Health Law, PA Profession History, Practice and Regulation PDF

Health Law, PA Profession History, Practice and Regulation PHYA 501 -FOU NDAT ION S II CO2027 S TA NDA RDS B2.14, B2.1 6, B2.17 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 1  Objectives Health Law, PA Profession History, Practice...

Health Law, PA Profession History, Practice and Regulation PHYA 501 -FOU NDAT ION S II CO2027 S TA NDA RDS B2.14, B2.1 6, B2.17 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 1  Objectives Health Law, PA Profession History, Practice and Regulation 1. Describe the components of professional practice regulation 2. Outline the basic process of PA licensure and credentialing 3. Review the origins, history, and development of the PA profession 4. Identify and recognize trends in the PA profession 5. Explain the roles of local, regional, national, and international organizations related to the PA profession January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 2 Statutes & Regulation January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 3  Definitions STATUTE REGULATION A statute is a law enacted by a A Regulation is an official rule. In the legislature. Statutes are also called acts, such as Government, certain administrative agencies the Civil Rights Act of 1964 or the Sarbanes-Oxley have a narrow authority to control conduct, Act. Federal laws must be passed by both houses within their areas of responsibility. These of Congress, the House of Representatives and agencies have been delegated legislative power the Senate, and then usually require approval to create and apply the rules, or "regulations“. from the President before they can take effect. https://www.law.cornell.edu/wex/regulation State statutes/laws, such as the PA Practice Act, are passed by State legislatures. https://www.law.cornell.edu/wex/statute January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 4  State Law: Statutes and Regulation Each state designates certain requirements for those employed in a healthcare occupation The purpose is to ensure these individuals are adequately trained and qualified to hold that professional title in order to ultimately protect the health and safety of the public For PAs: All 50 states & DC require licensure. PAs employed by the VA must be licensed in any state (not necessarily the state in which the facility is located.) Puerto Rico passed enabling legislation for PA licensure in 2019. https://www.aapa.org/news-central/2019/01/pas-now-eligible- licensure-puerto-rico/ Accessed 12.28.2024 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 5  https://www.aapa.org/news-central/2023/10/pas-for-the-win-2023-advocacy-update/ Accessed 12.28.2024 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 6  https://www.aapa.org/news-central/2024/12/new-york-governor-signs-three-bills-to-advance-pa-practice-streamline-healthcare-delivery/ Accessed 12.28.24 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 7  https://www.aapa.org/news-central/2024/05/maryland-governor-signs-pa-practice-modernization-bill-into-law/ Accessed 12.28.2924 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 8 https://www.aapa.org/news-central/2023/04/modernization-of-colorado-pa-practice-act-a-significant-win-for-patients/ Accessed 12.28.2024 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 9  Connecticut: https://portal.ct.gov/DPH/Practitioner-Licensing--Investigations/Physician-Assistant/Physician-Assistant-Licensure Licensure Application process to the state (varies state to state) Allows for legal practice of medicine as a PA in that state/territory/jurisdiction Holds the profession to rigorous standards, similar to physicians In general: ◦ Graduate from a PA Program accredited by the ARC-PA which must be verified ◦ Certified by the NCCPA (all states require for initial license) ◦ Successfully passing the Physician Assistant National Certification Exam (PANCE) ◦ Not all states require Certification Maintenance or PANRE ◦ Completing questionnaire about malpractice and criminal history ◦ Application fee ◦ Demonstrate pharmacology hours ◦ State specific CME requirements ◦ Renewal periods ◦ In some instances, states have additional requirements, may require proof of ongoing practice, etc. January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 10  CT Requires Verification of 60 Hours of Pharmacology Didactic Instruction https://portal.ct.gov/-/media/Departments-and-Agencies/DPH/dph/practitioner_licensing_and_investigations/plis/physician_assistant/VerifPharmpdf.pdf Accessed 12.28.24 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 11  State Practice Acts Intended to ensure quality of care Will vary from state to state to authorize both scope of practice and regulatory oversight Some states restrict practice despite having physician shortages Often regulations are grey and sometimes are more restrictive than federal regulations Hospital/healthcare facility can implement even stricter regulations if state not clear on their desire ◦ Ultimately, can open the opportunity for litigation/fines if facility rules are too strict and organizations are not following. ◦ Example: Hospital requiring a co-signature by a physician on all notes entered by a PA. January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 12  Professional Practice Regulations Each state has to recognize the ability of a PA to practice medicine and for physicians to supervise and delegate medical tasks ◦ Outlined in statutes The state’s Department of Health typically regulates PA practice with input from stakeholders across the state ◦ A governing board must be appointed ◦ This board oversees the process of granting a license along with oversight of PA regulations ◦ In CT, PAs fall under the Medical Board. Some states (MA, CA) have PA Boards. January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 13  Written/Delegation Agreements The physician has the authority to delegate tasks to the PA. Most states require agreements in writing. Some states require them to be filed with the state, some require state approval before the PA can practice, others allow the written agreement to be kept on file at the practice setting. Many states require that these tasks be within the scope of practice of the physician. This can be broad or well defined. Needs to be frequently reviewed and updated. CT requires ANNUAL review and signatures. The delegated tasks must be within the scope of practice that the specific state regulations have set forth in the PA State Practice Act. ◦ For example, if state does not allow PAs to prescribe Schedule II narcotic, physician cannot delegate the task Q: What is required to be in the written agreement? A: Whatever your state law requires to be in the written agreement January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 14  https://portal.ct.gov/DPH/Practitioner-Licensing--Investigations/Physician-Assistant/Physician-Assistant-License-Requirements Accessed 12.28.2024 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 15  Physician Assistant Liability PA serves as the agent of the physician is the historic model, making the physician liable for the actions of the PA. The profession is moving toward changing those statutes (where they exist) so PAs are liable for their own actions. PAs are held to the same standards as physicians Legal relationship in which one party is authorized to represent another in dealings with third parties and follow their principles: ◦ Loyalty ◦ Obedience as to reasonable directions ◦ Care (includes duty to notify) January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 16  Tips for ethical and lawful practice Understand your state’s statutes, regulations and practice acts Ensure you have continued communication with your supervising /collaborating physician Follow hospital and department protocols for clinical practice. If there is a need to deviate from protocol, have a discussion with attending physician and document discussion and rationale for deviating. Protocols should not be part of the delegation agreement. The Written Agreement is not the same as a job description. Ensure the job description aligns with above Ensure the practice understands the PA role - practice description January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 17  “Protocols” were eliminated in 2012 in CT. https://connapa.org/wp-content/uploads/2014/01/PA-12-37-An-Act-Concerning-PAs.pdf Accessed 12.28.2024 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 18  State Law: Statute and Regulation Components Definitions Scope of Practice ◦ Physician assistant ◦ Delegation of Functions, Written Agreement ◦ Supervision/collaboration ◦ Prescriptive Authority ◦ Supervising/Collaborating Physician ◦ Contents of Prescription ◦ DEA Registration Licensure ◦ State Controlled Substances Prescribing Registration ◦ Qualifications & Eligibility ◦ Permissions and Limits ◦ Application Process, Fees Responsible Agency ◦ Maintenance and Renewal ◦ (usually Depart of Public Health/Medical Examining Board or PA Board) Title and Title Protection January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 19  PA Title & Title Protection CT Statute PA Title Protection §20-12b (e) PA Identification §20-12d (c) https://cga.ct.gov/current/pub/chap_370.htm#sec_20-12a Accessed 12.28.2024 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 20 What’s in a Name? PA TITLE January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 21  NOT Physician’s Assistant January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 22  NOT Mid-level APP APC January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 23  What about Physician Associate? https://www.aapa.org/download/116915/?tmstv=1690405277 Accessed 12.28.2024 RETIRED From the 2022-2023 Policy Manual January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 24  JUST SAY “PA” We tried that back in 2016-2017…The AAPA had a big campaign. We are back to that while the dust settles on the Physician Associate title. January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 25 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 26 Back to Regulations January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 27  Six Key Elements of a Modern PA Practice Act 1. Licensure as a Regulatory Term 2. Full prescriptive Authority 3. Scope of Practice Determined at the Practice Level 4. Adaptable Collaborative Requirements 5. Co-signature determined at the Practice Level 6. Number of PAs a Physician May Collaborate with Determined at the Practice level (Ratio) January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 28 https://www.aapa.org/advocacy-central/state-advocacy/state-maps/pa-state-practice-environment/ Accessed 12.28.32024 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 29  Be careful about the source of your information! https://www.bartonassociates.com/locum- tenens-resources/pa-scope-of-practice-laws Accessed Jan 17, 2024: This chart hasn’t changed in three years. BUT, State laws have! January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 30  Where Do I Find My State Laws? [Membership/Login Required] https://www.aapa.org/advocacy-central/state-advocacy/state-laws-and-regulations/ https://www.aapa.org/download/4814/ Accessed December 28, 2024 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 31  https://www.cga.ct.gov/ Click on Statutes, then “Browse Statutes” January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 32  https://www.cga.ct.gov/current/pub/chap_370.htm January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 33  https://www.cga.ct.gov/current/pub/chap_370.htm#sec_20-12a January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 34  https://connapa.org/connapa-advocacy/ 12.28.2024 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 35 2019 CT Law “Collaboration” https://www.cga.ct.gov/2019/act/pa/pdf/2019PA-00144-R00HB-06942-PA.pdf Accessed December 28, 2024 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 36  Interrelated Elements Determine Scope of Practice State Law, Rules & Regs Hospital/SNF/NF/FQHC/RHC /LTCH/CAH/IRF Practice Act Insurance law Corporate law Ionizing radiation law Scope of Medical Staff bylaws, rules/Regs Joint Commission standards Laser laws DMV laws Death Certificate laws Disaster law Practice Medicare CoPs (Conditions of Participation) Camp/Sports/School Physicals laws Impaired practitioner laws Public Health Code Employer Medicaid law/Rules and Regs Workers’ Comp law/Policies Employment Contract State Medical Board Employer policies Payer policy/contract with employer Federal Law Medicare Supervising Physician(s) Dept. of Transportation EMTALA Delegation Agreement Dept. of Labor Protocols Payer Policy – Federal Workers’ Comp MACs (Medicare (state and federal) – Federal Employee Health Administrative Contractors) State Medicaid Benefit Plan Private Payers Worker’s Comp January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 37  Credentialing & Privileging “CRE DENT IALS” January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 38  Credentialing and Privileging Credentialing is performed by healthcare facilities to validate the professional background and qualifications of individuals desiring to provide medical care to the patients within the organization ◦ Safeguards the public and the institution This is an objective process which requires verification from the primary source. ◦ Current license (State agency or medical board) ◦ FEDERAL Registration for prescribing controlled substances (DEA) ◦ STATE registration for prescribing controlled substances. (In CT, the Department of Consumer Protection) ◦ Educational training (Transcripts) ◦ Certification (NCCPA) ◦ Competence (Letters of Reference, Procedure logs) ◦ Previous malpractice background (National Practitioner Data Bank) ◦ Previous issues with other state medical boards (Federation of State Medical Boards) January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 39  Verification of State Licensure January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 40  https://www.elicense.ct.gov/ January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 41  https://www.elicense.ct.gov/Lookup/LicenseLookup.aspx January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 42 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 43 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 44  Verification of Certification WHO IS OUR CE RTIFYING BODY? January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 45  NCCPA-Primary Source Verification www.nccpa.net January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 46 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 47 Privileging January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 48  Credentialing and Privileging Privileges allow the healthcare provider to perform certain tasks within that facility or organization. ◦ Privileges are granted based on the credentialing review and verified by ongoing skills assessment. ◦ Privileges must align with state and federal regulations, but can be more restrictive than the state scope of practice Written/Delegation Agreements should align with the Privileges granted. January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 49  History of the PA Profession PA HX MOD ULES January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 50  Returning Demise of the veterans with general medical training practitioner Increased War on poverty specialization of physicians Leadership who understood the Birth of Advancing processes of education and the PA technology apprenticeship profession January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 51  The st 1 Physician Assistant program In 1965, Duke opened the first formal PA program based on traditional a medical education model ◦ Implemented by Drs. Stead and E. Harvey Estes Goal of the 2 year program was to “expose the student to the biology of humans and to learn now physicians rendered services”. 1st Class graduated October 6, 1967. From 1965-1971, physician assistant programs thrived In 1971, the American Medical Association supported the national certification process and accreditation of educational physician assistant programs and assisted with regulation development Further support from The American College of Surgeons, The American Academy of Family Physicians, the American Academy of Pediatrics, and the American College of Physicians strengthened the profession. January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 52  A Medical Sociologist examines the PA Profession The Physician’s “This book contains a Assistant sociological analysis of the Eugene Stewart Schneller physician’s assistant occupation. It is my Innovation in the Medical contention that the PA Division of Labor occupation is a Significant Innovation in the medical division of labor.” Eugene 1978 Lexington Books S. Schneller, Ph.D. - 1978 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 53  “A Social Innovation is a novel solution to a social problem that is more effective, efficient, sustainable, or just - than existing solutions … and for which, the value created accrues primarily to society as a whole rather than private individual.” - Philils, James A, Deiglmeier, Kriss, and Miller, Dale T. Rediscovering Social Innovation. Stanford Social Innovation Review; Fall 2008; 6, 4; pg. 38. January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 54  Stages of a Social Innovation Social Innovation Drivers -Exchange of Ideas -Transformation of Roles & Relationships - Integration of Capital January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 55 PROMPTS The Flexner Report Impact on Medical Education Aftermath of 1910 Report Decreased Numbers African American Graduates Abraham Flexner 50% Closure of Medical Schools Decreased Numbers Female Graduates January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 56  Development of a Social Problem, 1945-1965 National View From 1945 to 1960 the USA saw a 250% increase in Gross Domestic Product (GDP) resulting in increased family wealth and buying capacity By 1960, 135 million Americans had employee or other third party health care Underwood Archives/Archive Photos/Getty Images insurance coverage Major technological and scientific breakthroughs occurred during this time 1960s begins period of civil unrest in the USA January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 57  Development of a Social Problem American Medicine 1945-1965 There was a major increase in specialist and subspecialist training By 1965, the number of trained specialists surpasses generalists, leveling off at 2:1 ratio by 1985 There were rapid advances in diagnostics, therapeutic and rehabilitative services Medicine shifts emphasis from primary to secondary and tertiary care (From Low End to High End of Spectrum) Rural and Inner City Communities begin having limited access to primary health care services January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 58  Unable to Address a Growing Social Problem– Necessity becomes the Mother of Innovation As physicians and hospitals struggled to meet the high end demands in the marketplace, their ability to deliver accessible, affordable and quality health care services to the lower end of the marketplace waned. January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 59  Setting the Stage for a Social Innovation LBJ signs Medicare Act 1965 Demand for medical services was already running ahead of Supply (trained personnel) when President Johnson signed Medicare Legislation in 1965. Nineteen million individuals signed up for Medicare during its first year. Increasing Medical School enrollments would be expensive and would take 10 to 20 years to have an impact. Was there another Solution? January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 60  PROPOSALS Exchange of Ideas: One Doctor’s Solution to a Growing Demand for Health Care Services Treadwell is made an Honorary PA in 1970 by the DUMC PA Program Dr. Amos Johnson and Buddy Treadwell; Example of the proprietary model of training January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 61  Attempt to Educate Advanced Clinical Skilled Nurses, 1958 Thelma Ingles, RN and Eugene Stead, Jr., MD’s failure to gain nursing leadership’s acceptance of clinical roles for nurses opened the door for the formal education for physician assistants. Photographs of Ingles and Stead are courtesy of the Duke University Medical Center Archives January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 62  Exchange of Ideas and Values: A Novel Solution Presented to the American Medical Association 1961 Charles Hudson, MD in the Journal of the American Medical Association, calls for the training of a "mid-level" provider to assist doctors –from a new source of health manpower such as former military corpsmen. January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 63  Training Former Military Corpsmen as Physician Assistants, 1964 Eugene A. Stead, Jr., MD sent a letter to Duke University Hospital Administrator, Charles H. Frenzel, stating his intention to develop a program for the “physician’s assistant” using former military corpsmen as the first students. January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 64  Training Former Military Corpsmen as MEDEX, 1969 Richard Smith, MD, launches the MEDEX program at the University of Washington, Seattle, WA, in partnership with the Washington State Medical Association. Photograph of Dr. Smith (front, left) with first Class of MEDEX graduates courtesy of Northwest MEDEX PA Program, University of Washington. January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 65  Shifts in Roles and Relationships Loretta Ford RN and Henry Silver Pediatric Nurse Practitioner/ Child Health Associate Other Innovators John Kirklin Hu C. Myers Surgeon’s Assistant Physician’s Assistants Baccalaureate Program January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 66  Exchange of Ideas and Values: Duke Conferences and National Conferences January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 67  A New Accreditation and Certification Model to accompany the Social Innovation 1971 The AMA approves Essentials and begins developing an accreditation process for PA Programs. 1972 The National Board of Medical Examiners approves development of a certifying examination for the assistant to the primary care physician. January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 68  State Legislative Model developed to Support the Social Innovation Model Legislation for PAs Developed by a team of lawyers and physicians at Duke University in 1969. First Enabling Legislation passed in CA in 1970 and in NC in 1971 Six Key Elements of a Modern PA Practice Act 1. “Licensure” as the regulatory term 2. Full prescriptive authority 3. Scope of practice determined at practice level 4. Adaptable collaboration requirements 5. Co-signature requirements determined at practice Level 6. Number of PAs a physician may collaborate with determined at practice level January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 69  Integration of private capital with public and philanthropic support Educational Programs Conferences Research & Evaluations Accreditation Process Certification Process Foundation and Federal Funding January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 70  Scaling Up of the PA Profession Increase in Numbers of PA Programs and Certified PAs No. of Certified PAs 148,500 267 # PA PROGRAMS 92,049 45,847 850 9,431 21,194 2020 YEAR Compiled From PAEA and NCCPA Statistical Data Reports January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 71  Presented at the PAEA Education Forum New Orleans, LA October 2023 December 28, 2024 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 72  Systemic Changes What Happens Next? January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 73 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 74 Negotiated Performance Autonomy “The PA is a competency-based occupation. Different PAs do different A Social work. It is based on a "negotiated" role between an individual physician Innovation in the Medical Division of Labor and a PA. This makes it unique. It means PAs can do a very wide range of tasks- and can have roles that change and expand significantly over 1978 the course of a career.” – Eugene Schneller January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 75  PAs as a Novel Social Innovation – Examples Building Alaska pipeline Rural Satellite Clinics Alternative to House Staff First Assist in Surgery Military PAs Public Health Service PAs EMR Triage/Primary Care Urgent Care Walk-in Minute Clinics Prentiss Harrison checking patient at Bragtown Clinic, 1971. Patient Centered Medical Photograph courtesy of Duke University Archives. Care Centers January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 76 PA Organizations CERTIF ICATION , ACCREDITATION AND RE PRES ENTATION January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 77 NCCPA CERTIF ICATION January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 78  National Commission on Certification of Physician Assistants (NCCPA) Founded in 1975, it is the single certifying body for Physician Assistants in the United States Ensures the public and others that Physician Assistants credentialed by the NCCPA, meet established standards of knowledge and clinical skills upon entry into practice and throughout their career. NCCPA’s administrative functions include: ❑Physician Assistant National Certification Examination (PANCE) ❑Physician Assistant National Recertifying Exam (PANRE) ❑Monitoring CME requirements for Certification Maintenance ❑Verification of Certification Status www.nccpa.net January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 79  Verification of Certification www.nccpa.net/verify Exercise: State: Connecticut 1ST Name: Patricia Last: Marriott Click Verify Certification January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 80  NCCPA Dashboard https://portal.nccpa.net/HDVideo.aspx?assetId=195691122 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 81  CME Logging January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 82  CME Logging January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 83 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 84  NEW NCCPA Maintenance of Certification OPTION https://www.nccpa.net/news/panre-la/ Accessed 12.28.2024 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 85  What might the consequences be of not maintaining certification? January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 86 ARC-PA ACCREDITATION BODY FOR PA PROGRAMS January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 87 ARC-PA is the accrediting agency that protects the interests of the public and physician assistant profession by defining the standards for physician assistant education and evaluating physician assistant educational programs within the territorial United States to ensure their compliance with those standards. http://www.arc-pa.org/about/ Accessed 12.28.2024 The average PA program curriculum runs approximately 24-32 months and requires at least four years of college and some health care experience prior to admission. ❑Accrediting agency for physician assistant education programs ❑Defines accreditation standards for physician assistant education: Evaluates physician assistant educational programs for compliance with accreditation standards. 5th Edition Standards: https://www.arc-pa.org/wp-content/uploads/2024/07/Standards-5th-Ed-July-2024.pdf ❑Maintains database of existing and developing programs and accreditation status: Currently 311 programs listed: http://www.arc-pa.org/accreditation/accredited-programs/ Accessed 12.28.2024 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 88 AAPA AME RICAN ACAD EMY OF PAS January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 89  American Academy of Physician Associates (AAPA) Formed in 1968 by the original graduates from Duke University to represent the PA profession. www.aapa.org January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 90  Membership AAPA Membership supports national advocacy initiatives (legislation, reimbursement, federal agency policy), educational opportunities and marketing and communication efforts for the profession. Headquarters in Alexandria, VA, right across the river from DC. Currently about 88 staff. AAPA hosts an annual CME conference & many educational opportunities and resources at great discount and/or free for members. Challenge Bowl is held at AAPA’s Annual conference; to qualify, a program must have 75% of enrolled students as members.www.aapa.org January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 91  American Academy of Physician Associates (AAPA) Constituent Student Academy Organizations (SAAAPA) Assembly of Caucuses and Special Specialty State Chapters Representatives Interest Groups Organizations (AOR) AAPA House of Delegates January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 92  About AAPA We We We We ADVOCATE EDUCATE CONVENE LEAD 93 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT  Structure of AAPA AAPA consists of House of Board of Directors Student Academy Volunteers Delegates The governing Responsible for Leads student Participate in more body responsible enacting policies efforts to further than 400 internal for AAPA’s establishing the the mission of the and external strategic, collective values, Academy, and opportunities each administrative, and philosophies, and gives voice to year to represent financial principals of the PA student AAPA and the management. profession. perspectives on profession, ranging issues facing the from long-term Academy and the appointments to profession. one-day activities. January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 94  Student Resources January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 95 PAEA REPRESENTS PA ED UCATORS AND PA PROGRAMS January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 96  OLD: Physician Assistant Education Association (PAEA) NEW: PA Education Association (PAEA) National organization representing PA education Gathers data from individual PA educational programs Goals: Assists programs in producing competent and compassionate PAs Supports programs to maintain qualified students and faculty Serves as the voice on matters related to entry-level PA education; starting to get into post- graduate and doctoral degree https://paeaonline.org/ January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 97 ConnAPA REPRESENTS PA PRACTICING IN CT January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 98  Connecticut Academy of PAs (ConnAPA) Connecticut’s State PA organization: Membership Organization representing PAs in Connecticut Work in collaboration with the AAPA to further the PA profession in the state. Work with lobby groups to aid in formulating state statute Provide an annual conference and student leadership conference www.connapa.org January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 99 Optimal Team Practice (OTP) HT T PS: // WWW. AA PA.ORG/A DVOCA CY -CE NT RAL/ OPTIM AL -T EA M-PRA CTICE / A CCES SE D 1 2.28.2 024 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 100  The “Ask” Self-Governance Payment currently goes to employer Autonomy in many instances Liability for Own Actions January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 101  “Selling” Points for State Legislators January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 102 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 103  Connecticut Stakeholders January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 104  AMA guidelines for physician/PA practice https://www.ama-assn.org/media/21466/download Accessed 01.14.2020 (Behind a firewall) January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 105  AMA Campaign https://www.ama-assn.org/practice-management/scope-practice/ama-successfully-fights-scope-practice-expansions-threaten 12.28.2024 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 106 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 107  Do NOT recommend…. January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 108 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 109  https://www.aapa.org/news-central/2019/04/pas-across-america-celebrate-first-stat e-with-key-components-of-optimal-team-practice-following-the-legislative-vict ory-in-north-dakota/ Accessed 1.18.2024 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 110  North Dakota https://www.aapa.org/news-central/2019/04/pas-across-america-celebrate-first-state-with-key-components-of-optimal-team-practice-following-the-legislative-victory-in-north-dakota/ Accessed 1.18.2024 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 111  West Virginia https://wvumedicine.org/news/article/wvu-medicine-tops-list-of-state-s- largest-private-employers/ Accessed 1.18.2024 https://www.aapa.org/news-central/2019/04/significant-progress-towards-achieving-optimal-team-practice-in-west-virginia/ Accessed 1.18.2024 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 112 PA Title/Title Change DIDN’T WE ALREADY TALK ABOUT THIS? January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 113  NOT Physician’s Assistant January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 114  NOT Mid-level APP APC January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 115  https://www.aapa.org/title-change/#tci-implementation Accessed 1.18.2024 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 116  https://www.aapa.org/advocacy-central/title-change/#tci-implementation Accessed 12.28.2024. January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 117 NCCPA Position https://www.nccpa.net/resources/board-certification-and-title-change/ 12.28.2024 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 118  Posted to PPP website: Article posted to Bb https://www.medscape.com/viewarticle/966059 Accessed 12.28.2024 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 119 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 120  https://www.medscape.com/viewarticle/966589 Article posted to Bb January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 121  JUST SAY “PA” We tried that back in 2016-2017…The AAPA had a big campaign. We are back to that while the dust settles on the Physician Associate title. January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 122 Trends TOP 5 S EVE N YEARS RUNNING https://money.usnews.com/careers/best-jobs/rankings?src=usn_pr Accessed 12.28.2024 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 123 https://www.forbes.com/advisor/education/healthcare/highest-paying-medical-jobs/ 12.28.2021 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 124  Trends Despite the focus of PAs to be extensions in primary care, more PAs are finding themselves employed in hospital settings and surgical subspecialties More training programs are developing feeder programs direct from their undergraduate studies programs, decreasing the average age at time of graduation. SNAPSHOT Median Age=38 (unchanged over 5 years) 70.6% Identified as Female As of December 31, 2023: 178,708 Board Certified PAs January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 125  Where is the Data? NCCPA: 95% of all PAs MAINTAIN CERTIFICATION, requiring them to interact with NCCPA at least every 2 years. Every certified PA is asked to update their profile when re-certifying. www.nccpa.net/research AAPA: Membership organization with about 60,000 members including student members. A total of 12,180 PAs responded to at least some of the questions in the 2023 AAPA Salary Survey. American Academy of PAs. (2023). 2023 AAPA Salary Report. Alexandria, VA Available at https://www.aapa.org/shop/salary-report/ (Login required) PAEA: Gathers student data from participating PA Programs. Last published report 2019. January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 126 Demographics January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 127  Source: National Commission on Certification of Physician Assistants, Inc. (2024, April). 2023 Statistical Profile of Board Certified PAs, Annual Report, Retrieved 12.28.2024, www.nccpa.net/resources/nccpa-research/ January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 128 Source: National Commission on Certification of Physician Assistants, Inc. (2024, April). 2023 Statistical Profile of Board Certified PAs, Annual Report, Retrieved 12.28.2024, www.nccpa.net/resources/nccpa-research/ January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 129  Current Practice Area of Principal Clinical Position Source: National Commission on Certification of Physician Assistants, Inc. (2024, April). 2023 Statistical Profile of Board Certified PAs, Annual Report, Retrieved 12.28.2024, www.nccpa.net/resources/nccpa-research/ January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 130  Diversity (?!) Source: National Commission on Certification of Physician Assistants, Inc. (2024, April). 2023 Statistical Profile of Board Certified PAs, Annual Report, Retrieved 12.28.2024, www.nccpa.net/resources/nccpa-research/ January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 131 Student Demographics This report has not been updated in 5 years! Physician Assistant Education Association, By the Numbers: Program Report 35: Data from the 2019 Program Survey, Washington, DC: PAEA; 2020. doi: 10.17538/PR35.2020 Available at: https://paeaonline.org/resources/public-resources/research-reports/program-survey-and-reports Retrieved 1.19.2024 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 132  Diversity Additional Reading Smith, D. T., & Jacobson, C. K. (2016). Racial and Gender Disparities in the Physician Assistant Profession. Health services research, 51(3), 892–909. https://doi.org/10.1111/1475-6773.12358 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4874816/ Bottner, R. Improve the Diversity of Physician Assistants. KevinMD.com https://www.kevinmd.com/blog/2014/12/improve-diversity-physician-assistants.html McCarron, B. Rutgers Helps Bring Diversity to the PA Profession. Rutgers Today. December 2018 https://news.rutgers.edu/rutgers-helps-bring-diversity-physician-assistant-profession/20181210 Fleming, Shani. PAEAs Diversity and Inclusion Initiatives Status Report PAEAOnline.org. December 2017. https://paeaonline.org/paeas-diversity-and-inclusion-initiatives-a-status-report/ Don Pedersen Awardee Addresses Race and Ethnicity in PA Program Admissions https://paeaonline.org/resources/public-resources/paea-news/don-pedersen-awardee-addresses-race-and-ethnicity-in-pa-program- admissions January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 133  2021 https://money.usnews.com/careers/best-jobs/physician- assistant Accessed 01.14.2020 2020 https://money.usnews.com/careers/best-jobs/physician-assistant Accessed 01.29.2021 2022 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 134  2023 2024 Dec 2024: National Unemployment Rate 4.1% January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 135 International January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 136  PAs Around the World Bareja, Sylwia MMS, PA Poland and physician assistants, Journal of the American Academy of Physician Assistants: November 2020 - Volume 33 - Issue 11 - p 47-49 doi: 10.1097/01.JAA.0000718292.45648.bf https://www.thepalife.com/physician-assistants-pas-and-associates-around-the-world/ Accessed 12.28.2024 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 137 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 138 January 22, 2025 PHYA 501_CO 2027_ MARRIOTT 139