NCCPA Position Statement (was: report)

[TWR]

Please read the report that was done by Dawn Morton-Riaz and and comment please. It was in the HUDDLE. The comments are great. Her article is eye opening. I would attach it if I could but I am too old to know how :(

[Reality Check 2]

I can't navigate the HUDDLE to save my life.

I can't find her discussion. Found a 1000 others but nothing with her name on it.

 

I am old too

[aimyhtixela]

Copied and pasted from http://www.medpagetoday.com/PublicHealthPolicy/GeneralProfessionalIssues/60431

 

The PA Recertification Debate: We Need to Be Tested

Professional credibility and patients' confidence is at stake

 

by Dawn Morton-Rias EdD

09.23.2016

 

A battle is looming in healthcare. At stake is your professional credibility and the confidence patients have in the care they receive.

At the heart of this battle is what PAs and physicians must do to retain certification throughout their careers and a debate about whether healthcare providers should have to periodically demonstrate the currency of knowledge on an exam.

 

As a certified PA, I appreciate the individual perspectives and passion this topic evokes. However, I also think it's an issue important to view through a much broader lens

Currently, PAs -- like physicians in 24 specialties -- recertify through a two-tier process that includes completing substantive CME requirements and passing a secure, proctored exam every 10 years.

On one side of the issue are those who believe testing is an important way to gain, retain, and demonstrate current knowledge. On the other side are those who assert that testing is time consuming and costly, and unrelated to patient care and safety.

 

Opponents of proctored exams maintain that they can self-identify and self-correct knowledge gaps, that traditional CME activities are sufficient to maintain current knowledge, and that "their" patients do not care if they recertify by exam. In that context, the public is being asked to simply trust.

 

Shouldn't patients expect that providers are being held to objective standards, passing a once-a-decade exam to confirm they have maintained a baseline fund of knowledge and are up to date on the latest medical advancements and treatments? Do we honestly want to tell patients, "your health, and that of your family, isn't worth the time it takes for me to prepare for and take a test?"

 

Without doubt, testing is stressful and takes time. I studied for, took, and passed my recertification examination this summer. Was it an enjoyable experience? Of course not. I do believe, however that taking the test demonstrates continued commitment to high-quality patient care.

 

The facts are that testing does matter. The preponderance of evidence suggests or demonstrates that testing is a valuable learning tool; it is more effective than study alone, it aids knowledge retention, and it improves practice (see the research on the NCCPA website). On the other hand, despite claims to the contrary, no credible evidence exists that eliminating testing is good for patients.

 

The National Commission on Certification of Physician Assistants serves the interest of the public through certification and recertification programs that ensure patients have access to safe and effective care.

The NCCPA board of directors and staff have spent the last year and a half talking and listening to PAs, analyzing data, and assessing feedback from a variety of stakeholders, including patients. All indicators suggest what most of us in health care know: health care continues to change, and it does so rapidly. Demand is high, more clinicians are practicing in specialties, and patients want and expect assurances that their providers have the knowledge and skills to provide the care they and their families need.

 

It's our role to take those insights and create the best process for recertification we can. Most importantly, we want to assure patients that as a profession we are fully committed to their health and safety and are willing to be held to the high standards necessary to demonstrate that.

 

The time has come to take a stand for what is the right thing to do -- not necessarily the easy thing to do and certainly not just what others are doing. We need to recommit to what has served the PA profession and patients well from its start and what continues to be best for patients and the healthcare community. The complexity of healthcare today calls for a 21st century certification for the 21st century PA. Our patients expect our best and deserve nothing less!

 

Dawn Morton-Rias, EdD, PA-C, is the president/CEO of the National Commission on Certification of Physician Assistants (NCCPA). Before joining NCCPA in 2014, she was dean of the College of Health Related Professions and a professor at SUNY Downstate Medical Center. She has also been president of the Physician Assistant Education Association; an adviser to the National Health Service Corp.; and a commissioner on the Accreditation Review Commission on Education for the Physician Assistant.

[mmiller3]

Nothing biased about the CEO of the NCCPA advising us of the need to take a test they are paid to administer... 

[Reality Check 2]

At least she IS a PA and not just a CEO...

[Reality Check 2]

I do not mind taking a test every 10 years and maintaining some sort of certification similar to the 10 year cycles of physicians in 24 different specialties.

 

Having NO certification puts us at increased risk in litigation since we would have NOTHING to show we have been tested in any way to show basic competencies.

 

I would not take my family to a NON board certified orthopaedist - and they DON'T exist. 

 

It is NOT just the money in my mind - it isn't that bad and only every 10 years.

 

We finally got rid of the SI/PA CME - we have made ONE STEP in the right direction.

 

It finally sounds like someone is listening.

 

If we can keep the test at every 10 years without the 2 year interval nonsense then I would be fine.

 

I have done this a long time, been there - done that. Done Pathway II, done PANRE 2 different ways, did the old fashioned 3 day PANCE which is actually much better than PANCE today. 

 

I HATE PEARSON testing and feeling like an inmate on camera. BUT, the idiots and frauds and cheats have forced us to this situation. If folks would just behave and follow the damn rules - we wouldn't have to be dang near strip searched and monitored like errant children. That said - I have nothing to hide and will endure this every 10 years. I am already fingerprinted in 2 states and am not hard to find or follow.

 

I can't see us with NO recertification except that first test right out of school. We need some measure of our competence to maintain professional standards and withstand scrutiny - it IS the right thing to do.

 

The NPs can do whatever they want. We have our own professional integrity to maintain. I would rather be compared to an MD/DO model and have standards in education, certification and maintenance.

 

And, once again, I will restate it. UNDOING 50 YEARS OF STATE LAWS, BYLAWS, HOSPITAL BYLAWS, CONTRACTS AND EVERY SINGLE INSURANCE CONTRACT IS NOT GOING TO HAPPEN AND NOT GOING TO HAPPEN EASILY.

 

IF PAs AREN'T CERTIFIED - NO ONE WILL HIRE US, CREDENTIAL US OR PAY US - GET USED TO THAT 50 YEAR CONCEPT.

 

No hospital in my city will allow a PA privileges if they don't have a current and maintained "C" behind their name. No insurance company will credential a noncertified PA and none of the corporate monsters will hire a NON Board Certified PHYSICIAN or a non certified PA. 

 

If you know your stuff - no worries. Every 10 years - like a colonoscopy -necessary but not super pleasant or exciting. JUST DO IT

[TWR]

reportedly that PA CEO is making just under $300K a year so I guess she is not biased!!!!!!!!!!!!!!!!!!!!

Go to the medpage and READ ALL the comments.

[Reality Check 2]

I read the comments.

A bunch of angry folks. Not sure how long they have been in practice or what the perspective is.

 

For me - whatever. A test every 10 years is no big deal. 

 

I don't have room in my life for anger over this issue. The broken US healthcare system is a much bigger problem along with our political landscape. There are much bigger things to be worried about that could have a catastrophic impact on daily life.

[overthehorizen]

The argument for retesting is laughable. Raise your hand if you believe that Hospitals are not hiring NPs because they don't retest? Raise you hand if you think patients refuse to go to NPs because they don't retest? Raise your hand if you think patients are even aware that NPs don't retest and PAs do retest? Raise your hand if you think Morton-Rias is motivated by personal self-interest and the financial gains she derives from raising revenue for NCCPA. Retesting is a another step toward the death of the PA profession. While the PA profession enters the death spiral, the NCCPA will be laughing all the way to the bank. I would like to see a PA running the NCCPA who is a serious intellectual that the PAs can respect. 

[UGoLong]

NPs have an edge because they don't need to be supervised the way we are. That's the deal in a more or less nutshell.

[overthehorizen]

The comments in the article reveal Morton-Rias to be the fraud that she truly is.

[rev ronin]

Let's keep it civil, folks.  Don't post things about people on the Internet you wouldn't say to them in person.

 

Does anyone object to me changing the title of the thread from "report" to "position statement"?

[True Anomaly]

"Position statement" is absolutely more accurate

[overthehorizen]

I don't object to changing the title of this thread. I do wonder why attributing the word "fraud" to Morton-Rias is considered uncivil. Do people on this forum see her actions as that of a serious minded researcher sharing study results? I think the word fraud fairly characterizes the sentiments of the overwhelming majority of comments. To your point though, I would happily call her a fraud in person. 

[Reality Check 2]

I am shocked by all the hate and negativity for a CHOSEN profession of those posting here.

 

Not everything in life is a conspiracy or money grubbing effort.

 

I am sure the inception of the NCCPA originally had nothing to do with money and more to do with bringing legitimacy to a fledgling profession.

 

Every profession pays for licensure, continuing education, etc.

 

Sometimes things just ARE.

 

The anger here is almost complete distrust, hostility and irrational. It is professionally disturbing.

 

For the love - it is a test every 6-10 years and we all knew about it when we signed up for school. No one was blindsided.

 

It is highly unlikely to go away completely and it has a long history. It has a purpose in our profession up to this point.

 

MDs will continue to board every ten years and hospitals and insurance require it.

 

I don't have room for this type of anger at this point in my career. If the distrust is that deep and volatile, perhaps a career switch is something to consider for some.

 

I want autonomy and independence based on my experience and testing will undoubtedly play a role in this. There is no other measure I can think of to show my knowledge base.

 

Make our credentialing board a nonprofit agency that banks national info and works with state boards to centralize testing and licensure.

 

I will keep testing when required and doing my CME but mostly doing riht by my patients and finding outlets for anger that sucks away all my energy.

[TWR]

Reality Check 2, How "catastrophic" would it be if you worked in a state that requires passing the PANRE to keep your "C" but you failed the test????? I think it would be "catastrophic" IMHO. NCCPA holds your feet to the fire with this test.

[ventana]

lets keep it professional here.....

[TWR]

I agree with Rev Ronin about "civility" and Ventana about "professional". But this post clearly shows the passion people have on this subject. NCCPA needs to listen to those that contribute to their salary. This board and CEO are not elected by "us" giving any type of platform to be "elected", but rather apply for a job and are hired or not! I believe that is how it is done. If I am right, then they of course would hire someone who agrees with the PANRE and other means of testing some of which have been rescinded. IMHO

[WeBuyAndSellJunk]

I would really love to see some evidence. There seems to be a lot of conjecture one way or the other that the testing is necessary and effective or has shown no benefit with regard to morbidity/mortality. Extrapolating evidence from other means of testing is not sufficient to call a test once every 10 years sufficient. 

[Reality Check 2]

Reality Check 2, How "catastrophic" would it be if you worked in a state that requires passing the PANRE to keep your "C" but you failed the test????? I think it would be "catastrophic" IMHO. NCCPA holds your feet to the fire with this test.

 

Everyone KNOWS they have to take the test. You get 3 chances. Start early and study.

It is not that tough.

I, for one, am glad someone is holding our feet to the fire to show our competency.

I have to test in 2017 but could take it this year. So, there are options. There are study guides, there are free ways to study.

Not passing is always a fear in the back of the mind, but since it isn't a pop quiz or surprise - study...................

[TWR]

Reality Check 2, Yes everyone KNOWS they have to take the test but have you noticed that over the last 3-4 years we have become more vocal about the validity of the PANRE being the only way to prove competency? By your own admission, to take this test and pass we have to BUY reviews PAY for and go to review classes, and start to study for the test 6 months out??? This is stuff we do everyday. You for 25 years, why do we have to study like it is the first time we ever heard the question?? Shouldn't

the test be a review of what we know? The test has become increasingly difficult over the 30 years I have practiced. Certainly veered away from core knowledge. All of the above is IMHO.

[Reality Check 2]

I have questioned the validity and format of questions for years.

It is not perfect.

It is all we have right now.

 

Blowing it to smithereens and abolishing it isn't a good idea in my opinion.

 

Fixing it is a better idea but hard to do. We have to be heard.

 

I study the stuff I don't see daily. None of us sees everything everyday - neither do docs.

 

I have resigned myself that it is what I HAVE to do to keep practicing and will continue to advocate for fixing it and modifying it be more reflective.

 

Being angry and mad all the time sucks the life out of me. There are things I have to do in life - the IRS, a mammogram, a colonoscopy at some point - I don't like them but it is stuff I have to do.

 

I want to keep my C and work toward change, not barnstorm and yell at people and threaten and make egregious claims. 

 

We got rid of SI/PA CME and that is a start.

[ohiovolffemtp]

There are many issues with the NCCPA and how they represent both themselves and the need for testing:

• Key: physicians choose to re-board based on exams their specialty organizations require and develop.  They do NOT need to reboard to maintain their license.
• Maintenance of physician licensure is dependent on state law, which requires CME, not re-examination.  The NCCPA has mis-represented this in their communications.
• Board certification is required by some but not all hospitals and by some payers.  For example, I work in emergency medicine.  In many smaller hospitals the ED physicians are not ACEP certified.
• Board certification comes from the specialty organization, not from some testing organization.  To be true to the physician model, organizations like SEMPA should be the source of the certification for ED PA's, not NCCPA's CAQ.
• There is no accountability of NCCPA to the PA's out there working.  Each of the physician organizations that provide board certification are accountable by frequent, usually annual, election of officers by their members.
• Many other professions, not just NP's, even lawyers and professional engineers, maintain licensure via CME, not re-testing.  These are fields where the knowledge base required to be effective is changing constantly, just like ours.

[rev ronin]

Many other professions, not just NP's, even lawyers and professional engineers, maintain licensure via CME, not re-testing.  These are fields where the knowledge base required to be effective is changing constantly, just like ours.

This is very true in IT: once you've passed a certification exam, there's no good reason for you to ever take it again.  In fact, taking a subspecialty exam counts towards other exams.  In my IT security world, I used my HCISPP exam as CPE hours to maintain my CISSP and CISM, for example, according to the rules of each certification for which it is counted.

 

There are older certifications which require no recertification.  I am still a Microsoft Certified Systems Engineer... for Windows NT 4.0. :-)  The vast majority of my certifications have expired, because they were too irrelevant to my current work to justify the time and expense to keep them.  On the other hand, in the IT field, there is no such nonsense as credentialing, and certainly no single recertification exam that, if failed, results in you losing an existing job.

[mmiller3]

For those oddly vocal people who support the re-testing, why do you feel the re-cert is vital to maintaining professional knowledge? The last re-cert test I took had precious little to do with my daily practice. I feel that medicine, like most other professions, is a self-policing profession. If you start screwing up, or end up making a mistake that kills someone, you probably aren't going to be practicing much longer.

 

CME will help keep you current, not some stupid, anxiety-inducing test.