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| 6 Year Follow Up on paper by ACC focusing on Areas for NPs and PAs to Work Together On |
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by Bob Blumm, MA, PA-C, DFAAPA Past President, ACC - April 18, 2011
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My wife has me throwing out books, papers, trophies and almost anything that I have not used in the past five years and I ran across this paper on a gathering place for NPs and PAs. As I looked carefully, many of these things have been done but mainly by one profession who believes that a rolling stone gathers no moss.
We spoke of research and this has been done by both professions with an emphasis on the needs for healthcare in America. We have both made contributions and the NP universe has made definite inroads into changing legislation that gives them the solid opportunity to be gatekeepers. I believe that PAs will do this to a lesser extent as we are tied down by our dependent status which should be changed to something which relates to reality, we collaborate with physicians.
We also spoke of professional education and the PA world had seen the need of having a Master’s as an entry level to remain on par with their fellow clinicians but the NP world upped the ante and went for the Doctorate. This is a calculated move with varied responses among the NP profession as many of the seasoned but older NPs feel that they have what it takes and a title or degree will not make them more acceptable. The flip side of the coin has to do with respect and demonstrates that there are others who are also called doctor who have the ability to render professional care. I’m 60 so I will not move forward but there are those in my ranks and in the NP ranks that are the same age and yet were willing to pay the price to gain the prize. My humble opinion is that professional clinical education in a structured course will lessen the debate and add a modifier that makes sense to administrators.
Public Education was a strong point and in this dimension the AANP and the NP profession as a whole has done a stupendous job in informing the public concerning their role in healthcare thusly winning the seat at the table.
Name change has been a twenty year item for PAs and at the present moment may be in the AAPA HOD this May or may be approached by membership writing the BOD of the AAPA. The name stinks, is unattractive because it makes PAs a lesser clinician then they really are and causes gaps of credibility.
Reimbursement, yes this is something that the NPs have jumped upon as they feel and rightfully so, that each clinician that treats a disease should be reimbursed at the same rate. I love the logic of the NP world.
“Only a doctor can”, this is the manner in which many of the pharmaceutical companies have written their verbiage to patients so that they can ask their doctor about the product. It is short sighted in that the additional 31 million patients that are entering the system will be seeing more NPs and PAs and where will they be if we decide that we will boycott heir products. We have a real powerful piece to play in this game of corporate chess.
Rx tracking needs to done for accuracy and for safety and will find its place in the column of things that need to be accomplished within two years.
Wellness. This is a subject that is a portion of all clinicians approach to their patients but the NP universe spends more time educating their patients on preventative medicine and ultimately when more patients are seen by this provider I believe that the statistics will demonstrate that this philosophy works unless we all begin to have ratios of one patient per each seven minutes like some clinicians have put in place in their private practice.
Advocating for each other. This is an area where we can strengthen one another, support one another and ultimately win many of the future battles. We need to agree when we have mutual ideas and work together and when we disagree we need to learn to be silent as each profession should be self driven.
Managed Care is an issue that the federal government is looking at and the answers are in a state of flux but you can bet that what has been accepted in the past will not be status quo for the future.
Uninsured Care is another issue that is worthy of any clinician from doctors, NPs and PAs as well as Nurses and Technologists, PTs and RTs, etc. there are a number of people in this country that need healthcare and this is what we are sworn to do as a profession. Do No Harm also means not to tolerate uncontrolled disease and sickness because of an insurance problem. The question relates to how many of us have a “missionary spirit” or if this should be the testing ground for well supervised residencies. Underinsured care has my same sentiments.
State legislation is an area that the NP world has proven that they can be adept at as they have successfully encountered outdated legislation that should have been sunsetted and have worked together to change the state laws. I applaud the groups that have taken this seriously and have committed themselves to the teamwork involved in this process.
Local CME’s are not a problem as there seems to be an abundance between state, specialty, association and educational companies that are providing the best education that can be accomplished with the cooperation of all of the stakeholders including the journals and websites.
Advocating for patients has always been the hallmark of nursing and always will. Whether one is an NP or an RN, the concept of advocating for the patient has been infused early in their careers. As an former Army medic this was drummed into me by my nursing instructors and this is why I have maintained the reputation of being a patient centered PA.
Post graduate training has become an expected outcome of the newest technologies and has been a part of our joint educational experiences.
Teaching students is the only template that will ever really work as we educate our peers and our student clinicians to emulate our care and treatment. The one problem is that we have different educational experiences, some which were initially taught poorly and they need to be changed. I believe that our workshops are doing this as we focus on the hands on aspect of many procedures and examinations as well as skills.
The last issue on our list was ignorance. We have been ignorant of our collective contributions to healthcare. We have been short-sighted in acknowledging that there are areas that some clinicians have more education in and therefore they function at a higher level. The secret of dispelling ignorance is to teach with the goal of providing excellence in patient care. I speak at both NP and PA meetings, conferences and workshops and am accepted by both groups. My ratio is now 50/50. When I am attending NP meetings and conferences I see many of my PA colleagues. We share in the desire to learn from each other. I go to meetings of PA groups and see an abundance of NPs both as participants as well as speakers. We are learning to accept each other for what we all contribute and this dispels the ignorance. Years ago we built walls to separate us and today we are knocking down those walls as if they were the Berlin Wall and instead are building bridges. We have much more in common than we initially considered. My dream is to see us working together in a united fashion for the sole purpose of the delivery of excellence in healthcare in America.
 Robert M. Blumm has received national recognition as a distinguished fellow of the American Academy of Physician Assistants (AAPA). He is the past president of the Association of Plastic Surgery Physician Assistants, and was past-president of the American Association of Surgical Physician Assistants, past president of the American College of Clinicians and NYSSPA, as well as Chairman of the Surgical Congress of the AAPA. In addition, Bob received the John Kirklin MD Award for Professional Excellence from the American Association of Surgical Physician Assistants. Along with his associate, Dr. Acker, Bob was the first recipient of the AAPA PAragon Physician-PA Partnership Award. He has been a contributing author of three textbooks, written 150 plus articles and is a sought out conference speaker throughout the United States.
The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
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