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paft response to AHA


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Recently the american hospital assoc. put out a paper of the future of medicine with zero mention of pa's. np's were mentioned and part of the group writing the paper. paft has responded as follows:

Dear Dr. Combes:

 

 

I have just read the White Paper published by the American Hospital Association regarding "Workforce Roles in a Redesigned Primary Care Model".

 

As the President of a National organization that represents PAs, I have some questions to ask about the paper. I am hoping you will be able to help answer them for me.

 

It seems that while five physicians, one emergency nurse practitioner and a number of other nurses were involved with the paper, no PAs were involved in the work force roundtable group. As there are only three professions that can deliver the full spectrum of primary care (NPs, PAs and physicians), why did one profession have no participation? If we were invited, who exactly was invited? As it seems they declined to participate?

 

As I (and most PAs) hold both physicians, nurses and nurse practitioners in high regard and work with many, it took only a few minutes of reading to see real differences a PA could have made. One question is; how many people on the panel have actually practiced primary care; and how many on the panel have worked arm and arm with a PA? Another question we had is why it is pointed out that PAs must work UNDER the supervision of a physician on page 5 and the chart on page 12 but it is not pointed out that NPs must work "under" the collaboration of a physician. It should be noted in a number of states NPs are also required to have supervision. Why was at least the requirement of collaborative practice for NPs not noted? I am sure you aware that 80% of all NPs across the USA are in collaborative practice and that in some states it is more "supervisory" than PA supervision? Also why is it also not noted that medical assistants must work "under" a physician? Seems the PA was singled out.

 

Lastly, why are there no articles on PAs listed in the references section? There are three or more on NPs.

 

 

By the way, if this white paper is looking towards the future, PAs will be working towards using the same word our NP colleagues use, collaboration, as we feel supervision is a word that does not represent the way we practice medicine-collaboration does. PA’s are full primary care providers allowed by law to provide the full spectrum of medical care. We understand that the "assistant" part of our name can be misleading. As you may know, supervision can be hundreds of miles away and in many states the physician never has to be on site. There are many PA run clinics all over the United States. We do not feel your report recognizes this.

 

Please let me know how we can become involved in future committees you may plan for primary care and other specialties as PAs can be found in all medical and surgical specialties and as the system is evolving, so is our profession. Adding the PAs point of view, along with the nurse practitioner and other clinicians can only help improve future reports regarding all areas of medicine we practice in.

 

Thank you for your understanding; I look forward to your response.

 

Sincerely,

 

 

James R. Piotrowski, PA-C, MS ,

 

President, PAs For Tomorrow

http://pasfortomorrow.us/

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I'm very glad that someone's doing something, but if I had been drafting the letter, I would have phrased several things differently. For example, it asks a lot of rhetorical questions, which might be OK for a real dialogue, but let's face it: this letter isn't going to start one. It's simply a "we noticed you left us out" notice--and as such, it should be written to the public and the rest of the medical community, rather than as if the recipients were actually going to be entering into a dialogue. I worry that too many such questions make the letter look both weak and snarky. They left us out, they know they left us out, there's no excuse for them having left us out, so better to just state the facts and point out the omission succinctly.

 

But again, I'm not the one writing--or editing--it, so I really don't have any particular right to complain.

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Agreed that PAFT needed to respond to this outrageous oversight, and grateful you did, but I think as an aspiring national policy & advocacy association for PAs we need to become much better writers. I could and would help with this.

 

We all have our strengths. Let's capitalize on them.

 

Lisa Lanning OMS2, MS, PA-C

LECOM-Erie Accelerated Physician Assistant Pathway, Doctor of Osteopathic Medicine, Class of 2014

Pacific University PA Program, 2000

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Firstly, thank you James for the obviously well-thought-out response! It is difficult, at best, to respond to such a milk-toasty position paper in the first place! It seems to me that the AHA is just bowing to the tenets of the Affordable Care Act without any acknowledgment that, as a medical community, we have already been developing these initiatives - without any need for a "seal of approval" from the federal government. I too would have liked to have seen a bit more direct punching back for obvious oversights in Physician Assistant exclusion from being on the board who drafted this AHA paper. However, as a return fire across the AHA bow, the questions were pointed and worthy of considered response from the AHA. I hope that such a response will not be buried on page 12C under the fold. The AHA response needs to be a reissue of the original or an official addendum addressing the glaring omissions made by this panel.

 

It really is kind of a head-scratcher why they would have not included such a valuable asset (the PA) on their panel. The other troubling omission is that this discussion barely made any reference the critical role Physician Assistant's are currently playing in providing the infrastructure already in place to provide such care as they propose. But, I digress. Anyway, thank you James and the PAFT for keeping on top of these issues that affect us all!

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  • 2 weeks later...
Strong work on the part of the AAPA! President Delaney is really stepping up and tackling some of the issues important to working PAs today.

 

Ditto. The letter was well written and sets a positive tone towards working jointly with the AHA, while forcefully advocating for the profession's role in solving some of the challenges facing the US health care system.

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I appreciate his straightforward use of the fact that (paraphrasing) "PAs, like physicians, practice medicine autonomously in all 50 states".

 

Glad to see multiple PA groups hitting this issue.

 

Great letter and I sent an email response to President Delaney thanking him for his response.

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