AFPPA Collaboration Proposal

[EMEDPA]

If you agree with the following, please send something similar to your state organization reps:

Please support the AFPPA proposal at the HOD in Boston to allow the use of the term "collaboration" instead of supervision. This reflects how most PAs in (insert your state) practice today. Words matter, and employers often believe that PAs require direct supervision in order to practice and hire NPs instead due to this. I practice without a physician present on all of my shifts and have my charts reviewed after the fact. This is not uncommon.
Thank you-
XXXXXXX, PA-C, MPAS, DFAAPA
Emergency Medicine PA
Doctoral Student, Health Science & Global Health

[jdtpac]

If you agree with the following, please send something similar to your state organization reps:

Please support the AFPPA proposal at the HOD in Boston to allow the use of the term "collaboration" instead of supervision. This reflects how most PAs in (insert your state) practice today. Words matter, and employers often believe that PAs require direct supervision in order to practice and hire NPs instead due to this. I practice without a physician present on all of my shifts and have my charts reviewed after the fact. This is not uncommon.

Thank you-

XXXXXXX, PA-C, MPAS, DFAAPA

Emergency Medicine PA

Doctoral Student, Health Science & Global Health

 

 I would like to mention the resolution is also Co-Sponsored by:

·         Ohio Association of Physician Assistants

·         Public Health Service Academy of Physician Assistants

·         Society of Physician Assistants in Addiction Medicine

·         Veterans Affairs Physician Assistant Association

[EMEDPA]

 I would like to mention the resolution is also Co-Sponsored by:

·         Ohio Association of Physician Assistants

·         Public Health Service Academy of Physician Assistants

·         Society of Physician Assistants in Addiction Medicine

·         Veterans Affairs Physician Assistant Association

Thank you for mentioning that. I appreciate your efforts to bring this forward John.

wait, did we just agree on something?.....:)

[Guest Paula]

Dave Mittman just emailed that collaboration resolution passed first round in hod without opposition. Final vote comes up soon, not sure what day but will keep all posted

[Guest Paula]

Email from Dave Mittman:  The HOD passes resolution defining PAs as collaborative:

 

"PAs are health professions licensed, or in the case of the Federal government credentialed to practice medicine collaborating with physicians". 

[jdtpac]

 

Email from Dave Mittman:  The HOD passes resolution defining PAs as collaborative:

 

"PAs are health professions licensed, or in the case of the Federal government credentialed to practice medicine collaborating with physicians". 

 

 

Paula and Eric,

What happened at this year’s House of Delegates was truly an amazing historical event. What transpired was the result of the AFPPA addressing the issue initially at the 2013 HOD. The key turning point was the development of a new definition of PA practice in the VA Health System.  AFPPA’s Past President, Beth Smolko, then took up the torch and followed through to built a coalition of several key individuals and constituent chapters which drafted and submitted a resolution to the 2014 HOD that would change PA scope of practice terminology from “supervision” to “collaboration”. The debate on the floor of the HOD reference committee was overwhelmingly in support of this change. In the end, I'm proud to say that the Ohio delegation, with the support from the AFPPA and other key delegation, submitted the final amendment which actually read:

 

"PAs are health professions licensed, or in the case of the Federal government credentialed to PRACTICE MEDICINE IN COLLABORATION WITH PHYSICIANS".

 

The AAPA also announced they have changed their lexicon to not use the word “assistant” and only use the term “PA”. I know this may not be exactly what individuals who are in support of a title change would have wanted, but I believe this is probably the best compromise at this time. I believe the change in our scope of practice terminology will do much more for us at this time than a change in title.

 

AAPA changing our scope of practice terminology and our lexicon to "PA" is the easy part in the big picture. What lies ahead will be our biggest challenge since the beginning of our profession. Changing attitudes, state and federal laws and rules to accept and embrace the policy changes that were newly adopted by our profession will not happen overnight. Just as it took time for every states to introduce enabling legislation for PA practice and prescriptive privileges, the same will be true for adopting new laws and rules that will include our new scope of practice terminology. Hopefully it will not take as long.

 

I'm glad that I was able to witness and be a part of this truly momentous occasion in the history of our profession.

[jmj11]

Paula and Eric,

What happened at this year’s House of Delegates was truly an amazing historical event. What transpired was the result of the AFPPA addressing the issue initially at the 2013 HOD. The key turning point was the development of a new definition of PA practice in the VA Health System.  AFPPA’s Past President, Beth Smolko, then took up the torch and followed through to built a coalition of several key individuals and constituent chapters which drafted and submitted a resolution to the 2014 HOD that would change PA scope of practice terminology from “supervision” to “collaboration”. The debate on the floor of the HOD reference committee was overwhelmingly in support of this change. In the end, I'm proud to say that the Ohio delegation, with the support from the AFPPA and other key delegation, submitted the final amendment which actually read:

 

"PAs are health professions licensed, or in the case of the Federal government credentialed to PRACTICE MEDICINE IN COLLABORATION WITH PHYSICIANS".

 

The AAPA also announced they have changed their lexicon to not use the word “assistant” and only use the term “PA”. I know this may not be exactly what individuals who are in support of a title change would have wanted, but I believe this is probably the best compromise at this time. I believe the change in our scope of practice terminology will do much more for us at this time than a change in title.

 

AAPA changing our scope of practice terminology and our lexicon to "PA" is the easy part in the big picture. What lies ahead will be our biggest challenge since the beginning of our profession. Changing attitudes, state and federal laws and rules to accept and embrace the policy changes that were newly adopted by our profession will not happen overnight. Just as it took time for every states to introduce enabling legislation for PA practice and prescriptive privileges, the same will be true for adopting new laws and rules that will include our new scope of practice terminology. Hopefully it will not take as long.

 

I'm glad that I was able to witness and be a part of this truly momentous occasion in the history of our profession.

I hope that I'm living to see the day that real change happens.  I will rejoin the AAPA in a heartbeat if the tide is truly turning.

[andersenpa]

Paula and Eric,

What happened at this year’s House of Delegates was truly an amazing historical event. What transpired was the result of the AFPPA addressing the issue initially at the 2013 HOD. The key turning point was the development of a new definition of PA practice in the VA Health System.  AFPPA’s Past President, Beth Smolko, then took up the torch and followed through to built a coalition of several key individuals and constituent chapters which drafted and submitted a resolution to the 2014 HOD that would change PA scope of practice terminology from “supervision” to “collaboration”. The debate on the floor of the HOD reference committee was overwhelmingly in support of this change. In the end, I'm proud to say that the Ohio delegation, with the support from the AFPPA and other key delegation, submitted the final amendment which actually read:

 

"PAs are health professions licensed, or in the case of the Federal government credentialed to PRACTICE MEDICINE IN COLLABORATION WITH PHYSICIANS".

 

The AAPA also announced they have changed their lexicon to not use the word “assistant” and only use the term “PA”. I know this may not be exactly what individuals who are in support of a title change would have wanted, but I believe this is probably the best compromise at this time. I believe the change in our scope of practice terminology will do much more for us at this time than a change in title.

 

AAPA changing our scope of practice terminology and our lexicon to "PA" is the easy part in the big picture. What lies ahead will be our biggest challenge since the beginning of our profession. Changing attitudes, state and federal laws and rules to accept and embrace the policy changes that were newly adopted by our profession will not happen overnight. Just as it took time for every states to introduce enabling legislation for PA practice and prescriptive privileges, the same will be true for adopting new laws and rules that will include our new scope of practice terminology. Hopefully it will not take as long.

 

I'm glad that I was able to witness and be a part of this truly momentous occasion in the history of our profession.

Each legislative action group in each state will be working hard to intorduce bills to include this "collaborative language" in order to affect rules and code.

We will be "opening the books" (what the HOD claim they feared 2 yrs ago)

It is unfortunate that we couldn't have included the Associate title at the same time

 

The push to use the term "PA" is meaningless. Acronyms, by definition, stand for something. The "A" will still stand for assistant.

 

When Kentucky Fried Chicken changed their name to KFC, it didn't change the fact that they fry chicken.

You may want them to call us PAs but we will still be assistants in the eyes of many.

 

The collaboration term is revolutionary and wonderful, but anyone trying to convince you that "PA" is gained ground is just trying to fool you.

[jdtpac]

Each legislative action group in each state will be working hard to intorduce bills to include this "collaborative language" in order to affect rules and code.

We will be "opening the books" (what the HOD claim they feared 2 yrs ago)

It is unfortunate that we couldn't have included the Associate title at the same time

 

The push to use the term "PA" is meaningless. Acronyms, by definition, stand for something. The "A" will still stand for assistant.

 

When Kentucky Fried Chicken changed their name to KFC, it didn't change the fact that they fry chicken.

You may want them to call us PAs but we will still be assistants in the eyes of many.

 

The collaboration term is revolutionary and wonderful, but anyone trying to convince you that "PA" is gained ground is just trying to fool you.

 

Eric,

 

It's not that I disagree with you about the title and the implications of the acronym "PA". I've had my disagreements in the past with the pundits that support a title change, however; in light of what's happening in Missouri my position is softening. For now I think we've made great strides and we do need to give the Academy some credit for trying to move our profession forward. Those states that are going to be setting the standard for incorporating the new scope of practice terminology to "collaboration" are truly going to be having an uphill battle which I doubt most constituent organization will not be able to afford financially without the support of the Academy. Ohio, for example, received over $250,000 in grants between 2001-2006 while we were in a battle for increasing our scope of practice to include physician delegated prescriptive authority.This was only made possible through the funds the Academy receives in revenue from membership. 

 

if by chance, some constituent chapters are able to incorporate a title change along with the new scope of practice terminology, I don't think anyone would not support. What we need from the physician assistant forum, PAFT and all PAs is for us to support the Academy by becoming members. Regardless of how you have felt about the Academy in the past, it is superfluous to what all of our attitude should be in the future. Supporting the Academy may not benefit you now but if we prevail it will benefit us all in the future. Please do not wait to see what happens now, give them the benefit of the doubt, encourage all your colleagues to support the Academy NOW, and I believe you will begin to see things change. I challenge all of you to support the Academy and give them a chance to prove they can deliver. Thank you.

[jmj11]

When Kentucky Fried Chicken changed their name to KFC, it didn't change the fact that they fry chicken.

You may want them to call us PAs but we will still be assistants in the eyes of many.

 

Which reminds me of an interesting story. I was taking care of (the) Colonel Sanders in the hospital (before he passed away). I was between my BS degree and starting the PA program.  He asked me what I was going to do. I said I was waiting to get into the Physician Assistant program at the U. of Kentucky. Then he said something along the line, "Hell boy, why don't you go to college instead."  I had to explain to him what a PA was, but he assumed it was the same as a medical assistant. 

 

I know . . . I digress. But a true story.

[andersenpa]

Eric,

 

It's not that I disagree with you about the title and the implications of the acronym "PA". I've had my disagreements in the past with the pundits that support a title change, however; in light of what's happening in Missouri my position is softening. For now I think we've made great strides and we do need to give the Academy some credit for trying to move our profession forward. Those states that are going to be setting the standard for incorporating the new scope of practice terminology to "collaboration" are truly going to be having an uphill battle which I doubt most constituent organization will not be able to afford financially without the support of the Academy. Ohio, for example, received over $250,000 in grants between 2001-2006 while we were in a battle for increasing our scope of practice to include physician delegated prescriptive authority.This was only made possible through the funds the Academy receives in revenue from membership. 

 

if by chance, some constituent chapters are able to incorporate a title change along with the new scope of practice terminology, I don't think anyone would not support. What we need from the physician assistant forum, PAFT and all PAs is for us to support the Academy by becoming members. Regardless of how you have felt about the Academy in the past, it is superfluous to what all of our attitude should be in the future. Supporting the Academy may not benefit you now but if we prevail it will benefit us all in the future. Please do not wait to see what happens now, give them the benefit of the doubt, encourage all your colleagues to support the Academy NOW, and I believe you will begin to see things change. I challenge all of you to support the Academy and give them a chance to prove they can deliver. Thank you.

I'm Matt, not Eric (though he and I are friends and PAFT Charter Members).

 

I am an AAPA member and have been so all along. As well as my state (WAPA). I firmly believe in change from within and know that we have one major voice which needs to be supported.

Furthermore I think the AAPA has taken the right stance lately. Openly rejecting the antiquated idea of supervision, and the president agreeing that the assistant title is inaccurate, are milestones.

 

That being said I am still pessimistic about the delegates' modus operandi. They (last time I looked into it) are not individually accountable for their votes. I have no way of knowing how MY delegates (that I elected to represent ME) individually voted. If this changed I would love to hear it. They are also susceptible to influence from the BOD and staff (this may be conjecture on my part but I trust my sources).  The state chapters that undertakes this will be dependent on academy funding as you say. The same academy that was openly hostile to the title change advocates, crafted a survey with loaded questions to skew the results, and (by nature of our still dependent profession) must kowtow to the state medical boards and societies who will pitch a fit at the idea of daring to call ourselves Associates.

 

At a WA state DOH meeting I brought up the title change survey and the FIRST question I got from a physician commission member was "does this mean PAs want independent practice". I am skeptical that the academy is going to fund a process that would generate that much opposition from the state's physicians.

 

So the HOD CANNOT be convinced of the need for an "investigation into the ramifications of a title change", but CAN (seemingly) agree that collaboration is better than supervision. Doesn't reconcile to me as an outsider, so something is going on in the HOD or board that made a HUGE sea change in 2 years. Hopefully its a sign of better things to come. 

 

If you can explain why the same group that crucified Associate now supports Collaboration, I'm eager to hear.

[Guest Paula]

Matt, how did you answer the question from the physician about independent practice for PAs?

 

What the heck is their beef with us wanting independent practice?  Optometrists have it, podiatrists have it, chiropractors have it, naturopaths have it, NPs have it.

 

Why not PAs.  We would still collaborate. Just like the ODs, DPMs, DCs, NPs.  (Not really sure if naturopaths collaborate with any of us).

[andersenpa]

The doc who brought it up was a family med DO. Competition concerns, like they have w/ NPs.

I told them it would be foolish to not think that some PAs want independence

 

WAPA and their people were there and after I got done at the podium, they were quick to stand up and state that  (paraphrasing) "no PA groups are seeking independent practice."

 

State PA chapter, kowtowing to the state docs.

[Guest Paula]

"AAPA changing our scope of practice terminology and our lexicon to "PA" is the easy part in the big picture. What lies ahead will be our biggest challenge since the beginning of our profession. Changing attitudes, state and federal laws and rules to accept and embrace the policy changes that were newly adopted by our profession will not happen overnight. Just as it took time for every states to introduce enabling legislation for PA practice and prescriptive privileges, the same will be true for adopting new laws and rules that will include our new scope of practice terminology. Hopefully it will not take as long."

 

@jdt: I'm in it for the long haul....or at least until I retire....in 10 years or so.   We are protecting our profession for the upcoming PAs and some of us will not bask in the fruit of our labor.  It can be done.  State by state and when we develop a vision plan for the PA profession and go for it we will succeed.  Our model can be patterned after what the AANP has done successfully for their constituents. 

[ventana]

fool me once, shame on you

fool me twice, shame on me........

 

I am hoping that AAPA has gained a new perspective and will continue to follow through on this......  

 

I will join the AFPPA as they deserve my $$$

I am one of the first members of PAFT and will send them extra $$ next time I renew

I will renew with AAPA and hope then remain true to changing, but I am suspect....  

[ventana]

Matt, how did you answer the question from the physician about independent practice for PAs?

 

What the heck is their beef with us wanting independent practice?  Optometrists have it, podiatrists have it, chiropractors have it, naturopaths have it, NPs have it.

 

Why not PAs.  We would still collaborate. Just like the ODs, DPMs, DCs, NPs.  (Not really sure if naturopaths collaborate with any of us).

 

 

I would answer "PAs are part of a team approach to health care, we don't want independent practice, but instead to be able to practice at the top of our license, to help our patients, and not be encumbered by antiquated regulations based off the 'assistant' part of our past name".  Let me sign for VNA, Hospice, DME, and Death Certs,  basically I should be able to sign anything for my patients.......

 

 

I am very pleased that Assistant is removed from the AAPA verbiage, just today I was thinking the AAPA could do this ASAP at no cost or expense, no legal fees, and simply call us PAs.   It is a small step but at least it is a step in the right direction.....

 

 

My business cards say:

 

________________ PA-C

Associate Medical Director

 

No where does it say Assistant and AAPA can follow this lead idea - just make "Assistant" go away!

[Guest Paula]

The doc who brought it up was a family med DO. Competition concerns, like they have w/ NPs.

I told them it would be foolish to not think that some PAs want independence

 

WAPA and their people were there and after I got done at the podium, they were quick to stand up and state that  (paraphrasing) "no PA groups are seeking independent practice."

 

State PA chapter, kowtowing to the state docs.

Sad, really sad that the chapter is kowtowing.  What does the chapter think now that AAPA has made their declaration for collaboration?  

 

 If PAs could be credentialed under our own NPIs with all insurance companies, get rid of incident to billing,have autonomous practice rights within a collaborative relationship, get HITECH funds, sign for hospice, DME death certs, sign Motor vehicle licensing evals for elderly, sign pre-ops for pediatric dental surgery, have independent DEAs, be responsible for our own work (within the collaboration environment), and not have the collaborator be required to sign for any of that I would be jumping for joy.  

 

Also PAs should gain the designation as Primary Care Provider by CMS that is recognized by all states.  Those of us in rural care should have the practice rights to collaborate with groups of physicians or medical facilities rather than just a lone physician to protect our right to work. Independent licensing but collaborative practice. 

 

If we get all that and are still called PAs I would settle for PA, but still not convinced either of the title.  I haven't said assistant now for about a year and my patients haven't asked "what does  PA stand for?"

[rcdavis]

 

Nicely stated.

[andersenpa]

Sad, really sad that the chapter is kowtowing.  What does the chapter think now that AAPA has made their declaration for collaboration?  

 

 If PAs could be credentialed under our own NPIs with all insurance companies, get rid of incident to billing,have autonomous practice rights within a collaborative relationship, get HITECH funds, sign for hospice, DME death certs, sign Motor vehicle licensing evals for elderly, sign pre-ops for pediatric dental surgery, have independent DEAs, be responsible for our own work (within the collaboration environment), and not have the collaborator be required to sign for any of that I would be jumping for joy.  

 

Also PAs should gain the designation as Primary Care Provider by CMS that is recognized by all states.  Those of us in rural care should have the practice rights to collaborate with groups of physicians or medical facilities rather than just a lone physician to protect our right to work. Independent licensing but collaborative practice. 

 

If we get all that and are still called PAs I would settle for PA, but still not convinced either of the title.  I haven't said assistant now for about a year and my patients haven't asked "what does  PA stand for?"

Well this is all my interpretation of their actions. It was so reflexive in trying to counter what I thought was an obvious statement- of course there will be PAs who want independence- that I don't know how else to say it.

 

My pts rarely ask what a PA is but I don't get the impression that they really get it- most call me doc just like lots of other PAs get....

 

Where does the PCP status for PAs stand on a state basis- is it most, or uncommon?

[ventana]

Sad, really sad that the chapter is kowtowing.  What does the chapter think now that AAPA has made their declaration for collaboration?  

 

 If PAs could be credentialed under our own NPIs with all insurance companies, get rid of incident to billing,have autonomous practice rights within a collaborative relationship, get HITECH funds, sign for hospice, DME death certs, sign Motor vehicle licensing evals for elderly, sign pre-ops for pediatric dental surgery, have independent DEAs, be responsible for our own work (within the collaboration environment), and not have the collaborator be required to sign for any of that I would be jumping for joy.  

 

Also PAs should gain the designation as Primary Care Provider by CMS that is recognized by all states.  Those of us in rural care should have the practice rights to collaborate with groups of physicians or medical facilities rather than just a lone physician to protect our right to work. Independent licensing but collaborative practice. 

 

If we get all that and are still called PAs I would settle for PA, but still not convinced either of the title.  I haven't said assistant now for about a year and my patients haven't asked "what does  PA stand for?"

 

 

bada bing!!!!!!!!!!!!!!!!!!!

[Guest Paula]

I do not know what the PCP status is for PAs in all states.  I recently saw a post on a PA facebook site of a PA in Idaho who was de-credentialed by insurance companies and all of her patients were listed under the Nurse Practitioner at her clinic.  Her SP was unaware of the change and the insurance companies told her she cannot be credentialed because of the ACA.

 

Something is fishy in Idaho.

[jmj11]

I do not know what the PCP status is for PAs in all states.  I recently saw a post on a PA facebook site of a PA in Idaho who was de-credentialed by insurance companies and all of her patients were listed under the Nurse Practitioner at her clinic.  Her SP was unaware of the change and the insurance companies told her she cannot be credentialed because of the ACA.

 

Something is fishy in Idaho.

There is something fishy and potentially serious about this.  I recently contracted with Group Health. They decided, mid-stream that they were no longer credentialling PAs but would credential NPs. As I called and talked to them about it, they said, their words, "A Patient would not go to a practice just to see the PA. They would go there to see the MD, DO or NP.  The PA works in helping the other providers."  I was quite upset and saw this as a serious matter and argued with them (I've been arguing with Group Health for three years).  I did turn this over to Michael Powe the insurance Guru at AAPA.  I never heard back and that was in early March.

[rcdavis]

Here it is, again. ASSISTANT Denegating what we do, for and to whom.

 

Until the NPs finagled themselves into an approved provider status, I really didn't care.

But hearing now how insurers make the, to them, obvious conclusion that the work "assistant" is a the noun and physician is the adjective, we will forever be classified as medical assistants, office help, etc.

 

Thanks AAPA. Thanks a lot.

[G. Davenport]

A title and a hand shake are more important than our profession understands.

 

 

Sent from my iPhone using Tapatalk

[jdtpac]

 

 

 

 

That being said I am still pessimistic about the delegates' modus operandi. They (last time I looked into it) are not individually accountable for their votes. I have no way of knowing how MY delegates (that I elected to represent ME) individually voted. 

 

If you can explain why the same group that crucified Associate now supports Collaboration, I'm eager to hear.

Matt,

I first want to apologize for not remembering your first name, and I in no way was trying to "change your name". With that said, let me address these two questions.

 

The HOD has never taken a voice or electronic vote from each individual delegate. However, I believe if asked, each delegate should be required to divulge to a member of their constituent chapter regarding their vote on any issue. Especially, because you are a dues paying member of a particular constituent organization that has voted them into that position. if you didn't agree with their vote the only alternatives you have other than a good "lip lashing" is to not vote for them again or take more drastic measure and not renew your membership.

 

The second question is probably the hardest to explain and most difficult to make you understand. And I'm giving this answer to you through my perspective and it does not reflect the opinion of any other individuals or organizations. As I stated, I think the impetus for this change was a result of our countries largest employer of PA, the Veterans Health System, changing their definition of PA scope of practice within the VHS. There was also the strong and persistent influence of the AFPPA that originally drafted the resolution to mirror the VA's new definition. And as natural as it would be,because they were the genesis of our profession, there was very strong support from federal services PA, public health service Corps and the veteran PA's. the Society of PA's in addictive medicine was the only specialty organization and Ohio was the only state chapter that cosponsored the resolution. As co-author of the draft resolution with Beth Smolko, I can tell you we did reach out to other constituent organization which I believe helped us gain support prior to the HOD. It was timing, timing, timing. I don't believe it had anything to do with title and the new Academy lexicon PA. I was also very impressed by the student delegation as they spoke very eloquently in support of this resolution.

 

I know that doesn't satisfy those individuals who are dissatisfied with our current title, but I believe this is a huge step forward which might facilitate re-opening the dialogue on title change.