The "Awoke" AMA: Are they for real?

    We are in the midst of a global social reset. Many countries including the US are trying to become more transculturally transparent by attempting to discard institutionalized biases & racist transgressions committed in their transactional roles with all traditionally disenfranchised ethnic groups. Also, along the same vein, corporations. profit and nonprofit organizations have begun to effectively address workplace inequalities while the healthcare industry is trying to eradicate past healthcare inequities as well.

    So given that premise, we’re all embarking in crucial conversations facilitating change with elevated empathy, sensitivity and awareness of past poor systemic inequalities. Mostly if not all perpetuated by our so-called/racist systemic myopic biases infringing on minority or marginalized groups. 

    Multicultural health disparities corrections & access to care has been long overdue. Naturally, removing these stereotyped attitudinal beliefs and offensive cultural behaviors will require a huge concerted effort from all healthcare industry stakeholders. But putting into practice this fresh embraced perspective will require the AMA to go beyond lip service to their partnering stakeholders such as the patient community & us as well.

    If they want to be viewed credibly by society and other various industry stakeholders as a vested enlightened & unbiased organization as alluded in their newly revised/embraced diversity policies, then they must openly recognize two fundamental needs of the PA profession/community; namely:

1. Recognize OTP (Optimum Team Practice )

2. Recognize our new professional designation–Physician Associate       

    Anything short of valuing inter-professional differences or seeking ways to grow and embrace their understanding & support of the PA profession would be hypocritical. Thus failing to truly collaborate in building an industry culture where non-physician providers are not empowered to bring their full, authentic selves to the table, nor increase access to healthcare to vulnerable patient communities is not only disrespectful, but downright morally hollow. And worse yet, such a move could be viewed as nothing more than an insincere case of organizational moral self-exculpation in the eyes of many in any transactional role they would attempt to engage in. Especially with prior oppressed social groups.

    For PAs diversity, equity & inclusivity have always been more than ideas, they have been part of our professional DNA and calling when providing care to our patients for the past 5 decades.

   So will the AMA abide by their own modernized organizational policies and revamped organizational image? Perhaps…only time will tell if they are as passionate in rebuilding and maintaining an honest transparent cultural philosophy that is representative of this new paradigm were intolerance of any form of discrimination is openly rejected & ultimately condemned in the name of social justice. 

    In sum, as George Bernard Shaw said it best: "Progress is impossible without change, and those who can not change their minds can not change anything". 

  

Patient Safety Outcome Metrics Disputed: Where is the outrage of the Physician Assistant Community?

         

         The problem with half-truths, or media disinformation is that oftentimes they are actually believed if continually repeated or perpetuated. Unfortunately these incorrect spins can become deeply ingrained in the collective mind of people; especially when. grossly out of context or worse yet, not corrected contemporaneously by the reporting entities. Sadly, and  painfully, a very well known reality to all PAs who have experienced this stigmatization first-hand in their respective careers by the misinformed patient, practice manager or even dept head administrators. Even more troubling to this author is the apathetic indifference of many of our own peers who remain complicit with our detractors or opponents in this regard primarily the data ( patient safety outcome care metrics) reflect very similar clinical care outcomes between our physician counterparts and us-- the non-physician providers as some like to refer when compared by others.

As I am sure, you have noticed our profession has been malaligned for several years now. Whether it is overtly or not, we have yet to surmount a credible vigorous rebuttal campaign with political muscle in Washington,D.C. PAs for Tomorrow, a recently created Specialty interest group, split from the AAPA given their indifference or anemic stance when creating and developing the PA brand. While they may have been proactive in educating many in advancing our interests, at the end of the day they are somewhat limited since they rely mostly on donations and membership dues. Sadly, to this day, The AAPA has not advanced our brand aggressively nor launched a major national advertising campaign aimed @ focusing on our most pressing initiatives in the marketplace today. For example, nationwide OTP acceptance @ once...not 10 years from today, loss of employment parity due to the strong alignment of the AANP (nursing profession) with  strong lobbying supporters.These organizations openly support & fund generously the nursing profession,thus creating friendly Congressional allies. Unlike our community which we lag behind because have not learned “the Art of the deal” by being timid in advocating our own cause, so we remain marginalized...so where's the outrage from the PA community? Obviously yet to be heard.

But, if we continue being passive, uninvolved in our own affairs, the outcome of our professional destiny then will be fated. I hope that this incorrect patient safety narrative spewed by some physician groups through various informational outlets would be the catalyst in becoming the driving force to fundamentally change & awaken us from our collective passivity. 

It is my hope that we can all see that without this outrage, we cannot protect and preserve our significant professional advancement that our predecessors secured in our progressive professional evolution.

Stand up and oppose  professional misinformation or disinformation or even mischaracterization of a great profession that has served you & all of us well. Donate,  speak and or write  to debunk this flagrant lie. You must assert the truth when clarifying or inform others about our magnificent profession.

PAs' & Puerto Rico: Are we there yet?

Patient-centric care: Has the pendulum swung too far?

 

         Frankly, many healthcare providers think so ( including this author ). Until recently, it was not much an issue for many clinicians. In fact, many healthcare providers embraced this about-face from the medical profession’s long-held stance of centuries old practice of paternalism. In the old model the mantra was: healthcare providers knew best,. However, nowadays, supporters of the new paradigm of patient centric-care have altered the playing field to such an extent that one would have never imagined anticipating that it would become one in which dictates the patient always knows best or is always correct.

         Who knew or would have anticipated the proponents and supporters of the “patient autonomy movement” would have garnered so much power in their own advocacy role to technically open the door to patients’ capriciousness creating such havoc. But, truthfully, can a provider assure the patient that their wellbeing and safety will not be jeopardized when the overseeing professional’s clinical judgment or guidance is removed or relegated from the clinical-decision making process all because the imperative mantra of patient satisfaction comes first?

         Isn’t this new imposed “business metric”  by HCOs “patient advocates” or office managers on practicing clinicians absurd?  Of course it is, if your tenure is “indirectly” threatened or being “blacklisted as an insubordinate” all because you were non-compliant with this loaded hypocritical economic metric. For example, I know of several colleagues who lost their jobs for not providing unneeded prescriptions for abusive demanding difficult patients. Since when patients' self-prescribed under our licenses?

         Personally, it infuriates me, when non-clinicians try to justify or relegate a medical encounter to a business transaction always under the pretext of patient satisfaction is paramount to the “satisfaction scores”. Even when superseding acknowledged contraindications even when not clinically indicated. For instance, a known prior documented PMHx of substance abuse/dependency and mental health issues in a given patient. Simply put: quite troubling if not beyond comprehension in these instances.

         Or prescribing antibiotics on non-meritorious clinical presentations, for example patients with clear viral syndromes is a very disingenuous if not a corrupted business practice. Patient satisfaction should not mean “carte blanche” treatments under no circumstances.

         So, are we ( the healthcare industry ) losing sight of what’s truly  really important? Yes, if we continue submissively accepting and practicing medicine under these lines of blurred expectations & downright unethical conflict of interests if you ask me. Burdensome and extremely short-sighted and/or professionally threatening as these mandates might appear, we, the medical community must individually & collectively remain vocal and resolute when denouncing these unrealistic and misguided expectations from other parties.

         To sum it up: respect for patient-centric care, not administrative threats is key to sound patient-provider relationships. Do not allow yourself ever to be pigeon-holed into thinking that a medical encounter boils down to a mere economic transaction or a survey metric. By doing so you’re basically allowing the demise and disrespect of our professional calling and standing in the industry. Moreover, you allow a pervasive view of financial gains trumping patient beneficence, thus allowing the subjective dimension of patients’ satisfaction scores rein unchecked and rein unbalanced, akin to allowing the pendulum to swing way too far...if you asked me.

 

 

 

Political Correctness: Has it gone too far ?

 

      Traditionally, debates were once venues in which civil discourses would dissect & weigh in the pros and cons both, rationally and logically on a contested issue or a perspective with hopes of ( at best ) enlightening or dissuading the dissenting party by effecting change at a fundamental level. But it does appear to this author that in recent times, we have become so entrenched in our ideologies ( as wrong as they might be ) that we are at times blinded by our own amoral compass, skewed political views or simply outdate views of the world in which we live in. So we no longer listen politely to others.

It is during these stances that we fail ourselves to objectively reflect on the  meritorious points of view of the dissenting argument at hand just because we simply refuse to ponder these different or contrarian ideals to what we have been programmed to accept or believe as our own reality or world. Psychologically speaking, these threatened & insecure minds avoid transcending from their comfort zones even though it might be a momentary departure from such. Sadly, they prefer to remain myopic, stunted. This positional view often times fails to effect change by becoming a barrier or a hurdle; often times laying the foundation to biases and/or prejudices. 

        Better yet, another related deleterious effect seem commonly is the self-delusion of “I’m the better one or my position is the correct one”. Again all failing to move the group think forward. Conversely, I do realize the human mind is shaped and conditioned by many factors; from biology to gender, to culture, to education or even to some socioeconomic strata, but one common denominator that many “political correct “ folks have in common is their steadfastness to remain anchored in “filtered” or badly skewed information.

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We all have been those folks during certain points in our lives. Why? Because it’s easier to deal with the known rather than stretch and/or exercise our intellect and welcome new perspectives or contrarian points of view. 

This wave of “political correctness” is making our society a handicapped one. One in which researching and philosophizing is too much work. Much like Jesus said, we should be equally desirous to ”give back to Caesar what belongs to him”.