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Changes Coming to Healtcare . . . and We Are Not At the Table


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For certain the health care system in America is going to be changing over the next 4-8 years. Recently the Obama administration held a large Health Care Forum on March 4th in the White House. They invited all the major players in the future shape of health care (see the long list of attendees posted below). Missing from this list were anyone representing either PAs or NPs (except for the nursing association).

 

 

I've written the Health Care policy team stating that it is very important that PAs and NPs are invited to the table as we represent the only health care professionals that were created specifically to increase the access to health care while holding down the cost.

 

 

So, here is a link to reach them:

White House Forum March 4th:

I. BREAKOUT SESSION ONE: STATE DINING ROOM

 

Moderator: Melody Barnes

Moderator: Bob Kocher

Sen. Byron Dorgan (D-ND)

Sen. Mike Enzi (R-WY)

Sen. Sheldon Whitehouse (D-RI)

Sen. Orrin Hatch (R-UT)

Rep. Rob Andrews (D-NJ)

Rep. Baron Hill (D-IN)

Rep. Jan Schakowsky (D-IL)

Rep. Jo Ann Emerson (R-MO)

Rep. Allyson Schwartz (D-PA)

Rep. Earl Pomeroy (D-ND)

Rep. John Conyers (D-MI)

SEIU, Dennis Rivera

 

Business Roundtable, Ken Powell (CEO of General Mills)

American Hospital Association, Rich Umbdenstock

American Cancer Society, Daniel Smith

American Nurses Association, Rebecca Patton

Blue Cross Blue Shield Association, Scott Serota

Consortium for Citizens with Disabilities (CCD) Health Task Force, Peter Thomas

Planned Parenthood, Cecile Richards

National Council of La Raza (NCLR), Janet Murguia

II. BREAKOUT SESSION TWO: EEOB 350

Moderator: Valerie Jarrett

Moderator: Zeke Emanuel

Sen. Chris Dodd (D-CT)

Sen. Robert Bennett (R-UT)

Sen. Bernie Sanders (I-VT)

Sen. Debbie Stabenow (D-MI)

Rep. Steny Hoyer (D-MD)

Rep. Roy Blunt (R-MO)

Rep. Miller (D-CA)

Rep. Buck McKeon (R-CA)

Rep. Rosa DeLauro (D-CT)

Rep. Donna Christensen (D-VI)

Rep. Tim Murphy (R-PA)

Rep. Michael Burgess (R-TX)

Rep. Nathan Deal (R-GA)

National Association of Manufacturers, John Engler

Federation of American Hospitals, Chip Kahn

University of Chicago Medical School, Eric Whitaker

Pfizer, Jeff Kindler

PICO, Scott Hersey Reed

National Partnership for Women and Families, Deb Ness

Racial and Ethnic Health Disparities, Fredette West

Alliance for Retired Americans, Ed Coyle

 

III. BREAKOUT SESSION THREE: EEOB 474

 

Moderator: Peter Orszag

Moderator: Secretary Shinseki

Sen. Barbara Mikulski (D-MD)

Sen. Tom Harkin (D-IA)

Sen. Sherrod Brown (D-OH)

Sen. Judd Gregg (R-NH)

Rep. Charles Rangel (D-NY)

Rep. Dave Camp (R-MI)

Rep. Frank Pallone (D-NJ)

Rep. Lois Capps (D-CA)

Rep. Wally Herger (R-CA)

Rep. Xavier Becerra (D-CA)

Rep. Patrick Kennedy (D-RI)

Rep. Eric Cantor (R-VA)

United Food and Commercial Workers International Union (UFCW), Joe Hansen

National Federation of Independent Business (NFIB), Dan Danner

Catholic Health Association, Sister Carol Keehan

Hispanic Medical Association, Elena Rios

America's Health Insurance Plans (AHIP), Karen Ignani

Campaign for Mental Health Reform, Bill Emmett

Asian and Pacific Islander Health Forum, Dr. Ho Tran

Families USA, Ron Pollack

Center for American Progress, John Podesta

IV. BREAKOUT SESSION FOUR: EEOB 180

 

Moderator: Nancy-Ann DeParle

Moderator: Diana Farrel

Sen. Max Baucus (D-MT)

Sen. Charles Grassley (R-IA)

Sen. Jeanne Shaheen (D-NH)

Rep. Henry Waxman (D-CA)

Rep. Joe Barton (R-TX)

Rep. Jim Cooper (D-TN)

AFL-CIO, Gerry Shea

Small Business Majority, John Arensmeyer

American Medical Association, Nancy Nielsen

PhRMA, Billy Tauzin

National Indian Health Board, Stacey Bohlen

National Association of People Living with AIDS, Frank Oldham

 

V. BREAKOUT SESSION FIVE: EEOB 248

 

Moderator: Larry Summers

Moderator: Neera Tanden

Sen. Jay Rockefeller (D-WV)

Sen. Jeff Bingaman (D-NM)

Sen. Ron Wyden (D-OR)

Rep. John Dingell (D-MI)

Rep. Lucille Roybal-Allard (D-CA)

Rep. Mike Ross (D-AR)

Rep. Pete Stark (by phone) (D-CA)

Teamsters, Jim Hoffa

U.S. Chamber of Commerce, Tom Donahue

National Medical Association, Mohammad Akhter

Children's Defense Fund, Marian Wright Edelman

AARP, Bill Novelli

HCAN, Richard Kirsch

University of Miami, Donna Shalala

 

Everyday Americans

In December, 2008 the Transition's Health Policy Team solicited everyday Americans to hold Health Care Community Discussions around the country. The seven everyday Americans listed below all conveyed problems with the current health care system, expressed a desire to reform the system, and hosted discussions in their communities on health care issues. They were invited to participate in Thursday's White House Forum on Health Reform.

 

Travis Ulerick is a 24-year old firefighter from Dublin, Indiana. He started out as a firefighter and first responder for the volunteer fire department on June 28, 2000. When the fire department became the sole EMS provider for the southwestern portion of Wayne County in 2007, Ulerick was one of the four crew members hired to work full-time on the department's ambulance. He graduated from nearby Lincoln High School, and is currently a senior at Ball State University in Muncie, Indiana. Travis hosted a health care community discussion with other local first responders, doctors, and everyday Americans in January in the bay of Dublin's fire station. Recently HHS staff followed Travis around his job, and he will be featured in an upcoming video on the new healthreform.gov website. *NOTE: Travis Ulerick will introduce the President at the opening session.

 

Julia Denton is a 52-year old Republican from Yorktown, Virginia. Her husband is an active duty Air Force dentist with more than 23 years service. Julia currently devotes her time to caretaking and advocacy on behalf of her son Matthew, who was born with a rare genetic disorder resulting in multiple disabilities. Although Julia was a volunteer for the McCain/Palin campaign during the general election, she is now committed to the Obama health plan. She hosted a health care community discussion in December and since has continued to support the health reform effort.

 

Siavash Sarlati is a 24-year old Iranian-born, American citizen, and a medical student at the University of Wisconsin. After completing high school, he pursued a degree in Biochemistry from the University of Wisconsin-Madison, graduating with honors. Siavash is currently a second-year medical student at the University of Wisconsin School of Medicine and Public Health, and he hopes to pursue a Masters in Public Health. Siavash hosted a health care community discussion in December. He is interested in doing his residency in an under-served urban area.

 

Yvonne Rubie is a 57-year old from Brooklyn, New York. She is an active volunteer at House of the Lord Church, where she hosted a health care community discussion in December. Yvonne has a master's degree in public health and uses her skills to promote health and wellness through health fairs, church discussions, and information sessions on diabetes. In an effort to continue the community discussion, she is in the process of planning an event in May focusing on elder care. Yvonne is committed to improving health care at both the national and local level.

 

James Stoffer is a 54-year old teacher and small-business owner from Delafield, Wisconsin. As the owner of a malt shop, James is all too familiar with the high costs of insurance. Although his family has a history of cancer, he cannot afford the checkups due to cost. He spoke about insurance being an obstacle to fulfilling his lifelong dream of owning his own business and fears that the current system limits other entrepreneurs.

 

Jose Oliva is a 63-year old Mexican-born, United States Citizen from El Paso, Texas. Jose works as a Customs and Border Protection Officer along the Texas-Mexico border. He is a veteran who served in the United States Air Force from May 1965 through May 1969, and all his higher education costs were paid through the GI bill and part-time employment. Jose and his wife have been married for 38 years and have four grown children. In December, Jose hosted a health care community discussion, where group participants discussed challenges to people in impoverished areas of the country. Jose believes that the biggest challenge in reforming health care is by improving access to all Americans.

 

Angela Diggs is a 42-year old Washington D.C. native, who is the administrator of the Congress Heights Senior Wellness Center, which is a partnership of the District of Columbia Office on Aging and Providence Hospital's Wellness Institute. The center provides health and wellness classes for seniors on D.C.'s southwest side. In December, Angela helped organize a health care community discussion.

 

Members of Congress Expected to Attend

Majority Leader Harry Reid (D-NV)

Minority Leader Mitch McConnell (R-KY)

Sen. **** Durbin (D-IL) ¿ Assistant Majority Leader

Sen. Edward Kennedy (D-MA) ¿ Chairman, HELP Committee

Sen. Mike Enzi (R-WY) ¿ Ranking Member, HELP Committee

Sen. Max Baucus (D-MT) ¿ Chairman, Finance Committee

Sen. Charles Grassley (R-IA) ¿ Ranking Member, Finance Committee

Sen. Jay Rockefeller (D-WV) ¿ Chairman, Health Subcommittee of the Finance

Committee

Sen. Orrin Hatch (R-UT) ¿ Ranking Member, Health Subcommittee (Finance

Committee)

Sen. Tom Harkin (D-IA) ¿ Chairman, Appropriations Subcommittee on Health Care

Sen. Arlen Specter (R-PA) ¿ Ranking Member, Appropriations Subcommittee on Health Care

Sen. Byron Dorgan (D-ND)

Sen. Chris Dodd (D-CT)

Sen. Robert Bennett (R-UT)

Sen. Bernie Sanders (I-VT)

Sen. Debbie Stabenow (D-MI)

Sen. Barbara Mikulski (D-MD)

Sen. Sherrod Brown (D-OH)

Sen. Sheldon Whitehouse (D-RI)

Sen. Jeanne Shaheen (D-NH)

Sen. Jeff Bingaman (D-NM)

Sen. Ron Wyden (D-OR)

Sen. Judd Gregg (R-NH)

Speaker Nancy Pelosi

Rep. Steny Hoyer (D-MD) ¿ House Majority Leader

Rep. Eric Cantor (R-VA) ¿ Republican Whip

Rep. Xavier Becerra (D-CA) ¿ Vice Chair of Democratic Caucus

Rep. Henry Waxman (D-CA) ¿ Chairman, Energy & Commerce Committee

Rep. Joe Barton (R-TX) ¿ Ranking Member, Energy & Commerce Committee

Rep. Charles Rangel (D-NY) ¿ Chairman, Ways and Means Committee

Rep. Dave Camp (R-MI) ¿ Ranking Member, Ways and Means Committee

Rep. George Miller (D-CA) ¿ Chairman, Education and Labor Committee

Rep. Buck McKeon (R-CA) ¿ Ranking Member, Education and Labor Committee

Rep. John Dingell (D-MI) ¿ Chairman Emeritus of Energy & Commerce Committee

Rep. Frank Pallone (D-NJ) ¿ Chairman, Health Subcommittee for Energy &

Commerce

Rep. Nathan Deal (R-GA) ¿ Ranking Member, Health Subcommittee for Energy & Commerce

Rep. Pete Stark (by phone) (D-CA) ¿ Chairman, Health Subcommittee of Ways and Means

Rep. Wally Herger (R-CA) ¿ Ranking Member, Health Subcommittee, Ways and

Means

Rep. Rob Andrews (D-NJ) ¿ Chair, Education & Labor Subcommittee on Health, Labor, et al.

Rep. John Conyers (D-MI)

Rep. Baron Hill (D-IN)

Rep. Jan Schakowsky (D-IL)

Rep. Jo Ann Emerson (R-MO)

Rep. Allyson Schwartz (D-PA)

Rep. Earl Pomeroy (D-ND)

Rep. Roy Blunt (R-MO)

Rep. Rosa DeLauro (D-CT)

Rep. Donna Christensen (D-VI)

Rep. Tim Murphy (R-PA)

Rep. Michael Burgess (R-TX)

Rep. Lois Capps (D-CA)

Rep. Patrick Kennedy (D-RI)

Rep. Jim Cooper (D-TN)

Rep. Lucille Roybal-Allard (D-CA)

Rep. Mike Ross (D-AR)

 

Community Leaders and Stakeholders Expected to Attend

(in alphabetical order by organization name)

 

AARP, Bill Novelli, President

ADAPT, Bobby Coward

AFL-CIO, Gerry Shea, Assistant to the President for Governmental Affairs

AFSCME, Gerry McEntee, President

AFT, Randy Weingarten, President

AIDS Action Rebecca Haag President and CEO

Alliance for Retired Americans, Ed Coyle, Executive Director

America's Health Insurance Plans, Karen Ignani, President and CEO

American Cancer Society, Daniel Smith, President

American College of Physicians, Jeff Harris, President

American Academy of Pediatrics, David Tayloe, President

American College of Cardiology, W. Douglas Weaver, President

American Academy of Family Physicians, Ted Epperly, President

American Diabetes Association, Larry Hausner, CEO

American Heart Association, Timothy J. Gardner, President

American Hospital Association, Rich Umbdenstock, President

American Medical Association, Nancy Nielsen, President

American Nurses Association, Rebecca Patton, President

Asian and Pacific Islander Health Forum, Dr. Ho Tran, Executive Director

Association of Asian Pacific Community Health Organizations, Jeff Caballero, Executive Director

Building and Construction Trades Department, Mark Ayers, President

Better Health Care Together, Jody Hoffman, Executive Director

Blue Cross Blue Shield Association, Scott Serota, CEO

Campaign for America's Future, Roger Hickey, Founder and Co-Director

Campaign for Mental Health Reform, William Emmett, Director

Catholic Health Association, Sister Carol Keehan, President and CEO

CCD Health Task Force, Peter Thomas

CED, Charlie Kolb, CEO

Center for American Progress, John Podesta, President and CEO

Change to Win, Anna Burger, Chair

Children's Defense Fund, Marian Wright Edelman, Founding President

Columbia University Mailman School of Public Health, Irwin E. Redlener, M.D.

Communications Workers of America, Larry Cohen, President

Families USA, Ron Pollack, President

Federation of American Hospitals, Chip Kahn, President

General Mills, Ken Powell, President and CEO

Health Care for America Now, Richard Kirsch, National Campaign Manager

Hispanic Medical Association, Elena Rios, President

Human Rights Campaign, Joe Solmonese, President

Jennings Policy Strategies Group, Inc, Chris Jennings, President

League of United Latin American Citizens, Brent Wilkes, Executive Director

Markle Foundation, Zoe Baird, President

National Association of Counties, Valerie Brown, Incoming NACO Chair

National Association of Manufacturers, John Engler, President and CEO

National Association of People with AIDS, Frank Oldham, President and CEO

National Association of Community Health Centers, Tom Van Coverden, President and CEO

National Council of La Raza, Janet Murguia, President and CEO

National Jewish Hospital, Dr. Michael Salem, President

National Congress of American Indians, Jacqueline L. Johnson Pata, Executive Director

National Federation of Independent Businesses, Dan Danner, President

National Indian Health Board, Stacey Bohlen, Executive Director

National Medical Association, Mohammad Akhter, Executive Director

National Partnership for Women and Families, Debra Ness, President

National Business Group on Health, Helen Darling, President

National Association of Children's Hospitals, Larry McAndrews, President and CEO

National Association of Public Hospitals, Larry Gage, President

National Rural Health Association, Dennis Berens, President

National Coalition on Health Care, Henry Simmons, Founder

National Association for Home Care & Hospice, Val Halamandaris, President

National Women's Law Center, Marcia Greenberger, President

National Minority AIDS Council, Paul Kawata, President

National Gay and Lesbian Task Force, Rea Carey, President

National Hispanic Health Alliance, Dr. Jane Delgado, President

National Education Association, Dennis Van Roekel, President

Pfizer, Jeffrey Kindler, CEO

Pharmaceutical Research and Manufacturers of America (PhRMA), Billy Tauzin, President and CEO

Physicians for a National Health Plan, Dr. Oliver Fein, Director

PICO, Scott Hersey Reed, Executive Director

Planned Parenthood Federation of America, Cecile Richards, President

Racial and Ethnic Disparities Health Coalition, Fredette West, President

Robert Wood Johnson Foundation, Dr. Risa Lavizzo-Mourey, President and CEO

SEIU, Dennis Rivera, Chair

SEIU, Andy Stern, President

Small Business Majority, John Arensmeyer, Founder and CEO

Teamsters, Jim Hoffa, President

Trust for America's Health, Jeff Levi, Executive Director

UAW, Ronald Gettelfinger, President

UFCW, Joe Hansen, President

University of Chicago Medical School, Eric Whitaker, Executive Vice President For Strategic Affiliations

University of Miami, Donna Shalala, President

USW, Leo Gerard, President

US Chamber, Tom Donohue, President

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I've just looked at the AAPA website. There's a number for Public Affairs but no email address for that office. I'm not even sure if that's the right office to get in touch with--anybody know? I do NOT want to let this issue slide, but am realizing how hampering bureaucracy is.

I thought it was funny that the little email blurb the Health Care Policy team specifically asks you NOT to include any identifying information--but it asks for my email address ;) Of course I gave my institutional (university) address.

Hmmm....

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I've just looked at the AAPA website. There's a number for Public Affairs but no email address for that office. I'm not even sure if that's the right office to get in touch with--anybody know? I do NOT want to let this issue slide, but am realizing how hampering bureaucracy is.

I thought it was funny that the little email blurb the Health Care Policy team specifically asks you NOT to include any identifying information--but it asks for my email address ;) Of course I gave my institutional (university) address.

Hmmm....

 

I used my home email address, but L, as a new faculty, never underestimate the power of a making this a PA professions class project, or a PA student society activitiy. Get your students commenting as well....lol. Support for PA education and training, support for additional funding for the NHSC scholarships to PAs. Increase PA training and deployment to Community Health clinics and as Primary Care saftey net providers.....FWIW

 

 

LesH

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AAPA really is not in the position to be a player in the health policy discussion. This is for reasons both within and outside to their control. All this letter writing and public announcements is like yelling into the wind when there is no one listening. It is a good PR attempt to the PA audience, but is not effective public advocacy.

 

But, the PA perspective and needs are not completely lost. A number of organizations invited and playing a central role do include the PA (and NP) perspective in their opinions. This includes hospital associations, some physician groups, and community health providers. It is the sheer number (and growing) of PAs and these organization's reliance on PAs that makes them aware of PA needs. The American Academy of Pediatrics, for instance, has been very reliable in incorporating PA practice needs into the standards for electronic health records, prescribing and so on. The hospitals and some doc groups are adamant that the proposed requirements for continuity of care and longitudinal reimbursement recognize the work of PAs. AAPA is no where to be found in these discussions.

 

AAPA needs to partner more closely with those organizations that are more major players - being part of a bigger partnership helps you get seen. Also, AAPA can quit playing toady to the AMA, which does nothing for PAs and is increasingly recognized as not even representing practicing physicians.

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AAPA really is not in the position to be a player in the health policy discussion. This is for reasons both within and outside to their control. All this letter writing and public announcements is like yelling into the wind when there is no one listening. It is a good PR attempt to the PA audience, but is not effective public advocacy.

 

But, the PA perspective and needs are not completely lost. A number of organizations invited and playing a central role do include the PA (and NP) perspective in their opinions. This includes hospital associations, some physician groups, and community health providers. It is the sheer number (and growing) of PAs and these organization's reliance on PAs that makes them aware of PA needs. The American Academy of Pediatrics, for instance, has been very reliable in incorporating PA practice needs into the standards for electronic health records, prescribing and so on. The hospitals and some doc groups are adamant that the proposed requirements for continuity of care and longitudinal reimbursement recognize the work of PAs. AAPA is no where to be found in these discussions.

 

AAPA needs to partner more closely with those organizations that are more major players - being part of a bigger partnership helps you get seen. Also, AAPA can quit playing toady to the AMA, which does nothing for PAs and is increasingly recognized as not even representing practicing physicians.

 

 

Agreed 1000000000%.

 

Luckily, count me among those "in the policy arena" for PA's. I am now working with the Mayo Clinic Health Policy Center, and currently I am the only PA working with them. My work at Mayo has exposed me to many of the leaders in both the political, as well as the national physician leadership arenas.

 

In fact, I have a meeting this coming Wed with the director of the MCHPC, and he is wanting to know HOW I can work with the AAPA, and other PA groups to make our efforts in concert. SO, I need to talk with the AAPA leadership too.

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I wouldnt worry about it too much. I had a chat with one of our AAPA BOD members today about this issue. He assured me that, yes, PAs nor NPs were at the table last week (and in fact only ONE RN), but that they WOULD be in the regional meetings. His view was that he would rather be a part of the meetings that will actually do something.

 

The AAPA is on top of things. I know that was a concern expressed here by someone. Gotta give them more credit haha!

 

To say that PAs are not key players I think is a mistake. The PA profession is a big player in our society's healthcare. To miss that would be, IMO, a HUGE mistake. (PAs and NPs for that matter.) Whether that be on our part or the new administration's.

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"To say that PAs are not key players I think is a mistake. The PA profession is a big player in our society's healthcare. "

 

Yes, PAs are key players, and an increasing number of institutions and organizations recognize that. The takeaway is that there are many channels, and many that are much more effective than AAPA for whatever your particular issue should be. Look at the PAs who are leading players in current focus areas of health care education, health information exchange, health IT, personal health records, comparative effectiveness, community health centers, rural health, etc. They are successful and respected as part of a leadership team in their issue area.

 

Lesson - it is not the 1970s-80s. PAs do not have to be afraid of the big health care world and hide in the siloed, special interest group of AAPA. They can go join, become effective, and lead from many vantage points.

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Agreed 1000000000%.

 

Luckily, count me among those "in the policy arena" for PA's. I am now working with the Mayo Clinic Health Policy Center, and currently I am the only PA working with them. My work at Mayo has exposed me to many of the leaders in both the political, as well as the national physician leadership arenas.

 

In fact, I have a meeting this coming Wed with the director of the MCHPC, and he is wanting to know HOW I can work with the AAPA, and other PA groups to make our efforts in concert. SO, I need to talk with the AAPA leadership too.

 

Physasst - congratulations. You are one of many PAs that are realizing their value and influence in health policy discussions.

 

The Mayo Clinic Health Policy Center work is impressive - and frequently quoted by policy-makers in DC and nationwide. They made several offers for participation by PAEA and AAPA. However, these PA groups did not take them up on the offer - though the nurses and NPs did! It is comforting to know that there are groups like MCHPC that are proactively thinking of the PA role in advancing health care and PAs who are capable and willing to step up to the plate!

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Would someone remind me, again, why the AAPA has a "war-chest"?.

 

If they are not involved in these discussions, why not? They have beaucoup fulltime MPH types who would, i think, be perfect for participation...

 

If they are not gettin PROACTIVELY involved, is there any reason for us to support them?

 

They, after all, our employees...

 

davis

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I agree Davis.

 

As a follow up, if anyone lives in these areas (below with dates) consider signing up to be part of the health care discussion. More info here:

 

Burlington, Vermont, March 17, Des Moines, Iowa, March 23rd, Greensboro, North Carolina, March 31st, Los Angeles, California, April 6th

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Physasst - congratulations. You are one of many PAs that are realizing their value and influence in health policy discussions.

 

The Mayo Clinic Health Policy Center work is impressive - and frequently quoted by policy-makers in DC and nationwide. They made several offers for participation by PAEA and AAPA. However, these PA groups did not take them up on the offer - though the nurses and NPs did! It is comforting to know that there are groups like MCHPC that are proactively thinking of the PA role in advancing health care and PAs who are capable and willing to step up to the plate!

 

 

thanks, it was however, a bit disconcerting, when I contacted the AAPA, and got a very, shall we say....

 

lukewarm reception.

 

Changes are coming, we can either be part of crafting them, or be part of simply serving in them, but they are coming.

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I spoke with steve and brian at napa(www.nationalassociationpa.com) and they are going to try to arrange representation at one of the regional meetings

(physasst are you a napa member yet?)

 

 

Nope, not yet.

 

I am going to talk with the SEMPA leadership here soon. I started with meetings at 7am this morning, and am now working a 4pm until midnight shift.

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  • 3 years later...

I guess i am little late to the discussion, as we really need to think about healthcare services and the changes it need to and work more efficiently. As there are very few healthcare institutions, who are providing some standard services and facilities at some reasonable costs, that all people could afford to take.

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