The Monitor - June 2021

President's Message

Gabrielle Zecha, MHA, PA-C

Gabe Zecha, MHA, PA-CHello PAs of Washington!

It has been quite a year for all of us hasn’t it? We have made progress with our legislative bill which passed last year and is due to be implemented in July 2021. We couldn’t have done this without support from PAs in Washington State. To continue progress, we need your ongoing support and advocacy. You may be wondering what I mean by advocacy as it relates to PA practice.

Well, one thing (of many) that I have learned in the last year is that people do not know what it means to be a PA. And specifically, a great many of our legislators do not understand our role. In order for PAs to retain equal footing for jobs in the state of Washington, it is critical that we educate them.

WAPA is hearing from PAs all over the state that they are being excluded from jobs because of the supervisory language in our laws (and the “assistant” in our title).

WE all know that the capabilities of PAs are extensive and adaptable. But we need your help to educate your legislator. You will start to see requests come your way to advocate on behalf of all of us and I urge you to get involved with the organization that works on your behalf: WAPA.

We understand the importance of leadership, the value of understanding our political landscape (as it applies to PAs) and the significance of community engagement. With that in mind, we have established an early career leader fellowship. This is a one year fellowship that we hope will draw those who are interested in a leadership role to engage with our Legislative and Membership Committees to further Optimal Team Practice. We will be accepting applications thru June 30th for this Fellowship which is intended to develop PA leadership and advocacy skills for our next generation of PAs. In return, that person will have dedicated time with experienced PA leaders, completion of a project geared toward advancing OTP, waived registration for WAPA conferences, and a $1000 stipend. There is more detail in this newsletter.

This is my last communication to you as President and I would like to thank a few of the many people who have put in exceptional amounts of time and energy on our behalf this last year:

  • Bonnie Joy (incredible energy-bringer, solution finder and Chair of Membership Cmte & soon to be Secretary of WAPA)
  • Linda Dale (exemplary and unflappable Legislative Chair & WSMA delegate)
  • Leah Yoke (tireless advocate, COVID expert, social media whiz)
  • Gaby Romero (thoughtful innovator and new Chair for DEI)
  • Michelle Cardenas (fiscal maven and Treasurer for WAPA)
  • Eileen Ravella (mentor & passionate advocate extraordinaire)
  • Laura Wendzich (dedicated WAPA Secretary and boss of Robert’s Rules)
  • Monica Morrison (Chief Delegate to the AAPA House of Delegates)
  • Lyle Larson (long-time supporter, data nerd, bylaws revision pro)
  • Chelsea Hager (our knowledgeable, patient, and amazing Lobbyist)
  • Tei Habenicht (writer extraordinaire - this publication wouldn’t be in existence without her)
  • Linda Krause (tireless executive and the glue for our WAPA family)

Please remember, none of the board members or committee chairs is paid and I can tell you that countless hours are spent working on your behalf. Won’t you join us?

And finally, THANK YOU for the honor of serving you this last year – I have learned so much and gotten to know some really amazing, cool, passionate, smart and dedicated folks. Look forward to seeing you in person in October (fingers crossed) at the WAPA Fall conference!

With appreciation,

Gabe

Read More on PA Bill 2378
Donate to WAPA's Legislative Efforts

 Early Career- Leader Fellowship with Stipend

Calling all early career PAs (less than 5 years from graduation from PA school) who are interested in:

  • Understanding and developing PA Advocacy skills
  • Being a good steward of the PA profession
  • Improving organizational education about PA practice across the state of WA
  • Service through leadership
  • Developing your professional network

Consider applying for the WAPA Early Career Leader Fellowship!

Purpose

Early Career Leadership & Advocacy Fellows are PAs who have a passion for the profession and would like to develop their leadership & advocacy skills. This Leader Fellow will have the opportunity to work closely with WAPA leadership to improve the practice environment for PAs. This includes but is not limited to working towards OTP. The 12-month fellowship is intended to foster leadership and professional development within the PA profession.

Honorarium

A $1000 stipend is available to offset the cost of attending the AAPA annual conference, the WSMA Leadership Conference, and/or attendance at AAPA's Leadership and Advocacy Summit (LAS).

Eligibility

Applicants must have graduated within the last five years from an accredited PA program and must be a WAPA member at the time of application & throughout the Fellowship.

What we’re looking for: demonstrated innovation & creative approaches to difficult problems, integrity, service, overcoming adversity/inspiration, dedication to the profession

Expectations

  • Work with a Legislative and/or Membership Committee Chair to identify a project which benefits PAs in the state of Washington
  • Participate in WAPA Board of Director’s meetings and actively participate in the Legislative & Membership Committees.
  • Attend both of WAPA’s CME events (registration is gratis via WAPA)
  • Attend a minimum of one of the following conferences:
  • AAPA Leadership and Advocacy Summit (LAS)
  • AAPA House of Delegates (at the annual AAPA Conference)
  • WSMA Leadership Conference
  • Other activities that may be defined later, such as promoting the fellowship and encouraging engagement by potential applicants

Milestones

  • October 1st: outline of proposed project submitted to the WAPA Legislative Chair (year 1) or Membership committee (year 2). Subsequent year Fellows may choose either committee to work with.
  • The outline must include least 3 related “SMART” goals which must be approved by the committee Chair no later than October 15th
  • SMART: specific, measurable, achievable, relevant, time based (has a deadline)
  • Formal presentation at the January and April WAPA BOD meetings providing an update on the project. This would be a formal PowerPoint presentation

Fellowship Term

The Fellowship term begins September 1 of the current year and runs through August 31st of the following year.

Note: Honorarium funds will be awarded in June of each year based on conference attendance & completion of identified project.

Instructions

  1. Write a statement of interest of ~500 words. Please include:
    1. Why you are interested in this Fellowship opportunity
    2. What you hope to achieve through your involvement with WAPA
    3. How you propose to contribute to achieving the mission and vision of WAPA
  2. Letter of recommendation from a peer is optional but encouraged
  3. Application link/button is below-apply today!

Deadline: Applications are due by 11:59 PM EST June 30th. Recipients will be announced no later than August 1st.

Early Career Leader Fellowship Application

PAs are Left Behind as Virtual Medicine Gains Momentum

Virtual Medicine (VM) has revolutionized healthcare. VM extends access family medicine and many specialties. It is essential in rural and under-resourced areas. VM jobs are plentiful for many clinicians but not for PAs. This has nothing to do with proven capability. It has everything to do with unnecessary restrictions on PA practice that have been in place for decades. In no other area of medicine have the consequences of PA complacency been so detrimental.

Here are the challenges for PAs:

  • Most VM companies operate in multiple states. When care needs cross state lines, it becomes even more cumbersome for organizations to follow state by state PA practice laws, making it exceedingly challenging or impossible to hire PAs.
  • Some states mandate that the PA and supervising physician (SP) reside in the same state or have a certain proximity to one another, regardless if they ever meet face-to-face. This may not be possible in a multi-state organization.
  • Each state also restricts the number of PAs a physician can supervise, limiting the number of PAs they can employ in any given state and creating an administrative nightmare.
  • In many states, SPs must make in-person visits at the site where the PA practices. Most VM providers practice at home, making this requirement logistically difficult. Some physicians request compensation for this added work.
  • To acquire a license in some states it requires an already established PA/SP relationship. If the employer requires the PA to have this license as part of the application process it is impossible for the PA to apply.
  • Employers cannot justify the cost to hire an SP when they can hire an NP or MD that does not require supervision. NPs living in restricted practice states can be hired to work in 22 other states and have full practice authority.
  • PAs require a practice plan or a delegation agreement. Some state medical boards must approve the practice plan before the PA can work, while other states allow the plan to be filed at the practice site. This plan must be updated every time there is a change in SP, creating additional administrative burdens when hiring PAs.

While many large companies do not employ PAs for reasons above, the expansion of AmazonCare is especially concerning. Amazon implemented a VM pilot program for their employees in Washington state, then extended this to employees nationwide. AmazonCare has a huge imprint on so many things and does not hire PAs and has no plan to in the future.

As PAs, we must understand our practice laws and why we are not being considered for VM jobs. This should be concerning and frustrating for all of us. Urgent and aggressive action is necessary. The solution is Optimal Team Practice (OTP) and it needs to be adopted in every state as quickly as possible. VM is pushing us to make sure that this happens.

Your involvement is essential now. While you may not be working in VM or even considering it in the future, VM is rapidly growing and may replace in-person care in some form, and it already has in some areas. We need to work now to position ourselves so that we are employable in the profession we love.

Get involved with WAPA to support and implement OTP. Talk to your PA friends and colleagues about what is happening. Support AAPA efforts to get OTP in every state. Act NOW! Contact us at [email protected] for questions, more info, and how to get involved.

By Christi Dahlgren PA-C and Jennifer Morris PA-C

*Note regarding the article in the April Newsletter: it was inaccurately stated that we are advocating for “independent” practice. In fact, we are working toward OTP (Optimal Team Practice), which places supervisory decisions at the practice level and removes unnecessary paperwork.


 

Fall 2021 Conference October 7-9, 2021

Save the date and join us this Fall in Spokane at the Historic Davenport Hotel.

Online registration is open! Register today for the Super Early Bird rate of $225.00 for WAPA members if you register by August 15th!

Online Registration
Lecture Topics

PA Title Change

The AAPA announced on May 24, the AAPA House of Delegates (HOD) passed, by a majority vote of 198 to 68, a historic resolution affirming “physician associate” as the official title of the PA profession ending decades of debate.

There was a lot of passion regarding this change and testimony from all sides of the discussion. Several supported the marketing and communications firm that proposed Medical Care Practitioner as the new title.

During this historical time, I would like to thank the WAPA delegation of Leanne Brink, Anju Jain, John Tomchick, and Justin Thibeault who served our members with distinction, hard work and diligence. It is not an understatement to say that we are living in extraordinary times. A monumental meeting of the House of Delegates for such an important resolution itself would have been difficult as we came together as an academy and ironed out the details and implications of changing our title. But to do this in a ZOOM format, for four days, while considering a full consent agenda AND this resolution... it added a challenge that I could never have anticipated. The AAPA and the HOD leadership should be commended for pulling off such a large, complex and intense meeting successfully.

The WAPA delegation was resolute in representing its membership during this time. We sent a survey to PAs in Washington State prior to the HOD meeting and this informed us as well as the HOD reference committee as we proceeded towards the final recommendations and vote for the name change.

Thank you to members and hopefully future members who participated in this survey, it was heard at the national level. (survey results are below)

So, what does this mean? As soon as the resolution passed, the AAPA cautioned that we not represent ourselves as physician associates until the proper regulatory title changes are in place. This will require that the title change is approved by the Washington State Legislature. Given the current timeline of the legislative session in Olympia, we would not be able to submit a bill until the following session- at the earliest. And we are being mindful that enabling legislation such as Optimal Team Practice will provide the best use of our lobbying resources.

We will keep you informed regarding progress towards this change as well as the efforts we are making towards Optimal Team Practice. Remember, your membership dues go towards representing you at a state and national level.
I highly encourage you to support WAPA and its legislative efforts at such a crucial time. Thank you for the honor of serving you as we write a new chapter in our history.
Submitted by: Monica Morrison, PA-C, DFAAPA

Read more from AAPA on the name change to Physician Associate: https://bit.ly/3yJyxbr

WAPA Survey Results on Name Change

Featured PAs

Hayley Arceneaux, PA-C
Senator Fred Baldwin, PA-C

In this month's feature, we are presenting two PAs who have stepped out of their traditional roles and expanded their talents in continuing to serve their communities and country. Please take the time to read Wyoming's landmark legislation brought by Senator Fred Baldwin, PA-C and below our first PA astronaut; we proudly present Hayley Arceneaux PA-C.

PAs in Space!

In the days of the Apollo missions, one had to be an experienced pilot to stand much chance of getting into the program but the idea of commercial space travel always promised that one day… and that day is almost here! The next few years will see a series of missions for non-astronauts. This fall SpaceX plans to launch Inspiration 4, the first all-civilian crewed mission to space, on its Crew Dragon spacecraft.

Hayley Arceneaux, 29, became a physician assistant at St. Jude Children's Research Hospital nearly a year ago. She is fulfilling her dreams of working at the research hospital and traveling around the world, as well as raising crucial funds for the lifesaving work of St. Jude almost two decades after beating pediatric cancer there herself. Now, she's set to reach new heights as the youngest American in space, beating NASA record-holder Sally Ride by over two years, and the first to launch with a prosthesis.

Arceneaux will be one of four crew members on the world's first all-civilian mission to space, which is called Inspriation4 and is tentatively set to take off at the end of 2021. Trip commander Jared Isaacman, a 38-year-old tech entrepreneur, billionaire and pilot announced that he had purchased the flight from SpaceX and would donate the other seats to members of the general public, with the goal of raising $200 million for St. Jude.

Arceneaux will occupy the mission seat representing the pillar of hope. The remaining two seats, representing "generosity" and "prosperity," will go to individuals who donate to St. Jude.

Isaacman called Arceneaux an inspiration not just to aspiring astronauts, but for "all people who need hope when encountering life challenges."

Hayley Arceneaux, PA in front of rocket


Wyoming Landmark Legislation Repeals Requirement for Specific Relationship with Physician to Practice for PAs

 The new law repeals requirements for PAs to have a specific relationship with a physician or other provider in order to practice also recognizes PA’s ability to practice medicine consistent with their education, training, and experience.

Senate File 0033, sponsored by Senator Fred Baldwin, PA-C, makes historic improvements to PA practice in the state and is the result of the dedication and hard work of the Wyoming Association of PAs (WAPA).

The new law also states that PAs may collaborate with or refer to the appropriate member of a health care team as indicated by the patient’s condition; the current standard of care; and the PA’s education, experience, and competence. Collaboration is determined at the practice level, which allows for greater flexibility among treating providers.

The bill also requires a PA majority on the state’s PA advisory committee which makes recommendations to the state medical board on matters relating to PAs.

The bill becomes effective January 1, 2022.


PA Median annual base salary report for 2020

Physician assistant median compensation decreased from $111,000 in 2019 to $110,000 in 2020, partly because of reduced hourly wages resulting from the COVID-19 pandemic, according to the 2021 AAPA report released April 29.

Data in the report is based on a survey of 13,865 physician assistants between Feb. 1 and March 1. Compensation includes base salary, hourly wages or some form of productivity pay.

Physician assistants in Alaska earned the highest median annual base salary of $137,000 in 2020, while those in Alabama earned the lowest at $90,00.

For state by state report visit: www.beckerhospitalreview.com


May 2021 COVID-19 Vaccine Distribution for Washington State

Our state achieved another incredible vaccine milestone. As of May 10, more than 6,046,656 doses of vaccine have been given in Washington. Most people are choosing to get vaccinated. More than 57% of people in Washington eligible for vaccine have received at least one dose and nearly 44% of people 16 and older are fully vaccinated against COVID-19.


NCCPA Reports High Passing Rate for Alternative to PANRE Pilot Exam

18,099 Certified PAs earned recertification following successful completion of the Alternative to PANRE Pilot exam in a two-year study by the NCCPA. The exam, was a flexible, online alternative to PANRE, a part of a pilot program that closed in December of 2020. Nearly all participating PAs passed the exam, with this assessment having had a higher first-time pass rate than the traditional PANRE.

PAs reported being able to pace themselves through in a more accommodating environment, and then taking the exam when they felt comfortable and ready, was found to be beneficial. These combined components led to PAs feeling more confident in the testing environment and the overall performance proved successful.

PAs received immediate feedback on whether they answered the question correctly, as well as provided evidence-based rationales as to why the answer was either correct or incorrect. Additional reference materials were provided for more clarity, and PAs were tested again on topics that they previously answered incorrectly, improving the learning curve.

Data shows that 93.1% of PAs read the rationales and more than 85% of PAs indicated that having questions based on their performance was beneficial. PAs trying to identify where their gaps are and want to maintain that core base knowledge, find the longitudinal assessment to be a better indicator of where they fall, whereas the traditional PANRE exam checks the box of either you pass or you don’t pass. The longitudinal assessment is a constant check on where you are and it provides you with information on filling in those gaps.

The NCCPA Board of Directors will continue to review the data and feedback collected from the Pilot alternative program prior to deciding on next steps later this year in offering the new alternative option to recertifying PAs.


MEDEX NW Kona Update

In spite of a world-wide pandemic MEDEX was able to establish and open the first PA program in the state of Hawaii in September 2020. Seventeen students from across the state and with strong ties to the islands, started a hybrid program of socially distanced in person learning and virtual internet based curriculum. In person learning took place at our new campus in Kealakekua, HI.

The students will be completing their spring quarter soon and will start Hawaii based clinical rotations in September 2021. The community of Kona has been very supportive and we are excited to have our students out and visible in the medical community.

On Friday September 10th, we will be having a traditional Hawaiian blessing of the campus. This will provide an opportunity for both Kona Class #1 and #2 to meet and share in this special occasion.

Our new highway signage has already been noticed by more than a few UW faculty and graduates. Please stop in and say Hello if you are visiting the Big Island. Our address is: Address: 81-6350 Mamalahoa Hwy. We are always happy to give a quick tour of our beautiful space.

Betty L. Stewart PA-C, MPAS, DFAAPA
MEDEX Kona Site Director 


 

CME's | Save the date!

  • OCTOBER 7-9, 2021 | WAPA Fall CME at the Historic Davenport Hotel in Spokane, WA. Registration is now open! A super early bird registration rate of $225.00 is open to all WAPA members by August 15th. Register today!

  • OCTOBER 1-2, 2021 | Oral Health Virtual Event | October 1-2, 2021

    For: Primary care clinicians (PAs use registration option # 1: $175.00)
    What: Medical/Dental Integration, Policy Changes and Future Trends of Dentistry

    Keynote speakers:
    Patricia Braun, MD, MPH, FAAP
    Marko Vujicic, PhD
    Mike Plunkett, DDS, MPH

CME by Pacific NW University of Health Science
For more information, visit: www.PNWU.edu/acchealthconference