AAPA, name change....etc.

[physasst]

Okay....So reading the myriad of other threads about the name change and the AAPA....and how our organizations are not helping us....yada yada....a couple of questions come to mind.

 

This will be a poll......

 

I'm merely curious.

 

Policy is enacted/determined by those who show up.

[EMEDPA]

I currently am a member of aapa( DFAAPA in fact) and sempa. I have been a member of the ca, or, and wa state societies in the past but am not currently as they all focus almost entirely on primary care issues and I work in a specialty. was always happy with capa when I lived there. ospa in the past has not been helpful to those in specialty practice but is improving and I may rejoin. wapa is currently a wall to everything I have asked of them( and it's more than just the name change) so unless they do a 180 I probably won't rejoin.

[EMEDPA]

the aapa does a lot of good but I would like to see them help out individual pa's in the trenches with significant issues.

mike jones approached the aapa about helping him when insurance companies refused to pay him because he was the owner/operator of his specialty clinic. no response. they should have had their lawyers draft a letter to the companies with case law stating why they needed to pay, threatened to sue on his behalf, etc. this is a major issue and they totally blew him off because ownership of clinics by pa's isn't an important enough issue for them but apparently late term abortions is (wtf)..

also I think when the majority of pa's want something(say name change) the aapa should at least be willing to discuss it, not just say "it's a nice idea but it's too expensive. "

being turned away by legislators(because we are "just assistants") is too expensive

being told by insurance companies that "pa's can't read ekg's"(because we are "just assistants") is too expensive

being told we can't order xyz while np's can (because we are "just assistants") is too expensive

being told we can't be pcp's or order certain consults or equipment while np's can(because we are"just assistants") is too expensive.

almost every barrier to pa practice comes from our name. solve that and many of these problems wouldn't have been created in the first place because some ignoramus paper pusher who doesn't know what a pa is decided that "assistants" shouldn't do something.

there is nothing on the aapa agenda that is more important than this issue. the aapa can't solve disparities in health access by themselves or vaccinate every child so they need to stop hiding behind major issues like this that they can't in fact effect.

more people care about this issue than who runs the aapa. only 3000 people voted in the last aapa election. over 6000 folks care about this issue and that is only based on grassroots efforts to find them. imagine if we asked every pa. maybe they should let us. it costs nothing to add 1 question to the annual aapa questionaire; "do you favor aapa investigating a name change to physician associate?" if 80% of the membership says "yes" they need to act on it. if 40% says yes I will shut up and never bring this up again.

[andersenpa]

This reasoning has been posed here on the forum by other state/AAPA characters- the thrust is, if you are not active at the academy level, state or nat'l, then you don't have a right to raise an issue.

 

If you want to lead an issue/agenda, then the mechanics of it require you to be in contact with those bodies since that is the only way to accomplish anything (hopefully, since this requires open ears/minds from these organizations). But this has been brought to some absurd extreme where even those agreeing in philosophy are shut down for not sitting on a committee.

 

The reasons our representative bodies exist is to represent the interests of the profession as a whole and the needs of the individual members. Sadly, there is recurrent evidence- I read it here on the forum regularly- of a failure from the AAPA and states to do so. These groups need to carry the ball at some point and not always pass the buck to the PA in the field and say "put up or shut up".

 

Speaking for myself, I work, often times heavy hours....work on additional hospital committees, precept students, and help with what causes I can. I am not alone in those demands on my time. The AAPA and states need to do their job that we as dues paying members ask them to do- represent us (bold request!).

 

This forum catches PAs who are more interested/involved than the average working PA. I would suspect the average PA hasn't sat in the HOD or on committee. And that doesn't make them any less deserving to have their voice heard and their needs as a PA represented by the academy.

[physasst]

This reasoning has been posed here on the forum by other state/AAPA characters- the thrust is, if you are not active at the academy level, state or nat'l, then you don't have a right to raise an issue.

 

If you want to lead an issue/agenda, then the mechanics of it require you to be in contact with those bodies since that is the only way to accomplish anything (hopefully, since this requires open ears/minds from these organizations). But this has been brought to some absurd extreme where even those agreeing in philosophy are shut down for not sitting on a committee.

 

The reasons our representative bodies exist is to represent the interests of the profession as a whole and the needs of the individual members. Sadly, there is recurrent evidence- I read it here on the forum regularly- of a failure from the AAPA and states to do so. These groups need to carry the ball at some point and not always pass the buck to the PA in the field and say "put up or shut up".

 

Speaking for myself, I work, often times heavy hours....work on additional hospital committees, precept students, and help with what causes I can. I am not alone in those demands on my time. The AAPA and states need to do their job that we as dues paying members ask them to do- represent us (bold request!).

 

This forum catches PAs who are more interested/involved than the average working PA. I would suspect the average PA hasn't sat in the HOD or on committee. And that doesn't make them any less deserving to have their voice heard and their needs as a PA represented by the academy.

 

I disagree with the point of not being able to raise an issue....However, these Academies are representing hundreds and thousands of PA's....the "us" you refer to, may not be the majority.....

 

EVERY PA is in support of the name change in the abstract, hell Cawley and I argued about this in May, the problem is when you set out a list of items....And say, HERE are the ten most important items pertaining to our profession....Name Change included.....But we only have resources to work on 4-5 of them.....what do you choose?

 

They don't have unlimited resources. They don't have unlimited funding....

 

You may think that a particular issue is a big deal...and it is to YOU. The problem is, when you have lots of issues being brought forward to be addressed, and you only have the resources to address MAYBE half of them...how do you, for lack of a better term, triage them?

 

When you discuss the name change issue for example, should the AAPA focus on that? OR, should they focus on examining the current rollout of the PPACA as the regulations are being written by the HHS to address any problems that might arise for PA's (there have already been a few that I am aware of)? OR, should they focus their effort on lobbying attempts to remove the 85% nonsense in the Medicare reimbursement policy? Or, etc.etc.etc.

 

Let's say that they only have the resources to accomplish 2 of those items listed above.....WHO decides priority? It's often NOT that societies aren't listening to members, but that sometimes individual member concerns cannot be fully addressed due to either:

 

A. Conflict with other priority items

 

B. Limited resources....

 

C. Not a majority support

 

Part of leading or governing is prioritizing....problem with that is, no matter how you do it, someone isn't going to be happy.

 

After being involved in politics for years, I can however guarantee you one thing with certainty....you will exponentially increase the odds of your particular item becoming a high priority item if you get heavily involved, challenge the status quo, steer the organization in the direction you want, and donate significant money to the organization...Now, people don't have to like that (hell, when I am traveling all the time and missing my family, I don't much either), but this is how it works.

 

I am in support of the name change and have been since Dave and I talked about years ago. I remember the debate on it back in the HOD in 99 (or was it 2000?, not sure, my memory's not as good anymore..LOL).....

 

I remain in support of it now, as I did then.

[alleycat]

a few days ago I received an email from aapa re a survey. said it went out to only "a few selected members". why I got it, no clue. I made a few suggestions...1. come visit PA FORUM 2...get out and advertise our profession, billboards (docs now do it), pop culture magazines, med students 2nd yr and interns. the entire survey was geared toward "what should be aapa's new goals. they offered 4 or 7 preformed statements and asked they be numbered in order of importance...one panel was so poor that none of the ideas looked important. mostly options consisted of new committees, new polls, visits to PA programs to solicite membership, lots of new policy-making. once or twice they accidently included something important that has been discussed on Forum. I also noted they needed to listen to what the members are actually saying, rather than formulate high-falutin policies and ask us to choose from among their ideas. their survey seemed to fit this thread. anyone else "chosen" to take the survey??

[EMEDPA]

a few days ago I received an email from aapa re a survey. said it went out to only "a few selected members". why I got it, no clue. I made a few suggestions...1. come visit PA FORUM 2...get out and advertise our profession, billboards (docs now do it), pop culture magazines, med students 2nd yr and interns. the entire survey was geared toward "what should be aapa's new goals. they offered 4 or 7 preformed statements and asked they be numbered in order of importance...one panel was so poor that none of the ideas looked important. mostly options consisted of new committees, new polls, visits to PA programs to solicite membership, lots of new policy-making. once or twice they accidently included something important that has been discussed on Forum. I also noted they needed to listen to what the members are actually saying, rather than formulate high-falutin policies and ask us to choose from among their ideas. their survey seemed to fit this thread. anyone else "chosen" to take the survey??

 

Name change on there?

[LIPPER]

EVERY PA is in support of the name change in the abstract, ..... most important items pertaining to our profession....Name Change included.....But we only have resources to work on 4-5 of them.....what do you choose?

I'm sorry, but I believe you are wrong. THIS may be why our representative organizations do not persue change. Perhaps they know something you do not. I agree a poll is in order, but remember that poll will only represent those responding. If we have 40K + licensed PA's nation-wide, with say 8000 responders indicating 100% in favor of change THAT STILL doesn't not represent the majority. Now if grass-roots can get a majority of licensed PA's to sign a petition...that's a different story.

[LIPPER]

Furthermore, a while back I had posted on this forum a story about my Optometrist wife who was helping to organize a fight against her national representative group; the AOA. Their fight and dedication in creating a whole new organization; the AOS. The crux of the AOA issue was to enact their own legislation stating Optometrists must seek Board Certification despite already being specialists in their own right, being licensed via state specific and national boards but most improtantly have no meaningful effect on patient care or income generation for the profession. The AOA's push was ridiculous, and money-based as it would generate a lot of income for the AOA, Board review organizations etc..... As of now via AOS membership and response, the AOA's fight has been diluted and appears to be waning......The AOS has lobbied their state representatives in DC that their organization WILL now be representing all OD's...much to the chagrin of the AOA at first....but over time the AOA realized how real a threat this was becoming to their own legitimacy that they ultimately relented in order to insure their own continued existence....

 

Perhaps if many here feel that the AAPA is so detrimental to overall PA cause and is not listening to the base constituency, then creation of a new "legitimate" organization is in order. The AAPA is recognized b/c there is no other representing organization. It would take work, but if Optometrists can do it, then so can PA's.

[physasst]

I'm sorry, but I believe you are wrong. THIS may be why our representative organizations do not persue change. Perhaps they know something you do not. I agree a poll is in order, but remember that poll will only represent those responding. If we have 40K + licensed PA's nation-wide, with say 8000 responders indicating 100% in favor of change THAT STILL doesn't not represent the majority. Now if grass-roots can get a majority of licensed PA's to sign a petition...that's a different story.

 

It's far more complicated than that. It's kinda like asking people if they'd like a tax cut......The answer is obviously YES, but what if you ask people, Would you like a tax cut, but it would require significant cuts in law enforcement and emergency response services? Now the answer isn't so obvious. I talk to and know a lot of PA's....as do a lot of the members on here....I have yet to speak to a single PA who would oppose the name change in a "perfect world"

 

There are significant concerns for state chapters....many of the older PA's remember dramatic battles over verbiage and language with different bills, and have been burned by other organizations when opening state practice acts. Most state chapters believe that you need to have a very, very good reason to open your practice act because of the possibility of unintended negative consequences.

 

The AAPA as well, HAS debated this issue many times. It's been about a decade or so, but there are concerns there as well. First, the AAPA cannot change the professions name. All they can do is pass and HOD resolution in support of changing the professions name. They can help to a limited degree with money and support for the states. You would need to get the NCCPA to agree...(Really, they have more power here than the AAPA to be honest) as well as the PAEA...ARC-PA, etc.etc.etc.

 

THEN, every single state would need to agree at the same time. EVERY single state would need to hire lobbying and legal firms for representation.

 

It's not impossible, and an HOD resolution would definitely help.....but people need to remember...the AAPA cannot simply flip a switch and change the name. It doesn't work that way. Not only that, but the AAPA isn't really a governing body, they are a guild....

[LIPPER]

It's far more complicated than that.

 

That's fine, I won't let this devolve into a "who knows more about what the majority want" :)

 

I will then argue that it would require such a push requiring finances/man-power out of proportion with the net gain....that IMHO those resources can be much better spent.

[physasst]

Never stated what the majority would want or not want....merely pointing out why some older PA's might be a bit more reluctant to jump in headfirst into pursuing a name change...that is all.

[jmj11]

Mike, I of course have great respect for you and you are making a very valid point . . . we should not be complaining if we are not involved with the process.

 

I may not speak for the majority, but I know there are many, other than myself, who at one time (and for me it was 15 years) were very devoted to the AAPA, the state and specialty organizations . . . but who, though real life experiences with trying to work with them, became disillusioned. I am grateful for the work that they have done for us. But I really found, at the time I left, that their priorities were very different than mine or most of my in-the-trenches PAs.

 

For me, I was tired of being put on a lower tier than NPs in virtually all new federal legislation. For them, at the time at least, it was speaking out against PAs prescribing drugs to convert homosexuals to heterosexuals. I honestly didn't even know those drugs existed. I hope there isn't a question like that on the recert I'm taking next week. I don't know of a single PA for which this concept was even on their radar. In the meantime so many vital issues seem not to be on the AAPA's radar.

 

As I've said before, I've sat poised to rejoin the AAPA and the state societies as soon as I see a difference. I thought I had seen a change in recent years. But then I'm disappointed once more. For example this issue I'm dealing with right now where a major insurer is boycotting a practice because it is PA owned, and they are arguing that a PA cannot be a specialist . . . these both are very important issues for PAs. Yet, and you know as well as I do, that my attempts to discuss this with the AAPA and the state organization has fallen on deaf ears. No response. I'm totally invisible to them. But I was also totally invisible to them when I was a member and trying to be political and an advocate for real issues. I got a nasty personal threat from our state chapter president when I said, in great humility, that I would spearhead a team to fix the FMLA act that stated that PAs could only sign it if they were supervised by a MD, DO OR NP. I found that wording very frustrating. But when I made a statement that it was wrong and I wanted to work to fix it, the state president sent me an personal e-mail telling me to keep my mouth shut or he could ruin my career. He made it clear that only he had the authority to decide what was important. What the hell does that mean? I won't say who it was but he works for the same institution that you do.

 

So, many of us are on the sidelines . . . hell no we aren't . . . we are just not in the AAPA boat. But many of us would be willing to work with the AAPA if they changed their ways. The HOD use to make me sick with the petty personality and culture war issues being debated and played out. I haven't sat in on one in fifteen years, has that changed?

 

So, I may be speaking for the minority but that's how some of use disillusioned people feel. For the others, who have never tried the AAPA or tried to work within their state organizations, I agree with you and encourage them to try it first, before they criticize.

[andersenpa]

I disagree with the point of not being able to raise an issue....However, these Academies are representing hundreds and thousands of PA's....the "us" you refer to, may not be the majority.....

 

EVERY PA is in support of the name change in the abstract, hell Cawley and I argued about this in May, the problem is when you set out a list of items....And say, HERE are the ten most important items pertaining to our profession....Name Change included.....But we only have resources to work on 4-5 of them.....what do you choose?

 

They don't have unlimited resources. They don't have unlimited funding....

 

You may think that a particular issue is a big deal...and it is to YOU. The problem is, when you have lots of issues being brought forward to be addressed, and you only have the resources to address MAYBE half of them...how do you, for lack of a better term, triage them?

 

When you discuss the name change issue for example, should the AAPA focus on that? OR, should they focus on examining the current rollout of the PPACA as the regulations are being written by the HHS to address any problems that might arise for PA's (there have already been a few that I am aware of)? OR, should they focus their effort on lobbying attempts to remove the 85% nonsense in the Medicare reimbursement policy? Or, etc.etc.etc.

 

Let's say that they only have the resources to accomplish 2 of those items listed above.....WHO decides priority? It's often NOT that societies aren't listening to members, but that sometimes individual member concerns cannot be fully addressed due to either:

 

A. Conflict with other priority items

 

B. Limited resources....

 

C. Not a majority support

 

Part of leading or governing is prioritizing....problem with that is, no matter how you do it, someone isn't going to be happy.

 

After being involved in politics for years, I can however guarantee you one thing with certainty....you will exponentially increase the odds of your particular item becoming a high priority item if you get heavily involved, challenge the status quo, steer the organization in the direction you want, and donate significant money to the organization...Now, people don't have to like that (hell, when I am traveling all the time and missing my family, I don't much either), but this is how it works.

 

I am in support of the name change and have been since Dave and I talked about years ago. I remember the debate on it back in the HOD in 99 (or was it 2000?, not sure, my memory's not as good anymore..LOL).....

 

I remain in support of it now, as I did then.

 

 

This is the same old argument. The problem we have is not that the AAPA (to focus on them) will not prioritize the issue; they won't publicly acknowledge it. They won't put it in the mill. The states, as their sudsidiaries, won't either. There can be no formal "triage" if the patient doesn't enter the ED. The ED is on divert and the patient is being sent across town.

 

It's nice to see that you guys read and recite the same talking points:

 

It's kinda like asking people if they'd like a tax cut......The answer is obviously YES, but what if you ask people, Would you like a tax cut, but it would require significant cuts in law enforcement and emergency response services?

 

No one is being asked the question. It's foolish and insulting that the AAPA won't recognize this. They have recieved 6000 emails. We know they are talking about it and have an opinion. They know the power of that statement. They know what that means to current and prospective membership. I don't want to drag Mike J. into my argument but he's a prime example of a PA who has given up on the AAPA for their apathy on issues that matter to PAs...whether it's the name change, practice laws, etc. But the issue is not on the table, not being brought as a poll through their or the NCCPA's roster. Just more paternalistic attitudes like "it's more complicated than that".

 

Why did the change from Physician's Assistant to Physician Assistant not tear down the practice laws? Why have other professions done similarly with their titles without falling apart as a profession? Why not allow PAs to direct donations to the cause if cost is an issue?

 

In other words, why not be honest, put the issue on the table and let the profession decide?

[andersenpa]

I'm sorry, but I believe you are wrong. THIS may be why our representative organizations do not persue change. Perhaps they know something you do not. I agree a poll is in order, but remember that poll will only represent those responding. If we have 40K + licensed PA's nation-wide, with say 8000 responders indicating 100% in favor of change THAT STILL doesn't not represent the majority. Now if grass-roots can get a majority of licensed PA's to sign a petition...that's a different story.

 

There has to be some basis for democratic decision making. We don't have anyhting close to a true majority vote in our national elections but the system's laws are in place to determine what is a fair representation of the will of the people. Maybe those not voting don't care either way. The result is determined by those who care to vote.

[alleycat]

EMEDPA.... there were no references/ questions regarding a name change. none about PA ownerships. none about PA specialty problems. in hindsight, wish I had written them down (sigh)

[EMEDPA]

EMEDPA.... there were no references/ questions regarding a name change. none about PA ownerships. none about PA specialty problems. in hindsight, wish I had written them down (sigh)

so nothing of substance then....not surprising....

[Contrarian]

but people need to remember...the AAPA cannot simply flip a switch and change the name. It doesn't work that way. Not only that, but the AAPA isn't really a governing body, they are a guild....

 

Oh... ok...

 

So please remind me WHY I should send them my cash again...

 

Also, Looks like it might be time to officially form the "American Academy of Physician Associates" (AAPA).

[physasst]

Oh... ok...

 

So please remind me WHY I should send them my cash again...

 

Also, Looks like it might be time to officially form the "American Academy of Physician Associates" (AAPA).

 

Because Guilds can be incredibly powerful. Their power lies not in executing or implementing legislation or policy, but in steering the debate. Advocacy for the profession that it represents..

 

Even your state chapters are the same way. Your hypothetical "American Academy of Physician Associates" wouldn't have any legislative power either.

 

For the name change to be realized in ANY state, let alone nationally, a legislator has to introduce legislation to change the PA name. Then you need to lobby other members and get the vote passed. You also need to spend a lot of time negating other threats or riders on the bill.

 

The guilds true power lies in its ability to influence the legislators. THIS is what the AAPA does.

 

The NCCPA being a governing body can actually change the name in their documentation and the certification exam to specify this. ARC-PA can also influence this debate significantly.....

[Contrarian]

Their power lies not in executing or implementing legislation or policy, but in steering the debate.

 

Umm... you do know that I get that... but was pointing out that their flat out refusal to "steer the debate" in ANY direction that many of us "in-the-trenches" FORMER AAPA members want them to is the reason why we choose to cease funding them... don't you...???

 

Or are you simply interested in regurgitating the talking points, name-dropping and educating us lowly, un-informed PA-Cs to the inner-working of the tower... and then suggesting that if we don't play their game and send them cash... we should stop complaining and really shouldn't have a opinion...???

[physasst]

 

Or are you simply interested in regurgitating the talking points, name-dropping and educating us lowly, un-informed PA-Cs to the inner-working of the tower... and then suggesting that if we don't play their game and send them cash... we should stop complaining and really shouldn't have a opinion...???

 

Nice ad hom...Where did I say that? If you don't feel that the AAPA is representing you, then don't pay for a membership if you don't want. Personally, I could really care less. You can all of the opinions you want. But if all you do is complain about them on some obscure internet forum...then...well. Not sure what to tell ya champ, except that results are generally directly correlated to effort.

 

Perhaps a better approach would be to actively try and change the direction of these organizations from the inside. Subversion..organization...lobbying...etc.etc.etc...cause if you don't, you could still be here 10 years from now complaining about the same issues. Choice is yours. You might succeed, you might not.....

[Contrarian]

Nice ad hom...Where did I say that?

 

Not "Ad-Hom" at all...

 

You have so much as stated/suggested or better put... the historical underlying tone of your missives in this and other threads suggest that those who aren't members of the AAPA and other orgs, frequent the HOD, chat with Bill, Jack and Sharon, text message John, Jill and email Karen should either join and play or stop complaining.

 

Funny thing is...

Since 2009... a couple folks here have been running non-monetary side bets by PM, on your ability and/or inability to post a opinion without a "appeal-to authority" logical fallacy included. You've gotten a lot better lately... but in the beginning... EVERY post somehow included the name of WHO in PAdom you were talking to or hanging out with, conference calling, emailing, etc. as if that would somehow magically make what you were writing acceptable or correct.

 

If you don't feel that the AAPA is representing you, then don't pay for a membership if you don't want. Personally, I could really care less.

 

Umm... if you "could really care less"... why ask and create a poll on a "obscure internet forum"...??? To do so is contradictory to not caring.

 

You can all of the opinions you want. But if all you do is complain about them on some obscure internet forum...then...well.

 

Hmmm... so tell us what YOU REALLY think about this place and the importance of the members and opinions here. As I'm sure our thoughts and perspectives posted on this "obscure internet forum" probably aren't are sophisticated and relevent as those of Bill, Jack and Sharon, John, Jill and Karen in those really really important policy meetings you chair-- um, attend, and as a treat, you come here to enlighten us on the process of organizational governance.

 

Perhaps a better approach would be to actively try and change the direction of these organizations from the inside. Subversion..organization...lobbying...etc.etc.etc...cause if you don't, you could still be here 10 years from now complaining about the same issues. Choice is yours. You might succeed, you might not.....

 

This I agree with.

 

Try a 1:2 scotch to H2O sequence.

For every scotch drink 2 same size glasses of water.

Your wife and your dignity will appreciate it tonight... and you body will appreciate it tomorrow... :;;D:

[physasst]

 

Try a 1:2 scotch to H2O sequence.

For every scotch drink 2 same size glasses of water.

Your wife and your dignity will appreciate it tonight... and you body will appreciate it tomorrow... :;;D:

 

Scandalous.....the only water that should go with scotch is frozen......:)

[EMEDPA]

nope, straight up, but only the good stuff.

[physasst]

 

Funny thing is...

Since 2009... a couple folks here have been running non-monetary side bets by PM, on your ability and/or inability to post a opinion without a "appeal-to authority" logical fallacy included. You've gotten a lot better lately... but in the beginning... EVERY post somehow included the name of WHO in PAdom you were talking to or hanging out with, conference calling, emailing, etc. as if that would somehow magically make what you were writing acceptable or correct.

 

Umm... if you "could really care less"... why ask and create a poll on a "obscure internet forum"...??? To do so is contradictory to not caring.

Hmmm... so tell us what YOU REALLY think about this place and the importance of the members and opinions here. :;;D:

 

Now that made me laugh. Thanks, I actually needed that today. I can see where some of my posts are probably a little pompous...but so am I....I'm pretty arrogant and I have an ego the size of Canada. I'm probably a little more arrogant than many physicians....but I'm completely okay with that. It's who I am and I wouldn't change it even if I could.

 

As far as the next part, it IS an obscure internet forum. That doesn't mean that the members or their thoughts/opinions aren't important, but that to think that some small forum is going to change the medical world is sheer folly. It's a place to share thoughts and ideas among like minded professionals sure, but the scope of it's influence is going to be limited. That doesn't mean it isn't a place to visit, and I hope that it continues to grow. Seeing people concerned about their profession is always encouraging as it combats the primary problem with many professions......

 

Apathy.