Please Read if you oppose a title change to Medical Care Practitioner

[PractitionerAwesome]

(Reposted with permission from original author)

 

Summary: Our natural inclination is to judge a title from our own perspective, what makes sense to us, but the purpose of a title is the other way around, to help those outside our profession understand who we are. To determine if a title is effective, you have to put yourself in the shoes of a regular person outside of healthcare who doesn't know the role or training of a Physician Assistant (which is the majority of people). Rather than starting from a point where you need to convince someone that we're more than an Assistant, we can use language they already know to start off on the right foot by identifying ourselves as practitioners of medical care.

 

Healthcare Professions Made Easy

• A Medical Doctor/Physician has a doctorate and 3+ years of specialized residency training in the medical model of care.
• A Medical Care Practitioner has a master's degree and training in the medical model of care.
• A Nurse Practitioner has a master's degree and training in the nursing model of care.
• A Nurse has an associates or bachelor's degree and training in the nursing model of care.
• Medical Assistants, Clinical Assistants and Nursing Assistants have a certificate or associates degree.

 

The top 10 criticisms of Medical Care Practitioner

1. Medical Care Practitioner sounds clunky and awkward.

   1. Any brand new title will sound awkward at first. People adapt and terms start to feel normal quicker than you would think. Clunky beats confusing when introducing yourself, especially in healthcare.

2. Medical Care Practitioner is too vague and generic.

   1. Physician Assistant would sound vague if you were hearing it for the first time too. The more you hear Medical Care Practitioner connected with this profession the less generic it will sound. That's how language works. Words become meaningful through use. It may not sound as vague to those outside of healthcare, but vague is okay as a starting point. We can make it our own with time. Vague beats bizarre or misleading. We're far better off being paired with Medical Doctors and Nurse Practitioners than Medical Assistants and Nursing Assistants as a first impression.

3. Changing titles would erase the work we've done to educate patients on the role of Physician Assistants.

   1. The PA name is tied to fond memories and pride for so many of us and I completely understand why those in the profession would feel attached to it, but we don't have to give up our memories or pride with a new title. Nor do we have to give up the trust we've earned from our current patients. The patients who value us truly do not care what we call ourselves. There will likely be a transition period where our business cards read "Medical Care Practitioner/Physician Assistant" and we'll need to tell folks about the change, but it won't be as bad as it may seem, people will quickly learn that Medical Care Practitioner is simply a new name for Physician Assistants, like Nissan was for Datsun. It won't erase our history or be confusing to patients who already understand our role. The real benefit is for future patients and those who don't understand our role. Medical Care Practitioner offers a more intuitive starting point. It causes people unfamiliar with our profession to start off with the positive impression that we're just as capable as other Practitioners of Medicine (rather than just as limited as other assistants). We've tried to get over the stigma of being Assistants of Physicians for 50 years but it won't go away until we fix the root cause.

4. Physician Associate is an easier improvement to Physician Assistant.

   1. You're right, keeping PA would be easier in the short term, but it's not the best long term solution for patients, employers, or law makers to understand our role in healthcare. An Associate in a law firm is often a junior, non-terminal position. It's what new graduates are called who are seeking to become partners in the firm. Then there's a Walmart Associate, which may be the most familiar use of the term to many. Physician Associate isn't intuitive to those unfamiliar with PAs because we aren't Physicians and "associating" doesn't describe what we do. It will define our profession with another profession and prevent people from seeing us as distinct medical professionals. Medical Care Practitioner is much more clear. It speaks to patients in their own words instead of asking them to learn our new definition.

5. More PAs want to be called Physician Associates right now.

   1. That's a fair point, but PAs already know what we do, a large purpose of a professional title is to identify ourselves to those who don't know what we do. Patients, physicians, and employers associated higher level tasks such as diagnosing patients and prescribing medications with Medical Care Practitioner more than Physician Associate. Physicians were also more likely to work with and recommend a Medical Care Practitioner compared to a Physician Associate. We have to put our patients, law makers, and employers ahead of our personal preferences to have the most effective title that moves us forward as a profession.

6. It's too expensive.

   1. It will only get more expensive. That's the nature of putting things off. Being doubted of our ability and training due to our title has large costs too! How many patients have cancelled an appointment when they heard they'd "only be seeing the Physician's Assistant"? How many patients left dissatisfied expecting to see the Physician after us? How many legislators stopped paying attention when they heard "assistant"? These lost opportunities are major financial, legal, and legislative costs that easily amount to millions of dollars, they just don't appear on a balance sheet.

7. It's too much work to have to explain a new title.

   1. Yes, it's a lot of work, and those nearing the end of their career will see less of the payoff than those earlier in their career, but like a lot of things, long term success is dependent on some short term sacrifice. Not addressing the underlying issue with our title will continue to hold our profession back if we ignore it. We can't expect to turn the tide for better results without doing something different.

8. Changing our title will cause waves in the medical community.

   1. Any progress for our profession will cause waves in the medical community. Physicians are not in favor of us changing our name to Physician Associates. They will fight that change and it will generate resentment among some physicians if we disregard their wishes. It's easier to just let them have "Physician" for themselves. Medical Care Practitioner is our best option that has a viable chance to be acted on in the foreseeable future to cause the least waves without allowing further decline in our proportion of new hires relative to Nurse Practitioners.

9. Our focus should be on OTP.

   1. We can walk and chew gum at the same time. How many emails have we sent to law makers to only have them read the subject line that an assistant is asking to not be considered an assistant and never heard a response? How many law makers assume we are less capable and more dependent on physicians than Nurse Practitioners because we call ourselves "Physician's Assistants" (what most people hear)? Politicians care about the way things sound to the general public. Passing a law stating "Physician Assistants no longer need direct supervision from physicians to treat patients" will never be as well received as "Nurse Practitioners and Medical Care Practitioners no longer need direct supervision from physicians to treat patients".

10. Why not just Medical Practitioner? MCP sounds like a finger joint.

    1. WPP has said that among the 11,000 free response suggestions they reviewed, Medical Practitioner was suggested more than any other title, but legal review indicated it would be nearly impossible to adopt a title that has been used to mean other things in the past. This is also why Advanced Practice Provider, Advanced Practitioner, and many other suggested names had to be eliminated. The addition of Care makes Medical Care Practitioner a "new" title. MCP does remind those in healthcare of a metacarpophalangeal joint. I have no counter-argument there lol, but PA means posteroanterior and Pennsylvania, so we've overcome acronyms before.
        

Thank you for your time and consideration! I really do feel that this could have a huge positive impact for our profession in the public eye and legislatively and I hope that this encourages others to support this positive step

Make sure to check out the Title Change Investigation Report and Presentation if you are an AAPA member. WPP are the experts on market research and growing brands. They did a great job looking at this from multiple angles. They didn't become the #1 advertising company in the world by leading people astray and I think we would be wise to listen to their professional guidance.

Edited February 1, 2021 by PractitionerAwesome

[ventana]

Well said. 
 

I have been a strong advocate for physician associate.  
 

but!!

 

this whole thing is about perception not reality.  Reality is PAs rock and our name (perception) has really hurt us.   To have a world wide PR company say MCP is better rec’d is all I need to know.   Bring it on!!!  All in for MCP!!!!

[MSPAC2]

I saw this on the Huddle and have been meaning to respond.  These are excellent points! One of the users here also brought up that physicians don't see us associates, instead, we're property.  The MCP title can break us from that.  We are not physician anything.

I hope you keep your passion for the profession when you graduate. 

 

 

[iconic]

Dave Mittman also posted an excellent reply on Huddle 

[PACali]

4 hours ago, ventana said:

Well said. 
 

I have been a strong advocate for physician associate.  
 

but!!

 

this whole thing is about perception not reality.  Reality is PAs rock and our name (perception) has really hurt us.   To have a world wide PR company say MCP is better rec’d is all I need to know.   Bring it on!!!  All in for MCP!!!!

Agree with you on precept vs reality. 

I told myself, even If the final report shows clearly that Physician Assistant is the best title there is, I will accept that. 

WPP definitely knows more about marketing and PR than I am. I will accept the reality now, and all in for MCP.! 

[PACali]

Anybody know what PA for Tomorrow's stance on this issue? MCP or Associate? 

[kang1208]

I’m all in for MCP as well!

[RadAssPA]

My vote is for MCP. It is long and clunky, but our patient's and the public will undoubtedly shorten the title and just call us "Medical Practitioners" which sounds much better IMO. We must get rid of "physician" from OUR title. And "associate" must never be implemented into OUR title. Tell everyone!!!

[sas5814]

7 hours ago, PACali said:

Anybody know what PA for Tomorrow's stance on this issue? MCP or Associate? 

We don't have an official position yet. We were waiting for the title investigation to complete. There wasn't much point in spending a lot of energy on the issue until we knew what the issue was.

Personally I have long advocated for ANYTHING that cuts us loose from physicians in title and the minds of the public. We need a title that is ours...just ours...and not one that associates us (makes us a lesser version of) any other group. I would have supported Praxician over Physician Associate

[Cideous]

19 hours ago, iconic said:

Dave Mittman also posted an excellent reply on Huddle 

What was the jist of his reply?

Edited November 26, 2020 by Cideous

[TheFatMan]

1 hour ago, Cideous said:

What was the jist of his reply?

Says he has been pushing for a name change for years. Provides some great examples of his (failed) efforts to educate people on our title and our role. His best example is speaking with some pharmacy reps who he struggled to convince he could legally prescribe their medication. Their reply was "if you are not an assistant, then why would you call yourself an assistant?" Talks about all the patients we are losing due to being told they will be seeing an assistant when scheduling, patient expectations of seeing a doc after seeing the assistant, losing students because there are so many opportunities to be a 'doctor' (MD, DO, pharm, podiatry, etc). Talks about how many medical professionals are actually surprised to hear what our actual role is. How not changing out title will lead to more costs than changing it.

I think that's about it.

[martinitosnl]

At first at was for the Physician Associate title. It seemed the 'obvious' one. But the more I look at MCP it basically is so easy that it really shouldn't even be a debate. Even if it costs more in the short term, there is no doubt it is worth in the long term of the career. You don't want to be tied down to anything 'Physician' related or you will always be relegated to some type of Physican Extender, basically working on behalf of another career. It honestly does not matter if the name is generic or not. Eventually, people will adjust to saying the name. The main and the most important point is differentiating our career as its OWN. From there you can have a legit doctorate terminal degree that looks better on paper and you can push/ lobby more easily for rights and stop this unnecessary stuff that is holding us back. We are literally the only advanced graduate medical career that I can think of that doesn't have an established doctorate. Come on guys, we sign off on papers from doctorate trained OTs, PTs, we send RX's so PharmD's can fill, our training (my MS has more hours than a friends DPT) and scope is obviously way more than those former that we mentioned but on paper we look inferior as 'Assistants' that have a mere Master's degree. I always knew that the word 'Assistant' was gonna be a crutch. It's now or never!

[ANESMCR]

37 minutes ago, TheFatMan said:

Talks about all the patients we are losing due to being told they will be seeing an assistant when scheduling, patient expectations of seeing a doc after seeing the assistant...

Happens at least 5 times, minimum, per week at my practice. 

[Guest anonRAM2023]

I'm just a student, so apologies if I've stepped out of my lane. However, the more thought I give to MCP, it doesn't seem so bad. What comes to mind are other generic title acronyms like EMT: Emergency Medical Technician. That's a relatively generic name but implies the point "I am a technician that provides emergency medical care". No one second guesses what an EMT is anymore, even if 99% of EMTs do not actually provide emergency medical care.

Now, with MCP: "I am a practitioner, who provides xyz medical care"... Medical care is generic as generic gets, but if you lead up to the "medical care" part of the title WITH YOUR SPECIALTY, for example;  EM guys/gals - an Emergency Medical Care Practitioner.

Ortho folks; Orthopedic Medical Care Practitioner.  Urologic medical care practitioner.  Cardio-thoracic Medical Care Practitioner. Voluntarily drop the "care" for introductions, if you please, just to streamline the delivery; Emergency Medical Practitioner. Not so bad. Patients will be able to associate the role of "Practitioner" with the type of care provided.

I work with a lot of NPs and they don't say "Hey, I am John, the Advanced Registered Nurse Practitioner."  He is "John, the NP".  And I'll tell you what, the vast majority of my patients/family know what an NP is without hesitation, just due to exposure over the years. But a decade ago, when I would make an appt at my PCP and the clerk would say I'm booked for "Cindy the Nurse Practitioner at 4pm", I didn't know wtf a Nurse Practitioner was, but as a patient, I eventually figured it out: someone with a higher level of education who can prescribe me those Abx jawns, and that's all I cared about.

Some patients may be perturbed by hearing "assistant." However, toss out "assistant" for "practitioner" and I guarantee nobody will think twice about it. "Practitioner" is common tongue and associated with some "advanced medical care person".  To the lay person, "Assistant" has never and will never be associated with anything "advanced", regardless if you tell them 1000 times that PA's are advanced. Critical thinking is slim pickings. At the end of the day, most patients just want to be treated, and treated well. If you screw up, it doesn't matter what your title is... MD, RN, Plumber... they'll remember you and associate you with shit care until the day they die.

Be a GOOD MCP --> win patient trust --> make hospital admins happy --> everyone that matters is happy.

I think the name change should be dealt with swiftly and attention turned back to bigger fish like FPA and rebuilding that relationship with the VA. Also, maybe the AAPA and AMA can find common ground in combating the NP creep. MCPs and MDs can be a unified force, instead of belligerents in a three-sided war. We need  docs, and docs need us, but the idea that mid-levels can replace docs is dangerous. Forums like SDN and /r/residency can spread all the hate they want about NPs, but PAs (MCPs) should do all they can do avoid that negative attention. Some of you may think anecdotal rhetoric on internet forums/social media is nonsense and shouldn't be used as a metric to gauge the bigger picture... but this is the internet age, where platforms like reddit/twitter and forum boards influence millions upon millions of opinions, even swaying national elections. As a student, it disheartening to hear some of you consider jumping ship to NP. Honestly, that's not even a lateral transfer, its a downgrade. If you're so hell bent on being a completely independent clinician, go to med school.  NPs have a healthy head start, but that gap can be closed. While we argue over semantics of MCP, the NPs conquer entire states and with them thousands of jobs.

Time to move forward, quickly.

[PAinPenna]

Wow -  great post. You give me hope for the future of our profession! Stay involved- be sure to join your state and national organizations and encourage your fellow students to do the same.  Keep up the great work! 

[Joelseff]

12 hours ago, JDB91 said:

I'm just a student, so apologies if I've stepped out of my lane. However, the more thought I give to MCP, it doesn't seem so bad. What comes to mind are other generic title acronyms like EMT: Emergency Medical Technician. That's a relatively generic name but implies the point "I am a technician that provides emergency medical care". No one second guesses what an EMT is anymore, even if 99% of EMTs do not actually provide emergency medical care.

Now, with MCP: "I am a practitioner, who provides xyz medical care"... Medical care is generic as generic gets, but if you lead up to the "medical care" part of the title WITH YOUR SPECIALTY, for example;  EM guys/gals - an Emergency Medical Care Practitioner.

Ortho folks; Orthopedic Medical Care Practitioner.  Urologic medical care practitioner.  Cardio-thoracic Medical Care Practitioner. Voluntarily drop the "care" for introductions, if you please, just to streamline the delivery; Emergency Medical Practitioner. Not so bad. Patients will be able to associate the role of "Practitioner" with the type of care provided.

I work with a lot of NPs and they don't say "Hey, I am John, the Advanced Registered Nurse Practitioner."  He is "John, the NP".  And I'll tell you what, the vast majority of my patients/family know what an NP is without hesitation, just due to exposure over the years. But a decade ago, when I would make an appt at my PCP and the clerk would say I'm booked for "Cindy the Nurse Practitioner at 4pm", I didn't know wtf a Nurse Practitioner was, but as a patient, I eventually figured it out: someone with a higher level of education who can prescribe me those Abx jawns, and that's all I cared about.

Some patients may be perturbed by hearing "assistant." However, toss out "assistant" for "practitioner" and I guarantee nobody will think twice about it. "Practitioner" is common tongue and associated with some "advanced medical care person".  To the lay person, "Assistant" has never and will never be associated with anything "advanced", regardless if you tell them 1000 times that PA's are advanced. Critical thinking is slim pickings. At the end of the day, most patients just want to be treated, and treated well. If you screw up, it doesn't matter what your title is... MD, RN, Plumber... they'll remember you and associate you with shit care until the day they die.

Be a GOOD MCP --> win patient trust --> make hospital admins happy --> everyone that matters is happy.

I think the name change should be dealt with swiftly and attention turned back to bigger fish like FPA and rebuilding that relationship with the VA. Also, maybe the AAPA and AMA can find common ground in combating the NP creep. MCPs and MDs can be a unified force, instead of belligerents in a three-sided war. We need  docs, and docs need us, but the idea that mid-levels can replace docs is dangerous. Forums like SDN and /r/residency can spread all the hate they want about NPs, but PAs (MCPs) should do all they can do avoid that negative attention. Some of you may think anecdotal rhetoric on internet forums/social media is nonsense and shouldn't be used as a metric to gauge the bigger picture... but this is the internet age, where platforms like reddit/twitter and forum boards influence millions upon millions of opinions, even swaying national elections. As a student, it disheartening to hear some of you consider jumping ship to NP. Honestly, that's not even a lateral transfer, its a downgrade. If you're so hell bent on being a completely independent clinician, go to med school.  NPs have a healthy head start, but that gap can be closed. While we argue over semantics of MCP, the NPs conquer entire states and with them thousands of jobs.

Time to move forward, quickly.

You are a PA-S, you ARE the future of this profession! Spread it among your classmates and every student, faculty etc you encounter. 10 years ago when I was a PA-S I was already on board for a title change and talked to my classmates, professors, preceptor and hell even family about it. (I actually was thinking Physician Associate or Medical Practitioner back then) This recent development has given me hope. Let's not lose steam. You keep up your fire and study hard! 

[PractitionerAwesome]

I have joined as an admin at facebook.com/PAforMCP 

If you believe a title change to Medical care Practitioner would benefit the PA profession, please like our FB page. This following can show the AAPA our support of action on Title Change in May 2021.

I will be reaching out to my classmates and colleagues to support these efforts over the coming weeks and hope you will too! We can do this together!

Edited December 25, 2020 by scotshy

[Joelseff]

On 11/27/2020 at 3:48 PM, scotshy said:

I have joined as an admin at facebook.com/PAforMCP and started a petition at change.org/PA-for-MCP

If you believe a title change to Medical Care Practitioner would benefit the PA profession, please like our FB page and sign our petition. We will present this to the AAPA to show our support of action on Title Change in May 2021.

I will be reaching out to my classmates and colleagues to support these efforts over the coming weeks and hope you will too! We can do this together!

Signed and donated! Keep it up! 

Edited January 8, 2021 by Joelseff

[PractitionerAwesome]

On 11/28/2020 at 2:34 PM, Joelseff said:

 

Oh shoot, hopefully it wasn't much, I believe change.org donations just go to the site. I will be sure to mention that on my posts. Thank you for your support though! We are making progress  

Edited January 8, 2021 by PractitionerAwesome

[Joelseff]

6 minutes ago, scotshy said:

Oh shoot, hopefully it wasn't much, I believe change.org donations just go to the site. I will be sure to mention that on my posts. Thank you for your support though! We are making progress  

DOH! It was a million bucks! J/K lol Naw not much. But keep it up dude! I love your posts here and in the huddle. 

 

One thing though... I wonder if you are allowed to even share the title outside of AAPA members. The presentation was alluding to the need to keep things confidential to non AAPA members... Might wanna ask AAPA. 

Edited November 28, 2020 by Joelseff

[Cideous]

39 minutes ago, Joelseff said:

DOH! It was a million bucks! J/K lol Naw not much. But keep it up dude! I love your posts here and in the huddle. 

 

One thing though... I wonder if you are allowed to even share the title outside of AAPA members. The presentation was alluding to the need to keep things confidential to non AAPA members... Might wanna ask AAPA. 

Why is that?  We are all in this profession?  When did the name of the profession fall solely into AAPA's perview?

[Joelseff]

3 hours ago, Cideous said:

Why is that?  We are all in this profession?  When did the name of the profession fall solely into AAPA's perview?

I don't know why they did that... The confidentiality part was part of the presentation. Maybe to avoid premature reactions by others (physicians, other stakeholders etc) on a name that hasn't been decided yet? Also I would say AAPA funded the research with AAPA member funds so I guess they can do that... 

Oh a reminder... If you guys are AAPA members, watch the presentation. U get 2 class 1 CMEs and it's actually a great presentation. I see why it cost so much. 

 

Oh and to @scotshy I requested a refund from change.org  

Edited November 29, 2020 by Joelseff

[Hope2PA]

On 11/27/2020 at 6:48 PM, scotshy said:

I have joined as an admin at facebook.com/PAforMCP and started a petition at change.org/PA-for-MCP

(NOTE: We are not asking for donations via change.org, just signatures. Donations on that site go solely to change.org)

If you believe a title change to Medical Care Practitioner would benefit the PA profession, please like our FB page and sign our petition. We will present this to the AAPA to show our support of action on Title Change in May 2021.

I will be reaching out to my classmates and colleagues to support these efforts over the coming weeks and hope you will too! We can do this together!

Just looked at the change.org site, kinda sad that after 4 day you have a total of 50 supporters. If you look through other items on their list, there is one for nursing, they have over 10,000.  I know nursing has an amazing chain to pass along petitioners, because I get them from a family member requesting support, both signatures and financial for various nursing legislation, etc. Do PA’s aggressively share info and request help from other PA’s? Let alone family and friends? 50 is just sad.

Edited December 1, 2020 by Hope2PA
Typo

[PACali]

2 hours ago, Hope2PA said:

Just looked at the change.org site, kinda sad that after 4 day you have a total of 50 supporters. If you look through other items on their list, there is one for nursing, they have over 10,000.  I know nursing has an amazing chain to pass along petitioners, because I get them from a family member requesting support, both signatures and financial for various nursing legislation, etc. Do PA’s aggressively share info and request help from other PA’s? Let alone family and friends? 50 is just sad.

It is 63 now.  This is grassroots effort. This has no backing from AAPA or any other state organizations. We have to realize that most of PAs don't even see this petition. We need more people to spread the words out. Talk to your PA peers around you, your classmates, pre-PAs, family and friends. It is now or never. 

[PractitionerAwesome]

20 hours ago, Hope2PA said:

Just looked at the change.org site, kinda sad that after 4 day you have a total of 50 supporters. If you look through other items on their list, there is one for nursing, they have over 10,000.  I know nursing has an amazing chain to pass along petitioners, because I get them from a family member requesting support, both signatures and financial for various nursing legislation, etc. Do PA’s aggressively share info and request help from other PA’s? Let alone family and friends? 50 is just sad.

 

It was a bit of an experiment to see which is more popular amongst PAs: Facebook or a Change.org petition. We're over 150 followers on our Facebook, so that seems like our current winner. If that trend continues FB may become our primary focus. Two issues with change.org is some people don't like sharing their email and it also can tend to have more fake identities (nothing stops someone from putting a fake name and disposable email, whereas most people use their regular Facebook profiles because creating a new Facebook is more work and can ban your regular profile).

 

In addition to just being a much smaller, not as mainstream, and less active on social media profession as Nurses, we are targeting specifically PAs and future PAs for this effort right now, rather than gearing it towards the public at large (e.g. the family and friends of PAs), that will lead to less numbers overall but this is the group we need to inform first in order to urge the AAPA’s progress.

 

Finally, and what I feel is most important for people to understand is: Our support is based around people engaging the “slower” part of their brain, if you are familiar with Daniel Kahneman’s “Thinking Fast and Slow”. We’ve noticed that the “fast” brain reaction, based upon your own personal experience, makes you more against adopting something unfamiliar, while the “slow” brain where you take a step back, put yourself in a patient’s shoes, and consider that your initial impression as a PA or PA student may not have considered the complete picture or be biased by the past. This isn’t easy and will take friends explaining to friends, colleagues explaining to colleagues, and classmates explaining to classmates, why they believe MCP is a good title, which is slow and it takes time, but I and many others believe it is our best option once all the pros and cons are fully weighed, and with enough time and conversation can become accepted by a majority of our profession.