PAEA Participates in the NCCPA Forum on Recognition of Specialty PA Practice

Dawn Morton-Rias, EdD, PA-C
President

As reported in May at the PAEA Board of Directors meeting and AAPA House of Delegates in San Francisco, the NCCPA has begun to investigate “potential solutions to meet the recognition needs of physician assistants practicing in medical specialties.” Toward that end, NCCPA hosted a forum on June 24 in Atlanta, inviting representatives from physician specialty and PA professional organizations to discuss this important potential change for the PA profession. In what was described as a “landmark assembly of representatives from all facets of PA medical practice,” 31 professionals met to learn more about the impetus for the proposed change and to discuss the impact it would have on the profession.

In preparation for the meeting, I sent a memo to PAEA members requesting feedback on this issue. More than 25 of you responded and provided comprehensive commentary in record time. PAEA staff compiled the comments, questions, and concerns received, and Association representatives Dave Asprey, Patrick Knott, and I were well prepared to discuss our members’ thoughts and feelings regarding this issue.

Overall, PAEA respondents expressed continued support for generalist PA education, certification, and recertification, and the foundation these processes provide for flexible PA practice and our ability to meet health care needs. Members affirmed our profession’s commitment to meeting needs of diverse health care communities — through primary care, as well as specialty PA practice. Several respondents also acknowledged that PA practice in specialty and subspecialty disciplines might be extended and acknowledged the need for “recognition” of such clinical expertise. They also affirmed the value of on-the-job training for acquiring knowledge and skills in specialty disciplines. Members expressed concern regarding the potential loss of professional flexibility and the possible impact on licensure and employment of new graduates, as well as for the additional training time and costs associated with acquiring specialty certification. A number of questions were raised regarding implementation, anticipated requirements, expectations for postgraduate/residency training for specialty certification, and mandatory vs. voluntary specialty certification. Finally, PAEA respondents supported the continuation of Pathway II as a means of recertification.

At the June 24 meeting, NCCPA Chair Bill Kohlhepp said that the commission had for some time been discussing the specialty recognition issue in light of practice trends, but had deferred making a decision until recently. He pointed out that the purpose of the forum was to address specialty recognition only; the decision to discontinue Pathway II had been finalized. He also stated that there was no intention to change PANCE or PANRE. Finally, he assured the attendees that any specialty recognition program or process developed by NCCPA would be voluntary and would cover advanced knowledge.

Representatives from the Association of PAs in Cardiovascular Surgery, the American College of Emergency Physicians, and the Society of Dermatology PAs were invited to provide their rationale for specialty recognition. Representatives from the American Academy of Physician Assistants illustrated likely challenges associated with PA specialty recognition. The remaining representatives from PA and physician organizations were also invited to provide commentary on the issue.

In addition to the challenges identified by PAEA members, other dominant themes included how to differentiate between specialty "certification" and "recognition," the value of varied mechanisms to document expertise, challenges associated with multiple credentials, and competition with other credentialed health professionals. The forum concluded with an acknowledgment of the participants and a request that each organization provide written commentary following the meeting. NCCPA leaders said that the information obtained through these procedures would be considered in the planning and implementation of any new certification/recognition process or program. They acknowledged the value of ongoing dialogue and affirmed their commitment to continued collaboration across the PA and physician professions with regard to the specialty recognition issue.

PAEA will continue to be involved in the discussion of this important issue for the PA profession. I am grateful for your prompt and thoughtful commentary on this subject. The PAEA Board of Directors will keep you informed regarding next steps. If you have any questions or concerns, please let us know. If you would like to read more about this issue, please visit NCCPA’s What’s New page on its Web site at https://www.nccpa.net/News.aspx.