Chairman's Speech at the House of Delegates
Monday, May 29, 2006
Mr. Speaker. Good morning, delegates, alternates, AAPA Board members, and guests. I am pleased to stand before this body today to provide an update on important happenings at NCCPA.
As NCCPA’s Chairman, I find myself with a responsibility to help strategically plan for the future of the organization, but in so doing, I find myself looking back as well. When I graduated from PA school in 1979, I could have never imagined the rewards of my chosen career path: I’ve had unique opportunities to shape our profession as Speaker of this House of Delegates, as President of the Academy, and now as Chairman of the Board of NCCPA, our national certifying body.
At its meeting earlier this month, the NCCPA Board of Directors approved new initiatives. I’m announcing those initiatives to this body and from here to the profession at large. To me, these initiatives hail the next evolution of our profession – they are grounded in our history – but pave the way for our future.
Our first new initiative is an age-old issue that has resurfaced with an intensity and a frequency that we’ve never seen before and is manifested in calls for action from both PA and physician specialty organizations. The profession is changing, and the numbers of PAs practicing in specialties continues to rise. As a result, PA professional organizations have and continue to respond to this changing environment. As Speaker, I presided over a House that changed its composition in order to include the voice of specialty PA organizations in its deliberations. The NCCPA Board is responding to that changing environment by approving the development of a solution to meet the needs of specialty PAs.
The decision to embark on this path was arrived at only after the consideration of several key factors. First, I’ve looked back upon NCCPA’s history and found that discussions regarding meeting the needs of specialty PAs dates back to 1978. I’m reminded of a quote from Johann von Goethe, “Until one is committed, there is hesitancy, the chance to draw back, ineffectiveness.” The NCCPA Board’s decision is our commitment to effectively address the needs of specialty PAs. NCCPA plans to employ the same approach suggested by Steve Uzzell, the general session keynote speaker. Uzzell said, “Question everything and start at the beginning to gain a new understanding.” And that’s exactly what the NCCPA is committed to doing. In addition to the historical roots of this initiative, other factors played a role in the decision. For example, the public, including our patients, have an expectation about the care being delivered by PAs practicing in specialty settings. Patients have a right to expect that their PA has the training, knowledge and skills to deliver the specialty care they are receiving. Unfortunately, at this point, no set standard exists for PAs practicing in specialty areas. This lack of a set standard could prove to be a stumbling block for our profession. For example, the American College of Emergency Physicians convened a group of NPs and PAs, including representatives of NCCPA and the Academy, last fall to deliver the message that the training and skills of new practitioners isn’t sufficient to meet the needs of critical care situations in emergency departments. This assertion, in turn, led the NCCPA to yet another conclusion. Changes in the larger health care delivery system may be adversely affecting the teaching and mentoring that should be taking place between PAs and their supervising physicians who are linked via the PA-physician team practice model.
The good news is that PAs are talented, energetic professionals who are successfully moving in to a number of different specialty and subspecialty practice areas. The challenge is to ensure that they safely and effectively practice in those areas. As a result, the NCCPA Board has convened a special task force of NCCPA Board members to lead our efforts in this area. At this time, the details of a solution have not yet been devised because our first step is to determine exactly the problem we are trying to solve. The NCCPA Board has charged the task force with the responsibility to be inclusive in its efforts to identify the problem and to determine the solution, and the task force will solicit input from the Academy, other PA professional organizations, PA specialty groups, and physician specialty groups. In addition, the task force has the responsibility to ask the tough questions: Is now the right time? Are we as individuals and as a profession where we should be? Where will we as a profession be in the next 30 years?
NCCPA has not undertaken this venture lightly. The Board has revisited the topic every few years or so and engaged in conversations with leaders of the PA and physician specialty organizations who have requested action. From our most recent discussions, we conclude that the time for action is upon us, and NCCPA is committed to putting our expertise as the national certifying body to use in support of these groups. The PA profession has benefited tremendously from having a single, independent certifying body. The competency discussion, ongoing in healthcare, has intensified the calls for action; and the recent development of a for-profit organization interested in PA specialty certification have all spurred the NCCPA Board to conclude that NCCPA, with its history, experience and tradition of excellence should take the helm in the development of such a credential. This venture, while in no way designed to replace the generalist recertification process, assists PAs practicing in specialty areas by providing a distinction in addition to their
PA-C and is well within the scope of NCCPA’s mission of assuring that certified PAs meet professional standards of knowledge and skills.
In addition to defining a solution to meet the needs of specialty PAs, the NCCPA Board also looked at ways to makeover PANRE, so that it exists both as a generalist exam in its current format and can be flexible with regard to component areas that could serve as add-ons to a shortened generalist exam. I assure you again that PANRE will continue to serve as the requirement for completing the recertification process and PANCE will continue to serve as the requirement for initial certification.
Finally, with all of these new initiatives, NCCPA has also reevaluated the Pathway II recertification process. As a result of those discussions, the NCCPA Board has decided that the Pathway II exam will have its last administration in 2010. Take-at-home exams are no longer relevant as certifying bodies across the nation, including the American Board of Medical Specialties, are doing away with take-at-home examinations for the evaluative component of their maintenance of certification processes.
With all of these new initiatives, I anticipate great dialogue among NCCPA and other organizations that support and represent PAs in various capacities. During the development of the definition of PA competencies, the four major PA organizations communicated frequently and cooperatively. I commend our organizations for their efforts in strengthening those relationships in the spirit of cooperation. Such a spirit is essential as we together face these changing times.
It is my greatest hope that you join me in support of these new initiatives. One of the key ways that I ask for your support is to always go to NCCPA for certification information and to share your thoughts and concerns. As your complete certification resource, NCCPA, including myself, our Board and the staff, are interested in your thoughts and feedback. I encourage you to visit NCCPA’s Information & Resource Center here at the conference where you can provide your feedback to NCCPA leadership. We look forward to working with the profession to implement these new initiatives, and we are committed to keeping the profession up-to-date on the progress of these changes.
In conclusion, I leave you with my commitment that my ultimate priority among all of these new initiatives is to strengthen the integrity of the credential and to continue to deliver excellent products and programs to the profession. The NCCPA Board and I are wholly committed to ensuring that any changes or new initiatives meet the same high standards that our current programs meet. As I mentioned when I began my remarks, planning for the future had me looking into the past. What I saw in the past was a tradition of excellence and what I see in the future is dedicated effort to ensure that tradition of excellence and to establish a legacy of excellence for years to come. Thank you for the opportunity to address you today.
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