Shortsighted Power Struggle Dynamics

 

Tension between The AAPA and the AMA/AOA as well as many physician groups can be expected to escalate in the coming years. Over the past several years the physician community and the PA/NP Communities have been at odds over the Scope of Practice advancement sought by AAPs throughout the country. Both groups are opposed to each other’s agenda. Physicians favor restriction, and APPs favor expansion.

Many physicians' views of nonphysician providers are not very flattering ones. In fact, and currently, they seek to discredit this class of highly trained healthcare professionals by portraying them as unruly unsubordinates seeking to replace physicians with inferior care. Thus, believing this, they feel it places patients at medical risk given the short & inadequate training in their oftentimes misinformed views.

Conversely, APPs see their counterparts as entrenched myopic abusive team leaders. They rapidly claim and point out that physicians’ disdain for APPs is palpable if not visible in many circumstances. Thus, creating difficult interprofessional dynamics between both groups. Sometimes it is not uncommon to see animosity or acrimonious interactions between the two groups erupt overtly or subtly. 

Plus, APPs are not only continuing to evolve but also assume greater bedside clinical responsibilities. Traditionally part of the physician’s domain in the recent past, therefore being seen as a professional encroachment threat that has been usurped by lesser trained caregivers in their views. The fact, that PAs/NPs/CRNAs don't feel the need to be subservient practitioners to the past once-revered physician, has certainly contributed to this growing huge interprofessional strain on many fronts. 

So, given the strained relations between both groups, the question becomes this: Can physicians come to terms with nonphysician providers working alongside & collaboratively with each other?  

For physicians, the bottom line is they see themselves “as the perennial captain of the ship”. For them, is untenable to accept nonphysician providers as associates as seen & evidenced in many expressed opinions or official stances declared by their medical specialty organizations in various media or social platforms.

Likewise, nonphysician providers feel unless the physician/medical community comes to terms with acknowledging their growing presence and role (raised professional status) in the healthcare landscape, it will remain an impasse or a moot point too for them.

 If both groups fail to move beyond & come to terms, then the practice of medicine is going to be a miserable one for all stakeholders involved...including patients since neither group wants to concede to the other. 

Early Career Rough Patches.

 

I have a secret to share with any new PA grad or any newcomer to the profession who feels stressed or is/has been struggling to find a “right fit” employer post-PA school. Or even uncertain about their career choice if things have not gone as planned or envisioned before joining the PA world.

            I know, you feel like throwing the towel. Initially in my career, I struggled to get my bearings. In fact, I almost quit medicine altogether in my first year 3 years of practice. After spending 6 years in college & thousands of dollars in debt (school loans). Looking back, I must confess, I was overwhelmed, stressed, & tough it was all a huge mistake that I had made. Moreover, I even thought I made the wrong career choice.

            

            It didn't take me long to figure out that I needed to become strong and resilient if I was going to survive and push through the “workplace dark clouds”. This means that the quickly unsupportive employers, the toxic office politics, and the uncaring coworkers or even tone-death group practice managers were all very suffocating to me—the newbie & uninitiated PA. After all, PA school never prepared me for these battlefields & turbulent rollercoaster rides. At times I couldn't see past it nor endure these early difficult times. 

          But don't worry, it will come to pass once you realize it is not all your fault and you have value. I have seen this with countless others, sadly medicine sometimes can eat its own. I have seen it in medicine, nursing, etc. Fortunately, much of that has lessened to a more tolerable point. Once you start developing your clinical skills, and personal confidence the ride becomes less turbulent and easier.

          You must be in tune with yourself and have the support of your family and friends. And realize what mistakes you made along the way. For me, I was naïve and too trusting, but more importantly I didn’t do my diligent research on prospective employers during my job search. Sometimes I wished I would have had the internet at my fingertips, it would have made things a little bit easier.      

          Also, I wished I had known about de-stressing techniques earlier in my career or developed a Hobby. An advice that I pass on to my students to this day since I can spare them some of the trials and tribulations when I got started 35 years ago.

        As negative or uneasy as these experiences or circumstances can be, frame your mind to see these unforeseen situations as opportunities instead of setbacks which is very easy to default to when things are not going your way. Remember with a little help from your friends, and family and having faith or a "thick skin" as they say you can overcome these hurdles.

        So don’t throw the towel in quite yet if you’re going through a rough patch early in your career. ..think about the quote instead:

"Pain nourishes courage. You can't be brave if you have only had wonderful things happen to you"

Mary Tyler Moore

PA Pride

        What is PA week? Each year from October 6-12, we celebrate National PA Week, which recognizes the PA profession and its contributions to the nation’s health and wellbeing interventions.

        During that week, the PA community establishes this time as an opportunity to raise awareness and visibility of the profession nationwide. Before it was a weeklong event, National PA Day was first celebrated on October 6, 1987, in honor of the 20th anniversary of the first graduating class of PAs from the Duke University PA program. October 6 is also the birthday of the profession’s founder, Eugene A. Stead, Jr., MD. Now the profession is 56 years strong! Our numbers and acceptance continue to rise even though we might not be a household name...yet

      Since 1967, PAs have been improving patient outcomes and moving healthcare forward. Always innovative. Always flexible. Always ready for what’s next. As we celebrate the profession’s next 50 years, we should collectively view challenges as opportunities. Better yet, unforeseen industry circumstances as possibilities. Because PAs have always achieved the extraordinary and gone beyond.

The PA Community in partnership with all other dedicated healthcare professionals is constantly striving to increase awareness of how to make our healthcare system safer, more efficient, and accessible while providing increased quality to patients and value to the patient community.

PAs regardless of the medical specialty they practice in, they truly embody and every day humbly exemplify their "clinical excellence and service to people" in their diverse clinical roles & caregiving activities to the American healthcare consumer.

To my fellow colleague PAs, embrace your PA legacy with pride and distinction not only during PA week but also every day! Living that call honorably, intentionally, and measurably for the betterment of your fellow brother and fellow sister. 

         We have been trusted for over 50 Years...let's make it ready for 50 more!

                

A Thought on Physician Fragility.

    Isn't medicine about serving & caring for the less fortunate-- our ill /sick fellow society members? So why is it that modern healthcare seems more entrenched in partisan politics than the so-called politicians in Washington? Our patient community needs healthcare access and expert medical advocacy when it comes to medical policy-making...not legislative barriers, inter-professional intolerance (aka turf battles) flexibility. The lack of cooperation, inclusivity, and tolerance is obviously absent when physician groups' behavior departs from Team-based practices.

    How so? (you ask). Well, there are quite a few examples if one looks closely throughout the country. For example, many Medical Boards and Medical state chapter societies are seeking to label non-physician providers as unsafe clinicians. This new position not only seeks to discredit our industry value but rejects both, the mature flexibility and cooperation all physicians should embrace when working with PAs to best serve patients together.

    Is difficult to see the Physician community be so threatened by APPs. This "Physician Fragility" mindset should not be a problem. Physicians and PAs work together in teams and with other healthcare providers every day. Evidence has shown that when PAs have the flexibility to practice at the highest levels of their education and experience, patients benefit most as a result. Unfortunately, many seek to foment division and regression by proposing Scope of Practice restrictions. These partisan legislative moves only seek to reinforce archaic PA practices/regulations. These proposals already decrease access to care in many socio-economically disadvantaged communities or rural ones too. Also, situations like these consequently increase the physician's clinical burden by having to spend more time caring for an older sicker patient population. Hence another factor leading to burnout and/or early retirement.

    One doesn't have to be a "Rocket Scientist"  to see the results of myopic restrictive regulations do not serve patients well. In addition, there is no evidence these kinds of regulations improve patient care or that they are even necessary. The point is, that these proposed regulations are a screen for a disguised restriction of trade. Basically, in search of a problem where there's none.

    Even more disappointing, is the refusal to acknowledge our professional evolution and growth from mere assistants. Their denial seeks to seriously undermine skill  & desire to be professionally respected along with our request to promulgate & support PA-friendly policy regulations that make sense for PAs We know firsthand and understand the challenges and needs facing our profession better than anyone.  Therefore, if they are as patient-centric as they say they are, then, all Physician groups should stand to eliminate any additional layers of bureaucracy that limit healthcare access to patients.

    In the end, Physicians and PAs are all members of the same team when it comes to providing the  American patient with high-quality healthcare. There is no reason why PAs and physicians can mutually resolve/settle this important issue by reaching across the aisle and putting these attitudinal views to rest. 

FAQs: About PAs

        Through the years and throughout my career I have been asked many questions about PAs. While many different ones have been asked of me, seemingly they all seem to revolve around the four ones I will be covering in this piece/blog.

1. What is the Importance of  PAs in the Healthcare Industry? 

PAs are vital to the Healthcare Industry. The Affordable Care Act, which was enacted in 2010, recognized PAs for the first time as one of three primary care providers ( PAs, Nurse Practitioners, and Physicians ). The law also empowered & enabled PAs to basically lead patient-centered medical teams. Team-based care is at the core of a PA’s training. PAs practice with Physician-led teams and in a collaborative relationship with other members of a patient’s healthcare team. This combination is a major source of their strength & pride.

2. What can a PA do for me? How are PAs educated and trained?  

PAs are experts in general medicine. They undergo rigorous medical training. All PAs must graduate from an accredited PA program and pass a certification exam in general medicine to be licensed and certified. Much like physicians and NPs, PAs must complete extensive continuing medical education throughout their careers.

PAs diagnose, treat, and prescribe medications. Their education is modeled on the medical school curriculum, PAs learn to make diagnostic and therapeutic decisions while working with Physician-led teams & in collaboration with other members of the healthcare team. PAs are certified as medical generalists with a foundation in primary care. Throughout their careers, many PAs practice in two or three specialty areas, giving them deep experience and the flexibility to meet the changing needs of their patients, plus their employers and communities. Also, many PAs serve as surgeon's assistants & can be found in all surgical specialties.

PAs are trusted professional healthcare providers. Studies have shown that when PAs practice to the full extent of their abilities and training, hospital readmission rates and lengths of stay decrease, and infection rates go down. A Harris Poll found extremely high satisfaction rates among Americans who interact with PAs. The survey found that 93 % regard PAs as trusted healthcare providers, 92 %t said having a PA makes it easier to get a medical appointment and 91% percent believe that PAs improve the overall quality of care experience.

3. What is the demand/outlook for PAs in the marketplace?

PAs are in heavy demand. Three-quarters of PAs receive multiple job offers upon passing their initial licensing and certification exams. Studies show that the most financially successful hospitals maximize their use of PAs. The PA profession has been named by several top media outlets, including Forbes and USA Today, as the most promising job in America. The demand for PAs increased more than 300 percent from 2011 to 2014, according to the healthcare search firm Merritt Hawkins. As of December 2016, there were more than 115,500 PAs nationwide who interact with patients upwards of 350 million times annually, & 4,500 throughout Michigan & approximately 74 PAs throughout the HMC system ( i.e. clinics, urgent care, etc.) 

4. Where can I get more information about PAs?

You must  go to these PAs main websites:  www.aapa.org  & www.mapa.org

On Becoming a PA: An unplanned path.

There are many essays and blogs in cyberspace about folks stating knowing about their early calling in life such as: “I have always known that I would be a doctor” or "I was destined to be a physician". Well sorry to say or disappoint, but this piece is not one of those stories.

Nor will I use the clichéd stories of how an ill relative or a friend or a close family physician served to be the inspiring force for me to consider a healthcare career as a physician provider. But rather the opposite instead—namely a Physician Assistant. In fact, unlike so many other college students’ paths to medicine, mine was truly a circuitous one when compared to so many others that I have known or read about through the years. I suppose my path was different or as some would say atypical for that matter. 

Unlike those stories and truthfully, I was never ‘pushed’ nor ‘talked’ to going into medicine by my parents. However, medicine didn’t even cross my mind until I began enjoying my natural science courses, which I felt, I would end up pursuing a graduate degree in molecular biology. Early in my college preparation, I saw myself leaning towards becoming a bench researcher in the lab after graduating from college. I even entertained the thought of becoming a medical technologist. Moreover, during that time I was setting my sights on landing a co-op job experience as a research student at Argonne National Laboratory or some other prestigious national known research facility.

Yet, halfway into my 3rd year, I began to feel an affinity for medicine, so to be sure that I truly was interested in a medical career and not with the romantic idea of becoming a doctor, I decided to explore employment opportunities in a medical or a hospital setting. In a stroke of luck, I was able to land a job as a Pharmacist’s Assistant at a local Catholic Geriatric hospital while completing my 1st undergraduate studies. Luckily this particular experience gave me a different perspective if not a very insightful one into my final desired career path. 

        As I neared graduation, my options became clearer, and my desire to remain in medicine albeit in a different role was cemented; it was clear that my future would require a more definitive game plan from my behalf. So for a year or so, I methodically researched all about the different allied health careers, from “A” to “Z” and while the infinite options were considered and entertained, no would-be profession back then matched or resonated closely with my envisioned future as much as the unheard Physician Assistant Profession did for me. And as you can imagine, the rest is history as they say…    

                                                                               

The AMA: A two faced-organization.

 

False ideological narratives, political hypocrisy, and obtrusive partisanships are increasingly destroying our world, our country, and society at large. From the terrifying mischaracterization of objective realities to openly deceitful blatant lies spewed by many, it seems that this moral bankruptcy has reached an all-time epidemic high in recent years. We need to address this world/societal pernicious and myopic view rather fast. But, of course, how can we, the few, correct this unsustainable dizzying trend when everyone else supports it– the exact opposite?

We see this with former reputable leaders or former highly regarded business entities or even academia, including The AMA, who have spent countless hours pushing false narratives about the PA profession. Even openly dismissing our solid and rightfully earned a place in the healthcare industry as legitimate credible healthcare providers. But it turns out, this has & continues to be a two-faced manipulation and hypocritical stance. 

For example, the AMA peddles safety skepticism on our patient care outcomes and vigorously calls for PA practice restrictions. Physicians for Patient Protection, a national physician nonprofit watchdog group, pushes & spreads misinformation and even outright lies by mischaracterizing our outstanding 5 decades of cost-effectiveness when it comes to PA care improving access and quality of care. 

This type of hypocritical monopoly just shows their modus operandus: push these lies continually to the American medical consumer, and they will be bound to unquestionably believe it hence securing their marketplace monopoly. They practiced subtle pandering in years past, however, that’s no longer the case. Nowadays they are very open about it by creating and forging “the national stop the Scope of Practice Creep”. But, now this deception is out in the open calling for immediate denialism (SOP statewide restrictions) on APPs' progressive evolution). 

The juxtaposition between the AMA’s and AAPA’s position on this point of contention has fueled significant animosity between both organizations. They both staunchly vouch for their constituency rights in the marketplace. Naturally so, given the natural outgrowth & replacement of our old moniker “Physician Assistant '' to Physician Associate passed by the APPAs House of Directors hod. The stark contrast of philosophical differences couldn’t be worlds apart between these two organizations. It is beyond staggering. 

It's not a surprise that they no longer have any professional trust given the fostering of an arrogant acrimonious AMA perspective when it comes to PA practice. For the majority of the PA community, we have learned privately that our counterparts (Specialty Physician Organizations/groups) prefer the old physician patriarchal interprofessional relationships as opposed to the emerging collaborative team practice model. 

So what must we do to eradicate this malady? Answer, educate, educate, and tirelessly educate some more about the intrinsic value we bring to the table. Be a proud PA activist; we Physician Associates/Assistants matter now more than ever before. 

There is no way to excuse this kind of veiled bullying behavior, especially in an already fragmented & polarized healthcare industry. It is damaging to our society and the future well-being of our patient community. This virtue signaling is horrendously bad, they know they are being deceitful. Sadly, to this author/us, this is a grave betrayal of trust and epitomizes the moral bankruptcy of the AMA. They should be reminded they have a huge platform and therefore an equally huge responsibility to tell the truth and be inclusive and deliberate in practicing interprofessional acceptance transparently. 

We, society, policymakers, and all industry stakeholders must hold the media, medical societies, physician groups &The AMA, and or any unethical organization accountable. Demand them to immediately cease promoting & fueling skepticism, misinformation, and mischaracterization about The PA community!!!

Simply continue demanding the truth by holding them accountable in all their professional transactions with us–the PA Community as well as the medical consumer.

The Return of Interprofessional Apartheid in Medicine.

Nowadays professional practice boundaries between Physicians and PAs are no longer specialty-specific. Yet, some would like to return to those days. In fact, in many instances, this is especially true outside surgical or interventional medical subspecialties. Clearly, over the past several decades this crossing of professional boundaries has become less distinct due to the evolving clinical proficiency of PAs into the practice of mainstream medicine. As the delivery of medical services has become more of a patient-centric team-based model, we have also seen this advancement of Scope of Practice accelerate in order to meet the demands and needs of an industry that is constantly and rapidly evolving @ a dizzying speed. 

The reframing of clinical practice in which PAs undertake many tasks previously performed by physicians is not a new phenomenon. During the past several decades this has been the case in conjunction with the advancement and evolution of technology and SOP. 

This phenomenon has significantly shifted the traditional (limited) role of PAs as merely assisting Physicians in the provision of medical services. These forces have come into play favorably to our community by allowing us a much much more autonomous role as professional skillful providers than we were back in the beginning. Thus, to imply or merely see us only as “Physician Assistants” would be very myopic since it is a very inaccurate description of our roles. Particularly when seen from a glance perspective rather than looking deeper & understanding & knowing the real nuances of this antiquated industry professional misnomer. 

Essentially such a position would be akin to being misinformed or misled by an incorrect understanding of an idea or concept. On a closer look is not a case of two separate Healthcare domains with one profession being superior to the other, but rather the case of two close professions simply seeking to advance medical care to the American medical consumer from a common perspective: one of increasing quality and access of healthcare collaboratively. 

Reductions of many practice paradigms are becoming the order of the day in the practice and delivery of medicine. So does this mean that PAs have to remain Siloed inaccurately in non-descriptive professional terms? Do we still see ourselves as merely assistants to the Physician community? The simple answer to these questions is no, because in practice we provide physician-like services ourselves much like our counterparts do–the physicians. Anything short of recognizing PAs as skillful & cost-effective Physician Associates would continue to be divisive rhetoric of a continued industry interprofessional “Apartheid” mindset seemingly rising nowadays again. After all, our rigorous training parallels the medical model very closely, and so does our mission, vision & philosophy…so shouldn’t we put semantics aside, and continue moving our industry forward?

Best Basic Deposition Pointers

  

Stellar deposition performances stem from thorough review and pre-trial preparation. An unshakable humble and confident demeanor conviction can have the lifting power of asserting your defense against the med mal allegation(s) brought against you by the rapid-firing queries of the opposing legal counsel. 

Therefore, deposition readiness is very imperative because you could find yourself unsure of how to navigate this new adversarial process to you. This can occur swiftly and without much warning in many circumstances. Therefore anticipatory planning for such an event can make you feel less stressed and downright less overwhelmed. After all, feeling caught off guard is not uncommon nor is it a good feeling under these circumstances. Yet, with the right approach, and the right perspective and preparation from your attorney, you can live and remain confident if you devote the proper amount of time and effort to your pre-trial preparation and cultivating relaxation and de-stressing behaviors. 

So when confronted with this legal entanglement, it is critical to remain grounded so the process becomes less intimidating and reasonably stress-free. Naturally, this experience can be very taxing and stressful, both physically and emotionally, for the uninitiated, but it certainly can be mitigated--to a great extent if handled well. Remember, sitting idle or leaving things to chance is not productive; this is akin to the kiss of death. Such a lax approach places you in a legal jeopardy mode– a tense state of anxiety as opposed to one of prepared confident readiness. You must do everything to empower yourself if you’re to depose well. In essence, you must envision yourself as the “victor” and move past the “victim” mindset to which many deponents fall prey to unconsciously when not proactively taking charge of this career hurdle. 

        Truthfully trying to remove anxiety completely or remain stress-free is nothing but a zero-sum game you cannot avoid, but you can certainly manage it effectively, by trying to implement some of these interventional behavioral modification modalities. For instance, consider implementing yoga exercises, enhanced respiratory techniques, or simply modifications, reading, and/or exercising, etc. The key here is to lessen the “stress factor” burden on yourself. 

        So if you’re honestly seeking to appraise your deposition readiness, then you must ask yourself these questions: how prepared am I for this deposition? Have I been prepped accordingly by my counsel? Do I know this case inside out–strengths vs weaknesses?

Malignant Mischaracterizations

 If you are a proud and engaged PA, chances are you would be intolerant and very critical of the recurring mischaracterizing narrative about our profession. This growing anti-PA narrative seeks to sow doubt in the patients’ minds mostly by disparaging our highly studied/documented great patient care outcomes across the board through the past 54 years.

Stopping this malignant spread of interprofessional bigotry will require the commitment of many if not all of the members of the PA community. We must not only be alarmed but morally concerned --if not outraged-- about the long-term negative ramifications this may pose to our standing in the healthcare industry. Personally and professionally after 34 years of practice, I have never been more alarmed and concerned about what I am seeing take place in the marketplace these days

Our work history and our Industry credibility speak for themselves when it comes to delivering the highest competent patient care as it has been shown study after study. 

But most importantly, we don't have a moment to lose. And if you think about it, we are at a crucial crossroads determining the battle for our survivability. Make no mistake, about this: our fate is in our hands--not in the AAPA’s. Moreover, we still remain “brandless” to most Americans. It is very clear, we still are viewed as a subservient professional class to the various physician communities. Even the mainstream media has failed to be objective when it comes to describing the Physician Assistant community's contributions to the industry. 

And it is up to every one of us to get active and vocal by joining together and educating, all while advocating for our very own cause. I do believe that we should entertain the idea of creating a PA Watchdog organization to secure our own vested interests given the current anti-PA climate and rhetoric being spewed these days.. Naturally, coming together to see this shared vision come to fruition will help police those seeking to erect barriers or foster industry inequities by eliminating all prejudicial interprofessional ignorance. 

Do not allow your peers or yourself to be silenced or marginalized. It is simple to see, we

The AMA: A meddling (hypocritical) Organization

 

Every time I hear or read about the AMA meddling in our affairs, I must confess: I get more and more upset & worried about our future. Their constant open disdain of our profession so openly seen on various platforms not only troubles me but should also the rest of us. However, and quite frankly, I am surprised to see how no one in our community doesn’t denounce them for this behavior. Even if nothing else, I’m sure most PAs have felt the sting of these misinformed one-sided campaigns targeting our brand and community at large. 

But just as if this is not enough, the current marketplace is rapidly changing with potentially leaving us stigmatized as being nothing more than an "assistant". A detrimental label to our livelihoods. For instance, the AMA attempts to block or lobby against any PA modernization practice acts. By far the most disturbing and disheartening politics of their rhetoric is sowing fear and distrust in the medical consumer. They seek to undermine our credibility at every turn they can by deliberately overstepping their industry role & by simply fostering PA practice advancement barriers and disinformation. Moreover, professional mischaracterization.

Similarly, and nefariously they have undertaken other lobbying efforts to jeopardize similar PA practice modernization bills throughout the country all under the mantra of "patient safety". When asked directly about these interprofessional restricting marketplace activities, they always default to their skewed anecdotal statistics. They steadfastly continue claiming their actions were/are solely based in the interest of public safety despite the robust PA outcomes available data to this day, fifty years later proving our solid industry track record regarding comparable cost-effective patient care outcomes--- a very solid one indeed. 

Unfortunately, some physician groups such as ACEP, and Physicians for Patient Protection have chosen to openly discredit the PA community through their unilateral overzealous partisan protectionistic lobbying moves without creating a spirit of collaboration or bipartisan dialogue. I/we do not believe this to be the trait of a transparent organization as they like to claim themselves to be. Furthermore, I believe these lobbying activities are not appropriate nor in the best interest of creating a professional partnership between both groups. 

It does appear, the role and mission of the AMA are incongruent if this is the stance they want to undertake. Furthermore, they are not a “regulatory governmental agency “ nor a “policing” agency but rather an association of an interprofessional fellow group. Perhaps, we, the PA community should remind them they are not in the business of trade restraint & or fomenting interprofessional dissension but rather collaboratively increasing medical access to care. 

Would you all please make your voices heard…

Is there Ageism in PA Academia?

    

     For all my colleagues who are considering transitioning into teaching, one word of advice: you must do it before you're older than 40 years of age. Otherwise, you could be considered past your teaching prime...regardless of how experienced or accomplished you have been in your PA career or professional journey. 

How do I know? What makes me an expert? Simple – I have lived it, so I am speaking from my very own firsthand experience. Sadly, implicit and explicit ageism exists even to this day in PA faculty hiring and retention practices.

And what I am about to say/share with you in this post, I suspect most likely will not be embraced by some if not by most of my peers. Moreover, I am very aware & very prepared for the barrage. Yet, I feel I must be truthful and transparent on a few PA taboo issues such as this one– the huge Elephant in the room, sort of speak and everyone tends to be oblivious to it. 

In all fairness to PA faculty recruitment practices, I will be the first one to admit that these faculty search committees oftentimes strive for hiring fairness. Fair, perhaps, but in many instances not even close; sadly to say even as holistic their candidate selection criteria are advertised on their job postings. Why? Because even with all the talk of practicing hiring inclusivity and aiming for diverse faculty retentive practices, etc., the reality is a very different one. Particularly in academia when it comes to PA faculty selection. Unfortunately, there remains an unexplained gap; a dissonant one seen in many instances. 

    For example, while earning & shortly after obtaining my master's degree and working full-time as an EMPA, I was able to be a PA adjunct faculty member in one program and a guest lecturer at another one in my state. All while receiving excellent evaluations from my PA and non-PA undergraduate students from another local university. Doesn't my decade-long teaching track record account for anything? 

To date, after applying for several local PA programs within the past 4 years, having published over 95 non-clinical articles & commentaries in various PA Journals, spoken at various state yearly conferences, & served as an advocate at the state level for my profession through the years, all I have received has been only 2 phone interviews, but no invitations for a face-to-face interview.  Hum...could it be my age? Most PA faculty bios that I have researched seem to showcase PAs under 40 years of age and have practiced for 3-10 years.

If we (they) are as serious as they say they are in hiring qualified diverse faculty members, then they may have to rethink their hiring policies or protocols when hiring younger & much less experienced peers over older/senior seasoned colleagues. Because ageism (the unspoken practice) is still alive and practiced in many subtle ways, it is detrimental to potentially experienced PAs by sidelining and disallowing them to be enriching contributing faculty members to the next generation of PAs. 

Furthermore, practice what you preach w/o exceptions if you're a social justice advocate and authenticity & credibility is a core values of your system. Better yet, actively combat this myopic hiring practice. In the end, who gets to be your faculty is just as important as who gets to be your PA student.  

###

Is it January yet?

Is it January yet? This month were many of us wait to implement our New Year’s resolutions. Traditionally this is the month that we have decided to shed some pounds, stop smoking, or become better golfers, while others simply seek to have better work-life balanced lifestyles, etc. No one would argue these self-improvement strategies are meritless. But, how about a resolution outside yourself; not an individual one per se? 

Yet, as unhappy as many of us may find the environment we operate in, very few of us dive in to correct the crowded, confused, and at times unfriendly PA marketplace. Being able to provide a crystal clear brand image of our profession has not been our forte. We have remained brandless for far too long. Our internal culture has been one of apathy & passivity for the most part; this has been crystal clear through the years. We have allowed the anti-PA rhetoric to become louder & louder by the minute as seen by the American Medical Association (AMA) back in November 2020, entitled “ #stop scope creep... because patient safety isn’t a game”. Also, ACEP ( The American College of Emergency Physicians), and AFPPA ( The American Family Practice Physicians Association are the last physician communities to go public with this agenda. These Physician groups are morally bankrupt since their campaigns essentially seek to stall or halt the evolutionary progression of the scope of practice of Advanced Practice Providers ( APPs), mainly Nurse Practitioners, Physician Assistants, Nurse Midwives, and CRNAs. But they are not the only ones to blame. We must bear some equal responsibility after looking at both sides of the coin as this is difficult for some of us. 

We can still correct our course (professional destiny) if wanted & every member of our community decides to make a difference for the common good of the PA family. How? By taking personal responsibility, and professional accountability in becoming actively engaged advocates @ the state or national level. Everyone can make a difference for the better, even though they may not be able to be leaders on the national stage. Is time that we tell our truth, the one we have lived & know best. Namely, patient advocacy through uncompromised quality care deliverance. Increased patient access to healthcare through ongoing selfless interprofessional collaboration. 

And yes, you know what? We certainly can modify (reset) our internal culture, plus consequently optimize the marketplace we operate in by strengthening our brand. By executing a visionary strong servant leadership role, and staying above reproach this could be a collective resolution that we can implement without having to wait until January to see our promise come to fruition.