CAPA News June/July 2011 by CA Academy of PAs

News

Official Publication of the California Academy of Physician Assistants

Politics in Action

June/July 2011

\The Magazine

by Jacob Hauptman, PA-C

Beth Grivett, PA-C; Jacob Hauptman, PA-C; Maryann Sheps, PA-C; Daniel Seeman; Senator Fran Pavley; Chris Smith, PA-C; Ed Arias, PA-C and Bryce Docherty

ost of my life I have stayed on the sidelines of the political arena, placing my faith in others to ensure that my personal and public freedoms were protected. This proved to be much more difficult once I became a PA and witnessed firsthand the challenges facing practicing physician assistants. Recognizing that the best way to help a cause is to become involved, I joined CAPA’s Legislative Affairs Committee last year and since that time I have been treated to an in-depth introduction to politics. This was how I found myself flying to Sacramento in early June in order to lobby California’s State Legislature along with four other PAs. The subject of the visit to the Capitol was Senate Bill No. 233 (SB 233), a piece of legislation sponsored by CAPA and introduced by Senator Fran Pavley. The bill was drafted in response to a drastic restriction of the ability of PAs to consult and treat patients in California emergency departments. As

can occur with a relatively new profession such as physician assistants, existing law can unintentionally exclude members of the PA community. In this instance, current Health & Safety Code covering emergency departments had been written prior to the insertion of PAs into the professional code and consequently listed only physicians and surgeons as providers who could consult and treat patients in the emergency department. In order to ensure that physician assistants across California can continue both consulting and treating in the ER, CAPA sponsored SB 233 and we were in the Capitol to help our state legislators understand the personal importance of this bill to the PA profession. The day’s work began in one of the Capitol’s cafeterias where, Maryann Sheps, Edward Arias, Beth Grivett, Chris Smith and I met with Bryce Docherty, CAPA’s Legislative Advocate. It quickly became apparent that without the guidance and know-how of Mr. Docherty, the entire legislative process would become overwhelming. After briefly reviewing our schedule, that included meetings with key Assembly Members or their staffers, he briefed us on the nuances of the politics involved with moving a bill through the state legislature. Although SB 233 had already cleared a major hurdle by passing the Senate without opposition, there still remained a crucial hearing in the Assembly Health Committee as well as the final vote. It is during these meetings that both the proponents and

the opponents of a bill can present arguments to the Assembly Members in the hopes of swaying the members to agree with a specific point of view. Our goal was to speak with as many of these Assembly Members as possible prior to the Health Committee hearing so they could understand the importance of SB 233 to patients and to practicing PAs throughout California. We began to move our way through the Assembly Members’ offices, sometimes speaking with staffers, other times directly with the Assembly Members. We quickly learned that, after listening to the physician assistant point of view, legislators believed the bill to be a positive, straightforward piece of legislation. It was also apparent that the opinion of others around the Capitol was important to each legislative member, as the common questions seemed to be “was there any opposition in the Senate?” and “are there any groups that oppose the bill?” Thankfully, our answer to the first question was simple: our bill had already passed the Senate with unanimous support, which seemed to impress the people in each of our appointments. Our answer to the second question, that there was indeed opposition to our bill by two groups, did not seem to be a concern for the Assembly Members we spoke with. By and large they appeared to support our cause when we explained that the purpose of SB 233 was simply to change existing state law to comport with a federal Continued on page 22

News

Editor Gaye Breyman, CAE Managing Editor Denise Werner

Congratulations Incoming 2011-2012 CAPA Board of Directors President Eric Glassman, MHS, PA-C

Director-At-Large Margaret Allen, PA-C

President Elect Adam Marks, MPA, PA-C

Director-At-Large Roy Guizado, MS, PA-C

Proofreader Paula Meyer, PA-C

Vice President Jeremy A. Adler, MS, PA-C

Director-At-Large Greg Mennie, PA-C, MSed

Secretary Cherri Penne-Myers, PA-C, MSCS

Director-At-Large Larry Rosen, PA-C

Treasurer Bob Miller, PA-C

Student Representative Joy Dugan, PA-S

President Eric Glassman, MHS, PA-C president@capanet.org President Elect Adam Marks, MPA, PA-C presidentelect@capanet.org Vice President Jeremy A. Adler, MS, PA-C vicepresident@capanet.org Secretary Cherri Penne-Myers, PA-C, MSCS secretary@capanet.org

Congratulations to the 2012 AAPA House of Delegates

Treasurer Bob Miller, PA-C treasurer@capanet.org

Term July 15, 2011 – July 14, 2012

Directors-At-Large Margaret Allen, PA-C dirmargaret@capanet.org Roy Guizado, MS, PA-C dirroy@capanet.org Greg Mennie, PA-C, MSed dirgreg@capanet.org Larry Rosen, PA-C dirlarry@capanet.org

Elected AAPA President

Term July 1, 2011 – June 30, 2012

Editorial Board Eric Glassman, MHS, PA-C Beth Grivett, PA-C Bob Miller, PA-C Larry Rosen, PA-C Michael Scarano, Jr., Esq.

CAPA Board Of Directors

Jim Delaney, PA-C

Congratulations, Jim Delaney, PA-C

im was elected AAPA President

and will take office in June 2012. Jim served as CAPA President in 2001-02 and 2004-05. Jim currently lives in Texas, but we will always

Jacob Hauptman, PA-C Julie Theriault, PA-C Adam Marks, MPA, PA-C Jay Williamson, MS, PA-C Cherri Penne-Myers, PA-C, MSCS

consider him part of our CAPA Family!!

AAPA 2011 PAragon Award Winners from California

Student Representative Joy Dugan, PA-S studentrep@capanet.org The CAPA News is the official publication of the California Academy of Physician Assistants. This publication is devoted to informing physician assistants to enable them to better serve the public health and welfare. The publisher assumes no responsibility for unsolicited material. Letters to the editor are encouraged; the publisher reserves the right to publish, in whole or in part, all letters received. Byline articles express the opinion of the author and do not necessarily reflect the views or policies of the California Academy of Physician Assistants.

The CAPA office is located at: 3100 W. Warner Ave., Suite 3 Santa Ana, CA 92704-5331 Office: (714) 427-0321 Fax: (714) 427-0324 Email: CAPA@capanet.org Internet: www.capanet.org ©2011 California Academy of Physician Assistants

CAPA NEWS

Rachel Stark Farrell, PA-C, LM, CPM

Katherine G. Footracer, PA-C

Christopher E. Sadler, MA, PA-C, CDE

Daniel Einhorn, MD

For their pursuit of excellence, we congratulate these exceptional California physician assistants and take pride in their accomplishments. Rachel Stark Farrell, PA-C, LM, CPM Service to the Underserved Katherine G. Footracer, PA-C 1st Place Publishing Christopher E. Sadler, MA, PA-C, CDE/Daniel Einhorn, MD Physician-PA Partnership

CAPA Launches A Fantastic New Website!! We hope you have had a chance to visit us at www.capanet.org

t is important to note that the way you log-in has changed. You must create a new, unique password when you first visit the page. On your first visit, click on FORGOT PASSWORD? just underneath User Name and Password. You will be asked to enter your email address, first name and last name. Once you do that and select your name, you will receive an email with a link which when used, will allow you to create your new password. From that point on when you login, you will use your email address and the password you created on that first visit.

Create Log-in

Check Out Your Member Portal Once you are logged in, click on this button on the home page: Member Portal This will take you to your Member Portal. Once there, click on UPDATE MY INFORMATION so you can be included in the On-line MEMBERSHIP DIRECTORY. You decide what information, if any, you would like included.

Inside This Issue Incoming 2011-2012 CAPA Board of Directors.......................2

In Search of a Project..........................................................11

Keeping It Real...................................................................19

Jim Delaney, PA-C Elected AAPA President..............................2

Did You Know?...................................................................12

My Little Story About Playing Doctor...................................19

2012 AAPA House of Delegates.............................................2

In Memoriam.....................................................................12

Our Special Thanks to Peter Aronson, PA-C...........................19

AAPA 2011 PAragon Award Winners from California..............2

CAPA’s Committee on Diversity............................................12

At the Table........................................................................21

CAPA Launches A Fantastic New Website!!..............................3

Money Talks – Political Fundraising.....................................13

Bucket List….....................................................................23

Me And My Shadows.............................................................4

Would You Like to Help Raise CAPA PAC Funds?....................13

Special Student Track at the CAPA Conference......................24

Medicare Home Health “Face-to-Face” Encounters: Certification Requirements....................................................6

Come Be Educated and Inspired…......................................14

Attention: PA Program Directors, Class Presidents,

Fun in Palm Springs............................................................15

Student Society Leaders, Faculty and Students….................24

Keynote Luncheon..............................................................16

Student Medical Challenge Bowl Sign Up Now….................24

PA Visionaries Wanted - Apply Today!….............................16

Building a Curriculum Vitae…............................................25

Reform Timeline: When the Changes Happen.........................9

It All Began With a Vision....................................................17

Welcome New Members......................................................27

Genealogy: Looking at the Roots and Branches of the PA Profession............................................................10

Controlled Substances Education Course...............................18

Local Groups......................................................................27

Demystifying Emergency Medicine Course...........................18

The CAPA Legal Corner..........................................................7 Heath Care Reform and PA Education: Challenges and Opportunity..........................................................................8

JUNE/JULY 2011

Me And My Shadows by Larry Rosen, PA-C, Public Relations Committee Chair

’ll call her Kate. She’s 51 years of age from Northern California, an EMT with a fire in her belly to become a physician assistant. She got my name from the USC PA program. I’m a Trojan (when I’m not a Michigan Wolverine) and I’m often called upon to allow students or potential students to shadow me. “Shadow” is defined by Webster’s as “to accompany (someone) in their daily activities at work in order to gain experience at or insight into a job.” Exactly what Kate wanted to do. She had shadowed other PAs in various specialties but never family practice. Experience with practicing PAs reads “They see and hear everything. well on a CV and Kate was And then a remarkable thing about to begin happens. They experience a sense the process of applying of profound responsibility that to several California PA comes with having been allowed programs.

to participate in the process, even as an observer.”

Clad in her white coat, Kate spent the better part of four hours with me one Tuesday morning. Together, we saw about twelve patients. Her smile and ease with them was refreshing. A seasoned pro, she knew how to make patients comfortable around her. She also respected the fact that they were my patients and deferred any questions about diagnoses and treatment plans until after the visits. The patients liked her very much. So did my staff. So did I.

“…in order to gain experience at or insight into a job.” My first exposure to shadowing came in Youngstown, Ohio, in my other life, when I was directing local live television. 4

CAPA NEWS

My daughter, Betty, had been born two weeks prior. My wife’s anesthesiologist, Mike, heard I was doing this children’s afternoon TV show. It was called (don’t laugh) “Major Ted And His Space Rangers.” Mike’s kids were ardent fans and he was dying to see how it was done. The show, for its time, was pretty advanced; lots of special effects, rocket stuff, outer space gimmicks, games, costumes and an unruly kid audience. Mike came down one afternoon with a camera and a note pad and watched me stand on my feet in the control room for ninety minutes barking out orders to two cameramen, a stage manager and three studio techs; infuriatingly complicated but great fun. When it was over, Mike hadn’t taken a picture or written one note. He was exhausted, awestruck at the pace and complexity of the production. “My God, how do you do that?” The comment made me laugh. “You deal with human lives every day.” “Hell, that’s my job,” he said. “But this…this is tough!” A month before Kate shadowed me at my clinic, a young college student from L.A. who wanted to be a PA spent a day with me. “I can’t believe you do all that,” she said. It was one of my alone days in the clinic and it was packed; three lacerations, a knee aspiration, an abscess I&D and twenty-nine patients. She had no idea family practice PAs did so much medicine. It energized her and solidified her resolve to pursue a career as a physician assistant. And that’s why I do the shadowing thing. It was never my intention to seduce Mike, the anesthesiologist, into becoming a television director but it feels very good to inspire people to embrace the PA profession and strive to become a part of it.

Practicing PAs get lots of requests to not just allow potential PA students to shadow them, but to precept PA students in training; open our clinics to them to learn on specialty rotations that last four weeks. There are times we might be tempted to do it but the doing often presents problems for us, our employers and supervising docs. Liability issues and the responsibility of becoming a teacher whittle away at enthusiasm and we very likely wind up passing on the invitation. Which presents another reason why I like the shadowing process. Shadowing can be as long or short a time as you like. We get to decide how much time we spend with the potential PA applicant. Personally, I like a half day schedule. I ask them to bring a white coat, they see patients with me, we talk for a while and it’s over. In almost every case, the experience whets their appetite to come back and see more and, if I like the person, I do invite them back. The talk part is my favorite. I get to learn what they know about the profession, what they don’t know about the profession and what attracts them to it. Responses are as varied as they are interesting. Some want to impress upon me how much they want to “help people.” I actually believe some of them. A few fear the medical school route because of time or money issues or they just flat out feel they’re not smart enough to get in (it’s often an eye-opener for them when they realize what the prerequisites for PA school are). And there are those who come with years of life experience who, having tried several professions, now find themselves challenged and attracted by this provocative endeavor called medicine. I haven’t figured out what’s responsible for

this “calling” but I see more and more of it. Maybe it’s TV shows like House or Grey’s Anatomy or the lure of health care reform. Whatever the catalyst, interest in PA medical practice is blooming. Shadowing for the “shadower” is more than just an opportunity to watch a PA in practice. It gives them license to connect to the patient-provider interaction up close and very immediate. They see and hear everything. And then a remarkable thing happens. They experience a sense of profound responsibility that comes with having been allowed to participate in the process, even as an observer. Never once has a patient of mine said no when I’ve asked them if I can bring a potential PA student into the examining room. What happens in that room is private and often deeply personal. It leaves a powerful impression on the observer. If you’ve never considered setting yourself out to be shadowed, I’m asking you to think about it. More and more PA programs are requiring shadow experience on their applications. This is an easy, satisfying way of giving something back to your profession. Some of us have alumni ties with our programs and make ourselves available to requests made by applicants and students. Several have placed their names on a list at the CAPA office where frequent inquires are made.

Jana Pratt, PA-C “I’ve had three students and five non-students shadow me. Most come for a day or two. I did have one college student who spent four weeks here one summer as she couldn’t decide if she wanted to be a PA or a physical therapist!”

Jennifer Cates, PA-C “I routinely hear from prospective students about how few opportunities there are available to them. In reality, I could have a “shadower” with me four-five times every month. It is more likely that I take five to eight per year, typically for a single day or half day. I always ask patients if it is OK for a student or potential student to ‘sit in on our visit’ and rarely is it denied.”

James Kimber, PA-C in San Diego has taken shadowing to another level.

James is a neurosurgical physician assistant. He has PA students shadowing him every day he works. With the assistance of a UCSD student, Ashley Erazo, James has started an online website posting his work calendar where students can sign up to shadow him. “I have an online calendar and the students can view it anytime and sign up right online. I am now recruiting other PAs from San Diego to help with shadowing and now have six PAs involved and the interest is growing each month.”

http://www.supersaas.com/schedule/PA_ Shadow/James_Kimber-Neurosurgery In the months to come, James is planning to launch a nationwide shadowing site where PAs from anywhere in the U.S. as well as students will be able to check an area close to them to find PAs who will allow students to shadow. Currently, there are no written guidelines or protocols pertaining to shadowing but CAPA is considering taking the lead in producing such a recommendation. If you have been shadowed by a student or potential student, I would welcome your comments about the experience. Each setting seems to dictate its own best practice guidelines but an overview and optional protocol recommendations would be useful to distribute. In closing, I am happy to report that Kate is finishing up her prerequisite courses and is applying to several PA programs. And Mike, the anesthesiologist, is long retired. Neither he nor his ardent fan children ever pursued a career in television. 

CAPA FACT Did You Know? The address you provided to the Physician Assistant Committee is available to the public. Visit the PAC website: www.pac.ca.gov and click on VERIFY A PHYSICIAN ASSISTANT LICENSE. See what is there for public view. We suggest you use your work address. JUNE/JULY 2011

Medicare Home Health “Face-to-Face” Encounters: Certification Requirements by Bob Miller, PA-C, Professional Practice Committee Chair

ecent changes, in effect January 1, 2011, provided in the Affordable Care Act (signed into law March 2010) have defined a requirement for a faceto-face encounter with the patient before a physician can certify home health care. A PA may play a role in this process by performing the faceto-face encounter for the certifying physician. PAs cannot order (certify or recertify or sign for) Medicare Home Health Care benefits. Home health care benefits may include nursing, aides, physical therapy, “The face-to-face encounter occupational may be performed by a PA who therapy and other skilled is working with / collaborating services. There are also criteria with the physician. The in defining who qualifies to certifying physician must sign be considered “home bound” the document. ” and eligible for these services. PAs may be authorized to provide ongoing “Care plan oversight (CPO)” for established home health patients. PAs may write or revise health care orders, including for DME, only if it integrates with the physician’s home health plan for that patient. PAs cannot order DME for these patients if it does not integrate with the physician’s plan of care. The new “face-to-face” encounter rules for certifying home health care (for certification - but not for recertification) state that there must be a face-to-face encounter by the certifying physician to document the need for home health care. The 6

CAPA NEWS

encounter must occur within 90 days prior to the start of care or within 30 days after the start of care. The certification must include a minimum 5 items of information: 1. The patient’s name 2. The date of the encounter 3. A narrative statement of the patient’s condition and need for which skilled services 4. The physician’s signature (not stamped) 5. The date of the physician’s signature The face-to-face encounter may be performed by a PA who is working with/collaborating with the physician. The certifying physician must sign the document. The Act recognizes that other physicians may also be involved in the care of the same patient and allows for the “handing-off” of the certification from a physician in an acute care setting (like a hospitalist) to another physician in the community who can review and sign-off on the home health treatment plan. A PA attending to a patient in an acute care setting or ED may collaborate with the community certifying physician regarding the PA’s encounter with the patient so the community physician can certify based on the information provided from the PA encounter. It is not clear if the community physician must also be an official supervising physician (included in your DSA) for this interaction. The

following is an excerpt from: Medicare Learning Network, MLN Matters No: SE1038 As a condition for payment, the Affordable Care Act mandates that prior to certifying a patient’s eligibility for the home health benefit, the certifying physician must document that he or she, or an allowed NPP has had a face-to-face encounter with the patient. The affordable Care Act describes NPPs who may perform his faceto-face patient encounter as a nurse practitioner or clinical nurse specialist (as those terms are defined in section 1861 (aa)(5) of the Social Security Act), who is working in collaboration with the physician in accordance with State law, or a certified nurse-midwife (as defined in section 1861 (gg) of the Social Security Act, as authorized by State law), or a physician assistant (as defined in section 1861 (aa)(5) of the Social Security Act), under the supervision of the physician. Excerpted from the Social Security Act (as referenced in above paragraph): 1861 (aa) (5) of the Social Security Act (5) (A) the term “physician assistant” and the term “nurse practitioner” means for purposes of this title, a physician assistant or a nurse practitioner who performs such services as such individual is legally authorized to perform (in the state in which the individual performs such services) in accordance with State law (or the state regulatory mechanism provided by the State law), and who meets such training, education, and experience requirements (or any combination Continued on page 11

The CAPA Legal Corner by Mike Scarano, Jr., Esq., CAPA Legal Counsel

Minor Consent

As most PAs are aware, it is very important to obtain appropriate consent for treatment provided to patients, especially when the treatment carries significant risk. One area in which many practitioners often express confusion is consent for minors. The “general rule” is that minors cannot consent to their own medical care, but there are numerous exceptions.

General Rules Regarding Consent for Minors: The following sets forth some of the most important rules regarding who can consent for a minor:

• In the absence of a disagreement

between the parents of a minor, either parent has the legal authority to consent. Where one parent consents to the treatment, but the other parent is opposed, treatment should not be provided until the conflict is resolved.

• When the parents are divorced, if

both parents agree to the proposed treatment, both parents should be asked to consent and to sign the applicable consent form. If a disagreement exists with respect to the treatment of a minor with divorced parents, a copy of the court’s order pertaining to the

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THIRD

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custody of the minor should be obtained to determine which parent has the authority to make health care decisions for the child.

• If one parent has sole legal

custody, then that parent has the right to consent and make health care decisions for the child.

• Where the parents have joint le-

gal custody, either parent has the right and responsibility to make health care decisions for the child unless the court has specified, in its custody order, that consent of both parents is required. If parents having joint legal custody disagree regarding treatment of the minor, they should be instructed to secure a court order resolving the dispute before medical treatment is provided when the procedure can be delayed without jeopardizing the minor’s health.

Minors’ Right to Consent Independently: The general rule is that minors (i.e., persons under the age of 18) may not consent to medical care independently, and the minor’s parent or guardian must consent. There are, however, numerous exceptions to this rule. Some of the most common exceptions where

minors can consent independently are as follows:

• A minor 15 years of age or older

who is living separate and apart from his or her parents or legal guardian, and who manages his or her own financial affairs.

• Care related to the treatment or prevention of pregnancy, including emergency contraception.

• Minors 12 years of age or older

who have come into contact with any infectious, contagious or communicable disease of the type which must be reported to the local health officer, or a sexually transmitted disease.

• Minors 12 years of age or older

who have allegedly been raped or sexually assaulted.

• Minors 12 years of age or older

seeking treatment or counseling on an outpatient basis or to a residential shelter for mental health treatment, if the minor is considered mature enough to participate intelligently in the services; there is a danger of Continued on page 9

Third Edition of the California Physician Assistant’s and Supervising Physician’s Legal Handbook*

ichael Scarano, Jr., Esq. authored the California Physician Assistant’s and Supervising Physician’s Legal Handbook. Newly updated, it answers scores of questions in a concise, clear fashion, with citations and appendices that will permit practitioners to read the operative statutes and regulations for themselves. A must have for all California practices employing PAs. Visit the CAPA website at www.capanet.org for more information or to order the book online. *CAPA Member Price - $34.95

Non Member Price - $54.95

JUNE/JULY 2011

Heath Care Reform and PA Education: Challenges and Opportunity by Michael De Rosa, MPH, Ph.D., PA-C, Program Relations Committee Chair

ver the past 9 issues of the CAPA News, the Program Relations Committee has profiled the active PA Programs in the State of California hoping to update CAPA members on the state of PA education and perhaps help reconnect members with an alma mater or colleague. In some ways PA education changes very fast so I suspect we will have more similar updates in the months to come (Welcome to the Golden State Kevin Lohenry, new chair at USC!). For this issue, I thought I would focus more generally on PA education both nationally and in California. If you have been sequestered on a jury for the last 12 months or more you may not know that the health care reform legislation recently passed has everyone talking. I think the good news is that, thanks to the efforts of our advocates at the state and national levels, the physician assistant is a meaningful part of these discussions. Health care reform is not alone however in determining the future of health care or the physician assistant and her/his place within the U.S. health care apparatus. Reform will occur within an environment characterized by austere economic conditions. PA education and the PA profession as a whole will position itself to react well or poorly to the changing environment based on responses to shifting pressures both inside and outside the profession. Over the past few months I have found myself confronted with these issues and challenges in several settings including my home institution, CAPA and at the state level. The issues are complicated and, frequently, the answers to one challenge seem to come up against other challenges. Mostly, it goes like this: Sometime in the next 3 years, we are told that 30 million or so people, 8

CAPA NEWS

many within underserved urban and rural areas, who will get onto insurance roles, as a result of health care reform, will need providers. Coupled with the continuing decline in physicians choosing primary care, the predictions of a physician shortage you have heard about, unless your jury service dates back to the Vietnam era, seems, at least intuitively, comfortable. For these reasons, a number of people have asked a version of this question of me over the past 6 to 12 months: “What is PA education going to do to fill this need for primary care providers?” I suspect many people reading this have heard or considered similar questions. The simple answer is this: PA education cannot do anything to address this problem without significant and meaningful support from those with the ability to create the health care and educational environments that will facilitate the ability of training programs to produce more qualified providers and deploy them to the areas of greatest need. The challenges we face in achieving the potential of this profession to make a serious impact in this area are immense. These are a few:

1. The physician shortage: This is the

very same physician shortage that is supposed to mean more jobs for PAs in primary care. However, simply put, fewer physicians working in primary care and underserved areas means fewer supervising doctors to hire PAs and fewer training opportunities for students. Yes, that means rotations, rotations, rotations. Additionally, restrictions within the Business and Professions Code of the State of California on the number of students physicians can supervise at a given time, inhibit programs from employing preceptors with the patient load and ability to support more students.

2. Diminishing reimbursements: While some of the currently proposed changes to reimbursement structures pay for performance measures, etc., are interesting and may ultimately bear fruit, everyone agrees that reimbursement rates are declining rapidly. The pressure this situation puts on primary care, especially in underserved areas, means more and more reluctance on the part of providers to risk a decrease in productivity as a result of having a student – while I believe the notion that students reduce productivity is a spurious argument in primary care – is probably a topic for another submission.

3. It’s the economy, stupid. A pro-

vider shortage can imply two very different situations. Citizens living in a region with a defined number of providers per capita fitting an objective definition are said to live in one or another sort of underserved area (MUA, HPSA, etc.). What those terms do not capture is whether there are jobs for providers who would like to treat those underserved patients. In addition to a lack of viable supervising physicians, the economic downturn brought a significant contraction of the job market in Northern California. While there are indications that this situation may be easing, there will be no way to address provider shortages if health care institutions continue to respond to the economic climate with workforce reductions.

4. Degree creep. DNP, DPT, (DOT?), and, of course, the master’s as both entry and terminal degrees for the PA profession are concerns. Currently, 4 of 9 programs in California offer non-master’s degrees, three at the community college level. For this reason, California is disproportionately affected by the drive to eliminate non-masters programs over this decade. The challenges here reach

The CAPA Legal Corner Continued from page 7

into all aspects of this issue. Those in underserved areas, whom research shows will be more likely to return to their home communities to practice, are not simply underserved in terms of access to health care. Those underserved experience reduced access to education and gainful employment as well. The ability of people in the communities where the need is greatest to achieve the educational prerequisites and clinical contact hours necessary for admission at the master’s level and to bear the expense of that training is significantly limited. For people in underserved areas, then, community college programs offer a less expensive and often more expedient route to clinical practice, making PA a viable choice and serving workload needs more expediently. These are some of the significant and challenging issues we face as we look at the health care landscape and try to plan for the future. But as we face these challenges there are reasons for hopefulness. For most

MAR 2010

JULY 2010

of my 12 years in PA education, we have been debating the move to the master’s degree and its potential impacts. This is the first time in my experience, however, that the State of California has the impetus, brought about by reform, to seek to improve PA education’s ability to address the issue. I am deeply hopeful that the need of the policy makers at the State level to fulfill the mandate of health care reform will translate into training and funding opportunities for our students. Additionally, I believe this time of change will lead to new collaborations between educational institutions, health care institutions and, hopefully, government to improve the deployment of qualified providers in needed areas. The next few years figure to be an exciting time in PA education and in health care. I am grateful to CAPA and all of those working to find effective solutions to our challenges and look forward to working with them to grow the PA profession and serve patients throughout the State of California. 

SEPT 2010

JAN 2011

JAN 2013

serious physical or mental harm to the minor if the minor is not permitted to participate; or the minor is an alleged victim of incest or child abuse.

• Minors 12 years of age or older seeking

medical care and counseling relating to the diagnosis and treatment of a drug or alcoholrelated problem.

Finally, consent is not required where the minor requires immediate care for alleviation of severe pain or immediate diagnosis and treatment of unforeseeable medical conditions which, if not immediately diagnosed and treated, would lead to serious disability or death; and there is no one available to give consent. The foregoing is not intended to be an exhaustive recitation of the rules governing minor consent, but only a summary of some of the most important rules. See the Physician Assistant’s and Supervising Physician’s Legal Handbook (Third Edition) for more information on the importance of consent. 

JAN 2014

2016

2018

Reprinted from

JUNE/JULY 2011

Genealogy: Looking at the Roots and Branches of the PA Profession by Adam Marks, MPA, PA-C, President Elect

rthopedic Assistants emerged in America’s health care system in the mid 1960s and were part of a new wave of “physician extenders” which included but was not limited to, urology assistants and primary care physician assistants. Orthopedic Assistants were originally recognized as physician extenders by the AMA and the American Academy of Orthopedic Surgeons (AAOS). In 1967, the AAOS accredited its first OPA program. By 1970, the AMA and AAOS had developed guidelines for OPA education and certification. With these new guidelines, the AMA requested that the name be changed to Orthopedic Physician’s Assistant (OPA). The thought process behind the name change was “to bring uniformity to the names of physician extenders while identifying the specialty that they were trained in.” OPA programs, which included 9

civilian programs and 1 military program, produced OPAs who went into hospitals and clinics working alongside traditionally trained PAs. In 1974, the AAOS determined that they did not have enough man power to accredit OPA programs so they requested that the AMA and the American College of Surgeons undertake program accreditation. With the AMA supporting primary care trained PAs, OPAs were forced to develop their own accrediting body. Beginning in 1979, the American Society of Orthopedic Physician’s Assistant began to administer a national certification exam and certify OPAs. Without the support of the AMA and AAOS, OPA programs became logistically difficult to administer and began to close. In 1990, the Kirkwood program, America’s last remaining OPA program, graduated its last class. So the question is, why am I writing about a profession which sprouted from the same roots as modern PAs but eventually branched off? Two decades after the closure of Kirkwood, Florida’s University of St.

CAPA NEWS

Augustine has created a new OPA program. This program’s “unique degree prepares the student for the specialized field of Orthopedic Physician Assistant, as opposed to the more generalist offering.” Upon graduation, OPAs will sit for the National Board for Certification of Orthopedic Physician’s Assistants (NBCOPA). Students who graduate from St. Augustine and pass the NBCOPA certification exam would have a limited scope of practice in orthopedics and must be supervised by an orthopedic surgeon. Upon hearing this news and reading through the school’s website, I was concerned that California would eventually incur the same problem that Florida is currently facing. I spoke with the California Physician Assistant Committee chair, Steve Klompus, PA who reassured me that OPAs would not be licensed in California as PA-Cs and sees their potential role in Florida as limited and unable to compete with the scope of practice of modern PAs. Along with their limited utility in the medical field, Medicare and Medicaid do not reimburse for the services OPAs provide. Florida’s Academy of Physician Assistants is currently working with the AAPA regarding this program and the use of the name Physician Assistant in their title. One of CAPA’s missions is “to serve as a public information center regarding the physician assistant profession for its members, other health professions and the public.” The topic of OPAs is one that CAPA will continue to monitor and provide updates to the public, health care organizations and our membership as they become available. 

In Search of a Project by Miguel Medina, PA-C, Former Committee on Diversity Chair

n 2006 I was searching for a project as Chair of the Diversity Committee for CAPA. Gaye Breyman e-mailed me information about a Health Literacy Conference that was being held in Irvine. The topic sparked my curiosity and I attended the two-day conference. One of the highlights of the conference was a breakout session on how to improve communication with patients with low literacy skills. It was a wonderful conference and it gave me some valuable tools to use with my patients. After the conference, I thought that the information would be valuable to share with other PAs. I decided to launch a lecture series that would be presented to the students enrolled in the California PA Programs. The lecture series also incorporated a lecture that I attended at a genetics conference at Duke University in 2005 titled “The Multicultural Patient.” I contacted the California PA Program Directors and was invited to present my lectures. By the end of 2007 the lecture series “Health Literacy and The Multicultural Patient” was presented to all 10 PA programs. On March 8, 2011, I completed my project at the UC Davis FNP/PA program. Over the past 4 years the presentation has been attended by over 1,000 PA students from across the state. It has truly been an honor to travel the state and meet with students and faculty. I will miss sharing my experiences working with the multicultural patient and giving insight on how to identify patients with low health literacy. In my travels, I was enriched by my interaction with the PA students and faculty. Students from different cultures shared their perspectives on health care in America and their parents’ cultural and health care beliefs.

It was interesting to hear how many commonalities exist among diverse cultures. I remember one day after my lecture a student approached me with tears in her eyes and revealed to me that her father had just recently passed away. She mentioned to me that she never knew that he was illiterate until he was seriously ill and hospitalized. While in the hospital her father asked her to read the consent forms for him because he didn’t know how to read. She stated that she lived with him for over 20 years and never realized that he was

illiterate. On the flight home that night I couldn’t stop thinking about our conversation. I will never forget this particular story. I want to thank the California PA Program Directors and faculty for their hospitality. I also want to thank all the PA students for their welcoming attitudes and smiling faces. A special thanks to Gaye and the CAPA Board of Directors for sponsoring the Diversity Committee’s project, “Health Literacy and The Multicultural Patient.” 

Medicare Home Health “Face-to-Face” Encounters: Certification Requirements Continued from page 6

thereof ) as the Secretary may prescribe in regulations. So Medicare continues to place limitations on the ability of PAs to deliver efficient healthcare to beneficiaries requiring home health care and hospice care. To clarify some related issues, PAs can order DME and sign the Certificate of Medical Necessity (CMN) with

some exceptions (stated above). Also, the PAs cannot order (certify or recertify or sign for) Hospice Care under Medicare - it must be a physician. We will continue to follow and report on changes in Medicare rules to keep you informed. Find it here in the CAPANews and on our website at www.capanet.org. 

CAPA FACT Did You Know? CAPA may not use membership dues to contribute to political campaigns. Only funds specifically earmarked/ given to the CAPA PAC may be used for political contributions.

JUNE/JULY 2011

Did You Know? by Greg Mennie, PA-C, MSed, Director-At-Large American Academy of Pediatrics (AAP) has changed its car seat policy. In 2002 the AAP issued a policy on car seat positioning. The old policy stated that a child should be kept in a rear-facing car safety seat (CSS) until the child met the limits of the manufacturer’s height and weight maximums, or until age one or 20 lbs. The old policy did note that children could be kept in the rear-facing CSS as long as possible, however, most providers used the one-year limit and/or 20 lb. cut-off as a counseling point. In a 2007 article in the Journal of Injury Prevention, researchers

looked at vehicle crash data from the US National Highway Traffic Safety Administration for the years 1988-2003. They analyzed data for children under the age of two and whether they were in a rearfacing or front-facing car seat at the time of the crash. The researchers concluded that children under the age of two were far less likely to be injured if they were restrained in rearfacing car seats. (Injury Prevention 2007;13:398–402) Citing this data, as well as data on safety from a number of studies from Sweden, the AAP has now released new guidelines for car seat and child restraints while riding in a vehicle. The New Policy “Child Passenger Safety” published online March 21, 2011 (http://aappolicy. aappublications.org/cgi/reprint/ pediatrics;127/4/788.pdf ) states

that all infants and toddlers should ride in a rear-facing car seat until they are two years of age or until they reach the maximum weight or height allowed for their car seat. When a child reaches these limits or is over the age of two they should transition to a forwardfacing car seat with restraints. The child should remain in a forwardfacing car seat until they have outgrown the manufacturer’s limits for the car seat. When the child then reaches these limits, they should transition to a belt position booster type seat until they have reached sufficient height and weight requirements (usually 57” and ages 8-12) to utilize the vehicle’s regular seat and standard lap and shoulder restraint. All children under the age of 13 should always use the rear seats of the car. 

In Memoriam: Gregory Wayne Meyer, MD and Richard Fox, PA-C

Pictured above Paula Meyer, PA-C; Gregory Wayne Meyer, MD and Richard Fox, PA-C

Dr. Meyer and Rick were attempting to cross a low footbridge at Wapama Falls in Yosemite National Park when Rick was struck by falling water from the falls. Dr. Meyer tried to rescue Rick and both were swept away. The two, along with Dr. Meyer’s wife, Paula Meyer, PA-C, and two friends, were returning from a four-day backpacking trip. Both men worked at Presbyterian Intercommunity Hospital in Whittier, where Paula Meyer also works as a PA. Our thoughts and prayers go out to their families and their co-workers at Presbyterian Intercommunity Hospital.

CAPA NEWS

CAPA’s Committee on Diversity is looking for a few new members. This is an exciting opportunity to help advance equity and cooperation between the many different cultural groups within California’s PA profession. Goals of the committee include developing mechanisms to increase recruitment and retention of minority applicants, promoting a diverse representation in leadership positions, and expanding awareness of cultural issues in medicine. If you would enjoy mentoring minority students, promoting the PA profession, and supporting under-represented groups, please consider applying. E-mail Margaret.e.allen@gmail.com with a brief statement of your interest and/or for more information.

Money Talks – Political Fundraising by Gaye Breyman, CAE, Chief Operating Officer

aising money for most causes isn’t easy. Raising money to contribute to the political campaigns of California legislators is extremely hard. Not the most needy or sympathetic group. Hard to tie a touching image to the plea for political campaign contributions. However, it is the world in which we live and in US and California politics, MONEY TALKS. Legislators must raise money every day of the year. From the day they declare their candidacy until the day they retire from politics. Each and every day they are in office they need to raise funds for the next race and/or to repay the debt from the previous one. Why do we care and why do we want you to give your hard earned dollars to the CAPA PAC so we can give it to California legislators? Because, MONEY TALKS.

Although we will likely never be one of the major contributors to California legislators, (the CNA and other labor groups have huge Political Action Committees that dwarf what we can give) we can be and are extremely effective with the funds we do contribute.

legislators. Each year we deplete the funds in the CAPA PAC and begin to raise PAC funds again. It is a yearly cycle and we always encourage each PA in the state to give to the CAPA PAC each and every year. We are not as successful as we would like in this Political Action Committee fundraising arena.

What we have to remember is that in order to be part of the political environment we must participate in the political process to promote and protect PA practice in California (like it or not). Part of the political process is to donate funds to candidates/

There are almost 8,000 PAs in the state. If each gave just $25 (less than one hour’s pay) once each year we could raise $200,000. Now that is big money and big money opens big doors. 

Would You Like to Help Raise CAPA PAC Funds? Would you like to serve on the CAPA PAC Fundraising Committee? This is the group who plans the fundraising activities and helps to execute them at CAPA Conferences. Do you have an idea that Political Action Committee may help to fill the CAPA Political Action Committee coffers and open doors for California PAs? Let us know if you want to help. We would love to speak with you. You may email us at capa@capanet.org or call the CAPA office at (714) 427-0321. CAPA’s

Yes, I Want to Do My Part for the PA Profession in California (Donate online at www.capanet.org or mail this form to the CAPA office.) Name____________________________________________________________________________________________________

 $25.00  $50.00  $100.00  $200.00  $____________

Address ________________________________________City___________________________ State______ Zip_______________ Phone _______________________________________ Email ______________________________________________________ Amount of cash/check/credit card donation: $_______________________

If donation is $100 or more, please list employer_________________________________________________________________________________________ Please make checks payable to CAPA PAC. You may also pay by credit card. All contributions are voluntary. PAC ID # 981553 



Exp. Date______________________

Signature______________________________________________________________________________________ CVV#________________________

JUNE/JULY 2011

The Next 5 Years...

COME BE EDUCATED AND INSPIRED… by Eric Glassman, MHS, PA-C, CAPA President and CME Committee Chair

ou are enthusiastically invited to attend this year’s CAPA Conference in Palm Springs from September 22nd to September 25th. I am this year’s CME Committee Chair (and CAPA President) and am excited and proud of the work the Conference Planning Committee has done to develop an exciting and diverse program. One I think will have tremendous appeal to all California PAs. We certainly have tried to offer something for everyone. I feel like this year’s CAPA Conference will be one of the all time best! As many of you witnessed from last year, our CAPA Conference home, the Renaissance Palm Springs, is newly renovated and essentially a brand new hotel. It is beautiful inside and out. The lobby, lobby bar, pool area and all of the sleeping rooms have been upgraded for you to enjoy. The friendly atmosphere and many of the staff remain. Downtown Palm Springs, with all of its shops and restaurants is just a short walk away. I can’t tell you how excited I am! I could honestly go on for pages and pages to let you know why this is the year, of all years, to make it to the CAPA Conference. However, I have been told by our editor to make it short, not give everything away; keep some surprises. Hopefully by now you have received your copy of the CAPA Conference brochure in the mail and have seen the great schedule of speakers and noticed some exciting new topics. Also, the brochure included detailed information on the Wednesday pre-conference programs. This 35th Anniversary Conference is very special for all California PAs. We have all accomplished so much and, with the support of thousands of PAs, CAPA, as an organization is one of the most respected professional organizations in the State. Our reputation and the work we do are stellar. We are proud of our past and we are enthusiastic about the future for PA practice in California. As part of the 35th Anniversary Celebration we will have an exceptional keynote address during Friday’s lunch. See page 16 for more information.

Okay, so you have seen the CAPA Conference brochure (and if you haven’t, it is available online or we can mail you another) and know about the wonderful CME program with lectures to educate and fulfill your CME obligation set forth by the NCCPA and now the State 14 | CAPA’S 35TH ANNUAL CONFERENCE

of California (if you do not maintain your “C”). However, we know most of you come to the CAPA Conference in Palm Springs for more than the 20 or so hours of CME. You likely come to the CAPA conference for the fun and the sun and the camaraderie with friends and colleagues. Instead of writing about all the fun, I’ve decided to make a Top 10 List for you to look at and get you excited for another great year in the desert.

Top 10 Highlights of the CAPA Conference 10. Palm Canyon Drive within walking distance from the Renaissance and Hilton Hotels (My personal favorite restaurants are Las Casuelas and The Falls) 9. The Exhibit Hall (You never know what you will learn or who you will run into. And talking to the reps in the Exhibit Hall helps to keep them coming back, keeping your registration fees from going up.) 8. Visions Lab in the Exhibit Hall (use the inspiration to write your own personal vision statement) 7. Taxi Wisdom (Yes, we are going to be have a live band out by the pool on Saturday afternoon) 6. American PA Idol (Who will be singing next?) 5. Lobby Bar (THE place to gather and catch up with friends and colleagues) 4. Alumni receptions (Saturday evening – check with your program to see if they are holding one.) 3. Free popcorn and beer poolside (what other conference offers this?) 2. Student Challenge Bowl (poolside – that would be where the popcorn and beer are served) 1. The CAPA Conference “experience” (unexplainable really, you just have to be there and then you feel it. It is PA Central when 900+ California PAs get together every year in Palm Springs) If this doesn’t get you excited then we might have to start checking for a pulse soon. I can hardly wait and it will be another great conference that you just do not want to miss. The pre-conference starts on Wednesday, September 21st, with the Controlled Substance Education Course and an all new , 6-hour comprehensive course entitled: Demystifying Emergency Medicine. The one and only John Bielinski, Jr., MS, PA-C is the speaker for that course. See page 18 for more information. Continued on next page

FUN IN PALM SPRINGS Friday Evening at the CAPA Conference

PArty At The Pool – 5:00 PM - Saturday

9:00 P.M. The Dance and American PA Idol Competition The nightclubs of Palm Springs can’t compete with the PA PArty of the Year. It is the place to be on Friday night. We transform the beautiful lobby of the Convention Center into PArty Central with music that will please everyone. At 10:00 p.m. our American PA Idol show begins. The PArty continues as PAs compete and the audience votes to name the next American PA Idol. The Dance and American PA Idol Competition are included with your registration and guests are welcome to attend at no charge. There will be a cash bar. This really is an event you won’t want to miss!

APPLICATION

(Deadline August 12, 2011)

Sign U p for Id ol Today !

Name ______________________________________ Address _____________________________________ City ______________________ St ____ Zip _________ I will be performing:  solo  as a duet

 as a group of____________

Which category best describes your style of singing?  Pop/Top 40  Rock  Country Western  Rhythm and Blues  Gospel  Easy Listening  Rap/Hip Hop  Jazz  Show Tunes _________________________________________ Title of songs (please choose 3) you would like to sing: 1) _________________________________________ 2) _________________________________________ 3) _________________________________________ Would you say that your voice is (don’t be modest):  Absolute perfection!  Everyone tells me I have a great voice  Just okay  Not that great, but I love to sing & get a crowd going

Continued from previous page

Make your plans now to come to Palm Springs September 22-25th and see what all the buzz is about. This is truly an incredible conference experience and we want to make sure you are there to be part of the inspiration and the celebration. 

We are taking it up a notch this year. Just in case you don’t get enough dancing and music on Friday night at the CAPA Dance and American PA Idol Competition, we have more fun in store on the pool deck on Saturday afternoon –a live band with PA, Greg Mennie on drums!

Taxi Wisdom - We Have Been Trying To Book Them For Years! Taxi Wisdom is a local touring variety cover band. The band formed in 2003 during a recording session at a studio in North Hollywood, when the bassist and drummer thought they played so well together that the only logical conclusion was to form their own group. After a month of auditions for other musicians the recipe was complete. Take 2 European pop stars, 2 over-achieving guitarists from the East Coast, add 1 phenomenal (and lovely) female vocalist, and 1 schooled, ex-military, physician assistant visionoriented drummer and you have Taxi Wisdom. The current line up consists of 5 musicians with extensive teaching, recording, television, film, and touring experience: Charissa Nicole - Lead vocals, Andrew Campbell - Lead guitar, Moose McMains - Bass and vocals, Jim McMains - Keyboards and vocals, and Greg Mennie - Drums, percussion and vocals. Our special thanks to Greg Mennie, PA-C and the band for making this performance at the CAPA Conference possible.

www.taxiwisdom.com The Conference program and activities are subject to change without notice.

The Next 5 Years...

KEYNOTE LUNCHEON

Visions Lab

Friday, September 23, 2011

e are thrilled and honored to have CAPA’s Founding President, Rod Moser, PA, Ph.D. with us to celebrate CAPA’s 35 Anniversary. For th

PA Visionaries Wanted – Apply Today!

the Keynote Luncheon address, Rod shares the stage with Herb Schultz, Regional Director, Region IX, U.S.

We are looking for PAs to spend time in the

Department of Health & Human Services. These two

Visions Lab at the CAPA Conference. To

visionaries will share their experiences and insights

be present, to share your successes and to

and inspire us all to never let apparent barriers keep

inspire others to perhaps expand or enhance

us from our goals.

what they are currently doing as PAs. We will not ask for more than 1 to 2 hours of your

Rod Moser is the Father of CAPA, a

time only during Exhibit Hall hours.

valued advisor and a favorite speaker. He practices in pediatrics and writes a

Are you in a practice doing things you never

very entertaining (and educational) blog

imagined you would be doing when you began

on WebMD. You can find it at: http://

your PA career? Maybe you are working in

blogs.webmd.com/all-ears

Family Practice but running a special clinic. Maybe you have your own PA corporation.

Herb Schultz was a senior adviser to

Perhaps you run a surgical assist service

Gov. Arnold Schwarzenegger and the

for PAs doing first assist in surgery. Maybe

man charged with ensuring California

you are doing research. The possibilities are

gets its fair share of federal stimulus

endless. We would love to hear from you so

funds. He has since become Regional

we can select a few visionaries to be available

Director, Region IX of the U.S. Department of Health &

at the Visions Lab.

Human Services. Mr. Schultz is now part of the federal administration implementing the recently enacted

Please send a brief email to capa@capanet.org

national health care overhaul.

and let us know of your interest in working the Visions Lab and tell us what exciting/

Don’t miss this special luncheon presentation on Friday

cutting edge things you are doing.

beginning at 12:50 p.m. in the Grand Ballroom at the Renaissance Hotel, Palm Springs. Has It Been 35 Years Already? Rod Moser, PA, Ph.D. CAPA Founding President, 1976 PAs and Healthcare: A Look at the Future Herb Schultz, Regional Director, Region IX U.S. Department of Health & Human Services 

16 | CAPA’S 35TH ANNUAL CONFERENCE

Special 35% Discount Off Of Basic Course Given to the First 500 PAs Licensed in California* Use COUPON CODE: PA Pioneer when registering online. Or call the CAPA office and we can take your registration over the phone (714) 427-0321.

*Must be a current CAPA Member

IT ALL BEGAN WITH A VISION

hirty-five years ago PA practice was in its infancy. No one knew where this new profession would go, if it would be successful or be around for the next few decades. They took a chance on the PA profession, and they were not going to leave it to chance on the direction the profession would take. Rod Moser, CAPA Founding President, and the other CAPA Founders had a vision for the future for California PAs and they were going to do something about it.

mind. While you are at the Visions Lab, you will have the opportunity to use that time, that inspiration, and some worksheets to create your own Career Vision Statement. We will have people who can help guide you through that process if you like. Those who wish to may post their statement at the Visions Lab in the Exhibit Hall, either anonymously or include your name. Either way, doing it is important. Your Career Vision Statement may create a spark in others.

Visions Lab This small group of dedicated PAs made a huge difference in all of our lives here in California. Their actions paved the way to your future profession. Your actions today will impact future California PAs. Some of us may lose sight of the importance of our individual role now and then. What is your vision for your own career? What is your vision for this profession in which we have invested so much here in California? We encourage you to think about it, then write it down. Visions Lab At The CAPA Conference This year at the CAPA Conference it is all about possibilities and visions for the next 5 years! . Opening our eyes to new opportunities, opening doors for California PAs and allowing us to see beyond what is available to us now. That is what our Founders did and that is what we can do now, 35 years later; look to what we can do to ensure a better future for California PAs. Stationed at the Visions Lab we will have PAs who are doing cutting edge work. PAs who have taken their PA training and expanded the traditional PA role. What they are doing may inspire you to do something similar or something totally different. It may give you an idea for something you can do to make your current position that much better. The time you spend in the Visions Lab is meant to open your eyes and your

Hereâ&#x20AC;&#x2122;s an interesting snippet of research for you. Researchers asked a group of Harvard University graduates about their goals. As you might expect, almost all of them had goals. But only 3% of them actually wrote them down. Fast-forward 30 years to a follow-up survey. And guess what? The researchers found that those 3% who had written down their goals had amassed as much wealth as the other 97% put together. Although wealth is not our measure of success here, you see there is power in writing down your vision for the future. There is tremendous power for California PAs when we do so collectively. We look forward to another fun and exciting CAPA Conference. One filled with inspiration for the future and admiration for all who have gotten California PA practice to where we are today. Here is to the next 5 years!

Support Our Exhibitors â&#x20AC;&#x201C; They Keep Registration Costs Down When at the CAPA Conference, show our exhibitors how much you appreciate their support by spending quality time with them to learn about their products and services. Word will get out that PAs offer a great return on their investment and our Exhibit Hall will grow. Exhibit fees help to defer the costs of putting on a conference, keeping registration fees low.

“Great course!” “Good course. Good pace. Good facility. Food was excellent!”

6 Hours Cat. I CME

“Great class!! Great examples from Dr. Lowe’s personal experience. He knows my patients.” “This was an excellent presentation on behalf of both speakers. Thank you.”

Controlled Substances Education Course A Course Which Upon Successful Completion Will Allow You To Write For Controlled Substances Without Patient Specific Approval*

Wednesday, September 21, 2011

Registration begins at 9:00 a.m. Course begins at 10:00 a.m.

Renaissance Palm Springs Hotel 888 Tahquitz Canyon Way Palm Springs, CA 92262

(Prior to the 2011 CAPA Conference)

Registration Fees CAPA Member CSEC Course - $110 Non CAPA Member CSEC Course - $200 Non Member CSEC Course & CAPA Membership - $220 (includes CAPA Membership through 4/30/12)

*California Code of Regulations Sections: 1399.541(h), 1399.610 and 1399.612. A PA may administer, provide, or issue a drug order for Schedule II through V controlled substances without patient specific approval if the PA completes specified educational requirements and if his/ her Supervising Physician delegates the authority to them.

John Bielinski, Jr. MS, PA-C

“John, I have been a PA for 17 yrs. and you have brought back the excitement in CMEs for me. Your enthusiasm and your simple approach to Emergency Medicine is awesome.” “Excellent course. Even after 20 years as a PA, I learned many great tricks that I can use immediately in my practice.”

6 Hours Cat. I CME

“Excellent speaker, great practice PEARLS and practical information.”

New This Year At The CAPA Conference

Demystifying Emergency Medicine Course Wednesday, September 21, 2011 10:00 a.m to 5:30 p.m.

Renaissance Palm Springs Hotel 888 Tahquitz Canyon Way Palm Springs, CA 92262

(Prior to the 2011 CAPA Conference)

Registration Fees CAPA Member DEMC Course - $200 Non CAPA Member DEMC Course - $350 CAPA Student Member - $100 Register online or call the CAPA office.

This course is designed to cover diagnostics and therapeutics of the major causes of patients presenting with acute problems, from chest pain/shortness of breath to the more fast-track like complaints, such as a pediatric fever, wound care or orthopedics. The pearls of resuscitation will also be covered as well as key diagnostic principles in reviewing radiographs, EKGs, and laboratory values to include ABGs.

CAPA NEWS

Keeping It Real by Larry Rosen, PA-C, Public Relations Committee Chair and Director-At-Large

Beth Grivett, PA-C; Larry Rosen, PA-C; Julie Theriault, PA-C; Cherri Penne-Myers, PA-C, MSCS; Miguel Medina, PA-C; Peter Aronson, PA-C; Adam Marks, MPA, PA-C; and Grace Landel, PA-C

fter our delegation returned home from the May 30th AAPA conference in Las Vegas, we received an email from another state delegate who was in the House with us… It was great seeing everyone again..... California keeps it real in the house.... Good luck and take care.... “California keeps it real in the House.” Pretty weighty compliment. We were there to represent California physician assistants and our voices were heard on their behalf. I think that’s what our friend was referring to. Peter Aronson, CAPA’s Chief Delegate, spoke eloquently in favor

of reversing decisions, prompted by AAPA attorneys last year, that significantly limited the powers of the House of Delegates, transferring all fiduciary responsibilities to the Board of Directors. Sadly, the House is now relegated to enacting public and social policies, all policies relating to the profession. I spoke in favor of a Washington state resolution requesting the formation of a Public Health Professional Work Group to act as an advisory body to the Academy’s contracted PR firms. Sadly again, AAPA’s Public Relation Committee was dissolved during the House of Delegates meeting in Atlanta, 2010. Beth Grivett’s vigilant review of the Reference Committee recommendations uncovered a flawed rationale that authorized the AAPA Board of Directors to “enact interim

My Little Story About Playing Doctor…

ll my professional career as a PA, I have served the geriatric population in long term care facilities. Very conscientiously, I have never allowed anyone, patient or staff, to call me “doctor” knowing first, it is against PA regulation and second, because I happen to be very proud to be a PA and want everyone to know it unreservedly. Only on one occasion have I allowed a patient to call me “doctor.” I was visiting and caring for an elderly gentleman in his bed in his nursing home. After completing his examination and reducing his elongated toenails he said, “Thank you, doctor.” I hesitantly and loudly replied that I could not allow him to call me “doctor.” He stated resoundingly, “Well, didn’t you just doctor me?” I had to acquiesce, “Yes sir, that is what I did.” He then told me emphatically, “If you doctor me, then I am going to call you doctor.” I could only comply meekly and say, “You sir, may then call me doctor.” What an incredible blessing and journey it has been for me to be allowed to serve our older adult population. Thank you, Gaye, for appreciating my story and sharing it with our CAPA colleagues.

policies establishing the collective values, philosophies and principles of the profession.” Clearly, this had now become the purview of the House and she called upon the past and current Presidents of AAPA to give cause as to why this action was necessary. Neither could do so. Peter and I were not successful in our arguments. Beth was. But what I believe the House heard from the entire California delegation was passionate, vocal support for our views and our commitment to representing, to the best of our abilities, the interests of our constituents. CAPA members who are also AAPA members, elect delegates to represent them at the AAPA Annual Conference. Keeping it real is the goal of every delegate in the House. This and every year, California does its share. 

ur special thanks to Peter Aronson, PA-C for his decades of service at the AAPA HOD, serving as Chief Delegate for many of those years. Peter’s dedication to the governance process served California PAs well. Thank you, Peter, for a job well done!

Ellen Grimes Osborne, PA-C – Palos Verdes Peninsula, CA

JUNE/JULY 2011

At the Table

CAPA Public Policy Director, Teresa Anderson, MPH; Les Howard, PA; Lucinda Hirahoka, PA-C, FNP; and Roslyn Byous, PA-C, Ph.D. At their May 19 meeting, after two years of concentrated effort by CAPA and California PA Programs, the Physician Assistant Committee voted to begin the regulatory process to change § 1399.536. Requirements for Preceptors to allow PAs (and other “licensed health care providers”) to precept PA students. Currently, only a physician may precept a PA student. The regulatory process can be long and this is by no means a slam dunk, but we are one step closer.

Eric Glassman, MHS, PA-C and Larry Rosen, PA-C meet and talk team practice with family physicians at the CAFP Annual Scientific Assembly in San Francisco in May.

Beth Grivett, PA-C, CAPA’s Legislative Affairs Coordinator serves on the Medical Board of California’s Advisory Committee on Physician Responsibility Above: CAPA membership matters. PAs at Pri-Med 2011 in Anaheim sign up to support CAPA Below: Lisa Bradley, PA-C and Gail Gaboubrel, PA-C enjoy the surprise of opening CAPA’s ever-popular, pop-up calendars! A lovely parting gift for new members!

Atul Sharma, PA-C ; California Assemblymember Dr. Richard Pan, 5th Assembly District; and Ed Arias, PA-C at the April 18, 2011 fundraiser held at the Sierra Sacramento Valley Medical Society

JUNE/JULY 2011

Politics in Action Continued from page 1

law already in place, the Emergency Medical Treatment and Active Labor Act (EMTALA). The highlight of the day came during our meeting with the legislator who introduced SB 233, Senator Fran Pavley. She related to us that her own daughter had just graduated from USC’s PA program and had already accepted a position at an emergency department in Southern California. As we spoke about her daughter, the importance of ensuring that this bill becomes law seemed much greater as we all realized that our actions today

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would leave a legacy for future PAs. After hearing the update of our work during the legislative day, Senator Pavley took precious time from her busy day to usher us into the Senate chambers for a rare firsthand tour and photograph on the Senate floor. The rest of the day flew by and soon we were all boarding our planes, sad to say goodbye to each other but satisfied with the work we had done. That evening, as I settled in for the drive home from the airport, I glanced at the visitor’s pamphlet I had picked up from the Capitol building, noticing the bear prominent on the state seal. The description stated that the bear symbolized the strength and independence

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of California. I realized that like California, physician assistants also have to embody those same traits in order to continue to grow and succeed in our relatively new profession. This same strength and independence is what led our group to the Capitol that day, hopefully leading to the passage of SB 233 which would have positive repercussions for many PAs across California. I thought of how grateful I was for those PAs that had taken this same journey before I had become a physician assistant, walking the halls of the Capitol building in order to ensure that my freedoms to practice in the State of California were protected as well. 

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Physician Assistant Professional Liability Insurance 888.273.4686 | www.hpso.com/cnews This program is underwritten by American Casualty Company of Reading, Pennsylvania, a CNA company, and is offered through the Healthcare Providers Service Organization Purchasing Group. Coverages, rates and limits may differ or may not be available in all states. All products and services are subject to change without notice. This material is for illustrative purposes only and is not a contract. It is intended to provide a general overview of the products and services offered. Only the policy can provide the actual terms, coverages, amounts, conditions and exclusions. CNA is a registered trademark of CNA Financial Corporation. Copyright © 2011 CNA. All rights reserved. Healthcare Providers Service Organization is a division of Affinity Insurance Services, Inc.; in CA (License #0795465), MN and OK, AIS Affinity Insurance Agency, Inc.; and in NY, AIS Affinity Insurance Agency. ©2011 Affinity Insurance Services, Inc. CAPA0111A

CAPA NEWS

Students Students Students Students Students Students Bucket List by Jennifer Baltazar, PA-S, Former Student Representative

s I finish my last year of PA school, my term as Student Representative came to an end. It’s hard to believe how much has happened in the past 20 months, personally and professionally. As many Student Representatives have done before me, I’ve tried, on these pages, to share information that has helped make this incredible journey not just bearable but profoundly rewarding. This article, however, was written for another purpose. Our patients deserve the highest level of care, a level of care that comes from a student who was willing to take risks with their training, put themselves out of their comfort zone and explore beyond what meets the eye. It is in these moments where PA students give themselves the opportunity to go from becoming a good practitioner to a really good one. When people hear the words “Bucket List,” they often think of the movie with Jack Nicholson and Morgan Freeman who played two terminally ill men on a road trip

with a wish list of to-dos before they died. The “Bucket List,” for the purposes of this article, is a culmination of experiences that build new insight into human illness, foster compassion and evoke powerful emotions, changing one’s perceptions of medicine. This list was created with the help of my fellow PA students Justin Anderson and Rose Christensen and inspired through the advice of my preceptor, Dr. Mayorga, who reminded me that, you only have one chance in your lifetime to be a PA student, exploring the different specialties of medicine. While doing so, you are charged with the task of learning and expanding your understanding of medicine without the pressures of petty office politics and other real world distractions. Some of the experiences listed below I have had the chance to encounter first-hand, others I hope to experience before I graduate. I’ve tried to capture for you how these moments have been so important for me.

Catch a baby during delivery (Top of my list. I will make this happen.)

Tell a patient he or she has cancer (Inevitable. Sobering. I can wait on this one.)

Relate to a family member the end of life wishes of a relative Friday, 7:00 a.m. Our patient was unconscious and transferred to ICU after two weeks in the hospital. Her diagnosis was metastatic liver cancer. My preceptor and I had to tell her 25-year old son that his mother’s

cancer had rapidly advanced and there was significant damage to her brain. We explained what would be possible for the next stages in her care if a DNR was not initiated; intubation, ventilation, heart failure, blood transfusions, sepsis, a prolonged death. I watched this young man’s face as he tried to wrap his mind around his life without a mother he deeply loved. Letting her go might be the hardest decision he would ever make. We do such good, compassionate medicine today but despite the training and the medical wonders we can perform, there is at times an end to suffering that is unavoidable and heartbreaking. We owe it to our patients and their families to be as supportive as possible when they need us most.

Repair the wound of a child or infant The repair of a laceration is a very methodical, clear-cut process… ONLY if your patient is older than 12. Younger than that, all bets are off. If toddler Alex sees a needle, suture, or syringe, his world and yours can unravel in an instant. You will find solace in the caring, experienced intervention of your medical staff (and a loving mom or dad who can bear to participate.) Your trusted allies are lidocaine topical gel, barriers blocking the patient’s view of the procedure and steady hands from anywhere to hold the squirming tyke on the table. This experience at the Newport Beach Urgent Care taught me to always be prepared for the worst when the chief complaint on the chart you are handed is … child with a laceration. Continued on page 24

JUNE/JULY 2011

Students Students Students Students Students Students Bucket List Continued from page 23

Interview a patient who is suspected of being sexually or physically abused. ER rotation; 2:00 a.m. The on-call physician requested that I “have a one-on-one conversation” with his 11-year old female patient with an unusual affect. He suspected sexual abuse. Two hours later, we are sitting in the patient’s room with her father, a pediatrician and two police officers recounting multiple episodes of non-consensual sexual encounters. The perpetrators were either family or close family friends. This story is tragic but not uncommon. My doc had a gut feeling. The girl had

only complained of non-specific abdominal pain but a practiced eye and a keen sense of his patient gave that young girl the chance to seek the help she needed and the justice she deserved. I want to be that good one day. And still on my bucket list are challenges I suspect are not far off…

Instead of crying or showing defeat when a preceptor “breaks you down,” quietly laugh with yourself instead. Spend quality time with that “frequent flyer” that continues to frustrate your preceptor and office staff.

Special Student Track at the CAPA Conference – Friday, September 23, 2011 10:10 a.m. – 11:10 a.m.

Pearls for Labs/Diagnostics

12:35 p.m. – 1:50 p.m.

Student Lunch

1:55 p.m. – 2:55 p.m.

Microbiology Pearls

3:00 p.m. – 4:00 p.m.

Pharmacological Pearls for PA Students

Care for an elderly patient from the perspective that they might be your grandmother or grandfather. And from my collaborators… Justin Anderson, PA-S, “What you put in, you get out!” Rose Christensen, PA-S “Don’t be afraid to jump in, no matter what it is or how much experience you lack. Your confidence will soar just trying.” Rotations are crucial to giving your patients the best care you can give. So, what’s on your Bucket List? 

Attention: PA Program Directors, Class Presidents, Student Society Leaders, Faculty and Students

et CAPA know what you are doing by submitting an article and include a photo if possible. Or, you may simply send a photo with a descriptive caption. We want to let our readers know the wonderful things that are happening at our PA programs. We will print submissions on a space available basis. Send your article/photos, etc. to capa@capanet.org. Thank you!!

Student Medical Challenge Bowl Sign Up Now by Roy Guizado, MS, PA-C, Student Medical Challenge Bowl Coordinator

he 15th Annual CAPA Student Medical Challenge Bowl will be held Saturday, September 24, 2011, poolside at the Renaissance Palm Springs from 5:45 p.m. – 7:15 p.m. There will be a cash prize for the winning team: $250 for their Student Society. The winning 24

CAPA NEWS

team will also be able to display the official Challenge Bowl Trophy at their PA program. To sign up, to go the student section of the CAPA website (www.capanet.org). We look forward to seeing you there. 

Students Students Students Students Students Students Building a Curriculum Vitae by Roy Guizado, MS, PA-C, Student Affairs Committee Chair

raduation time is rapidly approaching, and it will be time to prepare for the Physician Assistant National Certifying Exam (PANCE). But once you pass the exam, your next step to becoming a practicing PA will be to find employment. As you begin your job search, one essential document you will need to create is a Curriculum Vitae (CV). A CV should not be confused with a resume. While both a resume and CV include education, academic background and skill information, a resume is very short (no more than two pages) and focuses on getting an interview. A CV is as long as it needs to be and focuses on your background and qualifications. There is no one way to create a correct CV, but there are general guidelines to follow, such as the use of a readable font such as Times New Roman, size 12, one-inch margins, and no graphics. To make information stand out, use capitalization, bold font, or italics. The use of white paper is preferred, although cream colored can be substituted. It is important that the information is clear, succinct and organized, listing only information that is current and complete. A CV is broken down into sections. The first section is your contact information, listed at the top of the page, which includes your full name, mailing address, email, and phone number. Do not list social security numbers or DEA numbers. (Some CV construction websites preferred the contact information as the last section on the CV, but this is not a very common practice.)

A proper CV will also include the following sections: •

Education (traditionally listed first)

•

Professional Experience

•

Certification and Licensure

•

Professional Affiliations

•

Publications or Research

•

Honors and Awards

•

Interests

•

References

The education section should start with the most recent degree and end with the first earned degree. The degree granting institution should be listed along with the date the degree was conferred. It is not uncommon for a PA CV to list their Master’s Degree, Bachelor’s Degree, and Associate’s Degree. The professional experience section should list the experiences that you have undertaken. They should be listed chronologically with the most recent work first. It is important to provide experiences that are relevant for employment. Some CV writing sources state that you should not write any descriptions of the professional experiences, while others say that a few sentences would be appropriate. However, long descriptive paragraphs are discouraged because potential employers will not take the time to read lengthy passages. It is also important to note that a new graduate would not list any PA experiences on a CV. Instead, it is common to list student rotations in reverse chronological order, with the name of the office included. You

are not obligated to list supervising physicians or preceptors, but if you choose to list the names, be aware that the potential employer may want to contact those listed. The certification and licensure section is self explanatory. Be sure to list expiration dates. Do not list any certifications that have expired. The professional affiliations section should list all current organizations along with the dates of affiliation. Alphabetical listing is preferred. It is important to list any positions held in affiliated organizations. Publications should be listed in chronological order of publication, with the most recent first. The CV author should bold their name in the authorship of each publication or presentation. Be sure that you have copies of publications or presentations if requested by the potential employer. Honors and Awards are listed with the most recent first. The award or honor should be accompanied by the date received. Descriptions of the award are discouraged. It is acceptable to list awards received in undergraduate education, but they should be academic in nature. The interests section gives you an opportunity to paint yourself in a different light. It is important to pick interests that truly reflect your inner self; ones that provide positive information about your beliefs and values. It is acceptable to list no more than four interests. Continued on page 26

JUNE/JULY 2011

Students Students Students Students Students Students Building a Curriculum Vitae Continued from page 25

The CV categories listed can be tailored to suit the needs of the potential employer and portray the applicant in the best light. Some CVs will include an additional area entitled Objective. The objective section is an area in which the CV writer indicates the reason why he/she is seeking a job. The more unique the objective, the better it will catch the employer’s eye. Limit the length to one or two sentences. The CV should have a Reference Section. If tailoring a CV to a potential employer, you can list the persons that have agreed to provide references. Otherwise, you can state that references will be provided upon request. Once the CV has been created, it must be reviewed for spelling and grammatical errors. The potential employer not only perceives these errors as a lack of attention to detail, but infers a possible lack of attention to patient care or patient records. The following sites provide additional tips and templates: http://healthcareers.about.com/od/ gettingthejob/qt/CVwritingtips.htm http://how-to-write-a-cv.org/how-towrite-a-medical-cv.html http://www.ematchphysicians.com/ resources/tips/tips-for-physician-cv/ http://www.allaboutmedicalsales. com/members/cv_writing/free_cv_ writing_advice.html http://209.235.219.102/pdf/ Students_Tips_CurriculumVita.pdf  The following is one example of the many different types of CV formats a new graduate may use: 26

CAPA NEWS

John Doe, MS, PA-C 123 Dover Street, San Verde, CA 90000 Phone: 123-456-7890 Cell: 555-123-4567 Email: jdoe@email.com OBJECTIVE: To seek gainful employment as a physician assistant in a family based medical practice where I will tend to the health needs of the patients while promoting primary disease prevention through positive patient education. EDUCATION Shady Grove University MS, Physician Assistant Education 2010 April Lake, CA

Mount Shasta Community College AA, Biological Sciences 2004 Grass Plains, ND

Baker’s College BS, Biological Sciences 2007 Downey Ridge, CO PROFESSIONAL EXPERIENCE April - June 2010 Physician Assistant Student General Family Practice Prime Care Medical Group Blue Mesa, CA February - March 2010 Physician Assistant Student General and Orthopedic Surgery Reno Orthopedic Specialists Lake Reno, CA

October – November 2009 Physician Assistant Student Pediatrics/Women’s Health Willow Medical Group Long Surf, CA August – September 2009 Physician Assistant Student Internal Medicine Acme Medical Group Monte Carlo, CA

December 2009 – January 2010 Physician Assistant Student Emergency Medicine Los Bernardinos Regional Medical Center Los Bernardinos, CA CERTIFICATION AND LICENSURE National Commission on the Certification of Physician Assistants 2010 California Physician Assistant Committee License 2010 Advanced Cardiac Life Saving 2009

PUBLICATIONS Smith, Henry; Doe, John; Patel, Ashish. Decreasing the Incidence of Strep Throat in Middle School Children (2009) Journal of the American Academy of Physician Assistants, Arlington, VA

PROFESSIONAL AFFILIATIONS California Academy of Physician Assistants 2008 CAPA Student Representative 2010 American Academy of Physician Assistants 2008

HONORS AND AWARDS PA Class Valedictorian 2010 Community Service Scholarship

This example CV is for content only. The formatting has been modified due to space limitations.

REFERENCES Available upon request

INTERESTS Community Soccer Coach Foothill Family Road Cycling Club

2008

Welcome New Members

Local Groups

April 1, 2011 through July 11, 2011 Elizabeth Aguilar Ben Alcocer, PA-C Asfia Ali, PA-C Eliezer Alvarez, PA-S Caroline Andersen, PA-S Stephanie Anderson, PA-S Andrea Arnold, PA-C Paula Arriaga, PA-C Patrick Arrington Craig Baillie, PA-C Viorica Bantea, PA April Baran, PA-C Brandie Baranowski, PA-C Julie Barnes, PA-C Ricki Barnes, PA-S Bruce Barnhart, PA-C Kennard Beard, PA-C Kristin Beitz, PA-C Clark Bishop, PA-C Sharon Blischke, PA-C Thomas Bosma, PA-C Shelley Boyd, PA-S Raquel Buckle, PA-S Hector Erwin Busante, PA-C Carlos Canizales, PA-C Terisa Chantele Sahli, PA-C Christina Cheng, PA-S Donny Cho, PA-S Matthew Cleveland, PA-C Aaron Clothier, PA-S Jennifer Collins, PA-S Ray Contino, PA-S Michelle Dao, PA-S Sandra Del Valle, PA Dana Derissi Walter Desha, PA Amanda Dick, PA-C Kate Doerksen Thomas Dowell, PA-C Gabe Dudley, PA-S Sean Dunn, MSHS, MPH, PA-S Kathryn Durdel, PA-S Sarah Ekberg, PA-S Melissa Ellis, PA-S Megan Ellwanger, PA-S Liesel Ernst, PA-S Javier Esquivel-Acosta, PA-C Cecily Falzone, PA-C Zola Ferguson, MS, PA-C Laura Field, PA-C Robert Fonseca, Ph.D., PA-C Alex Friedman, PA-S Luis Garcia, PA-S Edgar Garza, PA-S Morgan Gaura, PA-S Cheri Geist Christine Gold, PA-C Alex Gonzalez, PA-C Gabrielle Gonzalez Katherine Good, EMT, CPT Alan Gorenberg, M.D.

Aimee Hada, PA-C Nosha Hadi-Nahavandi, PA-C Casey Hahn, PA-S Lorna Hall, PA-C Brianna Hanson, PA-C Rosana Hernandez, PA-S Jennifer Hershey, PA-S Carolyn Hoang Randi Holmes, PA-S Joseph Hsu, PA-C Paul Hupp, PA-S Mathew Hutchings, PA-C Kimberly Hwa, PA-C Jenny Janke, PA-S Ismah Jawed, PA-S Iman Jomaa, PA-S James Jones, PA-C Linda Jordan, PA-C Loran Killar, PA-S Keils Kitchen, PA-C Debra Krol, PA-C Jessica Lam, PA-S Chakosha Lance, PA=C Kathryn Law, PA-S Kaitlin Le Amber Lehmann, PA-C Victor Leite, MSHS, PA-C Christiane Le-Mahon, PA-C Michael Lewis, PA-S Sarah Lockhart, PA-S Brittany MacDonald, PA-S Mercedes Machuca, PA-S Gary Mallit, PA Molly Maloy, PA-C Shane Manalang, PA-C Monique Mancia, PA-C Andrea Mang Carolyn Mansour, PA-S Eric Martinez Melanie McConnell, PA-S Joseph McCormick, PA-C James McKelvey, PA-S Kelly McNavish, PA-S Deisy Mendoza, PA-C Sophia Mesghenna, PA-S Natalie Meulenberg, PA-C Stephanie Mireles, PA-S Jillian Mongetta Stephanie Morales, PA-C Alicia Muccigrosso, RPA-C Ashley Mullen, PA-S John Muller, PA-S Andrea Nacca, PA-C Christine Napora, CPC Adolph Nava, M.D. Anita Nelson, M.D. Karl Nessi Gloria Ng, PA-S Alissa Nguyen, PA-S Michelle Oropeza, PA-S Dolores Orozco, PA-C

Kevin Parkes, M.D. Nima Patel, PA Salvador perez, PA-S Katie Peterson, PA-S Catherine Pham, PA-S Susan Potter, PA-C Adolfo Quiroga, PA-C Annie Regan, PA-C James Rho, M.D. Kathryn Richards Steven Rigor, PA-C Michelle Rios, RDMS Heather Rosaasen, PA-C Roy Rubin, M.D. Eva Nannette Rueda, PA-C Allison Russell, PA-S Eric Rypins, M.D., FACS Brian Salabarrieta Lysa Samuel, PA-C Reuben San Juan Nicole Schedeler, PA-S Rachel Scott, PA-S Michelle Scotti, PA-C Jeff Seidenrose, PA-C Sonia Sharma, PA-C Erin Sherer, PA-C Megan Shiroma Vasiliki Sideris Cody Sims, PA-C Gurpreet Smagh, PA-S Stephen Solum, PA-S Jennifer Speer, PA-C Daniel Speller, PA-C Aimee Spencer, PA-S Samuel Sperry, PA-S Jessica Starr, PA-C Michael Stephen, M.D. Taryn Stolpp, PA-S Stephen Strand, RN, FNP, PA-C Laura Strauss, PA Saloni Swarup, PA-S Lisa Tifft, PA-S Keir Todd, PA-C Michael Trofimenko, PA-C Kristin Utecht, PA-C Darlene Vuong, PA-S Cara Walker Lorraine Wang Devan Weidle, PA-C Jennifer Weiss, PA-C Kristen Wheeler, PA-C Scot Wigling, PA-C Nicole Willburn, PA-C Andrew Wood, MBA Matthew Woolf, PA-C Derrick Wright, PA-C Michael Wright, PA-S Thang Yang, PA-S Kathleen Youngs, PA-C, MS Michelle Zandian, PA

1. Redding Area PA/NP Alliance Summer Ross, PA-C; (530) 275-5747 summerross@hughes.net 2. Physician Assistant Society of Sacramento (PASS) Carlos De Villa, PA-C, PASS President; (916) 973-6185, pasocietyofsac@yahoo.com Atul Sharma, PA-C, MMS, MPH, CHES; (916) 397-6035, pasocietyofsac@yahoo.com 3. Contra Costa Clinicians Association Brian Costello, PA-C; (707) 651-2705, brianc510@comcast.net 4. San Francisco Bay Area Physician Assistants (SFBAPA) www.sfbapa.com, PO Box 14096, San Francisco, CA 94114-0096 Martin Kramer, PA-C; (415) 433-5359, Fax: (415) 397-6805, mkramersf@hotmail.com 5. Bay Area Mid-Level Practitioners Rose Abendroth, PA-C; (650) 697-3583, Fax: (650) 692-6251, rosepard@aol.com Matt Dillon, PA-C; (650) 591-6601, mattdillon42@hotmail.com 6. Bay Area Non-Docs Linda Oâ&#x20AC;&#x2122;Keeffe, PA-C; (650) 366-2050, lindapac@aol.com 7. Northcoast Association of Advanced Practice Clinicians John Coleman, PA-C; (707) 845-6008, streetdrag49@sbcglobal.net 8. Stanislaus County NP/PA Network Brian Cormier, PA-C; (209) 605-4966, briancor@verizon.net, www.nppanetwork.org 9. Stockton Midlevels Emma Calvert, PA-C; stocktonmidlevels@gmail.com 10. Journal Club for PAs and NPs (Fresno area) Cristina Lopez, PA-C; (559) 875-4060; Fax: (559) 875-3434, clopez875@aol.com; 2134 10th St, Sanger, CA 93657 11. Tulare/Kings NP/PA Association Steve Henry, PA-C; Pager: (559) 749-4348, msh649@sbcglobal.net 12. Central Coast Nurse Practitioners & Physician Assistants Kris Dillworth, NP; ccnppa@yahoo.com 13. So Cal PAs Linda Aghakhanian, PA-C; want2heal@hotmail.com 14. Orange County Hung Nguyen, PA-C; (714) 846-8178; nhy52@yahoo.com 15. San Gabriel Valley Local Group M. Rachel DuBria, PA-C; (818) 744-6159, racheldca@aol.com 16. San Fernando/Santa Clarita Valley Group Jonah Tan, MPT, PA-C; (818) 634-0007, jotptpa@yahoo.com 17. Coachella Valley Physician Assistant Group Matthew Keane, MS, PA-C; mkeanepas@gmail.com 18. San Diego Area Jeremy Adler, MS, PA-C; (619) 829-1430, jadler@simplyweb.net

JUNE/JULY 2011

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2011

CAPAâ&#x20AC;&#x2122;S 35TH ANNUAL CONFERENCE Renaissance Hotel | Palm Springs Convention Center

SEPTEMBER 22 - SEPTEMBER 25 see de t insideails pages 14-18

Optional Workshops | September 22 and 24 Controlled Substances Education Course | September 21, 2011 Demystifying Emergency Medicine Course | September 21, 2011