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


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why would states care if the ncccpa and aapa changed their names? they wouldn't.

with a cosmetic change NOTHING CHANGES IN STATE LAW. anywhere that the state requires we be physician assistants we are physician assistants(practice descriptions, etc). where it is not spelled out in the law we are physician associates or even just PA's. on billing forms we are assistants if required. we just don't ever say "assistant". we say PA or physician associate. I already never say assistant. not on my cv, not on my business cards, etc everything says PA.

when someone says "what is a pa?" I describe my education without ever saying assistant. if a state has requirements for ID's, etc they usually specify must use physician assistant or pa-c. no brainer, use pa-c.

It's not that I love the term physician associate, I just hate the assistant part of our title. physician associate keeps PA and describes what we do. if it really is too difficult to change the name( and I will leave that to folks who have done more research on this than I ) I would be in favor of promoting the title "PA" and never saying assistant again.

if the aapa wants to launch a PR campaign about quality care delivered by "PA's" I would be all for it.

I appreciate all that the aapa does behind the scenes for us but name recognition is also an important part of advancing the profession and the majority of americans don't know what a pa is, regardless of what the letters stand for. stop 100 americans on the street and ask them what a "physician assistant" is and they will say"the guy who checks your blood pressure for the doctor". ask them what a "PA" is and you will get a blank look. the only time a survey like this was done a few yrs ago the aapa was surprised by these results. working pa's weren't. do the same survey among physicians and they will get the initials right but have no idea about what our training really involves unless they are personally involved with training pa's. most of the docs I work with are surprised when I describe the 2nd yr of pa school to them. they had no idea that it is basically ms3.

the nurse practitioners have us beat hands down when it comes to PR. most folks know what a nurse practitioner is. they also have their organization working on state practice laws, etc in addition to PR.

it is possible to do both and that's what pa's want from the aapa. representation behind the scenes in forming good laws, dea privileges, etc but also recognition by the man on the street. in a perfect world pa would have the same recognition as md, rn, and np.

I am very impressed with what the aapa has accomplished in the last yr.

now I think it's time for them to take the next step. spend some of that multimillion dollar surplus in their war chest and make PA a household name so that when someone says " I made an appt with my allergy/neuro/cardiology PA for next week" everyone will know what they are talking about.

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why would states care if the ncccpa and aapa changed their names? they wouldn't.

you don't get it. with a cosmetic change NOTHING CHANGES IN STATE LAW. anywhere that the state requires we be physician assistants we are physician assistants(practice descriptions, etc). where it is not spelled out in the law we are physician associates. on billing forms we are assistants if required. we just don't ever say "assistant". we say PA or physician associate. I already never say assistant. not on my cv, not on my business cards, etc everything says PA.

when someone says "what is a pa?" I describe my education without ever saying assistant. if a state has requirements for ID's, etc they usually specify must use physician assistant or pa-c. no brainer, use pa-c.

 

OK. You initially stated the below:

 

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...

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.

 

I didn't get it either, but that was what I responded to. I totally disagree with you but we all have a right to our opinions. It you truly believe in this strategy, and that it is just a "cosmetic" issue, then you should begin introducing yourself as a physician associate, and put this on all your letterhead, business cards, name tag, lab coat, billing forms, etc. If it is just "cosmetic," then you have nothing to worry about, although I doubt that the Oregon medical board will look at this matter in such a cavalier manner. You don't need the AAPA, OSPA or NCCPA to do anything in my estimation.

--

Stephen Hanson, PA-C

Bakersfield CA

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how would you feel about a public PR campaign to promote PA's. forget associate if you want. no one knows who we are. 40 yrs on and we have recognition only from a small % of americans.

what is the downside to spending a few million dollars on promoting pa's? it would create jobs. it would increase pts understanding of who we are and what we do. the aapa keeps saying they are "considering a pr campaign". time to stop considering and just do it. poll pa's on if we think promoting the profession should be a goal of the aapa.

that is how the DO's got recognition. they had ads in all the national magazines. now no one thinks of them as chiropractors anymore. I have no problem with everything else the aapa does. the np's have shown that you can have both good pr and good practice laws. we can do better.

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Hello boys and girls...

Basically what Mr. AAPA presidente is saying above is that he doesn't care what the PAs want as he has already figured out what we need.

The above exchange is a indication of .... and part of the reason why the AAPA is irrelevant to most of the PAs "in the trenches."

My suggestion is:

If you are a current AAPA member... DO NOT RENEW...

If you are a student... DO NOT join...

It just doesn't make sense to financially support a organization that simply ignores you but does what it wants with your money.

Just my $0.02

Now back to your regularly scheduled programing...

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how would you feel about a public PR campaign to promote PA's. forget associate if you want. no one knows who we are. 40 yrs on and we have recognition only from a small % of americans.

what is the downside to spending a few million dollars on promoting pa's? it would create jobs. it would increase pts understanding of who we are and what we do. the aapa keeps saying they are "considering a pr campaign". time to stop considering and just do it. poll pa's on if we think promoting the profession should be a goal of the aapa.

that is how the DO's got recognition. they had ads in all the national magazines. now no one thinks of them as chiropractors anymore. I have no problem with everything else the aapa does. the np's have shown that you can have both good pr and good practice laws. we can do better.

 

Wasn't NAPA supposed to be promoting the profession? Are they even a force (I never really hear anything about them, so I don't know)? I think many would give to this cause. I am living off an entry level HCE job, with extra entry level pay :) , and I know I would give as much as I could.

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about 200 folks joined napa initially then the economy went in the tank so they haven't been able to do much yet.

I don't agree with contrarian about dropping aapa membership. they are the big dog and we need to support them,we just need to let them know what we want and vote for candidates who want the same things.

I work in a state with great pa laws(WA) so my #1 priority is a PR campaign. I would probably feel differently if I worked in ohio.

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... poll pa's on if we think promoting the profession should be a goal of the aapa...

 

That's the rub E...

They don't care what the PAs want... so why would they bother "polling" them...??

 

The AAPA is simply a overgrown constituent organization. It is no more important than say SEMPA, AFPPA, APAC, etc... but only seems important because you guys keep sending your money to it. Let it "shrivel up and die" by replacing it with a organization that is responsive to its members.

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if the aapa wants to launch a PR campaign about quality care delivered by "PA's" I would be all for it.

I appreciate all that the aapa does behind the scenes for us but name recognition is also an important part of advancing the profession and the majority of americans don't know what a pa is, regardless of what the letters stand for. stop 100 americans on the street and ask them what a "physician assistant" is and they will say"the guy who checks your blood pressure for the doctor". ask them what a "PA" is and you will get a blank look. the only time a survey like this was done a few yrs ago the aapa was surprised by these results. working pa's weren't. do the same survey among physicians and they will get the initials right but have no idea about what our training really involves unless they are personally involved with training pa's. most of the docs I work with are surprised when I describe the 2nd yr of pa school to them. they had no idea that it is basically ms3.

the nurse practitioners have us beat hands down when it comes to PR. most folks know what a nurse practitioner is. they also have their organization working on state practice laws, etc in addition to PR.

it is possible to do both and that's what pa's want from the aapa. representation behind the scenes in forming good laws, dea privileges, etc but also recognition by the man on the street. in a perfect world pa would have the same recognition as md, rn, and np.

I am very impressed with what the aapa has accomplished in the last yr.

now I think it's time for them to take the next step. spend some of that multimillion dollar surplus in their war chest and make PA a household name....

 

I appreciate a lot of what you are saying here, and want to assure that the AAPA has a great new communications staff and PR firm, and we are working on all these issues. Herein lies the core problem. Kudos to the nurses and it is a little easier because the have been around since the days of Florence Nightingale and number more than 2.9 million in the US. Physicians? 850,000. PAs not quite 75,000 and only in existence since 1967. In my estimation, the AAPA has been incredibly effective in advancing the profession given 40,000 members and against formidable competing lobbies of organized medicine and nursing on the state and federal level. BTW, what "war chest" are you talking about? The AAPA ran a deficit budget over the past two years pursuing its strategic goals and improving its infrastructure to better serve its members and the profession. The bottom line is that no name will change the confusion regarding our name. We will just substitute one confusion for another. The patient will get it when they see what we do for them. My patients have no confusion about it, and the average joe on the street will get it too when they interact with a PA. The best advertisement for a PA is a good PA. All the best to you!

--

Stephen Hanson, PA-C

Bakersfield CA

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here's a question:

what would be involved with placing an optional PR campaign contribution on the yearly dues statement? that way a pr campaign could be funded without jeopardizing other critical efforts.

if it raised a significant sum that would speak volumes about how important the membership thinks the issue is. if it raised a few thousand that would say something too...

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Mr. Hanson- I do appreciate your taking the time to express your views here. while not everyone here will have the same ideas I think exchange of concepts with our leadership is an important first step in initiating change.

 

Please, it is Steve and I put my scrubs on one leg at a time! I'm here because I do care. We honestly haven't been the greatest at the AAPA in everything that we have done over the years, nor are we given credit for a lot of the successes we have achieved. That comes with the territory. I work full time as a surgical PA, and have practiced for 30 years and in five specialties. I do the best that I can everyday in practice and leadership, and never lose sight of the wants, needs and preferences of the PA colleagues who practice along side of me.

 

I'm of the Capt. Phil school of philosophy (Deadliest Catch) in that you can either make it happen, watch what happened, or wonder WTF happened.... :-)

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Steve

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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.

 

This is exactly what they want you to feel. Rest assured that will never happen. We have proven not only our worth, but our financial viability. The future of primary care is sitting at our front door and we either let it in or turn it away. I hope our fears do not preclude us from the right choice.

 

I posted the following on FaceBook recently and it sums up why I think we need the name-change, and, and in contrast to a great deal of the posts i've seen, self-recognition or inflation of or collective egos has the least to do with it. It was in response to someone stating that they were happy with their current role, eluding that not rocking the proverbial boat might be the right direction for our profession:

 

While a desire for recognition no doubt plays a part in the driving force behind the name-change debate, it is by far the only reason. In fact, I believe it to be a very small part of it. At least for me.

 

I’ve heard the mantra that if you wanted to be a doctor you should have gone to medical school so many times it makes me want to explode. I don’t want to go to medical school, nor did I ever want to. I don’t think I need to to play the vital role I do. I’m comfortable with my training and know my limitations. And I shouldn’t be made to feel that I, or any of my colleagues, need to choose a different path in order to play that role. Likewise, we shouldn’t be encumbered from effecting change in the bigger scheme of things simply because we lack a respectable title. However, that maxim is very pervasive in our society. It’s a societal norm.

 

No matter how bad we want to, we’re not going to change societal norms. In that regard, the words “assistant” and “associate” have inherently different meanings. Meanings that are a detriment to our profession for the first, and what I believe would be beneficial for the later. I hate that we live in a time that we have to debate the nuances of vernacular, but we do, and it has huge implications for us politically.

 

For the past three years I have acted as Clinical Director for an Indian Health Service (IHS) clinic. As the only PA on our staff I feel a great deal of gratitude being given that opportunity. However, working in that position, with other physicians on staff (talk about oxymorons, a PA acting as a CD on a staff that includes other physicians) has truly brought to light the inadequacies of our name-sake. If I had a dime for every time I had to explain why I was CD in lieu of one of them I’d be a rich man. And not just the physicians, our staff has a dentist too, and it’s actually been eluded to, by pure essence of title and degree, that he would be better suited to fill those shoes, though he doesn’t have half the medical training I do. Like it or not, titles mean a lot indeed.

 

The clinic in which I’m employed is accredited by the Accreditation Association for Ambulatory Health Care (AAAHC). The folks that came to oversee the accreditation process our last go-around could not understand how an “assistant” could have the title of “director.” No matter how we tried to explain it. And these were educated folks, two nurses and a physician. They actually demanded that we change our organizational chart in order to allow us to pass. Talk about demeaning.

 

Likewise, in the position of CD for an IHS clinic, one is required to meet and work with tribal councils and their leadership. Again, if I had a dime for every time I was dismissed simply on the premise of nomenclature, I’d be rich. I actually had one councilman walk out on me ranting that he was humiliated that his time was being wasted talking to an assistant, demanding that he be shown proper respect by having someone with authority speak to him.

 

As I stated earlier, I strongly believe that the desire for self-recognition is only a small part of the bigger picture. Anyone that has walked in our shoes long enough knows that recognition is important and that we sometimes don’t get our fair share. Conversely, however, anyone that would suggest that we want to change our namesake simply to inflate our collective egos or play doctors is sadly misguided.

 

We need this name-change to stay afloat in today’s politically turbulent waters. This debate is bigger than just me, or you, or any one of our fellow PAs. It’s about the viability of our future as a profession and whether we want to be active and vocal participants in where its headed. It’s about the important role we can play in truly changing and shaping the way healthcare is delivered in these tumultuous times. It’s about shifting away from an ancillary role to one that is more rooted in leadership. And if we do decide that we want to take on those roles, I believe wholeheartedly, sadly, that our name indeed holds us back.

 

I truly understand the sentiment that you are happy with what you are, the role you play. I know most of us are. I know I certainly am and I often ask myself why I’m expending so much energy on a fight that I have doubts is winnable. I have to remind myself that this is not about me, that it’s about the health of this nation and our patients that are its backbone and at a time when change is in the air. And I have to keep telling myself that it’s about the bigger picture.

 

I know that our education is different than that of a physician’s. And again, I don’t think our desire for a more befitting name is a vain attempt at fooling anyone into believing that we are physicians. It’s an attempt at rebranding ourselves to even the political playing field. I like to think that our education is different in a good way. I like to think that, with our varied backgrounds and unique experiences, we possess a set of tools that can truly make a positive impact on the future of our healthcare society. With that, I humbly ask you to not be content with what you are. I ask you only to believe in what more you can be and what we as a profession can achieve if we stand and work together.

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I appreciate a lot of what you are saying here, and want to assure that the AAPA has a great new communications staff and PR firm, and we are working on all these issues. Herein lies the core problem. Kudos to the nurses and it is a little easier because the have been around since the days of Florence Nightingale and number more than 2.9 million in the US. Physicians? 850,000. PAs not quite 75,000 and only in existence since 1967. In my estimation, the AAPA has been incredibly effective in advancing the profession given 40,000 members and against formidable competing lobbies of organized medicine and nursing on the state and federal level. BTW, what "war chest" are you talking about? The AAPA ran a deficit budget over the past two years pursuing its strategic goals and improving its infrastructure to better serve its members and the profession. The bottom line is that no name will change the confusion regarding our name. We will just substitute one confusion for another. The patient will get it when they see what we do for them. My patients have no confusion about it, and the average joe on the street will get it too when they interact with a PA. The best advertisement for a PA is a good PA. All the best to you!

--

Stephen Hanson, PA-C

Bakersfield CA

 

OMG! I'm in sync with the AAPA leadership's position on this subject!

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While a desire for recognition no doubt plays a part in the driving force behind the name-change debate, it is by far the only reason. In fact, I believe it to be a very small part of it. At least for me.

 

No matter how bad we want to, we’re not going to change societal norms. In that regard, the words “assistant” and “associate” have inherently different meanings. Meanings that are a detriment to our profession for the first, and what I believe would be beneficial for the later. I hate that we live in a time that we have to debate the nuances of vernacular, but we do, and it has huge implications for us politically.

 

For the past three years I have acted as Clinical Director for an Indian Health Service (IHS) clinic. As the only PA on our staff I feel a great deal of gratitude being given that opportunity. However, working in that position, with other physicians on staff (talk about oxymorons, a PA acting as a CD on a staff that includes other physicians) has truly brought to light the inadequacies of our name-sake. If I had a dime for every time I had to explain why I was CD in lieu of one of them I’d be a rich man. And not just the physicians, our staff has a dentist too, and it’s actually been eluded to, by pure essence of title and degree, that he would be better suited to fill those shoes, though he doesn’t have half the medical training I do. Like it or not, titles mean a lot indeed.

 

The clinic in which I’m employed is accredited by the Accreditation Association for Ambulatory Health Care (AAAHC). The folks that came to oversee the accreditation process our last go-around could not understand how an “assistant” could have the title of “director.” No matter how we tried to explain it. And these were educated folks, two nurses and a physician. They actually demanded that we change our organizational chart in order to allow us to pass. Talk about demeaning.

 

Likewise, in the position of CD for an IHS clinic, one is required to meet and work with tribal councils and their leadership. Again, if I had a dime for every time I was dismissed simply on the premise of nomenclature, I’d be rich. I actually had one councilman walk out on me ranting that he was humiliated that his time was being wasted talking to an assistant, demanding that he be shown proper respect by having someone with authority speak to him.

 

I know that our education is different than that of a physician’s. And again, I don’t think our desire for a more befitting name is a vain attempt at fooling anyone into believing that we are physicians. It’s an attempt at rebranding ourselves to even the political playing field. I like to think that our education is different in a good way. I like to think that, with our varied backgrounds and unique experiences, we possess a set of tools that can truly make a positive impact on the future of our healthcare society. With that, I humbly ask you to not be content with what you are. I ask you only to believe in what more you can be and what we as a profession can achieve if we stand and work together.

 

Changing the name is not going to change the attitudes of these accreditation folks from AAAHC, and this bias comes from the opinion of some that only physicians can lead in a medical clinic administrative position. I wonder if they would have to same attitude regarding PA Mike Milner, admiral in the USPHS. As a flag officer, he commands lower ranking physicians and medical professionals.

 

I think that the tribal leaders problems is not going to be solved by a name change either. The expressions of their frustration may be cultural / experiential and go well beyond the issues that you perceive as a barrier or personal issues with you. Your authority will not come from a title, it will come with perceived experience in solving the problems important to the tribe.

--

Stephen Hanson, PA-C

Bakersfield CA

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Changing the name is not going to change the attitudes of these accreditation folks from AAAHC, and this bias comes from the opinion of some that only physicians can lead in a medical clinic administrative position. I wonder if they would have to same attitude regarding PA Mike Milner, admiral in the USPHS. As a flag officer, he commands lower ranking physicians and medical professionals.

 

I think that the tribal leaders problems is not going to be solved by a name change either. The expressions of their frustration may be cultural / experiential and go well beyond the issues that you perceive as a barrier or personal issues with you. Your authority will not come from a title, it will come with perceived experience in solving the problems important to the tribe.

--

Stephen Hanson, PA-C

Bakersfield CA

 

Nope....!!!

 

Its really obvious that YOU do not support a name change by your immeadiate use of talking points to counter every instance/example and the fact that you are NOW speaking about something you know not.

 

FYI.... in the PNW tribal setting, you authority DOES come from your title... which is evidenced by them bestowing the title "chief" on tribal members without regard to their education or age. Title IS important to this and other populations that we serve.

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Changing the name is not going to change the attitudes of these accreditation folks from AAAHC, and this bias comes from the opinion of some that only physicians can lead in a medical clinic administrative position. I wonder if they would have to same attitude regarding PA Mike Milner, admiral in the USPHS. As a flag officer, he commands lower ranking physicians and medical professionals.

 

I think that the tribal leaders problems is not going to be solved by a name change either. The expressions of their frustration may be cultural / experiential and go well beyond the issues that you perceive as a barrier or personal issues with you. Your authority will not come from a title, it will come with perceived experience in solving the problems important to the tribe.

--

Stephen Hanson, PA-C

Bakersfield CA

 

Yep, besides, you can always bring up Bill Hunt. I would say he's risen pretty far in the administrative world AS a PA.

 

Michael Halasy

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Nope....!!!

 

Its really obvious that YOU do not support a name change by your immeadiate use of talking points to counter every instance/example and the fact that you are NOW speaking about something you know not.

 

FYI.... in the PNW tribal setting, you authority DOES come from your title... which is evidenced by them bestowing the title "chief" on tribal members without regard to their education or age. Title IS important to this and other populations that we serve.

 

two thumbs up.

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I appreciate a lot of what you are saying here, and want to assure that the AAPA has a great new communications staff and PR firm, and we are working on all these issues. Herein lies the core problem. Kudos to the nurses and it is a little easier because the have been around since the days of Florence Nightingale and number more than 2.9 million in the US. Physicians? 850,000. PAs not quite 75,000 and only in existence since 1967. In my estimation, the AAPA has been incredibly effective in advancing the profession given 40,000 members and against formidable competing lobbies of organized medicine and nursing on the state and federal level. BTW, what "war chest" are you talking about? The AAPA ran a deficit budget over the past two years pursuing its strategic goals and improving its infrastructure to better serve its members and the profession. The bottom line is that no name will change the confusion regarding our name. We will just substitute one confusion for another. The patient will get it when they see what we do for them. My patients have no confusion about it, and the average joe on the street will get it too when they interact with a PA. The best advertisement for a PA is a good PA. All the best to you!

--

Stephen Hanson, PA-C

Bakersfield CA

 

Saying that a name change wont lessen confusion is a cop out. Until we change our names we will always be just "assistants" and will fall even farther behind the Nurse Practitioners.

 

"The patient will get it when they see what we do for them. My patients have no confusion about it, and the average joe on the street will get it too when they interact with a PA. The best advertisement for a PA is a good PA. All the best to you!"

 

Hasn't this been the strategy so far? Hows that working out? After 43 years people still have no idea who or what we are. Without a good PR campaign we will go nowhere. That bovine scatology of each individual PA will inform the country one patient at a time is lucicrous.

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saying that a name change wont lessen confusion is a cop out. Until we change our names we will always be just "assistants" and will fall even farther behind the nurse practitioners.

 

"the patient will get it when they see what we do for them. My patients have no confusion about it, and the average joe on the street will get it too when they interact with a pa. The best advertisement for a pa is a good pa. All the best to you!"

 

hasn't this been the strategy so far? Hows that working out? After 43 years people still have no idea who or what we are. Without a good pr campaign we will go nowhere. That bovine scatology of each individual pa will inform the country one patient at a time is lucicrous.

 

word!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

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Its really obvious that YOU do not support a name change by your immeadiate use of talking points to counter every instance/example and the fact that you are NOW speaking about something you know not.

 

FYI.... in the PNW tribal setting, you authority DOES come from your title... which is evidenced by them bestowing the title "chief" on tribal members without regard to their education or age. Title IS important to this and other populations that we serve.

 

You're right. I don't support a name change, and I clearly stand behind what I say. I've been saying it for two decades so it shouldn't come as a surprise to anyone. My arguments against the name change come from my personal experience over thirty years as a PA, and work over two decades in state and federal legislative affairs. If my personal opinions sound like "talking points," its because I have held these beliefs for a long time, and have articulated them many times.

 

As for standing I managed a community health center in Bakersfield for four years serving a largely Medicaid and uninsured population.

 

As for title, then "clinic director" isn't enough? I don't understand how calling yourself a physician associate will change the attitude of the tribal leaders.

--

Steve Hanson

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Since you are the president of the AAPA, I'm going to assume that you can read, have some semblance of cultural awareness and DO realize that words in the English language have both distinct and broad meanings and also carry intended and unintended connotations that can either help or hinder communication.

 

Now consider what the title "Assistant" means to 99.9999999999% of the human population and while you are at it... consider that Physician Assistant doesn't even translate correctly to many languages... especially when the person we are treating is looking past us, over our shoulder at the exam room door, waiting for the person we are "assisting" to arrive and give us direction/instructions.

 

I'm going to also go out on a limb and assume that you DO realize that your role in your position as the president of the AAPA is work to realize the goals of your constituency... NOT obstruct or replace those goals with your own.

 

Just a few thoughts...

 

Contrarian

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