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

[burnpac]

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.

 

We do have a public PR campaign, and over the past two years the AAPA has invested significant staff and monetary resources in aggressive public relations. I want to be clear in this post that if the goal is 100% of the American population knowing about PAs, then I waive the white flag right now as it is impossible given our small numbers relatively and scarce resources. Comparing PR campaign successes with 2.9 million nurses and 850, 000 physicians is unfair and a little like comparing apples to oranges. I admire what the nurses have done and there is much that we can emulate, even with our scarce resources and small numbers.

 

Even though we are smaller, and have fewer financial and other resources, we have been very smart and strategic the last two years. With a new and strong staff of PR industry veterans at the helm, we have been able to seem larger than we are. Changing public opinion (or even establishing it) take time, and is a marathon, not a sprint. Using their industry contacts, communications staff set up a meeting with then AAPA president Cindy Lord and editors from major magazines in NYC such as O magazine and other major publications to educate them about PAs and the positive and growing role that they play in the health care system.

 

Over the past year, I have focused on "desk side" interviews with reporters from NPR, Newsweek, Time, Examiner group, WSJ, and others, to educate them about PAs to increased the chance of positive publicity about PAs in health care stories. Some of these interviews have resulted in positive stories about PAs. It has helped that health care reform has focused a lot of attention on the PA profession, and we have leveraged that into even more positive coverage.

 

In a departure from past philosophy, we challenge every negative story about PAs, or failure to appropriately mention PAs. I have formally commented numerous times to editors to challenge their conclusions and ensure that they recognize the role that PAs play in the health care system. The AAPA will continue to challenge and refute misconceptions wherever we find them, and we comb the media daily to root them out.

 

Complicating PR and all other strategic goals has been the reality of the new PHRMA rules, which has dramatically and negatively affected the bottom line of every medical member organization in America. Gone are the days when organizations like the AAPA could rely on large amounts of pharmaceutical support in meeting their budget needs. We have to do more with less, and find new non-dues revenue sources. PA profession PR remains a high priority for the AAPA.

--

Stephen Hanson

Bakersfield CA

[burnpac]

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

 

I'm a surgical PA so I don't need to read.... :-)

 

Funny, I thought we were having a collegial discussion here. If I'm mistaken, let me know. My role as president is actually be the public spokesperson of the Academy. The 13 PA members of the Board share equally in all business decisions of the Academy. The mission, vision, philosophy and policies of the Academy are set by approximately 240 of your peers elected by states, specialty organizations and others at the Annual House of Delegates. I have worked tirelessly to advance the profession in my year as president and decades in state and national leadership. If you have any examples of me obstructing member goals or replacing them with my own, please share them.

--

Steve Hanson

Bakersfield CA

[Emerson]

We do have a public PR campaign, and over the past two years the AAPA has invested significant staff and monetary resources in aggressive public relations. I want to be clear in this post that if the goal is 100% of the American population knowing about PAs, then I waive the white flag right now as it is impossible given our small numbers relatively and scarce resources. Comparing PR campaign successes with 2.9 million nurses and 850, 000 physicians is unfair and a little like comparing apples to oranges. I admire what the nurses have done and there is much that we can emulate, even with our scarce resources and small numbers.

 

First, thank you for taking the time to participate in this conversation. I'm not going to buy in that our lack of awareness is based on our lack of numbers, it's simply a lack of creative initiative. When I attended the AAPA conference in San Diego, I was amazed that the amount of money spent on marketing materials didn't even mention the words "Physician Assistant". I recall walking through the hotels and hearing it's customers say, "What's AAPA?". If you do have PR strategies in place, then they are sincerely lacking forsight and direction. Anything ever printed not only should contain the words "Physician Assistant" but should be accompanied with a free brochure entitled "What is a Physician Assistant?" I would be very interested in reading your creative brief and marketing initiatives set forth by the academy, is that available? If the nursing community can form a relationship with pharm to help fund commercials saying 'thank you nurses', certainly a conversation can be had based on that fact that we actually prescribe their product. As you can tell, I am very passionate about creating awareness for the industry and hope to launch some local initiatives with my state chapter once I complete my education in just 2 short months.

[Contrarian]

Uhh Yeah... this IS a collegial discussion... It's usually VERY clear when I'm not being collegial.:heheh::smile:

 

As for the "obstruction" charge... I'm NOT saying that YOU are obstructing, I'm merely suggesting that your immediate oppositional responses to ALL concerns/ideas posted above gives ME the impression that you simply do NOT want to or basically refuse to even consider whats being said by the AAPA members here... based upon YOUR personal feelings about the name change. Which to me... doesn't seem to be the correct action of a elected organization leader.

 

Seriously... as I re-read ALL of your responses above... they ALL seem to be NOT the careful consideration given to the thoughts and concerns of respected peers and constituents, but responses resembling prompt dismissal of the thoughts and concerns of people who you feel don't know any better with YOUR personal thoughts and preferences used as rational.

 

But hey... thats just the impression I get...

 

Contrarian

[EMEDPA]

Steve- thanks for your behind the scenes work to correct false assumptions in the media about pa's.

does the idea of adding an optional section to the yearly dues statement for strictly mass market advertising( ads in newsweek, radio ads during the superbowl, for example) have any merit?

it would be strictly voluntary and if a lot of money was raised that would be a good indication of the seriousness many feel in regards to this issue.

if 40,000 pa's each gave even 10 dollars (and many would give more) we would have a significant chunk of change to spend strictly on mass market PR.

[Emerson]

Steve- thanks for your behind the scenes work to correct false assumptions in the media about pa's.

does the idea of adding an optional section to the yearly dues statement for strictly mass market advertising( ads in newsweek, radio ads during the superbowl, for example) have any merit?.

 

E -

 

Definitely a great idea worth exploration, so long as an effective campaign is created to utilize the use of those funds. Putting forth a creative brief on the AAPA website illustrating a clear focus would not only gain additional financial support from members, but improve the notion that the AAPA is actually promoting it's profession.

[medic25]

Steve- thanks for your behind the scenes work to correct false assumptions in the media about pa's.

does the idea of adding an optional section to the yearly dues statement for strictly mass market advertising( ads in newsweek, radio ads during the superbowl, for example) have any merit?

it would be strictly voluntary and if a lot of money was raised that would be a good indication of the seriousness many feel in regards to this issue.

if 40,000 pa's each gave even 10 dollars (and many would give more) we would have a significant chunk of change to spend strictly on mass market PR.

 

Since we are discussing PR and marketing, I've always wondered whether the AAPA has ever made any attempts to sway Hollywood into creating PA characters on television and in the movies. Although it sounds rather minor, all we have to do is look back at paramedics in the early 70's. Most of America thought of EMS being nothing more than ambulance drivers until John Gage and Roy DeSoto started saving lives on a weekly basis on "Emergency". They played a big part in making the public aware of what a paramedic actually did; is anyone working to help create the PA equivalent of John Gage?

[burnpac]

Since we are discussing PR and marketing, I've always wondered whether the AAPA has ever made any attempts to sway Hollywood into creating PA characters on television and in the movies. Although it sounds rather minor, all we have to do is look back at paramedics in the early 70's. Most of America thought of EMS being nothing more than ambulance drivers until John Gage and Roy DeSoto started saving lives on a weekly basis on "Emergency". They played a big part in making the public aware of what a paramedic actually did; is anyone working to help create the PA equivalent of John Gage?

 

Funny you should mention it. Remember St. Elsewhere (I'm dating myself....)? A PA friend of mine was a consultant on that show in the eighties, and there was a PA character. The most recent are the PA characters on ER and Royal Pains, not always so flattering. Stephen King also has a PA character in a book. BTW, as an ex paramedic, I grew up on Johnny and Roy, and even have an LA County 51 fire helmet.

--

Steve

[delco714]

There's a PA on House MD.. Dr Wilson has one, and when she makes an appearance she's looked at as a servant (aka assistant).

[burnpac]

Steve- thanks for your behind the scenes work to correct false assumptions in the media about pa's.

does the idea of adding an optional section to the yearly dues statement for strictly mass market advertising( ads in newsweek, radio ads during the superbowl, for example) have any merit?

it would be strictly voluntary and if a lot of money was raised that would be a good indication of the seriousness many feel in regards to this issue.

if 40,000 pa's each gave even 10 dollars (and many would give more) we would have a significant chunk of change to spend strictly on mass market PR.

 

I will run the idea up the flag pool and thanks for bringing it up. My personal opinion? A six figure chunk of money could be used in much more productive ways that full page ads in magazines, newspapers (NY Times $75,000) and Superbowl ads ($ million +). I don't think that that would be a responsible and cost effective use of the money and won't really educate the public effectively about PAs. However, expanding what we are doing and multiplying its effect would help to develop critical mass.

 

Here are the ads we ran during health care reform in Capital Hill publications (intended for legislators and policy makers and just an example of the work of our PR firm).

 

http://www.aapa.org/advocacy-and-practice-resources/call-for-action/advocacy-ads

http://www.aapa.org/advocacy-and-practice-resources/call-for-action/advocacy-ads/1268-june-2009

http://www.aapa.org/advocacy-and-practice-resources/call-for-action/advocacy-ads/1269-july-2009

 

 

--

Steve

[HLReed]

Steve- thanks for your behind the scenes work to correct false assumptions in the media about pa's.

does the idea of adding an optional section to the yearly dues statement for strictly mass market advertising( ads in newsweek, radio ads during the superbowl, for example) have any merit?

it would be strictly voluntary and if a lot of money was raised that would be a good indication of the seriousness many feel in regards to this issue.

if 40,000 pa's each gave even 10 dollars (and many would give more) we would have a significant chunk of change to spend strictly on mass market PR.

 

I wonder what would happen if 40,000 PAs took ten dollars each and made up some brochures on their computers or at Kinko's and plastered them all over their local areas. Start up the facebook group...

[burnpac]

First, thank you for taking the time to participate in this conversation. I'm not going to buy in that our lack of awareness is based on our lack of numbers, it's simply a lack of creative initiative. When I attended the AAPA conference in San Diego, I was amazed that the amount of money spent on marketing materials didn't even mention the words "Physician Assistant". I recall walking through the hotels and hearing it's customers say, "What's AAPA?". If you do have PR strategies in place, then they are sincerely lacking forsight and direction. Anything ever printed not only should contain the words "Physician Assistant" but should be accompanied with a free brochure entitled "What is a Physician Assistant?" I would be very interested in reading your creative brief and marketing initiatives set forth by the academy, is that available? If the nursing community can form a relationship with pharm to help fund commercials saying 'thank you nurses', certainly a conversation can be had based on that fact that we actually prescribe their product. As you can tell, I am very passionate about creating awareness for the industry and hope to launch some local initiatives with my state chapter once I complete my education in just 2 short months.

 

You're welcome, and you picked a great profession at a great time in its young history. Welcome to the profession.

 

Here is a good place to start:

 

http://www.aapa.org/advocacy-and-practice-resources/issue-briefs

--

Steve

[EMEDPA]

 

http://www.aapa.org/advocacy-and-practice-resources/call-for-action/advocacy-ads

http://www.aapa.org/advocacy-and-practice-resources/call-for-action/advocacy-ads/1268-june-2009

http://www.aapa.org/advocacy-and-practice-resources/call-for-action/advocacy-ads/1269-july-2009

 

 

--

Steve

 

I like these. I would really like to put them where more folks than just members of congress could see them.

the point of the voluntary contribution wouldn't be "what could we do with this money" but "we as pa's want this spent on PR visible to the american public at large. here is money that you wouldn't otherwise have and we want it spent specifically on items like the ad in newsweek or the wall st journal, etc". think of it as a PR xmas present that can only be used in the way that the donors direct. late night radio and cable TV ads are not terribly expensive and that would be one way to stretch the money. a nice 30 second spot outlining the work of a rural fp pa would be great:

"john smith is the only medical provider in backwater tennesee. he sees 30-40 patients/day with every type of medical condition imaginable. he delivers babies and stabilizes patients with heart attacks. he fixes dislocated shoulders and treats ear infections at 3 am. he has 6 years of college education in addition to his prior training and experience as a paramedic in memphis. john is a physician assistant.

PA's, bridging the gap in rural health care so all americans can get the medical care they need and deserve.....for more info on medical providers like john please see www.aapa.org/modernheroes"

[EMEDPA]

I wonder what would happen if 40,000 PAs took ten dollars each and made up some brochures on their computers or at Kinko's and plastered them all over their local areas. Start up the facebook group...

people don't read...you need to appeal to their senses in other ways(what do you do if a guy hands you an unsolicited flyer at the mall..yup, it's in the next trash can)...they need to hear the ad on the radio, see the picture in the magazine, or watch the blurb on late night TV. we put flyers in our lobby about pa's. for a while we even handed them to every patient at triage. they described the role of em pa's, our training, etc after the visit we had folks fill out a survey; who saw you and how would you rate your visit? no one recognized that they had been seen by a pa despite the flyers, our introduction as pa's, our lab coats that say john doe, pa-c, our business cards and aftervisit instructions with our names and titles. they all said" dr emedpa was great" or "dr emedpa didn't care because he didn't refill my fentanyl patches for my hangnail", etc

[Joelseff]

 

Here are the ads we ran during health care reform in Capital Hill publications (intended for legislators and policy makers and just an example of the work of our PR firm).

 

http://www.aapa.org/advocacy-and-practice-resources/call-for-action/advocacy-ads

http://www.aapa.org/advocacy-and-practice-resources/call-for-action/advocacy-ads/1268-june-2009

http://www.aapa.org/advocacy-and-practice-resources/call-for-action/advocacy-ads/1269-july-2009

 

 

--

Steve

 

Hi Steve, I want to say that I am proud to be a PCAP'er especially with you in office and I mean this with ALL due respect, but man I can't help but think "these ads were the best they could come up with?' I mean the first one looks like a Paramedic ad or even a ER nurse ad. The one with the lady freezing her buns off (lol) and the one after that, at first glance, were no better at really impacting on what we do. The last two look like ads for Nat'l Healthcare. I know the fine print has info on some of the scope of PA's but I like Emed's idea about John so and so PA-C in backwater Tennessee. At least it would portray what a PA is and does without having to read the fine print. Again, I know not the first thing about making ads but compare these to the "thank you Nurses," or "Hug a Nurse, PRN" ads these kinda fall flat. And just having the words assistant already connotates a subordinate role no matter how you look at it, especially if it is to the unaware and uninformed public.

 

Regarding the Name Change, you mentioned state level legislation to push it forward. Can we not get Karen Bass on board to help us out in Cali? I have noticed that of the PA's against the change, many are not so much against it but are mostly unwilling to fight the fight (as i have noticed here on this board and in person talking with a few PA's). The fact that so MANY PA-C's and PA-S' are rooting for this (see our facebook group 2000 members in less than 20 days and counting) is it not worth a look into. I may be just a PA-S but I have worked alongside and for PA's for the past 15 years and I can tell you, of the ones I know, one of their main frustrations about the job is the title.

[burnpac]

Hi Steve, I want to say that I am proud to be a PCAP'er especially with you in office and I mean this with ALL due respect, but man I can't help but think "these ads were the best they could come up with?' I mean the first one looks like a Paramedic ad or even a ER nurse ad. The one with the lady freezing her buns off (lol) and the one after that, at first glance, were no better at really impacting on what we do. The last two look like ads for Nat'l Healthcare. I know the fine print has info on some of the scope of PA's but I like Emed's idea about John so and so PA-C in backwater Tennessee. At least it would portray what a PA is and does without having to read the fine print. Again, I know not the first thing about making ads but compare these to the "thank you Nurses," or "Hug a Nurse, PRN" ads these kinda fall flat. And just having the words assistant already connotates a subordinate role no matter how you look at it, especially if it is to the unaware and uninformed public.

 

Regarding the Name Change, you mentioned state level legislation to push it forward. Can we not get Karen Bass on board to help us out in Cali? I have noticed that of the PA's against the change, many are not so much against it but are mostly unwilling to fight the fight (as i have noticed here on this board and in person talking with a few PA's). The fact that so MANY PA-C's and PA-S' are rooting for this (see our facebook group 2000 members in less than 20 days and counting) is it not worth a look into. I may be just a PA-S but I have worked alongside and for PA's for the past 15 years and I can tell you, of the ones I know, one of their main frustrations about the job is the title.

 

Wow this has been a good productive discussion on PR, and gave me a lot to think about. Now, I want you give you all something to think about. We are all PAs, right? Personally, I have zero expertise in marketing, branding, advertising, etc., We recruit and hire the best staff we can find on the nation level with expertise in advocacy, professional practice, and public relations. Doesn't it make sense to give our PR people the opportunity to give input into what to do to best utilize PR dollars? My gut tells me that a color glossy ad in Time make look great, but is it worth the money sitting on my coffee table, ignored and then discarded? The newspaper doesn't even last a day. Is there enough bang for the buck here? Does it really achieve the goals you all articulated so well? The story works for me as that is what touches people.

 

Has anyone every been to the AAPA Annual Conference General Session and seen the video productions on the PAragon winners? Moving. Here are some examples:

 

http://www.youtube.com/aapavideo#p/u/23/e1OJBxxuxv4

http://www.youtube.com/aapavideo#p/u/27/5lRSbOzxmOM

 

These colleagues of ours humble me and make me so proud to be a part of this profession.

 

As for Karen, two issues. This is not even on CAPA's radar as they have much more important legislative priorities, and secondly, she is a lame duck in the Assembly as she is terming out and running for Congress in Diane Watson's seat.

--

Steve Hanson

PA-C, Stanford/Foothill PCAP class of 1981

[huskymed]

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

 

With all due respect, Mr. President, I certainly don’t appreciate your dismissiveness. Some of your answers sound pre-programmed, almost robotic. Certainly not personal or respectful of the opinions of your constituency.

 

No, they would not have had an objection to Admiral Milner. Mike Milner is an admiral. Let me say it again - an admiral. Even the non-military amongst us know the import of that distinction. The title speaks for itself and certainly trumps the assistant part of his title. Poor example.

 

Unless you’ve spent a great deal of time working in tribal government, and I’m guessing you haven’t from the response, don’t comment on something with which you have little or no experience. It’s insulting to someone who has been knee deep in those trenches. I’ve had many conversations with tribal members and most agree that an associate title would indeed elevate perceived status. Bear in mind, the titles for government officials within the sovereign Indian Nations have taken on titles with English names. And believe me, they’re very fastidious about names and titles and rank. Associate would put us on par with a vice-chairman, who is in essence an associate chief, one who shares responsibility with the chief. It would be considered a respectable title.

 

Something Contrarian commented on, something I’ve been preaching until I’m blue in the face, and something you seem either not to understand or unwilling to admit. Words like “assistant” and “associate” have meanings that run much, much deeper than the definition you’ll find from the good ol’ Merriam-Webster. They have meanings that are deep rooted in culture; insinuations that are woven into the very fabric of our society. Those meaning are, in fact, societal and cultural norms. No media blitz, no amount of persuasion, no teaching one patient at a time is going to overcome those nuances. At the end of the day, to the layperson, no matter how we’ve pled our case, we’re still the guys and gals who hand the doctors their equipment. To politicians, legislators, and other prominent leaders, we’re still the guys and gals who have been sent to waste their time because the doctor didn’t have the time or desire to come himself.

[IRISH BULLDOG]

Well said AGAIN Mike So very correct!!!!!!!!!!!!!!

[Contrarian]

With all due respect, Mr. President, I certainly don’t appreciate your dismissiveness. Some of your answers sound pre-programmed, almost robotic. Certainly not personal or respectful of the opinions of your constituency.

 

No, they would not have had an objection to Admiral Milner. Mike Milner is an admiral. Let me say it again - an admiral. Even the non-military amongst us know the import of that distinction. The title speaks for itself and certainly trumps the assistant part of his title. Poor example.

 

Unless you’ve spent a great deal of time working in tribal government, and I’m guessing you haven’t from the response, don’t comment on something with which you have little or no experience. It’s insulting to someone who has been knee deep in those trenches. I’ve had many conversations with tribal members and most agree that an associate title would indeed elevate perceived status. Bear in mind, the titles for government officials within the sovereign Indian Nations have taken on titles with English names. And believe me, they’re very fastidious about names and titles and rank. Associate would put us on par with a vice-chairman, who is in essence an associate chief, one who shares responsibility with the chief. It would be considered a respectable title.

 

Something Contrarian commented on, something I’ve been preaching until I’m blue in the face, and something you seem either not to understand or unwilling to admit. Words like “assistant” and “associate” have meanings that run much, much deeper than the definition you’ll find from the good ol’ Merriam-Webster. They have meanings that are deep rooted in culture; insinuations that are woven into the very fabric of our society. Those meaning are, in fact, societal and cultural norms. No media blitz, no amount of persuasion, no teaching one patient at a time is going to overcome those nuances. At the end of the day, to the layperson, no matter how we’ve pled our case, we’re still the guys and gals who hand the doctors their equipment. To politicians, legislators, and other prominent leaders, we’re still the guys and gals who have been sent to waste their time because the doctor didn’t have the time or desire to come himself.

 

x100... from another "assistant" knee-deep in tribal politics working with a native PNW tribe.

 

Also... did anyone else notice that our title almost had us getting "supervised" by NPs...??

Fortunately, it was caught on time and changed, but the simple fact of the matter is that when additions and deletions to billing or the scope of practice of medicine practitoners are considered for providers... the "assistants" aren't even considered or if they are... its an after thought.

[huskymed]

x100... from another "assistant" knee-deep in tribal politics working with a native PNW tribe.

 

It's nice to know I'm not the only one. I feel your pain ...

[jmj11]

Steve, I want to thank you for engaging this group. This is unique. I've been involved with many discussions on this and previous Internet-forms where we knew that AAPA members were lurking but never engaging. It takes courage. I am also am grateful for your hard work . . . which I know comes with such a national office.

 

I don't know if I will say anything that has not been said, but maybe in another perspective.

 

Obviously you can sense the frustration among the rank-n-file PAs with the public’s perception of who we are and what we do. What frustrates me the most is how it continues to interfere with the quality of health care I can provide my patients.

 

When a patient believes on that initial visit that you are just a doctors’s helper, but that you are overstepping your boundaries, your professional preparation and possible legal allowances to diagnoses and treat their illnesses, then they are more likely to feel cheated with their visits, less likely to follow your plan and the sum outcome is poorer care. This is even despite stellar personal PR attempts which are limited to that initial visit.

 

While you mentioned that you’ve had 30 years of experience, I will say that I’ve had nearly the same . . . I think 28 years. My perspective has been different, and of course our personal experiences shape our views.

 

I’ve spent the bulk of my career working in a sub-specialty. In this setting, I often see patients as a one time consult. Many others I see for a few visits, just enough to get them on the right track, then I turn them back over to their PCP. So, I am constantly saying hello to new patients and goodbye to those who are on the right path. On a typical day, I will see 4-6 new one hour consults. The vast majority of those patients have a very poor concept of who PAs are and what we do. The frustrating thing is that while the understanding of our profession is definitely better than what it was in 1982, it is no-where I thought it would be by 2010.

 

When I was working at Mayo Clinic, I was in a unique situation because virtually all my patients were new, one time consults, and from virtually every state of the union. I did an informal survey (as a possible preparation of doing a formal study) where for a period of almost six months (in 1999) I did not assume anything but asked the patients if they had ever heard of the profession “Physician Assistant.” About 60% had not. Then I asked them to explain what a PA was in their own words. The only patients who even came close were a couple of wives of PAs and a few RNs who worked with PAs. No one else came close to describing our training or knowing that we practice medicine (rather than just assist the doctor). The vast majority ( I would estimate now as about 90%) underestimated our training and abilities.

 

The mantra of the AAPA since I was in PA school has been that we do PR one patient at a time. While such personal interaction and education is vital, it has only made a dent in the problem in the past 30 years. I spent time trying to educate each of the (about 1500/year) patients for the past 28 years . . . yet the PA-naive ones keep coming one after the other after the other. It also frustrates us that the media often has stories about NPs, how they will meet the needs of the future and we are even mentioned. When I was doing my survey and the patients said that they had not heard of our profession, they invariably did know of the NP profession.

 

But with our professional name proclaiming a deception (what they hear is “Hello I am a doctor’s helper”), we start our relationship behind the 8 ball. Yes, this original misconception can be over come in time with a positive experience with the PA and education, but from a marketing perspective it makes poor sense. Would a new soft-drink company name their drink “Ice Cherry” or “Red Colored Nasty Sugar Water?” Sure, if the name it the later name, they might eventually be able to overcome that psychological disadvantage . . . but why created a perpetual problem that would haunt them forever. To understand the psychological disadvantage of labeling I suggest you read: The Way We Think: Conceptual Blending and The Mind's Hidden Complexities.

 

Yes, our profession is still young, so now is the time that we make this major correction for the generations of PAs to come. I have no doubt that eventually the name of our profession will change to bring it into realm of reality. It is better to do it now than in 20 years.

 

j. Michael Jones, MPAS-C

[underserved]

With all due respect, Mr. President, I certainly don’t appreciate your dismissiveness. Some of your answers sound pre-programmed, almost robotic. Certainly not personal or respectful of the opinions of your constituency.

 

No, they would not have had an objection to Admiral Milner. Mike Milner is an admiral. Let me say it again - an admiral. Even the non-military amongst us know the import of that distinction. The title speaks for itself and certainly trumps the assistant part of his title. Poor example.

 

Unless you’ve spent a great deal of time working in tribal government, and I’m guessing you haven’t from the response, don’t comment on something with which you have little or no experience. It’s insulting to someone who has been knee deep in those trenches. I’ve had many conversations with tribal members and most agree that an associate title would indeed elevate perceived status. Bear in mind, the titles for government officials within the sovereign Indian Nations have taken on titles with English names. And believe me, they’re very fastidious about names and titles and rank. Associate would put us on par with a vice-chairman, who is in essence an associate chief, one who shares responsibility with the chief. It would be considered a respectable title.

 

Something Contrarian commented on, something I’ve been preaching until I’m blue in the face, and something you seem either not to understand or unwilling to admit. Words like “assistant” and “associate” have meanings that run much, much deeper than the definition you’ll find from the good ol’ Merriam-Webster. They have meanings that are deep rooted in culture; insinuations that are woven into the very fabric of our society. Those meaning are, in fact, societal and cultural norms. No media blitz, no amount of persuasion, no teaching one patient at a time is going to overcome those nuances. At the end of the day, to the layperson, no matter how we’ve pled our case, we’re still the guys and gals who hand the doctors their equipment. To politicians, legislators, and other prominent leaders, we’re still the guys and gals who have been sent to waste their time because the doctor didn’t have the time or desire to come himself.

 

Awesome post! You have my vote.

[MCHAD]

Since we are discussing PR and marketing, I've always wondered whether the AAPA has ever made any attempts to sway Hollywood into creating PA characters on television and in the movies. Although it sounds rather minor, all we have to do is look back at paramedics in the early 70's. Most of America thought of EMS being nothing more than ambulance drivers until John Gage and Roy DeSoto started saving lives on a weekly basis on "Emergency". They played a big part in making the public aware of what a paramedic actually did; is anyone working to help create the PA equivalent of John Gage?

 

For what it is worth, there is a current show "Royal Pains" about a concierge physician that has a PA that works with him (this show has already been discussed on the forum). From my point of view as a PA-student, it is a decent representation. In fact there is a scene that the Doc actually states that the name Physician Assistant is kind of confusing and doesn't really explain what PA's do...he then suggests the name Physician Associate.

 

Advance web actually wrote a small article on the scene i mentioned previously...

http://community.advanceweb.com/blogs/pa_1/archive/2009/06/23/royal-pains-doc-prefers-physician-associate.aspx

 

The show will be back on the USA network in June. There are 5 episodes available on Hulu.com (legally) if you wanna check it out.

[PUA]

This is the response letter to AAPA President from Mr. David Mittman, PA.

I got it from clinician1.com

 

___________________________________________________________

Response to AAPA President about his name change letter

 

Remember Steve Hanson’s letter is in small letters, my response is in CAPS.

STEVE:

I WILL RESPOND IN CAPS. I AM NOT YELLING-JUST EASIER. I AM ALSO TRYING TO USE “PA BLUE” AS I HOPE IT TRANSLATE TO DIFFERENT EMAIL SYSTEMS, SITES, ETC. (It did not)

FIRSTLY AND MOST IMPORTANTLY, I WANT TO THANK YOU FOR WRITING TO US ALL. ALTHOUGH I AM ABOUT TO CHALLENGE SOME OF YOUR ANSWERS, I RESPECT THE FINE WORK YOU HAVE DONE AND CONTINUE TO DO. I ALSO WANT TO ASK YOUR FORGIVENESS IN ADVANCE IF ANYTHING I SAY SEEMS DISRESPECTFUL. I MEAN NO DISRESPECT AND HOLD OUT MY HAND IN FRIENDSHIP. I BELIEVE WE NEED TO ESTABLISH A DIALOGUE ON THIS AND OTHER PROBLEMS. I KNOW BOB BLUMM ALSO WROTE YOU AND I HOPE OTHERS DO. OUR PROFESSION NEEDS OPEN, HONEST COMMUNICATION. OUR PROFESSION IS AT THE RIGHT TIME FOR CHANGE. PAs ARE NEEDED. NO ONE IS GETTING RID OF US. WE OWE IT TO ALL WHO CAME BEFORE US AND THOSE THAT WILL COME AFTER TO OPEN UP THE PROFESSION TO A NEW LEVEL OF DIALOGUE AND DISCOURSE. I TRUST THE AAPA AGREES. THIS IS A STEP TOWARDS THAT.

 

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.

OK , WE ALL AGREE OUR NAME DOES NOT REPRESENT THE 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. HERE IT IS AGAIN. THE NAME DOES NOT REPRESENT OUR PROFESSION, OUR LEVEL OF EDUCATION OR THE LEVEL WE PRACTICE AT. THERE ARE NO, NONE, NADA OTHER ASSISTANTS WHO CAN DIAGNOSE TREAT OR PRESCRIBE. IT CONNOTES A TECHNICIAN LEVEL WORKER IN HEALTHCARE AND ALL OTHER FIELDS. I hear that the name is “holding the profession back”. YES, IT DOES. 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. WE AGREE. AND THAT IS A TESTEMENT TO A GREAT PROFESSION. MOST PAs ARE EXCELLENT. WE HAVE DONE THE IMPOSSIBLE. DOES THIS WONDERFUL TRACK RECORD MEAN THAT WE SHOULD NOT LOOK TO MAKE OUR PROFESSION BETTER? DOES IT MEAN WE NEED TO LIVE WITH PROBLEMS THAT MANY OF US FEEL IMPACT US DAILY?

 

Surveying the PA population on “would you prefer another name?” is a waste of time and money as I already know the answer. SO YOU AGREE THE PROFESSION WOULD SAY “YES”. AMAZING. SHOULD A POLL NOT EVEN BE CONSIDERED?MAYBE WE DO NOT NEED ONE? 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?AGREE. 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. LOOK AT THE PEOPLE WHO SIGNED ONTO THE “PA LEADERSHIP STATEMENT”. THEY ARE THE BACKBONE OF THE PROFESSION. MOST ARE PEOPLE WHO HAVE FOUGHT LONG AND HARD FOR THE ACHIEVEMENTS YOU CITE ABOVE. TO INSINUATE THAT THEY HAVE “LITTLE OR NO DIRECT EXPERIENCE” WORKING WITH STATE LEGISLATURES IS JUST WRONG. IN FACT, I WOULD THROW OUT THEY ARE AMOUNG YOUR MOST EXPERIENCED PAs LEGISLATIVELY. The law of unintended consequences rules state legislatures and state PA constituent organization advocacy activities. GENERALLY, NOT IF WE DO OUR HOMEWORK AND DO IT WELL WE WILL BE FINE. IF WE EDUCATE THE PHYSICIANS, WE WILL BE FINE.

ARE YOU SAYING WE SHOULD NEVER TRY TO CHANGE THINGS LEGISLATIVELY BECAUSE THE CONSEQUENCES THAT COME MIGHT BE UNFORESEEN? AS WE GROW, THE TIME WILL NEVER BE BETTER. NOW IS THE TIME.

 

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. NO STATE WOULD DO IT WITHOUT AT LEAST A TACID OK FROM THE AAPA. AS TIME GOES BY, STATES WILL DO IT, BUT AS THE AAPA REPRESENTS THE PROFESSION, STATES SHOULD EXPECT THEIR SUPPORT. SOUNDS LIKE “IF YOU DON’T LIKE THE MY RULES, I’LL TAKE MY BALL AND GO HOME”. HARD TO PLAY WITHOUT THE BALL IN YOUR COURT, ESPECIALLY FOR STATE ORGANIZATIONS. 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 ("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.

WE ALREADY CHANGED THE NAME. WE TOOK THE “APOSTROPHE-S” OFF OUR NAME AND NOTHING HAPPENED. THAT WAS A FULL NAME CHANGE. ASSOCIATE IS THE SAME NUMBER OF LETTERS AS ASSISTANT. THIS SHOULD BE NO DIFFERENT. TELL ME WHY IT WOULD BE? THERE WERE NO CONSEQUENCES TO THAT NAME CHANGE AND I REMEMBER IT COSTING LITTLE.

I THINK THE 500 POUND GORILLA IN THE ROOM IS THE FACT THAT THE ONLY OPPOSITION WE WILL SEE IS FROM OUR PHYSICIAN FRIENDS. IF THEY CAN NOT UNDERSTAND OUR NEED, EVEN AFTER IT IS EXPLAINED AND FAIL TO COMPREHEND THAT WE ARE ASKING FOR NO EXPANDED PRACTICE, THEN THEY ARE NOT OUR FRIENDS. OUR FUTURE STRATEGIES SHOULD REFLECT THAT. WE HAVE TO BE ABLE TO DETERMINE OUR FUTURE WITHOUT FEAR OF CONSEQUENCES.

 

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.

AGAIN DID THIS HAPPEN WHEN WE CHANGED OUR NAME AS ABOVE? AND IF WE ARE SO VITAL AND IMPORTANT TO THE HEALTHCARE SYSTEM (AND I HOPE YOU BELIEVE WE ARE) WHY WOULD GOING BACK TO THE NAME WE ARE BORN WITH CREATE PROBLEMS? YOU MUST KNOW THAT YOU CAN INTRODUCE A COSMETIC NAME CHANGE AND NOTHING WOULD CHANGE LEGISLATIVELY. NOTHING BECAUSE THAT IS EXACTLY WHAT THEY ARE DESIGNED TO DO. PODIATRISTS DID IT FROM CHIROPODISTS. OPTOMETRISTS AND CHIROPRACTORS ARE NOW OPTOMETRIC PHYSICIANS AND CHIROPRACTIC PHYSICIANS IN MANY STATES. THE AMA DISLIKES THOSE PROFESSIONS AND THEY WERE ABLE TO CHANGE THEIR TITLES. THE AAPA MAINTAINS THE BELIEF THAT AMA LIKES PAs, SO IT SHOULD BE EASIER THAN OTHER PROFESSIONS? WHY IS ASSISTANT TO ASSOCIATE SO ALARMING? WOULD YOU PERSONALLY BE ON BOARD WITH ANOTHER NAME? CLINICAL ASSOCIATE? ADVANCED CLINICIAN? MEDICAL CARE PRACTITIONER?

IF THEY DO NOT LIKE ASSOCIATE LET’S COME BACK TO OUR PROFESSION WITH THREE OTHER NAMES AND PICK ONE OF THOSE?

MOST OF US SEEM TO FEEL ASSOCIATE APTLY DESCRIBES OUR RELATIONSHIP AND WAS PICKED FOR US BY PHYSICIANS.

 

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? BOY, THERE IS TOO MUCH PROSPECTIVE NEGATIVITY BUNDLED AROUND THIS TOPIC. WHERE WOULD THESE HURDLES BE COMING FROM? NOT NPs OR ANY OTHER PROFESSIONS BESIDES PHYSICIANS? HOW DO YOU KNOW IT WOULD BRING ALL THESE HASSLES? AND IS THIS PROFESSION NOT WORTH UPGRADING OUR IMAGE? ARE WE NOT ABLE TO EDUCATE OUR PHYSICIAN COLLEAGUES REGARDING THIS ONE ISSUE? 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. SORRY, BUT THAT IS A REAL DISCONNECT. YOU AGREE WE HAVE A NAME THAT DOES NOT REPRESENT OUR PROFESSION WELL. YOU AGREE A NEW NAME WOULD WIN IN A POLL OF THE PROFESSION. WHAT WE ALL ASK YOU TO SEE IS THAT SO MANY FEEL THAT THIS SAME NAME HURTS OUR PROFESSIONAL IMAGE, RANKING, PERCEPTION, IDENTITY? IT PLACES US IN A CATEGORY WE DO NOT BELONG IN. WE TRY TO SAY OTHERWISE BUT MANY OF US KNOW AND FEEL IT. LEGISLATORS WHO HAVE NOT SEEN A PA FOR THEIR OWN CARE THINK WE HAND THINGS TO PHYSICIANS, INSURANCE COMPANY EXECUTIVES THINK THAT PHYSICIANS SHOULD HAVE TO BE “ON SITE” FOR US TO BE REIMBURSED, (THAT THOUGHT MAKES PERFECT SENSE IF WE ARE ASSISTING). WILL WE ATTRACT GET THE BEST AND THE BRIGHTEST STUDENTS IF THEY ARE TO BE “ASSISTANTS”. WE BELIEVE THE NAME HURTS US IN MANY AREAS.

 

TWO POINTS YOU FORGOT: ONE IS, WE AS A PROFESSION HAVE A GENERIC NAME. ANYONE CAN BE A “PHYSICIAN’S ASSISTANT”.

MANY OF US THINK IT WOULD BE A WASTE OF TIME AND THOSE VALUABLE RESOURCES TO TRY TO DO EFFECTIVE PUBLIC RELATIONS ON SOMETHING WE CAN NOT CONTROL OR BRAND. FOR INSTANCE, IF WE SPENT A MILLION DOLLARS IN CALIFORNIA TO TEACH EVERYONE WE ARE PHYSICIAN ASSISTANTS AND A FOREIGN PHYSICIAN WHO WAS ACTING AS A “PHYSICIAN’S ASSISTANT” KILLED 17 PATIENTS, THE HEADLINE MIGHT VERY WELL SAY, “PHYSICIAN’S ASSISTANT KILLS 17 PATIENTS”. THERE GOES THAT MILLION. ASSOCIATE WOULD BRAND US. IT’S NOT A COMMON TERM. IT’S NOT A GENERIC TERM. IT IS NOT A TERM USED IN MEDICINE GENERALLY. WE COULD “BRAND” IT SO MUCH BETTER. WE WOULD FINALLY “OWN” OUR NAME.

 

SECOND POINT IS THATWE DO NOT DO “ASSISTING” ALTHOUGH OUR NAME SAYS WE DO. ASSISTANTS HELP SOMEONE DO A PARTICULAR JOB, THEY DO NOT DO THAT PARTICULAR JOB THEMSELVES. OUR PROFESSION HAS EVOLVED AND GROWN. SOMEONE’S ASSISTANT SHOULD NOT MANAGE THE HEALTHCARE OF HUNDREDS OF OUR TROOPS, THEY SHOULD BE HELPING THE SOMEONE THEY ASSIST MANAGE THAT. WE DO NOT. IT IS NOT FAIR TO THE PATIENTS THAT SEE US FOR CARE, TO THE PRACTICES WE WORK IN AND TO OURSELVES TO MISLABEL WHAT WE DO. I REALIZE WE MIGHT HAVE SOME EXPLAINING TO DO, BUT IF WE DO NOT DO IT NOW, IT WILL BE WORSE LATER. WE ARE ASSOCIATES IN EVERY SENSE OF THE WORD. WE WORK ARM AND ARM WITH PHYSICIANS AND GENERALLY DO WHAT THEY DO. ASSOCIATE WILL ALSO PLACE US BELOW THEM AS AN ASSOCIATE PROFESSOR IS NOT A FULL PROFESSOR, AN ASSOCIATE PARTNER, NOT A FULL PARTNER. PLEASE LET US BE CLEAR ABOUT THIS-THIS IS NOT A CALL FOR INDEPENDENT PRACTICE AT ALL. WE SHOULD BE ABLE TO SIT DOWN WITH OUR FRIENDS AT THE AMA, EDUCATE THEM AND ASK THEM FOR THIS CHIP.

 

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. THEN WHY DID WE TAKE THE “APOSTROPHE S” OFF? THE PUBLIC GENERALLY CAN NOT RECOGNIZE OR UNDERSTAND THE DIFFERENCE. MORE NEWS ARTICLES CALL US PHYSICIAN’S ASSISTANTS THAN PHYSICIAN ASSISTANTS. WE DID THAT CHANGE MORE FOR OURSELVES THAN FOR THE OUTSIDE WORLD. YOU WERE BEHIND THAT CHANGE AS I WAS, WERE YOU NOT? 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

WE, AS A PROFESSION HAVE GROWN PAST “CALL ME STEVE” AS AN ANSWER TO THIS PROBLEM. PLEASE DO NOT THROW OUT SELF ESTEEM OR SELF VALUE AS AN EXCUSE. PLEASE DO NOT SAY TO THE 70 LEADERS WHO HAVE SIGNED ON AND THE MORE THAN 3,000 PAs WHO HAVE SIGNED ON HAVE A SELF ESTEEM PROBLEM. THAT IS WHAT YOU ARE SAYING IN SO MANY WORDS. “AS LONG AS THEY LET US DO OUR JOB, AND WE DO IT WELL AND PEOPLE LIKE US AS INDIVIDUALS, WE SHOULD BE HAPPY”..........OBVIOUSLY WE ARE NOT. PLEASE DON’T MAKE LIGHT OF IT.

I WANT TO BE CLEAR THIS IS ABOUT A NAME THAT MISREPRESENTS THE PROFESSION.

I THANK YOU AGAIN FOR RESPONDING AND LOOK FORWARD TO A CONTINUED DIALOGUE.

YOURS FOR A STRONGER, BETTER, MORE SUCCESSFUL PROFESSION IN EVERY WAY,

DAVE

David Mittman, PA

Past AAPA Director at Large, Past-President, NYSSPA, Past AAPA Public Education Award Winner.

24/7 PA Advocate

[blueridge]

An observation....perhaps a path of reducing obstruction would be to apply different terminology. "Restore the title of the profession" vs. "change the name/title ...." Since physician associate is the given name at the inception of the profession, asking to restore the title, rather than change, seems to evoke less cause/argument for resistance from naysayers. Change, of course, would be the verb used to descirbe the forthcoming writing of legislation.