In this issue:
By Charlene M. Morris, DFAAPA, MPAS, PA-C
May has arrived and promises to be an interesting month for PAs. NCAPA’s own Jeffrey Katz was elected AAPA President-Elect and NCAPA’s quarterly Board of Directors meeting was the first weekend in May. NCAPA’s new North Carolina Physicians Health Program (NCPHP) liaison, Daniel Mattingly, introduced Dr. Warren Pendergast, who spoke to our attendees about NCPHP’s programs. Dr. Pendergrast cited that almost half of currently practicing physicians are suffering burnout in our current medical climate. That number certainly can, and most likely does, reflect PAs as well. We must be vigilant to ourselves and our colleagues as problems can adversely impact our patients and our own safety. Visit the NCPHP website; their extensive services may be utilized by PAs as well as physicians.
The Board meeting included a premiere presentation showcasing Wingate University’s PA program by Ms. Ashton Youngers, a 1st year PA student. Future PA leaders are FLOURISHING in our beloved state. You could also be involved with NCAPA leadership. Call or e-mail me or contact our central office and express interest in becoming a volunteer. No matter how limited your time, NCAPA appreciates and will utilize your talents.
Members of NCAPA’s Government Affairs Committee have long attended NC Medical Board meetings to stay informed and provide information about PAs when requested. By the time this issue of The Pulse has been received, NCAPA President-Elect Marc Katz and I will have presented a concise power point to the NC Medical Board. Invited to attend their meeting to share information about NCAPA, this is a tremendous honor.
The AAPA National Conference is in Boston at the end of the month and a contingent of NC delegates will convene with PAs from all over the nation. The House of Delegates (HOD) issues are varied and poignant, including discussion about whether or not the descriptive word “supervised” should be supplanted with “collaborative”. Other issues include whether the House of Delegates should be deciding AAPA leadership after another discouraging year of member voter turnout. Gun safety and Direct to Consumer advertising concerns are also on the docket. For those who have never attended an AAPA meeting or the House of Delegates, it is a worthy endeavor and an eye opener about the workings of AAPA. CME offerings are abundant and to experience the powerful gathering of almost 10,000 PAs is energizing.
Until next month, enjoy the last of Spring, the longer days, and the beauty of NC!
Charlene M. Morris
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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. This NCAPA developed DVD series prepares medical examiners to perform DOT/CDL medical examinations according to the new FMCSA standards. Upon completion, you will be prepared for the FMCSA Medical Examiner Certification Test. This course is approved for 6 hours of Category I CME*.
“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, NCAPA Member & Past President
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. Purchase yours today!
*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 Sabrina Boyte, PA-C
Endocrinology was not a “calling” for me, but rather the right opportunity at the right time. I had been working in a Rural Health Clinic for a number of years and loved the job and my employer. The PA who owned the clinic decided to retire at the same time a local Endocrinologist was looking to expand her practice.
Because this was not my initial field of study, I had a steep learning curve. I read everything I could on Endocrinology. I went to every Endocrine conference I could find. I joined ASEPA. I tested my blood sugar 4 times every day and injected myself using syringes (saline). I wore every continuous glucose monitor and every insulin pump available in our area. That was 9 years ago. I’m still fascinated with advances in medicine and I’m excited by each small step we take toward a cure.
Continuing with the diabetes theme, I saw a young lady in consult for management of diabetes in pregnancy. She was on an insulin pump and currently 6 weeks gestation. Her history was that she had been diagnosed with type 1 diabetes at 3 months of age. I told her at that visit that the good news was she would do very well with her pregnancy as she was well controlled on the insulin pump. However, the better news was that she was not likely a type 1 diabetic and, once she delivered, we would test her for a form of Monogenic Diabetes known as Neonatal Diabetes and, if positive, she would no longer require insulin. Type 1 diabetes is exceedingly rare in a child under the age of 2. She went on to deliver a beautiful baby girl who was also diagnosed with diabetes at birth. That confirmed what we already suspected in the mother. Both mother and child tested positive for the KCNJ11 gene and both are now treated successfully with sulfonylurea therapy which is the treatment of choice for Neonatal Diabetes. My patient now speaks around the country to help educate medical professionals about Monogenic Diabetes.
Endocrinology is not always what it seems. We saw a middle-aged man in consult for diabetes. Of note on physical exam, he had a near complete absence of body hair. When prompted, he noted that he rarely had to shave but it was of no concern to him. Testosterone, LH and Prolactin were added to his routine labs. His Testosterone was undetectable, LH was normal and Prolactin was over 10,000. MRI of pituitary demonstrated macro adenoma. The patient contacted his brother, who he felt looked just like himself, and advised him to be tested as well. Remarkably, his brother had very similar biochemical and MRI findings. The two things I find most interesting here is that the patient had no concern about what we saw on exam, nor did he have any symptoms of sexual dysfunction or visual disturbance, and his brother had exactly the same issue without symptoms.
In closing, I would say that Endocrinology, though not my first job, has been the most rewarding undertaking of my career. Every day is a new challenge, keeping me interested and engaged.
The polls closed on April 30th and the votes are official – NCAPA is pleased to announce that our own Jeffrey Katz has been elected as President-Elect of the American Academy of Physician Assistants (AAPA). Jeff has contributed to NCAPA and AAPA in numerous leadership positions over the years and we know he will be an excellent leader of the PA profession nationally as President-Elect and, ultimately, as President of AAPA. Thank-you to all who voted in the election. And congratulations to Jeff Katz!
Nominations for 2015 Board Positions
The time is now for nominating yourself or a colleague to serve on the NCAPA Board of Directors for two-year terms that begin January 1, 2015. Positions open for nominations are: President-Elect (1 year, followed by 1 year as President and 1 year as Immediate Past President), Vice-President, Secretary, Director-at-Large (two positions) and Nominating Committee (one position). Please contact any of the members of the Nominating Committee or the NCAPA central office for additional information, questions, or to provide written nomination of candidates (must have nominee’s consent). The deadline is approaching. Written nominations must be received by June 1, 2014! Download the Nomination Form
We appreciate your involvement and support in making the PA profession vibrant and strong in North Carolina.
- Sandy Pierce (Chair) – email@example.com 828-645-4802
- Alisha DeTroye – firstname.lastname@example.org
- Jane Girskis – email@example.com
- Don Metzger – Donatc63@aol.com
- Joshua Smith – Joshua.firstname.lastname@example.org
- Cathie Feild (staff liaison) – Cathie.email@example.com 919-479-1995
Sandy Pierce, PA-C, Nominating Committee Chair
NCAPA welcomes Harvey Krape to our Board of Directors. Harvey was selected at the NCAPA Board Meeting on May 3 to fill the Director position left vacant by Billie Collins’ move from North Carolina. He began to participate immediately at the May 3rd meeting and will complete the term of service on December 31, 2014.
Harvey brings much experience to the table. His career as a PA spans 37 years, the last 20 years in western North Carolina. He is the current Vice President of the Far West regional chapter and employed at Smokey Mountain Urgent Care and Family Medicine Center. He is also a Board member and former chairperson of the Swain County Board of Health and DSS.
The interest in NCAPA, expressed by those stepping up to offer their time and gifts, is very appreciated. Let us all continue to work together to promote the growth of the PA profession in this time of flux in medical care.
by Wanda Hancock,PA-C, Membership Committee Chair
Over the years, I have heard many PAs ask, “What’s in it for me?” I get a little aggravated when I hear this because I know the real and intangible value of membership in the North Carolina Academy of Physician Assistants. But then, I also have to turn it around and ask myself, “What have I done to let others know what’s in it for them?” PAs are all about helping others. I feel that we also need to work a little harder to help ourselves, by helping others understand the true value of our organization. The truth is, I pay my dues, attend conferences, read my publications, pay attention to my emails, and go to the board meetings, but when it comes to letting others know about the good things NCAPA does for all of us, I fall short. Many other members of NCAPA do these same things, but do not take the time to make others aware of all that NCAPA does for them, each and every day.
The Best State Chapter
If I have a question about my practice or what is happening in our healthcare environment today, all I have to do is call our office. The staff does an awesome job of keeping up with the daily business of our organization. If they cannot answer my question, they know exactly who to contact who can meet my needs. They go out of their way to work with the volunteers to move along our projects. Officers or committee workers who have little experience in those rolls are mentored so that they can be their best.
NCAPA is one of the best run chapters of PA professionals in the country. There is no other chapter in the entire country that can say they own their own building. Last year, the Board of Directors decided to pay off the debt for the building and now it belongs to US. The Stead Center is a complete tribute to the PA profession. The history of our beginnings and great forefathers are showcased there. This did not happen like magic. The dedicated professionals in our state have contributed many hours and much expertise to make this possible. I have served on the Constituent Relations Workgroup for AAPA for the past 6 years, and I can attest that we have so much to be thankful for that our forefathers worked so hard to establish. There is no other chapter that can compete with NCAPA.
The Best Practice Laws
North Carolina PAs have the best practice laws in the country. People like Marc Katz, Lisa Shock, Gail Curtis, and many before them, have worked diligently over the years to make this possible. It is true that our practice laws are wonderful in North Carolina, but they were not always that way, and could change at any time. Our dedicated members who serve on the Government Affairs Committee assure that we are on top of any proposed changes to our practice laws or reimbursement, and we ALL BENEFIT from this. NCAPA has a retained lawyer to scan upcoming legislation and ensure that PAs are included at the table when matters of health care are being discussed. It is much easier to be included before legislation passes than to hope someone will listen afterwards. NCAPA has its (our) finger on the pulse of this.
The Best State Conferences
When it comes to continuing education, NCAPA again surpasses all other state organizations and at DEEP discounts. We have the largest, most complete, and diverse conferences of any other state. People from all over the country come to our Summer Conference, and if you have never been to one, you have missed a major event in your professional career. Our Conference Committee and Professional Development Review Panel (PDRP) work very hard at selecting great speakers and making our Summer Conference fun, educational, thrifty, and accessible. When it comes to re-certification preparation, the Winter Conference tops it off. Members of the PDRP spend numerous hours putting together a conference that is right on target to prepare you for taking that examination. I have only worked in specialty areas since becoming a PA. I have taken the Pathway II in the past and the thought of the PANRE had me shaking in my boots. I went to the Winter Conference to get prepared, and I passed with flying colors. They have revamped the program in the last 4 years with the help of program evaluations and NCCPA guidelines, and the information is right on. Over the past few years, DOT examinations have been a hot topic for PAs. NCAPA met the needs of PAs and other medical professionals by developing a training program offered in-person and on DVD to help them prepare to take the newly required exam to continue to give CDL physicals.. For all the conferences and workshops, members appreciate significant discounts over those who are not. NCAPA, again, has been there for us.
The Best Leaders
In addition to the government representation and continuing education, there are numerous negotiated discounts that are available to NCAPA members. We also have Honorary and Retired membership categories and reduced rates for students and recent graduates. All of this has been developed to help us help each other. How many state organizations can say that they have two members in AAPA leadership at one time? NCAPA does, and this is in part because our state organization has leadership development and active members who are truly committed to the progress of our profession.
Just think that by encouraging someone to join, you can make a tremendous impact on them, as well as our organization. When I moved from South Carolina to North Carolina, all it took to get me started was one phone call from a fellow member to ask that I join. Just think, it could be you making one phone call to get others started on the pathway to a more fulfilling career. Networking with my fellow PAs in North Carolina through NCAPA has helped me in getting the position that I wanted, and getting through the licensing process initially. I am sure that there are PAs you see every day who only need to be asked to join. When I consider all that I have been provided by my NCAPA membership, the most important to me is that being a PA has become a career, not just a job. I want that for all PAs in North Carolina. We need to reach out to those who are not members and encourage them to join. Visit our website and see all the other benefits of membership and encourage those you work with to join and help us help us.
So when I hear someone ask “What’s in it for me?” my first thought is what’s not in it for them? If there is something I want from NCAPA, all I have to do is look or ask and it is there.
Time is running out! June 11 is the deadline to apply for 2014 NCAPA Endowment Scholarships. You must be a current member of NCAPA and be entering or enrolled in your second or final year in a physician assistant program in the state of North Carolina in 2014. To be considered, we must receive your completed application, done either online or by mail, and an official transcript from your PA program. Official transcripts (no copies please) should be mailed to:
NCAPA, att. Kat Nicholas, 1121 Slater Road, Durham, NC 27703.
Applications and official transcripts must be received or postmarked by June 11, 2014. Applications may be submitted by USPS, fax, or online.
Twenty-nine students, representing five PA programs in the state, competed on four randomly selected inter-collegiate teams in the 2014 Student Medical Challenge Bowl. The event was held on Saturday, April 26 and the sun was shining, the pizza was hot, and there were plenty of sodas and chocolates to keep everyone going. Everyone was geared up to have some fun and fun is what we had!
The Challenge Bowl is a Jeopardy-style game with two rounds of play, each with five categories of questions ranging in point values from 5-25 points, with a number of “daily doubles” thrown in. Buzzer technique and strategic wagering on Final Jeopardy are key, as is phrasing the answer in the form of a question. Question categories included neurology, dermatology, anatomy, physical exam, PA history, cardiology, pulmonary, EENT, musculoskeletal, and gastroenterology.
Samantha Rogers, chair of NCAPA’s Student Affairs Committee, served as the MC for the tournament. Cathie Feild, NCAPA Executive Director, was the buzzer-master and Kat Nicholas, Director of Membership and Marketing served as scorekeeper and game-board up-dater.
The four teams displayed great sportsmanship and demonstrated superb collaboration skills while deliberating their responses to the questions. At the end of Round 1, teams 1 and 4 were tied for first place. After a brief interlude, Round 2 began and finished with Final Jeorpardy. All teams answered the final question correctly and bid wisely. Team 3 made a great comeback from last place, but Team 1 held the lead and took first place with Team 4 as a close second.
The game was fun, challenging, and educational (especially the PA History category!) Perhaps the best part was the opportunity to meet fellow PA students from the various North Carolina PA programs and get to know a little about each other. A number of the participants in this year’s NCAPA Challenge Bowl plan to put their state-level experience to good use as they compete in the AAPA Challenge Bowl later this month.
Students participating in this year’s Challenge Bowl included Duke students, Bethany Applebome, Lacey White, Julia Chen, John Vrnak, Christina Cady, and Matthew Klein; ECU students, Rebecca Salman, Savannah Sipperly, Amy VanEgmond, and Ashley Pragosa: Elon students, Jaclyn Stevens, Lindsay Finch, Krista Meier, Arezu Shekari, Andy Tillery, and Justin Ollis; Campbell students, Braxton Kinsey, Christine Ciszek, Leighanne McGill, Kristina Hendley, Aimee Sharp, Krista Udd, Natalie Jones, and Kaley Morris; and Wake Forest students, Julie Martin, Erica Hill, Jacquelyn Allen, Bharath Balu, and Kelsey Blaine.
by Bowie Tran, MMS, PA-C
On May 1st, PAPA, with support from the NCAPA Endowment and Hospice and Palliative Care Center, held a Memorial Event for Mark Sizemore and Mandy Dozier at Forsyth Country Club in Winston Salem. The event was to honor and pay respect to two influential friends, colleagues, and past Presidents of the Piedmont Association of Physician Assistants (PAPA) who have passed away. I just want to take a moment to talk about Mandy Dozier, whom I regard as my wonderful mentor.
When I was a PA student attending my first PAPA dinner, Mandy immediately approached me at the dinner and struck up a conversation. She instantly made me feel welcome to the group. From that point on, she became a mentor to me, sharing stories of her PA career, allowing me to spend a month with her on a clinical rotation, and encouraging me to be more involved with our profession. Mandy was the epitome of what a PA should be: competent, caring, and compassionate. Mandy recently passed away after a long battle with cancer. During the Memorial Event, I was able to meet and share my condolences with her family. I also had the opportunity to meet the Sizemore family who was in attendance. I did not know Mark Sizemore personally, but I appreciate the positive impact that Mark made. The Memorial tribute to these two individuals was heartfelt.
The event incorporated a CME I talk on Palliative Care in Oncology from Dr. Nathan Streer of Wake Forest Baptist Health, which was insightful and appropriate for the occasion. There were over 30 members in attendance for this event. I want to give thanks to those that were involved in putting together this event and to those that attended.
Information from AHRQ
May is National Stroke Awareness Month, a great time to share AHRQ’s Effective Health Care (EHC) Program heart disease resources for both health care professionals and patients.
Health Care Professional Materials: Clinician summaries of comparative effectiveness research findings quickly give health care professionals the clinical bottom line for heart disease-related topics-
- Use Versus Nonuse of Dietary Supplements in Adults Taking Cardiovascular Drugs
- Effectiveness of Self-Measured Blood Pressure Monitoring in Adults With Hypertension
- ACEIs, ARBs, or DRI for Adults With Hypertension
Patient Materials: Plain-language summaries help patients explore treatment options for heart disease, compare the benefits and risks of these options, and prepare to discuss their options with their health care provider-
- Taking Dietary Supplements With Heart, Blood Pressure, or Cholesterol Medicines: A Review of the Research for Adults
- Measuring Your Blood Pressure at Home: A Review of the Research for Adults (Also available in Spanish)
- Choosing Medicines for High Blood Pressure: A Review of the Research on ACEIs, ARBs, and DRIs (Also available in Spanish)
For additional health information and more resources on heart disease, visit www.ahrq.gov/treatmentoptions for patient resources and www.ahrq.gov/clinicalbottomline for clinician resources. You can also subscribe to the EHC Inside Track newsletter for regular updates of new materials that objectively compare the effectiveness of treatment options for many common conditions.
Congress of Neurological Surgeons
The number one neurosurgery self-assessment is now available for physician assistants! These exams have been approved for AAPA Category 1 Self-Assessment CME. SANS Exams are designed to help educate both doctors and their PA staff on assessing the latest guidelines, evaluating medical knowledge, and recognizing the latest evidence in the treatment of various neurosurgical disorders across various subspecialties such as spine, tumor, trauma, critical care, pediatrics, cerebrovascular and functional disorders in addition to non-clinical core competencies.
Physician Assistants can earn up to*:
General SANS Examination – up to 24 CME Credits
SANS: Spine – up to 24 CME Credits
SANS: Pediatrics – up to 24 CME Credits
SANS Competencies – up to 10 CME Credits
SANS Neurotrauma – up to 10 CME Credits
Visit sans.cns.org to learn more and start using this valuable resource today!
*This Self-Assessment CME program has been reviewed and is approved for a maximum of number of CME credits listed above AAPA Category 1 Self-Assessment CME credits by the Physician Assistant Review Panel. Approval is valid until March 31,2016. Physician Assistants should claim only the credit commensurate with the extent of their participation in the activity. This program was planned in accordance with AAPA’s CME Standards.
The Centers for Medicare & Medicaid Services issued a rule on May 7 that provides regulatory relief for PAs and physicians who deliver care in rural communities. This advances a federal initiative to remove burdensome and unnecessary regulations.
The final rule eliminates a requirement for a physician to be physically on site once every two weeks at certified rural health clinics, federally qualified health centers and critical access hospitals (CAHs). PAs will continue to follow state law and facility policies.
Two additional issues in the rule include:
- Confirmation of existing CMS policy that PAs may be members of a hospital’s medical staff.
- Elimination of a requirement that CAH physicians review outpatient medical records at least bi-weekly for patients treated by PAs (or NPs). CMS will now defer to state law on this issue.
Ensuring patients receive timely access to medically necessary, high-quality care is the goal behind the federal effort to remove regulations that are outdated, don’t lead to improved patient care or are no longer reflective of the enhanced manner in which PAs deliver care.
For additional information contact Michael Powe, AAPA vice president of reimbursement and professional advocacy, at firstname.lastname@example.org.
Centers for Disease Control and Prevention
A Centers for Disease Control and Prevention study has looked at how primary care providers were varied by state in 2012. Primary care providers studied were primary care physicians, PAs and nurse practitioners. Primary care physicians are those in family and general practice, internal medicine, geriatrics and pediatrics.
Key findings include:
- The supply of primary care physicians per 100,000 population varied by state, with the national average at 46.1; In 2012, North Carolina was at 38.7.
- Compared with the national average of 53%, the percentage of physicians working with PAs or NPs in North Carolina was 78.6%
- PAs and NPs are more prevalent in rural and underserved areas, which have fewer primary care physicians.
- A higher percentage of primary care physicians in multispecialty group practices worked with PAs or NPs (77.5 percent) compared with those in small (solo or partner) practices (36.3 percent).
Read the full report here.