Sunday, December 13, 2009

Physician Assistant Professional Paradigm Shift

Yep, that's what we need.

Over on Clinician One, there is a thread posting an homage to Mary Mundinger, and her incredible work on behalf of the NP profession.

Someone then mentions that we need a Mary Mundinger for our profession, then, someone mentions that they think that person is me. I am humbled by their thoughts, and I think that we do need an aggressive change in direction, but I think that comparing me (really, in the start or beginning of my political/advocacy career) to someone who has been at this for a long time is a bit premature.

I will however, state, that Ms, sorry, Dr Mundinger, understands the importance of language. I will also state that the entire APN profession has understood that quite well since their inception. Words matter, Titles matter, Descriptions matter. Dr Stead understood this with the initial impetus of calling our profession Physician Associates, however, we have since lived in essentially indentured servitude to our medical masters. I say NO MORE.

Here's a list of some that are used in the lexicon of the PA profession:

Physician Assistant
Supervisory Agreement
Delegatory practice
Dependent licensure

Despicable. EVERY single one of them. I understand their utilization when our profession was young, weak, and politically insignificant, but now I can think of much better substitions.

Physician Associate
Collaborative Arrangement
Specialty Dependent practice
Independence/Completely autonomous licensure

We need to adapt. All professions grow, they change, they are by their very nature dynamic. Like the economy, it is not a static unchanging thing. The PA profession HAS grown since it's inception, but it is now reaching the parabolical end of the rope.

It's time to change again.


Morning Rounds said...
This comment has been removed by the author.
Morning Rounds said...

This arguement is not a new one, obviously. I think it is important to discuss how, if at all, making the title change will help improve patient care? If it won't, why take the large amount of time and money that it will take to devote to making the change? I'm not saying there are not other reasons that are worthwhile. What I am saying is I am new to this profession and do not know of any others. I appreciate any input. Thanks!

Dave said...

It hurts the patients perception of who we are and what we do. It hurts our growth. If you have to be supervised, it means you ALWAYS have to be watched. If you are an assistant it means you do NOT do what the person you assist does. WE DO AND ARE JUDGED ON The SAME LEVEL OF CARE.
I think words are important and I have been in medical communications for 25 years. In fact, I met insurance executives who said they will not reimburse assistants as that would be duplication of services. When I said it was not, they said that it had to be as assistants did not do what physicians did.
There is so much more. We do need to evolve or we will perish unless we stay in surgery as super technicians. In primary care the paradigm is changing.