After much debate and discussion, in May the House of Delegates of the American Academy of Physician Assistants (AAPA) passed a resolution affirming “associate physician” as the official title of the PA profession, by a majority vote of 198 against 68. This discussion is not New; in fact, changing the title of “physician assistant” has been debated for more than two decades. But this is the first time that the profession has taken the idea seriously.
The underlying premise of the change is to remove the archaic term “assistant” from the title and eliminate the misconception that PAs simply help physicians. In fact, they diagnose, treat and care for patients at a high standard.
Implementing the title change, of course, is quite a complex undertaking for the profession. It will involve many stakeholders, including the Association for the Training of Physician Assistants, the National Commission on Physician Assistant Certification and the Accreditation Review Board on Physician Assistant Training. Because it will take many years, the AAPA has asked PAs to refrain from calling themselves “associate physicians” until all legislative and regulatory changes are made years later. The AAPA has already started this process by updating its Articles of Incorporation, changing its name to American Academy of Physician Associates. They also work with federal agencies to begin title change at this level and rely on state constituent chapters to begin working with their legislatures.
The question is: what do the grassroots of the profession think about this change? The discussion over the past 2 years has polarized the profession, and opinions abound. Most of the people interviewed for this story support the change.
In favor of a clearer identity
After serving as an industry emergency medicine assistant in Texas for 11 years, Mike Sharma notes that “the business and practice of medicine in America has changed over the past 50 years. The associated term is more appropriate to describe the practice of medical assistants in 2021. does not change the functioning of PAs; it rather better describes what we are already doing. “
No one wants to be called an assistant. Being associated with a doctor would carry more weight and give more weight to the position.
W. Richard Bukata, MD, a longtime emergency physician in California and medical director of the Center for Medical Education, Inc., has been a supporter of the PA name change. “At least 5 years ago, if not more, I started to wonder why PAs wanted to be called ‘assistants’. No one wants to be called an assistant. Being the associate of a doctor would carry more weight and give more weight to the position. I think the concern raised by many that the term “associate” would confuse patients is overstated. Whenever an MA meets a new patient, they must present a professional business card to avoid misunderstandings about who is who. PAs have an obligation to inform patients that they are not physicians.
Kris Pyles-Sweet, DMSc, PA-C, AM in Internal Medicine in North Carolina and President of PAs for Tomorrow, has practiced for 22 years. She said she approved of the title changes because “the move to a whole new title would launch the medical assistant profession early on for recognition, cost and branding.”
Further, according to Pyles-Sweet, “PAs are trained according to the medical model, and sometimes with students from the traditional medical school. … Continuing with “doctor” in the title makes sense. Finally, she said using the term “physician” lets the public and administrators know what PAs are trained for. “Any other title contributes and increases the lack of identity of PAs.
A broader perspective
Laura Gunder-McClary, DHSc, PA-C, a Georgia PA for over 18 years, educator and accreditation consultant, offers a broader view of name changes. As a former medical technologist, she remembers the name change of her professional association to “clinical laboratory scientist”.
“There was a lack of understanding among the public as well as other healthcare professionals of whom they [medical technologists] were, the nature of their work and the critical influence of laboratory data on diagnosis and treatment. The similar sounding labels of “medical technician” and “medical technician,” and the overlap between their acronyms, was another reason for the migration to a more descriptive title. This change has worked for them and will work for the PA profession for the same reasons. “
Michael Doll is a former member of the AAPA Board of Directors and has been PA in Pennsylvania for 33 years. He pointed to the trend in the business community. “Many companies have changed their names. Examples [are]: Esso to Exxon, Weight Watchers to WW, Dunkin ‘Donuts to Dunkin’, to name a few. These businesses continued to thrive. The PA profession should not be afraid to change titles. “
Myles Whitfield, a psychiatric PA in Tucson, Ariz., On the ground for 31 years, supports the name change but doesn’t think it’s enough. “I preferred the title of ‘health care practitioner’ because it more closely matched our nurse practitioner colleagues. “
Herb Macey, now attending retirement after 44 years of practice, was initially not convinced the name change was necessary. “When I first heard about the desire to change my name and the many options that were available, I felt a little skeptical about the change. However, I am now in favor of a name change. I have spent my entire career in underprivileged or rural communities working as a PA. At one point, I worked with a doctor who called me his associate, and I saw the acceptance and understanding that reflected in my role. I believe patients have gained a better understanding of my place in the medical community by using the word “associate”. “
Hank Lemke is an educator in the PA profession that he has been practicing for over 32 years. Currently in Arkansas, he said he was not given a chance to vote “yes” or “no” when the profession’s leadership ratified his decision earlier in the year. But after seeing the decision, he now approves it.
“Looking back, I think that kind of work didn’t qualify me as an ‘assistant’. In fact, as I gained more experience, like most of us, we went from “assistant” to “colleague”, “colleague” and even for some to “consultant” . I think these titles should qualify us all as associates. “
Discussing the task ahead, he said: “It will be difficult. Like others in the area, I think it will take many years if that ever changes. call “colleague”, “colleague” and even “consultant” today. I don’t think state laws are the first hurdle we have to overcome. “
Difference of opinion
There are also MAs who think it was a bad decision. Mike Goodwin, an Arizona occupational medicine PA who has worked in the industry for 48 years, offered his perspective. “It’s a waste of time and money; both could be better spent.” Lee Dockins, another Arizona personal assistant working in emergency care with 21 years of experience in the field, is adamantly against the term “associate physician.” He said it “is just another demeaning name that does not adequately match our real role in reality as independent vendors. I now feel like a Walmart employee.”
Citing the financial cost of the effort, Bert Simon, DHSc, a PA educator in Pennsylvania who has been in the profession for 42 years, questions the overall value of the company. He further characterizes the name change as an “indistinguishable distinction” and believes the industry should just stick to the PA moniker.
Joe Weber, DHSc, a PA educator in South Carolina in the field for 12 years, agrees. “Honestly, as a friend of mine would say: I’m not sure the juice is worth it. Enormous energy, time and money has been spent on a name change, and we’re only at the beginning of the years. massive expense to change the name Our sound program will spend thousands of dollars to rename everything from stationery, websites, logos to all of our scrubs, clothes, coffee mugs etc.
Unintended monetary consequences
Alison C. Essary, DHSc, MHPE PA-C, is a Director and Clinical Professor in Arizona and has been an academic for 20 years. She points out some unintended consequences of the name change. “This resolution, presented at the AAPA conference in 2021, failed to capture the breadth and depth of research on the PA profession. This body of research clearly supports the value, security and access provided by PAs. concerns about training or clarify important differences between occupations.
The test indicates other complications. “One of the most significant challenges in increasing access to health care in the United States includes regulatory and licensing barriers.” She said the resolution could result in additional costs, including legal and personnel costs associated with the PA student clinical arrangements, PA program recruiting, marketing materials and other items that might ultimately be needed. absorbed by student tuition fees.
For PAs in clinical practice, changes to PA contracts for hospital privileges and accreditation may be necessary, Essary said. “These costs can be prohibitive for some students, programs, practices and / or healthcare systems, especially in the midst of COVID-19. “
Randy D. Danielsen, PhD, PA-C, is a former member of the Air Force, retiring as a lieutenant colonel after 28 years. He received a Masters of PA Studies (MPAS) from the University of Nebraska with a specialization in Internal Medicine in 1997 and his Doctor of Philosophy from Union Institute & University in 2003. Throughout his career he has been a clinician, PA educator, author and editor.
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