PA survey results

[bsady]

well. here is how i look at it (if it matters). Currently, it can't be EASY to move from specialty to specialty anyways. I am sure there is quite a learning curve. If, somehow, all that was required was some sort of documentation of competency made by the supervising physician and PA it really wouldn't be any different than what happens now. It would just be documented. I think as long as 1 year residencies arent required for specialty recognition we are fine. The only thing that will change is a little bit of documentation and a little certificate. The only other problem would be the cost of the tests but I am sure employers would foot that bill.

chris

Sorry Chris,
I have to say it really is pretty easy to move between specialties...at least where I am. Most physicians out here are willing to train the right PA in their specialty if you have ER or family practice experience. I could go into almost any specialty tomorrow and get paid to get trained.

[chatcat]

Thanks Lesh and David. I found this on the NCCPA site and thought I would share with everyone to save others time. (Couldn't find one thing about this on AAPA site )

Points of Consensus as of May 2007
Preamble

NCCPA assures that certified physician assistants meet professional standards of knowledge and skills. Physician assistant practice ranges from primary care to specialty and subspecialty services with all care being provided with physician supervision. In order to fulfill NCCPA’s mission to assure that certified PAs meet professional standards of knowledge and skills, NCCPA seeks to create and develop appropriate eligibility criteria and assessment mechanisms for specialty recognition. As with all NCCPA programs, specialty recognition will be a competencies-based process.

Consensus Points

1. Changes in the healthcare system and the clinical diversity of PA practice indicate that it is the appropriate time to pursue specialty recognition.

There is an increasing number of PAs practicing in specialty areas.
Employers and others are placing heightened emphasis on patient safety and risk management. Patient safety is an integral aspect of NCCPA’s mission.
Complexities and increased demands of current healthcare practice place constraints and increased burdens on the mentoring aspects of the physician-PA relationship.
Individuals entering PA training programs have more academic and less clinical experience than those from the profession’s formative years. The profession’s growth and increasing visibility has resulted in the need for greater accountability.
2. NCCPA will develop and administer specialty recognition according to the following principles.

Specialty recognition will be voluntary and will be independent of NCCPA’s certification and recertification processes.
Specialty recognition will support and reinforce relationships between PAs and physicians.
NCCPA will seek input and cooperation from other stakeholders. Specialty recognition will occur in conjunction with PA and physician specialty organizations.
Specialty recognition will support the credentialing process and not create barriers to licensure.

[LESH]

Points of Consensus as of May 2007
1. Changes in the healthcare system and the clinical diversity of PA practice indicate that it is the appropriate time to pursue specialty recognition.

Individuals entering PA training programs have more academic and less clinical experience than those from the profession’s formative years.

The profession’s growth and increasing visibility has resulted in the need for greater accountability.

What does this mean to you all? Just curious.

Lesh

[coloradopa]

What does this mean to you all? Just curious.

Lesh

First of all I would wonder if it is accurate. If you are asking is the entire profession composed ex Navy corpsman who saw combat in Vietnam the answer would be no. However, you could just as easily asked is the entire profession composed of white males with crew cuts and glasses. That the profession is getting younger is a matter of fact. However are we admitting less students without any medical experience then the answer is less clear. For every program that has come online in the last 10 years that requires no medical experience there is another that does. I would guess that the percentage of programs that require experience is proportionally the same. Now if you are asking if the depth of experience is that same, again we don't know. We have had the discussion about the worth of medical experience and how much is necessary on this board many times.

The second part is unfortunately true. For a long time the PA profession has been under the radar from various regulatory agencies as we tied the dependent status to our SPs. However as the profession becomes more visible and penetrates more areas we are going to be under additional scrutiny. I would think particularly of the Joint Comission, but there are other agencies that look at this. It is in some ways a sign of the development of the profession that we are looked on as medical professionals who need accountability. However, with accountability comes increasing scrutiny. Overall this is a good thing for the profession. The devil will be in the details.

David Carpenter, PA-C

[chatcat]

Lesh~so glad you asked!

As with all NCCPA programs, specialty recognition will be a competencies-based process.

Okay~so competency based is about clinical skills and does not equate to academic degrees.

Employers and others are placing heightened emphasis on patient safety and risk management. Patient safety is an integral aspect of NCCPA’s mission.

Okay-this is a true statement BUT we have good evidence that PA's do provide quality care with the current competency exam. If there is evidence to support that PA's have recently had problems in the area of risk management and patient safety with only the PANCE/PANRE someone please share?

Individuals entering PA training programs have more academic and less clinical experience than those from the profession’s formative years. The profession’s growth and increasing visibility has resulted in the need for greater accountability.

So, with increased visibility,focus on competencies we have lowered our previous standards of patient care and focused on academic degrees.? YET..by focusing on academic prereqs instead of clinical skills we now are entertaining the idea of other specialty exams to assure competencies? Please,am I the only one that sees this as a colossal oxymoron? I am really trying to see the light here but this makes no sense!

[LESH]

This is going to be good...lol. I got no answers for ya Cat, but it is kinda strange to us old folks huh?

Lesh

[chatcat]

This is going to be good...lol. I got no answers for ya Cat, but it is kinda strange to us old folks huh?

Lesh

Deep Breathe~calling my stockbroker on Monday and making plans to move up retirement at all costs!

[coloradopa]

Lesh~so glad you asked!

Okay~so competency based is about clinical skills and does not equate to academic degrees.

Okay-this is a true statement BUT we have good evidence that PA's do provide quality care with the current competency exam. If there is evidence to support that PA's have recently had problems in the area of risk management and patient safety with only the PANCE/PANRE someone please share?

There is no evidence on PAs. There is a lot of evolving evidence that BC physicians have better patient outcomes. Ironically the best study of this was a nursing study that purports to show that hospitals with more BSNs have better patient outcomes. Unfortunately in specialty certification PAs sometimes get drug along for the ride.

So, with increased visibility,focus on competencies we have lowered our previous standards of patient care and focused on academic degrees.? YET..by focusing on academic prereqs instead of clinical skills we now are entertaining the idea of other specialty exams to assure competencies? Please,am I the only one that sees this as a colossal oxymoron? I am really trying to see the light here but this makes no sense!

I don't think that one has anything to do with another. In a lot of ways this is about turf. If you look at the three groups that have proposed/implemented specialty recognition you can see that. Both Derm and EM have issues with competition. Derm with FP that wants to do med spa stuff. Derm recognition is pretty much solely tied to whether you work for a BC member of the AAD. I think this is pretty much turf protection so that a PA loses their recognition of they go to work for the competition. EM is in a similar position. There are still ERs in the heartland that have FPs running them. EM has a history of fractured leadership. In this case since they have been championing the BC EM physician for ERs they are demanding the same thing from PAs.

CV is a completely different animal. It is about new surgeons not having the time or inclination to train new PAs. They want PAs to already have the training to do CV surgery when they start work. The recognition is a way to show that. Eventually there will be an online didactic component with ability to learn endoharvesting at various venues. I think that good groups will continue to train PAs in house.

None of this really reflects on any facts that PAs are doing poorly. Instead it reflects the documentation driven nature (over actual competency) of hospital credentialing and the nature of newer physicians that are hiring PAs. I disagree with several of the statements in the consensus statement that are presented as facts when I am not sure that is true.

David Carpenter, PA-C

[nodakpa]

Well, I will just say that it may be of some interest to the NCCPA and the APA that, as a newly graduated PA, I'm not the least bit afraid to take exams or undergo specialized training, and I and several of the people in my class are hungry for opportunities like specialized training and residencies. (If that namby-pamby PANCE exam was anything to go by, I'll take all the 7 hour tests the NCCPA can throw at me.) We all have a master's degree already, and think that it should be a requirement. Maybe we just don't have a clue about real life, or maybe we're the wave of the future, but our opinions are valid, and might be of some interest to the powers that be. Only time will tell. But I doubt very seriously that the general trend toward more and better education/training/certification will skip over the PA profession. At least I hope it doesn't.

[Joseph22541]

That's because as a new PA you are naive and perhaps think that more credentials are better (ie nursing). I don't think you realize the cost, lack of flexibility, and further certification requirements on top of the fact that we are the ONLY allied health profession that has to recertify q 6 years. If you want to limit your opportunities, thats up to you. adly, I have a feeling that the specialty camp will win out - money talks and BS walks.

[Joseph22541]

Nodakpa,

The one this you said is true - you have no clue about real life. Ever think you should have been an NP?

[istat2]

Wow guys! This is a chance for NCCPA to generate additional revenues And after all, we all know that they need additional funding

[Contrarian]

Nodakpa,

The one this you said is true - you have no clue about real life. Ever think you should have been an NP?

Dude...!!!

I'm really... really SURE that you can probably express yourself... and hammer your point home... and even get some of us to agree... WITHOUT the personal ATTACKs.

ESPECIALLY considering that Nodakpa's thoughts have been public and in print for quite a while now (its kinda silly to be attacking dude from a 2 yr old post)...

Just thoughts...

Contrarian

[CAdamsPAC]

Wow guys! This is a chance for NCCPA to generate additional revenues And after all, we all know that they need additional funding

Two syllables = NCCPA ....Ca ching!!!!!!!!!!

[perico]

I wonder why this is the way it is? It is discouraging. The AAPA is losing a lot of my respect. They need to get on with the program and think more modern, more advanced, more gung-ho and less conservative. It will only hurt the profession to restrict specialties, recognition and training ops for PA's. No disrespect meant, but this has nothing to do with competition with NP's and the like. It is quite possible that some bored NP's and PA's decided to have a go at it and the whole mess started. Does it take an illiterate like Rodney King to set us in our place? "Can't we all get along?"