text:
Tuesday, April 20, 2010
I hope this link comes thru...The site is Sermo,a medical blog had this post yesterday...
And if that don't work just look up Sermo site and it's under Ethical Postings..
PA's need a high colonic on the way out the door!!
68 comments:
- H the IH (who has a Ph.D., but doesn't want to be called "Doctor")11:58 AM, April 20, 2010
OF - why is this griping your wagger? I have worked with (both as a patient and professionally) a number of PAs and found them to be quite a professional bunch. Most importantly, they understood what they didn't know and would immediately consult with their supervising Doc if they needed to.ReplyDelete
In other words, they seemed to be more of an "associate" than an "assistant." And does it really matter? If so - why?
The one that spins me a little are the RNs who have Ph.D.s and want to be called "Doctor." Where I come from (University-o-Midwest) the title "doctor" was reserved for:
1. In casual, non academic conversation - physician only.
2. On campus - any professor/non-graduate student teacher.
3. In the docket/depo for Expert Witnessing - any Ph.D./M.D. type.
A Ph.D. type, outside of academics or experting would never expect to be called "doctor."
I get why it chaps your ass you old-school dog. It chaps my ass for a different reason... for all I care they can call themselves Kings of the Known Universe... don't care. But, under O-care, and within ten years, PAs and probably NPs will be independently practicing in ERs and hospitals and clinics. Docs will stick at the large centers and their relevancy will decrease. For a while our jobs will be to unfuck a lot of medical silliness, but then what? In my little slice of heaven there are two PAs who practice in independent offices and they send their charts 100 miles down the road for review by a 'doc' within a month. There is also a chiropractor 'practicing' in one of the rural ERs not too far from me. I'm not kidding you. From the forest itself comes the handle for the axe.ReplyDelete
If I ever have a chiropractor try to treat me in the ER, I might just throw a fit.ReplyDelete
On another note, don't hate me OF, but I'm tossing around the idea of PA school. I'd do medical school, but it wouldn't be nice to my kids and I'm holding out for Obama to make education a right so I can go on your nickel.
I've got about 13 classes before getting my Zoo/Ent degree finished up :-) Can you tell I'm excited?
- Anonymous2:04 PM, April 20, 2010
Dont be hatin' on the Chiros Amy, there more useful than a Shrink or Neurologist....Cardiothoracic PA's the way to go, you get to crack more chests than Jeffrey Dahmer, Ted Bundy, and the BTK killer combined, dissect out saphenous veins, radial arteries, do most of the work on CABGs, while the MD takes the brunt of the malpractice exposure..Sure you might have to pencil whip a ton of H&Ps inbetween cases, but every specialties got its cross to bear...ReplyDelete
13 Classes??? thats like a whole year...
Here is my deal....I used to work with 911doc and I work with alot of PA's and NP's in the ED. They do alot on their own but they ARE assisting the MD in most aspects. If they want to go and say that they are an "associate" of the physician, then I think maybe RN's should change our name to something like that too because we are "associate" of the MD's as well. I totally get where you are coming from, you go thru a shit-ton more school and training to get where you are, as a PA they do as much school as I did as an RN! YOU are the one respoinsible for them so they DO assist you.....these 50 people just need to get over themselves, if they dont want to be an "assistant" then they should have put the time into being an MD.ReplyDelete
Dear Brayden's Mom,ReplyDelete
Whazzzuuuup? How's your little man? Your post made me want to add this... I have worked side by side with many PAs in a few ERs... One's that can't hang do nit last, those that can can treat me or any of my family.
I also think that the reality of O-care will force us, shortly, to call them "Physician Apprentice". Mark these words.
Guys you are making my case and I got all the LUV4U..ReplyDelete
Brayden's Mom. This is my opinion but there is a HELl of a lot of difference between "assistant" and "associate" I'm fighting it now from my administration who wants to have an "assoc" not an "asst" whatcha-ma-call-it..
To me an associate is some one who is as COMPLETELY as responsible for the output/product as me. But that ain't the way it happens in academic medicine..The "assoc" always lays in wait for the Big Dog to go DOWN and then they get the position..Despite the fact that an "assoc" should be equally as culpable for whatever the problem may be..
That's what happens in the real world. I'm sorry if you don't live in it..
I luv u B's mom..really You're up front..just listen to the experience here-in..OF
hey OF,ReplyDelete
you should have told me you were fighting with clipboard people... now I feel ya brah! agree with the fact that words mean things but we live in Orwellian times. eventually all that is understood is a punch in the face...I call it "non-verbal instruction".
good post,thanks a lot.ReplyDelete
- Anonymous5:17 AM, April 21, 2010
C-C-C-C-C-C- aint we all just g-g-g-g-g-g- et along...ReplyDelete
Divide & Conquer, same strategy the damned Yankees used to win the Wah of Northern Aggresssion...Thats there plan, get the RNs fighting the MDs, DOs fighting the Chiros, PAs fighting the NPs, while the Northern Devils burn down Atlanta and steal our slaves...
You wanta pick cotton the rest of your lives, be my guest...Dont argue...ORGANIZE!
and I ain't talkin no AMA organization, I want a group that'll make the KGB look like Greenpeace, the Teamsters look like a girlscout troop, you get the idea...
When even the President(Peace be upon Him) has to cross a picket line to get his lung cancer treated, maybe they'll get the message,
- priceless19:43 AM, April 21, 2010
You go, Farty!ReplyDelete
Have you read recently that NP's want to be called....DOCTOR. After all...chiropracters and PHD's are called doctors...so they think they should be tooReplyDelete
"PAs are held to the same legal and medical standards as physicians.".....In our ER, we have PAs work the fast track. The attendings name is attached to EVERY chart. So if something goes wrong....guess to get's sued??? Of course the doc, even thought we never saw the patient.
Let them have the titles they want if they don't hang our ass to dry when they fuck up. I don't blame them if I fuck up.
-ER Doc
Dear ER doc,ReplyDelete
now you have ruined my evening... NPs? "Doctor?" NPs? in what universe do they live? about 20% of the NPs that have worked in our fast tracks have survived as opposed to about 70% of the PAs. i don't object to them being called 'doctor' as long as it is said sarcastically and while suppressing a laugh. to the two NPs i know and have either recently or currently work with please ignore this rant.
- Anonymous8:08 AM, April 23, 2010
Thanks for stirring up my PTSD 911....ReplyDelete
"Being called "Doctor" said sarcastically while suppressing a laugh"?? That pretty much summed up my whole Med School/Internship/Residency experience...
after scoring "42" on Physiology Test first year... "Nice work, "DOC-TOR"...
after missing IV Steven Hawkins could have made... "Nice Stick, "DOC-TOR"
after putting ETT Tube in Esophagus... "Nice Intubation "DOC-TOR"
After putting Chest Tube for Iatrogenic Pneumothorax on wrong side...umm noone saw that one...one of the beni's of being on ICU call by yourself...
- Anonymous1:56 PM, April 24, 2010
Anyone who thinks that PA school is somehow the same as nursing school needs to have their head examined. They are completely separate entities and approaches. PA education is overseen by 5 different physician organizations, and is based on the medical model of diagnosis and treatment. Bottom line is, if you don't want to work with a PA (Physician Associate) then don't. Otherwise, take your old-school head out of your wide-load ass and move aside for those who are interested in continuing to get the job done as a team. Oh and, btw, many PAs already do practice independently, albeit still with Physician supervision as that is the model of their work. Maybe you think that PAs are there to bring you your coffee or take a history before you come in, but if that's the case then you need to educate yourself and refrain from commenting until you do.ReplyDelete
- Anonymous2:56 PM, April 24, 2010
A bunch of MDs top of the food chain crying about a name change? Nice....ReplyDelete
BTW how do you docs feel about working along side Doctor Nurse Practitioner Smith? Plan to hire some Doctor nurses for your practice? Let's see how your patients like that lol
And the only time a PA really "assists" is in surgery when they first assist. If you have your PA carrying thier own patient load, covering your office when youre out golfing or sailing the seven seas, covering your rounds and taking call for your office then they are an associate.
In a practice AND er a well trained PA not only reduces the load of MDs but can also generate additional profit by increasing the amount of patients that can be seen. A PA can add a few hundred thousand in additional profit to any practice just as a partner MD could only difference is a PA costs less.
A MA cant do that, an RN cant do that--only a PA or an NP can do that. The sad part is that simply because of the "assistant" attachment to their name people confuse them with medical assistants---all they want is recognition for the what they truly do and that is NOT being a medical assistant.
And we have a winner!!!Come on out of that closet you faggit PA. "old school head"?? "wide load ass"?? OMG, I am bleeding profusely from those zingers, boy howdy. How long did it take you to get your GED so you could go to, drum roll please, PA school? And just how does one get into PA school? I can see the personal statement now of how you have always wanted to help people, your dad was a PA, you saw a PA save someones life as a small child and never got over it, and, oh yeah, I couldn't get into EMT school much less Medical School!!!ReplyDelete
And you are right, I really did think you were for getting the history before I got there. I'm the fuckin' DOCTOR!!!!
Now get back under your clipboard until we need to have fun at your expense again..phaggit
hey douchebag anonymous beginner reader,ReplyDelete
try reading all the comments... try to get your mind around the concept before you go off and make a fool of yourself and give PAs a bad name. the ones i know are a credit to their profession.
then again, maybe Oldfart wants to kill you. he can, with only his thumb.ReplyDelete
dear 'yourmother',ReplyDelete
yes, i deleted your comment at it was gratuitous and was obviously written without reading the post and comments. go get your own blog.
ad-hominem, non-sensical attacks will be immediately deleted. hey PAs, either you are being punked by pretenders or you have some in your ranks who should never be allowed near a patient.ReplyDelete
- Anonymous10:12 PM, April 24, 2010
lol oh yea, because someone calls them a "phaggit"? dude, do you realize how STUPID you look? no one gives a shit what you think, trust me.ReplyDelete
- Jeff Topfer12:46 AM, April 25, 2010
"ad-hominem, non-sensical attacks will be immediately deleted"ReplyDelete
"Come on out of that closet you faggit PA." You mean like this?
since it's our blog we can do whatever the fuck we want asshole, but trolls, well, we do whatever the fuck we want to them too.
and anonymous,
you are wrong, if 'no one gives a shit what [I] think' then why are you writing a response to what i think? now go picket for change in your professional nomenclature so you can get that GIANT FUCKING CHIP OFF YOUR SHOULDERS or go to medical school, but that's like, four years right, and then you have to do like, three or five years of some kind of 'residency' thing and all... that sounds bogus, i'm going to get my PA online.
- Anonymous8:57 AM, April 25, 2010
Too bad you CANT get your PA degree online... there are a few online programs for ALREADY PRACTICING AND CERTIFIED PAs that received BS degrees for their education. Please do research and look at admissions requirements before you show your stupidity and misinform the public.ReplyDelete
- Anonymous9:06 AM, April 25, 2010
I'm a PA student getting close to graduation in Boston. I hate to see this kind of animosity over the name change situation, and just over PAs in general. I don't think people should lash out over the blog posts comments. I just think that this is simply an attempt by the PA community to return to its original name. Most people really aren't that concerned with this. I am thankful to be able to study and learn in a medical community as strong as Boston. I have only seen teamwork and respect from all parties involved in treating patients. I will say that the only thing I do take offense to, and I am sure that I will be ripped apart for this, is the statements about PA education. I was accepted into a program that had over 1200 applicants and only accepted 40 students. This same program had over 2200 applicants this year with around the same amount accepted. I have a huge respect for physicians, nurses and nurse practitioners. I also know that this educational experience has been extremely difficult and it by no means isn't the same thing as going to school online or becoming a medic etc. Anyhow, I know none of you really care about what I'm saying. I just want to let everyone know that the majority of PAs/PA students are sensible people who could care less what they are called, just as long as we can do a good job for the patients and for each other in the team. We obviously couldn't practice medicine, nor will we ever practice medicine, without being part of a physician/PA team.ReplyDelete
Ah, well, now I understand where this is coming from. I think there is a lot of confusion on this blog about what a PA really is. You all seem to be confusing us with a medical assistant or a clinical assistant, which is completely understandable given our name.ReplyDelete
In reality, the PA degree requires 3 years of INTENSIVE medical training AFTER a bachelor's degree. For those that wish to specialize after graduation, there are residency programs and fellowships. Our educational model is the same one used to "fast track" physicians through medical school during WWII. We are taught and trained by physicians to work with physicians (and the other members of the health care TEAM). We have decided as a profession NOT to give in to "degree creep" and do not have a terminal Doctorate degree, outside of the military. Those of us with doctorate degrees do not refer to ourselves as "Doctor" outside of the academic arena.
PHYSICIAN ASSOCIATE is our original name, bestowed upon us by our founding father, Eugene Stead, MD at our founding university, Duke University (yes, the one in Durham, NC), and is still the name given to the graduates of one of our original PA schools -- Yale University (yup, we have Ivy League schools, too). Our name was changed to "Physician Assistant" years ago under pressure from the AMA.
You CANNOT get a PA degree online. You CANNOT get a PA degree from a Caribbean Island. You cannot practice as a PA without being Board Certified and our boards are written with the assistance of such physician organizations as the American Board of Medical Specialties (ABMS) and the American College of Physicians.
As a profession, we DO NOT nor ever have wanted to practice independently of a physician; we do, however, practice and function much like a junior or senior resident (only we don't call ourselves "Doctor"). So as you can plainly see, the title "assistant" does our profession a disservice -- just look at your own posts. We simply want our old name back, a name that will better reflect what we do, a name that distinguish us from the physician's assistants (medical assistants and clinical assistants).
I've worked with some good PA's and some good NP's. I practice in an under served area, so we have a fair number of "physician extenders". It chaps my butt when patients call them "doctor". I am very quick to correct them.ReplyDelete
This goofy name change was dreamed up by someone with a serious inferiority complex. Point remains that PA's ASSIST a physician. My partners are my ASSOCIATES.
i am well aware of the requirements to get a PA degree and that some programs do a little more and present a 'masters of medicine' degree.ReplyDelete
i did not know, for a fact, that you could not get your PA degree online, and was confused, so i do offer my apologies. as a matter of fact, you CAN get your NP online which is why, if you will read my post a few above, i much prefer PAs to NPs out of the box.
but the point really is, as it is with physicians, can they do it? are they good? erdoc85 is right, an associate is a co-equal, PAs, for all their worth, are not the co-equals with doctors. i don't know why you guys want to go down this road except that it obviously is a chip-on-the-shoulder issue and you've met some docs (and there are lots of 'em) who aren't really that good at what they do. you then make the logical jump to 'there's no difference between what we do', but it is a false jump, especially when you start adding in procedures and critical care and surgery.
and you can stack up your 2-2.5 years of school after college to our four years and then residency all day long and it will still look like a duck, and quack like a duck.
assistant (dictionary.com)ReplyDelete
1. a person who assists or gives aid and support; helper.
2. a person who is subordinate to another in rank, function, etc.; one holding a secondary rank in an office or post: He was assistant to the office manager.
3. something that aids and supplements another.
4. a faculty member of a college or university who ranks below an instructor and whose responsibilities usually include grading papers, supervising laboratories, and assisting in teaching.
associate: (dictionary.com)
1. a person who shares actively in anything as a business, enterprise, or undertaking; partner; colleague; fellow worker: He consulted with his associates before proceeding further.
2. a companion or comrade: my most intimate associates.
3. a confederate; an accomplice or ally: criminal associates.
4. anything usually accompanying or associated with another; an accompaniment or concomitant.
5. a person who is admitted to a subordinate degree of membership in an association or institution: an associate of the Royal Academy.
i think aside from the tertiary and quinary definitions of 'associate' that assistant is much more useful and correct. you guys have a huge, huge chip... rodney king bitches.
As a PA I think the name change is a matter of respect not an attempt to act as a comparable with MD's. While i personally don't believe the name change makes a big difference b/c I will still have to explain what a PA is either way. Besides it makes no difference to me as long as I can provide the most effective care possible to the patient. I in no way believe my knowledge compares to that of an MD and when I am in a clinical situation I don't understand I always ask. I believe this is true with most PA's. The profession is designed so that we provide care in conjunction with doctors not in place of. When the issue of making the PA profession a doctorate degree came up it was out right rejected. So the model continues to be a team approach.ReplyDelete
I do not see how the name change garners any additional respect. The fact that anyone thinks so earns them less in my book.ReplyDelete
Respect is earned.
- Anonymous5:18 PM, April 25, 2010
Shame on ya'll. We are healthcare PROFESSIONALS!!! Having pride in your work and having a pissing contest are totally different things. If you docs ever want me to listen to a word you say, then you should try acting like a respectful, concerned and responsible adult. No one is "better" than anyone on this blog. There are too many factors that go into peoples decisions on education and career choices for some "high and mighty" to carelessly bash others professions. Please, think before you speak or type. Just as every PA must watch his P's and Q's to uphold the validity and respect of their profession, MD's should do the same. As for as the assistant/associate controversary; I would prefer the asscociate title, but could care less. Under your description, we should bunch together RN's,LVN,NP's,PCT,PA and everyone else into an assistant group,right? Wrong. PA do assist but they do more than what the public would think and thats why the profession is seeking the change. How would you feel if you finished undergrad, med school, residency and speciality and people didn't put up on your pedestal that you now stand on? You would probably scream and cry and wet your pants. Bottom line is we all are intelligent people who have curiousity and a drive to help others. Basically we've used that drive to memorize a bunch of shit and regurgitate it on demand. Let's not act like a bunch of jerks.ReplyDelete
I disagree, 85 & 911. I believe that to a certain extent respect is deserved. That "MD" and "doctor" are terms reserved for a very few people who have completed a path that from the very start is extremely hard both mentally and physically. When you awarded an MD degree and the title "doctor" that goes with it, it does indeed make that person deserving of some magnitude of respect. And an attending physician deserves the respect of an intern or a resident physician, as he has withstood the mental and physical rigors of a path that they have yet to complete.ReplyDelete
And I am speaking of the US medical education only...
That was until the 90's when medical schools began try to make their school classes look like the population of the general public. Now entering classes have a gender norming make up of about 50-50 men and women and soon it will be a majority of women. And you don't really want to know the rest of it..I guess what PA's call themselves is really not worth the little bit of thought we've given it here..
This new "healthcare" legislation is but the last arrow into the heart of medicine not the first...
dear OF,ReplyDelete
i think that erdoc85 and i are not in disagreement with you. sure you get a certain amount of respect (or should) from the medical community or your patient (in the old days) with "MD" alone, but past the first interaction the respect is either built or destroyed based on your actions. thanks for fighting this fight i think you are brave to do it because the PC movement has made this kind of discussion obscene on the public square.
and as for you anonymous, you are a fool... cont...
dear cloyingly patronizing 'anonymous' person sort of claiming to be a PA,ReplyDelete
"If you docs ever want me to listen to a word you say, then you should try acting like a respectful, concerned and responsible adult. No one is "better" than anyone on this blog. There are too many factors that go into peoples decisions on education and career choices for some "high and mighty" to carelessly bash others professions. Please, think before you speak or type."
"How would you feel if you finished undergrad, med school, residency and speciality (sp)and people didn't put up on your pedestal that you now stand on? You would probably scream and cry and wet your pants."
"Bottom line is we all are intelligent people who have curiousity (sp) and a drive to help others. Basically we've used that drive to memorize a bunch of shit and regurgitate it on demand. Let's not act like a bunch of jerks.
PS IF THAT WAS YOU MOM, PLEASE STAY OFF MY BLOG.ReplyDelete
- Anonymous7:41 PM, April 25, 2010
Did you call me 911? HA, wasn't me.ReplyDelete
Amy, do the Cardiothoracic PA gig. Saw 3 open hearts tableside. Too late, but if I could I would. Surgery is the only reason to PA IMHO. But skip the ortho, you'll just spend your time holding some big guy's leg in the air for half the surgery and then end up popping it back in the pelvis once the surgeon gets the hardware in -- totally like popping a barbie doll's leg back in, so you've been there done that, ho hum ya know.
- Anonymous8:44 PM, April 25, 2010
I am not a PA. Just a passerby. But, I must say that respect must be earned. I can respect you as a professional because of your completion of a difficult journey that decided to take, but when you name your blog "PA's can suck my dick" I instantly lose all respect for you as a man. Why don't you call it "the people I have to give free health care to that don't give me any respect can suck my dick"? That's the point I'm trying to make. Why bash an entire profession because they want to feel a little more respect than they are given. I agree with opinion that MD should be the DR's in the clinical setting. Noone else. Period. Let's keep it cool and try to make sense of the mess that the US healthcare is in. Whether or not anyone likes it, NP's and PA's are going to crucial in Obamacare. With all due respect 911, how do feel about the role of mid-levels in the forthcoming changes in healthcare?ReplyDelete
- Anonymous8:49 PM, April 25, 2010
And if I were a PA, of course, I would listen to you in a clinical setting but this is a blog. I was talking about listening to you as another human being not a doctor.ReplyDelete
- Anonymous9:09 PM, April 25, 2010
Actually I know alot about not receiving any respect, much less enough respect. I'm a medical microbiologist(med tech). When I tell people that I'm a med tech, they say; "oh, so you draw blood?" or "oh, you drive a ambulance?". We are usually at the bottom of the food chain for some crazy reason. My undergrad curriculum was basically pre-med(organic chem,biochem,physics,genetics,immunology,cell biology, molecular,etc..) and I still get talked down to by LVN's on a daily basis. So, I apologize if I've come off as being coy, but I'm about fed up with the disrespect. Just like every profession, there are some med techs that have "fallen through the cracks", but most of my coworkers are unbelievably intelligent and collaborate daily with physicians,infection control,transplant,etc. I basically would like for the hospital environment to be a more respectful institution, instead of everyone trying to act like they are better and smarter than the next guy. That's it. Plain and simple.ReplyDelete
What an idiotic post. For the record, after becoming a PA, I thought about going back to medical school, I passed my MCAT's, and was accepted into two separate programs. I decided not to go. The title assistant is anachronistic, and outdated. It implies a lack of training, and a person that can complete only a limited number of tasks. As an EM PA, I practice rather independently. One ED I moonlight at, is staffed ONLY by PA's, there is no physician on site. Why? Because the volume is too low to justify a physicians salary. Am I "assisting" anyone? No. But I am not a physician either, and have never claimed to be, however, I feel that with a decade in practice now, that I can handle about 95% of what walks through an ED's doors on my own. NOTE, that is not 100%. Also, to the person bemoaning the liability exposure. This is changing, IF a PA sees a patient, and the physician did not lay hands on, or know about the patient, or the encounter, then they are starting to often be dropped from the suit, leaving the PA exposed alone.ReplyDelete
For me, I am completing my Doctoral, but not in clinical work. I am strongly involved in health policy work on the national level, and am beginning to develop a reputation as a workforce researcher. In those two environments, that title will be used, and helpful, but NEVER in the clinical environment. Speaking of workforce issues, current predictions estimate 212,000 physician openings by 2025 from the BLS, and my friend and colleague Ed Salsberg at AAMC, estimates a shortage of 125,000 physicians by 2025, with a significant percentage being in primary care.
I would get off of the holier than thou concept however, it does nothing but paint you as an unprofessional, incompetent jerk who is railing against the wind. Perhaps you could give us a list of some cogent reasons WHY you opposed the name change? Then perhaps we could have an adult discussion. Lastly PA's are expanding into all kinds of areas. Susan Edgman Levitan is the Executive Director and founder of the John Stoeckle for Primary Care Innovation, she is also a PA, Catholic Healthcare West, which is one of the largest healthcare systems in the entire country, well, their COO and EVP, Bill Hunt, is a PA...I could go on and on with dozens of other examples, but the point is, that we are no longer some little scut monkey to have in the back of the office, if we ever really were.
anon. 8:44 and 8:49,ReplyDelete
if you will read the initial comments to this post, and I DID NOT WRITE THIS POST, then you will have your answers, but here they are.
my ER could not function without it's excellent PAs and NPs. on a personal level, if they want me to call them 'emperor' or 'your higness' then that's what i'll call them, but that, as oldfart knows, is not what this is about...
if PAs, as a group, want to change to being known as 'associates' then there are two problems...
1. since words mean things and have consequences, especially and perhaps solely, in this case, the PAs pushing for this already know how they are respected, or not, at work. if they are not respected where they work, changing their titles will not bring them the respect they seek and they know that... so, what this is about, is a cynical bit of incrementalism. it is about positioning themselves to capture the public (non-medical) world's belief that they are "just like doctors" and can therefore make more money and power and begin practicing indepependently. this will amount to misrepresentation and people will suffer because while there are PAs who could absolutely have kicked my ass in medical school or residency training, they did not, because they weren't there, and their on the job training has never included the most intricate or dangerous of medical procedures. for instance, while, at my present facility, the PAs do almost all the suturing and are, therefore, better than most of the docs at doing it, NONE of them intubate or run codes (care for dying patients), and that's the way it is. they are 'just as good' at lacerations, but, by necessity, are not even in the ballpark, for life and death stuff. similarly, while they may be 'just as good' as the cardiac surgeon at harvesting veins from the leg, they can not, and will never be as good, at stopping the beating heart and bypassing diseased vessels. if they want to do it, UNLESS THE RULES ARE CHANGED, then they will have to go to medical school, and this gets me to point two...
2. as i said in one of my early comments, if i were the PAs i would just go 'all in' and push for a title change to 'physician apprentice' because that's the only way this makes sense. they are positioning themselves, with this little ploy, to step in when O-care kills medicine and docs like me quit (if you are new to the blog it's a running theme... three of the board certified ER docs on this site alone are quitting mid-career because it's just not worth it in any sense any more). in this regard, i hope they win, because they, as a group, are better trained to do independent medicine than the NPs who are trained in the nursing model, and are therefore trained to follow.
the NPs i work with in the ER and the PAs i work with in the ER are excellent in every way, and, as i said earlier, i would let any of them care for me or my family any day, any time. but that's not what this argument is about.
and if you doubt that words mean things and have consequences, then simply visit your local 'hood and say the following... 'white power!' clayton bigsby did it, and so should you.
There are so many parts of the legislation that are illogical. But the promise of health care to everyone with no thought of how to deliver it would be considered malpractice in my profession.ReplyDelete
There are only 3 ways to increase the number of care providers:
1) import more foreign doctors
2) mandate increased med school class sizes
3) increase numbers of non-physician medical professionals & allow them more autonomy to treat & manage patients (PA, NP, RPh, DC, etc).
I believe all 3 will happen with an increase in mistakes and dissatisfaction.
I don't consider my worth by 85% of what I do. Indeed, I could delegate that to someone else. I earn my keep by the other 15% and KNOWING THE DIFFERENCE.
dear PA who signed your name,ReplyDelete
you can pile up your names and examples of all the neato things that PAs have done in the twenty or thirty years you guys have been arounhd and still not understand i am not arguing with you... but simply because your farts smell like strawberries does not mean that every PAs farts are like yours.
get the chip off your shoulder because it sounds like it's a big one... and you made a decision NOT to get an MD... seems a little late to be upset about what you are called.
thanks for covering the ER, get used to it. American this is Obama care, you better hope michael is as super a PA. as he says he is, your life is in his hands, and he is definitely a PHYSICIAN ASSOCIATE. perhaps we should come up with a new abbreviation too?
dear microbiol. tech,ReplyDelete
thank you for what you do. i hope that it rains unicorns too, and soon. O-care is passed so it should happen shortly.
in all seriousness, if you are that hung up on how others perceive you and treat you then you are giving them power over you. only you have the power to make yourself 'feel bad' or 'disrespected'.
Totally agree that respect is earned and not in a title.ReplyDelete
dear bayle,ReplyDelete
i respect that.
Actually 911, I don't disagree with you, I was rather arguing the OP, which was rather tasteless. I don't believe the title change will accomplish everything. Will it help, probably. Is it some panacea that makes everything right in the world? Not at all. My "chip" has to do with condescending comments by physicians. Such as the one suggesting an increase in errors. Surely, after 40 years of PA's in practice, we would see a higher malpractice rate on common medical mistakes, right? We would see lower patient satisfaction surveys (not that they are worth much, but still in the bigger picture) across the board with PA's right? Surely, the AMA would have reams of data proving conclusively that PA's provide inferior and substandard care, right? The fact is none of that exists.ReplyDelete
In my health policy role, I was at a Symposium last year on Health Care Education Reform. All the big players were there, heads of AMA, AANC, AAMC, etc.etc.etc. One of the common themes coming out of this meeting, was to tear down the silos in medical education. Nursing and Medical students should take SOME of the same courses....Medical students should be graded not only individually, but a large part of their grade should be based on how the TEAM performed. Oh, and they also discussed shortening medical school, to a 3 year format.
The Dean of Emory's medical school, talked about changing the way medical care is delivered, and now longer should it be in a heirarchal structure, but rather, it should be in a circular, team concept, where each member of the team is equal, and at certain times, each member may be best suited to be the leader, and it may not always be the physician.
THIS WAS OTHER PHYSICIANS, and the leaders in the medical academic community saying this. I was merely a participant.
I do more than merely suture in my ER, and have done more LP's than I care to count, have intubated on many occasions, participated in level one traumas, and codes, and even ran some codes at smaller hospitals...but guess what, that still doesn't make me a physician. But, I would say, that I'm not just an "assistant" either.
BTW, procedures are nice, I taught an MS IV how to use the ocular burr the other night, but knowing WHY, and WHEN to do the procedure is a million times more important. YMMV.
Oh, and lastly, I would just add, that Dr Eugene Stead, the founder of the PA profession in 1965, initially WANTED us called physician associates. The AMA opposed it at the time, and having no money, no graduates (yet), and no political power, we compromised at that time. Yale's PA program STILL calls their graduate PA's Physician Associate, and the Yale-New Haven Hospital does as well. We just want to return to our roots. It was intended to be the intial name of our profession, and 43 years after the first five PA's graduated, we want to return.ReplyDelete
Call yourself what you wish. No offense intended, but by definition you will still be my assistant. But I do appreciate what you do.ReplyDelete
I feel certain that the roots of this name change involve an attempt to put the PA on a more equal (thus associate) footing with physicians, whether you realize or acknowledge this or not. Why else is this ridiculous notion just now becomming an issue after 43 years? Coincidence??
Though your respect with most health care workers will be earned and is not inherent in a silly title change, sadly I believe this to be irrelevant. If the healthcare debate taught us anything, it taught us that in our current culture, people will listen and respond to "feel good" and "emotional" arguments while ignoring all logic, reason, and forethought.
Have heart. Us cranky Docs on here might never call you our "associates", but I strongly suspect that healthcare reform will have more and more patients calling you "doctor".
Er Doc, the impetus behind this has nothing to with respect from physicians, that is either earned or not, and for the most part, I could care less what they think. What my patients think is infinitely more important. I believe that I have already earned the respect of the phsycians I work with. I am frequently called a "colleague" to patients from the attendings, and senior residents have, on more than one occasion, told me that I function at the level of a senior resident, if not a junior attending. Does that make me a physician? Nope, but I'm sure as hell not someone's "assistant". And the name change is not a "new" issue, it has been visited about every 6-10 years in our profession since it's inception, not new at all.ReplyDelete
Even in my role in health policy, I once had a meeting on the hill with a congressman, who opened the meeting by stating "If you are a physician('s) assistant (got it wrong right from the start) WHY am I seeing you, and not your physician?" Needless to say, education was in order.
911, words DO matter, titles matter, and just being an MD does not grant you respect. There is variation in the physician profession, just as any other. I know PA's I would trust implicitly with my daughters life, and I know MD's I wouldn't trust to treat my dog. Like, I would kick them out of the room if they were assigned to my family.....AND VICE VERSA, I also know PA's who I wouldn't trust to treat anything, and MD's who I wouldn't hesitate to let treat my family.
In Minnesota, we finally got rid of that annoying title "Supervisory" agreement, and have now drafted up a "Delegation" agreement. Still not what it should be, Collaboration, but it's a start.
dear michael,ReplyDelete
best of luck.
- Anonymous4:39 PM, April 26, 2010
I don't know why any Physician Assistants here are offended. These doctors (if they even are ones) are like spoiled children deserving of time out for not having basic manners. Nobody with intelligence would really care about what they say because their boorish, immature demeanor forfeits their right to contribute to the conversation about mid-level practice that is currently going on in the medical community.ReplyDelete
Now you see my post. In a few minutes, you won't. It will probably be deleted by the moderators who cannot stand to see anybody point out their god complexes.
Of course we don't have you on any kind of pedestal. You don't deserve it. You're not any better than any other human being on the face of this planet, despite you citing your glorious years in college. None of those eight years has taught any of you humility, empathy, beneficence, or any other attribute that makes a great human being. You want a pat on the head for your achievements, do you? Looks like you're the one with the chip on your shoulder. There is no room in professional practice for this kind of bigotry and hatred. Try and be demeaning to PAs. Go ahead. See how many will jump at the chance to be demeaned by you. I hope you all enjoy the lip service respect that your title gives you. That's the only kind of respect you'll ever get.
dear "anon." 4:39...ReplyDelete
wow, that was a ton of words.
Can you really read this blog and conclude that we might not be physicians? This says more about your intelligence than it does about ours.
- Anonymous5:03 PM, April 27, 2010
I read this blog and conclude that if you are physicians, you do not behave like professionals.ReplyDelete
thus speaketh anonymous...ReplyDelete
- Wade Holloway, PA-C8:24 PM, April 27, 2010
To all anonymous posters, if you are going to run down someone you should atleast have enough guts to put your name down if that is really how you feel.ReplyDelete
you go Wade.ReplyDelete
Thank you Wade! You can be my Associate.ReplyDelete
Bet the Ano-pod who judges our professionalism here merely by blog comments has no clue about our side of medicine, has never witnessed the kind of stuff we write about first hand, and certainly isn't old enough to understand that what people THINK and the way they must BEHAVE professionally are often two completely different things.
Of course, but I have no problem posting my real name, as I stand by everything I say. I say it on my own blog under my name as well. I would state that the OP is crass and tasteless, there is a way to address your concerns, and to do so in a gentlemanly manner.ReplyDelete
I would only add that I hope our physician colleagues do not think that this represents a change in our practice model. For it does not. We are still DEPENDENT providers, but we practice autonomously, not independently. We would only like to eliminate the confusion that our current name sometimes suggests. I've had patients say, "Oh, so you take blood pressures, and are like a Medical Assistant, right?" Ummm no. I did a conscious sedation yesterday using propofol....I doubt many assistants do that. Does that mean that I am equal to a physician, no...but it does mean that I can perform MANY of the same tasks.
- Anonymous1:38 PM, April 28, 2010
Michael, if you read MDOD at all previously you would return only because MDOD is a "quaint" (NOT) destination.ReplyDelete
And now, are you trying to prove you can out-perform any good ICU nurse?!?! Quit while your behind, as they say :o)
*yawn* Mike, you can name drop and brag about how politically connected you think you are, but you're still not coolReplyDelete
If you had ever read this blog, you'd realize that there's not a lot of love for the fools on the Hill or lobbyists.
You're barking up the wrong tree my friend.
Excuse me. I hate to interrupt but I just want to say; Hey 911, it was nice seeing you man. And I'm going to be a Nurse Anaesthetist so I can sedate the patient and catch up on some casual reading/gossip and raise and/or lower the surgical table when the MD and/or the Physician (whatever they want to be called) asks me to. Then pray the patient wakes up.ReplyDelete
Let's see how badly I'm bashed. HA.
P.S. 911, you're my hero and I look forward to another 4 hr football quarter.
P.S.S. Anonymous, you can come suck my d!@% since you seem have an issue with sucking off OLDFART.
- Anonymous4:14 PM, May 05, 2010
What a quaint read, I have now finished reading all of the posts on this PA issue and as a practicing PA for 17 years know as we all do that there are jerks in every profession and at every level of life and it seems that I have run into some of both (PAs & docs) on these postings. Honestly I think 911 Doc would be a fun guy to drink beer and smoke a good cigar with. Everyone is allowed their own opinion and if PAs want to enter the fray on a blog moderated by an ER Doc he or she better get ready to take some serious shit. Albeit I should say they should be ready to give it back as well. I haven't met an ER Doc yet or any other Doc I was afraid of, especially over a blog, but how many do I respect, the ones that give good care. The only medical professional I ever met that scared me was an ER NURSE, Jimmie Gaskins from Oklahoma, she kicked a good many ER Docs asses and other medical professionals as well. But I digress... Teeh name change has nothing to do with any of us PAs wanting to change a thing about the way we practice medicine. Wht can't you guys get that through your thick skulls? I don't want the right to practice independently, as I already do. I have never had a Physician stand over my shoulder and tell me what to do, or how to do it, except in school. We do have a collegial relationship. An association with each other as professionals. You can cry about that all you want but "it's only the facts maam" Of course when first out of school there is a learning curve but by the time my med school buddies had finished their residencies and I had drank much more beer than them to their dismay, I had OJT that had placed us on an pretty much an even keel. After all what is residency other than OJT? Get over yourselves Docs and let us do our job and don't fret about what we call ourselves. Most of us don't really give a rats ass about what you think of us personally anyway, but on a professional level, we will continue to yes suck your &##$$2 and let you sign our charts as long as we continue to practice medicine. BTW, why don't you think we aren't sued for the work we do when it is shitty? Boy I wish I didn't have to carry malpractice for 1,000,000 -3,000,000. That would be sweet. We take the heat when we do bad just like you do. Except the statistics show we do bad on a much less frequent scale than you big boys. I know, I know it's cause you do all the big special things in medicine and are therefore subject to more things can go wrong. Just making the point that some here keep missing, that we take the heat for our mistakes. Yea the doc does too, but then he shouldn't have hired on as my super? Oh did I mention that I own my own clinic and the Doc works for me? Oh sorry to go there, will just make somebody cranky. And no their not losers and thsi is the only job they could get so don't try that. Oh I'm sorry I digressed again. We want to change our name back to Associate because were tired of answering the same question a million times from our patients, and building trust with your patient is utmost important. When I tell them to take this medicine so they don't fall over dead, probly not a bad idea for them to take it Lucy. Get my driftReplyDelete
Loving all Docs
Also a hiding PA cause of bad things I say and don't want to lose license. Baby needs shoes
Who gives a damn? If you like your job, why do you care what it's called or what anyone else's job is called? I think anyone who has a problem with this name change issue is probably threatened or unhappy in their own profession (doctor or PA). If you're truly happy with your job as a doctor and don't feel threatened by a midlevel, then you shouldn't give a damn what a nurse or a PA wants to be called. You're still a doctor who went to medical school; nothing can change that. Similarly, if you're truly happy with your job as a PA and don't wish you were a doctor, then you shouldn't care whether you're called an assistant or associate. All you should care about is doing your job.ReplyDelete
And for the people insinuating PAs are idiots who couldn't make it into medical school, I would graciously ask you to reconsider your preconceived notions about this profession. Let's consider this logically, shall we: what gender accounts for the majority of PAs/NPs/nurses?
Now, perhaps you'll conclude that all females are too stupid to make it into medical school. Well, that's your prerogative. However, based upon my own experience and that of other people I know, I would say many very intelligent females choose PA school over medical school due to the length of training involved in becoming a doctor. If we want a family, we have to realistically consider our options- not only do we have somewhat of a time limit on having kids (yes, yes, you can have kids past 35, it's just not recommended) but we're often also expected to be the primary caretakers of our children. The fact of the matter is that you cannot have everything. You can be a doctor and you can have a family. But you cannot be an amazing doctor and an amazing wife and an amazing mother. You have to make tradeoffs. And every female doctor I've talked to has spoken about these tradeoffs: sometimes, the job suffers. Sometimes, your family suffers. Usually, your sanity suffers. But something always has to give.
Of course, when I ask a male doctor if it's possible to have it all, I'll get the occasional- of course! It's just a matter of hard work and determination. I'm an excellent doctor and very involved with my kids.
*drum roll*
Then I ask, "So what does your wife do?"
*pause, guy looks slightly embarrassed*
"Uh, she stays at home with the kids..."
FYI, I'm about to graduate from one of the top ten universities in the nation, with a science degree and a high GPA. I worked as an EMT my freshman year of college, I've volunteered extensively with underprivileged children, and I've worked in a biomedical research lab for over 2 years now and have even been awarded a small fellowship to fund my research. I've volunteered in a hospital and I've worked with doctors and PAs.
And I want to be a PA. I choose to be a PA, knowing I have many other options. I feel it fits best with my future life goals and aspirations. Choosing PA school over medical school does not mean I'm an idiot or that I couldn't get into medical school. It means I don't WANT to go to medical school.
In fact, I feel as though I would actually have a better chance of getting into a top medical school than I would getting into a top PA school (the most competitive PA schools tend to weight direct patient care experience heavily, which I am lacking in).
There is no "easy" PA school to get into, just as there is no "easy" medical school to get into (I've looked into both extensively). There are some medical schools that I honestly believe would be much easier to get into than some PA schools. And vice versa, obviously.
Case in point, to say all PAs are idiots who couldn't hack medical school is an extremely ignorant statement and one I would not expect of someone who considers themselves to be a highly educated individual.


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This textbook introduces students to the contents of the Torah and orients them to the key interpretive questions and methods shaping contemporary scholarship, inviting readers into the work of interpretation today. Pedagogical features include images, maps, timelines, reading lists, and a glossary.
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Introducing Israel's Scriptures
Fortress Press is excited to announce a new collection of textbooks introducing the major components of the Hebrew Bible. Written for use in topical undergraduate elective courses or seminary survey courses, these books, appearing between 2016 and 2018, share a common organization.
Written by an ecumenical array of respected scholars, these volumes will provide fresh, student-friendly explorations to the writings of the Hebrew Bible and to contemporary scholarship on them. Each volume describes the historical and cultural context in which the writings originated; introduces important episodes, characters, and themes in each book; and addresses issues of contemporary interpretation and debate. Each volume invites the student, regardless of religious orientation, into conversation and exploration of the biblical heritage.
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Introducing Israel's Historical Literature
By Mark A. Leuchter and David T. Lamb
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Figures, Sidebars, and Maps
Chapter 1: Introduction
Chapter 2: Joshua
History has an inescapable centrality in the Hebrew Bible, and biblical narratives are for many readers the best recognized and most memorable parts of the Bible. Yet the history of ancient Israel and the nature of Hebrew historiography remain hotly contested topics in contemporary scholarship. The Historical Writings introduces students to the character of the Deuteronomistic History (Joshua through Kings) and other historical writings (Ezra, Nehemiah, and 1 and 2 Chronicles); to the different roles history writing plays throughout the Hebrew Bible; to the key historical questions and methods shaping contemporary scholarly debate in light of archaeological research; and to the literary and theological contours of the biblical narratives themselves.
An introduction presents issues in the historical and literary interpretation of these writings. Subsequent chapters on the books Joshua through Kings, Ezra, Nehemiah, and Chronicles each discuss literary concerns, historical issues, and theological themes relevant to each book, then offer succinct and informative commentary on the book. Pedagogical features include maps, timelines, photographs, primary sources from the ancient Near East, reading lists, and a glossary.
Introducing the Torah
By Thomas B. Dozeman
The Pentateuch is the heart of the Hebrew Bible and the foundational document of Judaism. It is also the focus of tremendous scholarly exploration and debate today regarding the complex history of its composition; the historical background and ancient Near Eastern parallels for its primeval history, ancestry narratives, and laws; the theological purposes of its final redaction; and the diverse ways it is interpreted in communities today.
In this textbook, Thomas B. Dozeman, one of the leading scholars of the Pentateuch, introduces students to its contents and the structure of each book, and orients them to the Pentateuch's place in the Hebrew Bible and in the interpretive traditions of Judaism and Christianity. Dozeman deftly introduces the key interpretive questions and methods that shape contemporary scholarship and explains their consequences, inviting students into the invigorating work of interpretation today. Features include maps, timelines, focus questions, reading lists, and a glossary.
Introducing Israel's Prophetic and Apocalyptic Writings
By Stephen L. Cook
The prophets remain figures of enduring interest and importance in contemporary Judaism, Christianity, and secular society as well. This textbook introduces the rise of prophecy in ancient Israel, possible ancient Near Eastern parallels, the messages of individual prophets, and the significance of the editing and composition of the prophetic writings, guiding students into leading questions in contemporary scholarship and surveying different contemporary approaches to the messages of the prophets.
Introducing the Writings
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Virginia Theological Seminary
United Theological Seminary, Dayton, Ohio
Biblical Theological Seminary
Temple University
The Historical Writings introduces students to the character of the Deuteronomistic History and other historical writings (Ezra, Nehemiah, and 1 and 2 Chronicles); to the different roles history-writing plays throughout the Hebrew Bible; and to the key historical questions and methods shaping contemporary scholarly debate.

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Copyright & Disclaimer
The International Working Group on the Diabetic Foot (IWDGF) is the owner of the International Consensus on the Diabetic Foot website and has the copyright of the complete content of this website, including texts, photographs and diagrams. This website is financed by the IWDGF; parts of this website are the result of IWDGF projects that were made possible by unrestricted grants from several pharmaceutical companies and from other sponsors. The views expressed herein are the independent views of the IWDGF and were formulated without the influence of any external partner.
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Representatives of The Lutheran World Federation (LWF) member churches in the Latin America and Caribbean (LAC) region have affirmed how strategic training for ordained and lay people is promoting church growth and encouraging more participation of members in the church's prophetic mission.
Lessons learned from Latin America and Caribbean Lutheran churches
"We feel that all our team members — from the pastors to the administrative workers — understand this process of 'just learn and do it,'" Linda M. Pérez Gómez of the Christian Lutheran Church of Honduras said of the LWF-supported five-year (2007-2011) sustainability program to develop churches' local capacity and empower leadership.
"We are beginning to grow in numbers and at the same time have the spirit to work together, to join our efforts as a first base and take our decisions collectively," she added.
Pérez and some 50 other participants at the Sept. 18-22 LAC meeting here reviewed the lessons learned and challenges encountered by the 16 LWF member churches in processes to strengthen their capacity to witness in situations dealing with poverty, violence and inequality.
The process of accompaniment, consciousness raising, capacity development, inclusion and sharing of responsibility was important for the churches involved in the five year program, she added.
The LWF Department for Mission and Development (DMD) organized the meeting hosted by the Bolivian Evangelical Lutheran Church. Networks of women and youth, persons living with disabilities, educators and diaconal workers, and church leaders were represented.
"The church's programs would have had more possibility of success in our churches and communities if we had taken care of the development of the human capacity of the people, the ministries and the lay leaders," said Miltom José de Oliveira of the Evangelical Church of the Lutheran Confession in Brazil.
Oliveira added he was convinced that the region's churches were now headed in the right direction with more strategic plans to offer the kind of formation and training that will help lay and ordained persons serve the church and community.
More participatory
United Evangelical Lutheran Church (Argentina) participant Enrique Nery Kallsten explained how his church had worked through home Bible study to become more engaged and responsible to one another.
"Our church needed a strategic plan. We needed to organize our ministries and make them more participatory for the members so that they might offer their gifts for the well-being of the church," he said.
The Rev. Everardo Stephan of the Evangelical Church of Río de la Plata (Argentina) maintained that ministries that focus on gender, youth and children required special training and urged the LWF to support these areas of work.
A key learning from the Santa Cruz meeting was the importance of developing the capacities and gifts of people and institutions so that church ministries can function well. "I am very excited about the sustainability program. It's more than a program. It is a way to be church," Stephan added.
It was also suggested by Rev. Guadalupe Cortéz of the Salvadoran Lutheran Church that the LWF LAC region should work collectively to create a frame of reference for its ministry.
Abebe Yohannes Saketa, LWF secretary for Human Resources Development at DMD, noted that the meeting had provided a "very rich content" because of the new perspectives developed under the five-year program.
"This meeting was unique and distinct from the previous gatherings, as I noted from the reports and comments. It was broader since about half of the participants were here for the first time. It was richer, due to new perspectives developed and presented. It was also deeper as it revealed several issues of mutual concern," said Saketa.
The LAC meeting was part of the LWF's strategic efforts to realign human capacity development initiatives among the member churches. A framework for long-term planning has been formulated for adaptation and use at church level.
Bogotá, Colombia-based journalist Edwin Mendivelso contributed to this story


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Bonta Bill to Address Education and Health Disparities in the Asian Pacific Islander Community Passes Committee
The AHEAD Act Reveals Critical Health and Education Data for API Ethnic Subgroups
(Sacramento, CA) – Today Assemblymember Rob Bonta (D-Oakland) announced that his legislation to uncover disparities within California's diverse Asian Pacific Islander (API) population has passed the Assembly Higher Education Committee. AB 1726, the Accounting for Health and Education in Asian Pacific Islander Demographics Act (AHEAD Act) will ensure the collection of data related to health outcomes and educational achievement for API Subgroups.
"Each of our diverse communities has unique social, economic, and educational needs that must be addressed differently," said Bonta. "Instead of lumping many API communities together under the catch-all 'other Asian' category, the AHEAD Act would identify API subgroups that are being left behind."
"Beyond each race and ethnicity box is our community's fight for self-determination for our community's needs and unique strengths to be revealed, not concealed, by transparent data systems," said Quyen Dinh, Executive Director of the Southeast Asia Resource Action Center. " The AHEAD Act, AB 1726, would shine a light on the diversity within Asian American and Pacific Islander communities, made of at least 48 distinct ethnic and linguistic subgroups with vastly different life experiences and outcomes. Better data would allow for resources to be used in better, more targeted, and more efficient ways to improve lives for ALL AAPIs in California.
Recent studies demonstrate that some communities within the API community have fallen behind in important measurements of public health and education. Although data shows the average API tends to have health insurance and is on track to obtaining a four-year degree, a break down by ethnicity demonstrates that Koreans, Cambodians, and Thai Americans have a higher percentage of being uninsured, and that Vietnamese, Laotian, Cambodian and Hmong American adults have the lowest educational attainment of Asian American ethnic groups.
AB 1726 takes a critical and practical step for the API community by requiring higher education institutions and public health agencies to disaggregate data into additional categories. The bill requires the California Community Colleges, California State University, the University of California, the Department of Public Health, and the Department of Healthcare Services to collect and release demographic data for the following additional populations: Bangladeshi, Hmong, Indonesian, Malaysian, Pakistani, Sri Lankan, Taiwanese, Thai, Fijian, and Tongan Americans. The data collected will include rates of admission, enrollment, completion and graduation in the education field, and disease rates, health insurance coverage, and birth and death rates for the health field.
In 2015 Bonta authored a similar bill to reveal health and education data for API subgroups. Unfortunately that bill was vetoed by the Governor. The California API Legislative Caucus promised to work closely with the Governor's Office on AB 1726 to address his concerns, while ensuring that the bill provides valuable and needed insights that recognize communities that have been rendered invisible by monolithic demographic categories.
Bonta concluded, "Our policies must give a voice to all API subgroups. We must ensure that each API subgroup's unique challenges are addressed appropriately."


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Property Location
With a stay at InterContinental Doha, you'll be centrally located in Doha, convenient to Qatar International Exhibition Center and Doha Golf Club. This 5-star hotel is within close proximity of Katara Cultural Village and City Centre Doha.
Make yourself at home in one of the 258 air-conditioned rooms featuring minibars and flat-screen televisions. Wired and wireless Internet access is complimentary, while video-game consoles and satellite programming provide entertainment. Private bathrooms have complimentary toiletries and bidets. Conveniences include phones, as well as safes and desks.
Rec, Spa, Premium Amenities
Relax and unwind with massages, body treatments, and facials. After a day at the private beach, you can enjoy other recreational amenities including outdoor tennis courts and a health club. Additional amenities include complimentary wireless Internet access, concierge services, and babysitting/childcare.
Grab a bite at one of the hotel's 6 restaurants, or stay in and take advantage of 24-hour room service. Thirsty? Quench your thirst at a bar/lounge, a beach bar, or a poolside bar.
Business, Other Amenities
Featured amenities include complimentary high-speed (wired) Internet access, a business center, and complimentary newspapers in the lobby. Free valet parking is available onsite.
Are you affiliated with InterContinental Doha? Apply to the Hotel WiFi Connect program to take control of your account, improve your hotel's confidence score and ranking.
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Welcome to Sri Aurobindo Centre for Arts and Communication (SACAC), New Delhi, a multi-disciplinary mass communication and media arts institute with a watch on the longer term. The overall purpose of this module is to extend normal understanding of the music business and to develop private confidence in it as a possible source of employment. By classroom and experiential preparation, COFAC's programs put together graduates for thrilling careers and/or graduate research.
Meet the Communications and Arts Minister, Senator the Hon Mitch Fifield. Graduates are prone to pursue careers in both the private and non-private sector and go on to work in promoting, TV manufacturing, journalism, independent media, movie, gross sales, teaching and public relations.
Our graduates are skilled broadcasters, sound engineers, digital artists, theatrical designers, journalists, graphic designers, artwork educators, music educators, and performers. Estimated cost of the course per 12 months if learning full-time. This module introduces college students …


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"I took this beautiful picture and wanted to share it with you, baby Harper cuddling Daddy! x VB," Victoria, 37, wrote via Twitter on Sunday morning. At a recent LA Galaxy game in Los Angeles, Beckham removed his shirt, inadvertently revealing a new tattoo of Harper's name near his left collarbone.
Last July 15, it was revealed that the Beckham couple plans to invite the Duke and Duchess of Cambridge, William and Catherine, to visit their newborn baby in their London home.


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Louisiana State University at Alexandria's golf course is getting an upgrade. This week, yardage signs began going in on all nine holes of the course.
The signs were donated with funds made available by the LSUA Alumni and Friends Association.
Each sign shows a drawing of the hole layout, the hole number, par, and the yardage for both women and men.
LSUA Golf Course Manager Jamie Trotter says that the new signs are a great addition to the course. "We're very excited about it. It will be a help to all the golfers and especially the newer ones," said Trotter. Trotter also expressed his appreciation to the AFA for their support.
Currently, about half of the signs are already in place and Trotter believes the rest of the signs will be up by the end of the weekend.
Robert Harper, LSUA's new Director of Theatre and Empty Space Players, has announced ESP's 2013-2014 season, dedicated to the memory of longtime theatre director and community leader, Richard Gwartney.
This musical season will include a production of The Fantasticks, the longest running musical in history, and close with Stephen Sondheim's Tony Award-winning A Funny Thing Happened on the Way to the Forum. Also included in the season will be two Open Mic Nights, one for Halloween and one for Valentine's Day.
The 2013-2014 Empty Space Players season is dedicated to Richard Gwartney, our friend and colleague, who passed away in 2011. Richard was a theatrical and artistic fixture in central Louisiana for over twenty years. It is with fondness and gratitude that we highlight his contributions to theatre at LSUA during the entire season.
Love, adventure, and magic are in the air as The Fantasticks takes the stage at LSUA's Black Box Theatre. The musical allegory, with book and lyrics by Tom Jones and music by Harvey Schmidt, tells of a young couple falling in love and their meddling fathers, all guided by the mysterious bandit El Gallo. Memorable songs from the musical include Try to Remember, Soon It's Gonna Rain, and They Were You. The Fantasticks will open on Thursday, November 14, 2013, and run through Sunday, November 24.
Winner of six Tony Awards including Best Musical, A Funny Thing Happened on the Way to the Forum, book by Burt Shevelove and Larry Gelbart, music and lyrics by Stephen Sondheim, is Broadway's greatest farce and one of the funniest musicals ever written. Forum seamlessly combines situations from the timeless comedies of Roman playwright Plautus with the fast-paced, slapstick energy of classic vaudeville to create a non-stop entertainment extravaganza. Noted musical numbers include Comedy Tonight, You're Lovely, and Everybody Ought to Have a Maid. Forum will open April 3, 2014, and run through April 13.
Ticket prices for the two musicals are $10 – General admission; $5 – Students and Seniors. All productions are presented at the LSUA Black Box Theatre in the new MPAC Building in the rear of campus.
The Halloween Open Mic Night rises from the grave on Friday, October 25, 2013 at 7:00 pm. Empty Space Players invites all to bring their scariest, spookiest, creepiest, and most blood-curdling story, song, poem, monologue, mime, etc., and share them with us. We ask that the offerings are kept under 15 minutes. Come in costume if you like and help us get into the Halloween spirit. This event is free and open to students and the community. It promises to be a night of spine-tingling delight!
Tired of the same old run-of-the-mill Valentine's Day date? Join us for the Valentine's Open Mic Night on Friday, February 14, 2014, at 7:00 pm, for an evening idyllic and creative. Following the format from Halloween, and free and open to all, we ask you to bring your best material with a romantic theme and inspire us. And there should still be time afterwards for that candlelit dinner!
In response to the Board of Supervisors' approval, Louisiana State University at Alexandria employees will receive a salary adjustment for the first time in four years.
This is a merit adjustment and will be based on performance and work.
The one-time salary adjustment for LSUA employees will average 4% and will go into effect January 1, 2014. Continuation of this adjustment will depend on availability of funds based on enrollment goals being met this fall and spring. The adjustments are being self-funded by each campus through cost-cutting and other efficiencies implemented over the past few years.
The pay adjustments for classified employees must first be approved by the Louisiana Civil Service Commission. A proposal for approval will be submitted next week.
This is the first pay adjustment since 2008, it was announced at today's Board of Supervisors meeting, and the adjustments are system-wide with each campus determining the timeline, details, and amount of the pay adjustments.
"It is crucial that we do everything we can to address faculty and staff pay adjustments within our current budget limitations," said Interim Chancellor Paul Coreil. "We are very grateful for the support provided by the LSU Board of Supervisors and President Alexander to make this one-time adjustment become a reality."
Louisiana State University at Alexandria is proud to announce a new Interim Chair for the Department of Business Administration.
Dr. Haywood Joiner will assume this new position within the department on August 1, 2013. With this move, LSUA will be able to put into place a structure that will allow the Department of Business Administration to grow both on campus and within Central Louisiana.
Dr. Joiner is well known throughout central Louisiana. Dr. Joiner currently serves as Chair, Department of Allied Health, but also serves on numerous boards in the community. Dr. Joiner is Past Board Chair, Central Louisiana Area Health Education Committee; Past Board President, Arna Bontemps African American Museum; Past President, CENLA Kiwanis Club; Member, Rotary Club of Alexandria; Board Member and Past Education Division Chair, Central Louisiana Chamber of Commerce; Commissioner, Rapides Parish Housing Authority; Commissioner, Rapides Parish Civil Service Commission; and Board Member, Rapides Regional Medical Center.
This change in leadership will allow Dr. Robert Bush, former Business Administration Department chair, to focus more on his position as the Alumni and Friends Endowed Chair in Business. As the endowed chair, Dr. Bush will provide the central Louisiana region with a stronger educational program in business and contribute to the growing local and state economy by providing additional expertise. Dr. Bush will also work toward increasing the number of internships available for LSUA students, work within the department to provide assistance to local businesses and develop research and publication initiatives.
LSUA is pleased to welcome Dr. Joiner in his new leadership role and support Dr. Bush in his new endeavors.
Students who want to accelerate their college experience can begin taking fast-track courses this fall at the Learning Center for Rapides Parish. The four- and eight-week courses will be offered by LSU Alexandria.
The courses will be offered in a blended format, meaning students will meet for class weekly but will also continue their learning experience in an online environment. LSU Alexandria has offered accelerated courses in a similar format during the summer, but this is the first time the institution has offered them during a regular semester.
"We recognize that there are students who want to attend college but have other obligations that prevent them from attending on a typical semester schedule," said Dr. Barbara Hatfield, provost and vice chancellor for academic affairs at LSU Alexandria. "We also understand how valuable a college education truly is. This blended format will make postsecondary education more achievable by making it accessible to more students."
"The Learning Center is excited to have the opportunity to host these courses," said Heather Poole, executive director of the facility. "The goals of the facility include providing enhanced access to postsecondary education in central Louisiana and meeting the needs of the region's workforce. I believe offering courses in this blended format will be beneficial, not only to the students but to LSUA and the Learning Center."
This fall, LSUA will offer eight-week classes and four-week classes at the Learning Center. The courses are all general education classes. The four-week classes include Intro to Fine Arts, Intro to Business, Public Speaking, and Western Civilization I. The four eight-week classes are College Algebra, General Statistics, English Composition, and English Composition II.
Eight-week classes will meet on Mondays at the Learning Center. The four-week classes will meet on Tuesdays.
To participate, students must first be accepted for admission to LSUA. For information on applying for admission, call 318-445-3672 or 318-473-6417 or visit www.lsua.edu.


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I'm a highschool teacher, easy going, clean, easy to live with. Don't party or drink much, don't smoke or have pets. I like to go out for dinner, a drink or two, movies etc on weekends and gym every day. Just interested in finding someone chilled out and easy to live with.
I would like to live in an apartment preferably something with a pool (I know, that sounds fussy!). I would like to team up and rent somewhere new probably around the Tenerife area. I don't have a whole lot of furniture other than for my room, so ideally you would bring yours! If this suits you please shoot me a message we can meet for a chat.
Thanks 😊


text: Intarcia Therapeutics has announced that the US Food and Drug Administration (FDA) has accepted for active review its New Drug Application (NDA) for ITCA 650, an investigational therapy for the treatment of type 2 diabetes (T2D). Intarcia looks forward to working closely with the FDA through the review process.ITCA 650 provides continuous delivery of exenatide via an osmotic mini-pump placed just beneath a patient's skin in the abdominal wall. It is designed to do this by leveraging Intarcia's innovative and proprietary technology, the Medici Drug Delivery System™. In studies, ITCA 650 mini-pumps were given with a 20mcg/day three-month introductory dose and then followed by a 60mcg/day six-month maintenance dose, which translates to twice-yearly dosing after initiation.Intarcia Therapeutics, is a biopharmaceutical company developing therapies to enhance treatment and prevention outcomes by optimizing and improving the efficacy, continuous administration and tolerability of drug therapies. Delivering medicines just once- or twice yearly to prevent and/or chronically treat diseases holds potential to improve outcomes by improving effectiveness over time and by addressing real-world unmet needs around poor patient adherence and persistence rates that are high in the majority of chronic diseases. Intarcia is investigating multiple therapies, including combination therapies, for chronic diseases leveraging the convergence of novel medicines and the proprietary medici drug delivery system. Intarcia is developing a strong pipeline in important therapeutic areas, including: diabetes, obesity, autoimmune diseases, HIV, and other serious disorders.


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Changes to the electoral system were hotly debated in Parliament yesterday. Here are some of the points raised:
'People who are proposed to be NCMPs are politicians who stood for an election and lost. Sir, they lost. They lost. I do not know how much more emphatic I can be about this. These are politicians who have stood on certain political platforms for certain political issues. A majority of the electorate have considered these issues, these politicians and rejected them at the polls. To then allow them into Parliament flies in the face of logic of a democratic election at best, and at worst is a slap in the face of the people who have voted against them.'
'Mr Calvin Cheng argued passionately opposing the NCMP scheme. NCMPs would have lost in the elections, why are they allowed in Parliament? He says it flies in the face of logic. I can see the point he makes, but on that same logic someone could argue that NMPs who did not even contest the elections, why are they in Parliament? So the answer to these questions is not to simply stick to a theory on what Parliament should look like. You start with the theory and then you ask hard questions on what the realities are and what Parliament should look like to meet the needs of our society.'
Law Minister K. Shanmugam, responding to Mr Cheng
'I find it quite ironic that someone who came into this august chamber through an interview can actually attack the NCMP scheme in such strong terms.'
NCMP Sylvia Lim, whose Workers' Party team lost narrowly in Aljunied GRC in 2006, responding to Mr Cheng
"They [NCMPs] can show Singaporeans that they understand the issues, have serious views on the national agenda and have the potential to form a government one day.
"They will then become a more serious force in the next elections. A group of nine Parliamentarians from the opposition can form a very credible caucus, a base from which they can expand their influence.
"Thus on a long term analysis, if this government was only interested in its own electoral prospects, then increasing the number of NCMPs is not a good idea. It is in fact a bad idea.
"It is noteworthy that the government's own MPs do not necessarily support the idea. Why would this government take this step which will give the opposition more space? We are doing it because we believe strongly in doing what is right for Singapore.
"We believe that these changes are good for Singapore and we believe that these changes will make for a better Singapore."
Law Minister Mr K Shanmugam talking about NCMPs who perform well in Parliament
For more The Straits Times stories, click here.
Elsewhere in AsiaOne...
NMP candidates attacked online


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The Lunatic fringe Dean Ambrose has been speaking about his current role in WWE and has claimed that he finds it strange being liked by people.
Since the split of the Shield a few months ago, Ambrose has risen in popularity as the fans have fallen in love with his crazy antics.
According to Ambrose however, he never intended to be liked by the fans and still finds it somewhat strange.
Ambrose cut a promo to start Smackdown where he compared himself to hardcore legend Mick Foley claiming the difference between them, is that he's not a nice guy.
"I've always fed off negativity and wanting people to hate me. That attitude really fueled me for my entire career." - Dean Ambrose
Talking about his anti-hero persona, Ambrose also took a look at the likes of John Cena and Kofi Kingston.
- WWE Universe sends big message about Hell in a Cell
- Big title match announced for Hell in a Cell with special stipulation
- Who should replace Randy Orton in The Authority?
Ambrose was claiming that every good guy has a style for winning matches and that he tried to avoid becoming a cliche when in the ring.
Giving some legendary names like Dusty Rhodes and Terry Funk, Ambrose claimed that he tries to model his style on those legends.
Ambrose did however keep his sense of realism and even created a bit of an enigma about himself.
"Who knows how long that will last? All the people who love me right now are probably gonna hate me next month."
The new fan favourite
Ambrose has been a fan favourite ever since the former Shield turned against the Authority earlier this year.
After two incredible matches against Evolution, his former Shield brother Set Rollins turned against him and their third brother Roman Reigns.
Now all three members of the Shield are going their own ways, but it has been Ambrose's mission since June to get his hands on Rollins.
Rollins continues to elude the Lunatic Fringe but there will be no running on Sunday when the two are locked inside a Hell in a Cell match.
The Hell in a Cell PPV is this Sunday and has shaped up to be a great event that no WWE fans will want to miss.


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What you see is what you get, and what you get is more than you could bargain for. Real - to the bone
Saturday, March 10, 2012
Experts coming in for The Business of Sport 2012
KINGSTON, March 10 – Experts in the areas of contracts, financial management, image building and psychology are among the over 20 presenters for the 2012 renewal of The Business of Sport, scheduled for Kingston, May 3 – 4 at the Jamaica Pegasus Hotel.
The two-day event, in its second year has attracted veteran NFL commentator and journalist, Steve Wyche; NBC track and field expert, Ato Boldon; financial manager Horace Madison; Personal Growth Consultant, E. Patrick Miller and ESPN Vice President, Bernard Stewart among others.
The event organizing team is seeking to establish a formula for The Business of Sport which can highlight the values of a sporting industry, a sporting brand and an athlete. According to managing partner, Christopher Samuda, "this cannot be done without establishing what the critical success factors that drive value into the industry and what elements are needed to make the formula work."
The six major areas of this year's conference will look at
- Contracts
- Psychology – Maintaining the Competitive Edge
- Image and Dollars
- Money Management
- Sport and Culture
- Athletes – up close and personal
Each session is expected to delve into the how and why of the specific areas, but more importantly the implementation and action plan to build the sporting industry in Jamaica and the wider Caribbean – forming partnerships with international experts.
President of The Business of Sport, Carole Beckford is optimistic that in the next three to five years, Jamaica and the Caribbean will not just be seen as a place where great athletes are prepared, but a destination that will host major events and the business matchmaking will be the order of the day. "Investment in sport is inextricably linked to a country's culture and can be enhanced once the framework is created," Beckford added.
"As a special tribute to Jamaica's 50th, the conference will feature a discussion about Sport and Culture – to identify how much more they can be effectively managed to develop bigger income streams for Jamaica. These two industries have consistently given Jamaica positive exposure and should be developed further," said Beckford. The speakers confirmed for that session are noted brand strategists, Kam-Au Amen, Dr. Christopher Charles and Dr. Sonjah Stanley Niaah.
The conference last year was attended by over 103 participants from Jamaica, the Caribbean, Canada and the USA.
The event this year will be streamed live for a small fee. Early bird registration is US$150 at www.thebusinessofsport.org and if you register up to 21 days to the event it will cost US$175.
Partnerships are being established with FLOW Jamaica, Wisynco (WATA), Jamaica Pegasus, EXIM Bank, JAMPRO, KLAS Sport Radio, KOOL 97 FM, Island Car Rental, Samuda and Johnson and the Jamaica Tourist Board, so far.
The event is a production of Carole Beckford and Associates and Strategic Corporate Interventions.
Contact: The Business of Sport
(876) 754 5637/8
Posted by Carole Beckford at 8:57 AM
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Welcome to The Shaun Tabatt Show! Today I speak with Jonathan Bernis, President and CEO of Jewish Voice Ministries International, about his new book A Rabbi Looks at the Supernatural: A Revealing Look at Angels, Demons, Miracles, Heaven and Hell (Chosen Books, 2016). Here are some of the topics we cover in this interview:
About the Book: There is a supernatural world--and it's just as real as our physical one. Dispelling the confusion, misinformation and doubt so prevalent today, Messianic Rabbi Jonathan Bernis takes you on an adventure into the heart of the supernatural realm. He'll transport you beyond what you can see, hear, taste, touch and smell to uncover the biblical truth about things like angels and demons, miracles, heaven and hell, good and evil. And he will answer questions such as:
Above all, you will discover that you are uniquely wired to live a supernatural existence here and now--and that there is a faithful, loving God who longs for you to embrace with confidence His supernatural work in your own life. About the Author: Jonathan Bernis is a Jewish believer in Jesus who has been active in Messianic Jewish ministry for more than thirty years and who currently serves as president and CEO of Jewish Voice Ministries International (JVMI). JVMI's mission is two-fold: proclaiming the Gospel to the Jew first and also to the nations (Romans 1:16), and equipping the Church--providing education about the Hebraic roots of Christianity, the Church's responsibility to Israel and the Jewish People, and keys to effectively and sensitively sharing Messiah with the Jewish People. Jonathan hosts JVMI's daily television program, Jewish Voice with Jonathan Bernis, broadcast to over 575 million homes worldwide through local, cable and satellite networks as well as the Internet. JVMI also conducts humanitarian/medical outreaches to some of the most impoverished Jewish communities on earth, including regular outreaches in Ethiopia, Zimbabwe and other points of need around the world. JVMI also ministers through large-scale international festivals of Jewish music and dance. Jonathan is the author of several books, including A Hope and A Future, A Rabbi Looks at the Afterlife, A Rabbi Looks at the Last Days and A Rabbi Looks at Jesus of Nazareth. Jonathan and his wife, Elisangela, reside in Phoenix, Arizona, with their two daughters. Connect with Jonathan:
For additional show notes, visit ShaunTabatt.com/098.


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Description of IPEN
The idea behind the International Plant Exchange Network was to develop a model for the acquisition and the exchange of living plant material within the botanic gardens community in respect of the ABS requirements of the CBD. IPEN is a voluntary registration system intending to facilitate the botanic gardens plant exchange in accordance with the CBD provisions. IPEN is characterized by the following aspects:
- only for botanic gardens according to the definition by the BGCI (see Definition of a botanic garden)
- IPEN covers only the exchange of living plant material, meaning living plants or parts of plants, e.g., diaspores
- only for non-commercial exchanges: Plants must not be sold for profit or used for any kind of commercial activity
- IPEN includes a documentation system (the so-called IPEN numbers, that makes the origin of the plant material traceable at any stage of plant exchange
The backbone of the network is the IPEN Code of Conduct, a three-page document stating the unified policy of the IPEN member gardens (seeIPEN Code of Conduct ). It covers acquisition, maintenance and supply of living plant material by the gardens as well as benefit-sharing. One key element is the above mentioned documentation system with the so-called IPEN-numbers (see "Documentation and IPEN numbers"). The Code further provides a Material Transfer Agreement (MTA) to be used for exchanges with institutions that are not member of the IPEN network.
Only botanic gardens that commit themselves to act according to the Code of Conduct can become member of the IPEN network. This commitment is expressed with the signature of the IPEN Code of Conduct (see registration).
Main principles of the IPEN Code of Conduct are the following:
- The garden shall only accept plant material which has been acquired in accordance with the provisions of the CBD
- When acquiring plant material from in-situ conditions, the garden shall obtain Prior Informed Consent of the country of origin and any other relevant permits.
- The garden will only distribute plant material within IPEN that has been obtained without any restrictions in respect of its use, especially regarding its supply to third parties.
- IPEN distinguishes between two types of documentation: The first, so-called 'maximum documentation' has to be kept by the first garden introducing an accession (plant material) into IPEN. In this documentation sheet all relevant information about the plant accession are recorded, such as taxonomic data, type of material, source, permits related to the acquisition and any conditions or terms of the country of origin. This first garden also has to provide the accession with the "IPEN number" (see Documentation and IPEN numbers below), which will follow the accession and all its descendants through all exchanges within IPEN as the so-called 'minimum documentation'.
- Plant material distributed through IPEN is intended for use in display, education, rising public awareness, scientific research and conservation activities. In case of intended commercial use and other uses not covered by the IPEN Code of Conduct, the participating garden commits itself to obtain a new Prior Informed Consent of the country of origin.
- In the spirit of implementing the objectives of the CBD, the gardens shall do their best to share benefits resulting from the use of plant material with the country of origin. Since the garden's use of the material covered by this exchange network is non-commercial, such Benefit-Sharing will be non-monetary (see "Examples of non-monetary benefit-sharing of botanic gardens").
Documentation and IPEN numbers
If a botanic garden has become IPEN member, the most important thing to do is establishing a computer based documentation system that allows to introduce the IPEN numbers or to modulate the existing system. The system must allow the introduction of IPEN numbers for all plants that shall be distributed.
All plant material supplied within IPEN by an IPEN member needs to be accompanied by an IPEN-number that remains connected with that material and its derivatives through all generations to come. With the aid of this number it is possible to trace back where and under which conditions the plant material entered IPEN. So, the first IPEN member garden that supplies a specific plant sample within IPEN has to provide this material with an IPEN-number (see IPEN number).
The IPEN number consists of four elements:
- Country of origin (two positions, abbreviation according to ISO 3166-1-alpha-2 (http://www.iso.org), "XX" for unknown origin).
- Restrictions of transfer (one position, "1" if there exist a restriction, "0" if none).
- Garden code, which can be found on the website of BGCI under "Garden Search".
- Identification number (accession number of the specific garden. Example: 2004-149 or 03214, whatever the specific recording system of the gardens generates).
Within IPEN the supply of plant material is very easy, as all member gardens share the same policy on access and benefit-sharing and through the IPEN-number one can always easily trace back the origin of the material. If the recipient is not member of IPEN, he will have to sign the IPEN Material Transfer agreement, which will bind him to the same terms and conditions.
If at one point an IPEN garden wants to start a commercial use with a given plant material, this material will leave IPEN. Therefore the garden will first have to get the Prior Informed Consent of the country of origin (found in the IPEN number) and find a bilateral agreement with that country on the terms of benefit-sharing. Only then the commercial use may be started.
Material can only be provided to an institution for commercial purposes, if this institution has the Prior Informed Consent of the country of origin and has negotiated a bilateral agreement regarding access and benefit-sharing.
Thus, IPEN is a closed network of botanic gardens committed to respect and enforce the provisions of the CBD. As all member gardens follow the same policy of the IPEN Code of Conduct, plant material can be exchanged freely between them, but of course only for non-commercial use.


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"I love secondhand shopping. You find the best stuff! I can't wait until my jeans and my boots are all worn in—when you shop secondhand, it's already done for you. Plus, you can buy a T-shirt for $10 and cut it up into a new style, and it doesn't matter if you mess it up."
—Actress Malin Akerman, who played the Silk Specter on Watchmen, on her yen for castoff clothing.