AAPA House Passes OTP with Amendment

Last week, following a lengthy and often impassioned debate, the AAPA House of Delegates (HOD or House) passed an amended version of resolution A-07-HO on “optimal team practice” (OTP) that included some of the language supported by PAEA. Passage of the resolution made a series of changes to AAPA’s Guidelines for State Regulation of PAs that will allow AAPA state chapters to push toward OTP — previously called “full practice authority and responsibility” — for PAs.

PAEA’s Stand on OTP

President William Kohlhepp, President Elect Lisa Alexander, Past President Jennifer Snyder, CEO Timi Agar Barwick, and other senior staff represented PAEA at the HOD meeting at the AAPA 2017 Annual Conference in Las Vegas.

PAEA had opposed one key section of the OTP resolution, on the grounds that PA programs may not currently prepare new graduates to practice without “a supervisory, collaborating, or other specific relationship with a physician,” and that the AAPA joint task force that developed the OTP proposal had not considered the implications of OTP for PA education.

Surveys of program directors, medical directors, and PAEA past presidents found that about 90 percent of all respondents believe that PA education does not now prepare graduates for OTP, and that potential consequences of this new practice model could include an increase in program duration, increased costs, reduced diversity, and new impetus toward a clinical doctorate for PAs. This information was captured in a white paper, written by a PAEA Board task force, that was shared with delegates and AAPA leadership in advance of the HOD meeting.

“PA education is built around curricula that prepares graduates to practice medicine with physician collaboration,” Kohlhepp stated in his testimony to the House. “If PA programs are to produce graduates to practice with full practice authority, we will need to educate them differently.”

PAEA, which has “observer” but not “voting” status in the HOD, submitted an amendment that attempted to modify key language in the resolution that eliminates the requirement for “a specific relationship between a PA, physician, or any other entity in order for a PA to practice to the full extent of their education, training, and experience.” Several state chapters also spoke against this language, stressing the need to maintain good relationships with their physician colleagues at the state level, while other states spoke of the need to equip PAs to compete for jobs with NPs in states where they have full practice authority.

The PAEA amendment was recommended by the reference committee but narrowly rejected by the House. However, a similar amendment, that emphasized the need for the physician/PA relationship to be established at the practice level, “taking into account the experience and competencies of the PA,” was submitted and passed.

“While the final language may not be exactly what we would like, we were pleased that our concerns were heard,” Kohlhepp said. “This issue will continue to unfold for many years, and I think we laid the ground work for a more collaborative approach moving forward.”

PAEA will likely establish a second task force to engage with the evolving OTP issue and consider its potential impact on PA education.

Concerns Surrounding Certification

The other resolution on which PAEA testified, “Recognizing New PA Certifying Agencies” (C-11), concerned AAPA’s plans to investigate establishment of a second PA certifying agency as an alternative to the NCCPA. PAEA also opposed this resolution, because multiple certifying bodies could mean multiple exams for which programs would have to prepare students.

“Multiple certification agencies, and multiple certification exams, would needlessly complicate PA education, requiring retooling of curricula to prepare PA students for multiple exams,” Kohlhepp said. “The PA profession has benefited from a single agency with a single certification exam establishing a widely respected universal measure of preparedness for practicing medicine. We do not want to follow the path taken by our nursing colleagues.”

This resolution was ultimately referred to the 2018 House of Delegates. The House debated more than 30 resolutions in total. Final language for all resolutions is expected to be available on the AAPA website next week.

Other Conference News

In other PAEA-related events at the AAPA conference:

• David Day was named the 2017 Preceptor of the Year, an award selected by both AAPA and PAEA as part of their combined efforts to promote precepting of PA students. Day has precepted more than 50 PA students in nearly two decades of practice in primary care and emergency medicine in western Kansas. (Click here to read more.)
• PAEA research staff gave a talk entitled, “Filling the gaps: Factors that predict PA students’ interest in practicing in medically underserved areas” and a poster on the same topic. CEO Timi Agar Barwick also joined AAPA Vice President of Education Daniel Pace to announce a new jointly funded research fellowship program that will fund three early career researchers to conduct research for 20 percent of their time for a year. The fellowship is designed to strengthen the research skills and productivity for qualified PA faculty and to develop the next generation of PA researchers.
• PAEA staff and leaders were on panels for two “SPARK” sessions, designed to introduce interested students to leadership opportunities in the profession and to PAEA’s two fellowship opportunities for students: the Student Health Policy Fellowship and the Future Educator Fellowship.