Synopsis of the 2018 AAPA House of Delegates Meeting

Greetings NDAPA Members,

I just returned from the 2018 AAPA House of Delegates (HOD) meeting in New Orleans and wanted to update you all on what the HOD decided this year for AAPA policy. Just as a background, the AAPA HOD is an elected group of 290 PAs from around the country that enact policies establishing the collective values, philosophies, and principles of the PA profession. While AAPA policy is not “law”, it is the driving force for many issues within the profession.

Here were the most debated and/or significant topics that were discussed and voted on:

1. Optimal Team Practice: An amendment to the OTP policy from last year was proposed. The authors of this new policy thought that the old language was too suggestive of PAs wanting independent practice and that some states were dealing with negative repercussions because of the wording.
   • There was a lot testimony most which was against any changes. Since this policy was so new (1-year), most in HOD were against any changes. In the end, the resolution failed and the policy will remain the same.
2. Change from “PA” to something else: This has been issue with the profession for quite some time. It has been brought in the HOD on numerous occasions but has never gone anywhere. A resolution was presented asking for an independent agency to investigate a name change for our profession and the possible implications, good or bad, that it could bring.
   • There was far more testimony that supported this resolution than apposed. Those opposed to the idea were most concerned about the $850k - $1.2m price tag that the consultants estimate. The AAPA Board said that they currently have strong financials and that they feel this is an important topic worth the cost.
   • Since our profession as matured over the last 50 years, moving away from the “assistant” is wanted by many and has actually caused issues in some states trying to move forward with OTP. Wisconsin, for instance, went to their medical board asking for their support but were told they could support such a change for a profession with “assistant” in the title. They said that an “assistant” implies that there must be supervision.
   • Others noted that we are the only profession that prefers to go by our initials (PA) rather than our full title because we are “ashamed of it”.
   • The resolution passed and the AAPA Board of Directors will be selecting a consulting firm to investigate a title change, reporting back to the HOD in 2019.
3. Standards for In-Person Instruction: The Tennessee delegation proposed a policy that requires PA schools to have at least 80% of the didactic portion of PA school be in a live classroom setting. Their concern was that many NP programs were going to all, or nearly all, online formats and that they didn’t want to see that with PA education. They have heard concerns about NP online education from physicians and don’t want us to be in the same situation.
   • The driving force for this resolution was the start of a primarily online PA program through the Yale School of Medicine which has only 3 weeks on campus throughout the entire program.
   • While policy from the AAPA cannot directly dictate the standards for PA programs, policies can have a way of influencing change. The Accreditation Review Commission for PAs (ARC-PA) is the accrediting body for PA schools and sets the standards. Both the ARC-PA and the AAPA Board were against this resolution.
   • Our own PA program here in ND is one of the few that uses a hybrid educational design and has been doing so for over 40 years, even before the internet. While 3 weeks of on campus time seems too little to me as well, there is more to it than a policy by the AAPA. There are numerous other factors that must be considered such as advancement in technology, providing education to those in rural and underserved areas, and not to mention federal anti-trust laws
   • This was probably the most debated resolution of the year. In the end, the resolution was not passed as written, but instead it was referred to the Speaker of the House who will select a panel of PAs and review the issue and report back to the HOD next year.

Though there were nearly 60 resolutions that were discussed, those were the most prevalent to PAs in North Dakota. The full report from the AAPA usually comes out later in June. Please let me know if you have any questions.

Jay Metzger

jay.metzger@med.und.edu