An Open Letter to All PAs: The Time Has Come for a Professional Name Change

[Emerson]

Perhaps one of the best examples of why a name change is relevant ... he called PAs "Physician's Assistants".

 

Why spend the money on advertising when it could go to changing the name instead? The NPs have had no problem instilling their DNP into society. Is there a reason why PAs can't move forward, with a simple name alteration? They would still be PAs, after all.

 

Physician's Assistant, who cares? Take 100 patients and I promise you not one of them could careless nor even pick-up on the implied syntax. The DNP keeps the Nurse Practioner name intact, it would be different if they decided to be a Doctorate of Nurse Associate. At the end of the day, I believe this is an ego move by PA's who for some reason feel inferior based on what assistant or 's implies. I've yet to meet a patient where it makes any difference, so what is the point? When I've had the opportunity to educate a patient about the physician assistant, not once have they replied with "so 's you belong to the physician or you merely assist the doctor".....

[Emerson]

I completely agree about the risk and cost to the name change. What I was wondering was, why does/did the AAPA never attempt a marketing campaign as Emerson proposed? I was speaking with my mother in law the other day (A Senior VP of Gov't and PR at one of the largest Level 1's in NC) and she even agreed that a marketing campaign would be very beneficial to the profession. It would educate the patient, get the name running through the veins of the media, and at the very least putting a stop to every major health care overhaul article only involving NPs. I understand the AAPA can only suggest a name change....but they can do more than suggest when it comes to promoting the profession-and that involves the media.

 

The nursing community have found innovative ways (ie pharm producing commercials to thank them) to better promote their field. The landscape of health care is going to be completely different in five years, in my opinion it is the midlevel practioner that can provide enormous relief to an already strained system. AAPA is more involved in legislation, not so much the PR aspects of the profession nor am I sure I want them handling our marketing. For example, when I was at the AAPA conference in San Diego there were hundereds of signs scattered throughout the city that said, "AAPA CONFERENCE" or "WELCOME AAPA MEMBERS". Meanwhile, I can't tell you how many people I heard ask, "what is AAPA"? If you're going to invade a major city with a conference, it might be a good idea to include the words "Physician Assistant" on your marketing materials.

[sillycibin]

In regards to patients, it doesn't matter if I'm a "physician assistant" or a "physician associate." They are still going to ask, "What's that?" Associate does not clarify anything to the patient. And once patients become familiar with us, we're PAs. So in regards to patients, I don't think a name change matters. I think it is more critical in evolving our profession and the way we are seen by doctors. We also need to keep up with the (D)NPs who will in a few years I'm sure, be making their moves to take over primary care and have independent practice in that area. I think a name change is better than chasing the degree creep and talking about doctorate level PAs.

[USN2UNC]

The nursing community have found innovative ways (ie pharm producing commercials to thank them) to better promote their field. The landscape of health care is going to be completely different in five years, in my opinion it is the midlevel practioner that can provide enormous relief to an already strained system. AAPA is more involved in legislation, not so much the PR aspects of the profession nor am I sure I want them handling our marketing. For example, when I was at the AAPA conference in San Diego there were hundereds of signs scattered throughout the city that said, "AAPA CONFERENCE" or "WELCOME AAPA MEMBERS". Meanwhile, I can't tell you how many people I heard ask, "what is AAPA"? If you're going to invade a major city with a conference, it might be a good idea to include the words "Physician Assistant" on your marketing materials.

 

Alright then, who would take that on? I know it is the mission of NAPA to do this, but are they large/funded enough?

[CAdamsPAC]

Physician's Assistant, who cares? Take 100 patients and I promise you not one of them could careless nor even pick-up on the implied syntax. The DNP keeps the Nurse Practioner name intact, it would be different if they decided to be a Doctorate of Nurse Associate. At the end of the day, I believe this is an ego move by PA's who for some reason feel inferior based on what assistant or 's implies. I've yet to meet a patient where it makes any difference, so what is the point? When I've had the opportunity to educate a patient about the physician assistant, not once have they replied with "so 's you belong to the physician or you merely assist the doctor".....

 

Emerson....there you go again with logic and valid comments! I'm with you.

[Ridiculopathy]

I like medical practitioner instead of physician associate. I wanna get the "physician" part out of our name b/c people will always be asking, "so when are you going to become a real doctor," lol. But I understand it might be easier to go to "associate" to keep "P.A." i just think MP would be cool because we train in the medical model verses NP's who train in the nurse model. Besides at work on the scheduling program I'm known as "MP," but that's short for midlevel provider, ha!

[lapelirroja]

The more backlash I'm seeing, the more I'm thinking... I'd rather be a Physician Assistant with a job than an unemployed Physician Associate because all the physicians are angry with us.

[USN2UNC]

The more backlash I'm seeing, the more I'm thinking... I'd rather be a Physician Assistant with a job than an unemployed Physician Associate because all the physicians are angry with us.

 

Considering the amount of income PAs provide them instead of hiring another physician, I'm sure they will get over it (or deal with it)....

[PUA]

The more backlash I'm seeing, the more I'm thinking... I'd rather be a Physician Assistant with a job than an unemployed Physician Associate because all the physicians are angry with us.

 

We are not going anywhere. The PA profession is here to stay for the healthcare reform. I am not worrying about no jobs, there will be. I am more worry about jobs will go to the DNPs, instead of the "Assistant."

[Hemegroup]

i just think MP would be cool because we train in the medical model verses NP's who train in the nurse model.!

 

The only problem with this is that people will think that you are a Murse Practitioner, which could lead to grave consequence.

[MikeyBoy]

i just think MP would be cool because we train in the medical model verses NP's who train in the nurse model. Besides at work on the scheduling program I'm known as "MP," but that's short for midlevel provider, ha!

 

MP sounds like NP. That would bring another cycle of explaining, "no, I'm a MP, formally PA"

[henceforth]

Okay now I am the one that is baffled. Because Pathologists Assistants are a type of Physician Assistant. We are to Pathologists what you all are to a GP, ER doc or whatever speciality you work with/in. Our educational tracks differ because we are exclusively taught one speciality in depth, whereas you guys are taught more in breadth so you can work in a few different areas. I really wonder what your PA friend who works with the medical examiner is doing, as Physician Assistant programs do not teach the level of pathology needed to conduct autopsies. I know of Physician Assistants that see what we do and want to switch over but can't because as you said it is two very different professions. They would have to go back to school. Pathologists Assistants are trained to conduct entire autopsies by themselves, and we do what Pathologists themselves used to do with little to no supervision. Bascially like PAs who have patient contact roles we do everything a doctor does except diagnose. So yes, we are PAs. Apparently there is confusion about peoples roles even within the profession itself...

[medic25]

Okay now I am the one that is baffled. Because Pathologists Assistants are a type of Physician Assistant. We are to Pathologists what you all are to a GP, ER doc or whatever speciality you work with/in.

 

While our professions may have similar relationships with physicians, a Pathologist Assistant is not a "type" of physician assistant. Physician assistant is not a generic sub-heading for any medical professional who works in collaboration with a physician. It is a distinct profession, with it's own educational process, board certification and professional organizations, and the only people who can call themselves physician assistants are those who have attended and graduated from a physician assistant program. Calling a Pathologist Assistant a "type of physician assistant" is really no different from calling you a "type of nurse practitioner", since you both work with patients and collaborate with a physician (usually...).

 

 

Our educational tracks differ because we are exclusively taught one speciality in depth, whereas you guys are taught more in breadth so you can work in a few different areas.

 

Our tracks differ because we are in two different professions; there are PA programs with a specific focus (e.g. surgery, peds), but at the end of it they still sit for the same PANCE exam as every other PA program. It's not really a matter of different tracks; it's two careers with different focuses of education.

 

I really wonder what your PA friend who works with the medical examiner is doing, as Physician Assistant programs do not teach the level of pathology needed to conduct autopsies.

 

http://www.nyc.gov/html/ocme/downloads/pdf/jobs_medicolegal_investigator.pdf

 

Here is a job description; most of their work is involved with scene investigation and evidence gathering, rather than performance of the actual autopsy.

 

Bascially like PAs who have patient contact roles we do everything a doctor does except diagnose. So yes, we are PAs. Apparently there is confusion about peoples roles even within the profession itself...

 

I am very confused right now; are you saying that PA's do not diagnose, or just that pathologist assistants don't diagnose? If it's the former I'd beg to differ; a significant part of my job is to diagnosis the condition my patient has presented to the ED for.

[ajohnson2]

Okay now I am the one that is baffled. Because Pathologists Assistants are a type of Physician Assistant. We are to Pathologists what you all are to a GP, ER doc or whatever speciality you work with/in. Our educational tracks differ because we are exclusively taught one speciality in depth, whereas you guys are taught more in breadth so you can work in a few different areas. I really wonder what your PA friend who works with the medical examiner is doing, as Physician Assistant programs do not teach the level of pathology needed to conduct autopsies. I know of Physician Assistants that see what we do and want to switch over but can't because as you said it is two very different professions. They would have to go back to school. Pathologists Assistants are trained to conduct entire autopsies by themselves, and we do what Pathologists themselves used to do with little to no supervision. Bascially like PAs who have patient contact roles we do everything a doctor does except diagnose. So yes, we are PAs. Apparently there is confusion about peoples roles even within the profession itself...

 

I work in an anatomical pathology/histology lab and the (PAs) as in, pathologist assistants, did not go to Physician Assistant school, they went to a program for Pathology Assistants. Totally separate. Around work, when I discuss going physician assistant school I have to spell it all out or they think I am going for their profession of grossing tissue and doing autopsies!

[henceforth]

While our professions may have similar relationships with physicians, a Pathologist Assistant is not a "type" of physician assistant. Physician assistant is not a generic sub-heading for any medical professional who works in collaboration with a physician. It is a distinct profession, with it's own educational process, board certification and professional organizations, and the only people who can call themselves physician assistants are those who have attended and graduated from a physician assistant program. Calling a Pathologist Assistant a "type of physician assistant" is really no different from calling you a "type of nurse practitioner", since you both work with patients and collaborate with a physician (usually...).

 

 

Our tracks differ because we are in two different professions; there are PA programs with a specific focus (e.g. surgery, peds), but at the end of it they still sit for the same PANCE exam as every other PA program. It's not really a matter of different tracks; it's two careers with different focuses of education.

 

 

 

http://www.nyc.gov/html/ocme/downloads/pdf/jobs_medicolegal_investigator.pdf

 

Here is a job description; most of their work is involved with scene investigation and evidence gathering, rather than performance of the actual autopsy.

 

 

 

I am very confused right now; are you saying that PA's do not diagnose, or just that pathologist assistants don't diagnose? If it's the former I'd beg to differ; a significant part of my job is to diagnosis the condition my patient has presented to the ED for.

 

Excuse me, but Pathologists Assistants are not just some medical professionals that work with Pathologists, you can call it what you want but we are *exactly* to a Pathologist what you are to whatever doctor or department you are working for or with. A Pathologist is a physician. We do the work that used to be exclusively the realm of this type of physician. We are filling in the need for professionals who can do a Pathologists work due to a shortage of Pathologists and hospitals trying to save money. This is exactly what Physician Assistants do. So yes we are called different things but its essentially the same type of relationship. I would hardly say I have anything in common with a nurse practitioner, what an absurd comparison.

 

Regarding diagnoses I thought that the MD is the only one that has scope of practice to diagnose.

[Joelseff]

Excuse me, but Pathologists Assistants are not just some medical professionals that work with Pathologists, you can call it what you want but we are *exactly* to a Pathologist what you are to whatever doctor or department you are working for or with. A Pathologist is a physician. We do the work that used to be exclusively the realm of this type of physician. We are filling in the need for professionals who can do a Pathologists work due to a shortage of Pathologists and hospitals trying to save money. This is exactly what Physician Assistants do. So yes we are called different things but its essentially the same type of relationship. I would hardly say I have anything in common with a nurse practitioner, what an absurd comparison.

 

Regarding diagnoses I thought that the MD is the only one that has scope of practice to diagnose.

 

PA's and NP's make diagnoses....but re: Path Assistants, perhaps the Phys Assistant societies and path asst' and AA'S and RA'S should unite under one common society/lobby. it would possibly give a stronger front and why not include our pathology, and radiology cousins? from what you describe you are in essence the PA to a pathologist. i respect your profession...perhaps others here are just unfamiliar with it kinda like how the public is unfamiliar with PA's...I think unification should be looked into in order to strengthen our numbers and interests.

[revilo304]

Regarding diagnoses I thought that the MD is the only one that has scope of practice to diagnose.

Um, youve made 25 posts here on a PA forum and you thought that MDs could only make a diagnosis...thats absurd.

[medic25]

Excuse me, but Pathologists Assistants are not just some medical professionals that work with Pathologists, you can call it what you want but we are *exactly* to a Pathologist what you are to whatever doctor or department you are working for or with. A Pathologist is a physician. We do the work that used to be exclusively the realm of this type of physician. We are filling in the need for professionals who can do a Pathologists work due to a shortage of Pathologists and hospitals trying to save money. This is exactly what Physician Assistants do. So yes we are called different things but its essentially the same type of relationship. I would hardly say I have anything in common with a nurse practitioner, what an absurd comparison.

 

Regarding diagnoses I thought that the MD is the only one that has scope of practice to diagnose.

 

You seem to be missing my point. I understand that the path assistant-pathologist relationship is quite similar to the PA-physician relationship, as is the relationship between the radiologist assistant & radiologist, the AA and the anesthesiologist, and the NP and their collaborative physician. The fact that we all function in similar relationships does not however mean that our job titles are interchangeable. "physician assistant" is a unique, protected professional title that cannot be used by other professions that work collaboratively with physicians (yes, I do grasp that a pathologist is a physician). If I were to take a job in pathology, I could not lay claim to the title "pathologist assistant"; you are going to school to earn that right, and the only people who may use that title are those who attended pathology assistant school. I would still be considered a physician assistant who specializes in pathology, but I could not assume to use your professions own title. I am not trying to denigrate or belittle the role of the pathologist assistant; I'm simply trying to clarify with you that physician assistant is not a generic catch-all term that can be taken on by any profession that happens to have some similarities with us.

[delco714]

Agreed we all should lobby together, but would that create the flood gated segway to mandatory residencies? Also, path assts are NOT phys asst in terms of the legal title and credentials. They are absolutely equivalent in their field no doubt, but they are a separate entity as stated like sixteen other times. Don't get offended, we support you and are not knocking you, I think you took it the wrong way. We just have different training and credentials, so we're different.

[medic25]

BTW, I'm calling myself out on digressing from the original subject of this thread.......

:heheh:

[henceforth]

PA's and NP's make diagnoses....but re: Path Assistants, perhaps the Phys Assistant societies and path asst' and AA'S and RA'S should unite under one common society/lobby. it would possibly give a stronger front and why not include our pathology, and radiology cousins? from what you describe you are in essence the PA to a pathologist. i respect your profession...perhaps others here are just unfamiliar with it kinda like how the public is unfamiliar with PA's...I think unification should be looked into in order to strengthen our numbers and interests.

 

I think that is a good idea. It would definitely be helpful for Path. Assts. because we are so much fewer in number than Phys. Assts. so by ourselves we don't have the strength of numbers like you guys do. And I think at least some of our interests and concerns are similar.

[henceforth]

You seem to be missing my point. I understand that the path assistant-pathologist relationship is quite similar to the PA-physician relationship, as is the relationship between the radiologist assistant & radiologist, the AA and the anesthesiologist, and the NP and their collaborative physician. The fact that we all function in similar relationships does not however mean that our job titles are interchangeable. "physician assistant" is a unique, protected professional title that cannot be used by other professions that work collaboratively with physicians (yes, I do grasp that a pathologist is a physician). If I were to take a job in pathology, I could not lay claim to the title "pathologist assistant"; you are going to school to earn that right, and the only people who may use that title are those who attended pathology assistant school. I would still be considered a physician assistant who specializes in pathology, but I could not assume to use your professions own title. I am not trying to denigrate or belittle the role of the pathologist assistant; I'm simply trying to clarify with you that physician assistant is not a generic catch-all term that can be taken on by any profession that happens to have some similarities with us.

 

I understand that. I don't ever call myself a Physician Assistant, I was just trying to say that it is an equivalent and similar role with equivalent responsibilities etc.

[burnpac]

I'm opposed to the name change but share everyone's perception and belief that a different name would be more appropriate for our profession.

 

Here are the details as far as I'm concerned. I'm not sure what problem that folks who are pushing for a name change are trying to solve. I hear that the name is "holding the profession back". When I look at the 30 years that I have been a PA, and working in state and national leadership over two decades, I have seen steady progress towards great practice acts in all states, huge wins at the federal level (especially this year), and a great environment for the coming ten years. Incomes are good, we can't train PAs fast enough (even turning out 6,400 annually), and we are listed in the top ten of every meaningful list of the best jobs to have.

 

Surveying the PA population on "would you prefer another name?" is a waste of time and money as I already know the answer. It is the same answer as "would you like lower taxes?" The question is "What would you be willing to give up or delay" to divert the energy of 50+ jurisdictions in accomplishing a name change across the board? If the PA population were asked to prioritize the legislative / regulatory agenda (prescribing and schedule drugs, ratios, cosignatures, supervision restrictions, access to quality affordable care, health care disparities, insurance reform and portability of coverage, ordering hospice, specific inclusion in all regulations, reimbursement, student loan forgiveness, fluoroscopy, etc., etc., and changing the name, I would be amazed if folks put the name change high on that list. I suspect that many folks who decry the lack of action on this have little or no experience working on state level government affairs, nor do they have direct experience on how difficult and uncertain any legislation is. The law of unintended consequences rules state legislatures and state PA constituent organization advocacy activities.

 

The current reality is that any state can change the name of the profession now as it is the local medical board and the state practice act that governs this in our practice jurisdictions. However, I know of no state that would put their hard earned advocacy dollars in this area at this time. I know that CA would never spend money or effort in this area as we have too many other issues that are barriers to physician / PA practice and barriers to caring for our patients. I can't support spending AAPA / state dollars in this area as I feel that it would be irresponsible and delay more important strategic goals in advocacy and many other areas.

 

More important, what are the consequences of a name change? Potentially devastating consequences. Let me give you one example. We may no longer be able to practice in certain areas and bill for services, because we won't be "recognized." Myriads and myriads of policies that govern practice and reimbursement of medicine potentially would no longer allow the (PA by any other name) to be recognized and be reimbursed for the care that they deliver. Polices out of our control in health care systems define who may practice and bill for services. The hard won policies (if we have done our job as PA advocates), allow physician assistant (not by any other name) practice and reimburse for services. It would be an almost insurmountable effort to change all of these policies in all arenas of health care systems. You may think this outlandish, but I can assure you that the keepers of reimbursement policy can and will use any reason to deny coverage. We deal with similar issues all the time in our burn care practice with California Children's Services.

 

At the end of the day, after spending millions of dollars, and years of effort, and dealing with untold legislative hurdles and regulators, and many unforeseen consequences, and on and on, what will we have accomplished? How does changing the name of the profession improve access to care and quality of care of the patients who give purpose to our lives? How does changing the name help make our communities better and improve our patients' quality of life? Aside from feeling better about ourselves, I can't see an upside that would justify the cost, effort, and delays of more important issues for PA practice.

 

The bottom line for me is that my value and self worth in the health care system comes from how I'm perceived by the nurses, physicians, other professional colleagues and most importantly the patients whom I work with every day, and not from what my title is. And, believe me, every indicator in Bakersfield, California, every other state of which I'm aware, and in our nation, regarding the value of PAs in the health care system is uniformly good. My patients and colleagues have a simple name for me -- Steve.

--

Stephen Hanson, PA-C

The Grossman Burn Center at San Joaquin Community Hospital

Bakersfield CA

[EMEDPA]

as has been mentioned elsewhere a "cosmetic" name change could be done overnight without opening a single state practice act. here's what would be required:

the aapa states that the terms are interchangeable and becomes the american accademy of physician assistants/associates. they have already done this to some extent with hispanic pts. the official spanish translation per the aapa for pa is associado medico(associate physician)

the nccpa does the same and becomes the national commission on certification of physician assistants/associates. all future certificates have both titles on them: Joe Blow, pa-c is recognized as having passed the natl exam and is hereby certified as a physician assistant/associate.

any state that requires "physician assistant" spelled out or use of the pa-c we use pa-c. any state that only requires pa-c on a name tag we use physician associate:

joe blow, pa-c

physician associate

billing forms remain the same. nothing changes except public perception of the profession.

never say "ASSISTANT" again.

[burnpac]

as has been mentioned elsewhere a "cosmetic" name change could be done overnight without opening a single state practice act...

 

You're kidding, right? I see from your profile that you are from Oregon State. Don't take my word for it. Contact the OSPA GA chair and ask them if this would work in OR. Until you change the practice act, your title in OR, CA and every other jurisdiction remains physician assistant. Using another title may actually be a violation of state law. The states of OR or CA could care less what the AAPA or the NCCPA thinks about the name of the profession, and will interpret this issue based on local law and regulation, not member organization or certifying body opinions. Sorry, I'm not buying it.