WHY? WHY? WHY?

by Ron Pace, PA-C

Don’t you get tired of asking yourself why our profession always seems to be under attack by some other medical professional group? Or why some group of doctors is always seeking to limit our practice in someway? Or why they always seem to lump us in with nurse practitioners? Or why do we drive on the parkway and park in the driveway? Or why some group of unlicensed medical graduates thinks they can be PAs just because they were physicians back home in their country? Or why does it take years to build up trust, and it only takes suspicion, not proof, to destroy it? Or why can’t we get rid of the cosigning requirement which most states do not have? Or why after over thirty years of existence here in Florida you still get the question – what is a PA?

I have some thoughts on these and other questions and thought I would share them with you all.

• Many of the medical organization leaders are older, did not train with us, did not train us, and are still feeling that we are “competition.”
• Physician/PA Team. They have no concept generally speaking. It is simply a public relations and education issue. We have to promote ourselves in a more positive manner.
• In all honesty, the PA profession is a young one – less than 40 years old. Look how long physicians and nurses have been around compared to us. Like it or not we are still paying our dues and fighting for true professional recognition.
• Florida medicine is conservative – always has been, always will be. Will this change as younger doctors who are more familiar with PAs get into positions of leadership? We can only hope.
• The nursing lobby is a powerful one here (as well as in California – just ask Arnold!) and even organized medicine does not want to challenge them and try and change the nurse practice act.
• If you consider there are over 45,000 physicians, and more nurses than that here in Florida and then only 3,500 of us….duh, do the math. Majority rules in numbers and in financial resources to do the lobbying and public relations. We cannot afford to compete with them in television, newspaper and radio ads.
• Pick on the little guys (us) and they stand a better chance of winning. However, back us up in a corner and we can come out fighting like a lion.
• I have said it before and I will say it again – politicians listen to voters, numbers, and money. We get what we pay for in reality. So we need a larger percentage of licensed PAs in Florida to be FAPA members and be active in the Academy.
• Politicians and many physicians lump PAs and NPs together as midlevel providers. While we understand the issues of differences in our practice acts, and the disparity in the marketability of our professions, many others do not and this will continue to be an issue for us.
• The foreign medical graduate issue is not going away but is taking on a new perspective as people are beginning to realize it is not only here in Florida, but everywhere. And it is not only involving foreign trained physicians but other professions as well such as dentists, lawyers, and others. It is going to take several years to resolve this issue and as usual with issues like this, not everyone will be happy in the end.
• We have not been able to get a large number of the physicians who supervise us to get more involved in their state organizations. Physicians listen to other physicians, and so do politicians.
• There are a large number of people involved in writing legislation and in writing the rules to support the statutes. Many times the way a statute or rule is written may have an unintentional unfavorable effect on our profession. That is why we have to have watchdogs in Tallahassee to keep the wolves from our doors.
• We have to realize that medicine is a business, and business is inherently competitive. And sometimes in business doing what appears logical and fair is just not going to happen because of this competitive nature, thus we have some very successful businesses and then some that are less successful, and then some fail.
• You pick your battles wisely. You do not choose a battle that you know you are going to lose. You don’t ask a question to which you do not already know the answer. These principles tend to make you more successful if you understand and follow them. These are principles that the FAPA leadership has followed for years.

So what do we do?

• Join FAPA and get your physician to do so as well.
• Convince your supervising physician to get involved in his professional organization and speak up or else their rights to utilize PAs are going to be in jeopardy.
• Write letters, emails and faxes when FAPA asks you to do so.
• All politics is local. Get involved with your local state representative and senator. Give money to support them, work in their campaigns in some way, and let them you are a PA and you vote. They remember, believe me.
• Can’t serve on a committee? Then support financially those that do by joining FAPA, giving to the PRIDE campaign, the Political Action Committee, and the Foundation. They all work to get us noticed by those that need to notice us.
• Attend the FAPA CME conferences. They are one of the main sources of operating funds for our Academy.
• Encourage your colleagues to join FAPA now. Greater numbers make a stronger organization.
• Promote the Physician/PA team concept.
• Join FAPA and get your physician to do so as well. (This one was worth repeating.)