2010News_July_August by CA Academy of PAs

News

Official Publication of the California Academy of Physician Assistants

July/August 2010

\The Magazine

Understanding The SOS Poster Project You Are A California PA, A CAPA Member, You Sooooo Should Do It! SOS Poster Project – In Short, Just the Facts •

It is a quick and easy project – we promise. All you need is some poster board and a glue stick.

Photo of the SOS Poster Larry Rosen, PA-C will bring to the CAPA Conference. When sending us this photo Larry wrote, “Wonderful project! This took me all of 15 minutes to put together. And, it was great fun to revisit the pictures and memories of those two extraordinary weeks in China. I hope others will take a few minutes to share their personal stories about how fortunate we are to practice medicine in this profession.”

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California PAs will benefit when we take your posters, highlight them in the CAPA News and even better, create stories and press releases about what you are doing. Your posters will be really simple seeds of inspiration needed to identify larger and more detailed stories (that is our job) we can get to your local media. Sometimes, what you see as just your day-to-day job is the story about health care that will hit home with a reporter. If you are doing it, it matters!

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Poster Board can be found at Staples, Office Depot, Michael’s or any stationary store. Standard size is 22 x 28. You can go up to 36 x 36 if you like.

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To your poster board, use a glue stick or a stapler and affix whatever you like: photos, words, images that will show us something about your practice, your volunteer work as a PA, your work as an educator, etc. Everyone can think of something to SHARE and we want hundreds of posters. Make it an office project. Add some photos of your MAs, your receptionist, etc. Show team medicine at its best.

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Getting your poster to CAPA is easy! If you are coming to the CAPA Conference, you will bring your poster with you (if it is 22 x 28, it will fit in the overhead compartment on a plane if you are flying, or the flight attendant can stow it). If you aren’t coming to the conference (and we hope you are) you can ship it to the CAPA office. Poster board is very light weight, will ship easily and it will be inexpensive.

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Need ideas? We have them. Tell us what kind of practice you are in and where you live. We’ll give you some ideas. Email: capa@capanet.org or call the office.

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Let us know today that you will be part of the movement to get PAs recognized by the media! Let’s do this together! 

Poster Deadlines: Deadline for your poster if you are bringing it with you to the CAPA Conference: October 8, 2010 at 9:00 a.m. Deadline for your poster if you are shipping it to the CAPA Office: Wednesday, September 29, 2010

News

On The Table

Editor Gaye Breyman, CAE

Do You Have An Interest in Legislative Affairs?

Managing Editor Jennifer Deane

Your Keen Interest and Desire To Learn, Make You A Perfect Candidate To Serve On CAPA’s Legislative Affairs Committee

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

Proofreaders Paula Meyer, PA-C CAPA Board Of Directors President Eric Glassman, MHS, PA-C president@capanet.org Vice President Larry Rosen, PA-C vicepresident@capanet.org Secretary Cherri Penne-Myers, PA-C, MSCS secretary@capanet.org Treasurer Bob Miller, PA-C treasurer@capanet.org Directors-At-Large Beth Grivett, PA-C dirbeth@capanet.org Matthew Keane, MS, PA-C dirmatt@capanet.org Adam Marks, MPA, PA diradam@capanet.org Greg Mennie, PA-C, MSed dirgreg@capanet.org Student Representative Jenn Baltazar, 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 ©2010 California Academy of Physician Assistants

CAPA NEWS

ecently, our lobbyist, Bryce Docherty was visiting Assemblyman Solorio and as he was leaving his office, there on a table in the lobby is the latest issue of the CAPA News! Bryce had to stop and take a photo.

We usually have a section in the CAPA News entitled: At the Table. We put photos and highlights of meetings/events attended to highlight the PA profession. We have worked hard for many years to ensure that CAPA/PAs are recognized by health care leaders, policy makers and legislators. Due to our diligence and our efforts, we are a valued part of the California health care team and we remain committed to always being at the table. As the saying goes: If you aren’t seated at the table, you may very well be on the menu. In this instance, we are very proud to be featured:

On The Table!

he Legislative Affairs Committee (LAC) Chair will soon be interviewing potential members of the committee. This is a volunteer position which runs from November 1, 2010 through October 31, 2011. Committee service will involve working with the committee on CAPA’s legislative agenda planning, following legislative bills for which CAPA has taken a position and making recommendations to the CAPA Board of Directors with regard to legislation. Almost always, LAC meetings will be held via conference call. Time commitment is typically three to five hours a month. If you are interested in serving on the Legislative Affairs Committee, please submit a short essay including your reasons for interest in legislative issues, why you think you would enjoy serving on the LAC, and any special skills/past experience you would bring to the LAC. No special experience is required. Please email your essay along with your name and CAPA membership number to lac@capanet.org or fax to (714) 427-0324. Deadline to apply is October 10, 2010. 

New Website Regarding the Implementation of Health Care Reform – www.healthcare.gov

n March 23, 2010, President Obama signed into law the Affordable Care Act. The law puts into place comprehensive health insurance reforms which will hold insurance companies more accountable and will lower health care costs, guarantee more health care choices and enhance the quality of health care for all Americans. The Act will not be implemented all at once. Portions of the law have already taken effect. Other changes will be implemented through 2014 and beyond. To track the progress, visit www.healthcare.gov regularly for the latest updates.

Advisory Committee on Physician Supervision – The Medical Board of California by Beth Grivett, PA-C, Legislative Affairs Coordinator

have been attending Medical Board of California (MBC) meetings on behalf of CAPA for about three years now. It is good to be at these meetings and I often find a reason to speak up to explain the PA’s role and to clarify CAPA’s position about an issue. Sometimes I get through the entire meeting and nothing was discussed that has anything to do with PAs. And, this makes sense, really, since PAs in California are licensed through a subcommittee of the MBC, the Physician Assistant Committee (PAC). As I work on legislation for PAs in the state, I am always interested in the MBC’s discussion and approved position on particular legislation. Sometimes I even learn about legislation that we should be following for our members and for our patients. This winter, I was honored to be appointed to a new advisory committee which has been developed specifically to look at issues related to physician supervision. The MBC licenses and regulates physicians with the sole purpose of patient/consumer protection. About three years ago, supervision issues were at the forefront of discussions at special MBC hearings

held to respond to reports of adverse outcomes at “Medi Spas,” where non-physicians were performing laser treatments without proper supervision. Since then, Operation Safe Medicine was reimplemented and investigators have closed down many such clinics mostly for violation of the Corporate Practice of Medicine Act. Senator Negrete McLeod, currently a co-author of CAPA’s sponsored SB 1069, requested that the MBC continue to look at physician supervision of non-physicians and, in response, this advisory committee was formed. There are many members of the health care team and there is concern that procedures and medical services are being delegated to non-physicians inappropriately. The goals of the committee are: (1) to delineate those services which can and should be delegated to non-physicians (2) to declare by whom, and in what circumstances, an informed consent may be obtained (3) to define physician supervision in various settings. I sit on this committee amidst specialty physicians and members of the MBC to represent CAPA and PAs

in CA. As I do so, I hope to impress upon the committee and upon the members of the MBC that the physician-PA relationship within the physician-led health care team should act as a model for other similar health care providers. Our training and experience qualifies us to perform those medical services delegated to the PA through our Delegation of Services Agreement. Our newly mandated continuing education assures our licensing board, the PAC, that we are committed to continuing education. The PA model is quickly becoming the model that physicians are looking to because it works. On June 23, I had the opportunity to present to the committee the physician supervision of PAs and the PA’s relationship to other health care professionals. The presentation went well and there were clarifying questions about the physician-PA relationship. I look forward to my continued work on this committee which should assure that the MBC is presented with accurate information about PA practice and how PAs fit into the health care team. 

Inside This Issue On The Table........................................................................2 Do You Have An Interest in Legislative Affairs?......................2 New Website Regarding the Implementation of Health Care Reform..............................................................2 Advisory Committee on Physician Supervision – The Medical Board of California.............................................3 Who Will Listen?...................................................................4 Taking The Baton..................................................................5 Retreat is Renewal................................................................6 Thinking About Being A Student Preceptor?...........................8 AAPA’s Legal Bombshell Hits 2010 House of Delegates.........10 Set Your Computer/SPAM Filter...........................................10 What’s a PA...So You Think You Know Your Profession?.........11

Protect Your Professional License.........................................12 The CAPA PAC is Hitting the Road for Palm Springs...............13 California ENT PAs: Let’s Talk!..............................................13 The Cost of The CAPA Conference Is Was Heavily Subsidized By Corporations..........................14 CAPA’s Conference Planning Committee Working for YOU!....15 2010 CAPA Conference.........................................................16 Uniquely CAPA...and YOU make it happen!..........................18 Controlled Substances Education Course...............................18 PA MarketPlace..................................................................19 Sharing Our Selves..............................................................19 CAPA Conference Registration Forms...................................20 My First Year As A Delegate To The AAPA House of Delegates.....22

Why is a Diverse Health Care Workforce Important?............23 Answers to Quiz on Page 11 ...............................................23 If You Want To Win The Lottery, You Have To Buy A Ticket!...24 CA State Loan Repayment Program Opportunity!!................25 My Lessons in Diversity.......................................................26 Student Challenge Bowl – Sign Up Now...............................26 Applying For Your PA License?.............................................27 Special Student Track at the CAPA Conference......................27 Democracy Is Two Wolves And A Lamb… . .........................28 PArtying on July 4th...........................................................29 Faculty Profile: Grace Landel, PA-C......................................30 Welcome New Members......................................................31 Local Groups......................................................................31 JULY/AUGUST 2010

Who Will Listen? by Bob Miller, PA-C, Professional Practice Committee Chair between PAs and NPs. Other frequent questions are about bringing revenue to the practice and, better yet, “Where do I find a PA?” We like that one. So, when an opportunity presents itself to educate the masses we jump at the chance to provide solid and clear information about PA education, laws, regulations, reimbursement and scope-of-practice. Also, where you can find one. The trick is finding the right audience who will listen.

ecause we are still a relatively young profession, as you know, many people remain uninformed, misinformed or lack a true understanding about PA practice in California. CAPA seizes every opportunity to provide education “It’s a significant step to about physician assistants – who see the legal profession we are, how we are trained and acknowledging the need to the benefits that we bring to a learn more about this health medical practice.

care provider who will be

When we speak to a group, it’s the play a major role in health Q & A session which is the care reform.” most revealing segment of the presentation. Encouraging that “No question is a bad question,” the ones we field demonstrate the confusion about every aspect of PA practice. And, of course, the question always arises, “Well, how are you different than an NP?” That one usually comes from the “lumpers” (lumping together PAs and NPs in one mid-level basket), not the splitters. The focus then is to help them understand both the similarities and the differences

looked to more and more to

CAPA NEWS

We’ve accomplished these educational efforts in several ways. Sometimes we are invited by organizations or groups who want to learn more about PAs. These invitations often spring from the desire to understand a potentially untapped source of clinicians to meet the needs of a growing practice or medical group. We want to do more of these! Another strategy to get the word out is to bring the audience to us. We have done that over the years with Larry Rosen, our PR master, spearheading our very successful Doc-to-Doc dinners and events. If you have not read about these dinners, Larry’s intention has been to provide a panel of physicians eager to share their experience with other physicians (Doc-to-Doc), of working with PAs in various medical settings. The typical audience consists of physicians and administrators who are considering hiring PAs but want to know more before they make the commitment. We want to do more of these too! Whatever shape an educational event takes, we need to help people and organizations understand the value of PAs. In early June, we were asked to do an educational session for a legal group. This was a new target audience for us. New, because in the past we were primarily focusing on potential employers of PAs. But

this makes perfect sense. As we grow as a profession, we intersect with other professions who become stakeholders in our own. Michael Scarano, Jr., Esq., CAPA’s Legal Counsel, and I were invited to the

Michael Scarano, Jr., Esq. and Bob Miller, PA-C

San Diego County Bar Association to discuss an overview of PA practice in California. Their group requested that the presentation be delivered from two perspectives – from a knowledgeable attorney’s point-ofview but also from an experienced PA in a medical practice setting. There were mostly attorneys in the audience but it was nice to also greet several PAs from the area. There were lots of good questions and active discussion. It’s a significant step to see the legal profession acknowledging the need to learn more about this health care provider who will be looked to more and more to play a major role in health care reform. If you are aware of a large organization, a hospital or large medical group that would like to have this type of presentation about PAs, please let the CAPA office know. 

Taking The Baton by Eric Glassman, MHS, PA-C, President

t was my honor to take the office of CAPA President on July 1. I am looking forward to the opportunity to serving you as President for two years. Our Past President, Miguel Medina, did an amazing job as a two-year president and it is my goal to follow in his footsteps. I am excited for the many opportunities to serve you and represent all California PAs statewide. This is a very exciting time to be a PA and the future of medicine here in California and the United States is really unknown. I believe with all of our hard work, we can help shape the future of medicine and be big players in the delivery of health care in California for years to come. And, its CAPA’s mission every day to make sure we are doing everything possible to achieve this goal.

in new legislation which is being introduced and could potentially impact our day-to-day practice. We also look through current state laws and listen to our members’ issues and concerns and introduce new legislation to make our practice as PAs in California better. With so much up in the air regarding the future of health care reform, this could possibly be the most important thing we do to protect our future. Our current PA Practice Act is excellent and it is our goal to make it even better.

with believe that mid-level providers will be the main deliverers of primary care medicine in the future. Our team approach to medicine has been an excellent and effective model over the years. Perhaps more than ever before, it is CAPA’s job to promote PA practice to the powers that be in Sacramento as well as to physician groups who hire PAs. We have a great Public Relations Committee chaired by Larry Rosen who comes up with new and innovative ways to promote our profession to those responsible for hiring and using PAs.

Many CAPA members only see your CAPA leaders once a year at the Annual Conference in Palm Springs and don’t really know what is going on daily behind the scenes. Although the conference really is a full, year-long project of finding quality speakers, exhibitors, funding, etc., CAPA does so much more everyday, working hard to make sure that your day-to-day practice as a PA in California is the best it can possibly be.

At our recent Leadership Retreat in June, among many different discussions, your CAPA leaders discussed how PAs can potentially fit into the new model of health care delivery. And, no matter which way it goes, we like where we stand. We have an ever increasing shortage of primary care physicians and now, under the new health bill, we are giving many more individuals the opportunity for health care. Obviously, as PAs, we feel we are an excellent choice to bridge this gap of supply and demand and provide quality health care to those individuals. We still feel very strongly of our mantra of providing highquality, cost-effective health care to the community will be the benchmark of primary care in the future.

I would also like you to know that everyday the staff at the CAPA office is eager to answer your questions and make sure your needs as a valued member are being met. We have a great website that is quite userfriendly to navigate through and can answer many of the questions you may have. And, if you can’t find it on our CAPA website, I am sure that our CAPA staff can assist you further.

We have a legislative advocate, Bryce Docherty, up in Sacramento who is making sure that PAs are included

Each year, we exhibit at several different physician conferences and many physicians we have spoken

Requires Physician Signature

I am excited about this opportunity to serve you as CAPA President and even more excited about the future of our profession no matter where Health Care Reform may take us. Please feel free to contact me if you have issues or concerns. I hope to see you at our upcoming CAPA Conference in Palm Springs October 7 – 10. 

o you have examples of forms, cards, certificates which have been rejected by organizations, insurance companies, state agencies, departments, school districts, etc. solely because the form was signed by a PA and not a physician? If so, please fax us a copy of the form, being careful to abide by HIPAA Privacy Rule Requirements. You may fax your examples (800) 480-2272 or email them to capa@ capanet.org or call us and we can speak with you to explore the best way to share the information. JULY/AUGUST 2010

Retreat is Renewal by Larry Rosen, PA-C, Vice President and PR Committee Chair

Lake Arrowhead 2010

ake Arrowhead is magnificent, an idyllic setting for company leaders to gather and shape their goals and directions for the coming year. In June, CAPA held its annual retreat in this peaceful resort and planned the blueprint of our work for the 2010-2011 fiscal year. Board members and committee chairs attend. The mood is relaxed and informal but our purpose is clear: examine our mission statement and use it, as always, to guide our work plans.

The Mission of the California Academy of Physician Assistants is: To represent and serve PAs statewide. As an advocate of its members for quality healthcare and for their valued, unique alliance with supervising physicians, CAPA will enhance, educate and empower physician assistants for the ultimate benefit of their patients.

New board members and committee chairs join us every year. Retreat is an opportunity to get to know one another. It is the board’s responsibility to determine the course CAPA will follow in the months to come, but each opinion is valued and listened to. Healthy debate, sometimes long hours of it, shapes the goals of committees and the direction of our Academy. 6

CAPA NEWS

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Under the inspired guidance of our Legislative Affairs Coordinator, Beth Grivett, legislative agendas are discussed; what bills we will support, oppose or simply watch.

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Bob Miller, our intrepid Professional Practice Committee Chair, walks us through the morass of laws and regulations which specifically affect PA practice in California. It is evolving constantly and we need to be alert to the changes in order to keep our membership informed.

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Public relations ideas are evaluated and developed. The Public Relation Committee’s purpose is to keep the physician community informed and excited about team practice with PAs. All goals lead to more jobs for more physician assistants.

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Conference planning and themes, under the leadership of CME Chair, Cyndy Flores and COO, Gaye Breyman, are presented. This year’s

“SHARING OUR SELVES” Annual Conference in Palm Springs promises to be one of our best ever. Register now and get to work on your SOS Poster! •

Student affairs, maintaining a connection with students from all PA programs and providing an environment where student voices are heard, is essential to CAPA’s future. With no reservation, I can assure you that our student population will be well represented this year by one of our returning board members and our new board member.

Taking Miguel’s place is Eric Glassman who, in the last year as President-Elect, has already demonstrated his eagerness to lead and shown his own, personal spark of confidence and commitment. Eric’s style is comfortable and easy, energized in part by his love for the late John Wooden and his PYRAMID OF SUCCESS. Eric shared that with us at the beginning the retreat. It set the tone for his presidency and for what looks to be an exciting, progressive two years for CAPA growth and success.

They are Adam Marks, Director-At-Large, and Jenn Baltazar, Student Representative. Adam graduated this year from SJVC and Jenn is in her second year at Western University. Their voices, far from timid, brought us a refreshingly new perspective. When they presented ideas they were well conceived and often challenging. The debates were spirited. Out of them came exciting, innovative projects and pursuits. Inevitable change always comes as each year we renew our commitment to the future of CAPA’s mission. Our beloved Miguel Medina will step down as President and hand CAPA leadership over to the capable hands of Eric Glassman. For the past two years, Miguel has been an inspiring leader for our profession and for all of us at CAPA who have been privileged to serve under him. He has made our difficult, often demanding work much easier by surrounding us with a safety net of cool, competent leadership.

Please join me in welcoming our new President, board members and committee chairs to the CAPA family. You’ll learn more about them as you read their articles coming up in the CAPA News. Our Annual Conference in Palm Springs this October will afford you an opportunity to meet them all in person. Take advantage of it. Tell us about the problems you face in your practice. If you support the direction we are going, let us know. If you are displeased with the way certain issues are handled, bring your concerns to our attention. We were elected to serve the needs of California physician assistants. Member input is invaluable and never discounted. And, above all, thank you for your membership and continued support of CAPA. 

JULY/AUGUST 2010

Thinking About Being A Student Preceptor? by Jed Sejismundo, PA-C, Childrens Hospital of Los Angeles, CAPA Member

The CHLA Hematology/ Oncology PA Group Jed Sejismundo, PA-C Bob Miller, PA-C Jennifer Hanly, PA-C Kimberly Ward, PA-C Carla Tapia, PA-C

o you remember examining your very first patient? Clumsily introducing yourself as a PA student (hoping they don’t ask you: “What’s a PA?” and if they do, hoping you give a good enough answer). Taking excruciatingly detailed notes during your history. Fumbling through the pockets of your pristinely white, un-stained lab coat for a reflex hammer you have no idea how to use. Barely pushing down on your patient during the abdominal exam for fear of hurting them. And finally, hurriedly leaving the exam room without once asking your patient: “Why are you here today?” Those we’re good times. Now flash forward a few years and imagine yourself watching these same events unfold as a PA student you are helping to mentor makes his initial foray into the realm of medicine. Bring back any memories? Forgive me for making light of what many clinicians find to be a truly stressful circumstance, but I do so to illustrate a point: as established clinicians, we at least have the luxury of looking fondly back on those days as a student realizing that in the end we’ve all managed to survive our rotations relatively unscathed. I know from my personal experience (and I’m not ashamed to admit that it was many, many moons ago) the didactic portion of my education was thorough, and I was a diligent and motivated student. However, going through mock physical exams using my classmates as unwitting guinea pigs, would not, could not, fully prepare me for when I had to deal with a real patient with genuine problems. Yet there was always at

CAPA NEWS

least one person who I knew would never allow me to fully fail or misstep, who would encourage me to learn from my mistakes and most importantly reaffirm my decision about going into medicine in the first place. That person was my clinical preceptor. Now years later, since becoming an experienced clinician and having had a hand in educating the next generation of PAs, I often ask myself the question: “Why don’t more people do this?” Shouldn’t like-minded individuals, who have decided to devote their lives to a career which practices compassion, embrace the opportunity to teach and mold new members of their profession?

“...This has been a great recruiting tool in our hands...”

As it turns out, the answer to this question was surprisingly straightforward. What I found out to be the case was clinicians typically don’t precept students for two reasons: 1) They simply don’t know how to get started or find the paperwork/process too complex and time consuming or 2) They find the responsibility of having a student too burdensome. Overcoming the first obstacle is not as difficult as you may think. There will be help for the paperwork and red tape. The key is having the support of your supervising physician in understanding the role and the responsibility which he or she accepts in becoming a clinical preceptor. Although the student may learn from several clinicians at the practice site, it is the physician who has the responsibility as clinical preceptor.

There are also clear benefits in taking on a PA student. One of which is working with and evaluating students who may, at some time, become future employees. This has been a great recruiting tool in our hands as we have been rewarded with recruitments of former students who know our practice setting – and we know them. A perfect fit. There are other positives a PA student can bring to the practice. Among these is the development of a working relationship with one or more PA programs. Experienced PAs in the practice may also have the opportunity to teach part of the didactic portion of the training program. This is a stimulating way to keep medical knowledge up-to-date and is personally rewarding. Your CV would also reflect your dedication and involvement in the PA profession and perhaps an adjunct faculty status. Yet the best rationale you can give, which underscores all these reasons, is that teaching is its own reward. What better way to positively influence the state of health care tomorrow than to invest in its fledgling students today. Of course the paperwork and logistics involved in establishing a rotation at your practice/institution can be daunting to say the least (affiliation agreement, liability insurance, HIPAA forms…just thinking about this makes me queasy). But help is not only available – schools are waiting for your call. Fortunately there is a person from every PA program’s staff specifically trained to help navigate you through the labyrinth of red tape: the Clinical Coordinator. If you are approached by an enthusiastic, abundantly energetic PA student desperately wanting to do a clinical rotation with you and you have the desire to accommodate them, their Clinical

Coordinator should be the first person you call. These consummate professionals, who are charged with the awesome responsibility of placing every student in a quality rotation, will be your best guide and resource. They can simplify the process because good rotation sites are difficult to find and they are motivated to place their students into appropriate educational settings. Any Clinical Coordinator will tell you there is a critical shortage of good rotation sites. PA programs are focused on primary care and their major efforts are putting students into rotations in those core fields. Substituting a highly-specialized rotation for a required core rotation could be a disservice to the student. However, there may be situations where advanced PA students would be allowed to choose a specialized area of medical practice through an elective process. We have chosen to accommodate that rare student who demonstrates a focus in our specialized field. The specialty exposure may help to solidify a student’s choice for a career path or perhaps, redirect them. Tackling the second obstacle toward PA student precepting is a little more complex and the excuses come in many shape and forms: “A student will just be in the way,” “I don’t have time to teach,” “It will diminish the quality of care I give my patients.” The best counter argument I have for these is to tell you briefly how a typical PA student journeys through our rotation. I’ve worked at Childrens Hospital of Los Angeles my entire career as a PA in the Pediatric HematologyOncology department. Along with four other outstanding PAs who make our cohort, we’ve had the

privilege to work with an amazing group of doctors and nurses who are very supportive of the physicianPA team model. (There are over 20 physicians on our DSA!) Because this discipline is so highly specialized, it wasn’t an easy decision to allow PA students to rotate through. Our patients are some of the sickest in the entire hospital and we were concerned that a student may not be able to emotionally handle working with kids and cancer. Finally after much debate, it was decided to take a limited number of students provided they had already rotated through Emergency Medicine and General Pediatrics (you have to know what a well child looks like first before seeing a really sick one, right?). A teaching hospital such as ours provides the perfect setting for a PA student rotation. The supervising physicians are always present working shoulder to shoulder with the student and the PA group. I usually meet our students for the first time in the main lobby of our humongous hospital. Despite being an institution designed for children, it’s still pretty intimidating. New students usually have the same general appearance: clean cut business attire, a backpack full of resource material, a firm handshake to greet you, a broad welcoming smile and a look in their eyes that’s filled with anticipation tempered with a little apprehension. You can always tell the difference between students and staff in my department. The students are the only ones wearing lab coats (“white coat hypertension” in the pediatric population does exist). After a day of orientation and observation, they go right to work. It amazes me sometimes how quickly most students pick up on things and how pleasant it is to realize that learning is a two-way street.

Our students also do mandatory PowerPoint Presentations in front of a small audience using an interesting case they’ve encountered. Some of these projects are so thorough and informative that I’ve learned more from them than some Tumor Board meetings I’ve attended. It’s also very satisfying to see the gradual evolution of our students in how they interact with our patients and our supervising physicians. Initially timid when encountering their first bald child during an examination to greeting them with a hug in the hallways by name a few weeks later. It’s a source of pride when we witness a student present a case to the physician or give sign out to a resident on a fever and neutropenia admission, thinking to myself “we had a hand in teaching them that.” Before you know it, their rotation is done.

Sharing Our Selves

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Share Your Work Site and Your Experience Become a PA Preceptor

Seasoned students usually have the same general appearance: a more “casual” look, a backpack littered with colorful stickers, a comforting hand to the shoulder to greet you, an even broader smile and a look in their eyes filled with hope and confidence. Their white lab coats slung over their shoulder, at the ready, in anticipation of their next rotation. 

JULY/AUGUST 2010

AAPA’s Legal Bombshell Hits House of Delegates 2010 Report to CAPA Membership by Peter Aronson, PA-C, Chief Delegate to the AAPA HOD

2010 California AAPA House of Delegates

CAPA NEWS

usual year at the AAPA House of Delegates (HOD) includes setting social, clinical, educational, professional policy and Academy governance. This year was anything but usual. Just weeks before the House convened it was revealed the legal authority under which AAPA has operated for more than three decades was incorrectly applied, in that the HOD doesn’t have the authority to set policy, only the Board of Directors has that power. Though the HOD has always functioned with very fair democratic hearings and deliberation of all business before it, the bombshell was the AAPA Board of Directors, not the HOD, had “sole authority” for operation of the corporation, including HOD responsibilities. The laws in the state an organization is incorporated have precedence over the governance created by the organization. It turns out the BOD had no authority to relegate responsibilities to the HOD, despite doing so for over 32 years. This meant we, the representatives of you and our respective chapters, didn’t have time to get direction from

you on this major shift in Academy function. Before this news, the HOD used the House legislative process to set all Academy policy. Legal Counsel & AAPA BOD suggested an ASAP “solution” which would result in the HOD making recommendations only and the BOD would accept or reject HOD actions. Bottom line – the HOD protected its vital democratic role by rejecting the suggested “quick fix” which would result in a few board members setting most all policy for the Academy and the profession. A compromise solution of shared responsibility is pending. If realized, it should provide for the BOD to retain fiduciary responsibilities, while the HOD would continue to set most professional policies and both the HOD & BOD retain shared roles in setting Academy Bylaws. The HOD & BOD will, next year, determine the best approach to Academy governance. To the uninitiated, this bombshell may not seem like much, but would

have negatively changed our “parent” organization in fundamental ways. The AAPA HOD, in a very real sense, defines our profession. Educators, students, payers, employers, clinicians, regulators and consumers look to AAPA for information about the profession. The HOD is an important professional process. If you wish to participate directly in your profession, and are a Fellow Member of both CAPA and AAPA, the HOD is a great place to contribute. It’s a natural entry path for leadership roles in both your state and national organizations. You may contact the CAPA office for more information about the CAPA delegation to the AAPA HOD, which meets at each AAPA National Conference over Memorial Day weekend. This is a funded position. The deadline to declare for one of eight positions at the 2012 HOD is February 19, 2011, 75 days prior to CAPA’s annual election held on the first Thursday in May. 

Set Your Computer/SPAM Filter So You Can Receive E-Mails from CAPA

f you haven’t received email from CAPA lately, we may have an incorrect email address or your computer may be blocking an unknown sender. Please add the following to your address book to keep from blocking our important emails: capa_action_network@capanet.org and webmaster@capanet.org. Please keep the CAPA office informed of your current email address by logging onto the CAPA website and updating your member profile by clicking on “Your Profile” in the top right hand corner.

What’s a PA...So You Think You Know Your Profession? by Greg Mennie, PA-C, MSed, Director-At-Large

have discovered a newfound interest/hunt to learn more about the PA “profession” (our profession), and the myriad of organizations that are part of our profession. While it’s really clear that a practicing PA should have a good base of knowledge about medicine, what’s not so evident is that it is equally important to have a good base of knowledge about our profession. I believe it is important for all of us to know where we came from, who were the key players in our development and who is driving the changes and agendas for our profession (i.e., CAPA fighting for PA practice legislation in California or the Physician Assistant Education Association monitoring our training programs).

Dr. Eugene Stead Photo provided by Physician Assistant History Center (PAHx).

There is so much noise on the health care landscape that it makes me wonder what the future holds for us as a profession. Understanding more about our profession and our organizations can only help ensure we

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have a great future. We really have to understand where we’ve been, so we can figure out where we want to be, or at least hope to get to. Knowing what organization does what helps us understand who is out their fighting for us and, most importantly, why. I gathered information from multiple sources (PA Historical Society, AAPA, CAPA, Wikipedia and Google) and put together a few short quizzes to share with you over the next few issues of the CAPA News. It’s really quite easy to find out a lot about our profession (good and bad) if you just take the time to peruse a few websites and sources. In fact, I’ll give you a great starting point www.pahx.org, it really is worth exploring. Good luck and happy hunting. (Answers are on page 23) 1. One of the first PA prototypes in the U.S. occurred in: A. B. C. D.

1800 1940 1950 1960

2. The first physician to employ a PA prototype was: A. Dr. Eugene Stead B. Dr. Michael Schmeil C. Dr. Amos Johnson D. Dr. Reginald Albastuis

3. Some consider these the forerunners of the PA profession; Peter the Great used them as Medical Assistants in the 17th Century: A. Bare Foot Doctors B. Feldeshers C. Aoktops D. MeAcectpas 4. In a 1961 JAMA article ____________ were considered a source to be drawn from to develop a “mid-level” provider. A. Licensed Nurses B. Nursing Students C. Former Military Corpsmen D. Orderlies 5. In 1962, this University had a physician assistant classification through its payroll department. A. Western University B. Drexel University C. U.S. Military Academy D. Duke University 6. This physician, in 1964, recruited military corpsmen for his two-year medical training program. A. Dr. Eugene Stead B. Dr. Charles Frenzel C. Dr. Michael Alostes D. Dr. Ruben Marcento Answers to Quiz on page 23.

Second 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/legalbook.cfm for more information.

JULY/AUGUST 2010

Protect Your Professional License It’s time to renew your individual professional liability insurance policy and someone in your workplace told you to cancel your policy because you could be sued simply for carrying your own policy. The truth is, however, no one can know that an individual health care professional has purchased his or her own policy. If there is a lawsuit, this information will not be uncovered until the “discovery phase” of the trial. At that point, you will already have been named in the lawsuit. The truth is, relying solely on an employer’s policy can be risky. An employer’s policy is usually designed to protect your employer first. Further, it will only provide protection to you for incidents that occur at work, and it is not likely that an employer’s policy will have any protection for you if you face charges of professional misconduct.

Let’s face it; your license is one of your most valuable assets. You need to protect your license, and your right to practice as best as you can.

The Value of License Protection Coverage Every year, many thousands of licensed health care providers face charges of professional misconduct. The complaints can come from virtually anyone— patient, colleague, supervisor, physician— and can involve such varied accusations as alleged theft, abusive behavior, substance abuse, insubordination and negligence. Although many charges have little merit and are investigated and dismissed, others result in disciplinary action and, in some cases, license suspension or revocation. The effects can be devastating, financially as well as emotionally. Remember, if a patient perceives she has been injured as a result of a physician

assistant providing, or failing to provide, professional services, that patient could sue. This doesn’t mean you have been negligent. It means that the patient perceives negligence, so being protected by a professional liability policy, like the one offered through HPSO, is one of the most important purchases you’ll ever make. You should maintain the policy as long as you keep your license active. This risk management information was provided by Healthcare Providers Service Organization (HPSO), the #1 provider of professional liability insurance for over 1 million healthcare professionals, and is now offering the same quality coverage, financial strength and level of service to Physician Assistants. The professional liability insurance policy is administered through HPSO and underwritten by American Casualty Company of Reading, Pennsylvania, a CNA company. Reproduction without permission of the publisher is prohibited. For questions, send an email to service@hpso.com or call 1-800-9829491. www.hpso.com.

E-8102-710-CAPA_E-8102-710-CAPA 6/15/10 11:17 AM Page 1

A physician assistant’s story… My child is home sick. Barely get to the office on time. Waiting room is packed. The office manager is out on vacation. Meet with supervising physician to discuss patients. Grab stethoscope. In first room is 3-yearold Emma. Pink eyes, a cough and ear infection. “Gifts” from daycare. Record on chart. Next room. A pleasant 55-year-old woman in no acute distress. She describes a new cough and onset of chest pain. Order EKG, chest x-ray and labs. Minor emergency of the day – 16-year-old Sammy fell off his skateboard while ‘performing an Ollie.’ Suture knee and write prescription for the pain. Fifteen minute break spent getting caught up on paperwork. Supervising physician e-mailed an article titled, “In a courtroom, your documentation can be your best friend or worst enemy.” Good thing I have HPSO!

Make sure your story has a happy ending.

Professional Liability Insurance for Physician Assistants

888.273.4686 www.hpso.com/capa7

Now with new expanded benefits!

This program is underwritten by American Casualty Company of Reading, Pennsylvania, a CNA Company. 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. ©2010 Affinity Insurance Services, Inc. E-8102-710-CAPA

CAPA NEWS

The CAPA PAC is Hitting the Road for Palm Springs by Cherri Penne-Myers, PA-C, MSCS, Political Action Committee Chair and Secretary

onference is a couple of months away. Wow, hasn’t this year sped by? I hope everyone has taken their well deserved vacations and are now back in the groove of working once again. The CAPA PAC events at the Palm Springs Conference tend to be our biggest fundraisers of the year. Below is a graph showing the total PAC funds raised each year over the past four years. As you can see, 2009 was not our best year but we are encouraged that things are getting better with the economy and people are starting to feel confident in giving again.

rounds of golf and jewelry. Or maybe you would like to re-gift some past presents. (We’ll keep that secret)! Last year, we had many generous donations and I hope that we can count on your support again this year. Contributions of any size are appreciated. Thank you in advance

2010 AAPA PAC Fundraiser I was lucky to attend my first AAPA PAC fundraiser for a candidate who is running for national office. This candidate has a strong relationship with us as she too was a physician assistant once. What a wonderful opportunity to have been able to meet and greet Karen Bass in Atlanta at the Aquarium.

$30,000.00 $25,883.25 $25,000.00

$23,492.50 $22,855.34 $19,570.05

$20,000.00

for your support and contribution. Please feel free to contact me at political@capanet.org. If you have a contribution you would like to donate to the Silent Auction, please let me know at the above email address. We’ll see you at the CAPA PAC booth at conference! 

$15,000.00 $10,000.00 $5,000.00 $0.00 July 1, 2006 − June 30, 2007

July 1, 2007 − June 30, 2008

July 1, 2008 − June 30, 2009

July 1, 2009 − June 30, 2010

If you are coming to this year’s CAPA Conference in Palm Springs, October 7-10, you may want to start planning today. Reserve your hotel room, register for the conference and get ready to enjoy beautiful Palm Springs during PA Week 2010 with great lectures and workshops. Don’t forget the fun in the exhibit hall with the CAPA PAC booth. We will again have a Silent Auction, the spin wheel and the infamous school fans to support the California PA programs participating in the Student Medical Challenge Bowl; or just to stay cool. We are again looking for items for the CAPA PAC Silent Auction such as: textbooks, services (i.e., dermatology services), gift baskets,

California ENT PAs: Let’s Talk! by Bernadine Sonnier, PA-C, CAPA Member

am the first physician assistant to work in the Department of Otolaryngology at USC Healthcare Network, a teaching facility with residency programs. As the department’s first PA, I refer to myself as a trail blazer, a pioneer and a ground breaker. Frankly, I use these terms to describe myself because they seem to glamorize my experiences as a struggling PA. My current position has taught me that I cannot become complacent thinking that the practice strides which PAs have made will remain intact without advocacy. I am told that PAs who perform ENT procedures do so mainly in

Midwestern states. Is this true? I am searching for insight into the field of PAs in otolaryngology. How many PAs work in otolaryngology in California? What is their scope of practice? Are there PAs mentoring other PAs? Has anyone faced challenges with skill development while working with medical residents? What are your favorite ENT resources? Are their any CME opportunities? What is the future outlook for PAs working in otolaryngology? Is their a community of ENT PAs in California? If not, can we develop one? Please email me at bernie586@sbcglobal.net. 

JULY/AUGUST 2010

The Cost of The CAPA Conference Is Was Heavily Subsidized By Corporations by Gaye Breyman, CAE, CAPA COO

How You Can Make Sure That Corporate Support Remains

s many of you know, securing pharmaceutical support for lectures at medical conferences has gotten increasingly more difficult over the past few years. Securing pharmaceutical support for meal lectures is all but impossible, unless the lecture is promotional in nature. This means there is no illusion that the lecture is not supported by a particular pharmaceutical company. It is honestly stated upfront who is paying for your meal and the speaker. At the CAPA Conference, we ensure that the information presented is relevant and well-presented. We also ensure that you have a nice meal to enjoy at the CAPA Conference. We will continue to be able to do that as long as you: • • • •

Attend the meal lectures Be attentive and polite Stay through the entire meal Sign-in to let the company know for whom they are buying a meal (they have to report that) • Thank your reps and exhibitors for their support. Speaking of exhibitors…the world of exhibiting and exhibit halls has changed a bit too. Pharmaceutical 14

CAPA NEWS

companies used to be able to entice you to come to the exhibit hall and talk to their representatives by giving away umbrellas, clocks, mugs, pens and Post-It notes. The same set of rules (PhRMA Rules) that under most circumstances keep the companies from being able to sponsor CME meal talks, keeps them from giving away branded items. Who knows, that pen may not only entice you to the exhibit hall, it may entice you to write only for their drug! Ha! The Exhibit Fees we collect allow us to keep the costs of the conference down. A larger exhibit hall with more paying exhibitors means lower overall costs for the PAs who attend the conference. Plain and simple. Our exhibit hall will grow if you: • • • •

Visit the Exhibit Hall often Stop and talk with each exhibitor Listen to what they have to say Thank them for being there

• Understand they are working that booth during this weekend at the state PA conference. Will they recommend to their company to do that again next year? We keep thinking that the pendulum will swing back to center with the PhRMA Rules but the FDA fines are so great if the pharmaceutical companies don’t comply with the rules, they are fearful and pay incredible attention to every rule that may cost them in hefty fines. Let’s make it a little easier for them to support PAs. It is our hope that California PAs will show the representatives who work the exhibit hall that PAs do appreciate the support. We hope that California PAs will let the meal speakers know how much you value their time and their message and how much you enjoyed that meal.

Thank you!

Recruit a New Exhibitor to CAPA and

Receive $100 Off Toward Your CAPA Conference Registration EXHIBITOR PROSPEC TUS

Reserve Booth Space Online at www.ca panet.o rg/ exhibit s.cfm

A Connection With A PA Is A Connection With A Practice The CAPA Conference Offers You An Incredible ROI!

California Academy of Physician Assistants

34th Annual Conference Palm Springs Convention Center October 8-9, 2010

New exhibitors are companies who have not exhibited at the CAPA Conference in the past 2 years. Exhibitor prospectus are available online at www.capanet.org or you may call the CAPA office and we will mail you a CAPA Conference prospectus.

Call: (714) 427-0321.

CAPA’s Conference Planning Committee Working for YOU! by Cyndy Flores, PA-C, CME Committee Chair

Renaissance Hotel

his year, CAPA revamped the entire process of how we plan the Annual CME Conference for you. Early this year, we asked for volunteers to serve on the newly formed Conference Planning Committee (CPC) and were happily overwhelmed by the response. There were so many California PAs (and even some pre-PAs) that the selection committee had to split the interviews up and the decision on the final members was a difficult task. The CPC was finalized with 18 members – 18 PAs from many different practices with varying backgrounds and perspectives. This committee helped draft the topic list and then each was responsible for finding at least two excellent speakers for the conference. The committee met by telephone multiple times starting in March giving up time with their families in order to help form the conference. We had so many great ideas and the enthusiasm was contagious! It made the sometimes difficult task of building the conference schedule a pleasure. One unintentional consequence was that by having the committee go out and find speakers, when we contacted the speaker about coming to CAPA, the door had already been opened and inevitably the answer to come to CAPA was a big “yes.” That certainly made this part of the job much easier than in years past. As always, the speakers were chosen carefully, as the

CPC was committed to bringing you only the best presenters on topics which are critical for day-to-day PA practice. The other advantage the CPC brought to the conference was with all these people working to complete the schedule, we were able to fill the schedule quickly, which means we are able to open the schedule up to you sooner than usual. Not to worry, we are bringing back some of your favorite speakers and fun activities that make the CAPA Conference the CAPA Conference. We’re taking what we’ve done in the past and making it even better. We must be doing something right, because we have already had registrations for the conference and so I am anticipating a full conference this year. What does this mean for you? It means that you need to

register for the conference early and make your hotel reservations now. Speaking of the hotel, those of you who attended last year’s conference experienced the hotel in midconstruction which was occurring during the conference. The good news is that the construction is finished and the Wyndham Hotel has now been transformed into a beautiful new Renaissance Palm Springs. All new sleeping rooms, conference rooms, pool deck and amenities are waiting for CAPA to be the first major group in their hotel for their conferences in 2010. We love being first!! Won’t you join us? Please visit the CAPA website at www.capanet.org/palmsprings.cfm to see the conference schedule and to register for the conference today!! 

Special Thanks To All Of The PAs Who Volunteer Their Valuable Time Making The CAPA Conference, The Best PA Conference in The West! CPC Members Raquel Caldera, PA-C Martha Cody, PA-C I. Jean Davis, PhD, DC, PA Cyndy Flores, PA-C Michael Flores Eric Glassman, PA-C Edwina Hardieway, PA Donald Jones, PA-C Amber Klispie, PA-C Dana Landavazo, PA-C Tam Le, PA-C Tina Lewis, MMSc, PA-C Daniel Lowery, PA-C Tony Luza, PA-C

Margaret Mandry, PA-C Miguel Medina, PA-C Sheri Oswald, PA-C Marsha Teague Grinstead, PA-C CME Committee Members Jennifer Carlquist, PA-C David Carter, PA-C, MHS Christopher Clark, PA-C Shelby Edwards, PA-C Cyndy Flores, PA-C Rodney Koenig, PA-C Michelle Lim Serrao, PA-C Jane Morse, PA-C

JULY/AUGUST 2010

Welcome Home to the Wyndham Renaissance Palm Springs We’re back in Palm Springs and, yes, you will Sharing Our Selves

S... ...S ---

still set your GPS to 888 Tahquitz Canyon Way. But, when you walk into the beautiful, new Renaissance Palm Springs, it will feel a bit like a palace. It is simply beautiful. It doesn’t even seem like it could be the same place. That is until you see the friendly faces of the staff, many of whom have been there greeting CAPA Conference attendees for several years. It still has a warm and friendly feel combined with the signature Marriott Renaissance level of service. The frosting on the cake is you get to enjoy it all at pre-renovation rates. Years ago, the CAPA board made the decision to sign a contract through 2013 given the information that a major renovation was eminent. Their wise planning and your loyalty and patience over the years has paid off greatly. The fun and the feel of the CAPA Conference remains – the setting is more beautiful and even more perfect for us.

RENAISSANCE ® HOTELS & RESORTS

Just

$162 ! a night

Call: 760-322-6000 You will want to reserve your hotel room today. We have a block of rooms at the Renaissance Palm Springs and the Palm Springs Hilton. Hotel rooms will sell out!

Thursday Evening at the CAPA Conference Take A Walk Downtown To Bring Attention To Breast Cancer Awareness Month and National PA Week

Sharing Our Selves

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Awareness, Education and Empowerment www.nbcam.org

At 6:30 p.m. we will take the short walk from the Renaissance Palm Springs to the CAPA Booth at the VillageFest on Palm Canyon Drive. The VillageFest is a fun, open market place where you can eat, drink, shop and run into your PA colleagues; a Thursday evening tradition for CAPA Conference goers. This year, the VillageFest will hold a special purpose. Walk with us, visit the CAPA Booth and/or come and hang out a bit to help welcome the local VillageFest crowd to SHARE information on Breast Cancer and about PAs and the work you do. We will have paper pink ribbons so that all who visit the booth can write the name of someone who is a breast cancer survivor or someone who lost their battle with breast cancer. We will post the ribbons on a wall at the booth. Donations will be requested for each of the pink ribbons and all proceeds will go to the Suzanne Jackson Breast Cancer Fund of the Desert Cancer Foundation. The Cancer Fund provides free mammograms to residents of Coachella Valley who are uninsured, cannot afford testing, and who meet income requirements. Just before our walk downtown, we will hear an informative and cutting-edge lecture relating to breast cancer risk factors and which factors are modifiable. Leslie Bernstein, Ph.D., Professor and Director, Division of Cancer Etiology at City of Hope will empower you and talk about the rationale that led to her research on physical activity and breast cancer.

Then, we are off to the VillageFest. We hope you will join us!

Speaker Notes… Download speaker notes before and after the conference! Beginning September 1, you will be able to access speaker handouts for those sessions you plan to attend. This will allow you to preview speaker slides and, if you wish, print those of particular interest to you. The handouts will remain on the CAPA website until the end of the year. The Conference program and activities are subject to change without notice.

Friday Evening at the CAPA Conference 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 31, 2010)

Name ______________________________________ Address _ ____________________________________ City ______________________ St _____Zip _ ________ I will be performing:  solo  as a duet

 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 be 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

Uniquely CAPA...and YOU make it happen! Special Interest Groups at the CAPA Conference Meet and Greet Those Who Share Similar Professional Interests and Experience We Make That Connection Easy For You! There are a lot of reasons to attend conferences. One of the major benefits of the CAPA Conference is that it is a great place to network with hundreds of California PAs.

Saturday, October 9

5:45 p.m. Student Challenge Bowl and Student Challenge Bowl 3rd Annual Cheerleading Competition Renaissance Hotel Pool Deck One of the major highlights of the CAPA Conference is the Student Challenge Bowl held on the deck of the beautiful Renaissance Hotel pool. It doesn’t get much better than this. Come and cheer on your favorite PA Program. To sign up your team, visit the CAPA website at www.capanet.org/ studentchallenge.cfm.

If you let us know that you are interested in one of the following three areas, we will make sure that your conference badge identifies you as such. We will also have tables set aside for each group at meal functions so you can sit with those who share your interest/experience. We have received requests for the following three areas. We are open to others. Just let us know and if we have enough people interested, we will add that to the list.

PA Entrepreneurs PAs who have been in practice for over 25 years (lovingly known as the Dinos)

The Cheerleading Competition is another Student Challenge Bowl highlight. This competition is open to all PAs – students and/or graduates. Visit www.capanet.org/ cheerleading.cfm and sign up your team today!

First time CAPA Conference goers/new CAPA members

Alumni Receptions If you graduated from a California PA program, contact your school and see if they will be hosting an alumni reception on Saturday evening. We know that several schools have already started to plan their alumni event at the CAPA Conference. Check with your school to see what you can do to make this year’s alumni reception even better.

Flying to the CAPA Conference? Fly Into Ontario (45 minutes from Palm Springs) Try Southwest Airlines. We checked Southwest.com and found roundtrip fares from Sacramento/San Jose/Oakland to Ontario for $160. We added a sweet little Sebring Convertible for 4 days ($200) – come on, you deserve it! Or, a compact car for ($90) – more money for shopping in Palm Springs!! Total for roundtrip airfare and car can be as low as $250!! Fly Directly To Palm Springs You can fly directly into Palm Springs. Check with United or Alaska Airlines. We checked United.com and found roundtrip flights from Sacramento/San Francisco/ Oakland/San Jose to Palm Springs for $184 - $274 per person. There is a free shuttle to and from the Renaissance Hotel and since you are staying downtown, almost everything is within walking distance. 

Controlled Substances Education Course at the CAPA Conference - Mark Your Calendar!

10/6/10

f you have not yet registered for the Controlled Substances Education Course and wish to do so, we will be holding a course on Wednesday, October 6 at the Renaissance Hotel in Palm Springs.

This course will sell out quickly, so register online today at www.capanet.org! We will be holding this course on an on-going basis in various locations throughout the state. Future course dates and locations will be available on the CAPA website as soon as they have been confirmed.  18

CAPA NEWS

A Place For You, Family and Friends to Sell Goods and Services While at the CAPA Conference

M A R K E T P L A C E

At the 2008 CAPA Conference we launched the PA MarketPlace. As part of the PA Community conference theme, we encouraged PAs to bring their own, their family’s or friend’s goods and services to the PA Community. And, in return for a free table in the PA MarketPlace, we requested a 20% donation of all net sales go to the CAPA PAC*. Well, it was a huge success for all involved. 1) We raised money for the CAPA PAC, 2) conference attendees got to do some fun shopping while at the conference and

3) those who brought their goods and services to the MarketPlace made some money and thoroughly enjoyed the experience. A win, win, win!! This year we hope to expand the number of PA MarketPlace participants. If you, or your family or friends have a product or service that you believe will be of interest to PAs, please contact the CAPA office for more details at (714) 427-0321 or e-mail at capa@capanet.org. The space is free. We do request that you donate 20% of the net sales to the CAPA PAC.

*CAPA PAC ID#981553

Sharing Our Selves

Sharing Our Spirit

...---...

Be Prepared www.healthcarevolunteers.ca.gov Disaster Preparedness

A fun and simple sign-up process will be available at the Conference with a chance to win an Apple iPad. Should cataclysmic events hit California, health care volunteers will be needed and PAs will be vital to the effort. But we need to know where to find you. The CAPA Conference is the largest gathering of PAs in California so we are using this opportunity to get you all signed up! And, you could walk away with an Apple iPad!

Sharing Our Selves

...---...

Awareness, Education and Empowerment www.nbcam.org

On Thursday Afternoon, Take A Walk Downtown

On Thursday at 5:30 p.m., we will hear an informative and cuttingedge presentation on exercise related research for reducing breast cancer risk. Leslie Bernstein, Ph.D., Professor and Director, Division of Cancer Etiology at City of Hope will empower you and talk about the rationale that led to her research on physical activity and breast cancer. Immediately following the talk, we will gather in the Renaissance lobby and begin our short walk downtown to the VillageFest.

Cheer On Your Favorite Team – Share In The Fun!

Student Challenge Bowl

Poolside, at 5:45 p.m.; be there or be square!! Each year, many note the CAPA Student Medical Challenge Bowl as their favorite conference event. The brand new Renaissance pool deck will give this year a bit of a new feel. We promise the same fun and excitement and the opportunity to enjoy time with friends while enjoying the perfect Palm Springs weather.

Sharing Our Selves

...O ---...

Health Literacy Campaign – PAs Reading To Kids

“How Does My Body Work?”

Children at Vista Del Monte Elementary School in Palm Springs will be visited by California physician assistants, Friday, October 8th, and have all their questions answered. Children will learn about how physicians and physician assistants help to keep them healthy and safe and each student will receive a brand new science book.

JULY/AUGUST 2010

Controlled Substances Education Course Registration Form - Wednesday, 10/6/10 Name______________________________________  PA-C  PA  Other__________ PA License #_ ___________________ Address_______________________________________ City______________________ State_____ Zip Code_ ________________ Phone (____) ________________________________ Email________________________________________________________ Work Address__________________________________ City______________________ State_____ Zip Code_ ________________ Work Phone (____) _ ___________________________________ Work Fax (____)______________________________________

 CAPA Member - $110  Non CAPA Member - $200  Late Registration Fee after September 29, 2010 - Add $20  Check enclosed (make check payable to CAPA) 



Total Amount Due: $_ ____________________

   

Name on Card________________________________ Signature_ __________________________________ Exp. Date__________



In accordance with the Americans with Disabilities Act, please check here if you have any special needs. You will be contacted by CAPA.

Mail completed Registration Form and make checks payable to: California Academy of Physician Assistants, 3100 W. Warner Ave., Suite 3, Santa Ana, CA 92704-5331. Phone: (714) 427-0321 . Fax: (714) 427-0324 . Toll Free Fax: (800) 480-2272

Optional Workshops Registration Form ACLS Recertification

REGISTRATION INFORMATION - Please Print

Advanced Cardiac Life Support (ACLS) Recertification

Due to minimum attendance requirements, all workshops are subject to cancellation.

Those registering for ACLS Recertification will not be able to attend Session 2 workshops on Thursday. Absolutely no refunds will be given after September 15, 2010.

Please fill out and include with your general conference registration form. Please include a separate check so it can be returned if one or more of the workshops you select are full. Your credit card will be charged for only those workshops that are open at the time you register.

Thursday, October 7, 2010 – 12:00 p.m. to 4:00 p.m.

 ACLS Recertification (4 hours Cat I CME)

$135

THURSDAY SESSIONS – October 7, 2010

NAME CHECK ONE:

Session 1 – 10:00 a.m. to 12:00 p.m.  Splinting (2 hours Cat I CME)  Basic Suturing (2 hours Cat I CME)  Heart Sounds (2 hours Cat I CME)

$45 $45 $45

Session 2 – 12:15 p.m. to 2:15 p.m.  Splinting (2 hours Cat I CME)  Minor Surgical Procedures (2 hours Cat I CME)  Advanced Suturing (2 hours Cat I CME)

$45 $45 $45

SATURDAY SESSIONS – October 9, 2010 Session 3 – 1:30 p.m. to 3:30 p.m.  Orthopedic Exam (2 hours Cat I CME)  Basic Suturing (2 hours Cat I CME)  Joint Injection (2 hours Cat I CME) Session 4 – 3:45 p.m. to 5:45 p.m.  Orthopedic Exam (2 hours Cat I CME)  Advanced Suturing (2 hours Cat I CME)  Joint Injection (2 hours Cat I CME)

$45 $45 $45

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2010 CAPA Conference Registration Form BASIC COURSE – Save $35 by Registering by August 23rd!

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$370* – Basic Course (19.5 Hrs. Cat. I CME) $260* – PA Student Basic Course (19.5 Hrs. Cat. I CME)

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REGISTRATION INFORMATION - Please print clearly

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ONE DAY – Save $35 by Registering by August 23rd!

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$135* – Thursday Only (6 Hrs. Cat. I CME) $125* – Friday Only (5.5 Hrs. Cat. I CME) $110* – Saturday Only (5 Hrs. Cat. I CME) $70* – Sunday Only (3 Hrs. Cat. I CME) $90* – PA Student Thursday Only (6 Hrs. Cat. I CME) $85* – PA Student Friday Only (5.5 Hrs. Cat. I CME) $75* – PA Student Saturday Only (5 Hrs. Cat. I CME) $45* – PA Student Sunday Only (3 Hrs. Cat. I CME)

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$120 – Guest - Meals & Exhibit Hall (Includes 5 conference meals; 3 breakfasts, 2 lunches, access to the Exhibit Hall, The Dance, American PA Idol and Challenge Bowl) Guest Name_ _____________________________________________

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$25 – Guest - Exhibit Hall Only (Access to the Exhibit Hall only)

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NON-MEMBER REGISTRATION - California PAs & Students If you are not a CAPA member and are a California PA or PA student, you must select one of the non-member registration options below.

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after 8/23/10 or ADD $55 if registration & payment are postmarked/ faxed/emailed after 9/13/10

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Interested in meeting/networking with other PAs in one of the following groups? Mark one of the boxes below and we will make sure that your conference badge identifies your interest. We will also have tables set aside for each group at meal functions so you can sit with those who share your interest/experience.

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 Please mark this box if you do not wish to have $20 of your CAPA Conference Basic Course registration fees donated to CAPA PAC ID #981553.

A Chance to Meet and Greet Like-Minded PAs

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PA Entrepreneurs PAs in practice for over 25 years (lovingly known as the Dinos) First-time CAPA Conference attendees/new CAPA members

GENERAL INFORMATION Included with Basic Course: Conference meals, Friday Night Dance PArty, Exhibit Hall and Student Challenge Bowl. Registration badges are required for all events except the Friday Night Dance PArty and the Student Challenge Bowl.

 Vegetarian Meals Requested with the Americans with Disabilities Act, please check here if  Inyouaccordance have any special needs. You will be contacted by CAPA.

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Phone or fax registration: Mastercard or Visa only: Phone (714) 427-0321, Toll Free Fax: (800) 480-CAPA (2272). To avoid duplicate charges, please do not mail the original registration form if you have faxed it or emailed it to the CAPA office. Mail registration form and make checks payable to: CAPA, 3100 W. Warner Avenue, Suite 3, Santa Ana, CA 92704.

My First Year As A Delegate To The AAPA House of Delegates by Matthew Keane, PA-C, Director-At-Large and Student Affairs Committee Chair

can remember being a PA student and going to our casting workshop to learn how to do casts for the first time. Our instructor was an orthopedic PA and worked in the field for almost 20 years. He began by showing us how to do some of the more common casts for the upper and lower extremities and by the time I figured out what the first step was he had put his model in a full body cast from head to toe. I had no idea what had just happened, but after a seeing it a few more times and getting to do it myself, it all began to make sense. In May, I had an opportunity to go to the Annual AAPA Conference in Atlanta, Georgia as part of California’s House of Delegates (HOD) and participated in three days of intense debate and deliberation over some of the most important national issues concerning PAs and PA practice. When we began preparing for the HOD several months before actually attending, I wasn’t quite sure what to expect when I got there. As a delegation, we had several conference calls leading up to the conference. During these conference calls we discussed and debated the importance and significance of approximately 50 different resolutions covering a wide variety of topics regarding PAs and PA practice. Being this was my first time, it was hard for me to find my place in the debate. Even on the plane to Atlanta, as I read and re-read the resolutions, I wasn’t quite sure what to expect or how I was going to fit into the delegation of more senior Delegates. As the saying goes, I definitely felt like “a small fish in a big pond.” As the first session began, I felt like I was sitting in my casting clinic all over again, things just seemed to be happening faster then I could keep

CAPA NEWS

up with. However, as the day went on and as my fellow delegates gratefully answered all of my seemingly very elementary questions, things began to slow down and I began to get a grasp of what was going on. There was passionate debate within the House and the delegations regarding a multitude of issues concerning PAs on a national level. A few of the issues dealt with PA students directly. One of the resolutions which the House discussed and debated was the need for AAPA to push for more tuition reimbursement for PAs who choose to work in primary care.

“Even on the plane to Atlanta, as I read and re-read the resolutions, I wasn’t quite sure what to expect or how I was going to fit into the delegation of more senior Delegates.”

With the passing of the new federal government health care bill, the health care climate in this country is gearing up for some major changes and as PAs we are going to have to be ready when called upon to do our part as health care begins to change. The one area of medicine which PAs will likely be able to have the biggest impact is in primary care. As the numbers are crunched and evaluated, one thing which everyone agrees on is the shortage of primary care providers. With the rising costs of medical school and the decreasing reimbursement fees, most physicians are steering away from primary care and into more lucrative fields which will help pay off debt and provide

a higher quality of life. Therefore, AAPA believes and supports the idea that as a profession, we must continue to encourage PAs to fill the void in primary care by offering such incentives as tuition reimbursement programs. My experience as a delegate was an amazing experience and as the Student Affairs Committee Chair, I was very impressed at the support which my fellow colleagues have for students. Students are a vital part of the evolving landscape of the PA profession. As students, we have two to three years to get through school and learn how to become competent and compassionate practitioners. However, once we get the “C,” our job is not done. As practicing PAs, we have to continue to be ambassadors for our profession. We have to continue to represent what it is to be a PA and to make sure those in California and Washington and others who have the “power of the pen” are recognizing the job we do and the importance of our role in the health care system. It was great to be part of a national delegation which seemed to understand that students are the future of the profession. We know that without students continuing to become PAs and getting involved in state and national issues, the profession would not have the ability to stay at the forefront of health care in this country. 

Why is a Diverse Health Care Workforce Important? by Miguel Medina, PA-C, Committee on Diversity Chair

“Patient-Centered Communication, Ratings of Care, and Concordance of Patient and Physician Race” Lisa A. Cooper, M.D., M.P.H., Debra L. Roter, Dr.P.H. et al., Annals of Internal Medicine 139, 11 (December 2003): 907–15 

In 1962, a cardiologist at Duke University named Dr. Henry McIntosh, used firemen in emergency procedures, and then had them staff the cardiac catheterization lab. As time progressed firemen were replaced with former Navy hospital corpsman and the Duke University payroll department used the term “physician’s assistants” as a job classification.

5. The answer is D Duke University

A 1961 article in Journal of the American Medical Association by Dr. Charles Hudson, in called for a “mid-level” provider from the ranks of former military corpsmen. Citation: Expansion of Medical Professional Services with Nonprofessional Personnel Hudson JAMA.1961; 176: 839-841

4. The answer is C Former military corpsmen

Derived from the German Feldscher (meaning field shearer), they worked as army field surgeons in Germany before being “imported in 1650 by Peter the Great and used to aid the ‘barber-surgeons’’ in the Russian armies. The World Health Organization notes the feldsher originated in the late 1800’s and there are now approximately 200,000 Feldshers in primary care, 20,000 Feldsher-sanatorians and 70,000 Feldshers in industrial medicine in Russia.

3. The answer is B Feldshers

In 1940, Dr. Amos Johnson was in a general practice in rural North Carolina. Dr. Johnson decided to train an assistant to help in his rural office. This first prototype PA was Henry “Buddy” Treadwell. It is in this practice that Dr. Stead and other general medicine residents at Duke University were first exposed to the “physician assistant” model.

2. The answer is C Dr. Amos Johnson 1. The answer is B 1940 Answers to Quiz on page 11.

Health care providers who are ethnically or racially discordant with their patients can improve their communications skills by taking CME courses on Cultural Competence. In addition, the day-today contact with patients of different ethnic and cultural backgrounds will also enhance cross-cultural communication. A genuine interest of the patient’s culture by the health care provider will also facilitate the learning experience.

References:

“Disparities in Patient Experiences, Health Care Processes, and Outcomes: The Role of Patient-Provider Racial, Ethnic, and Language Concordance” Lisa A. Cooper and Neil R. Powe The Commonwealth Fund, July 2004

6. The answer is A Dr. Eugene Stead

Research indicates that patients from underrepresented minorities prefer to receive health care from providers which are racially or ethnically concordant (patient and provider are the same ethnicity or race). The patients note improved communication with their provider, they sense that they participate more in their health care decisions and they are generally more satisfied with the health care received from a concordant provider.

In the upcoming year, as Chair of the Diversity Committee, I plan to continue lecturing on the “Multicultural Patient” and “Health Literacy” to all the PA programs in California. In addition, the Committee is planning to visit local high schools and colleges to promote the physician assistant profession. Please feel free to contact me at mac@capanet.org if you would like to join us on our visits.

Dr. Eugene Stead, Jr., first struck out to develop an advanced practitioner program (nurse clinician program) using nursing but was rejected. Rather than be discouraged he decided that ex-military corpsmen with their previous training and experience would be a reasonable group to trial his two-year program.

ne of the goals of CAPA’s Diversity Committee is to increase the number of underrepresented minorities in the physician assistant profession. In the United States, Hispanics, African Americans and Native Americans represent 25% of the population, yet only 6% of physicians, 12% of physician assistants and 9% of nurses are from these minority groups. Studies indicate that physicians from these underrepresented minority groups are more likely to choose primary care specialties, serve the patients in their ethnic groups, serve Medicaid recipients and work in manpower shortage areas. These studies help support the notion that a more diverse workforce can have a positive impact on the health care delivery to these diverse populations.

JULY/AUGUST 2010

If You Want To Win The Lottery, Then You Have To Buy A Ticket! by David Carter, PA-C, Former Director-At-Large

ow many times have you ever thought to yourself, “I never win the lottery?” Obviously someone does win. Why couldn’t it be you? Oh yeah, you didn’t buy a ticket! It dawned on me the other day that Legislative Advocacy is a lot like the state lottery. We can’t win if we don’t buy a ticket. Occasionally, someone waits until the jackpot is multi-millions and hits it big on a whim. But, usually it is the constant, unrelenting hope of winning, week after week - a ticket here, a ticket there - until “POW! Jackpot!” In the same way, Legislative Advocacy works best over time, with steady membership in CAPA and relationship building. Our Arizona colleagues have just hit the Legislative Jackpot. For years, PAs in Arizona have worked under an antiquated Physician Assistant Practice Act which was originated in the early 1980s. Previous attempts to modernize the act were unsuccessful, due in large part to a lack of finances as well as a lack of a supporting coalition of organizations. But finally, through steady membership growth over time in the Arizona

State Association of Physician Assistants (ASAPA) and attention to relationship building by ASAPA representatives, individual PAs and State Representative Barto, HB 2021 was passed this spring by the Arizona Legislature and signed into law by Gov. Brewer. Some of the highlights of the new law from the ASAPA fact sheet include: •

Eliminates a requirement that physicians file a notice of supervision with the regulatory board;

•

Removes a requirement that physicians designate an “agent” to supervise in the doctor’s absence;

•

Increases the number of PAs a physician may supervise at any one time from 2 to 4;

•

Permits PAs to pronounce death and authenticate with their signature on any form that may be authenticated by a physician’s signature;

•

Deletes requirement of supervising physicians to obtain a separate supervising license;

•

Removes the face to face weekly meeting for PA/ Physician teams working in the same location, while also allowing PA/Physician teams practicing in geographically separate sites to conduct the weekly meetings in person or via telecommunication.

It is important to realize that this victory did not come in one year. It is the result of years of diligence, “chipping away” at misperceptions about physician assistants and relationship building with stakeholders and legislators. This type of activity requires money, to be blunt, and therefore requires consistent membership in the representative state chapter, in this case ASAPA. Congratulations Arizona colleagues! Why is this important to us in California? State Chapters are not buildings and machines, they are people. Some of the people are full-time administrators and staff without whom chapters can struggle to accomplish even daily operations. Our CAPA staff members deserve our deepest thanks and admiration for both the mundane daily tasks

YOUR GUIDE TO THE PHYSICIAN ASSISTANT CAREER

inally, the ultimate guide to becoming a physician assistant is all in one book. Here is everything you need to know, from choosing the right PA program, to experiencing the diversity of PA specialty practices, to understanding the issues that the profession faces as it continues to grow. As health care delivery changes, and the general population ages, the PA profession Complete information:

will become an even more essential component of the physician-led health care team. Learn how you can make this your career and how you can become part of this outstanding profession. So You Want To Be A Physician Assistant by Beth Grivett, PA-C

www.physicianassistantbooks.com 24

CAPA NEWS

as well as the Herculean tasks they accomplish. But, I have known them long enough to know that they would, in turn, say that they depend on all of us, the California physician assistants, in the trenches, to make CAPA effective. We are the ones striving to provide consistent, safe, effective, compassionate care to our patients on a daily basis which is one of the strongest advocates CAPA could hope to have. However, in order to be effective, especially at the legislative level, CAPA requires volunteers like you and me, serving above and beyond our current daily commitments. Please, let us all give close consideration to the talents that we possess as individuals and consider service to CAPA, whether elected, committee member or other volunteer opportunities.

Just as important as formal CAPA service, though, is the funding required to remain effective and at the table. This is one area where we all can make a difference. One of the best ways to advocate for our profession is to remain a member of the organization that watches over us and sponsors changes to help us provide better, more efficient, sensible patient care. In short, regular membership in CAPA enables it to affect changes, pay our staff, legal counsel and lobbyist. Just look at our Arizona colleagues and the ASAPA. Simple math: If all of us paid our CAPA membership each year (there are 7,000+ PAs in CA) CAPA would have a yearly budget of over $1,200,000 and would put that to work exclusively for California PAs. Think of it as three to four hours

of work every year that we pay to the only organization in California working solely for PAs. It really isn’t that much when you think of it this way, is it? It has been my pleasure to serve on the CAPA BOD these last two years. I appreciate the opportunity to serve California PAs given to me by CAPA members. I will continue to stay active with CAPA through committee involvement. Hopefully, many of us will step forward to volunteer our time and talents in the future. But, if we have any hopes of winning the Advance PA Practice in CA Lottery, like Arizona PAs just did, then we have to buy a ticket. If we all “buy a ticket” as a group, then our chances of winning over time are much higher. 

California Residents – STATE LOAN REPAYMENT PROGRAM OPPORTUNITY!!

he National Health Service Corps (NHSC)/State Loan Repayment Program (SLRP) has received a grant for $2 million from the American Recovery and Reinvestment Act to repay outstanding government and commercial loans for expenses incurred during undergraduate or graduate education.

Up to $85,000 in funding is available on a first-come, first-serve basis for qualified primary health care providers who commit to a three-year service obligation at a public or private non-profit facility that is located in a Health Professional Shortage Area. They can help you determine whether or not your facility will qualify for the program

if you send the name and address of the site at which you are working. Each facility is required to pay a matching grant, meaning that $42,500 is paid by the State, and $42,500 is paid by the facility. This special NHSC/SLRP cycle ends on September 29, 2010 or when funds are expended, whichever comes first. You must be fully licensed, working full-time (40 hours per week) in order to apply for this program, and interns are not eligible. Qualifying primary care professionals include: Allopathic or Osteopathic Physicians specializing in Family Medicine, General Pediatrics, General Internal Medicine, General Psychiatry, Gerontology, or Obstetrics and Gynecology; Primary Care Nurse Practitioners; Primary Care Physician Assistants; Certified Nurse

Mid-Wives; Dentists; Dental Hygienists; Licensed Mental or Behavioral Health Professionals: Clinical or Counseling Psychologists, Clinical Social Workers, Professional Counselors, Marriage and Family Therapists, or Psychiatric Nurse Specialists Please note that you can only commit to one service obligation at a time and must complete any existing service obligations prior to accepting a new contract for this program. You may find additional program information at: http://www. oshpd.ca.gov. Please review the website and online application. Feel free to contact Kirsten Meza if you have any questions regarding the program or the application process. Please e-mail kmeza@oshpd.ca.gov with any questions.

JULY/AUGUST 2010

My Lessons in Diversity by Mercedes Dodge, PA-C, Former Committee on Diversity Chair

remember the day I ran across the CAPA website—I was that ambitious pre-PA student wanting to learn all I could about the PA profession and the life of a PA. The website was full of smiling faces and lots of useful resources. I became a CAPA member immediately and started my education at the UC Davis FNP/PA Program. Not even a quarter into my classes, I decided to fly down to the CAPA Conference in Palm Springs. It was there that I decided I needed to get involved. I thought to myself—how can one become a PA and not become an advocate of their own profession? That’s when I began my journey with CAPA. In December 2009, I was blessed to give birth to my first child, Gabriel Antonio; and now, as I completed my term as Committee on Diversity Chair for CAPA, I find myself reflecting on what I want to teach Gabriel about diversity as he grows from a baby to a man. “Diversity” is such an ambiguous word. We are taught to recognize its importance, but rarely are we taught what it really means. Does it merely mean diversity of skin color or of ethnic background? Certainly, this is an important aspect. Ethnic and racial minorities have certainly struggled to achieve equal standing in this nation and although we have made great strides in just a few generations, we still do not live in a colorblind society. I will certainly teach my son

that no person should be denied an opportunity to live a better life because of the color of their skin, or because of their religion, gender, or sexual orientation. Cultural diversity is also important. We have all experienced the sometimes hilarious, sometimes frustrating, sometimes enlightening joys of dealing with those who grew up in a different culture, with different ideas about what sorts of things are important in life. And, there is no doubt that some cultures meet certain needs better than other cultures. By keeping an open mind and exposing ourselves to diverse cultures at home and abroad, we can learn a tremendous amount about how to help ourselves and each other achieve happiness and contentment. •

But this is not the whole picture. I have been challenged as a PA and this has shaped me. In my two years as a PA, I have seen patients from every tax bracket, every continent, of every hue and shade of skin color imaginable. But what has impressed me the most is not our differences but our similarities. We all have the same basic desire – that our families will grow up healthy, safe and secure. I will be forever fortunate to be part of the PA profession and look forward to the lessons I will continue to learn in this challenging career. 

Student Challenge Bowl – Sign Up Now!

he 14th Annual CAPA Student Medical Challenge Bowl will be held Saturday, October 9, 2010, poolside at the Renaissance Palm Springs from 5:30 p.m. – 7:00 p.m. There will be a cash prize for the winning team: $250 for their Student Society. CAPA will provide other prizes like t-shirts and gift cards. The winning 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.

CAPA NEWS

CAPA at Napa

oin us in Napa. We are developing an excellent education program set in the beautiful, lush green Napa Valley and offer it to you at a very reasonable price. CAPA is coming to Napa and you won’t want to miss it.

Saturday, February 26, 2011 9:15 a.m. to 4:30 p.m. Napa Valley Mariott 3425 Solano Avenue Napa, CA 94558 For additional information contact CAPA at: (714) 427-0321 or Fax at: (714) 427-0324 Sponsored by the California Academy of Physician Assistants

Tentatively scheduled to coincide with the Napa Conference: Controlled Substances Education Course. The Course will be held on Sunday, February 27, 2011.

Students Students Students Students Students Students Applying For Your PA License? Be Really Sure To Tell The WHOLE Truth by Gaye Breyman, CAE, Chief Operating Officer

very year we hear of an unfortunate new graduate or seven who have not followed the Golden Rule and because of that, their career starts off on a very bad foot. Please, please tell the entire truth when applying for your PA license. To say later that “you forgot about that” or “I didn’t think that counted” just doesn’t work. It is unwise to think that you/your particular issue/problem is an exception to the rule. You worked hard to get into PA school. You studied hard and passed your NCCPA exam. And then you apply for your license to practice as a PA and suddenly all common sense leaves you. You decide that no one will ever find out about that little

(or big) violation that happened when you were just a young guy or gal so you lie/omit information when filling out your license application. Do you remember giving the Physician Assistant Committee (PAC) your fingerprints? Do you remember when you were arrested and booked for whatever all those years ago, you gave them your fingerprints? Computer matching is an amazing thing! Tell the truth – the whole truth or so help you God! Each year many new graduate PAs (and practicing PAs who are moving here from another state) fail to honestly answer question 19a. on the California Physician Assistant License Application. The question reads: Have you ever been convicted of or pled nolo contendere to any violation (including misdemeanor or felony) of any local, state, or federal law of any

state, territory, country, or U.S. federal jurisdiction? The application states: You are required to list any conviction that has been set aside and dismissed or expunged, or where a stay of execution has been issued. Please know and please heed the warning: The Physician Assistant Committee investigates each applicant (they have your fingerprints!) and subsequently finds out when applicants have been less than totally honest. In most cases, the truth will cause you little to no problem. In all cases, lying on your PA license application will cause you a tremendous amount of grief. I so hate getting those calls and you can’t go back. You can’t unbreak the egg! 

Special Student Track at the CAPA Conference

e will again have a special series of lectures for PA students at the CAPA Conference on Friday, October 8, 2010. There is no additional charge for this wonderful student experience at the CAPA Conference. Mark your calendar!

10:15 a.m. – 11:15 a.m.

Diagnostic Tools and Treatments in 2010 Part I – Microscopy and Urinalysis Greg Mennie, PA-C, MSed 12:30 p.m. – 1:30 p.m.

Student Lunch

1:40 p.m. – 3:40 p.m.

Diagnostic Tools and Treatments in 2010 Part II & III – Imaging and EKG Nancy Nielsen-Brown, PA-C and Tim Wood, PA-C JULY/AUGUST 2010

Students Students Students Students Students Students Democracy Is Two Wolves And A Lamb Voting On What To Have For Lunch, Liberty Is a Well-Armed Lamb Contesting The Vote* by Adam Marks, MPA, PA, Director-At-Large members, sits 14 student delegates representing AAPA’s 8,131 student members.

2010 AAPA HOD in session

CAPA NEWS

n 1773, early American colonists revolted against the British government by dumping tea into the Boston Harbor. “No taxation without representation,” a quote legendary in American history, catalyzed the birth of the legislative, judicial and executive branches. The core principles of democracy have historically been the roots of American professional organizations. While not all organizations take the complete form of the federal government’s organizational chart, they do mold their organization to mimic our current democratic process.

To get an idea of what it is like to participate in the AAPA’s House of Delegates, just imagine a scaled down version of our own U.S. House of Representatives. Picture a ballroom with thirty-eight rows of tables, where 225 distinguished PAs sit. Their presence floods the House floor with years of experience and a rich history of the profession. In front of them sits the Reference Committee. A group of six individuals are tasked with listening to both pro/ con arguments about resolutions brought before the House and then meet and make suggestions to the House on whether or not they should oppose, reject or amend the resolution. Behind the representatives is the gallery; a group of bystanders and alternates who are listening, taking notes and ready to add commentary to any resolution that is being discussed. This process may seem tedious at times, but it is the driving force behind all national PA policy.

The American Academy of Physician Assistants consists of two basic regulatory bodies, the Board of Directors (BOD) and the House of Delegates (HOD). The BOD is elected by the AAPA membership while the House of Delegates consists of representatives from State Chapters, Specialty Groups and Caucuses. Within the HOD’s 225

Although the AAPA student membership has had voting privileges for many years now; this article revolves around a student delegation that fought back against a resolution which threatened those privileges. They fought to preserve the right to participate, vocalize their opinion and vote on issues which would directly affect the future of PA practice.

Early one morning, a group of student delegates met to discuss a resolution proposed by the AAPA Board of Directors. The resolution’s name, which at first glance appears benign, was Committee A, Resolution17. Below is an excerpt from A-17: “…each chapter shall be entitled to select, in such manner as may be determined by each chapter, one AAPA student member who will serve in the chapter delegation as a non-voting delegate.” A-17 would effectively dissolve the SAAAPA HOD members and eradicate the ability of students to vote in the HOD. During open session, an hour of pro/con testimony was given for A-17. The student delegation testified on the importance of PA students being able to vote on resolutions which would ultimately influence their practice and the future of the profession. PAs defended A-17. Those defending A-17 stated that the student population was not experienced enough to understand and effectively vote on PA policies and procedures and proposed students would be better served in a nonvoting role mentored by individual chapters. After the testimony was over, there was feeling of uneasiness in the air. There was no clear cut feeling on how the HOD would ultimately vote on A-17. To think that a body which prides itself in representing the members of

Students Students Students Students Students Students PArtying on July 4th by Joy Dugan, PA-S, CAPA Member the AAPA would support a resolution which essentially silences a portion of its membership is an eerie feeling. With this type of mentality, who is to know who is next on the chopping block? With the passage of A-17, the democratic process would be wounded and the profession would lose an important voice; the voice of the future. The student’s right to be represented sat amidst 22 other bylaw changes awaiting final approval and its fate was unclear. The final day of the HOD was a closed session. The student delegation met early that morning to review each resolution with A-17 being the center of discussion. The delegation knew what was at stake and they hoped that they would be returning the following year, sitting amongst the HOD with their voices being emanated through votes. As the HOD ran through each item one by one, those heavily disputed were pulled from the Consent Agenda and discussed in detail, followed by the final vote which would effectively bring life to the resolution or result in its immediate death. A-17 was pulled for discussion and after one more heated discussion, the Speaker of the House called A-17 to a vote. The HOD resoundingly opposed A-17; the student delegation would maintain their vote in the House of Delegates. This past January, I wrote an article about the history of California PA legislation and a time in the early 1990’s when the PA profession was on the brink of extinction in California. I know that what happens in the AAPA HOD has no legal standing as it relates to State Law or our PA Practice Act. However, it is interesting to look back on those times and naively think that history cannot repeat itself; but this article has a twist. A-17, the resolution to remove the voting privilege of PA students around the country is not a tale which took place twenty years ago. A-17 was discussed and voted down this year at the AAPA Annual Conference in Atlanta, Georgia. My intent in writing this article is not to demonize our national organization or to boast the power that students have in the HOD. A-17 is a stern reminder that our right to representation in the AAPA, a concept that innately seems so fundamental, is not immune to extinction. So to all California PA students and PA students’ nationwide: voice your opinions, be informed on the issues and get involved in the process! It is your profession now and your voice will dictate its future.

From L to R: Erin McMorris, PA-S, Kevin Carrasco, PharmD-student, Joy Dugan, PA-S, Nicole Pursell, DO-S, Jessica Adamich, PA-S and Heather Hosack, PA-S

n celebration of July 4th, eight Touro University physician assistant students, along with four pharmacy and medical students, offered free blood pressure and blood glucose screenings at the 157th annual Vallejo 4th of July Celebration. This is the first year that Touro University students offered services at this event and we plan to make it an annual outreach event. We assessed and counseled 115 people on hypertension, diabetes, weight loss and healthy lifestyle changes. Many people expressed their gratitude for this outreach and were interested in learning more about hypertension, diabetes and the role of physician assistants. Besides the July 4th outreach, Touro University PA students are actively participating in the creation of a Student-Run Health Clinic in Vallejo. Working together with pharmacy, public health, and medical students, we will be initially performing screening exams and preventative services under the supervision from faculty from all departments. Eventually, we hope the clinic becomes a full-service, student-run clinic. Services will be offered every Wednesday for at least two hours at a community center located conveniently near many bus lines and freeways. As many barriers exist in accessing care for residents of Vallejo, this will be a big step by Touro University students to meet the needs of the community. Furthermore, this will be a great opportunity for students to practice their clinical skills, participate in interprofessional education, and most importantly serve the uninsured and low-income residents of Vallejo. 

*Benjamin Franklin  JULY/AUGUST 2010

Students Students Students Students Students Students What’s Going On At…Touro University, California Faculty Profile: Grace Landel, PA-C by Michael De Rosa, MPH, Ph.D., PA-C, PA Program Relations Committee Chair

ouro University, California is the newest of California’s physician assistant programs. Located on a former Navy base in Vallejo, California, the program began with an ambitious plan to offer dual masters in Physician Assistant Studies and Public Health under the direction of Bill Stanhope, founding President of Grace Landel, PA-C the AAPA. Earlier this year, the Touro University PA Program identified a longstanding member of the PA education community, Grace Landel, to lead the next phase in its growth and development. “Grace encourages CAPA While many of us in PA education members to serve as mentors associate Grace for potential PAs in the with the State of Washington, community and to consider California is a training students. ” familiar place for this graduate of UC Santa Cruz. Grace received her PA training at the Baylor College of Medicine in 1984 and started her clinical career in a small town in Nebraska where she worked in a traditional “womb to tomb” family practice. She later moved to Vancouver, Washington, where in 1990 she began a 20 year association with the MEDEX Northwest Physician Assistant Training Program at the University of Washington. Grace says that in PA school she was always good with helping her classmates find 30

CAPA NEWS

just the right analogy to make a concept stick. And, having taught before PA school, like many of us, she always thought PA education might be in her future. For Grace, the most rewarding aspect of being a PA educator is the knowledge that when she trains students she impacts the lives of every patient they see. She takes the responsibility to train quality PAs who will reflect positively on the profession very seriously, as she says, “there are not many of us…” While she has done most every job within PA education at one time or another over the past 20 years, she has never been the Program Director. She expects the biggest challenge of her new position to be learning a new system after so long working in the MEDEX system. Though having come from a program with four satellites and more students than Touro’s typical incoming class, she hopes she will be up to the challenge. She is excited for the opportunity to work at a program with a commitment to training PAs to work in underserved areas, “an important component of PA education and a founding principal of our profession.” As frequently happens these days, when PA educators talk, our conversations turn to issues facing PA education wherever programs may be located: rotations, tuition expense and recruitment. Grace shared an interesting realization that those with the least access to health care are also likely to have the least access to an educational opportunity – thus making the job of putting quality health care providers in those communities all the more difficult.

Like many of us, Grace would like to see the relationship between CAPA and the programs in the state grow in mutually beneficial ways. Coming from smaller states, with fewer programs, she is accustomed to a close relationship between training programs and the State Academy. PA programs and CAPA can help each other provide necessary education for California’s physician assistants. CME programs led by program faculty and speakers from CAPA who can lecture at state programs are ways in which we can work together to support a lifetime of learning. Grace encourages CAPA members to serve as mentors for potential PAs in the community and to consider training students. And, she believes program faculty can be a resource for CAPA when they need representation in the local community, the State House or elsewhere to represent the profession and support its development. Grace Landel brings a distinguished record to the Touro University PA Program. We look forward to seeing her and working with her soon. Welcome to California, Grace!! 

Welcome New Members

Local Groups

May 15, 2010 through July 14, 2010 Rosalva Aguilar, PA-C Jessica Albert, PA-S David Allen, DC, ATC, PA-C Anna Alongi, PA-C Silvia Alonzo, PA-S Nick Alonzo, PA-S Daniel Amos, PA-C Teresa Anderson, PA-C Troy Bainbridge, MPAS, PA-C Janna Belletto, PA-C Corinne Beniasians, PA-C Alexandra Bernasconi, PA-S Michael Bordner, PA-C, MMS Heather Bristol, PA-C Jessica Brower, PA-C Sue Brown, PA-C Flene Butler, PA-C Sandra Campos, PA-S Gabriela Carranza, PA-S Scott Catone, PA Lila Chahroudi, PA-S Randy Choi, PA Harvey Chong, EMT-I Edward Chow, RPA-C Chad Christensen, PA-S Sara Coburn, PA-S Brittany Coffin, PA-S Carrie Conley, PA-S Jessica Cresap, PA-S Casey Crocker, PA-S Yasamine Currie, PA-S Ann Marie DaVigo, PA-C Erick Davila, PA-C Jane Davis, PA-C Julie Duquette, PA-C Arnold Escarcega, PA-C Cory Ferguson, PA-S Angelina Flores, PA-S Katherine Footracer, PA-C Stacy Frazer, PA-S Cynthia Froehlich, PA-S Pasha Fruman, PA-S Evette Gabriel, PA-S Dalan Garcia, PA-S Anne Gartner, DO Stephanie Goldman, PA-S Claudia Gonzalez, PA-C Dennis Good, PA-S Alison Gracom, PA-C Carlos Guerrero, PA-C Amber Haag, PA-C

Virginia Hens-Piazza, PA Carrie Hilvers, PA-S Karissa Hodges, PA-S Sally Holland, PA-C Kimberly Hottmann, PA-C John Hudson, PA-C Brittany Jackson Yeelan Johnson, PA-C Julie Kasem, PA-C Jason Kato, PA-C Katie Knott, MPA-C Kimberlee Knox, PA-C Khvien-Kingaro, Kong Michelle Koval, PA-S Krystalee Krey, PA-S Kimberly Lanford, MPA-C Peter Le, PA-C April Leggett, PA-C April Limcolioc, PA-C Svetlana Lisovskiy, PA-C Abigail Liwanag, PA-S Fallon Lopez, PA-S Kristina Lynch, PA-S Xin Ma, PA-C Saul Macias, PA-S Kathleen Marty, PA-C Joseph Mattera, PA-S Helena Matthews, PA-C Redginal McCall, PA Meghan McCarty, PA-C Tracy Mejia, PA Kimberly Mello, PA-C Lisa Mendez, PA-C Marisa Mendez, MS, PA-C Victoria Muchnik, PA-S Agustin Muralidharan Mindi Neill-Fiola, PA-C Travis Nelson, PA-C Brandy Newton, PA-S Nancy Ninkyi, PA-S Cyndie O’Connell-Jobb, PA-C Sheila O’Shea, PA-S Corinne Olivera, PA-C Ingrid Olsen, PA-C Jon Onosaki, PA-C Jose Ortiz, PA Sharon Pabla, PA-S Marisa Parker, PA-S Shreya Patel, PA-C Margreta Purcell, PA-C Rose Quinones, PA-C

Beverly Redsar, PA-S Craig Reid, PA-C Diane Renteria, PA-S Raelyn Ritchie, PA-S Michelle Roberts, PA-S Gunnar Rohde-Moe, PA-C Lisa Rosing, PA-S Saeed Safaee, PA-S Catherine Schwanz, PA-C Amir Seifi, PA-C Sudha Sharma, PA-C Angela Sherbondy, PA-S Michael Sikich, PA-C Douglas Smith, PA William Stein, PA-C Jared Stinebeck, PA-S Kristin Taylor, PA-S Oksana Teleten, PA Kenneth Thompson, PA-S Tom Tran, PA-C, MPAS Scott Vahradian, PA-C Marilyn Varela, PA-C Ricardo Vega, PA-S Kathleen Vigano, PA-C Amy Vu, PA-C William Wantland, PA-C Shannon Webb, PA-C Jacob Weidert, PA-S Sean Wilson, PA-S Denise Wofford, PA-C Leigh Yorke, PA-S Jacquelyn Yuan, PA-S Kellie Zumot, PA-C

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. Sacramento Area NP and PA Association A. Lynne Wittekind, PA-C; (530) 906-1238, sanppaa@sanppaa.org, lwittekind@earthlink.net, www.sanppaa.org 4. Contra Costa Clinicians Association Brian Costello, PA-C; (707) 651-2705, brianc510@comcast.net 5. 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 6. 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 7. Bay Area Non-Docs Linda O’Keeffe, PA-C; (650) 366-2050, lindapac@aol.com 8. Northcoast Association of Advanced Practice Clinicians John Coleman, PA-C; (707) 845-6008, streetdrag49@sbcglobal.net 9. Stanislaus County NP/PA Network Brian Cormier, PA-C; (209) 605-4966, briancor@verizon.net, www.nppanetwork.org NEW

10. Stockton Midlevels Emma Calvert, PA-C; stocktonmidlevels@gmail.com 11. 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 12. Tulare/Kings NP/PA Association Steve Henry, PA-C; Pager: (559) 749-4348, msh649@sbcglobal.net 13. Central Coast Nurse Practitioners & Physician Assistants Kris Dillworth, NP; ccnppa@yahoo.com 14. So Cal PAs Linda Aghakhanian, PA-C; want2heal@hotmail.com 15. Orange County Hung Nguyen, PA-C; (714) 846-8178; nhy52@yahoo.com 16. San Gabriel Valley Local Group M. Rachel DuBria, PA-C; (818) 744-6159, racheldca@aol.com 17. San Fernando/Santa Clarita Valley Group Jonah Tan, MPT, PA-C; (818) 634-0007, jotptpa@yahoo.com

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18. Coachella Valley Physician Assistant Group Matthew Keane, MS, PA-C; mkeanepas@gmail.com 19. San Diego Area Jeremy Adler, MS, PA-C; (619) 829-1430, jadler@simplyweb.net

JULY/AUGUST 2010

California Academy of Physician Assistants 3100 W. Warner Avenue, Suite 3 Santa Ana, CA 92704-5331

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CAPA’s 34th Annual Conference

October 7-10 Optional Workshops, October 7 and 9 Renaissance Hotel, Palm Springs, CA

Sharing Our Selves

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Controlled Substances Education Course October 6, 2010 – Prior to the CAPA Conference

S ee Poster Project on Cov er