Must read changes at AAPA meeting! WOW!

[EMEDPA]

Copied from Dave Mittman's blog at clinician1.com:

 

Transformation At An AAPA Meeting
The AAPA Leadership and Advocacy Conference took place recently in Washington, DC.
I attended as President-Elect of “PAs for Tomorrow” and expected there to be a bit of fireworks at the conference. Not in a negative way, but clearly there are PAs who feel the profession needs to move ahead. We need to leave some things that are not working for us behind in this new playing field. Not because others do it another way, but because PAs need to evolve. It was not about competition with physicians or NPs, but because changes were needed so PAs could continue to grow in a way that would serve ourselves and our patients.
As a profession, we needed to clean up the message a bit. But before we could even start, there had to be a realization that there were many PAs that needed to be heard. We have had too many voices that have been shut out and it was time got heard in a way that’s not dismissive. We needed to come to a consensus on how some of the language we were using was hurting our profession’s soul. How calling yourself an “assistant” while never assisting was not helping anyone and the problem was never going to go away. How saying you were supervised in the first sentence of your “elevator speech” translated to the public that you were less competent than you really are. That supervision did not describe anything about how PAs practiced. That PAs collaborate with our physician partners, our NP partners and others as a team united for the benefit of the patient-that is a fact that will not change, but needed to agree the words we use were no longer serving us. That each and every one of us and our PA programs needed to become places where we learned to advocate for PAs being involved and effective medical care providers. That our patients and our profession was stronger when people effectively heard from PA leaders and that being quiet was in the best interests of no one. Yes, there is more. We need research. We need demonstration projects. We need legislative changes. We need insurance changes. We need to be pro-team while also being one of the strongest professions on the team. We need to clearly and proudly answer those in organized medicine who say we are unsafe or unskilled.
So I attended with some trepidation as our association (PAFT) is known for being quite outspoken. I knew there would be other people there who agreed with most of our positions, but being different is always hard, especially at these meetings.
So what happened was amazing and a credit to the AAPA. I was surprised to see and feel that those of us who felt the above were more than welcome at the meeting. For the first time in decades, people were listening. PA leaders, especially some from the AAPA were trying to meet in the middle. Debate was honest and worthwhile. Many people were generally willing to shift positions and there was a feeling of both change and forward momentum in the room. PAs were being positive and proactive. Wow.
When we got to the session on language and the words we use to describe ourselves, I was surprised and later impressed. Most of the leaders in the room agreed that “assistant” never really represented what we did or who we were. It was still misinforming our patients and it was time to leave it behind. It was a word that had lost it’s meaning for us. We, including leaders from the AAPA, decided that branding and using just “PA” would be the best way to solve our name “problem”. Like MD, DO, RN and the like-we would be “PAs”. PAs.....Yes, it would take some getting used to but generally using “PA” in our day to day speech was the best way to approach the “title” problem and a great compromise. It will be interesting to see how fast we start to do this, but clearly assistant is no longer the preferred descriptor. We looked at “dependent” and “supervision” in the same light. They do not inspire confidence nor are they particularly positive or accurate. PAs have always worked “arm and arm” collaboratively and it was clear more than 90% of the leaders in the room felt collaboration was the preferred word for how we work. Same with what we “do”. “Practice medicine” is not the easiest answer to explain, but most agreed it was the only answer.
And pinch me, the AAPA was saying it.
Now I will be the last one to say we solved all our profession’s problems in a two day leadership meeting. But I will be the first one to say, if the changes we discussed hold, that I saw history changed. The difference in leadership was real and palpable. The fear about change seems to be gone in many of our leaders. The inability to want to listen is gone from many leaders. Please let it continue.
Thanks has to go to Larry Herman and the AAPA leadership and to Jennifer Dorne who is heading up a changing, positive AAPA staff.  They deserve kudos for their strong leadership on this.
As I said, so much more has to be done. And some of us are still skeptical. But history was made. Positive PA history. I think times are changing.
Can’t wait until tomorrow.
Dave

 

[EMEDPA]

Summary of the above posting for those not wanting to wade through the whole thing:

1. AAPA agrees that titles matter and is ok with us calling ourselves PAs and not assistants.

2. AAPA agrees that supervision, midlevel, and dependent are poor terms and is ok with us saying we practice collaboratively with physicians.

[camoman1234]

Good job on helping us advance our profession!!! We all thank you for your hard efforts and ability to lead. I do have reservations on using the term "PA." Last night in the ED, I introduced myself, Hi, I am XYZ, I am one of the ED PAs and I will be taking care of you tonight, what brought you in? First thing she said, "What does PA stand for?" So, I don't think having ourselves introduced as PAs will help anything. We NEED a name change and not sugar coat this problem. This will never fix the problem. Physicians don't introduce themselves as an MD/DO. That would be like a speech therapist saying, "Hi I am XYZ, I am one of the SLPs that will be working with you today." At least where I work, people don't introduce themselves that way. I again thank you for your hard work and efforts, but I don't seeing this helping the problem since I already do this and it has not helped. A name change is a must. 

[cinntsp]

Good job on helping us advance our profession!!! We all thank you for your hard efforts and ability to lead. I do have reservations on using the term "PA." Last night in the ED, I introduced myself, Hi, I am XYZ, I am one of the ED PAs and I will be taking care of you tonight, what brought you in? First thing she said, "What does PA stand for?" So, I don't think having ourselves introduced as PAs will help anything. We NEED a name change and not sugar coat this problem. This will never fix the problem. Physicians don't introduce themselves as an MD/DO. That would be like a speech therapist saying, "Hi I am XYZ, I am one of the SLPs that will be working with you today." At least where I work, people don't introduce themselves that way. I again thank you for your hard work and efforts, but I don't seeing this helping the problem since I already do this and it has not helped. A name change is a must. 

 

I'm sure most agree with you but this is at least a step in the right direction.  Future moves towards a name change and better practice rights across the board are probably more likely if we can dissociate ourselves with "assistant" as much as possible first.

[Guest Paula]

^^^^^^ I agree.  I do not say the word assistant but if someone asks me I am compelled to say assistant.  There is no other legal way for me to say what the A stands for.  The A word has got to either change to associate or PA becomes Licensed Medical Practitioner. 

[JFarnsworth]

You can also say that it stands for Physician Assistant or Physician Associate, depending on who you ask.

[GetMeOuttaThisMess]

State law plays an important role on how one must answer such a question as well.

[EMEDPA]

"PA" vs "physician assistant" aside, this is important because AAPA states up front things they have been hesitant to say in the past such as :

PAs practice medicine

PAs work collaboratively with physicians

supervision is not an appropriate term as it does not describe the relationship in many circumstances

dependent practitioner is a poor term to describe what we do.

 

all of this stuff helps us shift the public consciousness to the fact that we are practitioners of medicine, not medical assistants.

[Febrifuge]

You can also say that it stands for Physician Assistant or Physician Associate, depending on who you ask.

This is exactly what I do. Seems to work okay.

[Wes797]

Mount Sinai uses physician associate:

 

https://mountsinaicss.igreentree.com/css_external/CSSPage_JobDetail.ASP?T=20140306162642&

[Woody85]

They use "Physician's Associate"... Just as bad as "Physician's Assistant". IMO

[EMEDPA]

the ideal title would include neither physician nor assistant, but PA works for now.

I rather like what the south africans did calling their PAs "Clinical associates". says it all.

[Wes797]

I like medical practitioner.  Much like nurse practitioner (which the public recognizes) but different in that we are trained in the medical model.

[EMEDPA]

I like medical practitioner.  Much like nurse practitioner (which the public recognizes) but different in that we are trained in the medical model.

the only downside is MP sounds too much like NP. would create mass confusion, kind of like MA and PA

[Wes797]

I would rather be confused with NP than MA, but I see your point.

[winterallsummer]

I would have no problem with a change to Physician Associate.  However some doctors or members of the general public may feel we are trying to be compared to physicians.  We don't care about that.  We simply don't want to be called assistants.  The bottom line is that there are many PAs that practice as autonomously as many doctors.  God forbid I say/type this "out loud", but it's true.  At the end of the day, a PA with "10" years experience can get the same outcomes as a doctor with the same ultimate amount of experience, and any study looking at any such outcomes can back this.  I am not saying a green PA is going to be as learned or clinically skilled as an MD/DO, but we sure as hell are as learned enough to never be considered an assistant in ANY right.  What we have our names changed to (clinical provider, medical provider, P-associate, whatever) is not as important as getting the name assistant out of our name.

 

"The man" wants to cite that this is not a priority because so much verbiage has to be changed.  Really?  So what, we wait another 50 years when there is 10x as much to change?  This is not a solid argument.  Public perception is vital, whether that is philosophically important or not.  And so is our perception of ourselves, and the perception of us by our colleagues and peers.

 

When the name changes, more positive changes will follow.  Ask anyone in business if a name or title matters, and if being considered an "assistant" is not a hinder in anyway... give me a break, what do you think they will say?  I do not care to be considered a doctor, I do not care to have my ego boosted in any way at all.  But I hold myself to a hell of a standard to be considered an assistant.  I am glad to see these changes the OP mentioned, but it is not enough.  I hope to see more aggressive and positive changes in the future.  Just my two cents.

 

 

http://annals.org/article.aspx?articleid=693344

http://annals.org/article.aspx?articleid=718840

http://www.ncbi.nlm.nih.gov/pubmed/9656041

http://www.ncbi.nlm.nih.gov/pubmed/14706124

http://www.ncbi.nlm.nih.gov/pubmed/24191084

http://www.clinicaladvisor.com/basic-np-pa-diabetes-care-similar-to-physicians/article/321534/

http://onlinelibrary.wiley.com/doi/10.1002/jhm.352/abstract?deniedAccessCustomisedMessage=&userIsAuthenticated=false

[jsfelder0417]

Still got a long way to go, but we are taking a big step in the right direction, and I for one am stoked.

[discogenic]

Mount Sinai uses physician associate:

 

https://mountsinaicss.igreentree.com/css_external/CSSPage_JobDetail.ASP?T=20140306162642&

 

Perhaps confusingly so, Mt. Sinai also has a physician group named Physician Associates.  My guess is there are many other physician groups with this name across the country.  Would this be an issue in terms of PA name change?

[Guest Paula]

I am eagerly looking forward to AAPAs statement about the meeting Dave Mittman attended.  Will they roll out a new campaign about the initials PA?  Will they update all the information and literature available on the AAPA web site that includes collaboration language?  Will they address the issues of team based care and that PAs lead teams?  

 

The difficulty for them will be overcoming the years of prior marketing of our profession and the new paradigm that we as individuals can quickly adapt to, but an organization groans in red-tape and administrative burdens to make changes. 

[KMD16]

^^ I agreed. We all shouldn't be too excited yet. I'm not. Yes. A statement from AAPA confirming this meeting would be appreciated.

[medic25]

Has anyone seen a written statement yet from AAPA addressing these concepts?

[Guest Paula]

Nope. Maybe there will be a "rollout" at the AAPA meeting in May.