Wednesday, May 26, 2010

Robert Wood Johnson Fellowship

SO, when I was in DC, I was able to meet with, and talk with several of the Robert Wood Johnson Health Policy Fellows. It is a prestigious one year fellowship (residential) in DC for mid career providers to work ON the hill, and in the Senate and WH, writing the legislation, drafting proposals, leading meetings, and advising the POTUS and Congress.

It's an incredible position, and so far, NO PA has ever done it, it has always been MD's, and the occasional PhD, RN.

Well, to make a long story short, I also got to meet one of the directors who thinks I would be the "ideal" PA candidate with my interest in Health Policy, and my informal association with the Mayo Health Policy Center.

What an opportunity, but alas, I cannot. Family is more important. But I'd be lying if I said I haven't been thinking about it EVERY day since.

Annual AAMC Physician Workforce Research Meeting

So, last week, I was in DC for several things, including meeting with a lobbyist, and several good friends who work in various committees on the hill. I was also there for the AAMC Meeting. It was great.

Contrary to the AAMC's usual position regarding workforce issues (train more physicians), they were very open to discussing teams of healthcare providers. Our AAPA has been working with the AAMC on some research into workforce issues, and they have been VERY impressed with our data. They have been very un-impressed with the NP workforce data mostly because it is so poor at this time.

One of the primary focuses of the talks, and agenda was a discussion of the recent legislation, and it's impact. Some of the absolute top researchers in the country were there, including several Robert Wood Johnson Fellows, as well as representatives of various medical schools. and several top think tanks such as the Robert Graham Center. Many of these folks, like the head of the Osteopathic Medical Association I've known, and talked at other meetings with, some were new to me.

The discussions surrounding Accountable Care Organizations, and the need for good primary care as it's foundation were good, and there were several research presentations dealing with PA's and primary care utilization, including community health clinics. Very positive outlook for the PA profession, and something that we should be very happy with.

One of my research focuses here, is going to be with experimentation in different care and team models, and how can we best design a team. My thoughts are ONE physician, and 4 PA/NP providers, and the preliminary numbers I've run show that this combination can see the equivalent of 4 physicians alone, or close (3.8 FTE by estimation).

Another thing that I learned on my trip, although not at the meeting per se, was that congress is becoming increasingly open to a cause that is very near and dear to my heart. Reducing the pay disparity gap in primary care. This will involve cuts to specialists, specifically interventionalists, and to a lesser degree surgeons, and an increase in pay to primary care. It makes sense, but Congress has been reluctant to involve itself in the marketplace in the past. However, this is one market that is in non pareto, and does not appear to be willing, or more specifically able to correct itself.

All in all, a great meeting, and the PA profession and community should be proud. I got more questions at the meeting, as well as many more after the meeting by email, than I have in a long time about PA training, education, and how can we increase the supply of PA's, and how to implement them into a team based model.

Plus I got have lunch with Len Nichols.....(BIG PLUS)

Kudos to you all, it is your work that has brought about these possibilities, I am but a mere ambassador and researcher.