American College pf Physicians Monograph on PAs

[andersenpa]

What do you all think of this....the joint monograph from the ACP, from 2010.

In particular, the 6 key position statements:

 

1. AAPA and ACP believe that physicians and PAs working together

in a team-oriented practice, such as the patient-centered medical

home, is a proven model for delivering high-quality, cost-effective

patient care. National and state legal, regulatory, and reimbursement

policies should recognize that PAs function as primary care

providers in the patient-centered medical home as part of a multidisciplinary

clinical team led by a physician.

 

2. AAPA and ACP encourage training programs from both professions

to promote and support opportunities for internists to

precept PA students and participate as faculty at PA programs.

 

3. AAPA and ACP encourage interdisciplinary education of physicians-

in-training and PA students throughout their educational

programs.

 

4. AAPA and ACP should continue to be represented on the accrediting

and certification bodies of the PA profession (ARC-PA and

NCCPA).

 

5. AAPA and ACP encourage the creation of an interdisciplinary task

force on workforce development. Workforce policies should ensure

adequate supplies of primary care physicians and PAs to improve

access to quality care and to avert anticipated shortages of primary

care clinicians for adults. Workforce policies should recognize that

training more PAs does not eliminate the need nor substitute for

increasing the numbers of general internists and family physicians

trained to provide primary care.

 

6. AAPA and ACP encourage flexibility in federal and state regulation

so that each medical practice determines appropriate clinical roles

within the medical team, physician-to-PA ratios, and supervision

processes, enabling each clinician to work to the fullest extent of his

or her license and expertise.

[Acebecker]

#6 seems to be an afterthought... as if to say, "What about those clinics who want to utilize PAs to a greater extent?" and cover this contingency. I'd like to see #6 be more of the center of the thinking around this position statement. As it is, #1 is the emphasis - key phrases like, "part of a team," and, "led by a physician," in a way pigeon-hole PAs to a "back row" position and I don't believe that having this as the emphasis is helping PAs a lot. CMS can grab hold of this and basically say that they'll only pay for PA services if they are a part of that "team" with physician leadership - leaving those of us who practice without a physician 90% of the time in some trouble (I mention this as a possible drawback from the position statement). Whereas if they had emphasized #6 over #1, then CMS would have little or no ammo to withhold payments that are due us, and PAs would be getting a much greater show of support from the ACP.

 

In all, I think that the position statement is merely adequate and that our physician colleagues could do a lot better to show their support for us.

 

That's my thought, but I tend to read everything with a bit of a skeptical eye these days.

 

Andrew

[EMEDPA]

looks ok to me. much better than some other "physician " statements re: pa's.

[andersenpa]

As it is, #1 is the emphasis - key phrases like, "part of a team," and, "led by a physician," in a way pigeon-hole PAs to a "back row" position and I don't believe that having this as the emphasis is helping PAs a lot. CMS can grab hold of this and basically say that they'll only pay for PA services if they are a part of that "team" with physician leadership - leaving those of us who practice without a physician 90% of the time in some trouble (I mention this as a possible drawback from the position statement).

 

you're not practicing w/o a physician, you have a state approved practice plan and SP. Physician "leadership" means that you have a physician of record attached to the patient's care.

[Acebecker]

you're not practicing w/o a physician, you have a state approved practice plan and SP. Physician "leadership" means that you have a physician of record attached to the patient's care.

 

100% correct. I mis-stated what I meant. What I intended to say was, "without a physician on-site."

 

As long as CMS recognizes that my practice plan and SP signatures in all the right places identifies me as part of the team, then there is no problem. Correct me if I'm wrong, though, but the wording in the monograph leaves it open for CMS to do something underhanded like withhold payment if a physician was not on-site ready to see the patient if needed.

[GeneValgene]

looks ok to me. much better than some other "physician " statements re: pa's.

 

looks alright to me too!

[dpayne2]

It's obvious where they got this from - looks like they almost copy and pasted the previously released AAFP-AAPA joint statement: http://www.aafp.org/online/en/home/publications/news/news-now/professional-issues/20110302aafp-aapastmt.html