Why do PA cross-orgs continue to alienate PAs?

[Ty2PA]

https://www.aapa.org/news-central/2023/07/cross-orgs-reaffirm-commitment-to-edi/

 

As I continue to meet more PAs and encourage them to advocate for the profession, I hear more and more of the same: "I don't like the political positions AAPA takes, so I stopped supporting it." Unfortunately, most who have thrown up their hands and stopped supporting professional associations also stopped advocating altogether at the state or federal level. I recognize there are some PAs (active on this forum) who continue to advocate without supporting the associations, but that is a daunting task for most. 

This post isn't to debate the court's decision on race-conscious school admissions linked in the article, but to question the leaders of the organizations as to why they consider it so imperative to publicly and proudly alienate what may amount to half of their would-be constituent base. I think this article would have been equally inappropriate had it lauded the court's decision. And I want to be clear about that: I'm not picking sides of the debate in this post, I'm condemning the AAPA for picking a side which is NOT consistent with its professional objectives and which flies directly in the face of the wants/wishes/positions of somewhere around half of its would-be base. In effect, demanding PAs be willing to pay hard earned money in support of political issues that the given PA directly opposes. How many PAs would like it if the AAPA publicly supported the Trump campaign? Probably near the same number that would like it if they publicly supported the Biden campaign. Easy choice: don't support either. It's not the business of the AAPA.

The article du jour is linked above, but there are so many more examples of this I could have picked. This is just an example from meeting this week with a wonderful, smart, bilingual seasoned PA whose patient panel includes an overwhelming majority of uninsured and/or undocumented people, and who is passionate about the care he provides to them. His voice will never be heard in conjunction with our national association because the leaders chose politics over PAs. I completely understand his frustration, and have a hard time responding with any sensible rebuttal. His politics don't align with AAPA leadership. He doesn't care about that, but he does care when leadership hijack the association to promulgate their own non-PA-profession opinions. He used to be a member. He didn't fully agree with OTP, but at least it was an attempt to advance the profession. He dropped out when he couldn't stomach their politics. By making proud declarations such as this (and so many others) the leaders demonstrate that they would rather not have him. What a shame. 

Someday, I hope the AAPA will spend 5 honest minutes asking why they cannot attract more members. I hope this comes up. So much more I could say here.

End of line.

[rev ronin]

8 hours ago, Ty2PA said:

https://www.aapa.org/news-central/2023/07/cross-orgs-reaffirm-commitment-to-edi/

 

As I continue to meet more PAs and encourage them to advocate for the profession, I hear more and more of the same: "I don't like the political positions AAPA takes, so I stopped supporting it." Unfortunately, most who have thrown up their hands and stopped supporting professional associations also stopped advocating altogether at the state or federal level. I recognize there are some PAs (active on this forum) who continue to advocate without supporting the associations, but that is a daunting task for most. 

This post isn't to debate the court's decision on race-conscious school admissions linked in the article, but to question the leaders of the organizations as to why they consider it so imperative to publicly and proudly alienate what may amount to half of their would-be constituent base. I think this article would have been equally inappropriate had it lauded the court's decision. And I want to be clear about that: I'm not picking sides of the debate in this post, I'm condemning the AAPA for picking a side which is NOT consistent with its professional objectives and which flies directly in the face of the wants/wishes/positions of somewhere around half of its would-be base. In effect, demanding PAs be willing to pay hard earned money in support of political issues that the given PA directly opposes. How many PAs would like it if the AAPA publicly supported the Trump campaign? Probably near the same number that would like it if they publicly supported the Biden campaign. Easy choice: don't support either. It's not the business of the AAPA.

The article du jour is linked above, but there are so many more examples of this I could have picked. This is just an example from meeting this week with a wonderful, smart, bilingual seasoned PA whose patient panel includes an overwhelming majority of uninsured and/or undocumented people, and who is passionate about the care he provides to them. His voice will never be heard in conjunction with our national association because the leaders chose politics over PAs. I completely understand his frustration, and have a hard time responding with any sensible rebuttal. His politics don't align with AAPA leadership. He doesn't care about that, but he does care when leadership hijack the association to promulgate their own non-PA-profession opinions. He used to be a member. He didn't fully agree with OTP, but at least it was an attempt to advance the profession. He dropped out when he couldn't stomach their politics. By making proud declarations such as this (and so many others) the leaders demonstrate that they would rather not have him. What a shame. 

Someday, I hope the AAPA will spend 5 honest minutes asking why they cannot attract more members. I hope this comes up. So much more I could say here.

End of line.

So, for this specific topic, the rationale goes something like this:
* Minority patients have worse health outcomes
* Therefore they must be getting worse care
* Therefore we need to make PAs that look like our minority communities
* Therefore we need to prefer admissions for minorities so we can select for minority candidates.
* Therefore this is an AAPA (etc.) issue.

Now, there is a massive boatload of unspoken assumptions in that topic, as well as a bunch of unconsidered pitfalls. These are finally getting talked about on X, but they won't be discussed on Huddle.

The people pushing this and other topics genuinely believe they are doing the right thing,  but are so myopic and lack critical thinking skills that, in combination with their own ideological commitments, can't comprehend that 1) they might be wrong, or 2) other people might disagree with them in good faith. Mind you, I served on the AAPA DEI commission for three years, so I've seen this up close and personal from a vocal minority of the participants. At one point, I tried to get the commission to engage with the problem of antisemitism, specifically Black antisemitism, and nothing came of my initiative. JAPA are putting a resolution forward about antisemitism this coming House of Delegates--I suspect that even in the aftermath of October 7th it will fail because of the political bent of those "representing" PAs at the HOD: the HOD is disproportionately staffed by PA educators who 1) tend to be more left-leaning than the population in general, and 2) do not encounter actual diverse patient populations to the extent practicing PAs do. Oh, and the AAPA HOD conducts most of its business on Saturday, so observant Jews are consistently disenfranchised.

The AAPA HOD is institutionally incapable of writing good policy. As part of the DEI commission, we worked hard to eliminate laundry lists (age, sex, national origin, etc.) that were repeated throughout policy, and combined similar policies whenever possible. Even when the streamlined policies were adopted, one delegate somewhere would come up with a reason that the old verbiage had to maintained that hadn't occurred to anyone on the task force rewriting policy... and the HOD would go along with it. Mind you, the proposed policy changes were published months in advance, but no one bothered to object until they were being considered by hundreds of people. Now, those weren't all necessarily BAD reasons, but the net result is even a policy streamlining effort just added bloat.

Part of the problem is the student academy, and its voice on the HOD. Not having any real experience in healthcare (at least not as PAs), the student academy routinely puts social issues forward. They don't know any better, and want to make an impact, so they try and craft the AAPA into what they think it should look like, which is out of step with many PAs who actually work in the field. Does anyone know or care that AAPA is against land mines? We are! In all fairness, I don't know that that was a student academy-led initiative... but it's one of the sorts of things they come up with.

It will be interesting to see if there is any pullback from this partisanship this coming HOD. I suspect that those who like the way it is lack the self-awareness that by intentionally excluding PAs based on political views on non-core topics, they are weakening the profession as a whole.

[Ty2PA]

4 hours ago, rev ronin said:

intentionally excluding PAs based on political views on non-core topics, they are weakening the profession as a whole.

This is the heart of it. In an honest effort to include, we exclude. In an effort to be strong and courageous, we weaken what should be our loudest voice for the profession. Arg.

[rev ronin]

Here's an idea: What if every AAPA HOD member were required to be practicing clinically at least 20 hours per week?

That would eliminate the people in managerial or educational roles who are able to benefit from their positions as prestige contributions in a non-RVU-centric performance evaluation system.

But is that too draconian?

[Cideous]

Simple, we had our chance.  We paid a million bucks to study a name change and the results were clear...."Medical Practitioners" easily won the day in every category.  It would have opened up the flood gates for massive legislative field reforms by getting rid of "assistant".  But AAPA and other so called "PA" advocate groups decided to shit on the research.  So...here we are.  Going nowhere fast unless you love surgery, good luck.  It's why my kid is currently in nursing school on his way to NP school after. The "better trained" argument carries little to no water with politicians now, especially in the shadow of the juggxrnaught that is the Nursing lobby.  We had our chance...and blew it.

[iconic]

In my field (psych), you have to go above and beyond and really stand out in order compete with NPs (and you still often can't). New grads have no chance at all these days 

[ventana]

6 hours ago, Cideous said:

Simple, we had our chance.  We paid a million bucks to study a name change and the results were clear...."Medical Practitioners" easily won the day in every category.  It would have opened up the flood gates for massive legislative field reforms by getting rid of "assistant".  But AAPA and other so called "PA" advocate groups decided to shit on the research.  So...here we are.  Going nowhere fast unless you love surgery, good luck.  It's why my kid is currently in nursing school on his way to NP school after. The "better trained" argument carries little to no water with politicians now, especially in the shadow of the juggxrnaught that is the Nursing lobby.  We had our chance...and blew it.

I love how the study actually said that the Physician Associate was only prefered by Physician Assistants..... yet they put it to a vote and low and behold...... associate it is....  stupid lack of vision 

[Hope2PA]

8 hours ago, Cideous said:

Simple, we had our chance.  We paid a million bucks to study a name change and the results were clear...."Medical Practitioners" easily won the day in every category.  It would have opened up the flood gates for massive legislative field reforms by getting rid of "assistant".  But AAPA and other so called "PA" advocate groups decided to shit on the research.  So...here we are.  Going nowhere fast unless you love surgery, good luck.  

PAs like to many other programs are heading to terminal doctorate. At this point, the DMSc grads, should change their title to MCP.  Just separate from PA altogether. 

[sas5814]

This touches on something I have talked about for years. I presided over PAFT for 2 terms and was often asked what our position was on (insert social justice or political issue). My answer consistently was .....none. We exist for the pure purpose of advancing the profession. We have limited resources both in terms of volunteer hours and money. Taking sides in political and social issues will use resources we don't have enough of and will just drive a wedge in between PAs while serving no benefit to the profession.

I am among those who finally threw up his hands and quit advocating. Like it or not AAPA is the 800 pound gorilla for the profession and any PA group that takes an oppositional view to their policies will not get much traction. Since the HOD is feckless and has no vision IMHO. I bowed out. I cannot continue to support and fund failure and inactivity on key issues.

Edited January 18 by Hemmingway

[rev ronin]

On 1/17/2024 at 8:47 AM, Cideous said:

Simple, we had our chance. [...] We had our chance...and blew it.

Not the point. We can keep fighting a battle from 3 years ago, or we can try to move forward with what we have now. I don't begrudge you the former, but I'm working on the latter.

[sas5814]

2 minutes ago, Boatswain2PA said:

The AAPA has leaned wayyyy left for years. 

I think it was 2013 when Dr. Ben Carson, one of the premiere neurosurgeons on the planet, was selected to receive the AAPAs Paragon (?) award for outstanding physician and PA partnership (or something like that).  But it was rescinded at the last minute by the AAPA because he voiced an opinion that was not in alignment with left-wing ideology. 

That was when I dropped my AAPA membership.  Unfortunately I have to be a member of the AAPA to be a member of my state PA organization. 

I can't count the number of times I sat chewing my tongue while listening to the BOD or the HOD spend hours and hours and hundreds of emails trying to carve out some political or social position that had zero to do with the business of the profession.

I don't care if they lean left or right or backwards. Stop wasting time and my money on feel good stuff that has nothing to do with protecting or advancing the profession.

[Cideous]

Aliens are real so none of this matters anymore.......