35
Speaker
National advanced practice provider week.
00:05:37
Speaker
So, um, we thought we would do an episode in honor of that because, um, you know, we worked, I've never stopped working.
00:05:45
Speaker
Exactly.
00:05:47
Speaker
I am technically on PTO, friends, but the APPs are so important to us and not just our sound APPs, but our APPs across the world that we could not miss an opportunity to celebrate these fabulous people.
00:06:03
Speaker
So work never stops, you know.
00:06:06
Speaker
Well, that's true.
00:06:07
Speaker
And, um, you know, we have talked in different instances of when we, you know, as clinicians, we actually literally never stopped working because we're always on the lookout for something going awry around us.
00:06:22
Speaker
Um, and we didn't talk about this when we talked about my trip, but, um, when I was on my flight from, uh, Japan to Hawaii, uh, it was a late night flight.
00:06:33
Speaker
Like, you know, we boarded at 10, we ate dinner, um,
00:06:36
Speaker
you know, like 1230 in the morning, everybody's like settling in to go to sleep.
00:06:39
Speaker
The lights are off in the plane and they come over the announcement and say, you know, we have a medical emergency.
00:06:45
Speaker
If there's any healthcare professionals on the plane, if they could assist.
00:06:49
Speaker
And, um, yep.
00:06:51
Speaker
And so, you know, of course I got up and went to the back of the plane and, um,
00:06:56
Speaker
You know, long story short, I ended up spending the majority of the flight in the back of the plane with a physician that was from Japan.
00:07:05
Speaker
The two of us were tending to a Japanese passenger who was having a medical emergency, and we were able to stabilize her and get her safely off when we landed to paramedics.
00:07:14
Speaker
But, you know, and then it was just... When you were telling this story, Abe, and you're probably going to say this, sorry if I jump a gun here.
00:07:22
Speaker
You told me this story when we were talking...
00:07:25
Speaker
you know, shortly after he had returned.
00:07:27
Speaker
But it was something really cool about this interaction because he didn't speak English, right?
00:07:31
Speaker
This was right.
00:07:33
Speaker
Right.
00:07:33
Speaker
So it was a patient who didn't speak English, first of all.
00:07:37
Speaker
And then so then I was the first one to go back.
00:07:39
Speaker
And then probably 20 minutes later, the physician came back and he said to me, do you speak English or Japanese?
00:07:45
Speaker
And I said, no, do you speak English?
00:07:47
Speaker
And he said, no.
00:07:49
Speaker
And we found ourselves in a situation where we needed to work together to care for a patient with a language barrier there.
00:07:56
Speaker
And there was a flight attendant that did speak both English and Japanese and was able to translate a little bit.
00:08:04
Speaker
But when you're in the moment and you're...
00:08:06
Speaker
trying to actively do something for a patient, um, you know, it, it just slows you down, right.
00:08:11
Speaker
Having a translator.
00:08:12
Speaker
And so, um, he, he was putting an IV in the patient and, um, which by the way, super cool to see the kits that are on airplanes, if you've never seen one, but, um, but yeah, so we, we opened the kit and,
00:08:28
Speaker
we're looking for the, what he needs to put the IV in.
00:08:32
Speaker
And we were working in sync and I would like, I, as he was looking for something, I knew what he was looking for and would hand it to him and he would be like, uh-huh.
00:08:38
Speaker
And, and we just were working in sync together despite, you know, the language barrier, but it's just, it's just funny.
00:08:45
Speaker
Cause it's, I mean, the medicine is the same obviously.
00:08:47
Speaker
Right.
00:08:48
Speaker
But, um, but it was just, it was interesting.
00:08:51
Speaker
Um, it was a good experience and, you know, luckily she was, she's okay.
00:08:55
Speaker
Yeah, she, yeah, she did.
00:08:56
Speaker
So,
00:08:57
Speaker
You didn't have to stop.
00:08:59
Speaker
There was no diversion for the plane.
00:09:00
Speaker
So kudos to you guys.
00:09:02
Speaker
Did they give you a refund for your seat?
00:09:04
Speaker
We were over...
00:09:05
Speaker
We were over water, so there was no landing.
00:09:09
Speaker
I know a couple landings that have happened that way, but that's another story.
00:09:15
Speaker
The most important question is, did you get a refund or something?
00:09:21
Speaker
Did you get wings?
00:09:22
Speaker
Did you get wings put on your shirt when you left?
00:09:24
Speaker
I did not get wings, but they do have a voucher or whatever.
00:09:29
Speaker
They have a standard...
00:09:34
Speaker
you know, we'll give you this credit.
00:09:38
Speaker
So I did receive that, but it was...
00:09:41
Speaker
I was, I was, you know, we were getting off the plane and the head flight attendant, like, as I was getting off, gave me this humongous hug and was like, thank you so much.
00:09:50
Speaker
Like, I don't know what we would have done without you.
00:09:53
Speaker
And the pilot, like, I, you know, obviously he was flying the plane and he knew what was happening, but like, he's not in the back to see who is doing what.
00:10:00
Speaker
Right.
00:10:00
Speaker
So as we're walking up the, the jetway, he like literally ran up the jetway to stop me and like, you know, make sure he said, thank you.
00:10:08
Speaker
And so that was really,
00:10:09
Speaker
That was nice, too.
00:10:10
Speaker
I love that.
00:10:12
Speaker
My kids won't travel with me because they're like, you just never stop.
00:10:16
Speaker
Like, you never turn it off.
00:10:18
Speaker
And you never, and I'm like, you know.
00:10:20
Speaker
My kids thought it was amazing.
00:10:21
Speaker
Like, the girls were like, Mom, like, you helped somebody.
00:10:24
Speaker
And, like, they thought it was very inspiring, you know.
00:10:27
Speaker
I'm like drunk people at Bengals games, you know.
00:10:31
Speaker
Like, that's.
00:10:32
Speaker
the type of stuff where I'm like, somebody get them before they fall.
00:10:35
Speaker
And then Ramey's like, well, why are they drinking like that?
00:10:37
Speaker
In the middle of the day, it's irresponsible.
00:10:39
Speaker
I'm like, well, you gotta, you know, you gotta, I can't turn it off.
00:10:44
Speaker
So, but I, that's what I love.
00:10:47
Speaker
And I love that about us.
00:10:48
Speaker
I love that about us as clinicians.
00:10:50
Speaker
I love that.
00:10:51
Speaker
I always laugh.
00:10:52
Speaker
One of my really good friends is a pediatrician.
00:10:54
Speaker
And when we go together, she goes, well, I'm glad you're here because I want to raise my hand.
00:11:00
Speaker
Um, because she's like, when I'm off work, I'm off work.
00:11:03
Speaker
No, understandably, she doesn't do what we do, but it was just, um, it was just funny.
00:11:08
Speaker
Cause there was like another passenger that at the end of the flight was like, are you, you know, what are like, and I told her, I was like, oh, I'm a PA.
00:11:14
Speaker
And she's like,
00:11:15
Speaker
Oh, that was like really nice of you to, you know, stand up.
00:11:18
Speaker
And we were all like, in my family, we're like, I wonder if she also is healthcare and chose not to stand up.
00:11:23
Speaker
And that's why she was like, do you ever wonder how many healthcare people are that just turned and everybody, we are reading you for filth right now because.
00:11:32
Speaker
There are people listening right now who have done that.
00:11:36
Speaker
I have done that.
00:11:37
Speaker
I mean, you know, and honestly, you, you sort of got to get the right moment back.
00:11:41
Speaker
Yeah.
00:11:42
Speaker
Yep.
00:11:42
Speaker
Like, do I have it in me or not?
00:11:44
Speaker
But there's, or do I have the skillset to even manage this?
00:11:48
Speaker
Um, I've never been at that point, but I do know other people who are like, I don't do CPR.
00:11:52
Speaker
Like I wouldn't even know what to do.
00:11:55
Speaker
Um,
00:11:56
Speaker
We had a time to, we were at one dinner one time with friends and I was like watching this thing, like unfold, you know, like a couple booths over and my husband's like, you need to go.
00:12:06
Speaker
And I'm like, no, no, no.
00:12:08
Speaker
I think, well, then I said, I was like, I think they're all right.
00:12:11
Speaker
And then I kept watching and he was like, you need to go.
00:12:13
Speaker
Don't you?
00:12:13
Speaker
And I was like, yeah, get up.
00:12:14
Speaker
I have to get out of this booth, you know, but, um,
00:12:18
Speaker
That you need to go is like the famous spousal line for anybody who's married to a clinician.
00:12:24
Speaker
That's male or female.
00:12:25
Speaker
They're like, do you need to go?
00:12:26
Speaker
They just know.
00:12:27
Speaker
Like, I was telling April, like, I just dropped my phone yesterday to go help some lady that I thought was getting ready to fall off some steps while I was on FaceTime with my kids.
00:12:36
Speaker
Like, dropped it to the ground.
00:12:37
Speaker
And it was, like, just out.
00:12:38
Speaker
Like, it's just so – it's almost like you hear –
00:12:42
Speaker
the alarm in the hospital and it's like it just does something to your brain off and you're like right you're like time to go yeah there was one time in like disney world we were walking by a restaurant and the kid was like choking and i'm like watching as we're walking by and he's like you need to and i was like just hang on a second and they ended up being fine like i didn't need to but you know you just choking is one that freaks you said yeah it freaks me out a lot but so you just sort of watch from afar but um but yeah i mean i think that is the fun part i mean
00:13:11
Speaker
Probably not our spouses think it's fun, but the fun part about it is that it's ingrained in us.
00:13:17
Speaker
That's not specific to a specialty or a, you know, like what type of clinician.
00:13:23
Speaker
I think it's in all of us.
00:13:25
Speaker
We came all, everyone that comes into healthcare comes in because they want to care for people for the most part.
00:13:31
Speaker
I'm sure there's outliers, but for the most part, we've just got this fundamental core need to like want to take care of people.
APP Profession Overview
00:13:38
Speaker
So I thought, yeah,
00:13:40
Speaker
vacation edition in honor of APP week that we should do.
00:13:46
Speaker
I know we did fact of fiction already, but let's do a factor fiction APP edition.
00:13:52
Speaker
do a few questions.
00:13:54
Speaker
Just a lot of appreciation is really what we want to put out there for our, all these people, our nurse practitioners, our PAs, our CNSs, our CRNAs, all of them that really do make a huge difference in patient care and deserve to have this honor.
00:14:11
Speaker
So yeah, let's do it.
00:14:13
Speaker
Let's go for it.
00:14:14
Speaker
How about you go first?
00:14:16
Speaker
All right.
00:14:17
Speaker
Do we keep score this week or is this a
00:14:20
Speaker
Let's not.
00:14:21
Speaker
It's a fun one this week.
00:14:22
Speaker
Let's look PTO score this week.
00:14:24
Speaker
And I feel like because I feel like we should probably know these answers.
00:14:28
Speaker
Yeah, I do kind of feel like this will be interesting.
00:14:31
Speaker
I did specifically try to go over questions that I didn't know.
00:14:34
Speaker
So that... Yeah, but we'll see.
00:14:37
Speaker
Mine are more ones that I thought you would know, but I thought we should cover.
00:14:40
Speaker
So, all right.
00:14:42
Speaker
Well, whatever.
00:14:44
Speaker
Knock it out the box.
00:14:46
Speaker
All right.
00:14:46
Speaker
First one is kind of gets that sort of just the...
00:14:50
Speaker
longevity of the professions um and so true or false the pa and np professions were created in the same year i guess you say founded i'm gonna tell you false immediately and the only reason i'm saying false i don't know what years they were respectfully respectfully but there's no way they are in the same year so which one was first i'm gonna say nps all right okay
00:15:16
Speaker
Well, you're right.
00:15:17
Speaker
So NPs, Loretta Ford and Henry Silver founded the first NP program at the University of Colorado in 1965.
00:15:24
Speaker
So that was the year the first ones graduated.
00:15:26
Speaker
And for PAs, Dr. Eugene Stead founded the first PA program at Duke.
00:15:32
Speaker
It started in 1965, but they graduated in October of 1967.
00:15:36
Speaker
So that is the date that is credited as founding the profession.
00:15:40
Speaker
Yeah.
00:15:43
Speaker
And they both were started, you know, because of the need for patients to have care.
00:15:48
Speaker
Yeah, the shortage of healthcare providers and the need for people to receive care.
00:15:54
Speaker
Yeah, I like that.
00:15:55
Speaker
And it was World War II, I believe.
00:15:58
Speaker
Yeah.
00:15:59
Speaker
And there was a fair amount of shortage there.
00:16:01
Speaker
And again, we're collaborating today.
00:16:05
Speaker
There was collaboration happening then.
00:16:08
Speaker
This has always been our destiny.
00:16:10
Speaker
I really believe that.
00:16:11
Speaker
So I think that's really, really cool.
00:16:13
Speaker
Okay, I got one for you.
00:16:14
Speaker
Ready?
00:16:15
Speaker
I'm ready.
00:16:15
Speaker
Dr. Fiction, physician assistants were originally called doctor's assistants.
00:16:25
Speaker
False.
00:16:27
Speaker
Oh, you're right, actually.
00:16:28
Speaker
Did I stump you?
00:16:28
Speaker
Because you paused.
00:16:30
Speaker
No, I was... Or did you really know the answer?
00:16:31
Speaker
Huh?
00:16:33
Speaker
I mean, I figured I knew the answer, but then I was like, is she trying to trick me?
00:16:37
Speaker
I was wondering if you were doing a little telenovela for us.
00:16:39
Speaker
Okay.
00:16:40
Speaker
But you're right.
00:16:40
Speaker
It is fiction.
00:16:41
Speaker
They were always physician assistants.
00:16:45
Speaker
They still use physician assistants, but did you know that some are moving to a title of physician associate?
00:16:51
Speaker
Have you heard that?
00:16:52
Speaker
Yes, I have.
00:16:53
Speaker
So that's...
00:16:55
Speaker
But it's, there's only, I think, three states right now that have officially adopted that title, like, clinically for PAs.
00:17:05
Speaker
Right.
00:17:06
Speaker
And so that's, you know, I'm actually keeping an eye on it for sound as the chief advanced practice officer.
00:17:13
Speaker
I'm keeping an eye on the states to see if there's any, anybody that we need to change, you know, for like contracts and things like that.
00:17:18
Speaker
Yeah.
00:17:19
Speaker
Well, but even though the name evolves, I think what's important to communicate is the mission is the same.
00:17:25
Speaker
Yep.
00:17:25
Speaker
And that is to provide excellent care.
00:17:28
Speaker
But you mentioned in your last question, like the PA role, the NP role, why they were created.
00:17:36
Speaker
But specifically to the PA role, from what I was looking up, it was created to make medical training more accessible.
00:17:47
Speaker
Yeah.
00:17:48
Speaker
and it grew into this profession after that.
00:17:51
Speaker
And I'm sure you probably know way more of that background, but they started around the same reason, same war, but to serve different, slightly different purposes at first, and then like, slowly blended.
00:18:02
Speaker
Yeah.
00:18:04
Speaker
Into their scope.
00:18:05
Speaker
So I think that's pretty cool.
00:18:07
Speaker
Look at us.
00:18:07
Speaker
No scorekeeping, no competition.
00:18:09
Speaker
We're united.
00:18:10
Speaker
I know.
00:18:11
Speaker
We're being so nice to each other.
00:18:13
Speaker
Why?
00:18:13
Speaker
Because there's sunshine in the sea that I'm looking at.
00:18:17
Speaker
So I should do my, guys, if I do my podcast here, we might not have a podcast because I won't be as cheeky.
00:18:23
Speaker
She won't be as mean to me.
00:18:26
Speaker
And as soon as I get back, I'll be like, it's terrible.
00:18:28
Speaker
I'm under my vitamin D lamp.
00:18:30
Speaker
Okay.
00:18:32
Speaker
All right.
00:18:33
Speaker
Your attorney, babes.
00:18:34
Speaker
Okay.
00:18:35
Speaker
So this one also, I think you'll know hands down, but I think it's important to point out because I do challenge me, Tito.
00:18:42
Speaker
I'm not going to challenge you today, I don't think.
00:18:44
Speaker
But one of the things that I think people don't realize is that there are some differences in the education that both PAs and NPs receive.
00:18:53
Speaker
So my question for you is, which education program teaches more generalized medicine, NPs or PAs?
00:19:04
Speaker
I'm going to say PAs.
00:19:04
Speaker
Okay.
00:19:05
Speaker
You are correct.
00:19:06
Speaker
So what do you mean by generalized medicine?
00:19:10
Speaker
So what I mean is our NP and nurse practitioners, when they go to school, they receive education kind of on a focused track, right?
00:19:19
Speaker
So like they will be maybe adult gerontology NPs or acute care NPs or a primary care nurse practitioner or a family nurse practitioner or pediatric or psychiatric or women's health.
00:19:32
Speaker
So they kind of
00:19:33
Speaker
Which, of course, you know, if it's adult gerontology or acute care, they're going to get generalized and for, you know, education in that field.
00:19:39
Speaker
But they're also kind of there's other tracks that are more focused, whereas P education is PA education.
00:19:45
Speaker
Everybody goes through the same program and it's not focused on one.
00:19:51
Speaker
specific track.
00:19:53
Speaker
Um, and so, uh, you know, when they do rotations, they do eight different rotations and eight different specialties.
00:20:00
Speaker
Um, and then of course there's, you know, post-graduation training that they can, you know, you can do in like a fellowship or, you know, things like that if you want to specialize, but, um, a PA degree is a PA degree, if that makes sense.
00:20:13
Speaker
So.
00:20:13
Speaker
Yes, I get it.
00:20:15
Speaker
And it's an easier licensing process.
00:20:18
Speaker
I would tell you that.
00:20:19
Speaker
I do know that much with all of our licensing barriers state to state.
00:20:26
Speaker
But yes, hey, speaking of APP week, I do think this is a good breaking news.
00:20:31
Speaker
You and I talked about compact for PAs.
00:20:35
Speaker
Yes.
00:20:36
Speaker
A couple of podcasts ago.
00:20:38
Speaker
Breaking news.
00:20:39
Speaker
There's only even though it is happening.
00:20:43
Speaker
The states don't have it up and running just yet.
00:20:46
Speaker
So there are, I think, one or two.
00:20:49
Speaker
So for those that took that information, then was like, April's a liar, just like I did.
00:20:54
Speaker
I actually had to look a little bit further.
00:20:57
Speaker
And it is real.
00:20:58
Speaker
It was passed in 24.
00:20:59
Speaker
You're absolutely right about that.
00:21:01
Speaker
Um, but this, I guess it takes like time to get it even then into legislation or something at the state level for them to adopt it.
00:21:10
Speaker
So they are projecting that as we roll into 26, we'll start going live with, I think it was, would you say 36?
00:21:16
Speaker
There's some, I don't think you said 36 states, but there was a fair amount that were beginning to come out.
00:21:21
Speaker
No, I think it was like 13 or something.
00:21:24
Speaker
Yeah.
00:21:24
Speaker
You lied by omission.
00:21:25
Speaker
That's all I was going to say.
00:21:27
Speaker
Um,
00:21:28
Speaker
April's a liar.
00:21:29
Speaker
I didn't lie.
00:21:30
Speaker
I've stopped looking at the sea.
00:21:32
Speaker
Could you tell I got mean?
00:21:33
Speaker
Okay, I'm back.
00:21:35
Speaker
Turn your chair back around to the water.
00:21:37
Speaker
I'm pacing because I can't.
00:21:40
Speaker
On my microphone, I told you so.
00:21:43
Speaker
I'm just chasing around and I quit looking at what was going on outside.
00:21:47
Speaker
I've quit having FOMO.
00:21:48
Speaker
All right, ready?
00:21:49
Speaker
Here's the next question.
00:21:50
Speaker
Factor fiction, April Burke.
00:21:53
Speaker
The APP workforce is projected to grow faster than the physician workforce over the next decade.
00:22:01
Speaker
True.
00:22:03
Speaker
I said factor fiction.
00:22:05
Speaker
Oh, so that's a fact.
00:22:07
Speaker
Right.
00:22:07
Speaker
I just wanted you to say the right word.
00:22:12
Speaker
It's actually fact, but this is not a competitive model.
00:22:15
Speaker
This is actually the demand of patients that's growing and the demand of availability, like the availability of nurses versus the physicians that are actually entering the workforce, which has been a challenge in some specialties in the physician lane.
00:22:30
Speaker
And I think we've experienced that and had those conversations within sound and
00:22:35
Speaker
You have your ebbs and flows.
00:22:36
Speaker
We have nursing shortages at times and you've got people like interested in VA that want to come in and then you've got shortages in that area and physicians are just kind of going through some shortages in some of the specialties.
00:22:47
Speaker
So yeah, there is a demand just to meet the demands of healthcare, meet the demands patients are living longer.
00:22:55
Speaker
And there's just not enough of us right now.
00:22:57
Speaker
So that growth just shows how central APPs have become, just not as a replacement.
Healthcare System Challenges
00:23:02
Speaker
This is like the key part, not as a replacement, but just an essential part of making sure that these patients, all of these patients get timely care, period.
00:23:12
Speaker
So yes.
00:23:13
Speaker
Yeah.
00:23:14
Speaker
We're projected to grow quite a bit.
00:23:16
Speaker
I know we are.
00:23:17
Speaker
It'll be fun.
00:23:20
Speaker
I think so.
00:23:21
Speaker
I think so.
00:23:24
Speaker
We continue to grow our numbers here at Sound.
00:23:26
Speaker
More and more of our programs are using NPMPs.
00:23:31
Speaker
I am impressed to see, um, you know, I get even more impressed when I interview and I'll talk to an APP and there'll be somebody that was like 2002, 2003.
00:23:42
Speaker
And I'm often like, what was it like back in the old days?
00:23:47
Speaker
Like, that's kind of what I feel like, like 2002, um, we, they, we still weren't as prevalent.
00:23:53
Speaker
I feel like the big blow up happened or probably around 2010, 2011, where, um,
00:24:00
Speaker
medical groups really started leaning into that model so yeah when did you graduate NP school what year 2012 okay I was 20 I was 2008 um yeah I did now I did nursing school first so technically four years your elder not necessarily I had I made two degrees before you had your PA degree okay okay
00:24:25
Speaker
I mean, if we're going to keep it honest, because this is an honest podcast.
00:24:28
Speaker
I just think we should be honest.
00:24:29
Speaker
Just kidding.
00:24:30
Speaker
I did.
00:24:31
Speaker
You were practicing way before me.
00:24:32
Speaker
That is for sure.
00:24:34
Speaker
But yes, it just it's kind of a different world.
00:24:37
Speaker
It's even it's even different.
00:24:40
Speaker
I feel like we're going into narratives here, but.
00:24:42
Speaker
It's an exciting topic for us.
00:24:45
Speaker
I feel like it's even different post-COVID.
00:24:48
Speaker
It's just interesting to kind of live through, and I know we keep throwing the COVID world around, but it really is kind of like pre-COVID, post-COVID, and even post-COVID, the demand has gone up.
00:25:01
Speaker
That's all the resignation, all the people that got burned out, all the things that happened, all the exposure of all the fractures of the healthcare system that we're now getting to remediate.
00:25:10
Speaker
which is exciting to be a part of that.
00:25:12
Speaker
It's just interesting.
00:25:14
Speaker
So I couldn't even imagine O2, but then you take it back to the 60s.
00:25:17
Speaker
Oh, is it like, did they have to do all that licensing?
00:25:22
Speaker
Did they have to do compliance training?
00:25:25
Speaker
I'm sure they did licensing.
00:25:27
Speaker
I don't know about the compliance training, but you know, one of the funny things that I think about is... Do they do CMEs?
00:25:33
Speaker
I should have looked that question up.
00:25:36
Speaker
I think it's interesting because...
00:25:38
Speaker
You know, when, when I graduated PE school, like when I was in PE school, when I graduated PE school, there was no electronic medical records.
00:25:45
Speaker
Nope.
00:25:45
Speaker
They were all in, it was all on paper.
00:25:47
Speaker
So like as a student, I could like, you know, easily write notes and stuff like that, write out orders and that, you know, then they would, you know, we would sign them, whatever.
00:25:57
Speaker
And I, I do think, um, that education is different a little bit now because of the EMRs, because a lot of the students don't have access to that, to do the documentation, to do all of that.
00:26:09
Speaker
But I also thought it was interesting because, you know, some of our sites go through downtime at times, right?
00:26:14
Speaker
Whether they're doing, you know, updates to their system or sometimes, you know, there's data breaches and systems have to go down for whatever reason.
00:26:22
Speaker
Yeah, cyber attacks.
00:26:23
Speaker
Yeah, things like that.
00:26:24
Speaker
And it's interesting to see that because a lot of the newer clinicians have never documented on paper, they've never written out orders on paper, right?
00:26:34
Speaker
Which is so different than...
00:26:37
Speaker
Just, you know, typing in the name of the medication and the doses come up and you pick it right like you have to like know, like, you know, when you write it on paper, you have to know so.
00:26:45
Speaker
Yeah, there's no prompts.
00:26:47
Speaker
Like, you know, you just have to know what you want.
00:26:50
Speaker
You need to know and you need to know that almost just makes me it's very nostalgic for me when you talk about paper charting.
00:26:58
Speaker
Because it really was like very barbaric, but it was normal.
00:27:02
Speaker
And I think I came in at a point like we had converted to Epic within a year when I had started.
00:27:08
Speaker
Yeah, we had Meditech in the ER when I started in 06.
00:27:14
Speaker
So we had, I mean, I think it was Meditech.
00:27:17
Speaker
I mean, it was still clunky.
00:27:19
Speaker
But yeah, EMRs also do all your task-like thinking for you.
00:27:26
Speaker
And like, I think just kind of paves the way for the minutia.
00:27:32
Speaker
But it's always really good to be able to exercise it because like you said, you never know when you're going to get a cyber attack.
00:27:37
Speaker
You never know when you're just going to have to handwrite a prescription.
00:27:40
Speaker
And I would tell everybody, don't forget how we have to write those suckers because it's.
00:27:47
Speaker
the pharmacy still have an expectation and i had to write one two weekends ago that's kind of like wait a second do we still do we still put our dea up here number here on the rocks like i wasn't really sure i've gotten so used to like the click and the electronic stuff so yeah it's probably good to exercise the old muscle you know i know i mean it's you know like and we have
00:28:10
Speaker
It sounds started to develop like downtime protocols and things to use so that our teams are prepared for it.
00:28:17
Speaker
But I will say the one nice thing is that
00:28:20
Speaker
on paper, you know, you went home and your work was done because you had to do it on paper that day.
00:28:25
Speaker
You know what I mean?
00:28:25
Speaker
Like you had, you had to write your note and put that in the chart.
00:28:29
Speaker
Yeah.
00:28:29
Speaker
And then you're getting, um, delinquent messages and your, um, privileges are going to get sent.
00:28:35
Speaker
Not just me.
00:28:36
Speaker
Okay.
00:28:36
Speaker
Um, just kidding.
00:28:37
Speaker
Um, just kidding.
00:28:39
Speaker
But I do, if I take work on my delay, that's for sure.
00:28:42
Speaker
Especially anything clinical.
00:28:44
Speaker
I try to wrap it all up in the field.
00:28:45
Speaker
All right.
00:28:46
Speaker
What do you say?
00:28:46
Speaker
One more quick round.
00:28:48
Speaker
um or maybe you let's let end with you and then we'll close i know you started i'm in such a great mood i think i'm gonna let you finish this one one more yeah and that also gives me the advantage when i go back and listen about how how how well i won oh yeah yeah okay when i come back and tell hi and i'm mad
00:29:13
Speaker
I'll remind you.
00:29:14
Speaker
Yeah.
00:29:14
Speaker
I'll just remind you.
00:29:15
Speaker
Yeah.
00:29:16
Speaker
All right.
00:29:16
Speaker
All right.
00:29:17
Speaker
Sounds good.
00:29:19
Speaker
All right.
00:29:20
Speaker
Last one.
00:29:21
Speaker
And again, this is one that you'll know, but I think is important to just talk about.
00:29:25
Speaker
Yes.
00:29:27
Speaker
So true or false, the independence level for NPs and PAs is the same?
00:29:35
Speaker
No.
00:29:37
Speaker
That's false.
00:29:38
Speaker
And this was a great question to ask.
00:29:40
Speaker
Tell us why.
00:29:40
Speaker
And there's so many layers to this.
00:29:42
Speaker
There's so many layers and we will be brief, but.
00:29:46
Speaker
But tell the audience that wouldn't understand what you mean by independence.
00:29:49
Speaker
Yeah.
00:29:49
Speaker
What do you mean by independence?
00:29:51
Speaker
Right.
00:29:51
Speaker
Okay.
00:29:52
Speaker
So what I mean by independence is whether or not they can practice without a supervising physician who's like signing off on charts or, you know, reviewing cases, things like that.
00:30:03
Speaker
And there's so many layers to this because every state is
00:30:08
Speaker
has different, has a regulation around this, right?
00:30:11
Speaker
So every state sort of says, you know, what the requirements are of a physician working with an NP or PA.
00:30:18
Speaker
And it's oftentimes different between an NP and a PA at the state, even at the state level.
00:30:24
Speaker
And so this dictates things like, you know, for PAs, oftentimes they have to have like a supervising physician or delegating physician that they sign an agreement with.
00:30:33
Speaker
In general, more states do allow more independent practice for NPs than they do PAs.
00:30:39
Speaker
And that is at the state level.
00:30:40
Speaker
But then the next layer is that...
00:30:43
Speaker
For us, it's at hospital levels, right?
00:30:45
Speaker
Because we work in the acute care setting.
00:30:47
Speaker
So there's documents at the hospital level, like called rules and regulations, bylaws, and actually your list of privileges of what you're allowed to do that also dictate.
00:30:57
Speaker
Yeah, we just don't walk into a hospital and like grab a stethoscope and a blood pressure cup and say, hey, what's up?
00:31:04
Speaker
In a computer, you've got to go through really rigorous processing for a hospital to trust you.
00:31:11
Speaker
And that's every hospital for those listeners that are not in the medical field.
00:31:14
Speaker
Any hospital you walk into.
00:31:16
Speaker
So you're safe.
00:31:17
Speaker
We're not just walking in.
00:31:19
Speaker
Right.
00:31:19
Speaker
And I mean, that's the same for all clinicians.
00:31:21
Speaker
But for APPs in specific, a lot of those documents will indicate what supervision level is required by the physicians that we're working with.
00:31:30
Speaker
And it can range from
00:31:31
Speaker
you know, both providers seeing the patient every day to the physician's co-signing notes, you know, things like that, reviewing things for quality checks and things like that.
00:31:40
Speaker
So I brought this question up because I think it's important for people to understand.
00:31:44
Speaker
But I also think as an APP, it is important for you to know...
00:31:49
Speaker
what your state and what your hospitals say, right?
00:31:52
Speaker
So my plea, you know, to all of any APPs that are listening is if you don't know what those documents say, then take the time to find out and really understand what the requirements are for your practice.
00:32:04
Speaker
So,
00:32:04
Speaker
Absolutely.
00:32:05
Speaker
And we've gotten into this when we were co-directing.
00:32:09
Speaker
This was a conversation that came up a lot.
00:32:12
Speaker
Sometimes it could be in reverse, right?
00:32:14
Speaker
It's what the hospital allows, maybe at the state level or at the board level, what is not...
00:32:22
Speaker
like what not recognized, we'll say it that way.
00:32:25
Speaker
So it can get really dicey because the two systems aren't, they're not expected to talk and, you know, and make it all make sense.
00:32:33
Speaker
And then if you start talking about going state to state and working between a bunch of states, again, every state has their own flavor.
00:32:40
Speaker
So I love that you brought that up because it's not even just between
00:32:44
Speaker
how a PA practices, how an NP practices, but also how a PA practices state to state and how an NP practices state to state.
00:32:53
Speaker
That varies.
00:32:54
Speaker
Yeah.
00:32:56
Speaker
All of it is, it's, it can be incredibly confusing, but you're right.
00:33:01
Speaker
Like advocating for yourself is the best thing you can do.
00:33:04
Speaker
Cause at the end of the day, it's on you to know what you can and can't do.
00:33:08
Speaker
Right.
00:33:09
Speaker
And like, I didn't even realize a lot of that as a, you know, as a practicing clinician until we came in a leadership position, we were directors together and we were sort of unfolding all these layers together to be like, oh my goodness, there's all these things to read and understand.
00:33:21
Speaker
Well, it's ultimately protecting.
00:33:23
Speaker
I think there's a ton of stuff that we all think we could do.
00:33:28
Speaker
I certainly don't think I could go do open heart surgery.
00:33:30
Speaker
I love procedures, but I'm not a surgeon.
00:33:34
Speaker
Right.
00:33:35
Speaker
But I need to know.
00:33:38
Speaker
in the worst case scenario, did I do what I was allowed to do?
00:33:44
Speaker
Not what I could do, but what I was allowed to do.
00:33:46
Speaker
And that's probably the best way
Episode Conclusion
00:33:48
Speaker
to take a look at it.
00:33:48
Speaker
So yeah, that was a great question to end this one on.
00:33:54
Speaker
Yeah, I think so.
00:33:55
Speaker
It's all over, April.
00:33:57
Speaker
I think I'm just going to stay.
00:33:58
Speaker
I'll just stay down here.
00:34:00
Speaker
I'm going to stay seaside for the summer.
00:34:03
Speaker
How about that?
00:34:04
Speaker
And then we'll have really good podcasts.
00:34:07
Speaker
Sounds good.
00:34:08
Speaker
We'll have very positive.
00:34:09
Speaker
We said through the summer.
00:34:10
Speaker
Good God, you see?
00:34:11
Speaker
It's already Freudian.
00:34:11
Speaker
I know.
00:34:12
Speaker
Through the winter is what I mean.
00:34:13
Speaker
I did hear that, but I wasn't going to call you out.
00:34:15
Speaker
Yeah.
00:34:16
Speaker
Well, you should have called me out.
00:34:17
Speaker
That's fine.
00:34:18
Speaker
I am living in my sunshine glory.
00:34:20
Speaker
And if you guys want to live in your glory, come join me.
00:34:23
Speaker
But if you can't, you can always DM April and I on Instagram.
00:34:28
Speaker
You can follow us at On Call with April and Alicia.
00:34:31
Speaker
Excuse me.
00:34:32
Speaker
That's on Instagram.
00:34:33
Speaker
You can also find us on LinkedIn.
00:34:34
Speaker
And you can find us in our email inbox.
00:34:37
Speaker
It has been so sad and lonely because, you know, does anybody email anymore unless it's about work, work, such...
00:34:44
Speaker
I don't know.
00:34:45
Speaker
But if you want to, it's on podcast.
00:34:47
Speaker
Sound physicians.com.
00:34:48
Speaker
And if you've got some ideas, you tell us what your APP thoughts are.
00:34:51
Speaker
What are some things that you're celebrating this week?
00:34:54
Speaker
What are you celebrating about yourselves?
00:34:55
Speaker
What are you guys celebrating your accomplishments?
00:34:58
Speaker
We'd love to hear that.
00:34:58
Speaker
We'd love to celebrate you.
00:35:00
Speaker
Send us some posts and let us repost you.
00:35:02
Speaker
We'd love to see that.
00:35:03
Speaker
So we certainly love to engage with you guys and really celebrate.
00:35:06
Speaker
And we're so grateful for every APP.
00:35:10
Speaker
I know we talked a lot about hospital medicine.
00:35:12
Speaker
That is our focus.
00:35:14
Speaker
Again, we have CNSs, we have EG, we have NP, we have CRNAs.
00:35:19
Speaker
All of these people deserve to be celebrated.
00:35:21
Speaker
All of these people help make our health care functional.
00:35:24
Speaker
So we are so grateful for all of you guys.
00:35:26
Speaker
I hope that you have the best week ever and that everyone celebrates you and recognizes you for what you've done for all these patients.
00:35:33
Speaker
Absolutely.
00:35:33
Speaker
Everybody have a happy APP week.
00:35:35
Speaker
And until next time, we'll stay on call and you guys stay well.
00:35:39
Speaker
You said it backwards, but we'll take it that way.
00:35:41
Speaker
That's all right.
00:35:42
Speaker
But you stay well and we'll stay on call.
00:35:44
Speaker
That's all right.
00:35:44
Speaker
It's APP week.
00:35:45
Speaker
We're going to give you forgiveness.
00:35:46
Speaker
Bye, everybody.
00:35:47
Speaker
Bye, guys.