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Winter 2004
Volume 5, Number 4
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(You will need Adobe Acrobat to open some of the documents referenced in this newsletter.)
Contents:
- Pathway II Changes Announced for 2006
- NCCPA Aims for Quality via "Six Sigma"
- Tools for "Proving" Certification Status
- Q&A Corner
- Short Takes
- Dates and Deadlines
Pathway II Changes Announced for 2006
In keeping with NCCPA’s commitment to fiscal responsibility, the Board of Directors approved the institution of Web-based
delivery and a fee increase for the Pathway II recertification exam beginning with the 2006 administrations.
The take-at-home Pathway II exam — with its additional "elective component" eligibility requirement — was adopted as a
full-fledged alternative to the now computer-based Physician Assistant National Recertifying Exam (PANRE) in 1998.
Since its inception, approximately 20% of recertifying PAs have chosen Pathway II each year. However, the cost of developing
and administering the take-at-home exam in its current form for less than a quarter of the recertifying population will result
in a loss of over $450,000 this year. The actual cost per Pathway II examinee in 2004 was close to $700, though NCCPA only charges
$300 for the exam.
"The administration of Pathway II is highly labor intensive and actually costs more to develop and administer per examinee than PANRE
does," said Lori Leal, NCCPA’s director of operations and finance. "The Board was faced with choosing to subsidize the current form
of the exam with fees paid for PANRE and CME logging, or to take steps to move the exam to a more financially independent position."
As a result, the Board adopted a two-tiered approach to bridging the gap between the cost for developing and administering the
Pathway II exam and the fee PAs actually pay for it.
A first step is a cost-saving measure: adoption of a more efficient delivery and administration mechanism. To that end, the
exam will be delivered and completed electronically via the Web beginning in 2006. The Web-based Pathway II will still be given
over a six-week period as an untimed, unproctored exam. Instead of receiving an exam booklet and paper answer sheet, Pathway II
examinees will simply log in to a secure Web site—as often as they like during the testing period—and complete the exam online.
Using the Web as a delivery vehicle eliminates the cost associated with printing and storing the test booklets, the cost of
shipping the exams (from NBME to NCCPA to the individual test takers and then back again), and the cost of tracking down exams
that are not returned in a timely fashion.
While offering Pathway II online lowers the cost of the exam's administration, that savings is, unfortunately, not enough to
develop and administer the Pathway II exam solely using the fees currently collected from applicants. To help close the rest
of the gap, the Board approved a new application fee of $475.
"By adopting the two-tiered approach, the Board increased the efficiency of the Pathway II process with the Web-based exam
option and, in turn, reduced the additional cost that we need to pass on to PAs who are choosing Pathway II," said Janet J.
Lathrop, NCCPA president.
In 2005, the exam will be offered under the current process as a pencil and paper exam with a $300 application fee. PAs who
want to take the Spring 2005 exam must submit their application, payment and elective component workbook by January 14, 2005.
NCCPA Aims for Quality via "Six Sigma"
In 2004, NCCPA stepped up its commitment to quality by adopting the rigorous Six Sigma methodology for process improvement.
NCCPA’s quality commitment builds on the "excellence in all we do" paradigm, which has been the organization's guiding
philosophy for customer service since Janet J. Lathrop became president in 2002.
Six Sigma is a customer-focused methodology that suggests a formulaic approach to problem-solving based on historical data,
input from current customers and cost-benefit analyses. By definition, to achieve Six Sigma a process must be nearly flawless,
resulting in less than 3.4 errors per million opportunities.
"While we’ve been undertaking serious process improvement efforts for several years now, we’re excited to be taking some high
impact steps that will better focus those efforts to provide top-notch services," said Lathrop.
NCCPA adopted the Six Sigma methodology after the information technology department used it to evaluate the effects of
infrastructure changes and software and database improvements.
For example, evaluation of NCCPA's automated phone system suggested changes that will reduce abandoned phone calls at NCCPA
in 2005.
To achieve improvements, Six Sigma offers a complete tool box for understanding and solving problems.
"Surveys are one of Six Sigma's key tools, and PAs have seen more NCCPA surveys this year," said Tim Perry, NCCPA director
of information technology. "The feedback they're providing is guiding us as we redesign our systems for improvement."
Another key component is the institution of control mechanisms to ensure ongoing process integrity. For example, NCCPA used
Six Sigma to develop the digital file room, a mammoth undertaking to scan all current and historical certification documentation
and store it electronically. Before scanning began, a control process that included a two-tier review of all scanned
documentation was devised. Based on early control feedback, the Six Sigma tools were used to develop system refinements. For
example, as soon as data entry begins from a CME logging form, a virtual holding place is created for that document in a PA's
digial file, facilitating the scanning process that will come later.
Six Sigma can also be used to launch new processes. NCCPA used the methodology to develop secure, customized Web portals that
have increasingly automated the work that NCCPA does with state licensing boards and PA programs.
The state portals provide licensing agencies direct, secure access to PANCE scores, reducing the time from examination to
licensure by up to six weeks.
The PA program portal automates the initial eligibility process for PA students and provides programs detailed information
about student registration, scheduling and examination performance. In addition, program performance reports are available via
the portal. Each program’s portal will serve as a historical file that can be reviewed whenever needed.
In 2005, NCCPA will again turn to portals to offer enhanced CME collection and reporting services. The CME project, developed
with Six Sigma tools, began with the use of now ongoing Web-based surveys. Be sure to check out future issues of
NCCPA News for the latest details about this project!
"Our adoption of the Six Sigma methodology has raised the ‘quality bar’ at NCCPA and given us a new target to strive for as we
serve all of our stakeholder groups," said Lathrop. "Process improvements are subjected to the highest quality standards,
which will allow us to offer the best systems developed around the needs of the customers who will use them."
Tools for "Proving" Certification Status
When surveyed, some PAs expressed concern that the new, larger certificate is difficult to submit to third
parties as proof of certification, which indicates a misperception about how the certificate is intended to be used.
"Your certificate is the recognition of your ongoing commitment to your individual professional development and your role in
the larger evolution of your profession. It’s our hope that you’ll proudly display this recognition," said Janet J. Lathrop,
NCCPA president.
The larger certificate size and new layout were devised, in part, to support NCCPA's long-standing assertion that certificates
and wallet cards alone are not proof of certification and to help curtail the appearance of fraudulent certificates. In 2004
alone, NCCPA uncovered three altered certificates that were submitted to employers, hospital credentialing boards and state
licensing boards.
To help ensure the ongoing integrity of the certification credential, NCCPA is enlisting PAs' help to train all third parties
to seek primary source verification of certification directly from NCCPA.
"As the certifying body, we can provide a PA's most up-to-date certification status to a third party exactly when they need it
at no cost," said Lathrop. "We recognize that some third parties currently require a copy of your certificate, and we're ready
to assist you in any way that we can in educating those parties about the appropriate tools for certification verification."
The quickest way to prove one's certification status is to use the "Verify PA-C" function at NCCPA Connect.
A PA or interested third party can access a PA's current certification status, certificate number, initial certification date
and certificate expiration date by entering either the PA's social security or certificate number or the PA's name and state
of residence.
If additional documentation is required, PAs or third parties can request that NCCPA send via e-mail or regular mail an official
verification letter by completing a simple Web-based form on the Verify PA-C page. A verification letter is the only
acceptable, official proof of certification that should be provided to third parties.
When PAs sign in to their personal certification record at NCCPA Connect, they can
select the "Third Party Information Release" link and also authorize the release of a verification letter or
recertification exam results to a third party by providing us the appropriate contact information.
Should a third party not accept a certificate verification letter, please ask them to contact NCCPA directly at 678.417.8100.
Q&A Corner
Q. I completed my certification maintenance requirements for the 2002-2004 cycle but haven't received my updated certificate.
Where is it?
A. Certificates for PAs who completed requirements before November 1 were mailed by November 15. Certificates for PAs who completed
their requirements after November 1 will be printed and mailed weekly through the end of the year. If you haven’t received your certificate,
sign in to your personal certification record at www.nccpa.net to verify that you’ve completed all requirements and that NCCPA has your
correct mailing address. If you’ve completed all requirements and your mailing address is correct, please contact our office at
678.417.8100.
Q. How can I find out when I need to register for and take my next recertification exam?
A. To find out when you are scheduled to recertify, simply sign in to your personal certification record at NCCPA Connect.
On your "My Record" page there will be a message letting you know when you may take the exam. Remember, NCCPA offers PAs up to four
opportunities to pass a recertification exam by allowing PAs to test in either the fifth or sixth years of their certification
maintenance cycle. If you’re scheduled to test in 2005 or 2006, view the upcoming PANRE and Pathway II exam windows and application
deadlines by clicking the "Recertification Exam Deadlines" link in your checklist.
Q. What happens if my certification expires at the end of 2004 and I haven't completed all of my requirements?
A. NCCPA offers two ways to regain your certification depending on what requirements were outstanding when your certification expired.
If your certification lapsed because of a failure to log CME or pay any fees, you can regain your certification by submitting the
outstanding paperwork and paying a reinstatement fee. We'll start processing reinstatement materials in mid-January (after we've taken
care of all paperwork submitted before the December 31 deadline). If your certification lapsed because of a failure to earn enough CME
or because you failed to take or pass an exam, you can regain your certification by passing a recertification exam – if you meet CME
requirements – or by passing PANCE.
Short Takes
- The NCCPA Board elected Board officers at its November meeting. The 2005 officers are:
- Chair Disty Pearson, PA-C
- Chair-Elect Bill Kohlhepp, MHA, PA-C
- Immediate Past Chair John W. Ogle, MD
- Treasurer Ed Dunn, MBA, SPHR
- Secretary Randy Danielsen, PhD, PA-C
- Executive Committee Member-at-Large Lee Bryan Smith, MD
The Board also re-appointed Disty Pearson and Ed Lopez to each serve a second term as PA directors at large. In addition, NCCPA thanks Gary Winchester, MD, our only outgoing board member and our immediate past chairman, for his dedicated service and commitment to the PA profession. - Thank you to all who responded to the Practice Analysis Survey conducted in recent months. More than 4,200 PAs completed the online surveys, giving us a representative sample of practicing PAs. In the coming months, those survey responses will inform discussions about whether the current exam content blueprint accurately reflects PA practice. Any decisions to make changes to the examinations will be announced in 2005.
- Check out the NCCPA-sponsored issue of APAP's "Perspective on Physician Assistant Education," published in November, that highlights the role of testing as a tool in the certification process and as a predictor of student success. "Testing is a bedrock principle for establishing minimum standards of merit on which to grant recognition," said Janet J. Lathrop, NCCPA president. "The PA profession was long heralded as a leader because of the testing component of NCCPA's recertification policies. We've partnered with APAP to provide PAs and educators insight into the value and mechanics of certification testing as well as to stimulate discussion as to how testing may evolve to meet the competency movement in the PA profession."
Dates and Deadlines
Click here for a current listing of dates and deadlines.
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