Timeline of Interaction Between NCCPA and AAPA on Potential Changes to the Recertification Process

Throughout the last seven months, NCCPA has repeatedly invited meaningful dialogue and substantive discourse with AAPA, hoping for a collegial and constructive discussion about how to improve the relevance of the PA recertification exam process given that more than 70% of PAs now practice outside of primary care.

We have been disappointed by the actions taken by AAPA over this past year and their unwillingness to engage in dialogue around this important issue.

  • April – September 2015: On multiple occasions through a variety of communication channels (including in person), NCCPA communicated to AAPA that we were undertaking a holistic review of PANRE to make it more relevant to PA practice, given that more than 70% of PAs are practicing outside of primary care. NCCPA made clear that we would seek AAPA input after our November Board meeting.

  • November 11-12,2015: NCCPA News was issued to all certified PAs overnight with initial announcement of the proposed model and the upcoming public comment period; a copy was sent to the AAPA CEO. That same day, without any communication with NCCPA about the potential changes, AAPA President Jeff Katz blasted the proposal on behalf of the AAPA Board as “seriously flawed” and “likely to financially benefit NCCPA,” inviting comments from members to “inform our official response to NCCPA, as well as any other actions that may be appropriate.”

  • November 30, 2015: NCCPA’s president/CEO contacted AAPA’s CEO, saying in part: “We know at least some of your leaders have concerns about this new model. We welcome the opportunity for dialogue about those concerns; that goes to the very purpose of this public comment period.” Ultimately, her request for a conference call with AAPA Board members resulted in a call being scheduled for January 19, 2016.

  • January 11, 2016: Within days of what was to be the first interaction between NCCPA leaders and the AAPA board on this topic, AAPA pre-emptively issued its first letter to the NCCPA Board, requesting a delay in the decision until after the HOD has an opportunity to weigh in. A matter that could have been addressed collegially and leader-to-leader on that conference call was instead CC’d to hundreds of HOD leaders and published on AAPA’s website. That letter included no expression of interest in board-to-board dialogue.

  • January 19, 2016: AAPA leaders indicated they would not entertain any questions from NCCPA or engage in any dialogue with NCCPA participants during the board-to-board conference call. They made clear they were only participating to get answers to their prepared questions. This was an interrogation, not a conversation.

  • January 20, 2016: In a follow up email to AAPA’s CEO, NCCPA’s Board chair wrote, in part: “Our Board certainly appreciates that you, Jeff and others were willing to bring your questions directly to us on last night’s call. I hope that we can continue in that vein during your discovery and deliberation process, avoiding any further public commentary that could compromise our ability to build accurate and full understanding of the model under consideration. We welcome further questions and remain eager to ensure your understanding of the changes under consideration.”

  • Late January 2016: NCCPA received word from multiple sources that AAPA was encouraging constituent organizations to survey their members regarding whether they believe PAs should have to retest at all, undermining efforts to elicit feedback that would improve PANRE and shifting the focus to the idea that testing could be eliminated altogether.

  • February 5, 2016: NCCPA representative addressed participants in AAPA’s Leadership and Advocacy Summit and was silenced when trying to address misinformation about the proposed PANRE model during an open forum on the topic.

  • February 6, 2016: NCCPA’s Board voted to extend the public comment period, as requested by AAPA.

  • February 8, 2016: Before NCCPA had even had the opportunity to communicate the outcome to AAPA, AAPA launched its online “news center,” the hub of a new and aggressive anti-NCCPA campaign.

  • February 9, 2016: NCCPA launched its PA survey to solicit feedback on the current PANRE and the proposed model under consideration.

  • February 12, 2016: AAPA published criticism of the NCCPA survey, “cautioning” members against participating – actively working to undermine our effort to gather input from the profession at large.

  • February 16, 2016: During a call from NCCPA’s Board chair, AAPA President Jeff Katz agreed that the rhetoric and tension between the two organizations needs to be significantly toned down.  That same day, NCCPA delivered its official response to AAPA’s request for an extension of the public comment period, which ended with another NCCPA invitation for dialogue with AAPA leaders.

  • April 22, 2016: AAPA again actively worked to undermine NCCPA efforts to gather input on the recertification process, this time by writing to the heads of the Federation of State Medical Boards to caution them about a survey NCCPA would be conducting during their annual meeting. Here they also published the AAPA Board’s anti-model, anti-testing resolution in advance of the HOD meeting. There was no prior communication with NCCPA about this resolution.

  • May 15, 2016: AAPA’s CEO addressed the AAPA HOD saying: “We are also looking at our legal options with regard to the NCCPA’s proposed changes to PA recertification exam requirements.” Bear in mind, AAPA had yet to accept NCCPA’s multiple invitations for real dialogue about these potential changes.

  • May 24, 2016: NCCPA received AAPA’s letter to the NCCPA Board communicating the resolution passed by the HOD. This letter contained AAPA’s first offer to work with NCCPA on this issue; however, at this point that offer is only to develop “alternate recertification model that is consistent with” the very restrictive principles laid out in that resolution, an offer further complicated by the earlier threat of legal action.

  • June 2, 2016: Just one week later, AAPA legal counsel issued a letter to the NCCPA Board expressing antitrust concerns and threatening legal action. This letter was, of course, also published online. (You can read our attorney’s response to that letter online.)

  • July 18, 2016:   AAPA President Josanne Pagel calls NCCPA’s Board chair to let him know – mere hours before the news was made public – that AAPA’s Board had voted to initiate steps to establish a new PA certification organization.  There had been no prior communication with NCCPA about this. AAPA took this dramatic step knowing that – while we extended the public comment period to allow the HOD to weigh in – our own Board has not yet met and thus has not had opportunity to discuss the feedback received from the HOD or others who weighed in prior to the June 15 conclusion of the comment period. 

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