In this issue:
By Charlene M. Morris, DFAAPA, MPAS, PA-C
The AAPA Conference in Boston was a measured success. In the House of Delegates, it was confirmed that PAs work in a collaborative practice. This change occurred as a result of the Veteran’s Administration changing verbiage in December of 2013, responding to expanding numbers of patients, yet not necessarily more staff. Regardless, this benefits our profession. The use of associate instead of assistant seems untenable, yet a commitment to utilizing the term PA in lieu of Physician Assistant was encouraged. Several other initiatives passed without issue, yet gun safety again was scrutinized, albeit with mostly careful and polite discourse.
Other issues from the HOD meeting are listed below. Please ask if you are interested in details.
- Elections for AAPA will remain with the members instead of the smaller HOD group.
- Capping the number of chapter representatives was defeated as our Constituent Organizations expand
- Change to the number and ratio of student reps as programs likewise grow and thrive was accepted
- Discussion of electing of alternate delegates for HOD is subject to ancient (past AAPA) rules and as such, is being scrutinized.
What I found heartening was the impressive presence of PAs from North Carolina. Gail Curtis is our House Speaker, Samantha Rogers and Sandra Keavey were on reference committees and Linda Sekhon, the new High Point University Program chair, was the AAPA Election Committee chair. Future AAPA president Jeffrey Katz, also from NC, was in attendance, with Past AAPA President Robert Wooten absent but with us in spirit.
Did you know if you have a concern that should be addressed on a national level YOU can address your HOD delegates directly? Please keep that in mind as the 2015 session is already being formulated. The new watchword for the HOD is “nimble,” and as such, we may soon have an electronic 365 day per year HOD.
Poster sessions at the conference were plentiful and impressive, with probably half of these submitted by students. I enjoyed seeing the topics that explored everything from orthopedics, social values, surgery techniques and pitfalls, to state issues including advances and continued barriers to care. A plea was extended to support the AAPA Political Action Committee (PAC) which, using our funds, furthers our cause as practicing PAs. If you have not, please do consider signing in and donating!
Perhaps the highlight of my AAPA conference experience was the Veteran’s program and reception on Memorial Day. Featured speakers included a Duke student alumnus, Dixie Patterson, PA-C,who had volunteered at the medical tent during the 2013 Boston Marathon bombing. She related a combat worthy emergency situation with shrapnel, injuries and, sadly, deaths. A runner herself, she understood the pain and pandemonium of those losing limbs and life as they knew it. Motivated by that experience, PA Patterson ran this year’s Boston Marathon and for every one of her 26.2 miles, she reflected on the six dead, yet also the survivors and their strength in surmounting what was a veritable battlefield.
I also met Rod Richmond, a PA from Nashville, Tennessee, who writes and performs country songs. He had prepared an original composition for the emotional meeting of recollection and reflection of those who serve in our military.
Summer arrives this month and, with it, promises of summer bounty from our gardens and farms, as well as the NCAPA Annual Summer Conference in Myrtle Beach, August 17-22. Join us and earn your CME by attending great workshops and sessions, while also enjoying a wide variety of activities on the beach. If you golf, plan on participating in the annual NCAPA Endowment golf tournament. There are fun runs for children and adults, as well as horseshoes and other beach activities. I hope to see you there!
Charlene M. Morris, PA-C
Embassy Suites, Kingston Plantation, Myrtle Beach SC August 17-22, 2014
Combine high quality CME with a family friendly beach vacation! The NCAPA has planned a great CME agenda, click here for the full schedule of events.
Don’t forget to make your hotel reservation soon! Our room block is filling up. You won’t want to miss out on our low negotiated rates!
As of May 21, 2014, all medical examiners who wish to provide DOT/CDL exams must meet Federal Motor Carrier Safety Administration (FMCSA) training and certification requirements. NCAPA has developed a DVD series that meets the FMCSA training requirements. Upon completion, you will be prepared to take the FMCSA Medical Examiner Certification Test. This course is also approved for 6 hours of Category I CME*.
The DVD series includes 4 DVDs and a Course Workbook. A Post-Test & Answer Key with feedback will be e-mailed to you as well.
Read what other PAs are saying about NCAPA’s training:
“Thank you for producing an excellent DVD based course which was very helpful in passing the FMCSA Certified Driver Medical Examiner National Registry Examination. The lectures, review materials and summary of waiting periods are well organized and geared for Physician Assistants.”
Nelson Zec, PA-C
“I was unable to attend an in-person class, so I ordered the NCAPA’s DVD set to gain my required Certified Medical Examiner training. This program exceeded my expectations in every way. The information presented was clear and thorough, and all of my questions were answered during the program. The accompanying written materials were a great supplement to the information provided by the lecturers, and will be a resource I use often in my clinic. I would recommend this affordable DVD program to anyone who cannot easily attend an in-person class.”
Ryan Vann, PA-C
*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.
By Jeff Katz, PA-C, Chair, NCAPA Policies and Procedures Committee
At the May 4, 2013 NCAPA Board of Directors’ meeting, then President Don Metzger charged the NCAPA Student Board members with developing a proposal for student representation on the Board as the number of PA programs in North Carolina increases and the academic calendars of the programs are increasingly diverse. Currently, each PA program elects a member of its incoming class to serve as a representative on the NCAPA governing board. At this time, there are eight PA programs operating in NC and four more programs have applied for ARC-PA provisional accreditation. The student board members, as a group, are allotted a total of two votes on the governing board.
The student directors presented a proposal that requires amendments to NCAPA’s Bylaws. The process for amending the Bylaws requires approval by the governing board at two consecutive Board meetings, followed by presentation to the NCAPA general membership for a vote. The changes were approved by the NCAPA Board on January 25 and May 3, 2014, and will be brought to NCAPA members for a vote at the regularly scheduled annual membership meeting being held Monday, August 18, at 8:00 a.m. at the Embassy Suites Hotel at the Kingston Plantation in Myrtle Beach, SC. As required by the Bylaws, this will serve as notice that an amendment to the Bylaws will be considered at this meeting.
By Cathie Feild, Executive Director
Below is an article published in PAs Connect about how a piece of legislation that could be damaging for PAs was approved in the final week of the Missouri legislative session. Think it couldn’t happen in North Carolina? It could. We urge every member to recruit just one non-member to join NCAPA. With your help, we can maintain a strong organization with our “finger on the pulse” of what is happening in the healthcare legislative and regulatory arenas in NC. We must be ever vigilant to protect PA practice.
AAPA and MOAPA update for PAs on Missouri legislation
from PAs Connect
On May 16, in the final hours of its 2014 session, the Missouri state legislature passed Senate Bill 716, a comprehensive bill amending several public health laws. AAPA joins with the Missouri Academy of PAs in being extremely disappointed the bill contains language authorizing the Missouri Board of Healing Arts to license medical school graduates that have not completed a residency as “assistant physicians,” practicing within the confines of a collaboration agreement with a physician and restricted to providing primary care services in rural and underserved areas. The bill also states the federal government should consider “assistant physicians” practicing in Rural Health Clinics to be considered “physician assistants” for the purpose of CMS regulations. Both AAPA and MOAPA were actively engaged in opposing this language since its proposal in a standalone bill (HB 1842). Read the full details on PAs Connect.
Reflections of a PA Student,by Kondie Lykins, PA-S
Campbell University, Class of 2015
I was glad I went to Boston. The AAPA conference was everything they promised it would be. Thanks to the wonderful lectures, I came home with new knowledge for my studies; thanks to the exhibitors, I came home with a couple dozen ink pens. I even snagged a few a ribbons for my kids, ‘PA Diva’ for the girls and ‘PAs Rock’ for the boys. But the last 28 hours were almost like an extended OSCE.
By Tuesday, I had walked many miles going to the conference center, through the conference center, back to my hotel, and a few visits to historical sites. I had to check out of my hotel by 11am, but still wanted to attend a few more lectures, so I ended up carrying my gear with me for most of the day. By the time I left for the subway to the airport, I was experiencing muscle fatigue in the shoulders and legs.
The first exercise that day was dealing with a difficult patient. Do you know you aren’t supposed to take pictures of street performers unless you pay them? I wish I knew that before I took the picture. The performers recognized an out of town country-bumpkin and were willing to let it go, but a nearby good citizen wasn’t so inclined. I first had to calm her down and try to explain that I had no cash and the street performers were not set up for debit cards. I offered to erase the picture from my iPad, but a compromise was reached when I remembered I had about 30 cents of change in my pack.
Once I reached the airport, I got to diagnose personality disorders on my fellow travelers when it was announced our flight would be delayed an hour. I then had the opportunity to do more assessments when, after being seated on the airplane, our flight was delayed another two hours before we ever took off.
Upon arrival in Chicago (why we go from Boston to Raleigh via Chicago I still haven’t figured out), I got to experience how NOT to give bad news when the airline employee flatly informed me the last connecting flight to Raleigh left about the same time I had left Boston. She told me the next available flight was scheduled for 7am the next morning, and then, “Next!” “Wait,” I interrupted, “what am I supposed to do for the next eight hours?” I was told there were cots at K1. I was left to figure out on my own that K1 was a gate. I was currently located at B12.
By the time I arrived at K1, I had self diagnosed exhaustion and dehydration as the progression of mild shoulder pain turned to borderline, severe pain. The cots looked like a refugee camp. They were lined up side by side and provided way too much personal space intrusion with complete strangers. Plus, I knew about infectious diseases brought in by world travelers, and chances were good that many of the occupants of the cots had come from various parts of the world. My biggest concern, however, was obstructive sleep apnea. I suddenly noticed all of the middle aged, overweight males with bull necks. This was portending to a poor outcome for my night’s sleep.
My flight the next morning was departing from K19. I decided to spend the night down there. “There are mice in the airport,” I was warned. I love meeting people and experiencing different cultures; nevertheless, I silently resolved to skip the K1 refugee camp and take my chances with the ‘insurgents’ at K19. I found a fast food joint still open and doubled my Total Cholesterol count.
Stage 1 sleep is difficult to reach on a concrete airport floor. Deeper stages are impossible. I spent the night determining which nerve was being occluded based on the tingling sensations in my fingers, hips, and legs. “C7, T4, L3,” etc. I noticed another traveler who decided to skip the refugee camp. Based on the way his arm was draped over his bag, I guessed his ring finger and pinky finger would be tingling at any moment. I was becoming afraid that, by morning, sleep deprivation would degenerate to full blown, acute psychosis.
On the fight the next morning, I discovered stage 1 sleep is also difficult to achieve when sitting bolt upright in a crowded airplane. I walked off the plane in RDU and began self assessing: positive for HA, joint soreness, but otherwise musculoskeletal was intact. I continued with a mini mental exam and found some ominous signs. Three objects the patient is supposed to repeat back to the clinician: First, in which terminal did I leave my car? Second, which level? Third, which row? My recall was deficient in all three. In fact, it was absent. I discovered another hole in my clinical abilities: I had failed to document these vital bits of information. The good news was that there are only two terminals at RDU airport, they each only have seven levels, and my musculoskeletal system was still intact.
After making my initial assessment, I began pondering the next step in my plan (make that, the next many steps). Yet, as I was walking from my gate, I saw something that changed my entire attitude.
Walking towards me was an older gentleman, next to him was a young man. They were walking silently towards the arriving aircraft. Neither had luggage. Both were dressed in Marine Corps dress uniforms, complete with spit shine shoes, medals and ribbons. The older gentleman had insignias on his shoulder boards that identified him as a high ranking officer. “An odd way to travel,” I thought as they passed. Then I saw eight more Marines in full dress uniform walking in formation, in step, silently and somberly. In my impaired cognitive state, it took a minute for me to realize what I had seen. When the pieces finally connected through the mental fog, I was jolted awake.
Someone is coming home…for the last time. I was stunned for a moment, wondering if the fallen Marine had been on my flight. No one had mentioned anything like this, but my flight was the only one back there.
So, the last question of my extended OSCE: If I were the one asked to deliver the bad news to that mother or father, spouse or child…what would I say? What do you say to a family whose loved one had sacrificed their life for someone else’s Freedom? The Freedom to get on planes and go to conferences, to go to school, to practice their chosen religion. The Freedom from tyrannical regimes.
I don’t know many details of how that conversation should go. One detail, however, I had figured out before I walked ten more steps. I would probably be on one knee to maintain the same eye level with the family, as I’m sure they would be seated. I would try my best at a healing touch, either holding a hand or with a hand on their shoulder. I would look into their tear filled eyes, match them with my own, and very sincerely say, “Thank you.”
Each year, the NCAPA hosts a Student Leadership Retreat at the Stead Center in Durham for student members from all PA programs in North Carolina. This year’s event will be held on Saturday, November 1st. This retreat is designed by the student representatives who serve on NCAPA’s board, and is geared specifically to the unique concerns of PA students who are preparing to enter the profession. Students should mark their calendars now! Further information will be available in the Fall from your NCAPA Student Representative, as well as here in The Pulse.
Wikipedia is one of consumers’ top online sources for health information, and about half of physicians admit to having used it as a reference. However, a new study published in The Journal of the American Osteopathic Association suggests the medical information found on Wikipedia is often inaccurate.
Researchers analyzed the Wikipedia entries for 10 of the most costly medical conditions in the U.S. in terms of both public and private expenditures as identified by the Agency for Healthcare Research and Quality: heart disease, cancer, mental disorders, trauma-related disorders, osteoarthritis, chronic obstructive pulmonary disease/asthma, hypertension, diabetes, back problems and hyperlipidemia.
The researchers and other physician reviewers fact-checked information found in the articles against peer-reviewed medical literature.
The study found “significant discordance” between information presented in nine of the 10 Wikipedia articles and the corresponding medical literature. Just the entry on trauma-related disorders (the Wikipedia article on “concussions”) was found to be mostly accurate.
from the NC Medical Board
The North Carolina Medical Board (NCMB) has revised its Policy for the Use of Opiates for the Treatment of Pain. The new policy can be found here.
from AAPA Medical Watch
The Centers for Medicare & Medicaid Services adopted a regulation on May 23, that aims to prevent prescription drug fraud and abuse. The regulation will go into effect on Jan. 1, 2015. The final regulation requires all Medicare Part D prescribers, including PAs, to:
- Be enrolled in Medicare as a condition of coverage for those prescriptions
- Have a valid Drug Enforcement Agency certification (not suspended or revoked)
- Be in good standing with state medical licensing boards
CMS is authorized to revoke a prescriber’s Medicare enrollment if his or her state license or DEA certificate of registration is suspended or revoked.
As one of our member benefits, NCAPA has arrangements with two insurance companies to help our members get the disability and professional liability insurance coverage they need. We encourage you to contact the following companies for more information:
MassMutual—disabilty and long-term care insurance
Contact Sean Godwin
Healthcare Providers Service Organization (HPSO)—malpractice insurance
By Samantha Rogers, PA-C, MMS, NCAPA Director at Large
As we seek to broaden the public’s awareness of the PA profession, it was exciting to see one of my recent graduates quoted in a reputable and far reaching publication- the Wall Street Journal. Stephanie Marcum, a student member of NCAPA, was quoted after the Commencement Exercises at Wake Forest on May 19th, 2014. The speaker that day was Jill Abramson, the former executive editor of the New York Times. She candidly acknowledged that, like the graduates, she also had no idea what was next for her. Marcum’s reaction as quoted in the Wall Street Journal, “It is tough to lose a job and stay confident . . .It is helpful to hear her encouragement.”
Read the complete story here.