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This is a political football because our image is linked to the perceptions of the people concerning our professional practice as well as our personal self image. This can easily segue into the reality that our name is inadequate as it does not describe what we do but rather denotes a generic type of assistant that works for a doctor. We have read many a discussion on this and I do not wish to alienate myself from potential readers by having them think I am discussing a one sided issue. PAs in general are most commonly known by their initials, and we have, in the past forty-five years, proven that we are successful and conscientious care givers. Image goes beyond a name and the audience stretches beyond patients. How does the rest of the world see us? What is the initial definition of a PA by their job description or by their achievements and scope of practice? A wonderful quote that I have given mileage to is: “'Tis far better to show what you know than to say what you know, and equally important to say, rather than show, what you don’t know.” This infers that we are imperfect and that we do not own all of the knowledge on a given subject. It demonstrates by the written word, that PAs have limitations and that they enjoy a scope of practice. That scope of practice is different from specialty to specialty and from PA to PA. The credentials “PA-C” demonstrate that we meet an academic standard but do not infer that we possess similar clinical skills. This, my friends, is why workshops are so important at our specialty and state meetings.
One of the most common quotes that I have heard concerning PA practice as well as NP practice is” we can do 85% of what a doctor can do.”I personally take umbrage with that philosophy or that comment as it is not universal, it lacks veracity and all PAs are not created equal. When I look at the word equality, for that matter, all NPs or physicians are not created equal either. The PA profession has quickly moved from a profession of generalists to a profession of sub-specialists. When you consider a surgical PA and the 85% solution, it would be pure foolishness to say that surgical PAs can operate at that level. Most surgical PAs assist. Assisting is different than being the decision maker throughout the entire case and performing every step of many complicated procedures. If the old guard at the American College of Surgeons would hear us spouting comments such as that, we would incur their wrath. Some PAs are trained so well and have so much practical experience based upon their years in the profession that they indeed can fulfill the 85% comment in a sub specialty but this is not true of all who call themselves a PA or PA-C. We need to know who we are, what skills we possess, maintain our standards and learn daily in order to be the best PAs that we can be. I’d throw away the percentage comment as it falls flat on its face. 10 years ago I stated that we excel in some areas and are weak in others. Truth and reality make for a good marriage and are never attacked by other professionals. Comparisons can be costly and create great upset because of their broad stroke. Studies on the other hand, particularly evidence based, are quoted and focused upon. We need to create the studies if we wish improved public relations and marketing. All PAs posses an “entry level” knowledge upon entering the profession and the workforce and we cannot sustain our existence with that knowledge alone. Every day of our career we are building upon the previous day and our knowledge is being multiplied when coupled with experience. If we choose to stop our education upon graduation we will be like helpless infants and sustain the damage called “failure to thrive.” Our knowledge nutrition comes from a desire to continually learn, from self-motivation, from mentoring experiences, from our patient encounters, from peer review and from our specialty CME meetings and their direct specialty centered lectures and workshops. Specialty groups are continuing to thrive because they have honed in upon the needs of their members and are making the hard decision to give them great, useable CME that is relevant to their present situation.
In conclusion to this first reality, I quote educator/consultant Howard Taylor who said, ”The roots of true achievement lie in the will to become the best that you can become.” This is my challenge to you and this is our challenge to each other. To maintain our image and to enhance our image requires a banner of competence that is the result of responsibility, self-sacrifice and a commitment to lifelong learning. As football’s great coach, Vince Lombardi once said, ”A person’s life is in direct proportion to their commitment to excellence, regardless of their chosen field of endeavor.” Let’s look this reality in the face and make personal decisions that will last a lifetime.
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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