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ArmyVetDude

Title Change Investigation email from AAPA

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17 hours ago, GapLustrum said:

PA Students and those applying to PA school seem to be overwhelmingly in favor of a title change. If WPP recommends no title change, it will just kick the can down the road.

And pretty much waste a million dollars. 

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24 minutes ago, corpsman89 said:

And pretty much waste a million dollars. 

and lose a lot of members...

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https://www.aapa.org/title-change-investigation-resources/?utm_source=newscentraltopas&utm_medium=email&utm_campaign=tci

 

 

Why is AAPA undertaking a Title Change Investigation (TCI)?

At the May 2018 AAPA House of Delegates (HOD) meeting, a resolution passed requesting that the AAPA Board of Directors (BOD), contract with an appropriate independent consulting/research firm(s) to investigate state/federal, financial, political, branding aspects, and alternatives to the creation of a new professional title for physician assistants that accurately reflects AAPA professional practice policies…”

What is the goal of the TCI?

The overarching goal of this project is to position PAs to successfully compete in the ever-changing healthcare marketplace by boosting the profession’s relevance and impact among stakeholder groups, especially patients, now and in the future.

How did the AAPA Board of Directors (BOD) respond to the HOD’s resolution about the Title Change Investigation?

In July 2018, AAPA’s Board of Directors, based on a preliminary project plan developed by an external marketing expert, approved initial funding to support an independent investigation of the physician assistant title and potential alternatives.

Will the Title Change Investigation (TCI) result in changing the name of the PA profession?

We don’t know whether the TCI will result in changing the name of the PA profession. This decision will be made by the AAPA House of Delegates (HOD) at the conclusion of the investigation and will be informed by the work of an independent firm(s). This investigation will:

  • Explore whether the current professional title accurately conveys to patients the PA role on the healthcare team
  • Assess stakeholder perspectives on the profession’s current name
  • Establish what is the existing brand rationale for the profession
  • Measure the brand equity in the existing name
  • Develop and explore creative options for changing the name/title of the profession
  • Evaluate the business and legislative impacts/costs (both positive and negative) of changing the name

 

How is AAPA ensuring that the investigation is independent and unbiased?

AAPA will contract with an expert firm(s) to deliver an extensively researched and wholly unbiased report in alignment with the HOD resolution.

How much will this project cost?

The total cost is yet to be determined but the AAPA Board of Directors (BOD) has designated an initial investment of up to $1 million.

Does the Title Change Investigation signify a move toward independent practice for PAs?

No, PAs remain deeply committed to team-based care with physicians and other providers.

What is the TCI Advisory Council?

The Advisory Council consists of 12 PAs who represent a broad range of clinical specialties from different geographic areas, and include individuals from PAEA, ARC-PA, and NCCPA. This group serves as a resource to the independent firms conducting the Title Change Investigation. The Advisory Council has the following responsibilities:

  1. To provide feedback to the independent firm(s) on the project goals and objectives;
  2. To serve as a knowledge base for developing the historical and future context and structural framework of the PA profession and the PA role in healthcare delivery;
  3. To act as a resource to the independent firm(s) for questions that require PA-specific knowledge or expertise;
  4. To act as a resource in identifying stakeholder groups and key individuals, or roles within groups, to include in the research, and facilitate introductions and meetings with various stakeholders; and
  5. To take on the role of champion for the project by encouraging stakeholder participation.
Who are the members of the TCI Advisory Council?

Members include:

Nichole Bateman, MPAS, PA-C, Oklahoma

John Burns, MMSc, PA-C, Georgia

Michael Doll, MPAS, PA-C, DFAAPA, Pennsylvania

Debi Gerbert, PA-C, DFAAPA, Florida

Grace Landel, PA-C, MEd, DFAAPA, California

Lyle Larson, PhD, PA-C, DFAAPA, Washington

Brooke McNamara, DMSc, PA-C, Virginia

Folusho Ogunfiditimi, DM, MPG, PA-C, DFAAPA, Michigan

Ben Olmedo, PA-C, California

Josanne Pagel, MPAS, PA-C, Karuna RMT, M.Div., DFAAPA, Ohio

Susan Salahshor, PhD, PA-C, DFAAPA, Florida

Shepard Stone, DMSc, PA-C, DFAAPA, Connecticut

 

Who is WPP?

A world leader in providing fully-integrated health marketing, communications and research solutions, WPP was selected to conduct an independent Title Change Investigation (or TCI) to recommend the best marketing strategy and title for the PA profession.

What key questions is the TCI attempting to address?
  1. Is there a need to evolve the PA brand based on an objective, well-informed, data and analysis-driven view of where it stands today?
  2. And if so, how do we redefine how the PA profession is positioned, how its value is conveyed, and how it is titled to meet the requirements of tomorrow’s healthcare landscape?
How does WPP plan to address these key questions?

To tackle these complex problems, WPP designed a rigorous 5-step learning process.

  1. Discovery & Design: Setting the foundation for success and gaining stakeholder perspectives.
  2. Research & Analytics: Conducting the research that will underpin our strategy development and potential title evolution.
  3. Analysis & Insights: Strategizing around research learnings to inform a decision on potential title change and develop a strategic foundation for the PA brand.
  4. Title Development: Leveraging insights and strategy from previous phase to explore potential new title opportunities, if decided on.
  5. Validation & Implications: Fielding a quantitative survey to validate potential new title and consolidating work in a report for AAPA’s House of Delegates.

 

 

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22 hours ago, EMEDPA said:

and lose a lot of members...

I will advocate people to dissolve AAPA and form a new group  if this happens

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On 3/1/2019 at 7:03 AM, ArmyVetDude said:

There was a concerned post in the Huddle about , What if WPP doesn't recommend a title change. Then what? the title change is must. It is equivalent to the US fighting in a war and being okay not to come out as a winner. There should be no other option but to win. Win (change the Title) or Bust

Are we going to just box ourselves in as "FOREVER ASSISTANTS" and destine ourselves to be future employees of NP owned clinics? 

I really don't think the AAPA  pay one million dollars just for a company to send out a survey and make a decision base on that survey. They could pay me half the money to do that. I could make a survey with survey monkey in 10 minutes and cash that check. 

But one million dollars for them to research the best "alternative names"  is money well spent. 

If after one million dollars, all they told us is we should keep the name, I am quitting my PA job and apply to WPP immediately,  that is where the money is.....

For us to spent one million dollars on things like this, I think there is no doubt among us PAs, that the name sucks.

 

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On 2/27/2019 at 12:33 PM, sas5814 said:

Recriminations aside....we need to move forward as fast as we can and all of us need to stop bitching and start working on these issues. It makes me pull my hair when someone complains about a bunch of stuff and then says "someone should fix this." YOU....YOU should help fix it speaker!

This is probably the most important point in this whole thread.  Far too many PAs are content to gripe continuously about nothing getting done and complain about the leadership, but they make no effort to actually work with their professional organizations (either AAPA, your state CO or your specialty organization). 

The PAs running these organizations aren't appointed from Mount Olympus; they are other PAs who cared enough to volunteer their time and effort to try and make a difference, typically at personal expense.  We would have a lot more lobbying power if more of us got involved in advocating for our profession.  OK, getting off my soapbox now....

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On 3/8/2019 at 8:58 AM, medic25 said:

This is probably the most important point in this whole thread.  Far too many PAs are content to gripe continuously about nothing getting done and complain about the leadership, but they make no effort to actually work with their professional organizations (either AAPA, your state CO or your specialty organization). 

The PAs running these organizations aren't appointed from Mount Olympus; they are other PAs who cared enough to volunteer their time and effort to try and make a difference, typically at personal expense.  We would have a lot more lobbying power if more of us got involved in advocating for our profession.  OK, getting off my soapbox now....

I plan to run for a leadership positing in my state within next few years

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14 hours ago, ArmyVetDude said:

I plan to run for a leadership positing in my state within next few years

Excellent; you'll have a blast having the chance to advocate for your fellow PAs.  

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the problem with Reddit is there is no telling how many trolls and bots are in there. It could be 75% physicians making the comments. Title change has been surveyed many times. Back when ...nobody cared much. Most recently the response was strongly in favor. 

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In response to Paula and others expressing a high amount of skepticism about the research firm, here is my view. I highly doubt that WPP will take one million dollars from a client and then deliver a final report that amounts to a steaming pile of crap. They have their own reputation to protect and have to stand behind their work. A comprehensive and independent investigation by a competent, highly respected research firm is not going to recommend that "assistant" is an acceptable word to keep in the title of graduate-trained clinicians who practice medicine. Anyone looking at this issue from an objective standpoint, not vested in the special interests of the various factions of health care will see that. The part we are paying for is a dispassionate look at what might work, what the perceptions are in the profession, and outside the profession. 

I hope I am not being naive and overly optimistic. But that is how I am currently thinking about it anyways. No matter what anyone thinks about the investigation, I think it is important for all of us to take that survey though. And to support our advocacy organizations in the mean time. Remember, lately AAPA doing some real work. They batted down NCCPA (who was literally threatening to let the practice act in IL expire in order to get their way). They have been running public campaigns like "You're PA Can Handle It". They are funding individual state academy efforts to pass OTP legislation. One thing I have learned from working with my current state's academy is that literally no one else in my state cares about PAs, our practice act renewals, our ability to get licensed in a timely manner from the board, our employment opportunities, etc., other than our advocacy organizations. If we blow them off because change isn't happening soon enough, they don't have money or numbers to do anything and then no one does anything (you cant do this alone). 

Even if HOD votes to support a title change, all that will become is an AAPA policy. Individual state chapters then have to do the actual work of getting legislation passed. and that is super hard to do. 

Edited by lemurcatta
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Cideous might be time to put up.  You cant complain if you don't participate.  Consider running for office or getting involved.  There are more people in TAPA that would embrace change than you think.  But remember majority rules.

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14 hours ago, lemurcatta said:

In response to Paula and others expressing a high amount of skepticism about the research firm, here is my view. I highly doubt that WPP will take one million dollars from a client and then deliver a final report that amounts to a steaming pile of crap. They have their own reputation to protect and have to stand behind their work. A comprehensive and independent investigation by a competent, highly respected research firm is not going to recommend that "assistant" is an acceptable word to keep in the title of graduate-trained clinicians who practice medicine. Anyone looking at this issue from an objective standpoint, not vested in the special interests of the various factions of health care will see that. The part we are paying for is a dispassionate look at what might work, what the perceptions are in the profession, and outside the profession. 

I hope I am not being naive and overly optimistic. But that is how I am currently thinking about it anyways. No matter what anyone thinks about the investigation, I think it is important for all of us to take that survey though. And to support our advocacy organizations in the mean time. Remember, lately AAPA doing some real work. They batted down NCCPA (who was literally threatening to let the practice act in IL expire in order to get their way). They have been running public campaigns like "You're PA Can Handle It". They are funding individual state academy efforts to pass OTP legislation. One thing I have learned from working with my current state's academy is that literally no one else in my state cares about PAs, our practice act renewals, our ability to get licensed in a timely manner from the board, our employment opportunities, etc., other than our advocacy organizations. If we blow them off because change isn't happening soon enough, they don't have money or numbers to do anything and then no one does anything (you cant do this alone). 

Even if HOD votes to support a title change, all that will become is an AAPA policy. Individual state chapters then have to do the actual work of getting legislation passed. and that is super hard to do.  

Start now, nothing is impossible.  AAPA will also need to change their title too and should be able to do it once this all passes, which won't be until 2020.  

Edited by Paula

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19 hours ago, NeoTrion said:

Cideous might be time to put up.  You cant complain if you don't participate.  Consider running for office or getting involved.  There are more people in TAPA that would embrace change than you think.  But remember majority rules.

I agree everyone with concerns needs to participate in the process. I have been working on behalf of PAs inside and outside of TAPA for 20 years. I left them for many years because I felt they were far too cozy with the physicians. Last year at the AAPA HOD after meeting with their leadership I re-joined and volunteered for the legislative committee. I got a nice note saying it was a very popular committee and there just wasn't room for everyone. Pull that through the translator and it means I'd rock the boat and challenge them so nope....

I have been involved in several PA organization for the last 20 years and there are NEVER enough volunteers. To turn one down with 20 years of leadership, regulatory, and political experience speaks volumes.

Its not easy breaking in without being a like thinker.

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SAS I am on the committee and can attest we didn't have anyone drop out like they usually do.  You can always attend the meetings as a TAPA member.  I think I am looked at the same as you are, and I have been on the committee for 3 years now.  There are usually openings on the off years.  The on years that we push legislation always have many that want to serve.  Either way I would look forward to working with you in the future.  Any idea when the voting results will be announced for office?

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From this observer’s perspective, the overwhelming majority of the thoughts shared on this issue convey disdain for the current professional title and often predict a bleak outlook for the profession if title change does not occur within the very near future. Many individuals displeased with their current professional title believe it doesn’t really describe what PAs do, is confusing to patients and doesn’t adequately reflect the level of authority PAs have gained over the past 50 years. A common theme is PAs are not “assistants”. I am not one who has yet embraced the sentiment of those in the vocal majority and have not necessarily liked any alternative titles they offered. Advanced Practice Clinician (APC), Advanced Practice Provider (APP), Advanced Clinical Practitioner (ACP), Licensed Medical Practitioner (LMP), Licensed Clinical Practitioner (LCP) and Physician Associate (PA or PAssoc.) are many of the titles that have been suggested.

I am not very fond of any of the title starting with “Advanced”. By chance or by design PAs are being titled APP’s along with Advanced Practice Registered Nurses (APRN’s) in either the medical staff bylaws and/or human resource policies of many institutions around the country. Unlike APRN’s whose training is advanced from their entry-level training as a registered nurse, physician assistant entry-level training is not “advanced” in the literal sense of the word. Physician assistant entry-level training is very intensive and modeled after physician entry-level training, which is also not considered advanced medical education at the entry-level for medical students. Physician advanced training, as we all know, is a residency in a specific specialty. Physicians do not receive an advanced title for that training. For those PAs that choose to attend an advanced formal training program in a specialty or have received a Certificate of Added Qualifications (CAQ) from the NCCPA, should we bestow upon those individuals that complete these programs the title Advanced Practice Physician Assistant (APPA).

Advanced Practice Clinician (APC) and Advanced Clinical Practitioner (ACP) have a good sound to them but, how many other individuals providing healthcare could be given that title, and do these two titles explain exactly what services the individuals provide? Licensed Medical Practitioner (LMP) and Licensed Clinical Practitioner (LCP) also apply to many medical professions; i.e., licensed psychologist, licensed social workers, licensed practical nurse to name a few.

When the survey comes out at the end of the month, it will be sent to every PA in the country (AAPA members and nonmembers) we all need to take the survey and answer the questions honestly. The survey is just the first step in the process, they will be surveying other stakeholders and the general public. There will be an interim report given to the 2019 HOD in Denver this May and the final report will be out in 2020. In the end, whether you agree or disagree with the final decision on title, we all need to work together to address the other obstacles that are preventing our profession from moving forward,i.e., Direct reimbursement for PAs, “independent” licensure, etc.

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This is just one of several hot issues we have going. I think it is not only a good thing but a necessary thing for the AAPA to include as many non members as they can. This really needs to be as close to a group decision as possible.

I see informal polls almost weekly about title change and we, as a group, are all over the map. I think it is critical we have a well qualified, dispassionate outside group guide us on how to proceed. That is part of their recommendation...not only what title might be best but the best ways to implement it.

Someone mentioned it has to be done state by state which is true. It was also said it would be very difficult. That may or may not be true. It is a simple word substitution that can be done by a line or paragraph attached to any other amendment as a rider. the political temperature of each state will determine whether that is hard or easy.

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The AAPA could also make a statement like" from this day forward the term x and PA shall be considered equivalent" and then folks could start using the new term and billing under PA until it was formalized in each state. Nametags could read(for example) John Smith, MP/PA to meet requirements that certain states have that PA be listed. I am really surprised this has not been done already actually. the chiropractors, naturopaths, and several other professions did overnight changes like this.

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7 hours ago, EMEDPA said:

The AAPA could also make a statement like" from this day forward the term x and PA shall be considered equivalent" and then folks could start using the new term and billing under PA until it was formalized in each state. Nametags could read(for example) John Smith, MP/PA to meet requirements that certain states have that PA be listed. I am really surprised this has not been done already actually. the chiropractors, naturopaths, and several other professions did overnight changes like this.

YES YES YES YES YES YES YES YES YES YES!!!!!!!!!!!!

 

 

AND YES!

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On 3/18/2019 at 7:34 AM, sas5814 said:

I agree everyone with concerns needs to participate in the process. I have been working on behalf of PAs inside and outside of TAPA for 20 years. I left them for many years because I felt they were far too cozy with the physicians. Last year at the AAPA HOD after meeting with their leadership I re-joined and volunteered for the legislative committee. I got a nice note saying it was a very popular committee and there just wasn't room for everyone. Pull that through the translator and it means I'd rock the boat and challenge them so nope....

I have been involved in several PA organization for the last 20 years and there are NEVER enough volunteers. To turn one down with 20 years of leadership, regulatory, and political experience speaks volumes.

Its not easy breaking in without being a like thinker.

It seems to me that as a profession, PAs do not have the spine to really take on a fight for themselves as the Nursing Profession does to advance or protect its members.  Yet I constantly hear PA lamenting how nurses are taking over and outpacin us. My observation has been that compromise and apologizing for stepping on toes while advocating for the profession is more our professions forte. It is because of this what I consider spinelessness,  disassociated myself from the state and national PA organizations. You can give me a nice non-hurtful professional title while treating me like crap in the workplace and I still won't be satisfied!

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CAdams, 

I just discussed this on a post with our legislative committee.  This person kept saying we need our physician "partners" to gain traction with our agenda.  I did state that's why this is important it is also important that there is mutual respect between the two parties to be "partners."    If there were respect I think they would allow an independent PA board, but they keep thumbing their nose at our board in different ways. 

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The problem is we keep talking about respecting or physician partners. 1) They have no respect for us except when they control us and 2) They aren't our partners. They never will be.

They oppose everything we do so why do we continue to worry about their feelings? What else can they do to us? We don't have to be antagonistic but we need to keep them informed and then proceed regardless of what they think or how they feel.

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We also need a good strong leader at AAPA who is fully on board with PA  modernization and LEADS a national conversation with the BIG stakeholders....CMS, VA, AMA, and those type of folks.   And LEADS the effort without capitulation to the BIG stakeholders who are likely to thumb us down......and has  a spine.  

I have a firm belief that there would be no problem with altering our title as suggested by EMEDPA and others who said a simple one sentence statement can be submitted to legislation to describe the analogous terminology.   Billing would need to still be under Federal rules and that should not harm our ability to change our title and still get reimbursed. 

I know we can do it and it will not be all that big of an effort in some states once we get AAPA approval.  I also theorize it could have been done without waiting for AAPA to put into policy and have personal evidence it could have been done. 

 

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On 3/22/2019 at 6:22 PM, sas5814 said:

The problem is we keep talking about respecting or physician partners. 1) They have no respect for us except when they control us and 2) They aren't our partners. They never will be.

They oppose everything we do so why do we continue to worry about their feelings? What else can they do to us? We don't have to be antagonistic but we need to keep them informed and then proceed regardless of what they think or how they feel.

Yeap. They want to control and push us around. They just want us to drive up their profits and give them more vacation and free time. They see us as inferior expendable meat movers not colleagues. WE need to LEGALLY unlike from them. They should not dictate where and how we should practice. There should NOT be MANDATORY collaboration. Practice decides to hire all PA team or have some physicians on board. Don't make the state law do it . Don't make admins get pissed at us for having to hire extra physicians (and pay high salaries) to collaborate  with us. NP's don't so they are ALWAYS at advantage. OLD PA's messed up. They need to go and we need change

Go read SDN. EM docs think of us as servants doing their dirty works. One of them even said they wanted to fire a PA for thinking outside the box, because they said our education and training doesnt' allow us to critically think. Many docs I worked with EMs felt that way and always referred to us as midlevels. 

Edited by ArmyVetDude

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