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Physician associate letter to aapa, please sign

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Joelseff

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Registration is free for PA-Cs and PA-Ss just put your school name in the license number section but here is the txt:

 

Enjoy!

 

Dear Colleagues: Five candidates answered the “Name Change Committee” questions. Some candidates did not. Here are their answers. Next week the committee will announce their candidate endorsement for the 2012 AAPA elections. If this issue is important to you, please read the below. Thank you.

 

The Questions: Dear Colleague: Please accept our congratulations on your decision run for AAPA office and help lead the profession into the future. As you might expect, there are many PAs who feel that different concepts and proposals could and should be adopted to advance our profession. The issue that may evoke the strongest feelings is our profession’s name. I think you know that many PA leaders, many people who founded state organizations, the first AAPA president, and the first PA ever trained agree our current name does not represent us. So do thousands of grassroots PAs, many who feel that the profession has not dealt with this issue with the seriousness it deserves

 

Two years ago, a committee of four PAs formed to discuss what we could do about this problem. We called ourselves the “Name Change Committee”. All were previous state and national leaders, past state presidents and all are DFAAPAs. That first year we gathered “100 PA Leaders” and sent a statement to the AAPA about our feelings. Please review the statement and especially the leaders who signed it. It is important to help you understand the genesis of this issue. http://www.associatenamechange.com/statement.php. There was no “official” response from the AAPA to the leaders of our committee or the signatories of the statement.

 

Last year, we took the issue to the membership and asked PAs to send a simple statement to the AAPA; http://www.associatenamechange.com. We only intended to do this for a three month period. Jim Potter and Jim Delaney were also sent a copy of every statement and notified along the way of our plans. No PA organization shared email addresses with us, nor did we request them to. The campaign was done only through email and our plan was to stop sending statements when we had 6,000 individual PAs send one in. Our thought was that this was more than double the number of people who voted in the AAPA election and we also thought this number would be meaningful and send a strong message to our professions leaders. By the way, we believe this was the largest number of PAs ever to send in their name to the AAPA for any cause. Again, we saw no “official” recognition of this action, no articles in any newsletters, no interviews in AAPA publications, no coverage in PA Professional. No one officially acknowledged that 6,000 PAs had asked the AAPA anything. A question was included on the AAPA census about the name change but a question preceded it about cost which was unprecedented. Be that as it is, our next step is to research where the candidates stand on the name change issue and share the responses with PAs as they prepare to vote in the upcoming elections.

 

Today the 14 PA leader members of the name change committee asks that you to let us know how you feel about this issue and others. We are sure other groups will also ask you to do the same regarding their specialties and certain issues they feel strongly about. We do not expect you to endorse all we have done (we would love it if you do) but we do feel a dialogue and meeting somewhere in the middle is important. Or you can choose to not answer us also (which we would NOT be happy about if you do). Either way let us know.

 

Please send your answers to the below questions to us by March 1, 2012. We will be posting them in places where we feel people will see them. Please feel free to contact me with any questions, to speak with others on the committee or for more insight regarding the below questions. Please realize, we all want the same thing; a strong and revitalized PA profession. We are hoping to work closely with the AAPA to find a win/win solution. We passionately feel that the profession cannot become the best it can be until this issue is solved.

 

From Larry Herman Running for President Elect If the majority of PAs in a poll support a name change would you come out in support of it?

 

If a valid poll accurately describing necessary resource allocation were made of AAPA Fellow members and the majority supported a name change, I would support the will of the members.

 

Do you feel the “assistant” portion of our title accurately reflects our role today as medical care providers?

 

I can remember this discussion as a student at Stony Brook more than 20 years ago and to this day I do not think it accurately represents what a PA does. But there is a clear difference between de facto and de jure. While the law in my state is clear and I cannot use anything but the term physician assistant, my physician colleagues most commonly introduce me as, “This is my associate Larry Herman. He is a PA.” I think many of us in the 46 states that require the term physician assistant have experienced this or a similar “work-around” often.

 

Would you be in favor of the AAPA President forming an Ad Hoc Committee to study this question and report back to the Board and House?

 

While I believe this is specifically under the purview of the House of Delegates, in principle I would.

 

Does the word supervision accurately reflect how PAs function in today’s medical care world? Should PAs be “watched and closely checked” years after graduation? Would you agree that at a minimum the word needs to be changed to the much more accurate word of collaboration and/or sponsorship?

 

Supervision is a regulatory term and the regulations need to be changed if this term is to change. Personally, I have supported and helped craft the following verbiage to answer the question, “What is a PA?” A PA is educated at the graduate level to practice medicine – treat, diagnose and prescribe autonomously – in health care teams that includes physicians. Virtually everyone in health care works in a team and I believe that this phrase best describes what PAs (and for that matter physicians) do on a daily basis.

 

Where specifically do you see the profession evolving over the next 10 years? Please get specific as you feel is appropriate.

 

Clearly, we are at a tipping point and at least some would say, “We have arrived” as a profession. With two or three years, we will have more than 100,000 PAs in the country, and this alone will raise both our level of awareness and collective importance with all constituencies. But beyond those facts and figures, it is virtually impossible to answer this question inasmuch as health care is in a dramatic state of flux never witnessed before. I believe PAs will play an increasingly important role in both specialties and primary care, perhaps being the savior for primary care, and certainly the only prescriber trained in the team-approach and the single best group suited to managing the patient centered medical home. PAs should be infused in health information technology, health care administration, and at every level of decision-making as patient advocates. We have already changed our name in many states (by removing the ‘s) and it did not cost millions nor did it upset any state laws? If handled well with education of organized medicine and others who might oppose, why would this name change be any different? Who besides organized medicine would oppose the change?

 

I believe it is naïve to equate the removal of an apostrophe with a name change that many – but not all – in organized medicine will find very threatening. This would likely be perceived by some as the first step towards independent practice and we must acknowledge that this will be perceived by many physicians as an immediate threat. A name change will require an investment of significant resources and can only be won by the grass roots and grass tops in each state, one by one, much like prescriptive privileges were won. This will necessitate a re-prioritization of goals and objectives, diversion of resources, and ultimately buy-in by each and every state and specialty constituency organization to be successful. One way around the problem is for the AAPA to spearhead “choice”. PAs would ask the appropriate state powers to allow them to use associate or assistant. Do you think this could work or is it better to figure out what is best and go with that?

 

No, I do not. First, AAPA does not “ask” states; state chapters do. Second and more importantly, legal counsel representing our state society here in New York has advised us that summarily changing your title on things like a name badge or embroidery on a lab coat is actually illegal (and I suspect this is the case in most of the 46 states that require the use of physician assistant) and doing so here would clearly be a misrepresentation to patients. The last thing that I want to see is a colleague being arrested effectively destroying any chance of a negotiated solution.

 

---------------------------------------------------------------------------------From Michelle DiBaise Running for President Elect There is overlap in the answers to these questions so I will answer them together. I do feel that there has been confusion at times, by patients and legislators in particular, with the name Physician Assistant and our scope of practice. While I have had to explain what a Physician Assistant is, what we do and where we fit into the health care team, I do feel that the frequency of these explanations has decreased over my 20 year career as a PA. Our scope of practice is not necessarily appropriately reflected by the term assistant. However, there are several issues that would need to be addressed if the name were to change. One question is, if not physician assistant then what? The most popular answer is clearly Physician Associate. I have also had individuals tell me that they prefer names that are completely different. I hope that the AAPA census results will provide a clearer picture as to what we as a profession want to call ourselves. In addition, there is a cost in terms of both dollars and manpower that would be required to change the title of the profession. The AAPA Board asked our lawyer what it would cost to change the name. It would require opening and changing the Articles of Incorporation, as well as all contracts with vendors, health insurers, and other benefits contracts. While I don’t have an actual dollar amount at hand, the cost is not insubstantial. If the name were to change at the national level, 44 states would need statutory change. Those 44 states specifically require a badge that identifies the individual as a physician assistant. With all that being said, there are some 6200 individuals who signed the petition regarding changing the name. While that is not a majority of all practicing PAs, it is a vocal enough group that the issue should be given its time to be heard. I believe that the venue for this is the House of Delegates. First, this is the body that would need to ultimately deliberate the topic. If a name change were to occur, it would require a bylaws change in the HOD. This body also consists of state leaders who would be most affected by such a change as they would need to carry the change onto the state legislative agendas. An alternative is to convene a House Ad Hoc Committee to study the issue and report back to the House the following year. As a member of the Board of Directors I would respect the will of the House as to matters of policy. The freedom of choice issue is another option. Again for the 44 states that statutorily require Physician Assistant on their badge, those PAs need to be aware of their state laws. They should also be aware of the regulatory climate so that they do not jeopardize their ability to practice. The definition of Physician Assistants has been discussed by the AAPA and PAEA Boards over this past year. The definition has not been changed since the 1990’s and it is recognized that it is time to update it. The amount of autonomy a PA has is determined by a combination of state laws and the supervising physician’s comfort with the PA’s skills. As an Academy we need to continue to promote the six key elements of good state practice laws that include prescriptive privileges, no ratios, licensure, scope of practice determined at the practice level, and chart co-signature determined at the site level. It is difficult to see into the future and determine where PAs will be, but there is no doubt that the number of PAs will continue to grow. There are at least 40 new PA programs in the pipeline planning to start in the next four to five years. Despite this increase in programs, there will still be a supply gap against the existing need. Where will PAs be? Some PAs will take on the role of care coordinator in the newly forming accountable care organizations or as team leaders in the patient-centered medical home; some will move back into primary care as the reimbursement improves in this area over the next decade. Others will move into the hospitals to fill the gaps left from residency hour restrictions. We will see PAs moving into administrative and educational roles as opportunities arise. In addition, we will see PAs move into newer fields as technology and patient safety issues arise such as human factors engineering, computer assisted order entry development, application development to assist EMR and coding, the formation of Regional Health Information Organizations and a National Health Information Network, and genetic testing and counseling. PAs will continue to provide health care in all the fields they currently practice as well. I foresee that as our numbers increase and we work with physicians who appreciate the high quality care we bring to practices, the acceptance of PAs in the medical community and among the public will continue to improve.

 

Thanks Michelle --------------------------------------------------------------------------------------------From Josanne Pagel Running for Secretary-Treasurer

 

The Questions: 1. If the majority of PAs in a poll support a name change would you come out in support of it? For the issue of name change, I would wait until a thorough research was completed on the ramifications of changing our PA name and the “ripple effect” it may or may not cause. At this time I am neutral on this issue, as I do not have any facts as to what the costs would be to states due to law changes, PR to public, etc. 2. Do you feel the “assistant” portion of our title accurately reflects our role today as medical care providers? Sadly, there are still some states and areas where the PA does just act as an assistant and not as an autonomous provider. It really depends on the location. 3. Would you be in favor of the AAPA President forming an Ad Hoc Committee to study this question and report back to the Board and House?Yes, I would encourage it 4. Does the word supervision accurately reflect how PAs function in today’s medical care world? Should PAs be “watched and closely checked” years after graduation? Would you agree that at a minimum the word needs to be changed to the much more accurate word of collaboration and/or sponsorship?Not sure where the wording “watched and closely checked” came from, it’s not in Ohio law, and I do not know if it is in any other laws. Being “dependent” practitioners, there would be some sort of “supervision” wording in our description. The word collaboration is truly recognized as an APN word. It is more “partner centered” and less subserviant. 5. Where specifically do you see the profession evolving over the next 10 years? Please get specific as you feel is appropriate. Please refer to my platform and answers to those questions. 6. We have already changed our name in many states (by removing the ‘s) and it did not cost millions nor did it upset any state laws? If handled well with education of organized medicine and others who might oppose, why would this name change be any different? Who besides organized medicine would oppose the change?Perhaps the legislators, and boards of medicine. Some physician groups may be threatened by a change to associate. 7. One way around the problem is for the AAPA to spearhead “choice”. PAs would ask the appropriate state powers to allow them to use associate or assistant. Do you think this could work or is it better to figure out what is best and go with that? I think the name must be all or none. Having a different name in different states will be confusing. Thank you for the opportunity to answer your questions. Josanne Pagel ----------------------------------------------------------------------------From Melinda Moore Running for Director at Large Thank you for the opportunity to address your readers. I understand that these are important issues and I hope these issues are explored to every ones satisfaction in the near future. The AAPA Board of Directors and the members of the House of Delegates are elected by the AAPA fellow members to represent PAs and further the PA profession. While the concerns about the title of our profession are based on a shared belief that PAs must strive to improve the public awareness of our role, it’s important to remember that these decisions lie in the hands of those PAs who step forward to accept the responsibility of those elected positions. I hope that a resolution will be brought forth to address the title change concerns. By doing this, the topic can be debated in the House and supporters of both sides of the issue can be heard. Supervision is decided at the state level although the ideals for supervision are emphasized at the national level. I think a position paper presented at and approved by the HOD would further the ideal standard of supervision.

 

-----------------------------------------------------------------------------From Jim Piotrowski Running for Director at Large In response to your questions of those individuals running for the AAPA Board of Directors, I am responding as a candidate for that position. #1. If the majority of PAs support name change would you vote for it?

 

Response: YES and if elected; I will fight to see that this is brought to the Board of Directors for appropriate action. I believe that the absolute authority of the AAPA lies in the Board of Directors and not within the house of delegates. It is time that the Board of Directors act and assume the responsibility they were elected too.

 

#2. In your personal opinion, why is it that the NP profession can say they will pursue “independent practice” and a “Doctorate”, while not worrying about the cost, while the AAPA has linked the issue of cost only to the name change question? Can you think of any other topic the AAPA has called and attached a cost to such poll?

 

Response: I. believe, in regards to the NP profession they have taken their profession on a different path, one of independence without concern or frankly any care of what organized medicine thinks. They also made it very clear years ago they intended to be independent and to “collaborate” with physicians. By their declaration of a “Doctorate “as their formal end degree they are telling the physicians they are there equal to a physician. But, one has to look at what the doctorate is in and what they studied to attain that degree.

 

Therefore their efforts have probably been without major financial cost, but there have been and are political costs in multiple states. But they never mentioned the financial cost taking such action nor do they.

 

For our national organization to make any statements regarding financial cost, is troubling and obstructionist. They are trying to put fear into members that the costs of such an endeavor will overwhelm and financially ruin our Academy. Yet they have never really produced a dollar amount or even an estimate of cost if even such an estimate could be given. Linking of costs to the name change question is nothing more than disingenuous behavior and scare tactics, of individuals who are trying to protect their positions within a failing institution.

 

#3. Would you be in favor of the AAPA endorsing a personal choice either associate or assistant as a first step towards a later change?

 

Response: I would personally prefer that the Board of Directors take the lead and act responsibly. That they take that formidable first step and endorse name change. But, I also understand politics and that” you can’t always get what you want” , without a battle that could severely injure the association. A reasonable compromise could be allowing the individual PA to make their own choice as to whether be called in assistant or an associate. This would still require the Board of Directors to make a decision on the issue of name change therefore it’s going to fall to the board one way or another.

 

#4. Does the word supervision accurately reflect how PAs function in today’s medical care world? Should PAs be watched closely checked for years after graduation? Would you agree that a minimum the word be changed to a more precise word of collaboration or sponsorship?

 

Response: The word supervision does not reflect how PA’s work with physicians. For the most it’s more of a collaboration or Partnership. I would prefer the word Partnership as that reflects more of the relationship I have with the Neurosurgeons and Neurologist I work with. As I see my own patients I discuss the cases with the physician and refer the patient to Neurosurgery as needed. I am a partner in the practice and business and I am as is the other PA in our practice as partners.

 

Does this mean that a PA coming out of school should be left to practice with minimal oversight? Of course not, just as a new Physician partner is given oversight and guidance for several years.

 

#5. We’re specifically do you see the profession evolving over the next 10 years?

 

Response: I believe first and foremost we need to resolve the name change issue once and for all. I am very biased on this issue, and without changing our name to Associate, we are doomed to be relegated to second or third tier players. We need to have total and mandatory inclusion in all health insurance plans across State lines to include auto, work comp, Medicaid and Federal plans. Without these changes we will just flounder. The profession is evolving slowly to a more stand-alone type of practice. Yes, PAs are still employed but I see a trend of practice partnership and ownership of practices. This is good for those who choose that path. For other Pas who remain employed in whatever practice or organization they work for, they will have more autonomy and their incomes will be a reflection of their work and practice. The AAPA in ten years may not be here if they do not break out of the mold of obstructionism and mediocrity

 

#6. In view of the fact that we put him more clinical hours than a PharmD or a DPT are you in favor of looking at those graduate residencies (post masters) awarding a doctorate degree upon completion? This would be voluntary and not an entry-level requirement PA practice or the residency.

 

Response: YES, a Resounding YES, I believe this is one of the keys to the evolution that our profession will undergo in the next 10 years. The Military has started the trend awarding Doctorates to PA’s who have completed a 2 year training in Anesthesia and I believe ENT and Orthopedics.

 

This is what will set our profession apart from DNPs, as PA’s will have 2 years of training in a specific specialty and can augment the practice they join .This raises the question why not just go to medical school ? Medical School and post grad training is not for everyone, and with our current training schedule thereby allowing PA’s more opportunities to receive specialty training makes PAs a more sought after profession.

 

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Joelseff

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Yeah...

Cleaned my Inbox today on several email accounts...

 

Still recieving entirely tooooo may (averaging 2/day) job offers for CNA and MA positions...:=Z:

 

Haha C, I was searching salaries in my area and was directed to MAs. At first I didn't notice until I looked at the salary....

 

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Joelseff

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Posted
Yeah...

Cleaned my Inbox today on several email accounts...

 

Still recieving entirely tooooo may (averaging 2/day) job offers for CNA and MA positions...:=Z:

 

Haha C, I was searching salaries in my area and was directed to MAs. At first I didn't notice until I looked at the salary....

 

Sent from my VEGAn-TAB using Tapatalk

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Grand Master

EMEDPA

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Every time I try this link, regardless of whose post I try it from I get taken to a page with a pretty young woman next to a bunch of ads selling bikes with the notation above that the domain name is for sale. Anybody have any ideas?

dave jones (mxpac76)

do you mean the paft link or the associate name change link?

you can also use www.pasfortomorrow.com for the paft site.

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Grand Master

EMEDPA

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Every time I try this link, regardless of whose post I try it from I get taken to a page with a pretty young woman next to a bunch of ads selling bikes with the notation above that the domain name is for sale. Anybody have any ideas?

dave jones (mxpac76)

do you mean the paft link or the associate name change link?

you can also use www.pasfortomorrow.com for the paft site.

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