Does the AAPA deserve our support in 2012?

[EMEDPA]

Andersen and I recently discussed this topic and thought it would be good to see where the forum readership is on this in light of recent developments and threads.

please anser yes or no and give your reasons. try to be civil.

thanks

[ventana]

YES

 

it is not perfect and we all need to banter them with emails - but it is one of the few national agencies that really do advocate for us (sometimes not enough and sometimes not in the right direction)

 

I have had a few issues with my local state and AAPA actually has been helpful

 

we have to take ownership and make it our agency though....

[andersenpa]

Yes, with the issue of AAPA membership acting as a carrot and a stick.

If they advocate the Associate issue (which is the defining current issue in terms of how many PAs it resonates with), they will retain and possibly gain members.

If they put up the same unyielding stance as always, they will assuredly LOSE members.

 

In my mind deferring to the HOD, while by the books, displays a lack of leadership that rank and file PAs are longing for. We see the nursing lobby "going for it", and making a strong profession for themselves. I wish that our PA leadership could show some support for an issue that their member (and non-member) PAs

feel strongly about.

[SocialMedicine]

I will continue my membership with the AAPA. The more money they have the more opportunity exists for professional lobby and improvement. They are not perfect ... but nobody else can you offer you close to what they can for your dollar. If you hate them ... try and become a leader among them and create change.

[andersenpa]

I will continue my membership with the AAPA. The more money they have the more opportunity exists for professional lobby and improvement. They are not perfect ... but nobody else can you offer you close to what they can for your dollar. If you hate them ... try and become a leader among them and create change.

 

I agree that we should support our organization.....however I disagree that the joining AAPA leadership is the final route for those who disagree with them. There needs to be a voice for the countless PAs who chose clinical work over leadership/committee roles.

[True Anomaly]

From my own personal experience....yes, because they do have a very active legislative arm and work hard at representing us in the political arena, and work with state organizations on their own state-specific legislative affairs.

[Febrifuge]

YES

 

it is not perfect and we all need to banter them with emails - but it is one of the few national agencies that really do advocate for us (sometimes not enough and sometimes not in the right direction)

 

I have had a few issues with my local state and AAPA actually has been helpful

 

we have to take ownership and make it our agency though....

 

^ This, right there.

 

I feel bad for touching something off in that other thread, with my comment that for now, I don't see the point in being an AAPA member. And I fleshed out that thinking by making it clearer I feel strongly about the name change issue, and don't feel the organization appears to be interested in representing my point of view. But that doesn't mean I think the organization serves no good purpose.

 

I seem to recall that only about 30 or 40% of MDs are members of the AMA. However, like it or not, the AMA represents docs in the public awareness. If the AAPA served a similar outreach and public-relations function (as I feel it should), then I would join, and probably participate. Most likely, participate more than some might enjoy. :)

[EMEDPA]

I am a member and will likely remain so but have been consistently disatisfied with the aapa's efforts to market pa's to the general public.

it's sad that the only way to get someone to understand what a pa is today is by saying " do you know what a nurse practitioner is? it's like that but many of us come from health care backgrounds other than nursing". then they understand because everyone know what an np is because they have a national organization that actually has a PR campaign involving national magazines, radio, etc

their blatant disregard for the name change issue supported by a majority of pa's also doesn't win them any brownie points.

[Gonadometrics]

If I were trying to make a decision to join an organization of any sort, I would ask them to show me their business plan. What goals did they have at the beginning of the last fiscal year? What did they accomplish in the current year? Did they exceed their own expectations? Were their expectations representative of memberships needs? I am wary of organizations that say "Trust me, the alternative is a lot worse." Right now, that is what the AAPA sounds like. The nursing lobby has a lot to brag about. Can AAPA brag about anything? I'm ready to listen if they can but don't expect my money anytime soon.

[Contrarian]

I think the AAPA does what it does WELL.

I think the AAPA should continue to do what it does as apparently some PAs are satisfied with that.

 

I'm not...!!!

Therefore, they have not received any money from me since 2004.

I think the "old-guard" at the AAPA is tooo "Paternal" and dismissive of the grass-roots... in the trenches PAs and it just doesn't make sense "TO ME" to send cash to any entity that insists it knows whats better for me than I do and is not interested in seriously considering MY thoughts on what I want/need.

 

As a matter of fact...

I'd probably re-join the AAPA IF they SERIOUSLY address the name issue AND implemented a SERIOUS advertising/marketing campaign aimed at making PAs as ubiquitous as that damned Geko...

 

Just as there are several organizations that represent physicians... and atleast 2 organizations that represent nurses... and atleast two organizations that represent NPs...

 

There needs to be multiple organizations that represent the interests of PAs.

The AAPA needs some incentive (?competition?) to listen to and work for PAs EVERYWHERE.

 

IMNSHO.... there needs to be an "alternative" to the AAPA and a "alternative" to the NCCPA...

 

Just my initial thoughts...

 

 

Contrarian

[alleycat]

I think the AAPA does what it does WELL.

I think the AAPA should continue to do what it does as apparently some PAs are satisfied with that.

 

I'm not...!!!

I think the "old-guard" at the AAPA is tooo "Paternal" and dismissive of the grass-roots... in the trenches PAs and it just doesn't make sense "TO ME" to send cash to any entity that insists it knows whats better for me than I do and is not interested in seriously considering MY thoughts on what I want/need.

 

IF they SERIOUSLY address the name issue AND implemented a SERIOUS advertising/marketing campaign aimed at making PAs as ubiquitous as that damned Geko...

 

Just as there are several organizations that represent physicians... and atleast 2 organizations that represent nurses... and atleast two organizations that represent NPs...

 

There needs to be multiple organizations that represent the interests of PAs.

The AAPA needs some incentive (?competition?) to listen to and work for PAs EVERYWHERE.

 

IMNSHO.... there needs to be an "alternative" to the AAPA and a "alternative" to the NCCPA...

 

Just my initial thoughts...

 

 

Contrarian

 

yeah, what he said. I did renew with AAPA for lack of an alternative. better than nothing.

[burnpac]

Yes.

 

The AAPA has been instrumental in advancing the profession and breaking down the barriers to physician - PA practice since its inception. Are they perfect? No. No organization can be all things to all people. I have always belonged to my state, national and specialty organizations, and always will, because I believe that they all have made a tremendous difference in my life at every level over 30 years. The minute fraction (diminishing) of my present income dedicated to dues in our professional organizations has been an excellent investment in my experience.

[jmj11]

I may regret getting into this argument again but, having read the perspectives above, I thought I should add mine as well.

 

I am not anti-AAPA. I respect the majority of those polled who renew. I'm not a member right now and I will not renew next year, but I hope there comes a time when I can.

 

I was a faithful AAPA supporter for 15 years. They had to go out of their way to make me resign. At the time of my departure (I think in 2002) I was having a conversation with the acting president over the issues that led to my resignation, so I didn't just slip out the back door.

 

No the AAPA is not perfect. But perfection was never the standard I held up for it. I had a reasonable standard, that in my view, was not being met.

 

Without getting entangled in the details, in a broad brush, the issue I have with the AAPA is that, historically, it was late to the table on nation health care issues. If you look at the Fed laws that influence us, the MDs, DOs, Chiropractors and NPs are always at the table. The AAPA shows up late and we end up as an amendment to the law and as a second class citizen. That is the area I'm most disappoint about.

 

I've had my member application, literally on my desk, filled in, credit card number in place . . . yet another great disappointment comes from them and I tear it up.

 

Each time one of these national issues comes up, I try talking to the AAPA and I want to be part of the solution. They are notorious, in my experience at least, of not returning phone calls or e-mails. It is as if they are this 200 foot high fortress with their draw bridge drawn up tight. You can see shadows of people walking up high peering down through their telescopes (like lurking here) but not engaging with us rank-n-file PAs. The one exception was when, in 2002 or was it 2003, that I did hear back from the president over a very important issue. We did dialog for about two e-mails then I think she put a e-mail-block on mine because I never heard back from her. I was one of the little people that the AAPA ignores.

 

So once again I was poised to rejoin after some shake ups at the AAPA in recent years. Then came the Obama Care and the HITECH law. I followed the law through Congress (via their web site). Once again I saw at the table MDs, DOs, Chiropractors and NPS . . . but no PAs. The language started coming out as they were writing that law describing medical providers as, MDs, DOs, Chiropractors and NPS . . . but not mentioning PAs. I tried calling the AAPA, sending e-mails and etc . . . but there was no response. Often, I will get a canned e-mail in response suggesting I buy publication X, Y or Z from the AAPA store . . .and to be sure and come to their conference (where they make most of their money) but no one would take the time to respond to the specifics raised.

 

So the HITECH Act passed and it had the language declaring the class of medical providers as, of course, MDS, DOs, DCs and NPs. Now, I don't think the Feds should be giving away billions of dollars right now to support EHRs but that's a different issue. For me, it was the principle. The Feds, our Feds, do not see PAs as medical care providers . . . we were invisible.

 

Now the AAPA did finally get to the table, after the horse was out of the barn (the law passed) and was able to get an amendment on the bill to include PAs. But if you read the language of the bill, it clearly puts PAs on a lower tier than NPs and the other providers. The conditions for PAs to get EHR incentive money is very restrictive(PA led RHC). This hits home very hard. If I were an NP, last week I would have received my first down payment on $65,000. But instead, because I'm a PA and not a NP, I will be getting $0 out of the bill.

 

Like I said, it is not about the money. I don't like seeing my indebted government writing billions in checks, mostly to rich physicians. But it is the principle that the government believes that PAs are on a lower tier than NPs and that is only going to get worse if the PA doesn't wake up.

 

My last issue, which I've alluded to, is how the AAPA marginalizes us in the trenches PAs. I've gone to them several times over major issues, which they should be involved with. Each time, save the time I did dialog with the president, they have treated me the same. My first e-mail is sometimes greeted with "thank you for writing" but then they ignore me completely. The don't return phone calls . . . ever. They don't write back. They give the impression that they don't really give a damn about anything unless it is a revenue generating process (for them).

 

In this last chapter, I had a major insurance company refuse to do business with me BECAUSE I, a PA, because the practice owner. I thought that was a huge issue for PAs and PA owners. I contacted the AAPA. The person asked for the details. Then, from that point forward every act of me trying to contact them has been complete ignored. I'm from the South and we are taught in Kindergarten that it is rude to ignore people who are talking to you. You can smile and say, "I'm not interested" but to totally ignore you is insulting. I'm sure if I had written and said that I wanted to brig a bus load of full priced PAs to the AAPA conference, they would be calling me right back. So based on this last behavior, once again I will not renew with them. Maybe though, next year will bring a wind of change . . . and I can rejoin. Like others have said, we have no other options for a representative organization.

[burnpac]

So once again I was poised to rejoin after some shake ups at the AAPA in recent years. Then came the Obama Care and the HITECH law. I followed the law through Congress (via their web site). Once again I saw at the table MDs, DOs, Chiropractors and NPS . . . but no PAs. The language started coming out as they were writing that law describing medical providers as, MDs, DOs, Chiropractors and NPS . . . but not mentioning PAs. I tried calling the AAPA, sending e-mails and etc . . . but there was no response. Often, I will get a canned e-mail in response suggesting I buy publication X, Y or Z from the AAPA store . . .and to be sure and come to their conference (where they make most of their money) but no one would take the time to respond to the specifics raised.

 

So the HITECH Act passed and it had the language declaring the class of medical providers as, of course, MDS, DOs, DCs and NPs. Now, I don't think the Feds should be giving away billions of dollars right now to support EHRs but that's a different issue. For me, it was the principle. The Feds, our Feds, do not see PAs as medical care providers . . . we were invisible.

 

Now the AAPA did finally get to the table, after the horse was out of the barn (the law passed) and was able to get an amendment on the bill to include PAs. But if you read the language of the bill, it clearly puts PAs on a lower tier than NPs and the other providers. The conditions for PAs to get EHR incentive money is very restrictive(PA led RHC). This hits home very hard. If I were an NP, last week I would have received my first down payment on $65,000. But instead, because I'm a PA and not a NP, I will be getting $0 out of the bill.

 

I totally understand the frustration expressed in your post about customer service, but I have to give you my thoughts about the statements regarding the Affordable Care Act / HITECH.

 

I'm not sure what you were reading, but PAs were specifically named in the ACA early on, and recognized by Congress and President Obama as integral to the success of the ACA. From the medical home, chronic care management, to funding for PA education, to hospice care, the AAPA, through the hard work of Sandy Harding, and all of our federal lobbying team, succeeded in nearly all of our federal legislative agenda. Our only failure in 2010 was hospice care, which was sacrificed on the alter of conference reconciliation of the House and Senate bills.

 

We have been at the table for ten years, and were at the table from day one on the ACA. Not supporting or opposing the bill, but making sure that the role and contribution of PAs was specifically recognized and included. President Obama was the first president to specifically talk about PAs in at least two speeches, and PAs were invited to the White House multiple times in 2010 and continue to be in recent years.

 

As for the incentive payments for EHR, this is a more complicated issue, and one that the AAPA was at the table, and is currently working on ( http://www.aapa.org/news_and_publications/news/item.aspx?id=2641&terms=HITECH ). Frankly, in my personal opinion, congressional actions such as this relate to the perception (erroneously) that always see PAs attached to physicians in most settings, and by regulation, and opine that when they take care of the doctors, they take care of the PAs. We battled this successfully in the ACA, and convinced legislators of the importance of recognizing PAs independently of their physician colleagues. Had you have been an NP, had an independent practice, and met the requirements of the bill (e.g. patient volume includes at least 30 percent Medicaid recipients, etc.), then yes, you would have been eligible. Given the fact that nearly all NPs (at least in my state) don't practice independently (we have independent NP practice), I think that the NPs benefiting from this provision are few and far between (the same would be true for PAs, if eligible). And, for the record, I applaud the recognition that EHRs are good for patient care at every level, and anything that we can do to expand EHRs to underserved populations is a good thing.

 

Standing together is the only way that we have been able to accomplish so much faced off against the organizations and lobbyists whose resources we can only dream of at this point in our professional evolution. The AAPA is obviously not all things to all PAs, but they are the only organization fighting 24 / 7 in Washington D.C. and in every state to improve legislation, regulation and reimbursement. In my 30 years as a PA, we have come a long way. We have much distance yet to travel to perfect PA practice in all jurisdictions. As PAs, we have to pick our battles carefully and expend our limited resources wisely to get the job done.

[jmj11]

Steve, I'm not attempting to argue about your points, but just to try and get my head around a few things. BTW, you can share my gratitude with Sandy for her work on this. So I will try to phrase my question as simply as I can.

 

Before I became totally consumed in trying start a PA-owned specialty practice (and lobbing hard for this cause), I use to follow health care related bills through Congress. It seemed invariably that the language would always start by including NPs and not mentioning PAs. Later PA language would be added as a second thought and a second tier.

 

But stepping off that launching point, I suspect that if you did a detailed survey on the hill of the roles of PAs and NPs, that the response would be that NPs are included with MDs DOs as medical care providers and PAs are on a lower tier. You will remember the original language of the FMLA looked at it this way, evening implying that NPs can be supervisors of PAs.

 

I know from my personal experience of dealing with my own representative supports this. I wrote a letter to Rick Larsen a few years ago on some PA - related bill. In response, I got this strange form letter about the rights of medical assistants and home health care workers. Then I got put on a mailing list for those groups. I tried calling to talk to him directly and couldn't reach him. I wrote other letters asking them to take me off the MA list and explained what a PA is. Then, I start getting letters explaining how Rick Larsen is fighting for Nurses and Nurse Practitioners.

 

But my question is, why, after all these years, do these very important people still don't get it right? Please convince me that if I re-joined the AAPA today, how my money would be used to change that culture?

 

I think the RHC Act was a grand slam for the PA profession (and if I remember right, AAPA president Ron Nelsen fought hard for that), but that was . . . what . . . 20+ years ago? I just though we would be further along than that by now.

 

Regarding the HITECH incentive bill, I would have qualified for the Medicaid portion but I can't now as our town has lost its geographic designation as a shortage area. Under the Medicare side, we ( I guess I should say my SP) will receive payments of about $1000 for the whole thing. If I, as a PA and been included in the language, we would have qualified for $44K. But I see 98% of the patients and the payments are based on Medicare billings of the MD only. I, as a PA disappear at that point and it doesn't matter that I'm the owner and am seeing 98% of the patients. We should have been included.

 

So, why should this be the year I come in from the cold?

[Contrarian]

^^^

 

Yep...

 

And I'm gonna "blow a artery" when the DATA 2000 gets amended next yr and the NPs get added to the list of authorized providers equivilant with/to MDs/DOs... while PAs continue to be excluded and unrecognized.

[burnpac]

Steve, I'm not attempting to argue about your points, but just to try and get my head around a few things. BTW, you can share my gratitude with Sandy for her work on this. So I will try to phrase my question as simply as I can.

 

Before I became totally consumed in trying start a PA-owned specialty practice (and lobbing hard for this cause), I use to follow health care related bills through Congress. It seemed invariably that the language would always start by including NPs and not mentioning PAs. Later PA language would be added as a second thought and a second tier.

 

But stepping off that launching point, I suspect that if you did a detailed survey on the hill of the roles of PAs and NPs, that the response would be that NPs are included with MDs DOs as medical care providers and PAs are on a lower tier. You will remember the original language of the FMLA looked at it this way, evening implying that NPs can be supervisors of PAs.

 

I know from my personal experience of dealing with my own representative supports this. I wrote a letter to Rick Larsen a few years ago on some PA - related bill. In response, I got this strange form letter about the rights of medical assistants and home health care workers. Then I got put on a mailing list for those groups. I tried calling to talk to him directly and couldn't reach him. I wrote other letters asking them to take me off the MA list and explained what a PA is. Then, I start getting letters explaining how Rick Larsen is fighting for Nurses and Nurse Practitioners. But my question is, why, after all these years, do these very important people still don't get it right? Please convince me that if I re-joined the AAPA today, how my money would be used to change that culture?

 

Sandy is the best, and I have worked with her for many years. Jim Potter is good also, and is very connected on the Hill. PAs are fortunate to have these folks on staff.

 

I have experienced the same in California and it took us decades to overcome this, and we did. This was not true for the ACA, and we were in on the ground floor due to decades of work by dedicated PAs and staffers. Here are some statistics. Nurses are the largest component of the health care workforce in the US and there are 2.6 million of them. The have been political active over two centuries. There are more than 660,000 physicians, and they have been politically active longer than nurses. There are about 85,000 PAs in the US. The budgets for legislative affairs for these two organizations alone exceed the AAPA's annual operating budget many times over. I share your frustration with visibility, but I feel that we have made an impact will beyond the size of our organization and budget, due to the smart way we have approached legislation and PR. We did much targeted advertising on Hill publications, and we have educated the members one at a time with lobbying by PAs and staff, like the event in March when 100s of PAs will descend on the Hill to personally lobby their legislators. It paid off big in the ACA, and is paying off in every state. I can tell you that my representative and friend GOP Whip Kevin McCarthy knows how to spell PA. :-)

 

 

I think the RHC Act was a grand slam for the PA profession (and if I remember right, AAPA president Ron Nelsen fought hard for that), but that was . . . what . . . 20+ years ago? I just though we would be further along than that by now.

 

Regarding the HITECH incentive bill, I would have qualified for the Medicaid portion but I can't now as our town has lost its geographic designation as a shortage area. Under the Medicare side, we ( I guess I should say my SP) will receive payments of about $1000 for the whole thing. If I, as a PA and been included in the language, we would have qualified for $44K. But I see 98% of the patients and the payments are based on Medicare billings of the MD only. I, as a PA disappear at that point and it doesn't matter that I'm the owner and am seeing 98% of the patients. We should have been included.

 

So, why should this be the year I come in from the cold?

 

Ron (RIP) was a fierce advocate for the profession, and we have him, and Libby Coyte and Ed Freidman to thank for much of the progress in RHC. I have to tell you being on the Board it was frustrating seeing what needs to be done in so many areas, and working with a small budget compared to our peer organizations. I'm not being sarcastic here, but if you have ideas about how to meet all the priorities of the PA profession across the nation with a less than $20,000,000 budget, you would be a better leader than me! As for the HITECH act, it is what it is, and the AAPA does have this on their radar, and an advocate, Rep. Karen Bass (who is the first PA elected to Congress) working on this. If folks want Rome built in a day, they are being unrealistic. PA visibility is a marathon, not a sprint, and we can't hope to compete level with physicians and nurses in the political arena.

 

Whether or not you decided to join the AAPA is a personal decision. I can say that the people hurt the most by folks that don't contribute to advancing the profession on the state and national level are your fellow PAs.

[jmj11]

I agree with everything you say, including the problems with a limited budget, but I do take great personal offense to suggest that because I don't belong to the AAPA I don't contribute to the advancement of the PA profession on a state or national level. As the founder and owner of one of the first PA specialty practices in the country I've worked my *** off and spent a lot of my own money this past year advocating for PAs. I could write 20 pages here telling you what I've done but I don't have time for that. I've had many meetings with the likes of insurance company CEOs, flying to Phoenix to meet with Pharmaceutical company CEOs ( who had been arguing that they couldn't call on PAs because PAs don't offer specialty care) and etc. all trying to advocate for the entire profession.

[burnpac]

I agree with everything you say, including the problems with a limited budget, but I do take great personal offense to suggest that because I don't belong to the AAPA I don't contribute to the advancement of the PA profession on a state or national level. As the founder and owner of one of the first PA specialty practices in the country I've worked my *** off and spent a lot of my own money this past year advocating for PAs. I could write 20 pages here telling you what I've done but I don't have time for that. I've had many meetings with the likes of insurance company CEOs, flying to Phoenix to meet with Pharmaceutical company CEOs ( who had been arguing that they couldn't call on PAs because PAs don't offer specialty care) and etc. all trying to advocate for the entire profession.

 

Please accept my apology; at no point was I attempting to offend you personally. Thanks for all you do in RHC / specialty care, and I have known many PAs who make a difference each and every day outside of the confines of "traditional" professional participation. I'm a firm believer that "all politics are local."

 

Read what I said: "I can say that the people hurt the most by folks that don't contribute to advancing the profession on the state and national level are your fellow PAs." This clearly doesn't apply to you because you are making a difference, and contributing to the advancement of the profession. However, I stand by what I said, and it is true.

[jdtpac]

EMEDPA,

Thank you for asking this question which is now been running on the forum for about a week. In that time you have had slightly over 900 viewers and only 34 voted(approximately 3.5%). Most status statistians will say a survey with that type of response would be considered statistically significant. Based on the response thus far I do not imagine that percentage or involvement will increase significantly over the next 4 days. What if any information or supposition do you believe you can garner from the survey? I suppose it is getting tougher to get people to reply to surveys in-as-much as I believe the AAPA was only able to get 14% of the membership to reply to the 2010 annual survey.

[jmj11]

Please accept my apology; at no point was I attempting to offend you personally. Thanks for all you do in RHC / specialty care, and I have known many PAs who make a difference each and every day outside of the confines of "traditional" professional participation. I'm a firm believer that "all politics are local."

 

Read what I said: "I can say that the people hurt the most by folks that don't contribute to advancing the profession on the state and national level are your fellow PAs." This clearly doesn't apply to you because you are making a difference, and contributing to the advancement of the profession. However, I stand by what I said, and it is true.

 

Apology accepted.

 

The RHC is only a recent side bar for me. My specialty clinic is headache (pacificrimheadache.com). The major battles I've been involved with this past year, taking to the board rooms of the entities are 1) Mal practice insurers that say a PA owned practice presents significantly elevated and prohibitive risks to patients. The same attitude was exhibited by a couple of major insurance companies who took the position that they would not pay for services rendered by a PA in a PA owned practice. I fought with them for months over this, taking it all the way up to their top executives. This was one area that I thought the AAPA would be interested in, but apparently not.

 

The third major arena was Allergan making a corporate statement that they will not call on PAs, will not allow PAs to order Botox and will not allow PAs to be included in any of their training programs. According to their cooperate lawyers "The problem is, PAs are only allowed to prescribe medications in 20 states." I went to Phoenix to meet with their top executives to present the case for PAs. While they have made a unique except from me, I am still fighting with them to make it universal for all PAs and NPs.

 

The forth issue. The insurance companies, Allergan and the American Headache Society have all declared that PAs can not be headache specialist because according to industry nomenclature, PAs specialty can only be the specialty of "Physician Assistant." So we got into many big philosophical debates. As part of that I work with a team for the past year on getting full membership for PAs in the American Headache Society. It was brought to a vote in November . . . and defeated by the current membership.

 

Besides that, I write and call my congressmen on other national issues as well as state legislators and am willing to go to the state capital if the situation arises.

[burnpac]

The RHC is only a recent side bar for me. My specialty clinic is headache (pacificrimheadache.com). The major battles I've been involved with this past year, taking to the board rooms of the entities are 1) Mal practice insurers that say a PA owned practice presents significantly elevated and prohibitive risks to patients. The same attitude was exhibited by a couple of major insurance companies who took the position that they would not pay for services rendered by a PA in a PA owned practice. I fought with them for months over this, taking it all the way up to their top executives. This was one area that I thought the AAPA would be interested in, but apparently not.

 

The third major arena was Allergan making a corporate statement that they will not call on PAs, will not allow PAs to order Botox and will not allow PAs to be included in any of their training programs. According to their cooperate lawyers "The problem is, PAs are only allowed to prescribe medications in 20 states." I went to Phoenix to meet with their top executives to present the case for PAs. While they have made a unique except from me, I am still fighting with them to make it universal for all PAs and NPs.

 

The forth issue. The insurance companies, Allergan and the American Headache Society have all declared that PAs can not be headache specialist because according to industry nomenclature, PAs specialty can only be the specialty of "Physician Assistant." So we got into many big philosophical debates. As part of that I work with a team for the past year on getting full membership for PAs in the American Headache Society. It was brought to a vote in November . . . and defeated by the current membership.

 

Besides that, I write and call my congressmen on other national issues as well as state legislators and am willing to go to the state capital if the situation arises.

 

Wow. You have been busy!

 

As for #1, I am not in a similar situation as you, but I have never had a malpractice carrier ask about my practice arrangement. I currently have a PA S-corp in which I'm the only employee. I don't work for any physicians, but contract with two practices. My contract stipulates that they must provide malpractice (and tail if we go our separate ways) for me. When I started first assisting privately two years ago and direct billing my services, I contacted the company that works with the AAPA ( I actually met the president of the company at a booth at the AAPA conference) and got a moonlighting occurrence policy ( <= 20 hours / week) for under $1,600. They even extended general liability coverage to my corporation for no extra charge (required by my hospital medical staff office). Aside from OB, I don't think that there is any higher risk category than exposure to plastic and reconstructive surgery. It may be worthwhile to shop around more, and this alone may be a good reason to join the AAPA. :-)

 

Regulatory relationships, and business relationships are two entirely different things, and folks like you, me, and others are at the edge of emerging practice for PAs, and we have to expect some pushback, and extra work in educating folks.

 

The folks at Allergan are definitely behind the curve on PA practice, and thanks for your efforts in educating them. We have a lot of industry execs on the PA Foundation, and this has been helpful in breaking down the barriers at some companies. There is still much work to do, and the AAPA continues to work in industry education and relationships.

 

I'm sorry about the AHS. These sort of physician only "clubs" are a tough nut to crack, and there have been many challenges for PAs here, in derm, and plastic surgery. These things are really territorial, and it boils down to $$. They are not likely to expand the circle of folks (even "dependent" PAs) to non-physicians. Many are happy to take your dues dollars (as affiliates), send you publications, etc., but PAs will never be voting members of physician societies.

[jmj11]

Keep it up Steve and I'll send in my dues.

[EMEDPA]

EMEDPA,

Thank you for asking this question which is now been running on the forum for about a week. In that time you have had slightly over 900 viewers and only 34 voted(approximately 3.5%). Most status statistians will say a survey with that type of response would be considered statistically significant. Based on the response thus far I do not imagine that percentage or involvement will increase significantly over the next 4 days. What if any information or supposition do you believe you can garner from the survey? I suppose it is getting tougher to get people to reply to surveys in-as-much as I believe the AAPA was only able to get 14% of the membership to reply to the 2010 annual survey.

as of right now it is around 2/3rd for, 1/3 against. I think if the question then asked of the "yes" folks how many are actually members we would see a smaller # still. I don't know how many pa's are members of the aapa but if I had to guess I would say less than 50% are active/paid members. anyone know the actual stats? something I can say is that I believe the way the aapa reacts to the name change issue over the next year will significantly impact their membership #s one way or the other. more people signed the name change statement than voted in the last aapa election. more than twice as many and they actually stopped counting at 6200 because they had made their point: more folks care about our name than who runs our official organization. and those 6200 were not from the official aapa database. they were from grassroots efforts at places like the pa forum. I'm guessing if it had gone out to every pa we would have seen > 70% in favor. I guess we will see when the census results come out. it included 2 questions about name change.

[Contrarian]

^^^ Agree^^^

 

As I'm one of the folks who voted "YES, RENEW MEMBERSHIP/JOIN".... but am not a member and really can't see becoming one anytime soon if things stay as they currently are.

 

I voted to "RENEW MEMBERSHIP/JOIN" because as I stated above...

 

I think the AAPA does what it does/chooses to do WELL.

I think the AAPA should continue to do what it does as apparently some PAs are satisfied with that.

 

Personally, I'm not...!!!

 

So for those new grads and PA-Cs who are ok with their performance... and/or ok with them ignoring or actively undermining advancement on issues that are apparently important to MANY PAs... I encourage you "JOIN/RENEW MEMBERSHIP."

 

Its a great organization for "some" PAs...