As part of my campaign for the AAPA Board Secretary-Treasurer position for the April 2014 election, I’m interested in looking for ways to build connections between disparate physician assistants who care deeply about the profession, but who differ greatly about organizational directions.

One example is the chasm between PAs who want to see the PA title changed from “Physician Assistant” to “Physician Associate,” and those that think such an effort is ill advised. It’s certainly not a new issue, but it generates plenty of heat.  

I recently reached out to my colleagues on the Physician Assistant Forum, the venerable website where PAs have been kicking around professional issues for years. My first effort was to ask if PAs think the AAPA elections are relevant to their practice.

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About 50 replies later respondents had covered a lot of ground, much of it angry, not really related to my question and focused on the ill will and hurt feelings that many associate with the AAPA. The issues ran the gamut – from PAs who felt the AAPA has ignored their concerns, to PAs who don’t think the AAPA works hard enough to promote the full utilization of the profession.

There was some discussion that was cooler, but mostly it had a very upset tone. The relevance of AAPA elections was hardly mentioned, which disappointed me, because I want to know what PAs think about how elections and organizational governance can be more relevant.  

I decided to post another question, this time reaching out to PAs For Tomorrow (PAFT) – the group advocating for a name change for PAs and a new agenda for the AAPA. A group whom I respect but have unintentionally roiled in the past.

I asked this group to help me understand what it is they think the AAPA can do, aside from the name change issue, to better address their views of how PAs should practice. Here’s what I posted:

PAs For Tomorrow: Help Me Understand What You Think AAPA Should Be Doing

PAFT Colleagues,

I’m running for the AAPA Board, and I really want to know more from you, PAFT leaders, about what you think the AAPA should be doing. I am very much hoping we can move the conversation beyond “they ignored our 6,000 emails” and the House of Delegates nixing discussion of the title change and from what has happened in the past, to what should happen moving forward.

As PAs in practice we all known that when patients get stuck in the past we can get really bogged down. I want to know where we should be going forward, and what you think the AAPA can do to address your concerns.

For example, the U.S. Department of Veterans Affairs recently pushed forward with moving from “supervising” to “collaborative” regarding how PAs are viewed. Former AAPA President Steve Hanson wrote about this, and I want to know what you think.

Can past wounds be healed between you and AAPA? If so, how can this occur?

Thanks, and let me put on my helmet now for the responses. I know how strongly a sense of betrayal some of you feel, and I just want to know what you think the AAPA and more importantly the AAPA Board should be doing to integrate your concerns into their work, aside from the 6K emails and the title change issues.

Feel free to call me anytime if you’d rather talk at XXX-XXX-XXXX, or if you’d rather email privately you can reach me at [email protected]. I care about what you think, because we are all part of the PA family.

The responses were quite heartening. Several posters wrote articulate and concise posts about exactly what they would like to see, and it was very encouraging:

  1. Support the move to get rid of supervision across the board in favor of collaboration in all settings.
  2. Market us as PAs, not as Physician Assistants. Anything we can do to diminish “assistant,” even if we don’t end up at associate, is a positive change.
  3. Try to get an IOM study of PAs. This did so much for the NPs.
  4. A national PR Campaign is important. Legislators as well as every Tom, Dick and Harry on the street needs to know what a PA is, specifically that we are not medical assistants.
  5. Work aggressively to seek parity with NPs and docs in regards to all legislative inequalities. If an NP can order home health, a PA should be able to as well. Ditto for EHR payments, etc. Support PAs as leaders of “medical homes.”
  6. Offer more support for PAs who own their own clinics. This forum is full of stories of PA clinic owners asking the AAPA for help with insurers, etc. and hearing nothing back.
  7. Support better postgrad education for PAs. Residencies are a good thing!
  8. Support those PAs who decide to get a postgraduate doctorate (PhD, DHSc, MD/DO, etc) better. These folks are potential leaders. Treat them that way.

I really like these points. They are clear, concise and rich with strength of vision. This is the kind of communication that can move the organization away from rancor and anger related to past actions, and towards building coalitions between PAs who have far more commonalities than differences.

Jim Anderson, MPAS, PA-C, ATC, DFAAPA, is chair of the American Academy of Physician Assistants Health Disparities Work Group, founder of Physician Assistants for Health Equity and faculty of the Department of Anesthesia and Pain Medicine at the University of Washington School of Medicine in Seattle.