State Medical Board Rep Opposing OTP

[corpsman89]

To me it seems like huddle rules are exaggerated in some cases and relaxed in others. 

[Cideous]

I honestly feel bad for young PA's.  Could see us go backwards decades as a profession over the next 5 years.  NP's are here, organized and a massive competition to us on every single front.  And they are dumping thousands of new grads every few months into the work place.  This is not the time to be tentative.  It's time to hit the panic button folks, and we can't even elect PA's that can see what a critical time we are in.  Just unreal.

[corpsman89]

Mittman sees it. 

My biggest worry is that all the money behind Jackson will get him elected instead. Sadly, I would wager to bet that most PAs would NOT vote for Jackson if they were a little more involved in the process. 

[sas5814]

Jackson seems to have an election machine including some old dinosaurs who like to tout their years of experience and conflate that with wisdom and understanding.

 

[Guest Paula]

I think part of the bigger equation is where was Jim Anderson when the Washington MQAC approved the FSMB resolution they wrote to support OTP for PAs?  He sits on the commission.  You can see the agenda from their January 2018 meeting on their website and the resolution was approved.  (It has now been withdrawn).  Was he part of the discussion?  The FSMB resolution was  a perfect segue for PAs to continue to promote OTP and we would have had a powerful organization behind us if that resolution would have gotten to the floor of the FSMB national meeting (coming up this month I think).

The Washington MQAC is made of up all MDs and  2 PAs. They passed the resolution (with some edits requested).  

The AMA got a hold of it and alerted state Medical examining boards and were lobbied to all oppose the resolution.  I am hopeful the AAPA will support the FSMB and the Washington MQAC in the next go-around. 

Washington Academy of Physician Assistants edits to FSMB Resolution 18-3 2018.pdf

[Guest Paula]

Washington PAs need to organize their troops and work at undoing the damage caused by the opinion piece in the commission newsletter.

[rev ronin]

3 hours ago, Paula said:

I would love to see the letter written by Rev published on the Huddle.

Feel free to repost with attribution.  It's likely going in email later today, because I've intentionally given my peers a chance to counsel me out of such a course, but the only thing I've seen is E suggesting we write a rebuttal for publication, too.

[rev ronin]

1 hour ago, Paula said:

Washington PAs need to organize their troops and work at undoing the damage caused by the opinion piece in the commission newsletter.

Yup, at least three of us who participate here are talking about doing just that.  I'd love more input from the greater PA community on how to address this--since this newsletter goes mostly to doctors.

[JustinPA]

So I posted this in response to the Huddle thread on this topic: 
"I believe James Anderson did something very unethical in writing this article and using his government position to distribute it.  I'm sure that will set any progress on PA legislation back quite a bit in that state, and maybe even in other states.  Perhaps he should have considered consulting some of his fellow PAs before publishing an article like that.  Ironically, didn't he just have a post questioning one of the candidates about their ethics?  I think he owes his fellow PAs an explanation about his "ethics."

On another note, the censorship is absolutely ridiculous.  I certainly think if someone has resorted to insults or name calling that it is okay for a post to be deleted, but not the entire discussion.  If someone does something that is highly unethical and someone expresses their strong disagreement for it, that is not an appropriate reason to censor that.  This situation is a big deal in my opinion, and the AAPA censoring the discussion does not look good at all."

They deleted my comment with the explanation being that the underlined sections violate the Code of Conduct.  This is blatant censorship.  You aren't even allowed to state your disagreement with someones actions using words like "unethical" without it being censored? The AAPA moderators are a joke.  
 

[sas5814]

They just deleted your most recent post as well. The Huddle mods are now officially off the rails. It now seems they have devolved from enforcing the guidelines to protecting one of their favorite sons.

[ProSpectre]

6 minutes ago, Just1n1985 said:

So I posted this in response to the Huddle thread on this topic: 
"I believe James Anderson did something very unethical in writing this article and using his government position to distribute it.  I'm sure that will set any progress on PA legislation back quite a bit in that state, and maybe even in other states.  Perhaps he should have considered consulting some of his fellow PAs before publishing an article like that.  Ironically, didn't he just have a post questioning one of the candidates about their ethics?  I think he owes his fellow PAs an explanation about his "ethics."

On another note, the censorship is absolutely ridiculous.  I certainly think if someone has resorted to insults or name calling that it is okay for a post to be deleted, but not the entire discussion.  If someone does something that is highly unethical and someone expresses their strong disagreement for it, that is not an appropriate reason to censor that.  This situation is a big deal in my opinion, and the AAPA censoring the discussion does not look good at all."

They deleted my comment with the explanation being that the underlined sections violate the Code of Conduct.  This is blatant censorship.  You aren't even allowed to state your disagreement with someones actions using words like "unethical" without it being censored? The AAPA moderators are a joke.  
 

I agree, I was following this thread closely and have watched them delete both your first post and your followup post (which just happened in the last few minutes). No profanity, no personal attacks, just a shared opinion that his actions were unethical. 

I think it is important to take part in discussions on the Huddle (especially with the current election) since so many PAs seem to post there that may not be active on this site, but the blatant censorship is really disheartening, and makes me wonder what else goes on behind closed doors. 

[Guest Paula]

3 hours ago, rev ronin said:

Yup, at least three of us who participate here are talking about doing just that.  I'd love more input from the greater PA community on how to address this--since this newsletter goes mostly to doctors.

Do you have a good lobbyist and strong legislators who will help?  I would suggest sending the article to your Washington Medical Association and ask to have it published in their newsletter.  If they are supportive of WAPA they should publish it. 

[corpsman89]

Just received this message in my personal E-mail. 

"Message From: [moderator edit: redacted] 

I like the deliberate and thoughtful statements of James Anderson PA-C. I share his feelings that we exist ONLY because MDs gave us a life and a chance to repay their trust through maintaining the highest standards of patient medical care planning and keeping our SPs in the loop of all care we plan and render.  I must ask what is fundamentally wrong with having physicians ( who go to school longer and have longer residencies than do PAs) as the extra layer of back-up and knowledge for us?  I have never found this oppressive in any way. In fact, there have been cases in every single day of my Internal Medicine practice life where I've been so happy to have my physician to talk to and to ask my the important WHY and HOW DOES THIS IMPROVE THE OUTCOME questions that have kept me from ever having a malpractice claim in 25 years!  What is oppressive about having an SP ask questions about medication interactions or provide recent data that I may or may not have reviewed relevant to new meds versus older, well known ( and cheaper) medications?

I don't want to be "uncoupled" from all that support. And I believe that PAs should be able to bill for, and be reimbursed by CMS all of our services in any specialty and in Family Practice. Those two ideas are not mutually exclusive. But they do require that we remain at the discussion table with the AMA and concerned physician groups. We have a responsibility to reassure them that we understand well our scope of practice and that, with their help, it will continue to evolve and expand as appropriate to increasing access issues.  Something about not biting the hand that feeds us keeps coming to mind as people weigh in on this topic.  And before any one publicly takes me to task for my views, reduces me to "antiquated" or "quaint" or "utopian" ( as has happened on this forum) I argue that the validity of my perspective is equal to that of all who support independent practice. My opinion has been shaped by my unique experiences as a PA. I accept that those with differing opinions have been shaped by their own unique practice experiences. And our history of collaboration with the physician community has won us a measured but steady evolution and expansion of what we can do, where we can do it and how we do it so well.

[mod edit: redacted]"


------------------------------
[mod edit: redacted] BS, PA-C]


[mod edit- redacted]

 

 

[sas5814]

ok where to start.....first misrepresentation of what OTP is followed by more misunderstanding of what elimination of uneccessary barriers to our use, then uses the word collaboration instead of supervision which is what OTP is all about, followed by insisting on her right to her perfectly valid opinion.

This is disorganized thinking.

[Reality Check 2]

Mr. Anderson of MQAC publishes on his LinkedIn site that he graduated from MEDEX in 2000 and has worked for an addiction type clinic for 18 yrs.

His very narrow scope of practice and single place of employment do not afford him the knowledge of those of us in Primary Care and Emergency Medicine who have been in different types of settings.  Those of us in Primary Care or EM - we are the forefront of the PAs in OTP. The need for providers and care coincide with this movement and have positives for all involved.

Check ANY match day reporting and, again, Family Practice and Psychiatry are the least chosen medical school matches for physicians. The need for care is immense and we, as PAs have certainly earned our spot in providing care to the top of our ability and need to expand our licensure. 

His OPINION has no place in a State Board publication. I would certainly hope that someone in his position would represent ALL of the PAs in the state with a both -sided piece or by following the thought processes of the majority of PAs in the state. 

His rant is certainly negative and not progressive for PAs. His position on the commission should not allow for this type of editorializing. I do hope the commission will listen to us. 

I am composing my letter now and using the mission and vision of MQAC as published on their website as guidance on what his job is and should be. 

Medicine has to adapt to serve the public, PAs have to adapt to serve as well - I have never considered physicians my enemy or my blockade to practice. They are my colleagues and I firmly believe we can work together in a new way.

Just my old 2 cents.

[Reality Check 2]

The Washington State Medical Quality Assurance Commission is headed by Dr. Warren Howe, Commission Chair.

The general email is medical.commission@doh.wa.gov

Dr. Howe's email is Warrren.Howe@doh.wa.gov

For anyone interested in commenting on the article, etc.

[Reality Check 2]

This is the letter I emailed Dr. Howe of MQAC:

Dear Dr Howe:

First, I represent only myself as a practicing PA in the state of Washington for nearly 18 years with a career spanning 26 years. I do not represent my employer or anyone else.

 

I read with interest the article written by James Anderson PA-C in the Spring edition of the MQAC Update! newsletter.  "Rough Waters Ahead for "Independent Practice" for Physician Assistant?"

 

According to the mission and vision of MQAC - MQAC promotes patient safety and enhances the integrity of the profession through licensing, discipline, rule making and education.

 

Nowhere do I see the words editorializing, posturing, expressing personal opinion or disparaging a profession.

 

Mr. Anderson's use of a state sponsored publication to express his own personal opinion is certainly wrong and should not have been at tax payer expense. His position is not one to use to promote a particular idea - and, strangely, coinciding with the upcoming AAPA national election cycle.

 

MQAC represents the current laws and rules of practice in the State of Washington - not ideas in progress on a national level or an individual's opinion of such. 

 

I do not feel Mr. Anderson represents me adequately as a practicing PA in the state of Washington if he is willing to use his position for self promotion or furthering the ideals of a national candidate or movement. 

 

Had he wanted to address this issue on a statewide basis - somewhere other than a state publication would have been more appropriate or it should have been addressed as a poll or survey of sorts asking state PAs what they want - and only with commission approval to address an off-topic issue. 

 

Mr. Anderson's actions need to be addressed by the Commission as inappropriate for an appointed representative as it clearly violates the Mission of MQAC. 

 

PAs in the state of Washington deserve to be represented by someone who can be unbiased and follow and respect the purpose of the commission.

 

Thank you for your attention to this matter.

 

Respectfully

[PACali]

On 4/8/2018 at 2:38 PM, corpsman89 said:

Just received this message in my personal E-mail. 

"Message From: [mod edit: redacted]

I like the deliberate and thoughtful statements of James Anderson PA-C. I share his feelings that we exist ONLY because MDs gave us a life and a chance to repay their trust through maintaining the highest standards of patient medical care planning and keeping our SPs in the loop of all care we plan and render.

  


 

 

1

This is ridiculous. She has no idea what OTP is. We are in trouble if majority of PAs still think like her.  Her statement reminds me of the movie Prometheus, the Alien created human but later changed their mind and decided to destroy all human with biological weapon.  

[lkth487]

2 hours ago, PACali said:

This is ridiculous. She has no idea what OTP is. We are in trouble if majority of PAs still think like her.  Her statement reminds me of the movie Prometheus, the Alien created human but later changed their mind and decided to destroy all human with biological weapon.  

I think that analogy might be going a tad bit too far ;). 

[corpsman89]

WAPA recenetly put out a rebuttle to the article written by James Anderson, PA-C

"Response to the recent article coming out of Washington State and WAPA work on OTP

 A recent newsletter printed an article on OTP (optimal team practice). After distribution last week, many PAs have commented on the article. The Washington Academy of Physician Assistants (WAPA) have been following the conversation and want to correct a few inaccurate statements made in the article.

 WAPA has been working on reforming PA practice, now referred to as Optimal Team Practice (OTP) for over 18 months. Last year we joined forces with our physician colleagues with the Washington Medical Association (WSMA) to address this problem together. We have made steps forward in strengthening our physician support to modify PA practice laws. The joint WAPA/WSMA work group's common principles state the following:

 

1. The PA/Physician relationship is an integral part of delivering safe, effective, and timely patient care.
2. PAs are not seeking independent practice, or seeking to compete with physicians in the workplace.
3. Recent experience indicates PAs are experiencing increased barriers to employment in primary care and specialty based practices.
4. Recent experience indicates that increasing numbers of physicians are concerned about increased liability for supervision of PAs who are not under their employ.
5. Stronger physician/PA relationships and more robust physician assistant practices will help provide better and more timely access to care for Washington State residents.

 The article does NOT correctly or adequately represent the hard and tireless work WAPA, WSMA and several groups have expended on reforming PA practice laws. The author of the article may not have been aware of the updated work the American Academy of Physician Assistants (AAPA) has done on OTP, which WAPA is aware. We understand the movement to modify PA practice laws in Washington State and throughout the country is moving at a rapid pace. WAPA's legislative committee is willing and able to answer questions regarding our work with OTP on the state level to ensure any statements or articles regarding updated practice reform for PAs in Washington State is accurate. We also ENCOURAGE PAs to attend our conference later this month to get updated, first-hand information about OTP in Washington State.

 Please refer to the following for more information:

1. WAPA's website with our newsletters, updated work, and information on our Spring CME 4/28-5/1. wapa.com
2. AAPA's current information on OTP, which WAPA supports

This is an exciting time for our profession, but it can also create an opportunity for misinformation to morph into facts. I ask all our PA colleagues and the medical community to continue moving forward with reforming PA laws nationwide and use evidence-based practices to formulate policy and opinion.

 

In Solidarity,

Constance D. Huynh, MPH, PA-C

Washington Academy of Physician Assistants

President"

[Reality Check 2]

To date my response from the DOH MQAC of Washington ----- crickets..............................

[sas5814]

24 minutes ago, Reality Check 2 said:

To date my response from the DOH MQAC of Washington ----- crickets..............................

Can you hear their eyes rolling? They already heard something that affirms what they believe. Everything else? Meh....

[rev ronin]

10 hours ago, Reality Check 2 said:

To date my response from the DOH MQAC of Washington ----- crickets..............................

Not even an acknowledgement of my email.  I got replies back from everyone else I complained to about that matter, but not the MQAC itself.

[ProSpectre]

I've noticed James Anderson, the author of the article, has been noticeably absent on the Huddle over the last week since all of this blew up, whereas he was a frequent poster up until then. He knows this article was very poorly received among other PAs (other Huddle members have apparently been speaking to him through email), but he has yet to address why he wrote it or what his goals were when writing the article, despite numerous posters asking for his thoughts on the matter.

The problem is that among the physicians who read the newsletter, the damage is already done. 

 

[rev ronin]

12 hours ago, ProSpectre said:

I've noticed James Anderson, the author of the article, has been noticeably absent on the Huddle over the last week since all of this blew up, whereas he was a frequent poster up until then.

Considering I've suggested that his article constituted misuse of his appointed position and use of a government platform and funding to advance a personal political agenda, I'm not surprised.  I am probably going to start escalating the situation (e.g., DOH leadership) if they don't put out a statement sometime soon.  The newsletter is still present on the website, apparently unchanged.