Provided by Clinician 1

A few things............

I owe you some thoughts on how we potentiate our voice in letting people know how we PAs and NPs are a major be a solution to the primary care distribution problem. That will be coming soon. I want the plan to include something we can all do and have us all make a difference with.

===============================================

Specialty Boards

A real debate has erupted (and it is good to see) in the PA profession. It is about the people that give PAs their certification and re-certification announcing that they will be moving into specialty boards for PAs.

A little background. This organization called the NCCPA, is free standing and is not controlled solely by the PA profession. There is much PA input though. Over the past few years a number of other organizations outside the NCCPA have threatened to start specialty boards for PAs, so the NCCPA being the “experts” thought it was the time for them to do it. As you may know, all PAs regardless of specialty have to pass broad based INITIAL certification boards which include questions representing patient management and more in all of the major medical/surgical specialties. As PA training tends to be very broad in nature, this has always been looked at positively. We also must have required CME hours each year but also are required to take recertificiation boards which are also broadly based in content, every six years. This has been a thorn in the grass roots PAs side for many years for two main reasons. One is that it has raised the anxiety level of many simply because these boards cover many of the major medical specialties. Hard for a PA in internal medicine or pediatrics (which are primary care specialties) to know emergency medicine, gynecology, adult psych or orthopedics and then have their professional future depend on that. To be fair, there are many fine courses to prepare you for these boards but they cost money and time.

Also remember that specialty based PAs constitute more than half of the profession. Imagine being in cardiac surgery for 20 years or psych or orthopedic surgery or derm or emergency medicine and having to worry about an exam where the majority of the questions do not cover what you do every day? Hardly fair.

Also these specialty PAs attend CME courses that are broad based, even though these topics may not at all cover what they do on a day to day basis. This is partly because they want to prepare for the recertification exam. To me that’s a waste of money and does little to insure that you spend your time learning what you need to learn.

Now on the other hand, because of our initial generalist training, the PA profession was, and continues to be, quite adaptable. A PA could work in surgery or the ER full time and at an urgent care center on the weekends. Or maybe segway into derm because of financial gains exactly because she/he had the the ability to move into new specialties. This is a real plus to the clinician and one that many NPs looked at with envy, especially when trying to get rulings from the Board of Nursing on what each specialty could do.

The Problem

Once specialty boards exist, generally they will be required. If not by the state, by hospitals and employers for sure. It may even bring us closer to the physician specialty groups. This would do two things; one is significantly box PAs into a specific specialty which will be harder to leave and secondly, I believe, offer more protection to the public.

If we are to say that the reason Boards are given is public protection AND if PAs (and NPs) are held to the same standard of care that physicians are, then Boards in the major specialties is a no brainer. To me there is no way around that fact. Given the choice, I’d like the PA taking care of me to be specialty certified, why not? If we are to say that we require Boards because of any other reason, I believe we should wait and not do this now, except for one specialty. Why? With healthcare being redesigned, it is not the time to be making major policy changes for PAs (or NPs). If PAs feel specialty boards are needed, we can start them once the healthcare mess we are in is somewhat straightened out. The PA profession needs to be as adaptable as possible for the next few years. Specialty Boards would tie us down and decrease our ability to adapt, change and respond. No one is forcing these down our throats at the moment. What we do need to do as soon as possible is create specialty boards in Primary Care/Family Practice. These could even be jointly developed between NPs and PAs and would insure competency in providing all facets of primary care. Why? Because primary care is where the need is and if we play our cards right the first area we can use these Boards. With these new Boards should come expanded privileges for us, more autonomy and a real loosening of the barriers which hinder the ability for PAs to get out there and make a difference. Graduates should be able to know how to run a small clinic as well as some public health.

Now is not the time for specialty boards. Let’s start with primary care and have significant impact from PAs who work in family practice, rural health and retail care. Let’s tie this to more autonomy and whatever else could help us delivery better care to more people. If this one works we just might have the model for the rest. And if we really want to blue sky it let’s call the PAs who pass the Boards Physician Associates.

That’s it for this week.

Dave   

RECOMMEND THIS ARTICLE

You must be logged in
to recommend articles

Average (Not Rated)

» Recommended Articles