Name Change - Letter from Jenna Dorn, AAPA EVP and CEO

[burnpac]

Colleagues,

 

In the spirit of free dialogue, and with the understanding that there are always two sides to every story, the following letter was sent to Paula Havisto 2/27/2012 by new AAPA EVP / CEO Jenna Dorn. Jenna Dorn shortly thereafter met face-to-face with Dave Mittman and Bob Blumm on 3/5/2012 for 90 minutes to discuss the name change, and the actual contact information of the "6000" was requested (all of the communications that the AAPA received from the name change website dedicated to communicating with the AAPA are essentially blinded). The C1 advisory board declined to provide contact information to the AAPA. To date, this contact information has not been provided to the AAPA to allow the AAPA the opportunity to respond directly to correspondents on this issue of importance to the members and profession. Dave and Bob requested a copy of the letter to post on C1, and the letter below was provided to the C1 advisory board members on 4/20/2012, but as of yet, it has not been posted.

 

I saw this letter for the first time 5/1/2012, and asked and received permission from Jenna Dorn and the AAPA to post it here.

 

 

February 27, 2012

 

Paula Havisto, PA-C,

Lac Vieux Desert Tribal Clinic

N10561 Grand View Lane

Watersmeet, MI 49969

phavisto@glitc.org

 

 

Dear Paula,

 

Thank you for your thoughtful letter and your warm personal welcome. I cannot tell you how excited and eager I am to support a profession that is poised to help transform healthcare in our country. As you might imagine, my first four months as CEO have been spent visiting and learning from smart, caring, innovative PAs about the issues and opportunities for the profession, as it provides critical team-based care and as it gains both visibility and credibility in legislative venues and the public consciousness. It is my intention to build on the strong foundation laid by the pioneers of the profession and its current leadership.

 

Thank you as well for conveying the views of the Clinician1 community. I certainly recognize and appreciate the passion and commitment that drives those views and interests.

 

With respect to a particular concern in your note – the title/name change from physician assistant to physician associate – I know AAPA’s Board of Directors recognizes how important this matter is to many PAs. And, I know that you, as a representative of one point of view in this matter, understand the importance of handling it in a way that is sensitive to all perspectives and also represents the best interests of all PAs. That is why the Academy has long-standing procedures to ensure that the outcome of such issues as this, which affect the entire profession, receive an appropriate hearing and the attention necessary to ensure the best outcome for the profession and the patients it serves. I believe you are aware that it is the role of the House of Delegates to provide the forum in which such policy matters are determined.

 

While sensitive to the desire of those promoting action to move the issue forward, because of the critical role of the House, the Board will take no official position on the matter at this time. Instead, it (the Board) and AAPA staff will continue their diligent efforts to both provide objective information and solicit greater insight into PA opinions about this issue through AAPA’s publications and other communications resources.

 

We also want to respond to PAs who contact the Academy directly with concerns about this matter, as is our practice with inquiries. Over the last several months, AAPA has received emails through the Clinician1 website from individuals who signed statements of support for the name change. We were disappointed that, when AAPA asked for the email addresses of these individuals in order to provide a direct response to each, it is my understanding that the leaders of Clinician1 chose not to make these available to us. It is certainly always our intent, to the degree possible, to acknowledge communications from all PAs, and I am happy to respond to any direct communication I receive.

 

We respect the views of all, and seek to engage in a respectful dialog. It is my hope that Clinician1 leaders might reconsider providing the contact information so that we may respond to every communication in an open and professional manner. If you choose not to do so, I hope you will respect our good intent in seeking to acknowledge the substance of those views in general publications and other venues available to the PA community.

 

In that spirit, I am looking forward to upcoming discussions with David Mittman, Robert Blumm, and Glen Combs, as well as other individuals who support the name change, as I have had discussions with others who do not. I do this with the knowledge that any decision about changing the “physician assistant title must be made by the AAPA House of Delegates.

 

I also invite you to call me for any further clarification of AAPA’s position, or any other concerns about this issue you feel merits further discussion.

 

Sincerely,

 

 

 

Jennifer L. Dorn

Chief Executive Officer

 

cc Eric Holden, PA-C; MJones, PA-C; Dave Mittman, PA-C; Stephen Lyons, PA-C; G. Combs, MA, PA-C; E. Ranzenbach, PA-C; Pamela Ivey, PA-C; David Larson, PA-C; William Mosher, PA-C; Ken Debarth, PA-C; Erik Pauls, PA-C; Thomas Roselle, PA-C; Roger Nevling, PA-C

[andersenpa]

Interesing. I emailed Dave and Bob about this.

Steve- if the AAPA wants to communicate to the 6000, and doesn't have the emails, why not send a group email to their database?

They send them out for the elections and <50% of that number end up voting.

As far as I saw there was never a public acknowledgment of the name change by the AAPA, was there?

[winterallsummer]

Thanks for posting. Hopefully good things will come from this.

[EMEDPA]

The issue is that when the poll was designed there was no disclaimer stating that personal info be shared with others. In light of this it would not be appropriate to share "the list of the 6500+" without their consent.

As Andersen mentioned, the aapa could send a specific letter regarding name change to each aapa member. this they have not done. the aapa census results should be out soon. there were name change questions on it. that should tell us a lot.

[burnpac]

Interesing. I emailed Dave and Bob about this.

Steve- if the AAPA wants to communicate to the 6000, and doesn't have the emails, why not send a group email to their database?

They send them out for the elections and <50% of that number end up voting.

As far as I saw there was never a public acknowledgment of the name change by the AAPA, was there?

 

When I want to have an impact, and be taken seriously by my Congressional representatives, the AAPA, or any other entity, I write them, and provide a way for them directly address my concerns and respond to me personally. This is common courtesy, and is the way business is done everywhere, and in every environment.

 

It is kind of hard to publicly acknowledge an anonymous group, the identity of which is not shared, isn't it? I'm not on the board so I don't know what else has been done, but this letter demonstrates that there has been a dialogue, and an attempt to address the concerns of folks who desire a name change. That side of the issue has not been highlighted.

[Guest Paula]

Hello everyone. Forgive me if I posted twice, but the first one I typed out went into cyberspace somewhere. This is Paula Havisto, the PA who wrote Jenna Dorn. The letter I wrote to Ms. Dorn came from a compilation of responses I gathered from a post I started on clinician1. It was titled Strategic Planning for PA's. The letter I wrote covered the title change issue and other PA issues and concerns. The letter had the names of the PA's who responded to my post,and they are listed on the bottom of Ms. Dorn's letter. I had summarized strategic goals for the next 1, 5 and 10 years for the PA profession. I was not representing the "name change committee" or C1 as a whole, just the PA's who responded to my post. They all agreed to have their names in the letter.

 

My address listed on the response letter is wrong, and so is the email, so I cannot be contacted at those addresses. I have since gone to AAPA website to update my email and address, and hopefully it is now correct. I do however work in Michigan in Watersmeet. I have contacted the Michigan Academy of Physician Assistants chief delegate to bring the title change issue to the AAPA national meeting. I have always tried to work within the framework conscripted by AAPA. In addition, I contacted Upper Peninsula PA's who are members of MAPA and asked them to contact our chief delegate about the title change issue, if they were so inclined. I do not know if any did.

 

I am hopeful that the AAPA HOD will take this issue seriously, and include all PA's in the discussion, not just those who are members of AAPA.

[ventana]

to the C1 folks - who about sending out an email blast to those that voted that says you are going to release contact info unless someone specifically opts out?

 

I would think AAPA (being our national rep agency) at this point should follow through on the topic in that there is obviously a large portion (rather this is a majority is not is unimportant as it is certainly a sig number of the PA's) of PA's think this is a topic that should be followed up on - BUT they have already put the question in the census - but don't expect that data out till early 2013.....

 

 

We gotta just keep pushing this topic along....

[andersenpa]

I was not representing the "name change committee" or C1 as a whole, just the PA's who responded to my post.

 

The letter by Dorn has been regarded by some as the formal response from the AAPA to the 6500 and the name change group.

It was not addressed to all PAs.

it was not addressed to the PAs who support the name change.

It was not addressed to Bob Blumm and Dave Mittman who have worked and sacrificed, and who met with Dorn face to face.

 

Steve, I see where you are coming from, but as I said before- if the AAPA can reach out to an anonymous group (those who would be voters in their election, those who may continue membership or enact new membership in AAPA), why can they not publicly acknowledge the 6500 or the issue? Put something on the AAPA website, send a mass email as a "common courtesy" (to use your term), post something on the FB page....something.

I am not a knee-jerk AAPA hater, but they can't have it both ways. They can't say they want the email list to speak to the 6500 and then in the same breath kick the can down to the HOD.

 

The emails from the associate site were supposed to have the name, email and state, EMED. The information should be there.

[physasst]

to the C1 folks - who about sending out an email blast to those that voted that says you are going to release contact info unless someone specifically opts out?

 

In the interest of transparency, this was discussed.

[burnpac]

Steve, I see where you are coming from, but as I said before- if the AAPA can reach out to an anonymous group (those who would be voters in their election, those who may continue membership or enact new membership in AAPA), why can they not publicly acknowledge the 6500 or the issue? Put something on the AAPA website, send a mass email as a "common courtesy" (to use your term), post something on the FB page....something.

I am not a knee-jerk AAPA hater, but they can't have it both ways. They can't say they want the email list to speak to the 6500 and then in the same breath kick the can down to the HOD.

 

The emails from the associate site were supposed to have the name, email and state, EMED. The information should be there.

 

I hear you and understand your frustration. And I knew that this issue, and the way that both sides approached it, was doomed to end up in massive frustration for all.

 

Here is my global perspective.

 

From the AAPA side, they are a legal corporation, governed by the corporations code of the state of NC, that has to operate within the bounds of the rules, regulations and articles of incorporation. I'm well versed in this as I was president when there was a dramatic shift in the decision making structure of the organization and power differential between the HOD and BOD mandated by compliance with existing law. The House remains the repository of all things mission, vision, philosophy, social policy, etc.

 

The BOD is the repository of all business decisions in the corporation. Each board member has a fiduciary responsibility to the corporation, and the members, as defined by NC corporations code and a ton of case law. The buck does stop with the BOD, but they are bound to make decisions in concert, and not ever conflicting, with the established policies of the HOD. It is a new dynamic that is a dramatic shift from my days as Speaker of the House, but one in which I fully support as there is no other choice but to act in compliance with all laws that govern corporations.

 

My point is, the BOD can't really do anything about the name change, because the official policy of the AAPA is that "physician assistant" is the appropriate and formal name of the profession. The AAPA has had a robust and continual strategic planning process, and attention will always be highest for those things that the process identifies as the highest priority for the Academy. Things that are low priority, or things that are contrary to existing policy, will never by given more than cursory consideration in a climate of needs exceeding resources. Budgeting 101.

 

From the name change side. I have tried to tell folks this over years, and have had repeated conversations with Dave, Bob and others, that until you change the policy of the Academy, this will never be given the kind priority that you and others feels that it deserves. I have been told by Dave and others on C1 and active in name change grass roots activism, that the House is irrelevant, and that the BOD should just be able to act on this. Others on the name change committee (typically those with significant national leadership and House experience) understand the role of the House in the governance structure of the Academy, and have told me that they have advised those active in the name change that everything starts in the House as to policy.

 

The grassroots activism started by C1 / Dave and the name change committee is admirable, but in my humble opinion, and as an observer and participant in state and national leadership since '91, it was doomed to failure because the target and focus was wrong. If the name change committee had put half as much effort in electing sympathetic delegates to the House, we wouldn't be having these discussions right now. When the only tool you have is a hammer, everything looks like a nail.

 

So, the definition of insanity is doing the same think over again and expecting a different result. The AAPA will decide these issues, on their court, with their rule book, for the main reason this is what is required of them to be a legal entity. The paradigm under which each side operates, and world views of the AAPA and the name change committee, are light years apart. For whatever reason, Dave and Bob and some others on the name change committee seem to be determined to pound a square peg into a round hole. So be it, but all I predict is continued frustration and anger if we all continue the present course.

 

This in my personal perspective and opinion and should not be construed to be anything more. Your mileage may vary....

 

See some of you in Toronto!

[jsfelder0417]

What would you propose the advocates do to get everyone on the same page? I find it surprising that such a large portion of the profession can place such importance on a topic, to simply have it thrown in the File 13 as irrelevant based on an old policy. I thought the mission of an organization like the AAPA is to advocate for and advance the profession, not act as an oligarchy, by simply dismissing the views of such a large portion of their representation. Just the opinion of a humble student interested in the future of his profession.

[burnpac]

What would you propose the advocates do to get everyone on the same page? I find it surprising that such a large portion of the profession can place such importance on a topic, to simply have it thrown in the File 13 as irrelevant based on an old policy. I thought the mission of an organization like the AAPA is to advocate for and advance the profession, not act as an oligarchy, by simply dismissing the views of such a large portion of their representation. Just the opinion of a humble student interested in the future of his profession.

 

Asked and answered. I outlined what I think needs to be done in my previous post, and the reasons / perspectives that have driven the decisions of each side.

[surgblumm]

Dear PA Leaders:

 

I have silenced myself for the past 24 hours after reading Patrick and Stephens letter. I chose not to speak from the abundance of my heart and the emptiness of my head. It becomes painful to observe one's name in print as a malefactor and supposed renegade rather than a member who has feelings and under our constitution , has the right to verbalize those feelings. I have a history of being the president of four national and one state organization and this was not won by pressing hands nor by requesting donations. I have been in leadership positions because I speak honestly and I defend the people that elected me. I respond to questions and I give advice. I try to bring honor to my associations and to my office.

 

I read both of the letters that Dave wrote this afternoon and share all of his feelings. I strongly am becoming aware that some of the rhetoric that is going on now smells of the manner that the AAPA has been accused of in the past. It's a game called tag team and one person tells an untruth, perhaps not intentionally and then the next person parrots a response.

 

The allegations concerning Clinician1 are totally erroneous and slanderous as well untruth and half truths. It is unfair and the epitome of a planned reaction prior to the HOD. I doubt the veracity of all of these statements made against C-1 as the entire planning of the arguments for changing our title is the responsibility of those that were on the Name change Committee and we utilized every outlet of internet access available too us to share the feelings of over6,5000 members.

 

Clinician1 is a social network and any of you can go to the site and read the thousands of posts of which 905 plus speak of changes and problems faced in medicine and surgery and the two advanced practice professions.. C-1 is a platform for both species of providers to build bridges, observe changes in the legislation, seek better methods to heal patients and occasional to complain about issues such as our name and the limitations that this has placed upon us as a profession. We encourage everyone o speak the truth from their heart and Dave, to the best of my knowledge has never edited anyone's post as to do so would make this a personal dictatorial site that served the needs of the ownership not the 23,000 members.

 

Regarding Dave and myself and the committee not sharing information , we have every letter that was sent to the AAPA including those that have mention that although requests for all the names were made by Jim Potter, we had an obligation to those 6500 people , in that we promised that we would not share their information. we were bound by the laws of honesty and would have considered this an infringement on their trust. I wrote the academy and suggested that a response be drafted and that we would then post it and this was not done. the one letter to a NY PA was addressed to her and no where in the letter do I see a statement that this should be shared with the 6500. If I am in error on this point, I would like to see the letter where we were permitted to follow this directive.

 

We forwarded all our information to Jim Potter , acting EVP and to James DeLaney, president-elect and both Dave and I have a file of every one of those 6500 letters. We were entirely transparent which was insisted upon by Dave as an individual and the committee as a whole. I also share Dave's concerns that insinuations are being made that may not be accurate especially as mentioned before , those from Patrick and Steve Hanson. there is power in bing the chairman of the board and being a pst president but with that power there does not become infallibility and omnipotence. They may feel that they are omniscient bu in fact people with predetermining philosophies are prisioners of their small thoughts and the influence that others have over them. collegiality and unity become more important than accurate responses to 6500 PAs who have cried out to have answers and who have and are losing faith in the organization that represents them. how long can this persist? Is there no concern or fear ? Is honor just a five letter word? This thinking was once a part of our academy history and we thought it was cleansed but perhaps we are in error.

 

In conclusion, we have always spoken as openly and honestly as we believed that we could. We are patriots with a cause , because we have ears to hear the cry of our members and more particularly, our colleagues.I say again that we have been totally transparent.If I misconstrued a letter sent to a member in New york as not being a edict to send this to the 6500 than it is my error not that of Dave Mittman or c-1. I do not believe this to be the case. In any case I propose that we move on from here as we have a meeting with destiny in Toronto. We will look much cleaner if we are not holding hatchets and looking ready for a new version of the Vikings gone wild. We can handle these issues without rancor and with a spirit of unity. We can leave the HOD and/or the conference as enemies or as friends and colleagues who disagree on a name but are pledged to support a profession. As a leader I would ask you which one of these you wish to be? We are both doing what we feel is best for the profession and obviously this will need to be the basis of our gathering or it will be a dismal failure. I wish you all the best and hope to see you in Toronto.

 

Regards,

Bob Blumm

[NoClinic4Me]

Posted today by Rob Wooten regarding the survey results:

 

http://www.aapa.org/news_and_publications/pa_pro_now/item.aspx?id=4231

 

Pat

[EMEDPA]

Posted today by Rob Wooten regarding the survey results:

 

http://www.aapa.org/news_and_publications/pa_pro_now/item.aspx?id=4231

 

Pat

In brief, among the nearly 15,000 PAs who answered these questions, 45.5 percent were in favor of a title change, 33.6 percent were against and 20.9 percent indicated they were either not sure, interested or preferred not to answer the question.

 

SO....AMONG THOSE EXPRESSING A PREFERENCE, THE MAJORITY FAVOR NAME CHANGE....

[andersenpa]

And that response was to the loaded version of the question, conflated with cost. Probably a higher number when you don't lead the witness...

[surgblumm]

Thanks for posting this No Clinic For ME.

Bob Blumm

[burnpac]

In brief, among the nearly 15,000 PAs who answered these questions, 45.5 percent were in favor of a title change, 33.6 percent were against and 20.9 percent indicated they were either not sure, interested or preferred not to answer the question.

 

SO....AMONG THOSE EXPRESSING A PREFERENCE, THE MAJORITY FAVOR NAME CHANGE....

 

Honestly, I'm surprised that there wasn't a greater majority in support. This is also interesting:

 

When it comes to paying for the direct and indirect costs of a title change, 46.2 percent of PAs did not want to pay for the associated costs, 36.3 percent of PAs were willing to pay and 17.6 percent did not know or preferred not to answer.

Among the 45.5 percent of PAs in favor of the professional title change, 70.5 percent were willing to pay, 10.9 percent against paying and 18.6 percent did not know or preferred not to answer.For the 33.6 percent of PAs against a title change, 91.2 percent were not willing to pay, 4.1 percent willing to pay and the 4.7 percent did not know.

[surgblumm]

Well done Mr. Anderson. the survey never was to "lead the witness" and yet the name change people outnumbered the others. Imagine if everyone that recieved the census knew about the 6500 colleagues letters of support as well as the 100 leaders statement which included the first PA, Vic Germino, an Army General who is a PA, a retired two star (Major General) who was a regional special forces Commander as well as presidents and officers from states, national AAPA presidents and specialty group president and leaders. I wish we could have put all 6500 on the list as they are all heroes and are all PAs.

[burnpac]

And that response was to the loaded version of the question, conflated with cost. Probably a higher number when you don't lead the witness...

 

I think both questions are valid and important.

 

Do you want to do something? Are you willing to pay to have something done?

 

Very important analysis to determining if something is desired enough for folks to sacrifice to get it done.

 

I found the expanded tabular date also interesting to see the breakdowns by gender, age, specialty, inpatient, etc.

[EMEDPA]

I found the expanded tabular date also interesting to see the breakdowns by gender, age, specialty, inpatient, etc.

interesting. more folks in em than any other specialty want name change and more folks in em are willing to pay for it....

[burnpac]

interesting. more folks in em than any other specialty want name change and more folks in em are willing to pay for it....

 

I noticed that too. Did you see that the results were flat across age? I would have predicted less folks in support of changing as they age.

[EMEDPA]

I would have predicted more. over time frustration gets worse, not better....but I'm just an em pa saying that and apparently we are a revolutionary bunch....:)

[jdtpac]

In conclusion, we have always spoken as openly and honestly as we believed that we could. We are patriots with a cause , because we have ears to hear the cry of our members and more particularly, our colleagues.I say again that we have been totally transparent.If I misconstrued a letter sent to a member in New york as not being a edict to send this to the 6500 than it is my error not that of Dave Mittman or c-1. I do not believe this to be the case. In any case I propose that we move on from here as we have a meeting with destiny in Toronto. We will look much cleaner if we are not holding hatchets and looking ready for a new version of the Vikings gone wild. We can handle these issues without rancor and with a spirit of unity. We can leave the HOD and/or the conference as enemies or as friends and colleagues who disagree on a name but are pledged to support a profession. As a leader I would ask you which one of these you wish to be? We are both doing what we feel is best for the profession and obviously this will need to be the basis of our gathering or it will be a dismal failure. I wish you all the best and hope to see you in Toronto.

 

Regards,Bob Blumm

 

Bob,

Thank you for your very honest, heartfelt and a passionate letter. Although we have had our difference of opinion on the issue of our professional title I believe them to be very slight and my biggest concern all along has not been the message from the name change committee but their process. I think there are so many individuals who are so passionate about a title change that their vision has been clouded by the hopes for a speedy resolution. Just because a survey may have indicated a plurality (not a majority) of respondents supported a title change does not mean the HOD will adopted a policy that mandates our professional title will change this Memorial weekend. Clearly there are many unanswered questions that need to be researched and the best solution (in my opinion) is for the delegates to adopt the resolution from Texas Academy 2012-C-05. This resolution calls for a task force to be developed which charges would be to research all the ramifications of a potential title change so the profession can come to an informed conclusion.

 

You know very well, this is how the world of policy and politics revolve. What this survey has done is to start us down that long and often bumpy road to the eventual resolution of this issue. As you might agree, that road will become very bumpy once we go outside our own organization. A very vocal segment of our profession with limited information and somewhat rosy opinions has asked for a call to action. And I believe the Academy will begin to journey down that road but we must make it very clear a final resolution to the issue of title (IMHO) is several years down the line. Compassion must be tempered with patience. Individuals like you, Dave, Steve, Mike, myself and many other leaders must assure that it happens this way.

 

I agree with you 100% it is time for us to move on. It is also time for the younger generation of PAs to come forward and assume leadership roles because this issue belong to them and their future. Those who have 30 years yet to practice, not those of us who made are place in the history of our profession. Thanks again, looking forward to seeing you in Toronto.

 

John Trimbath

[surgblumm]

For those attending the Toronto meeting which means the small number who are registered, Glen Combs is having a 5PM Saturday meeting on Title Change in a room that will hold 300. You will hear many of the arguments here but it is your delegates that need to be receptive. Ask them to contact Dave Mittman of bob Blummm for the 100 leaders statement.

Bob Blumm

surgblumm@gmail.com