PAEA and STFM Have Much in Common

By David Keahey, PA-C, MSPH
PAEA Liaison to STFM

Conference Theme

It was my privilege to attend the 42nd annual spring conference of the Society of Teachers of Family Medicine (STFM) held in Denver, Colorado, on April 29. Its theme was “Transforming Education to Meet the Needs of the Personal Medical Home.” The concept of the medical home has been gaining momentum from the rejuvenated health reform debate following the election of President Obama. Many of the 400 educational sessions offered to the more than one thousand conference attendees included reference to the personal (or patient-centered) medical home which is central to the near and long-term future of the discipline of family medicine in this country. My colleague at the University of Utah program and former PAEA liaison to STFM, Connie Goldgar, wrote on the patient-centered medical home in late 2008.

Board Presentation

Scott Fields, MD, the president of STFM, invited me to meet and speak with the STFM Board of Directors, and I focused my remarks on four broad areas: (1) greetings and recognition of our common origins and focus, (2) trends and status of PA graduate specialty choices, (3) challenges facing PA education, and (4) the recent recommendations of the PA Clinical Doctorate Summit.

STFM President Scott Fields, MD, addresses a plenary session of the 42nd Annual Spring Conference in Denver, Colorado.

I presented information from the most recent AAPA census about the specialty choices of graduate PAs in the United States and contrasted these with outcomes from the 1998 census. The decade-long decline in the percentage of PAs practicing in primary care has paralleled that of medical students over the same time frame — as shown by the difficulty that family medicine residencies have had in filing their residency slots. I highlighted concerns about the overspecialization of the U.S. medical system and the path that both physician and PA education have pursued in response to market and social forces that push graduates towards careers in non-primary care specialties.

We discussed briefly the following challenges facing PAEA members:

• Barriers to PA program expansion and the lack of recruitment of sufficient numbers of clinical preceptors
• PA faculty development and recruitment
• International growth and training of the PA profession

Rather than the barriers to expansion that our PA programs encounter, family medicine departments and residencies face the challenges of medical students’ declining interest in family medicine and the opportunities and costs associated with an increasing proportion of international medical graduates entering family medicine residencies. Both PAEA and STFM share the challenges presented by faculty development and recruitment. The international growth of family medicine is seen by STFM as an opportunity to expand that core discipline to other, often third world, countries. I shared the recommendations of the Clinical Doctorate Summit and, as might have been expected, several questions were raised about the summit’s fourth recommendation to explore bridge programs for PAs interested in becoming MDs.

At the end of the meeting, STFM directors expressed their consensus that the PAEA liaison should be invited to future directors’ meetings at the annual spring conferences. In addition, Dr. Fields recommended the consideration of communication between future STFM presidents and the PA programs’ medical directors.

Shared History and Purpose

The tone of the STFM meeting was cordial and welcoming in keeping with the ‘personality’ of the Society that I have come to respect and admire during my five years as a member: one of inclusiveness for educators from a spectrum of different disciplines who are involved in training future family physicians. The STFM community of educators includes physicians, education specialists, PharmDs, behavioral specialists, social workers, nurses, PAs, and others who play a role in clinical and didactic teaching in medical school and residency settings. I encourage PAEA members with an interest in primary care to seriously consider joining STFM to help grow the relationship between two professions that share a common history and purpose.

Although not in existence when the first PA students were accepted at Duke University (the first exploratory STFM meetings occurred in 1967), STFM reflects the core values of the early PA profession, then arranged nearly exclusively around general medical practice. Just as PAEA’s mission is to represent PA educational programs and faculty, STFM was founded to meet the needs of educators in what was then the new discipline of family medicine. Members who wish to know more about STFM’s development may view significant events at http://www.stfm.org/about/history/sigevents.cfm. Clearly, there is much to share with and learn from one another.