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Shots fired- AAPA to formulate new certification process


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I just read a post on a PA facebook page where someone asks about taking the EM CAQ......


When asked about why he was deciding to take it, he stated that his medical director offered him a hefty bonus if he could pass it....


I feel like this is the first step in it becoming mandatory for employment within a specialty.....


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KSmith

 

Until you have actually taken the PANRE multiple times (yep, I have) AND done Pathway II (yep, I have) and until you have been in practice for more than 15 years - I am on 25....

 

You really don't get to say you understand the problems with PANRE or NCCPA or CME.

 

This whole PI CME is a giant clusterFUC& and hard to find, hard to get and not uniformly accepted by AAPA/NCCPA.

 

The content of PANRE is INANE and so fraught with problems, in my opinion, that is does NOTHING of any use to my daily clinical practice and actually dumbs me down from doing what is best for my patients. 

 

And the PI and self-assessment CME was completely scrapped yesterday, according to the email from NCCPA. If you've already done it or choose to, it's worth double the allotted CME credits.

 

And those complaints about PANRE were, I thought, the entire reason behind the move to change it.

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So to point out the obvious

PA for a whole 17 months and now giving out advice on a recertification process you have never done....

Nuff said....

 

Well considering I "pointed out the obvious" myself - multiple times - in my posts on this thread, it's not as if it required any research of my past posts to reveal this.

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Ksmith 10

 

In an effort for transparency, are you currently on the BOD of the NCCPA? Do you have first hand information concerning the efforts of communication between the two boards?

 

No, I have just actually been reading the e-mails that have been sent out by both organizations, and the statements made on both websites since the beginning.

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  • 3 months later...

I've not been too impressed with the AAPA in the past, however, I am pretty impressed with the recent actions of the AAPA regarding this subject. 

 

What I'm also impressed with is that the AAPA's motivation seems truly to be in support of PAs. 

 

A contrast I've observed when reading postings on this subject on both AAPA's and NCCPA's sites, as well as speaking to reps/staff of both, is that the NCCPA has sounded highly distant, deflective, non-transparent, and negative in places...almost like an angered parent, who gets mad when their ways are questioned.  In contrast, the AAPA has demonstrated transparency and a genuine effort for support of the profession, were approachable, open, transparent, positive, and genuinely concerned. 

 

About PA experience:  As a PA, who just took the PANRE as I was up for my 2nd, (having passed the PANCE and 1st PANRE fine), I do see the difference, compared to when I was just out of the gates and still wet behind the ears.  I have worked in a subspecialty ever since graduating.  I feel to have found a niche and I love what I do.  I work very hard and put in a lot of hours--sometimes 10, 12, or even more a day and take call.  Since being in PA school, I now have a family, including 2 children.  I can really appreciate the comment made earlier about having to "dumb down" what I do when prepping for PANRE.  Having to study general medicine, and really there's so much to cover, WHILE working a hard job day-to-day--putting in many hours and come home and have kiddos with homework, and/or are sick, etc, and the list goes on.  Not to be whining about it, rather, simple experience/living it first-hand.  The fact is, coming up on the PANRE, when you've gotten to a point in your life where you're really stretched in life, yet, doing very well, doing a great job, being a very solid, highly trusted, and respected PA, it can be highly difficult to prepare well enough. 

 

I've recently read or heard of real stories of real people--PAs, who were working very hard, doing very well and well-respected, yet failing the PANRE and lost their jobs...some, their homes, etc...  This is the thing that gets me.  The fact that it holds that much impact on our lives.  I've tried very hard to get REAL stats on PANRE pass / fail rates and, while the NCCPA tells me one thing on the phone, I read something different elsewhere. ...but, for one's very profession on the line?  Is this truly necessary?  I do not feel it is.  I feel the PANRE process is very highly stressful and is, potentially, career-threating itself.  It's like PAs are a host and the PANRE is a potential virus that can kill it's host...yet, designed that way.  I am not against a life-long learning career; that is not what I'm saying at all. 

 

The fact that the AAPA has gotten in the NCCPA's face to advocate for this, is something I applaud.  As one, who took the PANRE very recently and await my results, I feel the full potential impact this could have on my very career and life.

 

The fact that the AAPA advocates for this very thing is something I support.

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  • 4 months later...

If the AAPA can tame the NCCPA down a little bit, more power to them. They are riding the wave of hate the AMA is throwing at the doc recert process.

 

Good to see the AAPA finally grew some stones. If they can step NCCPA back, next they should go after ARC-PA.

 

What's worth going after of the ARC-PA?  I'm well-aware of the NCCPA's severe BS but unaware of ARC-PA's.

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I hope I have not been un-cordial... If I have, I apologize...

 

I seem to have the minority opinion here. My personal take is that the proposed NCCPA changes are not that big a deal and have provoked a surprisingly high level of blow-back.

For the AAPA to use the "nuclear option" and threaten to make a new credentialing board seems like a show of disunity in the PA profession which I fear reflects badly on us as a profession. It doesn't make it look like we have our "stuff" together.

 

The addition of PI-CME/SA-CME or whatever (I have not fully familiarized myself with those because I'm in the last certification year on the 6 year cycle that doesn't need those) seemed to me much more onerous than the proposal to have to take some take-home tests that you can fail and then remediate. Or left-out specialties like geriatrics (see post above) to have to take a general knowledge test, which we already have to do.

 

CME and testing requirements may annoy you, and likely they are overly expensive, but doesn't it make our profession MORE respectable if we are held to a continuing education standard? Lifelong learning is at the core of the practice of medicine, no matter what the bureaucratic requirements may be.

 

Granted, there is a tendency for the boards (including MD boards) to over-emphasize silly and non-practical knowledge.

The certification requirements and recert and CME is just part of a long standing discussion/argument. The NCCPA has recently hired lobbyists to work state legislators to keep/make NCCPA certification a requirement for a state license. They often do this at the expense of state organizations legislative efforts with little or no discussion or coordination with said state organizations. Basically they are screwing over the PAs at the state level to try and maintain their stranglehold on PAs via certification. It is an outrage and until they make some statements and positive efforts to stop doing that..which they won't..then they are an out of control organization serving their own needs at the expense of the PAs they claim to care for so much. They are hurting the PAs on the ground where they work and live to maintain their current status. Option are needed besides the NCCPA.

Creating another certifying organization and making it accepted by states and insurers is a huge task but can be done with time and persistence.

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"If they can step NCCPA back, next they should go after ARC-PA."

 

I assume you are talking about program saturation/standards? Agree it time to control supply. Job saturation aside, there is no reason to increase seats beyond the ability to obtain quality clinicals and to admit only top-notch candidates, as this can only dilute the product. As an example, we are a relatively small program and our coordinators are generally able to, with some difficulty, obtain good quality clinicals for us, most without excessive travel. This is helped by the fact that quite a few people set them up elsewhere on their own and we are the only program in the region. That said, there is not a lot of "meat left on the bone" in this regard. A new program is opening up nearby that is projected to be almost twice our size. This will likely lead to a desperate fight for clinicals in this area with all the associated annoyance of preceptors and potential preceptors, ill will and accusations between two programs training people in the same profession etc etc. I am told we recently lost a quality preceptor because a program in a nearby state began paying preceptors.

 

To what end? While the healthcare industry in this area is able to provide jobs for the relatively few grads who stay local there is certainly not a shortage of PAs. IMO the goal should always be to maintain high standards and to maintain a little bit of hunger for grads on the part of employers.

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The certification requirements and recert and CME is just part of a long standing discussion/argument. The NCCPA has recently hired lobbyists to work state legislators to keep/make NCCPA certification a requirement for a state license. They often do this at the expense of state organizations legislative efforts with little or no discussion or coordination with said state organizations. Basically they are screwing over the PAs at the state level to try and maintain their stranglehold on PAs via certification. It is an outrage and until they make some statements and positive efforts to stop doing that..which they won't..then they are an out of control organization serving their own needs at the expense of the PAs they claim to care for so much. They are hurting the PAs on the ground where they work and live to maintain their current status. Option are needed besides the NCCPA.

Creating another certifying organization and making it accepted by states and insurers is a huge task but can be done with time and persistence.

 

I've long wondered where all the money is going in the NCCPA.

 

Certification maintenance fees are now $150.00. How many PAs does the NCCPA certify/maintain each year? Let's just say 50,000 for discussion's sake---that's 7.5 MILLION dollars of revenue...not including PANCE and PANRE fees.

 

Pockets are being lined somewhere...I refuse to believe their operating costs are that high.

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I've long wondered where all the money is going in the NCCPA.

 

Certification maintenance fees are now $150.00. How many PAs does the NCCPA certify/maintain each year? Let's just say 50,000 for discussion's sake---that's 7.5 MILLION dollars of revenue...not including PANCE and PANRE fees.

 

Pockets are being lined somewhere...I refuse to believe their operating costs are that high.

 

Of course. The NCCPA reeks of fraud and abuse. I would love a full investigation into their finances, but something like that takes money.

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Of course. The NCCPA reeks of fraud and abuse. I would love a full investigation into their finances, but something like that takes money.

 

I would like to see a forensic accounting job done on them with results made public to all certified PAs.

 

Another suspicious move was when they capitulated so easily to the AAPAs proposal of developing their own certification arm. Something like that would draw a lot of attention and scrutiny to their practices.

 

According to the NCCPA there were over 108,000 certified PAs at the end of 2015. That's $16.2 MILLION in annual certification revenue alone. We'll give them the benefit of the doubt and assume 10,000 of those PAs retired or went out of practice in a given year. Still, that's $14.7 Million. You cant tell me that's all going to (self-serving) lobbying and their overhead costs. A staff of what, maybe 100 people?

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I think the NCCPA is a non for profit so salaries are supposed to be public record.  I'm pretty sure the CEO makes like ~ $400,000 plus.  Have you ever tried to talk with someone--other than entry-level staff, who answer the phone on Fridays?  I'm pretty sure none of the staff is there on Fridays, apart from a skeleton crew for answering phones n stuff.  There's NEVER been any staff (apart from basic phone-answers) on Fridays, when I've called.

 

Having had numerous errors made from them recently with PANRE (and PearsonVue), how it was dealt with, and having been on the phone with them numerous times, the way I was spoken to and handled--combined with the re-cert test--itself--I have lost a ton of respect for the NCCPA.  It has become significantly increasingly obvious to me that they are severely self-serving. 

One illustration is: I was very stressed about the PANRE before taking it recently and yet knowing my job was literally potentially on the line and at stakes, an NCCPA staff, who is an RN and sits at a desk and can--in no way--relate to my stress said, "I can appreciate you anxiety."  Um...ok, yeah... um, no you can't.

 

However, nothing... nothing will happen if we aren't MUCH MORE of a squeaky wheel.  We, as a profession (and individually too), need to actually do something.. write pointed, yet intelligible letters to the AAPA.  The one thing I have been trying to research is who the NCCPA is accountable to.  ...there must be somebody.  Perhaps one, of some of us, can find a philanthropist and hire a forensic accountant. 

On a more practical level, we can--at least--write strong, pointed, yet clear and intelligible letters to the AAPA, who have stepped up the game in advocating for us and now seem much more involved in taking action on our behalf.

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I've long wondered where all the money is going in the NCCPA.

 

Certification maintenance fees are now $150.00. How many PAs does the NCCPA certify/maintain each year? Let's just say 50,000 for discussion's sake---that's 7.5 MILLION dollars of revenue...not including PANCE and PANRE fees.

 

Pockets are being lined somewhere...I refuse to believe their operating costs are that high.

The NCCPA should undergo a forensic accounting investigation. It is a group of aluminum siding salesmen running con games on hardworking PAs. Perhaps a PA insider who holds a board seat at the NCCPA could leak some valuable information to help start the invasion. FYI...with regard to "operating costs" they essentially have none. There in no research and development; there is no manufacturing. In a service organizations, margins are very high precisely because there are few operating costs.
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The NCCPA should undergo a forensic accounting investigation. It is a group of aluminum siding salesmen running con games on hardworking PAs. Perhaps a PA insider who holds a board seat at the NCCPA could leak some valuable information to help start the invasion. FYI...with regard to "operating costs" they essentially have none. There in no research and development; there is no manufacturing. In a service organizations, margins are very high precisely because there are few operating costs.

 

Why would they do this? I am sure anyone on the NCCPA board is compensated nicely in some form; I doubt they would be willing to give up that cash-cow.

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I know several folks who are or were previously on the nccpa board. apparently the cost of developing and validating pance and panre is not inconsequential. not excusing their actions, just putting that out there.

I honestly think all this talk of an alternate board is overblown. I'm actually pretty happy they got rid of the SA and PI requirements. those were the big deal for me, not taking PANRE every 10 years. I think compromises will continue to be made and we will continue status quo with only 1 certification body. one of the criticisms of the np educational process in the past has been multiple routes to certification. my understanding is that the np certification boards merged, so folks can't take multiple exams and only have to pass one.

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The NCCPA should undergo a forensic accounting investigation. It is a group of aluminum siding salesmen running con games on hardworking PAs. Perhaps a PA insider who holds a board seat at the NCCPA could leak some valuable information to help start the invasion. FYI...with regard to "operating costs" they essentially have none. There in no research and development; there is no manufacturing. In a service organizations, margins are very high precisely because there are few operating costs.

 

Some of their operating costs are used to hire lobbyists to lobby against us in Illinois, West Virginia, and New Mexico. 

 

https://www.aapa.org/nccpa-lobbies-state-legislatures/

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Some of their operating costs are used to hire lobbyists to lobby against us in Illinois, West Virginia, and New Mexico. 

 

https://www.aapa.org/nccpa-lobbies-state-legislatures/

You know, in unions, especially (or exclusively?) when membership is mandated as part of a 'union shop' arrangement, there exists an option for employees to opt out of paying for the political activities of the union.  I wonder if we have that same right, to not pay mandatory fees to an organization that subsidize that organization's political ambitions...

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There is one thing that is absolutely within our control. STOP APPLYING FOR CAQs. These money grabs directly fund lobbyist who work to keep mandatory PANRE and fight against FPAR. You folks who think the credential of CAQ is helping you but it is ammunition to hold down the PA profession and keep our necks under the boot of the physician. Fight back against these dishonest crooks and cease CAQ credentialing.

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I know several folks who are or were previously on the nccpa board. apparently the cost of developing and validating pance and panre is not inconsequential. not excusing their actions, just putting that out there.

I honestly think all this talk of an alternate board is overblown. I'm actually pretty happy they got rid of the SA and PI requirements. those were the big deal for me, not taking PANRE every 10 years. I think compromises will continue to be made and we will continue status quo with only 1 certification body. one of the criticisms of the np educational process in the past has been multiple routes to certification. my understanding is that the np certification boards merged, so folks can't take multiple exams and only have to pass one.

No offense EMED but we are supposed to accept that the NCCPA is an honest organization because you "know some of them and they said everything is cool". Seriously, why not say "these guys at the NCCPA are goodfellas?" I could buy that one.

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No offense EMED but we are supposed to accept that the NCCPA is an honest organization because you "know some of them and they said everything is cool". Seriously, why not say "these guys at the NCCPA are goodfellas?" I could buy that one.

 

Hyperbole aside, I actually agree with this.

 

It's nice to see a post from you that doesn't begin with "The sky is falling!"...

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EMEDPA, with humility and respect:  You're an ER PA I think?  There is a lot of us, who are in specialties and have legitimate feelings about this high stakes re-cert testing.  I'd humbly ask you respect, and even consider supporting the fact that many of us are in specialties/sub-specialties and that it's reasonable to pursue evolution of our re-cert process.  I did get an email from the AAPA that they have actually undergone real business proposals of what it would take to credential and find up-front funding for a new re-cert process.  (not an original certification but re-cert).  The AAPA BOD will be meeting again with this in Vegas.  It may, or may not, be a real potential but, it might be. 

 

I don't feel that any of us but particularly who work in specialties, over 70% of us--should have a high stakes test hanging over our jobs and livelihood. One of the points that the AAPA addressed with the NCCPA is that there are other ways to do and evolve our re-cert process, (as our profession has evolved), and in respect for us to have the laterality of moving to different areas of medicine--other than a high stakes test.  If you were in a subspecialty for many years and, in fact, never even worked a lick of general medicine/ER/hospitalist, you might not be as quick to say the high stakes test isn't a big deal.  The stress that comes with this for some/a lot of us is indescribable. The time away from my practice in preparation absolutely did hurt patient access as well as my family. 

I'd humbly ask you to have maybe a little more understanding and support for us--your colleagues, who don't work in gen medicine/ER/hospitalist.

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