After 14 years as a physician assistant, I’m only now starting to understand the unique origin and needs of PAs that are veterans of military service. I’m not a vet, and although I have worked hard to wrap my brain around the special needs of my military veteran colleagues, I must admit I have not fully grasped this issue.
Although the American Academy of Physician Assistants (AAPA) has been built on the backs of military PAs, a big challenge for many of the very PAs who created our profession has been figuring out how to fit back into it after leaving military service.
I recently talked to a veteran PA who just joined my organization, and he was able to capture and describe the challenges for military PAs moving into civilian service in a way I had not thought about before.
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One of the key challenges this PA described was moving from an extremely autonomous practice setting to one governed by state regulatory guidelines, supervising physicians and the presence of numerous input sources regarding treatment decisions that were not present during military duty.
The PA profession has long supported the advancement of military PAs, but unfortunately these advocacy efforts have not stopped the role of military vets from greatly diminishing within the AAPA during the course of the last several years.
If I am given the opportunity to serve on the AAPA Board, I’d like to move this issue to the front burner. As a PA for 14 years, I’ve grown fatigued hearing our organizations say, “We get it,” and then doing little about it. I’ve come to better understand the dangers of observing an organization wave off complex issues because they think they “get it.”
Clearly we don’t. Veterans of military service are still often treated as outsiders in the very profession their predecessors created. My venerated colleagues Gino Gianola, PA-C, and Kenneth Harbert, PhD, PA-C, frame the issue as an ethical one in a 2009 article published in the Journal of Physician Assistant Education. They put it this way:
Do we — PA educators and admissions committee members — have any social, moral, or ethical responsibility to medically trained military veterans or to society in general to address the impediments these veterans face to effectively using their skills and training as health care providers? Should these barriers be assessed and creative solutions identified? We will argue that the answer to these questions is yes.
The piece goes on to describe some specific steps that could be taken in our profession to advance the role of military veterans:
- Develop consensus among the Physician Assistant Education Association, the AAPA and the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) that at a minimum we honor military service and provide a veterans preference process for admission, as is done in many federal jobs.
- Obtain funding through Health Resources and Services Administration or other means to create a bridging program that will give veterans an accelerated academic program through which to complete their bachelor’s degrees.
- Accept the American Council on Education guidelines for equivalency of military training.
- Include in our curricula such veteran-related topics as post-traumatic stress disorder, traumatic brain injury, and an empathetic appreciation of why one out of three homeless men are military veterans.
- Actively create (and be creative in providing) educational opportunities for the men and women who have acted as “lifesavers then” and only want to be “caregivers now.
Although headway has undoubtedly been made since this article was first published, I regret that it’s taken me so long to really begin to appreciate the depth of this issue.
I’m hoping if I am elected to the AAPA Board of Directors in my current run for Secretary-Treasurer I’ll be able to contribute to our profession’s efforts to re-embrace these values, better recognize the efforts of the veterans who started our profession, and move beyond the mistaken organizational belief that “we already get it.”
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.
