<p>I often have students ask me questions about college, and I've heard that there will be changes in 2015 for many health careers. For example, the MCAT format will change in 2015. Aren't there changes in store for nursing education and other health careers? </p>
<p>This forum is full of so many people who are in the know. Because so many career paths take years of preparation, it would be helpful to know ahead of time what changes lie ahead. Perhaps we can create a list of the upcoming health career changes so our high school students know what's in store so they can prepare themselves.</p>
<p>This has already happened in many fields but I think it will happen to more where a doctoral degree is going to be the only one accepted for practice in the field, such as PharmD (Pharmacy) and AuD (Audiology). I’ve heard there are some doctoral degrees for nursing and physician’s assistants – how prevalent is this trend?</p>
<p>I don’t know this for sure and have not read it anywhere, but I think that much of primary care will be done at the nursing or PA level as insurance plans and Medicare/Medicaid look for more ways to reduce costs.</p>
<p>Great topic! There has been some talk about nurse practicioners being required to get a PhD, but nothing official yet. </p>
<p>There are a few BS programs for physician assistants, but most have moved to masters degree. LECOM (Lake Erie College of Medicine) just began offering a bridge program to PA’s, where they can receive a D.O. degree in a shorter time.</p>
<p>Payment for physician services has declined substantially over the past 40 years. This has been mitigated by efforts to increase productivity and a move towards specialization into fields with procedures for U.S. graduates. One way to increase productivity is to use lesser trained and paid staff to provide services when that is reasonable. When I was a kid my dentist cleaned my teeth but now a hygienist does that and the dentist pops in for the final five minutes of the visit. Physicians will increasingly be used for diagnosis and determining a treatment plan and all the efforts to collect that data beforehand and implement that plan will likely be largely delegated. Becoming a physician assistant after four years of college and a two years master is a very attractive profession.</p>
<p>With regard to the MCAT changes you mention above, there will be requirements for biochemistry, statistics, and psychology that are not needed now. Some schools are revamping their pre-med track to include those courses or just tweaking existing classes.</p>
<p>The changes in healthcare and insurance, for those planning a career in medicine, the cost of obtaining this training will not be as attractive if even worth it.</p>
<p>Right now insurance companies dictate a doctor’s salary. With the lawsuit against IGENIX and United health care, those which have out of network benefits, really better not use out of network providers EVER. REimbursement rates will now and forever be medicare based, so anyone with a $20,000 a year health plan will be worthless. </p>
<p>This pricing model will force newly licensed doctors to be employees of hospitals, unable to ever afford to begin a practice.</p>
<p>What about the training of various health careers? For example, the CNA certificate is just 75 hours of training, which I know is a stepping stone for many young people to get health care experience to become PA’s and MD’s, during their undergraduate degrees. </p>
<p>This is a path my oldest daughter did on her way to a BS in Nuclear Medicine, as the university she attended required hundreds of hours of patient contact before admittance. She was told that the 2 year Nuclear Medicine associates was to become obsolete in 2015.</p>
<p>My middle daughter got her Pharmacy Tech certificate in less than 100 contact hours. This was to allow her to have a better part time job while in college. Now I’ve noticed the same community college she attended while still in high school has made that program a 2 year associates. I’ve heard that in 2015 RN’s will be required to hold a BSN. Is this true?</p>
<p>For example:
CNA=75 hours
LPN=1 year
RN=2 years
BSN=4 years
Pharmacist-7 years? (use to be 4-6?)
Audiologist-7 years? (use to be 6?)</p>
<p>Can we make a chart of the various health care career paths and what is required and the possible changes you know are going to happen? I know there are students out there who need to plan ahead, as the cost of attendance is making for careful planning.</p>
<p>CNA=75 hours
LPN=1 year
RN=2 years
BSN=4 years
Physician Assistant=5-6 years, patient contact varies greatly
Pharmacist-7 years? (use to be 4-6?)
Audiologist-7 years? (use to be 6?)</p>
<p>In the nursing profession, I think we will see a regression in requirements. Hospitals (and some are already doing this) will hire a small number of BSNs to manage a much larger number of LPNs and CNAs. There will be expanded practice for non-RNs, as there won’t be enough RNs to go around, and they cost too much. In our state, there is no expansion of BSN programs, but a huge expansion in two-year RN programs.</p>
<p>On the whole, in order to deal with the rush of new patients, people with less training will end up doing more and more.</p>
<p>Right now, there is a gambit being played by the insurance companies and the hospitals for complete control of access to care by driving independent practices out of business. Insurance companies are lowering reimbursements to independent practices, while keeping reimbursements to hospital owned clinics the same or increasing them. What is happening is a real shame - people needing healthcare will be rationed to what is “medically necessary” as deemed by the insurance company. I don’t know the exact numbers, but 20 years ago about 85% of physicians were independents. Now, its 44% and shrinking rapidly.</p>
<p>There has been talk for years about raising the minimum requirements for many healthcare workers, partially because, right now, colleges can not charge a premium for what is potentially a more lucrative career. I know some NP programs have gone from 2 years to 3, but with no added coursework, granting a DNP instead of an MSN.</p>
<p>We will see a change to the English system, where you either get the “insurance” plan or you pay cash for the independents, who will be force to set up boutique healthcare clinics catering to the wealthy. For now, it is still a pretty good time to get sick. 10 years from now it will not be.</p>
<p>Tasks formerly performed by nurses will now be performed by CNAs. Some states have actually proposed expanding CNA practice formally, but since they will go through nursing boards, the changes will be resisted. But this won’t prevent hospitals from having some activities formerly performed by RNs now shifted to CNAs.</p>
<p>Healthcare schooling and reimbursement are getting out of hand.</p>
<p>I recently looked at the new AUD- Doctorate of Audiology that is required to practice. Comparing the “new” 3 year, plus one year for accreditation hrs, looks like I took more classes to get my M.A. then they take now. Also, they get credit for clinical, we did that every semester for non-credit hrs in addition to the 15 credit hrs we were taking. This change is a joke… an expensive one at that. </p>
<p>No reason why most classed can’t be taken undergrad and fewer filler (60 credits) of electives and gen eds. My engineering son has no elective hrs, few gen eds and all the rest double engineering major whish is harder than all these undergrads (in my opinion). He’ll graduate in 4 years with two B.S. degrees for the cost of 4 undergrad years. Many M.A. degrees could be completed as B.A./B.S. degrees if they would alter this. If they can do it for engineering, why not everything else?</p>
<p>One of the hospitals I worked at about 15 years ago tried that, it was a DISASTER.</p>
<p>Nurses Aide’s as they were called, were given a 2 month course and were delegated to doing many of the RNs jobs. Insert foley catheters, blood glucose monitoring, dressing changes etc. The infection rate SKYROCKETED. </p>
<p>It also had an LPN training program. Believe me old school LPN trained nurses are great nurses, this particular program was shoddy. Another disaster.</p>