In this issue:
By Charlene M. Morris, DFAAPA, MPAS, PA-C
February is said to be the saddest month. Valentine’s Day–with its affectations of hearts, candy, and flowers–is small compensation for the last bitter throes of winter and the short cold days before spring arrives next month.
For me, this February has solidified some of what I see in our profession as perhaps the other, less comfortable side. I was working in my office with no doctors on site this past week and the family of one of my elderly patients called, requesting hospice, as she was deteriorating. I [co]signed the order, spoke with the hospice nurse concerning my recommendations of medications and comfort measures, yet realized I am NOT legally allowed to care for my dying patients in North Carolina or any state of the U.S.!
With many by her side, and several home visits by me to console and reassure her family, she died this morning.
PAs of NC, we must work to get hospice care approved! This IS a natural extension of what we do! I plan to be in DC next month and will lobby for passage of the Hospice Bill along with several other PAs from NC and around our nation. I will also update you when letters and telephone calls must be made to further this cause and pass this legislation.
In this year’s State of the Union Address (1/28/14), President Obama showcased Amanda, an Arizona PA, as not having health insurance until ACA went into effect on 1/1/14. I heard many comments that this was not the best representation of PAs. In addition, President Obama used the despised ‘S in our moniker in his speech, despite the fact that the White House has had a physician assistant on staff for three decades!
My interpretation is this:
Public and legislative awareness of the value of PAs is growing, but we still have much to accomplish. Some of us do NOT receive benefits at our job. Is this wrong or simply the business model of the 21st century? It is probably both. Until very recently, we PAs were constantly compelled to reaffirm the fact that we are valuable to our practice, our communities, and our state. AAPA is proactively working to expand established parameters and I am heartened by the progress. Today, thanks to the the original vision and foundation of PAs, we enjoy an amazing benefit of practice flexibility, and North Carolina is one of THE most progressive states in which to work.
Recently, I recertified for ACLS. Many years ago I was told that the first thing to do in a code situation is to take your OWN pulse. To me, that says I must mindfully reflect on what needs be done and then DO it! Each of us is called to be not only a PAtient advocate, but also a PAdvocate. I am cautiously optimistic to be involved in the expansion of our profession’s public profile and our scope of practice.
For now, PAs appear to be assured a place in the future of U.S. medical practices. Still, there must be vigilance in order to ensure our profession’s future growth. Your membership and participation in NCAPA are crucial to this effort.
Thank you to the many PAs who have renewed their NCAPA membership for 2014. Also I wish to extend a warm welcome to the new members who have joined us. If you have colleagues who are not yet members, encourage them to become PArt of NCAPA this year. For those of you who have not yet renewed, please be aware that the temporary membership card you received in the mail recently will expire at the end of this month. The time to renew is now and it is easily done online.
If you appreciate and enjoy the benefits of working in NC and understand the need to support PA progress, make the most of your NCAPA membership in 2014 and beyond. Let your voice be heard. Your participation in NCAPA is one of THE best investments you can make for yourself and our profession! 2.4.14
Reprinted from AAPA
Your help is urgently needed to move legislation in the House of Representatives to allow PAs to provide hospice services to Medicare beneficiaries. Reps. Lee Terry (R-NE) and Mike Thompson (D-CA) introduced HR 2969, the Medicare Patient Access to Hospice Act, on July 30, 2013. The bill would allow PAs to provide hospice care to Medicare beneficiaries. With Congress taking a close look at ways to improve efficiency and cost in Medicare, NOW is the time to act. Please contact your Representative TODAY and ask him/her to cosponsor and pass this important legislation this year.
Currently, PAs are barred from providing hospice care to beneficiaries, even though it is allowed by state law. The inability of PAs to provide hospice care for their terminally ill Medicare patients places an unconscionable burden on the patient to find alternative care and denies patients access to their medical home at a time when they are the most vulnerable. Please contact your Representatives and tell them of the critical need for PAs in hospice medicine. Ask them to cosponsor HR 2969 today. To find contact information for your U.S. Representative, go to https://www.capwiz.com/ncapa/home/
In 1997, the 105th Congress passed the Balanced Budget Act (BBA), which made clear that medical services provided by PAs, as allowed by state law, are covered by Medicare in all settings at one uniform rate.
Unfortunately, the former Health Care Financing Administration (now the Centers for Medicare and Medicaid Services) decided that the BBA’s Medicare provisions regarding coverage of services provided by PAs did not apply to hospice care. As a result, PAs are not permitted to provide hospice care to beneficiaries who elect the hospice benefit. It makes no sense that Medicare beneficiaries who routinely receive full-spectrum medical care from a PA and who elect to receive the hospice benefit are not able to receive hospice care provided by their PAs.
Allowing PAs to provide hospice care does not change the PA/physician relationship, nor does it increase cost (as PAs are reimbursed at 85% under Medicare). What it does do is increase patients’ access to care, and improve continuity of care, especially in medically underserved areas. Without this technical fix, beneficiaries will continue to face delays and denial of medically necessary care covered by Medicare. Please contact your Representatives today and urge them to support HR 2969 this year.
28th Annual NCAPA Recertification Exam Review Conference
Sheraton Imperial Hotel & Convention Center, Durham NC
February 24-28, 2014
38th Annual NCAPA Summer Conference
Embassy Suites, Kingston Plantation, Myrtle Beach SC
August 17-22, 2014
Join NCAPA for CME at the beach! No one does it better! Sessions start early and they end early so you can get out there and enjoy Myrtle Beach!
Sunday, March 23, 2014
Eugene Stead Center for Physician Assistants, Durham NC
Saturday, April 5, 2014
Registration Opens Soon–location in North Carolina to be announced!
Ready to get certified?
The Federal Motor Carrier Safety Administration (FMCSA) requires all medical examiners who wish to provide DOT/CDL exams to be trained and certified by May 21, 2014. The NCAPA training course is designed to follow FMCSA training guidelines and will prepare the medical examiner to pass the national certification exam. This course is approved for 6 hours of Category I CME*.
*This program has been reviewed and is approved for a maximum of 6.00 hours of AAPA Category I CME credit by the Physician Assistant Review Panel. Physician Assistants should claim only those hours actually spent participating in the CME activity.
The NCAPA Nominating Committee is soliciting candidates for open positions on the Board of Directors and Nominating Committee in 2015. Serving on the NCAPA Board is an important way to contribute to your profession and a wonderful leadership experience for you. North Carolina is often cited as a great state in which to practice as a PA. It got that way through the vision, leadership, and volunteer work of PAs just like you!
If you know a PA who cares deeply about the profession, who wants to contribute to the future of the profession, who is a good listener, collaborator, and decision maker—or if you are that person—please nominate her/him for a position on the NCAPA Board of Directors.
The following positions for elected offices are open for nominees: President-Elect, Vice President, Secretary, Director-At-Large (two positions), and Nominating Committee Member. To read more about these positions and to nominate yourself or a colleague, click here. The Nominating Committee is looking forward to receiving your applications!
All terms begin January 1, 2015. Nominees for officer positions (President-Elect, Vice President, and Secretary) must have been a Fellow member in good standing of the NCAPA for the calendar year prior to election. All other nominees must have been a Fellow or Associate member.
Thus far, NCAPA has 107 brand-new members in 2014 (as of 2/10)! We extend a special welcome to these folks. Check this list to see who’s who.
By Wanda Hancock, MHSA, PA-C
Membership Committee Chair
In 2014 the goals of NCAPA are tremendous. We need your help. In order to meet the legislative agenda we will need the support of each of you. All it will take is to ask one PA who is not a member to join NCAPA. If we have a hope of meeting the challenges of ACA and changes to Medicaid and Medicare, we have to have a representative body. Currently, only about 14 percent of PAs licensed to practice in North Carolina are members of NCAPA. The work of NCAPA benefits all PAs in North Carolina, and yet this work is being funded by a small fraction of PAs who choose to be members. If we are going to achieve our goals, it will take a greater representation of those who are in the state. Firstly, we are unable to have a meaningful discussion with our legislators if we do not represent their constituency. We must have at least 30% to let them know that we are a professional group who is serious about sitting at the table with those who provide care in the state. Other medical groups do show this support, unfortunately we do not. Secondly, all of the PAs and medical practices in our state will benefit from any gains. We need them to show the support for those changes. NCAPA is known as the best state to practice in the entire country. This did not happen by accident. It DID happen because those first PAs here DID join and DID support the efforts to give us the best practice regulations, ones that are envied by all PAs. Thirdly, to meet with politicians, insurance companies, and community leaders, it costs money. While we have been privy to years of generous support by industry, this well has run dry with the onset of Pharma guidelines. We all must pay a little to get the progress we need.
I urge you to approach the PAs who work with you and ask them to join. The cost of membership is often covered by the practice and we have a cooperative program with the North Carolina Medical Society so that you can join both organizations for a reduced rate. This is often something your supervising physician will support. As we review our member benefits this year, I also urge your comments and recommendations for ways we can best meet your needs. Advocacy and continuing education were listed as the most important benefits to members when we surveyed them in 2012. This will be even MORE important as we enter the new healthcare system and as we all move toward the 10-year certificate program. CME requirements will change and NCAPA wants to be there for you to help you make this transition.
Help us continue these efforts by getting someone to join and increasing our membership level to AT LEAST 20%. We have an active and committed Membership Committee this year, but we need your help. Print out a membership form (several will work, too) from the website and sign someone up today. Step up to the plate to show your commitment to our success. We are depending on you as all PAs depend on NCAPA to continue the work we do to make this the best state in the US to work and get the CME we need.
Student members, please take note! The 2014 Student Challenge Bowl is set for Saturday, April 26 at the Stead Center in Durham. The Challenge Bowl is a Jeopardy-style contest comprised of four randomly-selected teams (not school vs school) who vie for prizes. The March issue of The Pulse will provide more detailed info as well as registration instructions. If you have questions in the meantime, please email Lee Busselman.
The NCAPA Board of Directors is pleased to endorse the candidacy of Jeffrey Katz for President-Elect of the American Academy of Physician Assistants (AAPA). Jeff has contributed to NCAPA and AAPA in numerous leadership positions over the years. We believe he is an excellent choice to lead the profession nationally as President-Elect and, ultimately, as President of AAPA. We encourage you to learn more about Jeff and his vision for AAPA and the PA profession by reading his platform statement. You must be a Fellow member of AAPA by March 1 in order to receive an election ballot. The election will take place in April. We urge you to consider Jeff Katz when you cast your vote!
By Chris Barry, PA-C, MMSc
Only a small percentage of PAs work in pediatrics or a pediatric subspecialty. According to AAPA’s just-released 2013 Salary Report, only about 3.4% of PAs work in general pediatrics and pediatric subspecialties. The reasons for the low percentage of PAs who seek a career in pediatrics are not completely known, but some possible reasons include: lower relative salaries, lack of comfort working with a pediatric population due to limited exposure in PA school, and lack of familiarity with the PA role in pediatrics by many physicians.
Through my volunteer position as AAPA’s Medical Liaison to the American Academy of Pediatrics (AAP), I have focused on increasing PA penetration into the field of pediatrics and increasing pediatricians’ familiarity with PAs. In 2010, AAP approved a by-laws change to allow PAs to join AAP as National Affiliate members, and in 2011, the first PAs began joining AAP as National Affiliate members, a category that currently does not include any other healthcare professions. In 2012, AAP News, a journal distributed to all AAP members, featured a cover story on PAs in pediatrics. AAPA and the pediatric specialty organization, Society for PAs in Pediatrics (SPAP), continue to partner with AAP on various projects, and share similar visions for pediatric medicine.
SPAP is a “small, but mighty” (in the words of my friend and former SPAP president, Alyson Smith) organization, and one that has grown since I was president of the group. SPAP offers PAs who practice in pediatrics a voice in the AAPA House of Delegates, along with networking and leadership opportunities, a quarterly newsletter, its own liaison to the AAP, and annual student scholarships. I am also proud to say that SPAP produces a top-notch pediatric-specific CME conference, with the 8th Annual SPAP Conference taking place in Cincinnati on March 7-9, 2014.
I didn’t always know I wanted to work in pediatrics. When I entered PA school, I had planned on going into either emergency medicine or family medicine. However, my very first rotation was pediatrics, and although I was nervous to start rotations, and even more nervous to be working with children, I immediately fell in love with the field. The children were so innocent and full of energy. I really enjoyed the interaction with both parent and child, and felt that I could really make a difference in a child’s life through preventive medicine. Surprisingly, instead of being afraid of me due to my height (6’5”), children seemed to be drawn to me. One of the greatest compliments I got during that rotation was from a parent who told me that “some people choose a profession, and others are called. You were called”.
During the rest of my rotations, I tried to keep an open mind about which field I wanted to pursue, but in my heart, I wanted a career in pediatrics. Towards the end of my PA training, I told one of my clinical preceptors that I really had a passion for pediatrics. He told me his child’s pediatrician was looking for a replacement for a nurse practitioner who was leaving the practice to be a full-time mother. I contacted the pediatrician, and soon landed my first job as a PA, where I worked for over five years. I learned a lot at this job, not only from my supervising physician, but also from the great nurse practitioners I worked with along with my patients.
PAs in pediatrics make a positive contribution to patient care, and we are well-equipped to meet the changes taking place with health care reform. Pediatrics is a challenging field of medicine, because there are almost always two (or more) people to treat at each visit—the patient AND their parent(s). Many people stereotype pediatrics as involving care only for infants, when in reality, we see patients from birth through 22 years in general, providing a diverse range of medical issues for PAs to manage. I have spent my entire 12+ years (so far) career in pediatrics, and I hope to continue in the field. I encourage anyone with a passion for pediatrics to follow their heart and go for it!
Chris Barry, PA-C, MMSc is a physician assistant at Jeffers, Mann, & Artman Pediatrics in Raleigh. Mr. Barry is a past president of the Society for PAs in Pediatrics, and the current AAPA Medical Liaison to the American Academy of Pediatrics.
Resources to help clinicians care for teens struggling with drug abuse were released January 23rd by The National Institute on Drug Abuse (NIDA). Resources include a treatment guide that highlights the clinicians’ role in identifying and supporting treatment and recovery, and an online module that provides videos on best practices for screening teens at risk for, or struggling with, drug abuse. In addition, NIDA offers a step-by-step resource that helps identify and manage substance abuse disorder in teens.
Thirty-one students completed the Physician Assistant Studies Program at Wingate University in December 2013. All of the graduates passed the Physician Assistant National Certifying Exam on first attempt. The national average for first-time test takers who completed a PA program in 2013 is 94%. Physician assistants are required to pass the certification exam prior to being licensed by state medical boards.
On October 18, 2012, Wingate University announced the approval from the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) to begin the PA program at the Hendersonville Campus. This synchronous distance education PA program welcomed its first class in August 2013.
If you haven’t yet renewed your NCAPA membership for 2014, now is the time. Otherwise, you’ll be saying goodbye to member benefits (including this newsletter) at the end of February. We don’t want to lose you! Renew online