|
Back To Our Roots
One of the unchanging premises about our profession has always been that as Physician Assistants we have always proclaimed to be "dependent" providers. We have always worked under the supervision of a licensed physician. We have never publicly sought to be independent providers; in fact we have deliberately avoided that label. That fact is one of the arguments we have been able to use successfully when some physicians claim that we are "competing" with them for patients. And I think that in the eyes of organized medicine that has had a very favorable effect for our profession. In recent years we have come to use the phrase, "Physician/PA team" in our marketing and educational campaigns for our profession. The "Physician/PA" team concept is an excellent description of what our position has been and should be in my opinion. I have been in practice some twenty-six years now and having had that much experience, I feel the amount of supervision I need is minimal once a physician has worked with me a while and knows and understands my capabilities. But I do not want to be an independent provider. I like the fact that as a physician assistant I always have someone to whom I can defer when I feel it is clinically or medico-legally in the patient's best interest, or mine. The one thing that I have learned in medicine is how much I still do not know. If one gets to the point where they do not believe that, then they are dangerous to their patients and to themselves whether they are a PA, a physician, or any level of health care provider. I do not have a practice myself. I do however, work for a physician who has a practice. It is "his" practice and they are "his" patients. The physician is the one ultimately responsible for the care given them under his supervision by myself or others in his employ. I hear some of my colleagues talk about "my practice" and "my patients", and I have used the phrases on occasion myself when talking with colleagues. I understand that what we really mean is not what we imply with that statement. Others outside of our profession may not be so understanding and misconstrue what they hear. And then there are some that would use that type of misinformation against us. And this type of misconception is not good for our profession in these days and times when all we hear is that many physicians feel that "all the mid-level providers want to do is increase the scope of their practice and be independent." That is not the message that we as physician assistants have ever portended to promulgate. It is certainly not what we want the physicians in Florida to perceive that they are hearing from us. We need to continue to strongly push the Physician/PA team concept and embrace it ourselves as a profession. In recent months we have heard complaints from a very few specialists revolving around how some of their physician colleagues are utilizing PAs in specialty practices. I see this as more of a physician problem, not a PA problem. There are enough rules and laws on the books to address this situation, but it is up to the physicians to regulate their own within the established procedures available through the Boards of Medicine. But we all know that physicians do not like to challenge other physicians where the issues are not black and white and there is so much gray area. But in all honesty, we as PAs would do the same in such situations. I think we have to tread lightly and with caution in this area. We do not want to be perceived as biting the hand that feeds us. As dependent providers we must continue to work with the various medical groups to solve these issues when they arise but we must do so only after carefully researching the issue and gathering appropriate data. A timely and informed decision can then be made about how to best resolve the issue in a manner that benefits all concerned and most importantly, protects the patient's rights and assures that they will receive the highest possible standard of care. The issue should not be addressed by changing the rules and regulations affecting PA practice when in actuality PAs are in compliance with the law. Another issue recently involves advertising. When and if a PA advertises in a practice, they must include the supervising physician's name so as not to be misleading and give someone the misconception that a PA is practicing medicine independently, which is not legal in Florida. The advertising must be clear about the qualifications of the persons in the ad also. If one is NCCPA certified and advertises themselves as "board certified", that is not correct. NCCPA certification is NOT a board certification. Board certification implies a higher level of training and education and has been traditionally associated with physicians. That is what the general public understands. The acronym, PA-C, simply indicates that the PA has graduated from an accredited PA training program and has successfully passed the certification examination and is maintaining the certification through continued medical education requirements and has passed the recertification examination when required. In fact the acronym "PA-C" is trademarked by the NCCPA, and only those PAs fulfilling the NCCPA requirements for that designation are allowed to use it. Attached is a letter I received recently on this issue from Katherine Adamson, PA-C,MMS, MA; President of the NCCPA affirming this position. NCCPA Letter PA educators need to emphasize from day one of each PA student's training, the Physician/PA team concept so new graduates are not under any false illusions or misconceptions of what the PA profession is all about in regards to being dependent providers. And maybe some of our more experienced PAs need to rethink things and get back to their roots. By promoting the Physician/PA team concept and avoiding competitive situations, we can only help our profession. Each and every one of us as practicing PAs must remember what we say and do projects on the entire profession. These are some very complex and emotional issues with no definitive answers and it is not going to be easily solved or done so in a short time either. We must continue to work with the organized physician groups and the Board of Medicine to investigate these issues and resolve them. We must work to arrive at solutions that will let us all survive and prosper, but most importantly protect the citizens of Florida by providing the highest standard of care we are all ethically and morally obligated to give to our patients.
I welcome your comments on this article.
Ron Pace, PA-C |
|
