Visits to the Stead Center are by appointment only. Please call the NCAPA office for more information. Read More »

Visits to the Stead Center are by appointment only. Please call the NCAPA office for more information. Read More »

The Pulse | September 2013

In this issue:
President’s Message: Don Metzger, PA-C
Advocacy Needed NOW: New Rules Could Negatively Impact PA Practice
Voting Underway for Board of Directors
Biggest Membership Benefit: A Student’s Perspective
Why Wait? Activate Your 2014 Membership Now
Your Chance for a Starbucks Gift Card: “Each One Reach One” Campaign
Make Plans Now to Attend Our 28th Annual Recertification Exam Review Conference!
NCAPA Donates to Project Lazarus
Controlled Substances CME in October
Governor Proclaims PA Week for North Carolina
Resources for PA Week
Gail Curtis Honored as 2013 PA of the Year
PAPA Fall Seminar
Students, Mark Your Calendars for Nov. 2
Letter to the Editor
Self-Nominations for Board Vacancy: Deadline Sept. 20
PAEC: Join the One-Hour Campaign


President’s Message

By Don Metzger, PA-C

WOW, what a year in the life of NCAPA.  We have just returned from the 37th Annual NCAPA Summer  Conference at Myrtle Beach with over 1,000 participants.  Fred Brason of Project Lazarus delivered a powerful keynote address on the epidemic of opioid abuse and how we can make a difference in the lives of our patients.  If you missed the conference this year, circle the dates for 2014 (August 17-22) and make plans to attend this wonderful event.  Also don’t forget to register for the upcoming 2014 Winter Recertification Conference.

NCAPA recently celebrated the return of the PA of the Year award.  Gail Curtis was honored as the 2013 recipient at the Summer Conference.  Read more about her accomplishments in this issue of The Pulse.  NCAPA will continue to celebrate the extraordinary work of our members, and we plan to have several more categories of awards for next year’s conference.

NCAPA has also been actively advocating for your right to practice medicine and to be reimbursed for your work.  We rallied to address an AMA resolution that would have curtailed your eligibility to perform surgical procedures, including laceration repairs.  NCAPA is also closely monitoring  the implementation of the Affordable Care Act.  We must make sure that PAs are listed specifically as providers or we will be lost in the shuffle.

NCAPA works hard to allow you to practice medicine in NC.  But we need your help as an active member.  One way you can make a difference is by volunteering for service on an NCAPA committee.  You can also encourage your PA colleagues to become members of NCAPA. (Participating in our “Each One Reach One” membership recruitment campaign will even reward you for your efforts with a Starbucks gift card!)

Together, we can ensure that PAs remain valued practitioners of medicine in NC.


Advocacy Needed NOW: New Rules Could Negatively Impact PA Practice

On August 19, Centers for Medicare and Medicaid Services (CMS) published a final rule that, unless changed before its October 1 implementation date, will cause tremendous problems in the hospital admissions process. Read more. . .


Voting Underway for 2014 Board of Directors

Electronic voting is currently underway for Officers and Directors-at-Large of the NCAPA Board.  Fellows and Associates who were members of NCAPA in good standing as of September 1, 2013 are eligible to vote.  Email notices with instructions for voting were sent on September 3 to all Fellow and Associate members for whom we have email addresses.  At that time instructions for online voting were also mailed to those members for whom we do not have email addresses.  If you have not received an email or letter with voting instructions, please contact Carin Head.  Voting ends on September 30.  This year the ballot contains candidates for President-Elect, Treasurer, and three Directors-at-Large.  We encourage you to participate in your Academy by casting your vote!


Biggest NCAPA Member Benefit: A Student’s Perspective

By Molly Calabria, PA-S, NCAPA Student Representative

After I participated in my first NCAPA Board of Directors meeting last fall alongside fellow student representatives, it quickly became clear how much time, energy, and effort committee and board members alike put into bettering the NCAPA as an institution and ensuring that PAs across North Carolina are able to practice to the full extent of their training.

I asked Marc Katz, Chair of the Government Affairs Committee, to add me to the GA email listserve so that I could keep up with the efforts of the committee—partly out of curiosity about their work, and partly because I have always been interested in policy. While I knew the committee put a good deal of time into advocating for PAs when particular concerns arose, I soon found out just how much committee members contribute weekly—and often daily—to advance the profession.

Whether questions come up about PA billing at local practices, legislation is introduced at the state level that might restrict the scope of practice for PAs, or an organization releases a statement that positions the training and ability of physician assistants in a negative light (whether or not that was the intention), the Government Affairs Committee is constantly, actively engaged in working for North Carolina PAs.

This enormous benefit to North Carolina physician assistants is, I believe, easy to take for granted. And so, in the middle of my education and at the beginning of my career, I write to express my appreciation for the extensive work of the NCAPA and the Government Affairs Committee in particular. If more physician assistants join the NCAPA—including new graduates—and current members become more involved in this advocacy work, the voice of PAs will be further amplified across NC to ensure that we are well-equipped to make contributions to our patients and to our communities. I am very much looking forward to what the Government Affairs Committee and the NCAPA will accomplish in the coming years.


Why Wait? Activate your 2014 Membership Now!

NCAPA is starting its renewal/recruitment cycle this month, so don’t put off until tomorrow what you can do today online. You’ll save yourself time and can skip filling out a paper renewal form later!


Each One Reach One: Membership Recruitment for 2014

Word-of-mouth is the best advertising! That’s why NCAPA members are the most powerful recruitment tool we have for attracting new members to our organization.

This year from September 15 through November 30, the “Each One Reach One” campaign is offering current members the incentive of a $10 Starbucks gift card when you convince a colleague or friend to join NCAPA as a 2014 new member.

Lest we be accused of encouraging excessive caffeine consumption, there is a one-per-member limit on the Starbucks gift cards. Nevertheless, we encourage you to recruit multiple new members! Come 2014, all “Each One Reach One” recruiters will be acknowledged in The Pulse.


  1. Tell colleagues about the benefits you find in NCAPA membership, and convince them to join for 2014.
  2. Ask them to join online via the NCAPA website (
  3. Tell them that when they are routed to the Demographics screen as part of the registration process, they should list your name in the “Referred By” field.
  4. As incoming new memberships are processed at the NCAPA office, we will note that you are a star recruiter for NCAPA, and mail you a $10 Starbucks gift card!
  5. Your recruitment prowess will be recognized in the January issue of The Pulse.

Questions? Contact any member of the Membership Committee, or Lee Busselman, Member Services Coordinator.


Make Plans Now to Attend Our 28th Annual Recertification Exam Review Conference!

February 23-28, 2014 – Sheraton Imperial Hotel – Durham, NC

This conference agenda will mirror the PANRE Exam blueprint, and will also be an excellent review of all organ systems for any medical professional.  Registration is now open!  Please visit our conference page for more information.


NCAPA Donates to Project Lazarus

The North Carolina Academy of Physician Assistants has donated $1000 toward the work of Project Lazarus, a community-based opioid overdose prevention program that began in North Carolina and is now serving as a nation-wide model.

Don Metzger, NCAPA President, presented a $1000 check to Fred Wells Brason II, Project Lazarus Executive Director, on August 19 at NCAPA’s annual summer conference. Brason served as keynote speaker at theconference. Brason’s presentation covered national trends in opioid overdose and the efforts of Project Lazarus to stem this problem at local, state, and national levels.

Metzger spoke to the more than 1,000 attendees, saying “Physician assistants (PAs) are on the front lines of this epidemic and are often the first to recognize and offer treatment for these patients.  Project Lazarus is a comprehensive program that not only recognizes the problem of prescription drug abuse but also offers treatment options for those who are addicted.  PAs are advocates for our patients and we fully support Project Lazarus.”

As of 2008, North Carolina’s drug overdose rate was 12.9 per 100,000 individuals over the age of 12, a rate higher than that of 24 states, including South Carolina and Virginia. In that same year, prescription painkillers were involved in 14,800 overdose deaths in the U.S.—more than cocaine and heroin combined.

Project Lazarus was established in 2008 in response to the extremely high drug overdose death rates in Wilkes County, NC. In 2007, Wilkes County had the third highest drug overdose death rate in the nation, according to the Centers for Disease Control and Prevention (CDC). Project Lazarus enables overdose prevention by providing technical assistance to create and maintain community coalitions help them create locally tailored drug overdose prevention programs, and connect them to state and national resources.

For the past year, NCAPA has partnered with Project Lazarus in urging all physician assistants practicing in North Carolina to register with the North Carolina Controlled Substance Reporting System, a voluntary program to track the prescribing and dispensing of controlled substances.

According to the CDC, the misuse of classified prescription drug abuse has now reached epidemic proportions in the U.S.  In 2010, 2 million people in the U.S. reported using prescription painkillers non-medically (i.e. recreationally) for the first time within the last year—nearly 5,500 new users each day.

While there has been a marked decrease in the use of some illegal drugs, the number of prescriptions filled for opioid pain relievers – some of the most powerful medications available – has increased dramatically in recent years. Data from the National Survey on Drug Use and Health show that nearly one-third of people aged 12 and over who used drugs for the first time in 2009 began by using a prescription drug non-medically. From 1997 to 2007, the milligram-per-person use of prescription opioids in the U.S. grew from 74 milligrams to 369 milligrams, an increase of 402%.

Project Lazarus has pioneered the use of community involvement to fight prescription drug misuse and overdose. After the program’s inception, overdose deaths declined by 69% in Wilkes County between 2009 and 2011. In 2011, not a single Wilkes County resident died from a prescription opioid from a prescriber within the county, down from 82% in 2008. Hospital emergency department visits for overdose and substance abuse were down 15% between 2009 and 2010.  Project Lazarus is now being used as a model for the federal government in its efforts to deal with the epidemic of prescription drug abuse.

“NCAPA is proud to support the efforts of Project Lazarus in fighting overdose prevention, and we look forward to our continued partnership in the days ahead,” Metzger said.


Controlled Substances CME in October

The North Carolina Medical Board (NCMB) is partnering with the North Carolina Medical Society (NCMS) and other healthcare organizations, including NCAPA, to give licensees the opportunity to participate in high-quality continuing medical education on the subject of appropriate opioid prescribing.

Register now for SCOPE (Safe and Competent Opioid Prescribing Education) of Pain training. The training will be held from 12 noon to 4:15 p.m. on Friday, October 25 in conjunction with the NCMS Annual Meeting at the Raleigh Marriott City Center, 500 Fayetteville St., Raleigh. Cost is $25. The workshop qualifies for 4 AMA PRA Category 1 Credits. SCOPE of Pain, developed by the Boston University School of Medicine and funded by an unrestricted educational grant from the manufacturers of extended release/long-acting (ER/LA) opioid analgesics, is designed to help physicians and other practitioners safely and competently manage patients with chronic pain. The FDA has mandated that manufacturers of ER/LA opioid analgesics make comprehensive prescriber education in the safe use of these medications available as part of a comprehensive Risk Evaluation and Mitigation Strategy (REMS).

During the afternoon-long program, attendees will learn how to:
• Decide on appropriateness of opioid analgesics
• Assess for opioid misuse risk
• Counsel patients about opioid safety, risks, and benefits
• Competently monitor patients prescribed opioids for benefit and harm
• Make decisions on continuing or discontinuing opioid analgesics
• Safely discontinue opioids when there is too little benefit or too much risk and harm.

The program will also include a panel discussion among national and North Carolina experts on the subject of controlled substances and the treatment of pain.


Governor Proclaims Oct. 6-12 as PA Week in North Carolina

Governor Pat McCrory has proclaimed October 6-12 as Physician Assistant Week in North Carolina.

North Carolina is considered the birthplace of the physician assistant profession. Dr. Eugene A. Stead, Jr. developed the initial curriculum for Duke’s PA program based on his knowledge of the fast-track training of doctors during World War II.  In 1965, Duke University Medical Center enrolled the first class of PAs.  Today, more than 6,000 physician assistants are licensed to practice in the state of North Carolina.   The Bureau of Labor Statistics predicts that PAs will be the second-fastest-growing profession in the next decade across the nation, increasing from 74,800 in 2008 to 103,900 in 2018.

North Carolina’s observance of Physician Assistant Week is part of the national celebration of the PA profession which is held annually to increase awareness of both the PA profession and the importance of PAs in the health and wellness of patients.

Physician assistants are represented on the state level by the North Carolina Academy of Physician Assistants (NCAPA), and nationally by the American Academy of Physician Assistants (AAPA). In addition, seven affiliated regional chapters of NCAPA are active in North Carolina. The NCAPA headquarters in Raleigh-Durham’s Research Triangle Park is named in Dr. Stead’s honor.

“PAs are a crucial part of healthcare teams and I believe the role of PAs in the delivery of quality healthcare to the citizens of North Carolina will continue to grow in the years to come,” said Don Metzger, President of NCAPA. “This proclamation by the Governor of North Carolina reinforces the tremendous contribution PAs provide to the citizens of North Carolina.”

Full text of the Governor’s Proclamation:
WHEREAS, quality, affordable, and accessible patient-centered healthcare, provided by skilled practitioners, contributes to the well-being and quality of life for all citizens of North Carolina; and
WHEREAS, physician assistants are often the first point of contact for many patients and play a vital role in helping patients understand their medical needs and empower them to become effective advocates for themselves; and
WHEREAS, physician assistants are academically and clinically prepared to provide healthcare services, including diagnosis and treatment of disease, assistance in surgery, and prescribing medications with the direction of a supervising physician; and
WHEREAS, physicians assistants are a valuable asset to the medical community and work side-by-side with physicians to enhance the delivery of high-quality healthcare for patients, often in medically underserved and rural areas; and
WHEREAS, the State of North Carolina recognizes the dedication of physician assistants and the contributions they make as part of a healthcare team to ensure delivery of efficient and effective healthcare services;
NOW, THEREFORE, I, Governor Pat McCrory, do hereby proclaim October 6–12, 2013, as PHYSICIAN ASSISTANT WEEK in North Carolina and commend its observance to all citizens.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed the Great Seal of the State of North Carolina at the Capitol in Raleigh this thirteenth day of June in the year of our Lord two thousand and thirteen, and of the Independence of the United States of America the two hundred and thirty-seventh.


Resources for PA Week

Check out the poster, email signature, and Facebook profile graphic that are available for your use in promoting PA Week in your area . . . Read More


NCAPA Honors Curtis as “PA of the Year”

L. Gail Curtis, MPAS, PA-C, is the recipient of the 2013 PA of the Year award from the North Carolina Academy of Physician Assistants.

Curtis was announced as the award winner at the NCAPA’s Summer Conference on August 18 in Myrtle Beach, SC. More than 700 conference attendees were present for the award ceremony, which was conducted by Don Metzger, NCAPA President.

“Gail’s outstanding gifts as a teacher and mentor have helped build the skills and confidence of hundreds of PA students over the years,” Metzger said. “She is an unflagging advocate for our profession on both state and national levels, and a valued member of NCAPA. We are very proud to recognize her as 2013 PA of the Year.”

Curtis is an associate professor in the PA program of Wake Forest School of Medicine. She joined the faculty there in 2004, and has been involved in clinical education of medical and PA students since 1986. She currently serves as Vice Chair, Department of PA Studies, and as Director of Pre-Clinical Education.

Gail has played an integral role in helping to create the practice laws that exist for PAs in North Carolina today.  She was part of the 1993 NC Medical Board committee tasked to create the state’s practice rules and regulations.

Gail has been an active member of NCAPA since 1986, and has served the organization in a variety of capacities. She helped develop the NCAPA Health Committee and has been a strong advocate in that group since its inception, committed to ensuring that there are 12-Step meetings and appropriate lectures dealing with impairment issues at NCAPA’s annual conferences. In 1994, as NCAPA President, she helped craft enabling legislation to protect impaired PAs and to allow PAs to enter into agreements with entities such as the North Carolina Physicians Health Program (NC PHP). She currently serves as NCAPA’s liaison to the NC PHP and is a member of their Board of Directors.

Gail also serves as a member of NCAPA’s Professional Development Review Panel, a position she has held since 2009. She was honored with the NCAPA’s 2010 Outstanding Service Award in 2010.

On the national level, Gail has served for more than 20 years in the House of Delegates of the American Academy of Physician Assistants (AAPA). For the past three years she has been a House Officer, and this summer was elected as Vice President/Speaker of the House of Delegates. The AAPA named her as a Distinguished Fellow in 2008.

The PA of the Year award honors a physician assistant who has demonstrated exemplary service to the PA profession and the community, and who has furthered the image of the physician assistant profession while providing significant contributions to the health of the citizens of North Carolina. To be eligible for the PA of the Year award, an individual must be a Fellow Member of NCAPA in good standing for a minimum of five years and be licensed by the NC Medical Board.

PAPA Fall Seminar

The Piedmont Association of Physician Assistants is offering a FREE Fall Seminar on Saturday, September 21, at the Forsyth Medical Center in Winston-Salem. This conference will provide six hours of Category I CME approved by the AAPA, and is open to all Physician Assistants and Nurse Practitioners. The conference will consist of six one hour-lectures, breakfast, snacks, lunch, and access to multiple exhibitors. Please direct any and all questions to PAPA Information.


Students, Mark Your Calendar for Saturday, November 2!

That’s the date for the NCAPA Student Leadership Retreat at the Stead Center in Durham. Registration is at no cost to students. Please see any NCAPA Student Director for more details, or contact Lee Busselman, NCAPA Member Services Coordinator. Registration information will be emailed to all students early in October.


Letter to the Editor: Malpractice Insurance

From Dave Baggett, PA-C

I read the article on malpractice insurance in the August issue of The Pulse. The paragraph on the forms of malpractice insurance is sketchy at best, confusing, and, for a new graduate, I would suggest he/she look elsewhere for definitions or descriptions of Claims Made and Occurrence Coverage and guidance on the subject.

In this mobile era when jobs change, etc., Occurrence Coverage is far preferable albeit more expensive. Occurrence policies protect the policyholder for alleged acts of malpractice which occur while the policy is in force, no matter when a claim against you is reported to the insurance carrier.

Claims Made Policies protect the policyholder for alleged acts of malpractice which both occur and are reported to the insurance company while the Claims Made Policy is in continuous force. Given that there may be a significant time lag between when a treatment, drug, or test was administered and the filing of a claim, Claims Made premiums are relatively low in the first few years and are structured to be increased each year that the coverage is in force. This means that if you decide to cancel your Claims Made Policy because you are changing jobs, retiring, moving, etc., you must consider Tail Coverage to insure you for incidents that occurred while the policy was in force but reported after the policy was cancelled.

When negotiating your employment contract and your prospective employer is offering Claims Made Coverage, make sure that it is clearly stipulated in the contract that the employer will purchase, at his/her expense, Tail or Extended Coverage when the PA’s employment ends or is terminated for whatever reason.

Response from Sola Ogunniyi, PA-C, Government Affairs Committee Member

Thank you for your detailed comments on the article on malpractice insurance in the August issue of The Pulse. The article was written as a quick summary/guide to new graduates and has been very well received. However, we regret if it was not explanatory enough in the key areas you mentioned. We will make appropriate revisions in future articles on malpractice insurance for new graduates. We encourage all PAs, especially new graduates, to utilize the NCAPA as a resource for any questions they may have.

Self-Nominations for Board Vacancy: Deadline Sept. 20

In accordance with Article V, Section 5 (b) of the NCAPA Bylaws, the Nominating Committee hereby gives notice to the NCAPA membership that the Board of Directors will consider a slate of candidates prepared by the Nominating Committee and vote to fill a vacant Director at Large seat on the Board for the remainder of the term.  The vote will take place at the next meeting of the Board on November 16, 2013 and the candidate elected will fulfill the remainder of the term as a Director at Large from November 16 through December 31, 2013.  Self-nominations are being accepted from September 16 through September 20.  The Nominating Committee will verify the credentials of all nominees.  Candidates must be Fellow or Associate members of the Academy in good standing for the entire term of office.  If you are interested in being considered as a candidate to fill the vacancy on the Board from November 16 through December 31, 2013, please submit your name to the Nominating Committee at with “BOD Self-Nomination” in the subject line no later than September 20, 2013 at 5:00 PM.


PAEC One-Hour Campaign: Give A Little, Help A Lot

Be an active contributor to your PAEC!  Advocacy is a dynamic and on-going process. It doesn’t start or stop on Election Day. We advocate for our profession throughout the year to develop and enhance our legislative relationships.

Join the Campaign: Please consider contributing to the PAEC. Donating just one hour of your salary each year can have a huge impact on your professional practice throughout your career. Please challenge your colleagues to do the same and help champion the goals of the PAEC. Please help preserve, strengthen and expand the PA practice in North Carolina!