In this issue:
by Samantha Rogers, PA-C
I hope that many of you are heading to New Orleans this week for AAPA’s Impact conference.Your NC Delegation is looking forward to an always exciting and thought provoking House of Delegates! Thank you to those who attended the April Board meeting and offered your feedback on the Resolutions that are coming before the House this year; we desire to represent NC PAs as best we can. This will be my 5th consecutive year serving in the HOD and it is an experience I highly encourage you to consider. We have elections every 2 years, with the next occurring in the Spring of 2019, so please watch out for emails on this and consider running. If you have no idea what the HOD is, please come by during the AAPA conference and spend some time watching and listening to how things are going. All conference attendees are welcome to sit or stand in the back of the room and take it in. I would love to speak with you personally and explain what all is going on and I know that our Executive Director, Emily Adams, would also appreciate that conversation, so don’t hesitate to find either of us and learn more.
NCAPA, in collaboration with our Regional Chapters, has begun our schedule of Listening Sessions regarding OTP and, so far, we are pleased with the attendance and the feedback we have received. Please look at the dates that are offered and make plans to attend one in your area. I am looking forward to traveling to parts of the state I am in less frequently to meet you and learn what PA practice is like for you and how NCAPA can serve you even better.
Lastly, May 30th is coming! We hope you’ll join us for PA Day at the NC Legislature in Raleigh. This is valuable time for you and our profession. We look forward to see you that day!
Samantha Rogers, PA-C
by Sarah Wolfe, Assistant Vice-President, McGuire Woods Consulting
NCAPA’s Government Affairs Committee met on May 1 in order to prepare for the 2018 legislative session, which begins on May 16. While there is no deadline on how long the legislature may meet for session, legislators have stated that they plan to adjourn before the next fiscal year begins on July 1.
As outlined in our strategic plan, the NCAPA board approved the 2018 Legislative Agenda, which will inform our legislative position statements. The Government Affairs Committee used this framework to draft NCAPA’s legislative priorities and position statements. These statements will be released prior to PA Day at the Legislature, so stay tuned for an email in the next couple of weeks.
NCAPA has been working with the North Carolina High School Athletic Association (NCHSAA) over the past couple of months in order to resolve an issue that resulted from the Gfeller-Waller Concussion Awareness Act, which became law in 2011. The law requires any student that exhibits signs or symptoms of a concussion to not be allowed to participate in school athletics until they have been evaluated and cleared by a physician, a neuropsychologist, an athletic trainer, a PA, or a NP.
NCHSAA, which is responsible for carrying out this law, has interpreted the law to only allow for physicians to sign off on the Return to Play form. Therefore, NCAPA met with NCHSAA on two separate occasions to remedy what NCAPA believes is contrary to the law. The North Carolina Medical Society and the North Carolina Pediatric Society had both submitted letters of support for NCAPA’s request, as well. Ultimately, NCHSAA chose to reject NCAPA’s request for PAs to be able to sign the form, which we believe is not consistent with the law. The Government Affairs Committee has plans to continue working to remedy this issue.
In the meantime, be sure to check the Legislative Action Center every week, in order to stay up to date on the latest happenings at the North Carolina General Assembly.
And don’t forget! This year’s annual PA Day at the North Carolina Legislature has been scheduled for Wednesday, May 30, 2018. Join your PA colleagues from across the state in advocating for the PA profession at the state legislature. As the providers keeping our neighbors healthy across this state, your voice is extremely important in the public policy process! The deadline for registering to attend this event is Monday, May 21st. For more information or to sign up, go here.
by Alexandra Godfrey, PA-C
The child lies across her mother’s lap. Her eyes are hollow, and I hear the rattle of her breathing. She’s tachypneic, tachycardic, and febrile. Her right lung wheezes and crackles, and her tongue sticks to the roof of her mouth. Her name is Elisa. She is four years old.
Elisa sustained a traumatic brain injury in a car accident when she was two years old. Now she can neither walk nor speak. She has struggled with multiple illnesses, and this time her family cannot get her to eat or drink. Without aggressive intervention, I think Elisa might die. I want to transfer her to the hospital for a higher level of care. This would be an easy decision in America. However, today I am not in America. And the usual rules do not apply.
I am working as a PA in a pop-up clinic in the remote mountain village of Paraxquim in western Guatemala. The road to the village is a track winding steeply up the mountainside along a precipitous drop. Trash litters the roadside, and the pungent smell of rotten debris on the rugged climb made two of our team vomit. We created our clinic in the village hall. Clothes pegs, drapes, and string make up our “rooms.” We examine patients on school desks placed end to end, their heads on ink wells and their feet against the wall. We lack access to labs, imaging or specialist services. We have medicines, the usual equipment for vital signs and ourselves. I have already splinted a fracture using tongue blades, bandages and tape and sent a man with angina home with lisinopril, aspirin, and a prayer.
A septic child? I felt a tightness in my chest and a sinking feeling in my stomach. To transfer Elisa from the clinic, we would need to use our own vehicle and leave some of our team behind. The hospital is hours away. Would she even make the journey?
At the hospital, the family would need to pay upfront: initial evaluation, lab work, X-rays, medicines, time in the hospital. Guatemala’s Constitution supports healthcare for all, but government funding is among the lowest in the world, and close to half the population has no access to care, struggling with pneumonia, heart disease, intestinal parasites, malnutrition, inadequate housing, and poor sanitation. Elisa’s family lives in a hut with a dirt floor on around $10 per week. Either we transport the child using our own limited funds to pay for her care and leaving the remaining villagers to fend for themselves, or we treat her here knowing that she might not survive.
I initiate care. I give Elisa Zofran, Tylenol, fluids and our only gram of ceftriaxone. I ask her family to stay with us in the clinic so we can monitor her progress. About mid-day, an experienced paramedic on our team approaches me. He wants to talk about Elisa. He rubs his forehead, then opens and closes his mouth as though struggling:
“If we use all our resources on Elisa, what happens to those we won’t be able to treat? What quality of life can this child expect, at best?”
He’s an amazing clinician and educator, and I appreciate his questions. Still, I sense that I am being asked to make value judgments on a life. I have a child with a severe and chronic illness myself, so this touches me personally. I, too, have faced my child’s mortality. I wonder if anyone ever questions my child’s value. My instinct is to treat Elisa as I would my own. But she isn’t my own. We aren’t in America. This isn’t my family. I must consider not only the best interests of this child, but also the team and community. I think we all have life experiences that make us particularly sensitive to a particular condition or presentation. And I recall the advice from my first job in emergency department:
“Alex, remember while you are giving everything to one patient, someone else in the waiting room might end up with nothing.”
I check on Elisa often. I note that her temperature is coming down. Her breathing improves, and by the end of the day she starts to tolerate oral fluids. This is a real breakthrough. As the day draws to a close, her vitals have all returned to normal. She is still very sick, but she looks much better. I tell the team that Elisa might be okay if we supply her family with antibiotics, anti-pyretics, Albuterol, anti-emetics, Pedialyte and some sort of nutrition. I think the journey to the hospital might pose a bigger risk to her and her family. Part of me wants the others to question my judgment. But they don’t. Their trust astounds me.
I look at Elisa sleeping comfortably on her mother’s lap. I think, better to die here in the safety of your mother’s arms than in a strange and distant place.
We leave the village that evening. We will never know whether or not Elisa survives the night.
The PA profession continues to grow and evolve as demands on our healthcare system and providers change. NCAPA is working to ensure that the PA practice environment and laws in North Carolina meet the needs of PAs in this changing environment. We need your help to be successful!
NCAPA, in conjunction with NCAPA Regional Chapters, will be holding PA Listening Sessions across the state to share more details regarding Optimal Team Practice (OTP) and hear your questions or concerns. To find out where and when the sessions will be held and to RSVP, please visit our website. We look forward to hearing your thoughts and ideas.
Once the sessions are complete and we have an understanding of what PAs in North Carolina want, advisory groups will be formed to make recommendations regarding each of the 4 pillars of OTP, ideally resulting in a modern practice environment that emphasizes team-based care and ensures North Carolina is the best state to be a PA.
August 19-24th, 2018
Embassy Suites, Kingston Plantation
Myrtle Beach, SC
Early Bird Pricing through May 31st!!
NCAPA combines the best CME conference for PAs (and NPs!) with a family-friendly beach vacation. We start and end our sessions early so you can have the best of both worlds!
NCAPA has reserved a block of rooms at the Kingston Plantation in Myrtle Beach. Rooms in our block fill up very early, so we recommend you book your room ASAP! You may reserve your room by clicking here or by calling the resort directly at (843)449-0006.
Saturday, June 9th
8:30am – noon
Duke University PA Program, Durham, NC
The NCAPA, in collaboration with the Duke University PA Program, is pleased to offer a beginner’s point-of-care ultrasound (POCUS) workshop led by regional POCUS experts from Duke University Medical Center. This 3-hour workshop will provide an overview of broadly useful exams, including soft tissue, musculoskeletal, and early obstetric ultrasound. Attendees will receive didactic instruction on the fundmentals of POCUS, followed by small-group, hands-on sessions with live models and a high-fidelity ultrasound simulator. Space is very limited, register today!
by Kat Nicholas, Director of Membership and Marketing
On Saturday, April 14th, PA students from all over North Carolina gathered at the Stead Center to attend the 2018 Student Medical Challenge Bowl.
Every year, NCAPA staff and the Student Affairs Committee try hard to find a date that works best for the largest number of programs, realizing Spring can be difficult with exams and Spring Break. This year, 9 out of the 11 PA programs in the state were represented – our best showing yet! Due to the large interest and some dedicated volunteers, we decided to switch things up this year. First and foremost, Student Affairs committee members Molly Calabria (Chair), Laura Gerstner, and Betsy Melcher, took on the onerous task for creating brand new Challenge Bowl questions, as our previous batch had not been updated for quite some time. And, not only did they update the previous categories’ questions, they created three new ones, resulting in a total of 13 categories! Categories included the original ten: Cardiovascular, Pulmonology, EENT, Musculoskeletal, Gastrointestinal, Neurology, Dermatology, PA History, Anatomy, Physical Exam; and three new: Reproductive System, Infectious Disease, and Pediatrics.
Students were divided into six inter-collegiate teams so that members could network with PA students from other programs. In previous years, all teams played all rounds, ending with a final “Jeopardy” question. This year, we tried something a bit different, with three teams playing the first round, three different teams playing the second round, and the winning team from each round playing the third and final round.
The winning teams playing in the final round, were No MRSA and The Pulse, with The Pulse for the win. No MRSA placed second, Syncopy or Swim tied with the Glute Kickers for third, followed by the Gila Monsters and Kick Acidosis.
Another exciting and fun Challenge Bowl, readying our NC PA Students for the National Challenge Bowl at the AAPA Conference. Best of luck to all of you headed to New Orleans!
by NCAPA Nominating Committee
The NCAPA Nominating Committee is currently soliciting candidates for the 2019 Board of Directors and Nominating Committee. Serving on the NCAPA Board is an important way to contribute to your profession and a wonderful leadership experience. North Carolina became a great state in which to practice as a PA through the vision, leadership, and volunteer work of PAs just like you!
If you know a PA who cares deeply and 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 submit a nomination 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 a Nominating Committee Member. To read more about these positions and to nominate yourself or a colleague, click here. The deadline for nominating a colleague is May 31, 2018. The deadline for nominating yourself is August 1, 2018.
All terms begin January 1, 2019. Nominees for officer positions (President-Elect, Vice-President, and Secretary) must have been an NCAPA Fellow member in good standing for the calendar year prior to election. All other nominees must have been a Fellow or Associate member.
The seat on the North Carolina Medical Board designated for a PA will be coming up for appointment this Fall. Applicants must meet the following:
- Hold an active license or approval to perform medical acts, tasks, and functions in North Carolina.
- Have an active clinical or teaching practice. For purposes of this subdivision, the term “active” means patient care, or instruction of students in an accredited medical school or residency, or clinical research program, for 20 hours or more per week.
- Have actively practiced in this State for at least five consecutive years immediately preceding the appointment.
- Intend to remain in active practice in this State for the duration of the term on the Board.
- Submit at least three letters of recommendation, either from individuals or from professional or other societies or organizations.
- Have no public disciplinary history with the Board or any other licensing board in this State or another state over the past 10 years before applying for appointment to the Board.
- Have no history of felony convictions of any kind.
- Have no misdemeanor convictions related to the practice of medicine.
- Indicate, in a manner prescribed by the Review Panel, that the applicant: (i) understands that the primary purpose of the Board is to protect the public; (ii) is willing to take appropriate disciplinary action against his or her peers for misconduct or violations of the standards of care or practice of medicine; and (iii) is aware of the time commitment needed to be a constructive member of the Board.
Candidates who are selected to serve on the North Carolina Medical Board will be required to uphold and abide by the NCMB Code of Conduct.
Further information and application may be found on the North Carolina Medical Board Review Panel web site at http://www.ncmedboardreviewpanel.com. If you have questions about time commitment and/or the responsibilities involved, please contact Marc Katz PA-C at email@example.com.
by Kat Nicholas, NCAPA Director of Membership and Marketing
Change is happening at NCAPA! I’d like to take a moment to explain one that you may notice this time next month, when you start looking for your issue of The Pulse..
We have come to the realization that the information we share in the monthly issues of The Pulse is information that would benefit ALL PAs in NC, not just our members. Beginning in June, our members will receive a members only email from NCAPA on or about the 15th of the month. This email letter will be from the President, a committee chair, or the Executive Director and will highlight specific items pertaining to the particular committee and/or NCAPA as a whole and will include links to news articles, essays, etc. on our website.
You will be able to find all the information you are accustomed to getting in the Pulse and more on our new blog, now called The Pulse! We hope by making this change that PAs throughout North Carolina will have fuller access to information affecting the profession, which will better demonstrate the value of NCAPA and the importance of membership. Thank you for your patience and willingness to come along with us as we continue to make NC the best state to be a PA!
If you are interested in writing a piece for our blog or have any thoughts or suggestions you would like to share, feel free to email me at firstname.lastname@example.org.
Time is running out to apply for an NCAPA Endowment Student Grant! There will be one grant awarded to one PA student PER PA PROGRAM, meaning 11 programs, 11 grants!
June 11 is the deadline to apply for 2018 NCAPA Endowment Scholarships. You must be a current student member of NCAPA and enrolled in your clinical year in a NC PA program in September of 2018.
To be considered, we must receive your completed application and an official transcript (no copies, please) from your PA program, postmarked by June 11, 2018. Transcripts should be mailed to:
NCAPA, att. Student Grants, 1121 Slater Road, Durham, NC 27703.
from the Duke PA Program
Jacqueline Barnett Named Director of Duke Physician Assistant Program
Jacqueline S. Barnett, DHSc, MSHS, PA-C, associate professor of community and family medicine, has been named program director, Duke Physician Assistant Program, effective June 1, 2018. Barnett has served as associate program director since late 2015.
The decision was made after a national search conducted by an internal committee led by Kenyon Railey, M.D., assistant professor of community and family medicine. In the interim, Patricia McKelvey Dieter, MPA, PA-C, professor of community and family medicine and PA division chief, has served as program director. Read the full article here.
April Stouder Named Associate Program Director of Duke Physician Assistant Program
Effective June 1, 2018, April Stouder, MHS, PA-C, associate professor of community and family medicine, will become associate program director of the Duke Physician Assistant Program. April currently serves at the director of clinical education, a role she’s held since 2012. Find out more about April here.
Save the Date! The Piedmont Association of Physician Assistants (PAPA) will be holding its Annual Fall Seminar on Saturday, October 13th at the Forsyth Medical Center in Winston-Salem, NC.
The PA History Society will be offering a PA Historian Boot Camp this Fall. This will consist of two-days of interactive sessions, approved for a maximum of 12 Category-1 CME hours. Find out more information here.
Welcome to our renewing and our brand new members!
The following members have joined or renewed their membership since our last issue.
Thank you all for your support of NCAPA and all PAs in North Carolina!
Rebecca Bailey, Wake Forest
Jennifer Baxley, Charlotte
Rachel Bennett, Jacksonville
Charita Bivens, Durham
Curtis Bowe, Jr., Chapel Hill
Karen Brown, Kalamazoo, MI
Mark Cavaliere, Greenville
Sally Chapin, Sanford
Michelle Christian, Charlotte
Dawn Coffman, Sharpsburg, GA
Barbara Cole, Charlotte
Gregory Conner, Charlotte
Gregory Creel, New Bern
Earl Cummings, Lumberton
Jacqueline Curley, Locust
Annelise Davis, Cullowhee
William Davis, St. Pauls
Morrow Dowdle, Hillsborough
Evan Dropkin, durham
Brandy Embry, Lillington
Ryan Finan, Charlotte
Harold Fite, Belmont
Amy Ford, Pittsboro
Mikala Fowler, Columbus
Janet Garvey, Galax, VA
Bryan Geigler, Winston-Salem
Alan Gindoff, Greenville
Barbara Graham, Lumberton
Samuel Halajian, San Antonio, TX
Kurt Hammermueller, Sanford
Jessica Harrison, Durham
John Harrison, Concord
Christopher Hass, Murphy
Pamela Hudak, Linden
Laura Ivey, Carolina Beach
Mary Keller, Elkin
Brooke Lilley, Raleigh
Rebecca Maphis, Carolina Beach
Thomas McLellan, Charlotte
Sheri Meinert, Cary
James Messersmith, Durham
Jacqueline Moreda, Boiling Springs
Lindsay Morgan, Winston Salem
Dawn Morton-Rias, Johns Creek, GA
Kristen Murphy, Winston-Salem
Shafia Naeem, Columbia, SC
Pierce Neitzke, Charlotte
Lisa Oxendine, Lumberton
James Robson, Charlotte
Angie Rogers, Christiansburg, VA
Lynne Saffo, Wilmington
Yang Song, Glenshaw, PA
Megan Speziale, Raleigh
Michele Stavovy, Wilmington
C. Kim Stokes, Greenville
Katie Sweetapple, Cary
Steven Taxman, Durham
Carole Van Dyke, Matthews
Temeka Wallace, Carthage
Melinda Wekony, High Point
Marjorie Whitehead, Mint Hill
Ashley Wilson, Charlotte