Toronto HOD Discussion PA Name Change - Topic Dissection

[jmj11]

We seemed to have had two topics sharing the same brain . . . or thread. The name change discussion in Toronto and the TV bit about the PA appearing under the name of his SP and the backlash. The former topic seemed to be the original. So I'm performing a topic dissection and moving the HOD discussion to its own thread.

 

To prime this pump, I will paste Dave Mittman's report today:

 

For those of us who hoped the AAPA would creep forward regarding the title change the House of Delegates and the Board decided to take no action at the annual meeting this week. It seems that even though 6,500 PAs sent in a statement of support of a change, and the majority of the states voted positively in the census, the delegates felt that there were more important things to worry about than what their members indicated was singularly important to them.

At the end, a resolution to study the matter and report back to the House was defeated.

The “Name Change Committee” continues to believe that the Board of Directors can and should study the pros and cons of a title change and did not expect any positive action at the House. Still they did have a golden opportunity to say that they heard the profession, but clearly chose not to move on this issue.

More to come.

[LT_Oneal_PAC]

Disappointing.

[Joelseff]

Kinda what i expected.....smh

 

Sent from my myTouch_4G_Slide using Tapatalk

[EMEDPA]

I am very disappointed and discouraged by this result.

anyone know how we view how folks voted?

[LIPPER]

Pleased.... Let's move on.

[burnpac]

I am very disappointed and discouraged by this result.

anyone know how we view how folks voted?

 

Votes are recorded as "motion carried" or not. They represent a 50% plus one majority in the official record. There were a few "divisions", which record the actual number of ayes and nays, but these don't make it into the Summary of Actions. I can tell you how I and California voted. We supported C-05, attempted to amend it with an external unbiased study of the ramifications of a title change, supported reconsideration when motions all failed, and supported subsequent amendments in an attempt to get something supporting a look at this issue to the BOD. You all know that I don't support changing the title. However, after reviewing the results of the survey done by AAPA, I don't think that we can ignore this issue. I will continue to work with sympathetic folks on the AAPA BOD to hold their feet to the fire on the matter of changing the title.

[Guest hubbardtim48]

Not pleased....Let's move forward.

[CAAdmission]

The only organization with any power to effect change in our profession is the NCCPA. Just look, they are running roughshod over just about anyone they want. Their CAQs and this new certifcation process will fundamentally alter the nature of our profession. We are stuck with the NCCPA since they drive the certification process. In essence, there is nothing we can do to hurt them (even when they recklessly harm PAs by mis-scoring exams).

 

On the other hand, the AAPA is dying with no one but themselves to blame. Their intransigence has relegated them to obsolescence. The only reason they have existed this long is that they have been the only show in town. As our profession disintegrates into a loose collection of specialists, the AAPA will enter the dustbin of history. I am no longer a PA - I am now an "ER PA," a member of an elite team with a fancy test.

 

You do not have to look to closely to note that the AAPA is hemorrhaging both cash and members. You also do not have to think hard to figure out why...

[Monkeyball]

Disheartening

[LT_Oneal_PAC]

What if we proposed a "nuclear" option? A letter (similar to the grass roots letter ) signed by aapa members stating that they will end their membership on such and such date if it isn't addressed.

[EMEDPA]

Thanks Steve, I do appreciate your efforts.

[Joelseff]

Votes are recorded as "motion carried" or not. They represent a 50% plus one majority in the official record. There were a few "divisions", which record the actual number of ayes and nays, but these don't make it into the Summary of Actions. I can tell you how I and California voted. We supported C-05, attempted to amend it with an external unbiased study of the ramifications of a title change, supported reconsideration when motions all failed, and supported subsequent amendments in an attempt to get something supporting a look at this issue to the BOD. You all know that I don't support changing the title. However, after reviewing the results of the survey done by AAPA, I don't think that we can ignore this issue. I will continue to work with sympathetic folks on the AAPA BOD to hold their feet to the fire on the matter of changing the title.

 

Thanks Steve! Let us know how it goes or what else we can do. your response was what i was hoping the other delegates would espouse to but...

 

Joe

[coloradopa]

What if we proposed a "nuclear" option? A letter (similar to the grass roots letter ) signed by aapa members stating that they will end their membership on such and such date if it isn't addressed.

AAPA still won't do anything unless the HOD changes its policy. If you want to change that policy then get involved in your state and/or specialty delegations. Make sure you elect people that support your position. Same for the board.

[LT_Oneal_PAC]

Will do, David. Thank you for clarifying.

[Joelseff]

AAPA still won't do anything unless the HOD changes its policy. If you want to change that policy then get involved in your state and/or specialty delegations. Make sure you elect people that support your position. Same for the board.

 

Totally agree!!! I Think every PA should join their state society at the very least and then probably their specialty society.

[physasst]

AAPA still won't do anything unless the HOD changes its policy. If you want to change that policy then get involved in your state and/or specialty delegations. Make sure you elect people that support your position. Same for the board.

 

Well, the HOD is fun, and while it can at times be useful, I feel that for the most part it has simply become primarily dysfunctional. And I'm not really speaking about this issue only....in fact, I have had that feeling for the better part of a decade.... I remember speaking with a close friend years ago, someone who is a pillar of the PA world, and he postulated that the HOD had really outgrown any sense of usefulness as they were no longer willing to attack complicated large or controversial issues. This latest issue only confirms this....

 

And Dave, I disagree with you about the AAPA. The Academy is really being disingenuous here, and I think Steve and even John would agree with me. The BOD spoke against this, and it likely had at least some influence over the delegates. The problem is, they opened the virtual Pandora's box by asking about this on the Census. To ask about this, receive a plurality of votes in support, along with over 6,500 letters, and then simply dismiss it is not good governance. While I support simply changing the name, I understand the Academy not doing that based on the census results....

 

HOWEVER, I feel strongly that the census results at the very least have delivered a mandate to the Academy to study this issue further. Which is what they are refusing to do. You cannot ask a question, and then ignore the results. That is simply insulting to every practicing PA, whether you support the name change or not. By that I mean, that I expect my State and National associations to listen to their membership, and to try and understand their desires and wishes...EVEN if they are contrary to their leadership. It doesn't mean they have to enact it, but by asking the question, they have by default, now created something that they need to at least follow through on and try to understand better.

 

Mike

[HLReed]

What if we proposed a "nuclear" option? A letter (similar to the grass roots letter ) signed by aapa members stating that they will end their membership on such and such date if it isn't addressed.

 

I would really hope you would give mature, logical thought before trying to intentionally harm the only organization that effectively lobbys for our profession on a national level.

 

This resolution was not flippantly dismissed and recieved more attention than most issues at the HOD.

[LT_Oneal_PAC]

I would really hope you would give mature, logical thought before trying to intentionally harm the only organization that effectively lobbys for our profession on a national level.

 

This resolution was not flippantly dismissed and recieved more attention than most issues at the HOD.

 

Effectively may be stretching it, at least from what I have heard here. Though that is the extent of my relationship with the AAPA so far. So grain of salt

 

My thoughts were: If they are truly losing membership that quickly for people feeling under-represented, then at least those who left would display why they were leaving. No one would sign such a letter without already considering leaving anyway. This way it would at least put a face on it and give them a way to resolve the situation.

 

A more palatable way may be for a letter to be signed by non-members saying they would join back if they would at least study the issue. Perhaps a look at potential revenue would be more persuading than threatening to cause more lost revenue.

 

It's all just spit balling as my opinion on this as a non-PA holds no real weight as far as the AAPA.

[coloradopa]

Well, the HOD is fun, and while it can at times be useful, I feel that for the most part it has simply become primarily dysfunctional. And I'm not really speaking about this issue only....in fact, I have had that feeling for the better part of a decade.... I remember speaking with a close friend years ago, someone who is a pillar of the PA world, and he postulated that the HOD had really outgrown any sense of usefulness as they were no longer willing to attack complicated large or controversial issues. This latest issue only confirms this....

I'll disagree. While the debate in the house has become more civil, they are still dealing with controversial issues, just not in a polarlizing way. The relationship with the BOD and house has changed and not in a positive way. I think that we missed an opportunity to make the house more relevant when we didn't adopt the resolution to elect the at large members from the house. If that had passed more than half the board would be elected from the house and that would fundamentally alter the relationship.

 

And Dave, I disagree with you about the AAPA. The Academy is really being disingenuous here, and I think Steve and even John would agree with me. The BOD spoke against this, and it likely had at least some influence over the delegates. The problem is, they opened the virtual Pandora's box by asking about this on the Census. To ask about this, receive a plurality of votes in support, along with over 6,500 letters, and then simply dismiss it is not good governance. While I support simply changing the name, I understand the Academy not doing that based on the census results....

The board spoke against this from a fiduciary sense. An undefined open ended task force does not make good fiduciary sense. If you read the April minutes from the board meeting they elected to remain neutral. This was strictly a comment on the fiduciary nature.

 

The board and the staff has started to gather information. There was a really large packet that the delegates received that contained information on the title change impact on the the different states. For example PA is mentioned 43 times in GA law, mentioned in Medicaid statue and workman's comp. It gives the delegates the necessary perspective on whats involved. As far as how the vote is spun. You can spin it any way you want. However from a fiscal standpoint and in testimony on the house floor whats apparent at this point is a majority of PAs have no interest in paying for a title change. Whats the point in moving forward if people don't want to pay for it? The name change committee has advocated for a name change without explaining to the bulk of the PAs or leadership how it benefits them.

 

HOWEVER, I feel strongly that the census results at the very least have delivered a mandate to the Academy to study this issue further. Which is what they are refusing to do. You cannot ask a question, and then ignore the results. That is simply insulting to every practicing PA, whether you support the name change or not. By that I mean, that I expect my State and National associations to listen to their membership, and to try and understand their desires and wishes...EVEN if they are contrary to their leadership. It doesn't mean they have to enact it, but by asking the question, they have by default, now created something that they need to at least follow through on and try to understand better.

 

Mike

Personally and speaking with a number of leaders is that the time is not quite ripe. In the board minutes there is a lot of discussion on where analysis of a title change fits in the current committee structure. The interesting thing to me is that the younger PAs seem to be more interested in this than the older. If you saw Dr. Crawley's analysis of the PA workforce on Tuesday that's going to be the majority of the profession in a few years. The other issue is that the right motion has to be there. Steve made a great try to fix the TX motion but a certain amount of discussion fatigue had set in. I think that a better written motion with clear goals and costs has a better chance next year.

 

There are really two things that needs to be examined (and hopefully will be during the year) is what is the cost of changing and not changing the title? We can speculate on the lobbying costs to change the title. I've heard Dave Mittman state that all we have to do is put in the law where it says Physician Assistant change to Physician Associate. Does anyone know if that is true or in the case of Georgia do we have to open up 43 laws, the medicaid and Workman's comp laws? One thing that either AAPA or the name change committe could collect from the states is the mechanism to change the title. Each state may have a different mechanism and obviously a different cost.

 

Finally we talk about the cost of changing, but there is a cost to not changing. The AAPA staff has to respond to each negative story in the press where we are run down because of the "assistant". They have to reply each time somebody mistakes us for MAs. The legion of hangers on OPA, RPA etc that want to use our title. I'm not going to pretend everything would be rainbows and puppy dogs by changing one word, but potentially some costs could be less. It also gives us an opportunity to change several historical faults in the state practice acts. The Florida delegate was complaining about how this would divert resources but changing the title would give Florida the opportunity to lose the albatross that is non-certified PAs in their state. A similar problem exists in Georgia with AAs. If we move to Physician Associate they can remain PA-anesthesia but would no longer be part of our practice act. We also discussed whether moving forward on this would re-energize the profession leading to increased and more robust AAPA membership. Change creates cost but it also creates opportunity and profit.

 

Its hard to turn a big boat. Change will come however. The name change committee needs to better explain the advantages of name change beyond "I don't like the name". The board needs to look at this issue and probably assign it to a committee. The membership that cares about it needs to make sure that BOD and presidential candidates care about this. The state and specialty members that care about this need to make sure their delegates care about this. Finally you have to show up to play.

[Just Steve]

Some things that stand out in my memory of attending the discussions at the HOD and the evening debate that occurred Saturday evening..

 

1. OVERWHELMING NUMBERS of PAs made their voice heard opposing the name change. Yes, there are a few, who are on this forum, who spoke in favor however they were greatly outnumbered by those who didn't want to spend the time, money, and energy on it.

 

2. Voices against it spoke about concern about opening laws and having negative motions that will harm the PA profession within their state. Granted, positive things could happen as well, however they are more concerned about losing ground within the state legislation. They feel opening the laws is like removing some of their already hard earned armor. The benefit of a "simple name change" far outweighs the risk of opening the laws.

 

3. Voices from the HOD on the floor spoke to illustrate their feelings that the original survey was not educational enough. People believed that PAs voted based on the idea of "that name change sounds good" but they didn't fully understand the financial burden and risk to existing laws that the name change would involve. There were motions put forth to the HOD for a new, more educational survey but that too was shot down.

 

4. Numbers were batted around a bit. New York State reported spending I believe around $70,000 to remove the apostrophe from the current title. It appeared to be widely believed by both sides of this discussion that the state government would not be funding this name change, thus the funding would have to come from other sources aka: the AAPA. One speaker took the microphone and shared their opinion that in order to fully study the impact of the name change it would be necessary to hire independent outside consulting firms who would hire anthropological study groups to perform a multi year study to the tune of many millions of dollars. I got the impression that this particular speaker's opinion was dismissed by most but I feel compelled to mention it as that is a reflection of some of the mindset of HOD delegates.

 

5. Much discussion took forth surrounding the concern of physicians and their opinions of PAs changing their name. From this observer's opinion, the concerns were split between "anti name change" and "we don't care what you call yourselves, just take care of my patients". I can't recall which physician group was reported in saying "we'll pull our support from you if you change to associate" but I believe it was the Association of Surgeons.

 

6. Some people (HOD delegates) spoke to a concern that patients would believe that PAs only have an associate degree if they were called Physician Associates. I had a hard time swallowing that one as a real concern. Especially since there are indeed, some PAs with associates or even no degree at all who are quite skilled and competent.

 

7. There is a lot of side bar conversations that revolve around the notion that if the AAPA is going to spend a bunch of money on anything surrounding the name change, spend the money on a wide spread, aggressive education campaign to put the PA profession out in the public and hiring sector eye. Spend the money to advocate more aggressively to insurance companies, hospital groups, legislation, and the general public of what exactly a PA is, what they can do, and how they can benefit the cost of health care. As one speaker on the floor commented "we stare at our navel and dissect to infinity over this name change..." in reference how this topic comes up on a routine basis on the HOD floor. The majority of the members present spoke in opposition to the name change, spoke in opposition to forming a task force to investigate the name change, spoke in opposition of a new survey.

 

8. I read here on this forum that many of these readers are fed up with the BOD and point a finger at them as the root cause. I attended the HOD all three days it was in session. (I was a teller). It was a new experience for me to witness any sort of legislation body in progress outside of a loose following of Robert's Rules of Orders used in fire department volunteer meetings.. aka: I was a virgin to the experience. I realize that my very limited view and understanding of the progress will be the impetus for dismissing my above comments as "uneducated" or "out of the true loop" but I am telling you that I am, as well as my fellow students, the future of the PA program. If we attend these meetings and witness these things, this is what we are left with in our memories. IF you really want to affect the change you need you need to make your voice heard... not by a handful of people speaking on your behalf, but by showing up. Anyone can speak at the microphone and make their opinion heard. Heck, I spoke at the microphone on a separate issue. Flippin' nerve wracking to say the least, and I was out of order, but the Speaker was kind to me as it was obvious I was a rookie. I didn't die, didn't burst into flames, I wasn't stoned to death.

 

Lots of talk of just letting the AAPA die...hhmmmmmmm lets make this into a metaphor. Who has a better governmental process.. the warlords of Somalia or the US? Yes, the US is flawed, but at least there is some sort of due process. Ignoring the AAPA and the existing process and electing to break into "village tribes" is about as effective of governing as village warlords. The NP profession, with their unified front, would simply lay a scorched earth policy over the PA profession and the next thing you realize, it's nursing home management and L&I evals. Granted, those are important things, but not the bread and butter of most of us here. If you want to break up the already limited funding of the AAPA and try to self finance as Ortho PA, or ER PA, or Cardiology PA to send your own representative to Congress to make your pitch, how much do you think your organizational dues will cost?

 

Like it or not, the AAPA is still the largest show in town for the PA profession. The notion of organizing effective leadership in another form will further distract the overall profession from moving forward, fracture the profession, confuse new members to the profession, and make us an easy target for other professions (read: NP) to ridicule us in DC where real policy is made.

 

You want change? Get involved. Already were involved? Awesome!!!! get back involved, bring your experience and lets give us something to stare at other than our own navels.

[HLReed]

Effectively may be stretching it, at least from what I have heard here. Though that is the extent of my relationship with the AAPA so far. So grain of salt.

 

Maybe you should re-consider your source of information. And maybe you should learn more about issues like these:

 

http://www.aapa.org/news_and_publications/news/item.aspx?id=3648

 

http://www.aapa.org/news_and_publications/news/item.aspx?id=3281

 

http://www.aapa.org/news_and_publications/news/item.aspx?id=2641

 

 

It's all just spit balling as my opinion on this as a non-PA holds no real weight as far as the AAPA.

 

Anyone's opinion can matter if it is thoughtful and well-informed.

[MediMike]

Steve-

 

Glad to see you've had the opportunity to get involved while in school! Thanks for the first hand report on the meeting.

[Just Steve]

I forgot to mention...I am sure Stephan or Dave will correct me if I am wrong but I believe I heard that 31,000 surveys went out regarding the name change. 6100 were returned speaking in favor. There are close to 90,000 PAs. My loose extrapolation of numbers leads this uneducated pundit to round things out to about 20% of PAs were willing to speak in favor of the name change. In the rules of the democracy, 20% doesn't make a majority. The Board has a duty to support the majority of the PAs. If that 20% is to become 51% then either more people who are indeed in favor of the name change need to send in their ballot/make their vote, or those who are currently in favor need to convince those opposed why they are mistaken in their opinion.

 

I had Robert Wooten's ear for 20 seconds during an escalator ride Monday evening. Not often a 1st year student has an unopposed 20 seconds with the president of the AAPA and I didn't have my 20 second speech constructed nor rehearsed. So I winged it... I repeated what I have heard in the hallways.. "what has the AAPA specifically done for us?" Whenever that question is asked the answer comes in broad generalized phrases like "advocate for the profession". I don't like those broad, vague phrases. So I told Mr Wooten that "if the AAPA could disseminate a bullet list of specific things that they have done to bolster the PA profession... real things, tangible things, things that make a difference in our practice ability, then I could convince my fellow students to join". He was polite, smiled that far, distant, "I have other things on my mind" political smile and replied "thanks, I'll work on it". Better than the expected "You're such a sweet boy, now run along". So I got that going for me...

 

CAQs... who's gonna fire that forum topic off?

[CAAdmission]

Worrying about "opening a law" is absurd. It is simple fear mongering used by those opposed to a name change. In the United States, all of our laws are always "open." Any bozo can propose any change at any time. Some laws might be harder to change than others (like things requiring a consitutional amendment) but nothing is beyond change.

 

In my state (and I suspect, most others) "Physician Assistant" is a legally protected term. Its use is confined to one who is licensed as a PA. It would be a simple matter to create a new law thus:

 

"The use of the terms "physician assistant," "PA," and "physician associate" shall be confined to those healthcare professionals who are licensed by the state to practice as a physician assistant."

 

Presto! People can call themselves whatever they desire, no laws are "opened" (whatever that means), and there is no need to update the 25,000 laws that everyone is having apoplexy over.

[EMEDPA]

Worrying about "opening a law" is absurd. It is simple fear mongering used by those opposed to a name change. In the United States, all of our laws are always "open." Any bozo can propose any change at any time. Some laws might be harder to change than others (like things requiring a consitutional amendment) but nothing is beyond change.

 

In my state (and I suspect, most others) "Physician Assistant" is a legally protected term. Its use is confined to one who is licensed as a PA. It would be a simple matter to create a new law thus:

 

"The use of the terms "physician assistant," "PA," and "physician associate" shall be confined to those healthcare professionals who are licensed by the state to practice as a physician assistant."

 

Presto! People can call themselves whatever they desire, no laws are "opened" (whatever that means), and there is no need to update the 25,000 laws that everyone is having apoplexy over.

yup, this is called a cosmetic name change and is the method recommended by many involved with the name/title change debate.