by Ryan Vann, PA-C
PAs recently were included as licensed health care providers who are able to fully clear high school athletes for return to play after recovering from a concussion. How this change came to fruition is a perfect case study for why advocacy on behalf of the PA profession is so vitally important.
In late 2017, I asked the NCAPA and our Government Affairs Committee to take a look at the “return to play” issue. At that time, only physicians were designated as being authorized to return athletes to play after a concussion. Due to this, I had several patients in my family practice clinic who could not be cleared by my authority alone, resulting in necessary office visits with a physician who likely had not seen him/her before. Our research into the issue quickly showed that our exclusion from the full concussion clearance process was not consistent with existing law.
NCAPA Executive Director Emily Adams, PA Cody Malley (who has extensive experience in concussion management), and I met with senior staff at the North Carolina High School Athletic Association (NCHSAA) about the return to play issue in January of 2018. We took the opportunity to discuss the value of PAs, the types and quality of healthcare PAs provide, and why including PAs as authorized providers for return to play is important. The NCHSAA staff was very welcoming and receptive to our request. From there, we met with the NCHSAA’s Sports Medicine Advisory Committee (SMAC). It is the SMAC’s role to recommend such changes, if appropriate. Unfortunately, the SMAC chose to recommend against adding PAs as providers, necessitating a different strategy to accomplish our goal.
It was at this point that legislative advocacy became an important part of the story. The NCAPA’s members, volunteer leaders, and staff have been working very hard over the past several years to establish both grass roots and organizational relationships with our state legislators. In considering our next steps, we focused on the fact that the existing law clearly states that PAs (among other non-physician providers) are allowed to oversee concussion management from beginning to end. We knew that Representative Chuck McGrady, one of the primary sponsors of the concussion law, had attended an NCAPA-sponsored, PA program legislative visit in 2017. As a result of that prior connection, we had established a working relationship with him on other matters. We asked Rep. McGrady to intervene on our behalf, and he kindly sent a letter to the NCHSAA, resulting in PA inclusion in the concussion clearance protocol. To their credit, our partners at the NCHSAA support the change, as they realize that it will increase patient access to quality care.
Click here to view the NCHSAA Concussion Return to Play Protocol
This may appear to be a small issue, but the larger point is that it was your Academy’s legislative relationships that made this change possible. It is so important that we have relationships with our legislators so that we can act quickly when issues arise that may challenge PA scope of practice. With that in mind, I encourage all of you to find out who your state House and Senate members are and send them a message offering your expertise on healthcare issues. To a legislator, hearing from people in the district they represent is valuable. Whether or not you agree with (or even voted for) them is irrelevant – they simply want to hear your opinions and draw upon your knowledge. Also, plan on coming to PA Day at the Legislature next spring. This has become an annual event, and it is exciting to be at the General Assembly with so many PAs at once – it makes a real impact on the legislators as well. More information will be available about this annual event in early 2019, so please watch for this.
And lastly, please be sure to maintain membership in NCAPA and encourage your fellow PAs to do so as well. The more PAs we have standing with us, the louder our voice, and the more likely we are able to able to keep North Carolina a great state to be a PA.
