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  • hmtpnw
    This week, I am continuing my series on the most common personal statement mistakes. If you didn’t catch part one, check it out here. Below, you can find five more mistakes that applicants make when writing their personal statements.
    Writing About Something That Makes You a “Good Applicant” - Referencing being a “strong applicant” in a personal statement is not something I am a huge fan of. Your goal throughout your academic and clinical experiences should be to build a foundation that will make a better PA student and a stronger PA. It should not be about checking off boxes just because you think that it's what adcoms want to see.
    Don’t list off your extracurriculars in your personal statement, including things because you feel that they make you a “more competitive” applicant. This essay is not a resume. Instead, write about experiences that you’ve had that are central to your decision to pursue this profession, not about those that you think adcoms want to hear about.
    Addressing Difficult Topics the Wrong Way - To include or not to include… that always seems to be the question. Whether it’s bad grades, mental health issues, struggles with addiction or other life tragedy, it’s hard to know what should be addressed in a personal statement. I find that when applicants choose to include difficult topics, they focus too much on the negative without emphasizing the positive while including lots of unnecessary details. They often don’t even mention how their experience was relevant to their journey towards the PA profession at all.
    The big takeaway here is if you are going to touch on a difficult topic in your personal statement, make sure that it's an integral part of your journey before dedicating characters to it. If you have decided to include it, the best thing you can do is be concise about shortcomings/difficult subject matter/etc. Don't dwell on the negative. Instead, emphasize how you addressed the issue whether it's mental health, grades, chronic illness or whatever other issue or circumstance you experienced. Did you grow from it? Did it push you towards the profession more? Did it motivate you to change something? Explore that.
    Forcing the Reader to Read Between the Lines - I can’t tell you how many times I highlight a sentence and make the comment, “Why?” Applicants will often say something like, “Being a paramedic/scribe/MA/EMT made me want to become a PA. It was a great experience.” But, why?! What exactly was it about this experience that drove you to pursue your goal of becoming a PA? When sharing your experiences, make sure you say exactly what you want to say. Don’t force the reader to make inferences about your feelings and insights.
    Using Passive, Questioning Language - This one seems minor but it can change the entire tone of your essay.
    Let me give you an example - “Some of my grades in my undergraduate career were not stellar, but I think that with my recent successes I am likely more prepared to take on PA school. I know it will be a challenge but I feel I could be ready.” Try to avoid using terms like, “I feel… I think… Could… Would... Probably… Likely…” when projecting your future success. Be certain of yourself in your language and your tone.
    Reframing this and emphasizing some stronger language - “Although I occasionally struggled early on in my undergraduate career, my more recent successes are a reflection of my true academic ability. PA school will be a challenge, but I know that I am ready and more prepared than ever to take it on.” In this iteration, you’ve said that your recent successes are reflective of your abilities, not that “they might be.” You have said that you “know” you are prepared to handle PA school as opposed to just “thinking” you could be ready.

    Flowery Language - Last, but definitely not least, flowery language. This one is an essay killer. “The morning was crisp and bright when I stepped out my creaky, old door. I noticed the beautiful, pink rose sprouting from the green bush, covered with dew droplets on petals that were as bold and stunning as they were fragrant.” This is drowning in unnecessary descriptors. Please, don’t do this. Adcoms don’t want to read this. You probably don’t even want to read this. It’s all filler. Tell an engaging story but avoid using flowery, overly descriptive prose that says absolutely nothing while taking up an offensive amount of characters. Be concise and intentional with your writing.

    surgblumm
    The Next Step in your Career

    Robert M. Blumm, MA, PA, DFAAPA, PA-C Emeritus

    A multitude of PAs and NPs are on professional social media sites requesting information on how they can apprehend that first job. In contrast, I see very few requests relating to how to disengage from a current job, with the exception of those who thought that they were being victimized or underpaid. As a senior resource for PAs and NPs, I am often contacted with privileged information that many cannot openly discuss on the public forums. I thought that, as a service to you, I would undertake discussion of this type of problem with some reasonable suggestions.

    Working as a PA or an NP can be akin to being a co-pilot: when you lack confidence in the pilot, their decision-making process, their inconsistent results or their visual limitations. When you begin to doubt the integrity of those that stand across the table in the OR, when the pilot has problems with truth and reality. When, as my plastic surgeon associate of 46 years asserted, “When it stops being fun, Bobby… it’s time to quit.” Perhaps it is useful to remember that a fighter jet has an ejection system that is fast to react at the touch of a finger.

    What can happen if you fail to recognize that the future is looking bleak and that the aircraft will not land safely? What will happen to the two hundred souls on the aircraft or the one patient who has placed their confidence and truth in you and your profession? What if you fail to recognize the signs and then fail to hit the ejection switch or hit it too late? The answer is imminent disaster for you personally and for the patient with whom you share a sacred trust. Their assurance is your integrity. The choice we must make to eject into the unknown skies with strong winds is small when compared to being involved in a tragic medical error.

    If the aforementioned conditions exist, you are on an unsure journey that could possibly end in disaster. Our very foundation is built on the iconic pledge “Do no harm.” The risks in patient care are great.  The risks of practicing medicine and nursing and caring for patients is greater if you do not have a personal liability insurance policy. Why even mention this in an article that calls for a decision to eject? Because many clinicians are unaware of their liability. They are unaware of the fact that the aircraft or the practice has ceased to be safe. They have failed to do a “walk around” and to do an intensive search of their practice situation. They have slowly been desensitized to the inadequacies of their contractual relationships with supervising or collaborative physicians. There are also those who feel a sense of obligation because they have been in a practice for a lengthy time and leaving would feel like a betrayal. These emotions spell an imminent disaster. Having thirty thousand miles in your aircraft or thirty years in practice can make you a conformist. Now is the time to be adequately insured and represented and your lifeline can be a call to CM&F and the purchase of A++Best Superior rated policy. This decision is as important as your decision to eject from your practice as it gives you the freedom to think clearly.


    hmtpnw
    Writing a personal statement is one of the most difficult parts of the application process. For some, it may be the single most daunting and intimidating aspect of applying to PA school. The personal statement is something I have discussed here before, with previous articles addressing what the personal statement is and the best way to go about writing it.
    If you already have a solid understanding of the purpose of the personal statement and have an idea of how you will approach the writing process, you may be thinking about what pitfalls you should try to avoid. After reading and critiquing nearly a hundred personal statements over the last year, I’ve learned that most applicants are all making the same mistakes when writing their essays.
    In a two part series over the next two weeks, I will be sharing the biggest mistakes applicants are making when writing their personal statement. Here are the first five:
    1. Forgetting the Question at Hand - This one is huge, and I tend to make comments about this concept on almost every essay that I read. The purpose of the personal statement is to explain who you are while answering the question, “Why PA?” It really is that simple, and because of that it’s so easy to lose sight of why you’re writing in the first place. I get to the end of so many essays and think, “I have no idea why you want to be a PA.” Which is a huge issue. My advice is to make sure you aren’t getting so caught up in the details of sharing your story that you forget the question at hand. When speaking about your experiences, work to explain how they furthered your interest in the PA profession. Continue to speak directly to that idea throughout the entirety of your essay.
    2. Speaking in Generalities - Many applicants write about how they’re interested in medicine or healthcare… but there are so many careers that allow you to work in medicine and healthcare! Be sure that your essay is addressing the PA profession directly. Don’t say that you want to work in healthcare, or that your goal is to be a great provider. Say that you want to be a PA, and tell the reader explicitly why.
    3. Telling too Many Stories - Applicants often tell too many stories centered around other people in their personal statement. Often times, each paragraph is a patient story, or a story about a provider they shadowed or have worked with. Your personal statement should not be a series of observations about others. Tell one or two stories about other people, max. Make sure sure that your essay is still about you. And be certain to share your insights on how these experiences furthered your desire to become a PA.
    4. Not Telling a Coherent Story - Oftentimes I read through an essay and find that there is nothing that is connecting each of the individual paragraphs. The essay will feel disjointed and scattered, creating a big distraction for the reader. One remedy for this is to identify a theme. You don’t necessarily need to construct a dramatic literary device - a theme can be subtle. Having some kind of running thread throughout your essay that can provide a backbone to relate all your stories helps with continuity. Overall, a theme can make an essay much easier to read.
    5. Transitions - This is my absolute, number one personal pet peeve. Seriously, it kills me. I would say that in about 80% of the essays I read I end up writing, “How does this paragraph relate to the last? These are two completely unrelated ideas and you’re in need of a transition.” I find that applicants will regularly paste five paragraphs into a document, with each paragraph having no connection to the next. Starting a new paragraph is NOT a transition. Transitions are so important, as they’re the glue that will hold your essay together. Do not abandon basic grammar and writing rules just because the personal statement is a format that you’re uncomfortable with. Be sure that each paragraph feeds into the next. Much like a theme, transitions create flow throughout an essay and they’re integral to creating a seamless, easy to read personal statement.
    Keep these common mistakes in mind throughout the writing process. Check back next week when I will share five more of the biggest mistakes that applicants make when writing their personal statements.

    hmtpnw
    How to Prepare for PA School Interviews
    Each leg of the PA application process comes with its own unique kind of stress. First, there’s the chaos of preparing and submitting your CASPA. You have to round up letters of recommendation, order and input all of your transcripts, send out GRE scores, perfect your personal statement and keep track of supplementals for each program. After submitting, there’s an eerie quiet that settles over. You patiently wait to hear back from schools… or you check your email repeatedly hoping for news. Same thing, right?
    Some schools will get back to you in days, others may take weeks or months. Eventually the madness culminates in an interview invitation, which brings on a new kind of stress. This is the moment you’ve been waiting for, but how exactly do you prepare for the next step in the process?

    Research interview questions. There are many lists of PA school interview questions that you can find with a quick google search. Some major categories to focus on are behavioral, ethical, situational and standard PA interview questions. There are also books about the interview process with commonly asked questions. A good starting point is “How to Ace the PA School Interview” by Andrew Rodican.
    Brainstorm and practice! It was helpful for me to create a working document with a list of the questions I found. I brainstormed with each question in mind and made bullet points of things I could touch on in my answers. Often times these points were in reference to specific situations I found myself in or relevant experiences that I had. I was careful not to write out word for word answers. It’s important to maintain authenticity and some degree of spontaneity in your answers - you want to avoid sounding too rehearsed.
    I then made it a point to review my list and practice answering each question out loud. I would do this with friends or colleagues, but oftentimes I would just practice by myself when I was driving in the car.
    Research the program. When walking into an interview, you should be well informed about the program and faculty. Scour the website, reach out to alumni or current students and try to become as educated as possible.
    There are many things to keep in mind when researching a program, but here are a few things to consider:
    Is there anything unique about the curriculum format? How long is the program? Is the program well established? Is there a cadaver lab? If so, are cadavers prosected or are they dissected by students? What kind of opportunities are there for early clinical exposure? When researching, keep a list of questions that come up. Make notes of interesting aspects about the curriculum and clinical rotations. This will prepare you to ask thoughtful questions on your interview day and will ensure you don’t forget to ask about something that is important to you.
    If possible, arrange a mock interview! This is one of the best ways to prepare yourself for the interview process. It’s an excellent way to work through the nerves associated with interviewing and it can help you understand your weak spots. Mock interviews can be done with colleagues, peers, friends, family, professors and even through paid services online. My undergraduate institution offered free mock interviews for students, so be sure to check with your university to see if this is an option.
    Stay up to date about the PA profession. Be informed about issues facing the profession. Understand the role that PAs play in healthcare - be sure that you can articulate exactly what a PA does and how that can differ from NPs and physicians. Understand any state specific laws about practice.
    Know your application. This is a big one that can easily be overlooked. Know your application inside and out! The details should always be fresh in your mind. Maybe you worked on a research project sophomore year and the details are now long forgotten. You may have written your personal statement months ago, and it’s easy to forget what you chose to emphasize when talking about yourself. Anything you put on your application is free game, and you should be ready to answer questions accordingly.

    hmtpnw
    Last week I got my first official application decision of the cycle. Opening the email, I scanned the words frantically until I found the sentence I was fearing the most. It read, “I regret to inform you of the program’s decision not to pursue your application further.” These words translate much more simply to “rejection.”
    For a moment I felt like I couldn’t breathe. I knew that I would be receiving rejections throughout the cycle, but had hoped and prayed it wouldn’t be from this school. Not only was this program one of my top choices, but it is also the only school in my home city. The realization that I would not have the opportunity to interview hit me like a ton of bricks. With GPAs well above the program’s average and my state residency giving me a leg up over other applicants, I felt that I would likely secure an interview. I was wrong.
    After the news, I began to question my application strategy entirely. I chose to apply more intentionally to a handful of carefully selected programs landing on the lower side of things - 6. As the September 1st deadline for many programs was only a few days away I sent my GRE scores off to an additional school that I was going back and forth on, hoping that they would arrive on time. I was relieved to have everything complete with one other program, but I still questioned if 7 would be enough to land me an acceptance or even an interview.
    At this point I was doubting myself, my personal statement, my clinical experiences… everything. I wondered if there were red flags in my application or if I said the wrong things in the answers to the supplemental questions. I tried to stay optimistic, but I was disappointed and feeling insecure. My first rejection was certainly humbling, planting seeds of doubt that were becoming overwhelming.
    And then I saw it. I was eating my lunch and scanning my email when I suddenly read “Invitation to Interview” in the subject line of an email from my top choice. My heart started racing and my palms were sweating. After seeing the date provided, only 3.5 weeks away, I could barely focus enough to read about the interview details. I was ecstatic. Their initial email contained a typo and in a follow up email with a correction the admissions director revealed that I was the very first applicant to be offered an interview. I couldn’t believe it. This school was my reach, and I certainly wasn’t counting on being offered an interview, let alone the first one. I was over the moon.
    Here I am now, in the midst of the cycle with one interview scheduled and one rejection. Things are still up in the air, but I feel that I am at least back in the game. The ups and downs of this roller coaster ride will continue, and I couldn't be happier. Thus far, this process has been unpredictable. Although I have heard this repeated many times here by those wiser than myself, this experience has definitely shown me that there is no such thing as a sure thing when applying to PA school. Don’t be so quick to count yourself in, but also don’t count yourself out.

    hmtpnw
    Put the Highlighter Down and Nobody Gets Hurt
    By Hannah Turner
    You’re sitting in class, pulling out your notebook and pencil when you see her. She’s sitting in the front row, right in the center of the classroom. It’s highlighter girl, and she has her game face on today. Her laptop is open and sits to her left, the lecture slides are printed out sitting directly in front of her, pens, pencils and erasers are ready to go on her right, and she has every color highlighter imaginable at her disposal. Class starts and highlighter girl stays true to her name, adding color to nearly every line of text on those printed slides, switching between markers rapidly as she goes. She seems like she really knows what she’s doing. You look down at your notes and can’t help but feel inferior, like you’re missing something. Weeks later, the class gets the first test back. When students are comparing scores you’re surprised to find that highlighter girl didn’t do very well… Maybe you weren’t missing something after all.
    One of the most important things you can learn in undergrad is how to streamline the note taking and studying processes to allow for maximum learning in a minimal amount of time - you have to learn how to be efficient . Everyone seems to have their own method, and many students tend to complicate the process with no real return on investment. Throughout my college career I have had to find ways to increase my studying and note taking efficiency to create more time for myself. Between upper level science coursework, extracurriculars, part-time and often even full-time work, more time is something that I desperately needed to be successful. Below are a few of the things I learned along the way that allowed me to maintain a 3.9 cumulative GPA and a 3.97 science GPA with a busy schedule in a science heavy major.

    Put Your Pack of Highlighters Down
    It’s easy to be enticed by underlining and highlighting the text on those lecture slides, but in reality you aren’t accomplishing much. The idea that these methods are useful in a note taking capacity comes from the Von Restorff Effect, which states that differentiating text by using color makes it stand out against other words on the page, aiding in memory recall. The problem here is that the information on a lecture slide has already been summarized and contains only the most salient, concise points, so you’re often tempted to highlight much of the text on the slide. If the majority of the text on a page is highlighted, you are defeating the purpose of highlighting entirely.
    Another issue with highlighting and underlining is that these methods are largely ineffective for actively processing information compared to other note taking methods. Writing out your notes forces you to condense and summarize information in your own words, allowing the learning process to begin. If you instead only pick up your highlighter and move it across the page, you’re accomplishing much less.
    Don’t take the bait! Actively take notes in lecture and put your highlighters away. Consider keeping one highlighter or pen out to make note of extremely important information, and resist the urge to colorize.
    Note Taking, the Better Way
    The better way to retain information is to actively take notes, and to take them by hand. Studies have shown that those who used laptops in class had a more shallow understanding of lecture material and performed more poorly on tests, especially with conceptual questions. This is even worse when students are multitasking with their laptops during lecture, creating a distraction for themselves.
    Although with a laptop students are able to take more notes, there is little processing involved in transcribing the material. Due to the time constraints associated with taking notes by hand, students are required to actively condense and summarize information throughout lecture while focusing on the most relevant pieces of information. This means that the learning starts from the moment the pen hits the paper, building a solid foundation for studying in the future.
    I believe that for nearly every undergraduate level course, note taking by hand is the superior method, as the speed at which the material is delivered tends to be fairly manageable. When considering graduate level coursework, I do feel that courses move at a more rigorous pace and typing can become a necessity. The moral of the story here is to use your best judgement and prioritize taking notes by hand whenever it is possible.
    The Next Step
    Taking notes is important, but this will only build the foundation for learning. What you do with your notes will determine how successful you are in your courses. My next article will address the most effective ways to study and provide tips for the best methods to utilize for different prerequisite courses.

    hmtpnw
    The Five Steps to Writing a Strong Personal Statement
    By Hannah Turner

    The process of writing a personal statement is so overwhelming… Where do you start? How do you say so much with so few characters? In the beginning, it all feels so unattainable. Many applicants struggle with writing their personal statement, and I certainly struggled to write my own.
    In the end I utilized a five step process that allowed me to produce a strong personal statement. Below I have detailed each step.
    Step 1: Start Early + Free Write
    First and foremost, start early. Not “give yourself a couple months” early, but “start thinking about this in the year before applying” early. Create a working document on your computer, keep a running note on your phone, carry around a notebook to log your ideas - whatever you need to do to keep track of your thoughts, DO IT. This is the most simple form of free writing. It’s low stakes, no pressure, and it allows you to write when the experiences are fresh in your mind.
    So, what should you write about? Anything that answers the questions, “Why PA?” and “Who are you?” is a great start. It doesn’t have to be logical or organized, just keep track of things that feels important. For me, I would often be at work and something would happen and I would write it down. Other times I would be out and about or at home and think of sometime interesting that I wanted to convey and I would add that. Keep track of experiences with providers, memorable patients and breakthrough moments in your journey. This will make your life SO much easier when you sit down to formally write your personal statement.
    Step 2: Organize + Trim the Fat
    Now that you’ve got your material, it’s time to start organizing. Put all your notes into a word or google document and bullet each idea/statement/paragraph. At first everything, will feel unrelated and you’ll have much more to work with than what you will use. That’s okay. Start sifting through everything and identify the weak points. Get rid of anything that feels unimportant or trite. This is where you really start trimming the fat.
    This is also a good time to expand on those ideas that resonate with you and really communicate who you are.
    Step 3: Create a Story
    After editing each bullet, begin to arrange things in a way that feels more like a story. I personally arranged my thoughts along a timeline allowing things to progress in chronological order. This can naturally lead to flow as your journey towards the PA profession happened in real time. There are other ways to create a story, like by identifying a common theme which can give your essay a backbone. Find what works for you.
    Here you will continue to trim the fat and keep paring everything down. Keep those big questions in mind, “Why PA” and “Who are you?” This will allow you to find the main points that you want to get across about yourself and why you are pursuing this profession.
    Step 4: Finishing Touches
    At this point you should have some kind of working draft. Now you should concern yourself with adding some finishing touches. Make sure that there is flow within each paragraph and between. Add transitions so that each idea will feed into the next. Polish your introduction and conclusion, making sure that each are strong and interesting.
    Things do not need to be perfect right now. This is a draft. Keep telling yourself this, and don’t worry that it’s not exactly how you want it. Don’t feel discouraged as your personal statement is still a work in progress.
    Step 5: Editing
    Step 5 is editing, and it’s crucial. It will make or break your essay, so take it seriously. Once you have a draft you need to get other eyes on your personal statement. After working your material over and over there are flaws that you can no longer see. To remedy this, reach out to current or former professors, PAs, friends, the writing center at your school or even this forum for editing.
    From here, take it all in and just keep making edits. Each comment on your draft will provide you with a jumping off point to rework or change an idea. I went through at least 3 or 4 drafts, maybe more. Remember, your personal statement doesn't need to be perfect from the very beginning, so please don't be discouraged! Writing is a process and everyone's first draft kind of sucks. That's why editors exist.
    Bonus Step: Keep the Faith
    Eventually you will be done editing, and it’s kind of a strange feeling. There will be no more comments and you will be satisfied with what you’ve created. It’s hard to see the point from the beginning, so you have to resign yourself to taking the writing process one step at a time.
    The most important thing that you can do is start, having faith that at some point it will come together. Start making notes, start writing, and don’t get discouraged when you don’t get it right the first time. If becoming a PA is your passion, a narrative will come through if you devote your time to this.

    hmtpnw
    The Finer Details of the Personal Statement
    By Hannah Turner
    Writing is a special form of masochism. You construct something you’re deeply proud of, fretting over the mechanics of each sentence and the placement of every word, only to ask peers and editors to tear it apart completely. You take in their criticisms, ditch the bad ideas and get right back to work on the next draft. Along the way you have to let go of concepts that you were deeply attached to, and it hurts. In the end, the writing process is satisfying in its own right - in search of perfection you can create something really remarkable.
    The personal statement is an especially challenging form of writing, mostly because it’s so… deeply personal. The ideas and words that you choose to share are reflective of who you are; not only is it difficult to write about and articulate your own personal experiences and feelings, but you then have to submit this material to the editing process, which at times can be brutal. When applying to PA school, the personal statement is a challenging rite of passage that each of us must endure.
    So, what exactly is the PA school personal statement? At first glance, the parameters appear to be simple - it’s a 5,000 character essay which asks the question “Why are you interested in being a PA?” Although this question seems direct, there are nuances to the essay that are left unstated. First and foremost, implied in any personal statement is the idea that this piece of writing should explain who you are. That means that this is your chance for the admissions committee to get to know you. In addition to answering “Why PA?” and “Who are you?” your personal statement should also chronicle your background, experiences in healthcare and understanding of the PA profession. Although the prompt asks a singular, unassuming question, it quickly becomes a complicated web. A good personal statement will integrate the answers to all of the stated and unstated questions seamlessly.
    A big piece of understanding the personal statement is recognizing how programs utilize this portion of your application. The admissions committee will have your transcripts, summaries of clinical, volunteer and non-healthcare work experiences, information about awards or scholarships and explanations of any extracurricular activities. Although this is a major part of your application, a lot is left unsaid. They have your resume, but that doesn’t encompass who you are as a person. Are you are deeply passionate about caring for the medically underserved? Do you have a desire to work in primary care so that you can give back to your community? Tell the admissions committee about it! Here is your big opportunity to shine and leave your mark.
    The personal statement can also give you the chance to discuss any personal issues, discrepancies in your application or bumps in the road. Some applicants choose to address their upbringing or any disadvantages they experienced in their childhood and adolescent years. Others will briefly touch on academic struggles and extenuating circumstances they dealt with that caused disruptions in their coursework. The floor is yours to expand on anything you feel isn’t clear.
    Writing your personal statement will almost certainly be challenging, but it’s a necessary evil. This essay will allow admissions committees to understand who you are and what has been driving you towards the PA profession. It will give them an idea of what was happening in all of the space between the lines of your resume. Be genuine and get personal, because the personal statement can make or break your application. No pressure.

    For tips on writing your personal statement, check out this article about the five steps that make the process easier. 

    surgblumm
    New Hampshire Votes on a New Healthcare Provider as March Ends
    By Robert M. Blumm, MA, PA, PA-C Emeritus
     
    In a few short days, one of the northeast states is going to vote on having non-residency medical graduates licensed in N.H. to provide medical care because of their shortage of physicians. There are a plethora of PAs and NPs who could continue to grow and provide this care, but they were not approached.
     
    I only wish that the legislature in N.H. would have looked at the FMG program at Harlem Hospital initiated by the wife of the first president of the AAPA, Bill Stanhope, where a test was given before and after their participation in an accelerated PA Program. All participating FMGs failed on both pre and post-testing. During my presidency of NYSSPA, this data led to the State Board of Medicine writing a law into the NYS law: an FMG could not apply for a position as either a PA or physician. The Harlem Hospital study proved the incompetence of this type of provider. Dana Stanhope agonized in putting this accelerated program together, but the conclusion was discouraging, to say the least. New Hampshire will now place their citizens at risk while there is a large supply of PAs and NPs that could fill the needs of their state. This is not unlike us in the infancy of our profession. Physicians said that we could never care for their patients and neither would they accept us. We were formally trained in similar fields and worked feverishly to start and maintain our professional status and today, fifty years later, are a force to be reckoned with. Good luck N.H. and let's see the increase in medical malpractice.
     
    Where can these new providers become entangled in medical errors? The main area would be in failure to diagnose. An insurance study was performed on NPs and this was the area they were most implicated in, failure to diagnose cancer and heart disease. My assumption is that if and when these newly minted clinicians become licensed in N.H. that they will be missing a diagnosis in many cancers, many types of heart disease; they will mistake severe back pain for a sprain instead of an aortic aneurysm, a DPT for a leg cramp an overuse injury' abdominal pain for an ectopic pregnancy and abdominal aortic aneurysm for gastroenteritis Oral or dental pain will mislead them from diagnosing a Ludwig's Angina and a SAH will be misdiagnosed as a migraine headache and the patient will never recover. These are just a few of the areas of concern and we could add dermatological diseases and melanomas, ophthalmological diseases and retinal melanoma and retinal detachment, head and neck cancers instead of enlarged lymph nodes and osteosarcomas instead of fractures.
     
    How are these clinicians going to be credentialed? What will their limitations be? Will they get prescribing privileges and who will insure them outside of an institution? What will this do to the rates of the hospital insurance carrier and how will it affect PAs and NPs?
     
    These questions bring me back to my age-old argument that we, as responsible providers, need to protect ourselves, our careers and our families by purchasing a professional liability insurance policy with our name on the title page. This will be our anchor in a time of a storm. I suggest the AAPA endorsed company, CM&F, who offers both claims made and occurrence and is A++( superior) rated by A.M. Best. Students and first-year clinicians receive discounts and this policy allows the insured to moonlight. What more can we ask for in these days?

    surgblumm
    Many years ago an infamous general gathered his commanders in a war room and with a quivering finger he pointed to a map and said these words; "There is a sleeping giant, let her sleep for when she awakens, she will shake the world."
    The giant that Napolean spoke of was China, she has awakened and the world trembles at her footsteps. Today, the PA profession is the sleeping giant. We have awakened, we have become recognized, we have furthered our education, our experience, and our reputation and we are forced to both contend with and to meet the needs of healthcare in our generation. The future is now, the time is ready and we desperately need unity and leadership and vision to make greater changes in the next 50 years.
    Unity in an organization is no different than unity in a family or military group. There is no room for caring about ourselves in particular but about those with whom we work from day to day and our profession which has been so good to all of us.Unity can be defined as having the same voice as we begin to attack new problems and start new ventures. We can have different opinions but in the boardroom, once an opinion has been voted upon and has passed, it becomes one opinion and we all stand behind it. This is the manner in which an organization is sustained. When cooking outdoors one needs fuel, the natural environment, and flame.When the coals are placed together they produce the necessary heat to cook and thus sustain life whereas when they are separated, they rapidly cool and diminish.We need to stand together and not separate ourselves because of our egos.There is no room for Lone Rangers in a professional organization.
    Another ingredient that we need is excellence. We have proven our excellence for the past fifty years. We have fought in the trenches, we have formed alliances, we have become a respected, educated group of professionals who know what it takes to succeed and then do what it takes to succeed. We strive for excellence. I can remember as a new PA asking the chief of Otolaryngology at Greater Baltimore Medical Center when he last performed a perfect surgery. This was sort of a stupid question but this man trained me at his home and we performed dissections at 0500. He said;" bob, I have not yet performed a perfect case and when I do, it is time for me to retire because there would be something wrong with my standard." His humility and his response have remained unforgotten for more than forty years.We must all strive to be better than we were the day before.
    The Election: In a week we will be voting for new leadership in our professional organization. We can vote for old favorites, we can vote based on years of service to the Academy but we can also vote on platforms that indicate the direction in which the new leadership would take us. Like Columbus, we need to seek the new world, we need new goals and we need to fire new enthusiasm in the ranks of this new generation of PAs. We need to vote, we need to pass our customary 5% and we need to become excited again just as we were fifty years ago. It can be done and you can do it.

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