News
Official Publication of the California Academy of Physician Assistants
November/December 2011
\The Magazine
SB 233 – Why Did We Do That? by Beth Grivett, PA-C, Legislative Affairs Committee Chair
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egislative goals are discussed every year in the fall. When the CAPA Board approved the legislative agenda, 2011 was looking like a quiet year. That is until we heard from a CAPA member working in orthopedic surgery who had just been told that he could no longer perform consultations in the emergency department at his hospital. We inquired further and found that Mission Hospital was written up for allowing PAs to consult in the ER. After investigation, we found the citation, which quoted Section 1317 of the Health and Safety Code pertaining to emergency services, stated that only a physician can
perform a consultation in the emergency department. Furthermore, this code stated that only a physician can TREAT a patient in the emergency department. Obviously, PAs provide care, both as providers in the ER and as providers in specialty services which perform consultations in the ER. Although most PAs in the state practice in a primary care specialty, the next largest practice areas are in the emergency department and orthopedic surgery. So, CAPA felt compelled to act. This was clearly a concern at this one hospital site, but what if other hospitals followed suit out of fear of a cita-
Legislator of the Year by Beth Grivett, PA-C, Legislative Affairs Committee Chair
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have been doing legislative affairs for CAPA for over 10 years and it has been rare to find a true champion in the legislature. CAPA’s lobbyist works to find legislators to author our sponsored bills. Thankfully, a few years ago, he found Senator Fran
Pavley. In 2009, SB 171 was passed which specifically allowed PAs to perform pre-employment physicals for school district employees. The following year we built on that bill and got SB 1069 passed. SB 1069 allows PAs to do numerous things which needed to be codified in regulation, including ordering durable medical equipment and home health services for Medicare beneficiaries, more pre-employment physicals, perform athletic screening physicals for high school students, order medications for children to have on campus during their school day and order amplified hearing devices for the deaf and hard of hearing. I would have thought Continued on page 9
tion? At least one inspector took this code literally to mean that a PA could not legally perform these services. Now that SB 233 has passed, what is different? Hopefully, not much! We expect that starting January 1, 2012, Mission Hospital can again allow their PAs to provide consultative services in the emergency department. We expect that we have eliminated the possibility that other hospitals will limit the practices of PAs. In the following excerpts, PAs are included in “other appropriate licensed persons.” But, always remember that your Delegation of Services Agreement should explicitly state which functions your supervising physician has delegated to you. This should include the setting, as well as, specific tasks such as “consultation” or “stabilization and transfer” as they apply to your particular job. Remember that a supervising physician or hospital can choose NOT to delegate tasks to you even if the new law allows you to perform these tasks. They can impose additional restrictions or require more stringent supervision than the law Continued on page 2
ALERT!
New Regulations See Page 5
News
Editor Gaye Breyman, CAE Managing Editor Denise Werner Proofreaders Lindsey Banovac Cherie Murray
At The Table CAPA: Making Sure That Every California Legislator Has A PA Experience!
Editorial Board Eric Glassman, MHS, PA-C Beth Grivett, PA-C Bob Miller, PA-C Larry Rosen, PA-C Michael Scarano, Jr., Esq.
CAPA Board Of Directors President Eric Glassman, MHS, PA-C president@capanet.org President Elect Adam Marks, MPA, PA-C presidentelect@capanet.org Vice President Jeremy A. Adler, MS, PA-C vicepresident@capanet.org Secretary Cherri Penne-Myers, PA-C, MSCS secretary@capanet.org Treasurer Bob Miller, PA-C treasurer@capanet.org Directors-At-Large Margaret Allen, PA-C dirmargaret@capanet.org Roy Guizado, MS, PA-C dirroy@capanet.org Greg Mennie, PA-C, MSed dirgreg@capanet.org Larry Rosen, PA-C dirlarry@capanet.org Student Representative Joy Dugan, PA-S studentrep@capanet.org The CAPA News is the official publication of the California Academy of Physician Assistants. This publication is devoted to informing physician assistants to enable them to better serve the public health and welfare. The publisher assumes no responsibility for unsolicited material. Letters to the editor are encouraged; the publisher reserves the right to publish, in whole or in part, all letters received. Byline articles express the opinion of the author and do not necessarily reflect the views or policies of the California Academy of Physician Assistants.
The CAPA office is located at: 3100 W. Warner Ave., Suite 3 Santa Ana, CA 92704-5331 Office: (714) 427-0321 Fax: (714) 427-0324 Email: CAPA@capanet.org Internet: www.capanet.org ©2011 California Academy of Physician Assistants
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CAPA NEWS
Jeremy Adler, PA-C, CAPA Vice President and leader of the San Diego Local Group attended a reception in honor of Assembly Member Ben Hueso on Thursday, October 6th (PA Day!) at the Reo Vista Healthcare Center.
Steve Goss, PA-C and Conrad Rios, PA-C, NP attended a reception in honor of Assembly Member Henry T. Perea on Tuesday, September 13th at the Fresno-Madera Medical Society.
SB 233 – Why Did We Do That? by Beth Grivett, PA-C, Legislative Affairs Committee Chair a consulting physician and surgeon, who is qualified to give an opinion or render the necessary requires based in part on your experience, expertise treatment in order to stabilize the patient. and the length of your partnership as part of a proIf you are a PA who is working in the emergency vider team. department, you should be aware that the following applies to you and may change the way that If you work as a PA who consults in the emeryou are currently practicing. It involves requesting gency department (i.e. in orthopedics or general a consultation: surgery), you should be aware that the following applies to you: A request for consultation shall be made by the treating physician and surgeon, or by other appropri“Consultation” means the rendering of an opinion ate licensed persons acting within their scope or advice, prescribing treatment, or the rendering of of licensure under the supervision of a treating a decision regarding hospitalization or transfer by physician and surgeon, provided the request is telephone or other means of communication. When made with the contemporaneous approval of the determined to be medically necessary, jointly by the treating physician and surgeon. The treating phytreating physician and surgeon, or by other approsician and surgeon may request to communicate dipriate licensed persons acting within their scope of rectly with the consulting physician and surgeon, and licensure, under the supervision of a physician and when determined to be medically necessary, jointly by surgeon, and the consulting physician and surgeon, “consultation” includes review of the patient’s medical the treating physician and surgeon and the consulting record, examination, and treatment of the patient in physician and surgeon, the consulting physician and surgeon shall examine and treat the patient in person. person by a consulting physician and surgeon, or by other appropriate licensed persons acting within their scope of licensure under the supervision of Continued on page 7 Continued from page 1
Someone Asked Us ... by Bob Miller, Chair, Professional Practice Committee
Physical Therapy Orders Q) Why do some physical therapy offices return my referral slips and require a signature by a physician? I thought I could write orders for PT. A) While not an answer, I can provide speculation. This problem comes up from time to time. We have tried to solve this issue before but made little headway through the bureaucracy. It seems that most of the problem comes from the California Code of Regulations (CCR), Title 22 and Medi-Cal (see CCR, Section 51309 below) where PAs are not specifically listed as one who may write a prescription for physical therapy (PT). This section of the CCR, applied to the Medi-Cal billing manual, describes those who may order physical therapy as “...a physician, dentist or podiatrist...”. The folks at Medi-Cal have informed us that this does not include physician assistants. It is unclear, but this may be the main obstacle resulting in PT orders being returned for physician signature when originally written by PAs. It seems that some PT offices
may adopt a general policy to obtain only physician signatures to prevent having to deal with potential claims denials. Or perhaps, because of the lack of clarity in the regulations and law, it may be perceived as the more prudent path - to obtain a physician signature. CCR, Title 22 (applied to the Medi-Cal Billing Manual) Section 51309. Psychology, Physical Therapy, Occupational Therapy, Speech Pathology and Audiological Services. (a) Psychology, physical therapy, occupational therapy, speech pathology and audiological services are covered when provided by persons who meet the appropriate requirements specified in Article 2 and Article 3 of this Chapter. The written prescription of a physician, dentist or podiatrist is required for physical therapy and occupational therapy services. Speech pathology and audiological services shall be provided only upon the written referral of a physician or dentist.
(b) Physical therapy services shall include physical therapy evaluation, treatment planning, treatment, instruction, consultative services, and application of topical medications. Services do not include the use of Roentgen rays or radioactive materials or the use of electricity for surgical purposes including cauterization. Services are limited to treatment immediately necessary to prevent or to reduce anticipated hospitalization or to continue a necessary plan of treatment after discharge from the hospital. (c) Occupational therapy services shall include occupational therapy evaluation, treatment planning, treatment, instruction and consultative services. (d) Such services, except physical therapy, are subject to the limitations set forth in Section 51304(a). Physical therapy services may be provided after prior authorization and approval of a treatment plan is obtained from the Medi-Cal consultant. (1) The authorization request shall include diagnosis, modalities, frequency, Continued on page 7
Inside This Issue At the Table..........................................................................2 Someone Asked Us ..............................................................3 Everybody Do Your Part!!!....................................................4 ALERT: New Regulation – Notification To Consumers...............5 Chronic Disease, Chronic Care, Chronic Healthcare Dollars......6 Virtual Risk Taking................................................................8 Partnering with Local Groups...............................................10 An Update on Tele-Health in California................................11 Does CAPA Need a Diversity Committee?.............................12 Faculty from California PA Programs Participate in Regional Education Meeting................................................14 100 + 700 = 800 “Thank Yous”.........................................15 The 35th Annual CAPA Conference Was a Hit!......................16 CAPA’s 35th Anniversary Conference – Retrospection and Inspiration..............................................17
Celebrating Our Successes and Looking to the Next 15 Years......18 PAC at Palm Springs Conference 2011.................................20 Honoring Our Past and Just Two of the Leaders Who Got Us Here................................................................21 Special Thank You to Taxi Wisdom.......................................21 2011 American PA Idol.......................................................21 Interprofessional Education.................................................22 Special Call for: CME Program Development Committee Members.................23 Caution: Telephone Advice...................................................24 Bob Miller Volunteer Spotlight.............................................25 Controlled Substances Education Course...............................26 CAPA at Napa.....................................................................27 CAPA Launches Prescription Drug Discount Card...................28 Most Physicians Don’t See PAs as Major Liability Risks..........29
Celebrating PA Week 2011..................................................29 Keck School Expands PA Program........................................31 Students Celebrate PA Week with a Community Health Fair.....31 PAying for PA School...........................................................32 CAPA Student Scholarships..................................................32 SJVC Trifecta.......................................................................33 Thank You to Our 2011 Student Ambassadors......................33 Touro Student-Run Health Clinic Celebrates One Year of Service............................................................34 Project Homeless Connect....................................................34 Welcome New Members......................................................35 Local Groups......................................................................35
NOVEMBER/DECEMBER 2011
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Everybody Do Your Part!!! by Eric Glassman, PA-C, President
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e are all PAs who love our jobs and what we do. We all went to PA school for the love of medicine and the challenges it brings every day in our practice. We were able to get into PA school because we excelled in academics, showed leadership capabilities and stood out from the rest of our competition. Health care today is rapidly changing and the future of medicine is still quite unknown. We need to continue to practice medicine and strive to take Deadline for CAPA office care of our patients to receive Candidate as best as we possibly can. In Data Form for those addition to this, we all need to take it who do not wish to go upon ourselves and through the Nominating remember what got us to where Committee: we are today, both individually and February 17, 2012 as a profession with – leadership, a vision and a drive to succeed and get Deadline for CAPA office to where we want to to receive Candidate be. This is such an important time for Data Form for those who our young profession and we all need to do wish to be reviewed/ chip in and do our endorsed by the part to lead the way into a strong future.
Nominating Committee: March 2, 2012
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CAPA NEWS
So what does it mean to “Do Your Part?” Does it mean we should all run for a position on the CAPA Board of Directors or even run for Congress? No, not at all. What it means is we all do whatever we can to promote the profession, help educate patients/physicians/students/etc. about what a PA is and what we do, help with precepting PA students,
or sitting on a board for your office or hospital. This list could go on and on about the many different ways everyone can do something above and beyond just showing up to work, doing your primary job, and going home. PAs by history and definition are leaders and we need to keep leading the way. If we all do more than the minimum to get by and find more ways to get involved, it will make PAs stand out and will benefit the profession in the long run. So often, we just rely on somebody else to help out and hope that someone else is doing it. A prime example of this is precepting PA students. We were all PA students at some point being precepted by PAs and physicians. How many students have you precepted in the past year? Ever? So many programs would love to increase their class sizes to increase the supply of PAs as the demand increases but the limiting factor is finding clinical sites. So, don’t say, “Well, nobody has asked me to do it. Rather, take the initiative, talk with your supervising physician, call up a program and volunteer yourself. Or, when someone from one of our PA programs asks you to precept, gladly say “Yes.” It is a rewarding experience and you will be glad you accepted. We don’t always know what we can do to get involved, but if you keep your eyes and ears open you will find opportunities or get ideas where help might be needed. We can always use the excuse that we are too busy with our job or family, but anyone can find a little extra time somewhere. Sometimes people ask me how I have time to be the President of CAPA while
working a full-time job and having a life outside of all this. I simply tell them, “I make time.” It is a priority for me and is important enough for me to find balance and increase efficiency in a work day to accommodate the additional time I need to get things done. We can all make time or use our time more efficiently to help out our profession at this important stage. I’m not going to give every example of how to get involved, the purpose of this article is simply stated, “get involved.” Help out in any way you can. For sure that means remaining a CAPA member throughout your entire PA career here in California. Don’t just leave it up to someone else or hope that everyone else is doing it. Take it upon yourself to make sure you are doing something positive for your profession in this crucial and important time. We have all heard the saying, “Many hands make light work.” Well, it is certainly true in this case. So please, lend a hand and get involved. If someone is asking for help, by all means, offer up some! We will all be better off if you would. Our profession needs you and your help.
If you would like to learn more about running for CAPA office or serving on a CAPA Committee, please email President Elect, Adam Marks, MPA, PA-C at presidentelect@ capanet.org
ALERT: New Regulation – Notification To Consumers Effective August 11, 2011, Section 1399.547, Title 16 of the California Code of Regulations, mandated by Business and Professions Code section 138, requires that physician assistants inform patients that they are licensed and regulated by the Physician Assistant Committee. The notification must include the following statement and information: NOTIFICATION TO CONSUMERS PHYSICIAN ASSISTANTS ARE LICENSED AND REGULATED BY THE PHYSICIAN ASSISTANT COMMITTEE (916) 561-8780 WWW.PAC.CA.GOV Physician assistants may provide this notification by one of the following three methods: Prominently posting a sign in an area of their offices conspicuous to patients, in at least 48-point type in Arial font. Including the notification in a written statement, signed and dated by the patient or patient’s representative, and kept in that patient’s file, stating the patient understands the physician assistant is licensed and regulated by the Committee. Including the notification in a statement on letterhead, discharge instructions, or other document given to a patient or the patient’s representative, where the notification is placed immediately above the signature line for the patient in at least 14-point type. The regulation language and notification format may be downloaded for your use at: http://www.pac.ca.gov/consumers/notice.pdf. For more information, please contact the Executive Officer of the Physician Assistant Committee, Elberta Portman, at (916) 561-8782 or Elberta.Portman@mbc.ca.gov.
NOTIFICATION TO CONSUMERS PHYSICIAN ASSISTANTS ARE LICENSED AND REGULATED BY THE PHYSICIAN ASSISTANT COMMITTEE (916) 561-8780 WWW.PAC.CA.GOV
NOVEMBER/DECEMBER 2011
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Chronic Disease, Chronic Care, Chronic Healthcare Dollars by Teresa Anderson, MPH, CAPA Public Policy Director
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illions of dollars are spent every year caring for people with one or more chronic disease. More than 75% of every health care dollar spent in the United States is spent on care for chronic diseases (CDC 2009). In fact, more than 16 million people in California live with one or more chronic conditions. While we fare slightly better than the rest of the United States in heart disease and cancer the statistics are still very alarming. The following California statistics begin to show the magnitude and burden on our state’s population health and the health care system (CDC 2008):
Heart Disease caused 27% of the deaths in California in 2005 Stroke caused 7% of the deaths in California in 2005 25% of adults in California reported having high blood pressure in 2007 35% of those screened for blood pressure had high cholesterol 7,697 adults died from diabetes in 2005 8% of adults in California reported being diagnosed with diabetes in 2007 21% of adults in California reported being diagnosed with arthritis in 2007 59% of adults in California reported being overweight in 2007
The United States spends less than 5% of every health care dollar on prevention. It is estimated that 80% of heart disease, 80% of type-2 diabetes, and 40 % of certain cancers could be prevented through screening and lifestyle changes. 6
CAPA NEWS
Controlling rising health care costs will require a systemic approach to addressing the underlying drivers of chronic disease with a strong focus on prevention. The need to focus on prevention is recognized at the national, state, and local levels. The first ever National Prevention Strategy was created by the National Prevention Council and presented by the U.S. Surgeon General on June 16, 2011. The National Prevention Strategy (NPS) has identified four strategic directions that include: Healthy and Safe Community Environments, Clinical and Community Preventive Services, Elimination of Health Disparities, and Empowerment of People. Within these strategic directions are priority areas that focus on reducing chronic disease and promoting health and wellness. Effective implementation of this Prevention Policy will rely on a coordinated effort at all levels. Recently CAPA joined the California Chronic Care Coalition (CCCC), an alliance of more than 30 leading consumer health organizations and provider groups that promote the collaborative work of policy makers, industry leaders, providers and consumers to improve the health of Californians with chronic conditions. We are excited to be part of this coalition and participate in statewide discussions that will influence policy related to preventing and managing chronic conditions throughout California. Liz Helms, Chair of the CCCC, poignantly states the reality of chronic disease and health reform changes that need to occur: “Chronic disease is the public health challenge of the 21st century. Reforming California’s health care
system will require a paradigm shift from crisis-centered care to prevention-centered care.” The CCCC is putting this philosophy into action as they partner with the Department of Managed Health Care’s Right Care Initiative to launch a patient activation campaign and demonstration project in San Diego. They are working to make San Diego the first ever “Heart Attack and Stroke Free Zone.” The “Be There” patient activation campaign is a multicultural multimedia effort to encourage people to take care of themselves so they can “Be There” for their loved ones. As legislation and policy begin to align with the aims of the Affordable Care Act, much attention will be given to coordinated care efforts that focus on prevention and management of chronic disease. Physician Assistants throughout California can play a vital role in ensuring successful alignment of policy goals and implementation of the National Prevention Strategy. As mentioned earlier, Clinical and Community Preventive Services is one of the four strategic directions and we know that PAs across the state are ready, willing, and able to meet the challenges, needs and recommendations presented in this area. However, this is also an opportune time to represent and advance the PA profession in other areas of policy. The other three strategic directions of the NPS are not clinically based; nevertheless require critical thinking, collaboration, and dedication to promoting health and wellness – all qualities PAs use every day. Imagine just in a few short years from now when California is recognized as a leader in implementing the NPS and Continued on page 9
Someone Asked Us ... Continued from page 3
therapeutic goals, duration of treatment and date of progress review where applicable. The physician’s, dentist’s or podiatrist’s prescription shall be attached to the authorization request. (2) Authorization for physical therapy services shall be contingent upon compliance with the following requirements: (A) There is direct and specific relationship of the services to written treatment plan prescribed by the physician, dentist or podiatrist after consultation with a qualified physical therapist. (Emphasis added) Our PA regulations clearly state that PAs can write orders for physical therapy and occupational therapy (see CCR, 1399.541(b) below). In addition, recent passage of AB3 added important new language to the MediCal Billing Manual regarding PAs in the NMP section under “Covered
Services” which states “Covered services for PAs include services performed by a PA within the scope of practice when the services would be a covered benefit if performed by a physician and surgeon.” This broad statement, derived from AB3, would seem to cover the issue of PAs ordering PT but other interpretations exist. We will renew our efforts to attempt to solve this problem. Watch for any progress in the CAPA News or on our website at www.capanet.org . CCR (excerpt) 1399.541. Medical Services Performable. Because physician assistant practice is directed by a supervising physician, and a physician assistant acts as an agent for that physician, the orders given and tasks performed by a physician assistant shall be considered the same as if they had been given and performed by the supervising physician. Unless otherwise
specified in these regulations or in the delegation or protocols, these orders may be initiated without the prior patient specific order of the supervising physician. In any setting, including for example, any licensed health facility, out-patient settings, patients’ residences, residential facilities, and hospices, as applicable, a physician assistant may, pursuant to a delegation and protocols where present: (a) Take a patient history; perform a physical examination and make an assessment and diagnosis therefrom; initiate, review and revise treatment and therapy plans including plans for those services described in Section 1399.541(b) through Section 1399.541(i) inclusive; and record and present pertinent data in a manner meaningful to the physician. (b) Order or transmit an order for x-ray, other studies, therapeutic diets, physical therapy, occupational therapy, respiratory therapy, and nursing services. (Emphasis added)
SB 233 – Why Did We Do That? Continued from page 2
The consulting physician and surgeon is ultimately responsible for providing the necessary consultation to the patient, regardless of who makes the in-person appearance. To save you from Googling®, “contemporaneous” means “existing, beginning, or occurring in the same period of time.” In our many stakeholder discussions, there were those emergency medicine physicians who believed it was essential that the PA consult with their supervising physician PRIOR TO requesting a consultation of a spe-
cialty physician. We argued that, while optimal in some settings, putting this into state law could put PAs and physicians at risk since prior approval is not always possible nor in the best interest of our patients. Ultimately we settled on “contemporaneous” and decided that it is best practice for the supervising physician to be aware that a PA is requesting a consultation for an emergency room patient, but notifying the supervising physician prior to requesting the consultation is not mandatory. All PAs who work in the ER should be aware that they will be covered
for stabilizing a patient for transport as well: A patient is “stabilized” or “stabilization” has occurred when, in the opinion of the treating physician and surgeon, or other appropriate licensed persons acting within their scope of licensure under the supervision of a treating physician and surgeon, the patient’s medical condition is such that, within reasonable medical probability, no material deterioration of the patient’s condition is likely to result from, or occur during, the release or transfer of the Continued on page 9
NOVEMBER/DECEMBER 2011
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Virtual Risk Taking by Greg Mennie, PA-C, MSed, Director-At-Large
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remember as a young man in the late 80s speaking with a gentleman who was about 101. He seemed to have all his faculties about him and at the time was doing remarkably well. I asked him what he thought was the greatest invention or achievement he had seen in his lifetime. He said, “the toaster.” What we may see as insignificant, others may see as grand cultural changes. What we may dismiss as a fad, may well become a cultural norm. I wonder if his parents thought the toaster was just one of those “new-fangled” contraptions that wouldn’t last? As providers we pride ourselves on staying up-to-date on disease processes and new treatment modalities but perhaps we forget to recognize the impact on our patient populations with changing cultural norms. Kids these days are benefactors of some of the greatest inventions of our lifetime, but they also are recipients of the difficulties associated with those discoveries. As providers, understanding some of the risks associated with new “inventions” is just as important as understanding the latest and greatest antibiotic. As our society changes, providers should become more aware of the modern day issues associated with teens and risk taking behavior. Specifically, a new concept of risk taking behavior… virtual risk taking. I think we would all recognize that one of the “greatest” new achievements of our lifetime (at least so far) is the Internet and social networking. We also recognize that it’s fraught with a whole new set of social and cultural difficulties, especially for our adolescent patients. Almost 90% of today’s adolescents use the Internet on a regular basis. Social networking on the Internet has exploded. There are currently 8
CAPA NEWS
800 million Facebook users and according to Pewinternet.org, nearly three-quarters of all adolescents use social networking sites. With such large exposure and the false sense of privacy, many teens and their parents are unaware of the potential issues associated with the Internet and its use. In fact, almost 25% of teens say their parents are unaware of their online activities. No one would argue that parents should be responsible and understand the risks associated with social networking as it pertains to their family and specifically their children. I would argue that as providers, we should take the time to offer a brief anticipatory guidance checkpoint to our well-child care appointments. A checkpoint that discusses the pitfalls and safety issues associated with Internet use and social networking as it pertains to our teen patient population.
So what’s the big deal?
11% of teens admit to sexually explicit conversations online.
19% of teens report being bullied or bullying someone online.
75% of teens say they share personal information. 64% of teens post photos with 70% being personal photos.
69% of teens say they regularly communicate with people they don’t know.
It’s anonymous right?
Posting something today on the Internet could have ramifications far reaching into a young person’s future. According to Careerbuilder.com, almost a third of employers now use Google to check on applicants. Over half of employers peruse social networking sites and about 10% follow job candidates on Twitter. The problem with the perception of anonymity is that it allows people to do, say or show things that perhaps they otherwise wouldn’t. A recent study from the University of Florida evaluated online public information pertaining to their medical students and residents. They discovered that nearly half of the students used Facebook, over 80% listed at least one personally identifiable piece of Continued on page 9
Chronic Disease, Chronic Care, Chronic Healthcare Dollars Continued from page 6
we look at advisory councils, boards, planning committees, etc. and see PAs as leaders on all of these. Soon, I hope to be writing policy articles about a PA on: the Air Quality Board advising on pollution controls to reduce asthma, Regional Planning Committees advising on increasing access to bike trails to reduce obesity
SB 233 – Why Did We Do That?
or The Little Hoover Commission reviewing the critical role community colleges have in promoting ethnic diversity in workforce training. All of these roles can promote health and wellness, impact the prevalence and incidence of chronic disease, reduce health care costs, and of course, promote the PA profession.
Legislator of the Year
Continued from page 7
patient as provided for in Section 1317.2, Section 1317.2a, or other pertinent statute. As always, please feel free to contact me at lac@capanet.org or by calling the CAPA office if you have specific questions about this bill or if you have other legislative concerns.
Thank you to the following PAs on the LAC for their service this year:
This bill was signed by the Governor on September 22 and becomes law January 1, 2012. SB 233 solidifies the future of those PAs consulting or treating patients in Emergency Departments throughout the state.
Conference. On Wednesday, her daughter Jennifer attended the conference and passed the Controlled Substances Course! Jennifer is one of California’s newest PAs having just graduated from the USC Keck School of Medicine Program and is now working as an ER PA in Southern California. Jennifer shared with me that it was the contact with Assemblymember Bass and the bills which her mom had voted on in support of PAs that introduced her to the profession and got her excited about applying to the USC PA Program.
Senator Pavley has been a champion for PAs in Sacramento. She and her husband travelled to Palm Springs to receive her award in front of a crowded ballroom at the 35th CAPA Annual
We truly thank Senator Pavley for the passion with which she embraces issues about the PA Practice Act. Senator Pavley, you have served the PAs in California well.
Chris Smith, PA-C
Continued from page 1
the good Senator had had enough of us but this year when she learned that the jobs of ER PAs could be jeopardized, she agreed to author SB 233.
Virtual Risk Taking Continued from page 8
information, and in some accounts they displayed unprofessional material such as overt sexuality, foul language, racist remarks and content or HIPAA violations. These were not very anonymous and probably not what most of these up and coming professionals want floating out in Google search engines. So what exactly can we do as providers? A good place to start is to develop a set of probing questions
regarding your adolescent patients’ computer use (see Table 1). The old saying, “there are some things you can’t take back,” really is true in the Internet world. Teaching young patients about the lack of anonymity and the public nature of their actions may be enough for some to stop and consider what they post in a blog or on a social network site. Taking that quick minute to discuss the potential issues of their computer use could actually save them from future problems, which in medicine is known as anticipatory guidance.
Edward Arias, PA-C Jacob Hauptman, PA-C Adam Marks, MPA, PA-C Maryann Sheps, PA-C, DC
Table 1 •
Are you on Facebook or other social networking sites?
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Are your privacy settings in place?
•
Do you only communicate on the Internet with people you know personally?
•
Do you share personal information on the Internet?
•
Are you aware employers and universities may research you via social networking sites and Google?
NOVEMBER/DECEMBER 2011
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Partnering with Local Groups by Jeremy A. Adler, MS, PA-C, Vice President
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ll across California there are clusters of PAs who routinely meet as “Local Groups.” These groups have independent leadership and are listed at the end of each issue of the CAPA News and also on our website. CAPA is aware of eighteen local groups that span the entire State from Eureka to San Diego and from the Bay Area to the Sierra Nevada. Some of these groups have organized only recently and others have been around for decades. Having been involved as a local group leader in San Diego for many years, it was natural for me to look into the relationship between CAPA and the local groups when I joined CAPA’s Board of Directors. I have always believed that bolstering the relationship between CAPA and local groups would help strengthen both entities. A primary objective for my role with CAPA has been to try and learn where local group activity is occurring, who leads the groups, how active the groups are, who attends the local group functions and what services are provided by the local group. So far it appears that local groups have evolved to meet the needs of their members by having dedicated leadership and providing a number of necessary services. For those not familiar with local groups or those practicing in communities without local groups, I ‘d like to share what has been happening in San Diego’s local group. In San Diego, through word of mouth, the local group has evolved from a small journal club to a group with sponsored monthly meetings. These meetings are booked about 12 months in advance and 10
CAPA NEWS
communication is via email. The email list contains nearly 600 PAs and PA students throughout San Diego County. Our meetings are attended by 40-50 “members” and often a waiting list is necessary due to limited space at the venue. Our group is led by three volunteers: Mark Hartmann, PA-C; Patrick Astourian, PA-C and me. We have opened membership to PAs, PA students and MD/DOs who supervise PAs. We do not charge membership dues and have no formal membership application. The group has established goals that include PA networking, job communication, professional education, PA student rotation connections and disaster response. We provide members a spreadsheet that identifies where local PAs are practicing and encourage them to refer their patients to practices that support PAs. For disaster response, our group was able to help coordinate emergency care when the San Diego wildfires happened in 2007. Generally, we receive financial support for our meetings from industry and typically meet in a variety of restaurants. Although industry typically sponsors our meetings, our local group controls the list of attendees to preserve the anonymity of our members. Feedback from members and sponsors has been very favorable. Our San Diego group appears to function similarly to other local groups but there are some notable differences. Some local groups only allow licensed PAs to participate. Other groups are comprised of a mix of PAs, NPs, students, physicians, nurses and support staff. Some of the groups charge dues and meet monthly, bimonthly or at random intervals. There are groups that control the attendance and others that have their sponsor create the invitation list. There are even groups that offer CME at their meetings. Some groups have
put together websites. For example, the San Francisco Bay Area Physician Assistant group can be viewed at www. sfbapa.com and the Stanislaus NP/ PA Network can be viewed at www. nppanetwork.org. All in all, each group has developed independently, but their similarities outnumber the differences. All of our local groups serve an important professional need for California’s PAs and CAPA is interested in supporting their goals. Ideally, every PA in California would have access to a local group. Successful local groups should have the infrastructure to share ideas and strategies with other local groups. One big issue for most groups is sponsorships. By having an organized infrastructure, sharing sponsors via industry counterparts could occur in different regions of the State. CAPA would like to help develop this infrastructure for the benefit of the current groups, but also to support new group formation in communities that are not currently represented. Many of you are active in your local groups and understand their value. For those who are not participating with your local group, you are encouraged to make the connection and attend a local group function. If your community doesn’t have a local group, consider starting one. Many of the local group leaders, including those in San Diego, would be happy to talk with you about the strategies required to form a local group and the professional satisfaction organizing a local group can provide. As part of CAPA’s mission to serve PAs statewide, CAPA will continue to work on supporting local groups. See Local Groups listed on page 35. For more information contact Jeremy Adler at vicepresident@capanet.org.
An Update on Tele-Health in California by Adam Marks, MPA, PA-C, President Elect
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here are many health care related topics being discussed, especially with full implementation of the Affordable Care Act (ACA) on the horizon in 2014. California is in a unique position to advance the goals of the ACA through demonstration projects, grant opportunities and support of key legislation required for early and timely implementation of the ACA. Responding to these opportunities will test capacity, technology and workforce needs in medical facilities across the state. One area which will be heavily impacted by the ACA is rural areas of the state. While not as densely populated, these areas lack the availability to specialists, primary care providers and have unique barriers that complicate medical care. While “rural areas” give the sense of a small isolated population, statistics tell a different story: 1) 85% of California’s land mass is rural 2) 44 of 58 counties in California are designated as rural 3) 13.7 % of the state’s population lives in rural California 4) 1 out of 60 Americans live in rural California The big question is how do we increase health care services to rural areas consistent with ACA implementation efforts? One answer is Tele-health. Currently, Tele-health is being used in various forms throughout the state providing services like retinal screening and specialty consults. Although current use of this technology does increase access to medical care, legislation was introduced to remove identified barriers and expand its use in the evolving medical system.
This year AB 415, the Tele-health Advancement Act of 2011, was signed into law. “The purpose of this legislation is to remove barriers in current law and update to current practice the use of Tele-health in the delivery healthcare system, while maintaining the original legislative intent of California’s groundbreaking Telemedicine Development Act of 1996” (California State Rural Heath Association 2011). This new legislation does a couple of very important things: 1) Removes requirements imposed by health care service plans, health insurers and Medi-Cal for Tele-health services 2) Broadens the definition of Tele-health services 3) Prohibits the department from requiring that a health care provider must document a barrier to an in-person visit 4) States legislative intent to allow hospitals to grant privileges to and verify and approve credentials for providers of Tele-health services AB 415 is just one of the many pieces of legislation that is being moved through Sacramento to aid in the use of Tele-health services across the state of California. Over the past few years several pilot projects have been conducted, many medical practices have explored and implemented the use of Tele-health and many of those practices are using PAs as a conduit for services. CAPA’s Public Policy Director, Teresa Anderson, has been working hard with constituent groups who are putting together Tele-health
policy and legislation. When asked about the future of Tele-health policy and the influence PAs will have in the field, she stated: “Overall, PAs are slated to be a major and critical component of successfully using Tele-Health technology to its fullest potential. Personally, I anticipate seeing future legislation around reimbursement for a full range of Tele-health services, education programs to include training in Tele-health and logistics around virtual multidisciplinary teams.” Recently, I had the opportunity to meet with Steve Barrow, Executive Director of the California State Rural Health Association. His organization was integral in helping pass AB 415 and he provided me with some great resources for providers looking for guidance with Tele-health. I would encourage anyone who is interested in learning more about Tele-health to visit: 1) California Tele-health Network, which aids in the infrastructure, connectivity and hardware needed to start a Tele-health program (www.caltelehealth.org). 2) California Telemedicine and eHealth Center, which provides resources for policy and operations (www. cteconline.org).
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Does CAPA Need a Diversity Committee? by Margaret Allen, PA-C, Diversity Chair and Director-At-Large
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f you elect to have a soup and salad lunch tomorrow, you might consider the make-up of your meal. The soup is an amalgam of selected ingredients while the salad is usually a lively mixture of clearly different tastes, textures and colors. Both of these choices are nourishing, healthy and can help get you through the day. Like the heterogeneous lunch counter offerings, our North American society consists of many different ethnic groups, social classes, languages and cultural traditions. We are a group of immigrants whose members enlighten and engage our entire communities. California is a minority-majority state. In the 2010 US Census, California’s population was 40.1% Non-Hispanic White, 5.8% Black or African American, 12.8% Asian, 4% American Indian, 2% Pacific Islander and 2.6% from two or more races and 37.6% of the total population is Hispanic or Latino. There are many vibrant communities of immigrants, among them Hmong in Fresno, Afghans in Fremont and
Armenians in Glendale. But not everyone belongs to a single group. Like President Obama, many people have, what Yoko Ono (in a recent Esquire article) rather prosaically described as, “two or three countries inside them.” If California has a thriving multi-cultural presence, does CAPA still need a Diversity Committee? Of course we do! We need a Diversity Committee for many reasons, not least among them the need for a watchdog to be vigilant and active in working toward eliminating health disparities and to ensure that under-represented groups have a presence in the health care workforce. At our recent annual conference people approached me with stories of discrimination, failure to provide access and wideranging health disparities. An overarching concern was the pressing need for health care providers to be better educated in cultural differences among our patients. To truly care for our patients we all need to understand these diverse
groups. For example, the Asian PA needs to know about Appalachian culture, the African American PA needs knowledge of Latino home remedies and the Whites among us need an understanding of Native American tribal customs. The work does not stop when we graduate from PA school or obtain our re-certification. The patient’s agenda should always be part of our agenda. Earlier in September, I attended the Network of Ethnic Physician Organizations (NEPO) Leadership Summit entitled “The Challenges and Benefits of Health Care Reform.” NEPO aims to champion improved individual and community health through a partnership of leaders in medicine, related health professions and the community. Anyone who is committed to improving the health care of California’s underrepresented minorities is welcome to join the organization and I encourage PAs to look into it. It was an interesting, colorful and inspiring weekend. My favorite moment was when one of the physicians, an African American
Race and Ethnicity of the US population and US Physician Assistants NonHispanic Black (%) 12.1
Hispanic (%)
Asian/ Pacific Islander (%)
US population over age 18 (2000)
NonHispanic White (%) 69.1
3.7
American Indian/ Alaska Native (%) 0.7
Other/ Multiracial (%) 1.8
12.5
Physician Assistants (2006)
86.4
3.5
3.7
3.5
0.8
n/a
California PAs (2003)
62.4
7.8 (African American)
15.7
7.7 (Asian)
n/a
4.8
Adapted from Grumbach K, Mendoz R. Disparities in human resources: addressing the lack of diversity in the health professions. Health Affairs, 27, no. 2 (2008): 413-422, and Grumbach K, Hart L, Mertz E, Coffman J, Palazzzo L. Who is caring for the underserved? A comparison of primary care physicians and non physician clinicians in California and Washington. Ann Fam Med. 2003 July; 1(2): 97-104 12
CAPA NEWS
woman from the Central Valley, stood up and said that “Diversity is not just about skin color. It’s about poverty, discrimination, poor communication, and misunderstandings.”
among primary care providers as the most diverse and most likely to practice in underserved communities. Nevertheless, our profession still needs to strengthen the ranks of people of color in order to more accurately resemble the ethnic and racial composition of our state.
Kevin Grumbach and his colleagues at UCSF have written several articles about health care of the underserved. Foremost among their conclusions is that the racial make-up of members of the health professions does not reflect the demographics of our society. Dr. Grumbach told me that he is impressed by how PAs stand out
Improving the diversity of the healthcare workforce requires that we address the educational pipeline, support innovative admissions policies and recognize that a culturally and linguistically diverse workforce is associated with
better access to quality care for disadvantaged populations. It is a public health imperative. CAPA’s Diversity Committee has an important role to play in continuing the conversation; being vigilant on the need for diversity in our schools and workforce and staying attuned to the needs of our multi-cultural patients. Whether you believe in the melting pot theory or support the salad bowl idea, we all have the responsibility, regardless of our race or ethnicity, for eliminating inequities in health care.
CAPA FACT Did You Know? 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.
CALIF
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nia Califor tant’s n Assis Physicia ing Physician’s pervis k and Su andboo Legal H no, Jr. ael Scara LLP R. Mich Lardner Foley & ral Counsel CAPA Gene
THIRD
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Third Edition of the California Physician Assistant’s and Supervising Physician’s Legal Handbook*
M
ichael Scarano, Jr., Esq. authored the California Physician Assistant’s and Supervising Physician’s Legal Handbook. Newly updated, it answers scores of questions in a concise, clear fashion, with citations and appendices that will permit practitioners to read the operative statutes and regulations for themselves. A must have for all California practices employing PAs. Visit the CAPA website at www.capanet.org for more information or to order the book online. *CAPA Member Price - $34.95
Non Member Price - $54.95
NOVEMBER/DECEMBER 2011
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Faculty from California PA Programs Participate in Regional Education Meeting by Kristine Himmerick, MS, MPAS, PA-C, Faculty - University of California, Davis, FNP/PA Program It is with great pleasure that I introduce the newest member of the CAPA Program Relations Committee: Ms. Kristine Himmerick, MS, MPAS, PA-C. Kristine is a graduate of the University of Iowa PA Program and is currently on the PA faculty at UC Davis. Kristine’s work on medical reasoning has been published in JAAPA and presented at the Physician Assistant Education Association national conference. She is a National Health Service Corps Scholar and a recipient of the AAPA award for student writing (2004) and the PAragon Award (first place) for publication in 2010. For this issue of the CAPA News, Kristine has agreed to provide a report on the recently concluded meeting of the Western Consortium of the Physician Assistant Education Association (PAEA). Michael De Rosa MPH, PhD, PA-C Chair, PA Program Relations Committee
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s the demand for more physician assistant clinicians increases in response to our ailing health care system, our profession has more urgency than ever to recruit and retain PA educators. Currently no formal training path exists to become a PA educator. Any PA with clinical experience and an interest in teaching and mentoring students has the potential to become a PA educator. The Physician Assistant Education Association is the only national organization representing physician assistant educational programs in the United States. PAEA provides services for faculty at its member programs, as well as to applicants, students, and other stakeholders. In an effort to facilitate communication and networking among PAEA member programs on a geographical basis, programs are divided into regional consortia. California PA program faculty belong to the Western Consortium (WC). The Western Consortium gathers annually to foster collaboration and to address PA education issues specific to the large and diverse states on the west coast. In August, several faculty members from California PA programs attended the annual Western Consortium meeting in Park City, Utah for 3 days of idea sharing and faculty development. The meeting was organized by 14
CAPA NEWS
Olivia Walton from the University of Utah PA Program. Some of the primary topics of discussion included clinical testing, preceptor training, rural rotations, global health rotations, alumni tracking, student handbooks, work force issues and admissions criteria. The schedule also allowed unstructured time for peerto-peer mentoring and on research projects. As a result of PAEA Western Consortium gatherings, one multiinstitutional research project between two Western Consortium programs has been grant funded and others are currently in development. At the conclusion of the meeting, the group came up with a recommendation to the PAEA Board of Directors to recommend that PAEA explore
means to provide Category 1 CME for PA education activities. The Western Consortium proposes that the preparation for teaching medical education classes increases the educator’s knowledge, skills, professional performance and should be recognized as a continuing medical education activity. After the meeting Olivia commented, “I sincerely enjoyed this meeting, thank you for everyone’s energy and participation. In reflection, the Western Consortium is all about having an opportunity to really get to know our colleagues and to develop relationships in our region. This small and informal setting provides a critical opportunity for us to collaborate on scholarship and provide peer-to-peer mentoring. We are extremely lucky that the WC remains active and that both senior and junior faculty attends these meetings.” The USC PA program will host the annual Western Consortium meeting in 2012. For more information about the Physician Assistant Education Association or the PAEA Western Consortium, visit www.paeaonline. org. If you are interested in teaching, precepting, or lecturing to PA students, please contact your local PA program.
Western Consortium Member Programs (California Programs in bold): Arizona School of Health Sciences Idaho State University University of Southern California Keck School of Medicine Loma Linda University Midwestern University Glendale Oregon Health & Science University Pacific University Red Rocks Community College Riverside County Regional Medical Center/ Riverside Community College Rocky Mountain College
Samuel Merritt University San Joaquin Valley College Stanford University School of Medicine Touro University California Touro University Nevada University of California Davis University of Colorado Anschutz Medical Campus University of New Mexico University of Utah University of Washington Western University of Health Sciences University of St. Francis
100 + 700 = 800 “Thank Yous” by Larry Rosen, PA-C, Public Relations Committee Chair and Director-At-Large members signed up. CAPA is very proud of that figure. BTM was elated, not only for the sign ups but for the hundreds more PAs who will bring the message of need back to their families, friends, associates and patients. Sign-ups can still be done online at http://marrow.org
Larry Rosen, PA-C, swabs Cyndy Flores, PA-C for Be The Match, a national bone marrow donor registry during the 2011 CAPA Conference.
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ach year at CAPA’s Annual Conference in Palm Springs, public relations projects are rolled out that are designed to inspire attendee participation in health related issues affecting our patient population; blood bank donations, organ transplant awareness, disaster health care volunteerism, stroke prevention, etc. This year was no exception. Bone marrow donation and health literacy were featured and, true to form, CAPA physician assistants stepped up with enthusiasm and generosity. Be The Match (BTM), the national bone marrow donor registry, enlisted our support in bringing the need for more and more donors to the attention of our conference attendees. 17,000,000 donors are registered worldwide and thousands more are needed to extend the lives of the 50,000 additional patients each year who suffer from leukemias, anemias and lymphomas. Bone marrow donation is a decidedly personal commitment. It asks that you be willing to donate to anyone in need, anywhere in the world. The registry asks only that you fill out a short questionnaire, health history and do a painless cheek swab for a tissue sample. More than 100 CAPA
PAL (Physician Assistants for Literacy) is a health literacy program, aptly named by Joy Dugan, PR Committee member. Its intention is to inspire reading among elementary school students and to bring much needed books to children who can ill afford to buy them. CAPA attendees brought more than 700 books to Palm Springs. Students in most California PA programs will distribute the books to children all across the state. Again, our members recognized the importance of the issue and graciously participated. James Patterson, noted author and two-time Children’s Choice Book Award “Author of the Year” nominee, wrote:
“The best way to get kids reading more is to give them books they’ll gobble up…and that will make them ask for another. Yes, it’s that simple. 1+1 = 2. It just does. Kids say the number one reason they don’t read more is that they can’t find books they like.”
So, thank you, CAPA members, for the registry sign-ups and the books. And special thanks to Lin Oliver, of the Society of Children’s Book Writers & Illustrators in Los Angeles, for her kind acknowledgment of our efforts and the many books she sent to us. I love being a PA and the privilege of working with so many openhearted, compassionate people who consistently put their patient’s needs before their own. It’s a great profession and it keeps getting better.
CAPA FACT Did You Know? The deadline for declaring your reviewed/endorsed candidacy for the 2012-2013 CAPA Board of Directors is March 2, 2012. NOVEMBER/DECEMBER 2011
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The Next 5 Years...
The 35th Annual CAPA Conference Was a Hit! by Eric Glassman, PA-C, President
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or all of you that attended this year’s 35th Annual CAPA Conference in Palm Springs, I would like to personally thank you for coming to earn your CME with us and experiencing the magic of the CAPA Conference. We worked hard all year long to make sure that we provided the best quality speakers and topics for you. We hope you enjoyed the CAPA Conference Experience. For those of you who were unable to make it out to the desert this year, don’t fret as CAPA’s 36th Annual Conference in Palm Springs will be here before we know it – October 4-7, 2012. Many of you took advantage of all the fun and festivities this year including the PArty and Dance on Friday night. We had another successful American PA Idol competition during The Dance with many great performances. The winner again this year was Stephanie Rolfo, PA-C, recent graduate of the SJVC PA program. Saturday poolside was a new experience for CAPA Conference attendees, a live performance by Taxi Wisdom with, our very own, Greg Mennie, PA-C on the drums. Next, the Student Challenge Bowl with some fierce competition. SJVC earned the cup and $250 for their Student Society! Many thanks to those who came out to be poolside to enjoy the music and cheer on their favorite PA program. Probably the highlight of the conference was the keynote luncheon, hosted by CAPA, where we had the opportunity to hear two amazing speakers. First, CAPA’s Founding President, Rod Moser, PA, Ph.D spoke about the early years of CAPA, what life was like as a practicing PA back in the early 1970s and how far the PA profession has come. Listening to his talk really made me appreciate the laws and regulations that have passed since the 70s that define our profession today. Rod’s stories were heartfelt and what he has done for our practice in California, as well as what he has done for CAPA, is appreciated beyond words. We also had the opportunity to hear from Herb Schultz, Region IX Director of the United States Health and Human Services Department. He was wonderful. He spoke about the future of health
16 | CAPA NEWS
care and the impact PAs will have on our health care system. His words were inspiring to everyone in attendance and gave us all hope for a continued bright future for our profession. For further inspiration, PAs visited the Visions Lab in the Exhibit Hall, where they were able to speak with colleagues and explore what their vision was for themselves for the next 15 years. Many created Vision Statements and many recorded a video for YouTube in the Visions Lab Studio. Check it out on YouTube at: http://www.youtube.com/user/CAPAConnection. Beyond the lectures and CAPA fun, I hope you all participated in the Be The Match bone marrow project or donated some books to the PAL (Physician Assistants for Literacy project. It is always great to see PAs doing good things for the community and our patients. I would like to thank all the Student Ambassadors who worked so hard during the conference to make your experience the best. That hard work is appreciated. I would also like to thank the entire CME Committee for their dedication and volunteering their time to make this an amazing conference. The CME Committee included Tim Wood, Chris Clark, Jennifer Carlquist, Jennifer Baltazar, Shelby Edwards, Matt Keane and Michelle Lim-Serrao. You guys are amazing and this conference was great because of your help. Special thanks and recognition also goes to Tim Wood for chairing the Conference Planning Committee and to all its committee members who were dedicated to finding new innovative speakers and topics. I hope to see you all back next year in Palm Springs for the 36th Annual Conference from October 4-7, 2012. Mark your calendars now! If you missed this year’s conference, I hope you will be inspired after reading this and seeing all the photos, to join us for next year’s conference experience and CME opportunities.
CAPA’s 35th Anniversary Conference – Retrospection and Inspiration Thank you to all who joined us in Palm Springs … To Celebrate Our Successes and To Look To
The Next 1 5 Years.
What Will Your Professional Life Look Like in 2026? With the tremendous successes CAPA has experienced for California PAs, sometimes we don’t feel the urgency that those early PAs felt. After all, we are doing great! We have a lot to celebrate (and we did!) thanks to the hard work and commitment of thousands of PAs over the past 35 years. While celebrating, we were reminded of the need to remain diligent and continue to press on with the same focus and commitment we have had for the past 35 years. What will your professional life look like in 15 years? When we celebrate CAPA’s 50th Anniversary (with many more wins under our belt for California PAs) what part will you have played? CAPA is here to continue to promote and protect PA practice here in California and it was good to look to the 50th Anniversary and beyond. There is a lot to do. We still don’t have the dream PA Practice Act (although we have come a very long way!) Together, with your commitment to remain a CAPA member each and every year you practice in California, there is no limit to what we can achieve. Rod Moser, Ph.D. and other CAPA founders are blown away by what has been accomplished, beginning in 1976 with a group of PAs who were driven to build and pave the roads to more and better jobs, better laws, better reimbursement and wider acceptance of the then new PA profession. They knew if they didn’t do something, PAs could be left behind. In today’s climate of health care reform, decreasing reimbursement and the turf battles that go with it all, we need to hold on to and honor that commitment to promoting and protecting California PAs or we may find ourselves left behind.
For those who visited the Visions Lab in the exhibit hall, the look to the future and the part each of us will play in our own success (impacting always on the overall success of PAs) was looked at more closely. Stationed at the Lab were “visionaries” available to spend time with visitors to focus on their own career vision. To see some of the Playsheets (not Worksheets J) used in the Lab, go to http://www.capanet.org/ annual-conference/visions-lab/. There are some great documents there to get you thinking. It is a great time of year to take a close look at your vision for your future.
Visions Lab Many also visited the Visions Lab Studio to record their answers to the following three questions: 1. Where were you in 1976? 2. Was medicine on your radar? 3. Where do you see yourself professionally in 2026?
Visit http://www.youtube.com/user/CAPAConnection To See The Visions Videos Treat yourself to some or all of the short videos (typically 1 minute) shot in the Visions Lab Studio. They really are fun to watch and will inspire you. You may see an old classmate or colleague! Special thanks to Chase Hungerford, our Videographer in the Visions Lab Studio. And, thank you to the PAs who shared their funny, heartwarming and inspirational reflections.
NOVEMBER/DECEMBER 2011 | 17
The Next 5 Years...
Celebrating Our Successes and Looking To...
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The Next 5 Years...
NOVEMBER/DECEMBER 2011 | 19
The Next 5 Years...
PAC at Palm Springs Conference 2011 by Cherri Penne-Myers, PA-C, MSCS, Secretary and CAPA PAC Committee Chair Allen, PA-C; Dr. Daniel Amen; Justin Myers; Newport Beach Vineyard and Winery; Georgette Laurenzano, Licensed Aesthetician; Lorraine Halverson; Sally Tilsen, PA-C; Alex Panzardi; Covidien Specialty Pharmaceuticals; Michael De Rosa, MPH, PhD, PA-C; Beth Grivett, PA-C; Greg Mennie, PA-C and Teresa Anderson, CAPA Public Policy Director. Many of these donors are repeat donors and I would like to give a special thank you to them for being so very supportive of the CAPA PAC for the past few years.
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hirty-five years of CAPA. Wasn’t this year’s Palm Springs conference awesome? Thank you to all the PAs that stopped by the CAPA PAC Booth in the Exhibit Hall and the CAPA PAC table in the Renaissance Ballroom foyer. I would like to express sincere appreciation to all who stopped to say hello, took a turn at the Spin Wheel, bid on the Silent Auction items, bought a school fan to stay cool with or wave during the Student Challenge Bowl, or just handed us a donation. All of these CAPA PAC fundraising activities, of course, could not have been done without a lot of planning, helpers and donations for the Silent Auction. I extend thank yous to the CAPA office and staff (Gaye, Barbara and Denise). They were instrumental in so much behind the scenes work. I also had assistance from Student Ambassadors from many of the PA programs during the conference. Much appreciation to all of you for helping out with the CAPA PAC Booth in the Exhibit Hall and CAPA PAC table. All of you did an excellent job communicating the purpose and goals of the CAPA PAC.
We also had two very special PAs who continue to donate many hours working with the CAPA PAC at the CAPA conference. Thank you to Vickie Cranford-Lonquich, PA-C and Maria Caserio, PA-C! I would like to thank the following individuals for their donations to PAC Silent Auction: Margaret
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Thank you for the continued support to the CAPA PAC. If you would like to make a donation to CAPA PAC, you can visit the website, go to the flashing CAPA PAC link and then the contribution link. Any contribution is helpful.
Why Have A CAPA Political Action Committee (PAC)? A PAC is an organization set up to provide financial support to candidates seeking public office. We cannot use membership dues or other money from our general fund to contribute to candidates. Your PAC contributions allow us to have a voice with legislators. It opens doors. PACs are powerful because candidates are dependent on fundraising in general and PACs in particular. The contributions made through the CAPA PAC are made ignoring party lines. Your PAC Board focuses on the wellbeing and promotion of the PA profession in California. I look forward to seeing everyone again next year at the CAPA Conference in Palm Springs. I also look forward to meeting more of you at CAPA at Napa in February 2012. CAPA’s
Political Action Committee
Honoring Our Past and Just Two of the Leaders Who Got Us Here Miguel Medina, PA-C On Friday, September 23, Bob Miller, PA-C, Past President and PPC Chair, presented an award to past CAPA President, Miguel Medina to acknowledge the major role he played in the development of the Controlled Substances Education Course (CSEC). He moderated and proctored each and every one. On Wednesday, September 21, the 21st Controlled Substances Education Course was held. It was Miguel’s 21st and the last of the courses he would moderate. Mr. Medina (as he is lovingly known by his students past and present), adds such integrity to all he does. We know the 3,400+ PAs who have taken the CSEC to date, have appreciated Miguel’s commitment to educating California PAs.
Thank you, Mr. Medina.
Our special thanks to Greg Mennie PA-C and the band for creating a truly magical afternoon at the CAPA Conference. It really was incredible. If you have an event and are looking for a fabulous cover band or would like to know where the group is playing, you can visit their website at:
www.taxiwisdom.com.
2011 American PA Idol
Steph o n CAPA You Tub e
Cyndy Flores, PA-C On Saturday, September 24, Beth Grivett, PA-C, Past President and LAC Chair presented an award to past CAPA President, Cyndy Flores, PA-C who served as CME Committee Chair for 10 years (2000-2010). During her Presidential year, the CME Committee Chair resigned in the middle of his term. There was no choice but to quickly fill the position and Cyndy stepped in “until she could find someone qualified.” Ten years went by and there was never anyone more qualified than Cyndy Flores! She is a wizard. She took the CAPA Conference to new heights in organization and sophistication. Cyndy’s capacity to keep track of hundreds of issues/ tasks/projects/people, etc. seems limitless.
Steph o n CAPA You Tub e
Congratulations to CAPA’s 2011 American PA Idol, Stephanie Rolfo, PA-C with a repeat PA Idol victory performance of Let Your Hair Down!
Thank you, Cyndy! NOVEMBER/DECEMBER 2011 | 21
Interprofessional Education by Roy Guizado, MS, PA-C, Student Affairs Committee Chair and Director-At-Large
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nterprofessional education (IPE) is a common buzzword these days in PA schools and is beginning to filter out to the medical community at large. Interprofessional education “occurs when students from two or more professions learn about, from, and with each other to enable effective collaboration and improve health outcomes. Interprofessional education is a necessary step in preparing a ‘collaborative practiceready’ health workforce that is better prepared to respond to local health needs.” Source: World Health Organization (2010): Framework for Action on Interprofessional Education & Collaborative Practice. IPE has provided opportunities for medical education institutions to develop strategies resulting in innovative ways to educate students from various health professions. The main goal is to increase the knowledge of the scope of practice of other’s professions which is accomplished by the use of technology. IPE in the medical education institutions is developing student networks to facilitate the exchange, integration and application of knowledge in an ethically acceptable manner. It is hoped that the students will take this collaborative exchange with them after graduation and develop similar methodologies in their practices. It has been proposed that IPE, through its patient-centered health professional collaborative model, can provide better comprehensive health care at a lower cost than the current health care model. 22
CAPA NEWS
Why should the PA profession embrace IPE? Health care is an everevolving science and IPE can be an effective tool to address many of today’s pressing issues. For example, the changing focus of health care reform requires the collaboration of all health professionals to work together in a patient-centered system and where individual silos of medicine can collaborate for the good of the patient and health care. This new paradigm of rapidly evolving scientific knowledge, in all aspects of medicine, requires knowledge sharing among health professions. The rapidly aging society is another impetus for IPE. Medicine, as it has been traditionally accessed, is now overwhelmed. As more baby boomers start to retire and face the health complications of aging, the need for increased access will grow exponentially. Health care providers will need to collaborate even more effectively and efficiently to meet the demands that are imminent. There are, unfortunately, some barriers to the acceptance of the IPE concept. As IPE is not the current medical model, there are no true role models to follow. Canada has been one of the leaders in IPE, but a working model is still being developed. Some medical teaching institutions throughout the United States have also been exploring ways to incorporate IPE into the education of current students. However, IPE has not been fully realized by the general health care mainstream. One of the main areas of concern and resistance centers on reimbursement issues. In a collaborative practice, who bills and receives payment for services - all the providers or just the main provider? This question needs to be further explored.
More hesitancy in accepting IPE involves patients’ logistical challenges. What would the collaborative care appointment look like? Let us look at a hypothetical diabetes patient. It is conceivable that a diabetic patient visit would require a history and physical from a provider like a PA or physician for a general assessment of health. They would also need an optometric evaluation for retinopathy, a podiatric evaluation for foot neuropathy, pharmaceutical evaluation for the efficacy of the current medical regimen and a dietetic evaluation for proper food choices and weight control. These are routine examinations and the list gets larger if the patient needs to see an endocrinologist, nephrologist or a dentist. How are these appointments logistically handled? Does the patient schedule a two-hour “one-stop shop appointment” where the health professionals go to the patient or do the health professionals have small rooms in close proximity to one another where the patient can ambulate from appointment to appointment? Another reason for not readily accepting IPE is that it is different from the current paradigm. Health professionals, like most people, are hesitant to embrace change, especially when the change is a distinct departure from the routine. The philosophy behind IPE is collaboration and patient-centeredness, which has always been the heart of PA education. We have always worked in collaboration with our physicians, nurses, and other health professionals because this is who we are and how we are educated. Currently, PA program accreditation requires IPE in student curriculum. PAs, in general, should easily adapt to the IPE philosophy. It is nice to see that PAs are ahead of the IPE learning curve.
Special Call for: CME Program Development Committee Members
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o you have an interest in helping to develop the educational programs for CAPA’s CME Conferences? We are looking for CAPA members who would like to help us identify gaps in medical knowledge of PAs working in various practices/ specialties. Once we identify the needs of our potential audience, we will come up with lecture topics. We will then need to find exceptional speakers to address those topics. We are very discerning in our speaker selection which makes for an excellent program and ensures a quality conference for those who attend. This is no easy task, but with a Committee of PAs who work in various specialties/ settings, it is manageable and we make it fun as well! Most, if not all, of the CME Program Development Committee meetings will be via conference call at a time determined to be convenient for the majority of the participants. Most of the communication will be done through email. Your time commitment should be no more than an hour or two each week for a period of about six months. The CME Committee’s term is November 1 through October 31 each year. The CME Program Development Committee is a sub-committee of the CME Committee. If you have an interest in helping to develop the Conference program, helping to find excellent speakers and at the same time becoming more involved with CAPA, we want to hear from you. No previous experience is required. If you are particularly adept at writing learning objectives or have experience with doing needs assessment, you are at the top of our wish list and we hope you contact us soon.
To apply to be on the CME Program Development Committee, please send us an email or letter describing why you think you would be a good fit for the Committee, what your particular interests are (if any), and any experience you have that would aid you in your assignments and what kind of practice you are in. There are several positions open on this Committee.
Evaluation
The deadline to apply is January 31, 2012. You may email your information to capa@capanet.org using the following subject line: CME Program Develop-
ment Committee or mail it to: CME Program Development Committee, 3100 W. Warner Avenue, Suite 3, Santa Ana, CA 92704. The selection process will be complete by mid February. If you have questions, please contact CME Chair, Eric Glassman, PA-C via email at cme@capanet.org. Thank you.
d Hear eat r Any G ers k Spea ? ly Late
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very year at the CAPA Conference in Palm Springs we hear it said: “You guys have the best speakers. How do you do it?” The answer is we hand pick them based on referrals, feedback and firsthand experiences. Please help us identify the great speakers out there. Keep your ears open for interesting topics and excellent speakers. Please let us know what/who they are. You can email, call and/or fax us the information.
Please Give Us A Call Or Send Us An Email. Email: capa@capanet.org Phone: (714) 427-0321 Fax: (800) 480-2272
NOVEMBER/DECEMBER 2011
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Caution: Telephone Advice
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hysician Assistants (PAs) give telephone advice in a variety of settings. The PA who responds to a patient’s question about a new prescription or takes a patient’s concerned call about new symptoms is in the position to provide valuable information and make important assessments. But in their eagerness to help patients, PAs must be careful not to expose themselves to legal risks. Here are some tips to protect yourself while providing patients with quality information. Consistency counts Consistency helps ensure that questions are answered completely and effectively. Protocols and responses to frequently asked questions are useful tools that also reduce legal risk. Tools should be predicated on current standards and evidence, so be sure to review them on a regular basis and update as needed. PAs who will be responding to questions should receive special training in how to conduct an assessment over the phone. Allow time to talk Allow plenty of time to talk with the patient so that you establish a connection and fully
answer any questions. To increase the patient’s understanding, explain why you or the care team made a recommendation, for example, in the case of a new prescription. For instance, you might say that research supports a particular prescription in the patient’s particular situation. Use a strategy called “teach back” to ensure the patient understands. In this method, patients state their understanding of key elements of the information they receive. This gives you the opportunity to correct misunderstandings right then and there. If it isn’t written… In the hectic rush of the day, it’s easy to neglect documenting telephone calls. Treat each clinically related telephone call the same way you would a face-to-face visit: Document the conversation, the assessment, the advice given, and any follow-up instructions given to the patient. Regular review of documentation will help maintain quality and identify areas of improvement. If you are ever involved in a malpractice lawsuit or brought before your state licensing board, how you documented, what you
documented, and what you didn’t document will influence the outcome of the trial. Building relationships Remember that giving advice over the phone establishes a relationship with your patients. Keep your clinical skills—and telephone skills— sharp so that the relationship yields positive results. It can help avoid a day in court and protect patients from harm. 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.
CAPA0111A_Layout 1 1/13/11 2:12 PM Page 1
You’re “on-call” 24/7. Make sure your malpractice coverage is too.
Individual professional liability coverage at competitive rates.
Physician Assistant Professional Liability Insurance 888.273.4686 | www.hpso.com/cnews This program is underwritten by American Casualty Company of Reading, Pennsylvania, a CNA company, and is offered through the Healthcare Providers Service Organization Purchasing Group. Coverages, rates and limits may differ or may not be available in all states. All products and services are subject to change without notice. This material is for illustrative purposes only and is not a contract. It is intended to provide a general overview of the products and services offered. Only the policy can provide the actual terms, coverages, amounts, conditions and exclusions. CNA is a registered trademark of CNA Financial Corporation. Copyright © 2011 CNA. All rights reserved. Healthcare Providers Service Organization is a division of Affinity Insurance Services, Inc.; in CA (License #0795465), MN and OK, AIS Affinity Insurance Agency, Inc.; and in NY, AIS Affinity Insurance Agency. ©2011 Affinity Insurance Services, Inc. CAPA0111A
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CAPA NEWS
CAPA Congratulates Past President and Current Professional Practice Committee Chair, Bob Miller, PA-C For 30 Years of Service as a Medical Coordinator at Camp Blood Brothers & Sisters Reprinted with permission from HemophiliAction, Volume 6. Issue 6, Spring 2011
Bob Miller Volunteer Spotlight
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ollowing my PA training, I worked in the Pediatric Emergency Room at L.A. County - USC Medical Center. It was fast paced and I learned a lot but there was little opportunity, in an emergency setting, to follow patients over time. I developed an interest in children who had different types of bleeding disorders and soon found myself on the team taking care of pediatric hematology / oncology patients. After 11 years at LAC – USC, I was recruited by Dr. Gomperts of Children’s Hospital Los Angeles to be a member of the Hemophilia Treatment Center. I’m entering my 30th year there. I was quickly learning how unique the hemophilia community is - with not only such a high level of knowledge about the disorder and its treatment, but also how this relatively small group works together for support and strength. I was invited to get involved and going to camp seemed to be a good first step. I first went to Southern California hemophilia camp in 1982 and have been going ever since. After that first year, I was “hooked.” So, 2011 will be my 30th year coordinating and providing medical coverage for the campers. I’ve never had an “official” title but my role at camp has been to coordinate the medical coverage for both before and during camp week. This has included the pre-camp application process, the just-before-camp check-in at the bus and the scheduling of our staff of hemophilia experts to ensure a safe environment at the camp. I have always had many others to help with these efforts over the years; including camp staff, nurses, physical therapists, pharmacists, physicians, and of course - Foundation staff. It has been a tremendously rewarding experience to watch these children grow into adults over the years and maintain the close friendships that began during their first week at camp many years before. There has also been a dedicated core of counselors, industry supporters and other Blood Brothers & Sisters staff who have given their time year after year to make that week special. They just keep coming back for more … and loving it. Everybody wins. Everyone associated with camp should look at the camp “Hall of Fame” which recognizes the icons of the camp’s history. These were, and are, some of the folks who made camp a huge success throughout the years. Camp has changed over the years. What began as a camp for boys and men with hemophilia or other bleeding disorders, was rocked when girls were then invited and entered the scene. It was no longer just about sporting activities and competition. These new campers brought a whole new complexity to camp. An important new question arose … who would dance with whom on dance night? I think one of the most gratifying experiences at camp is when a young camper sticks himself successfully for the first time at camp and earns the “Big Stick Award.” This is a huge milestone that is proudly accepted with roaring applause and enthusiastic yells from everyone at campfire that night. It’s a big deal! It’s a big stick - appropriately adorned with bells and whistles - making it a unique and meaningful trophy. And the applause continues after camp when the parents and family learn of his accomplishment and the Big Stick finds a prominent place for display in his bedroom.
Professional Leadership Award Bob Miller, PA-C For your loyal dedication, outstanding contributions, and unwavering commitment as a medical coordinator at Camp Blood Brothers & Sisters since 1982. NOVEMBER/DECEMBER 2011
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Registe r Today
s 6 Hour Cat. I CME
Controlled Substances Education Course A Course Which Upon Successful Completion Will Allow You To Write For Controlled Substances Without Patient Specific Approval* Sunday, February 26, 2012 Napa Valley Marriott 3425 Solano Ave Napa, CA 94558 (707) 253-8600
Saturday, April 28, 2012 University of Southern California Health Sciences Campus Mayer Auditorium, Keith Admin. Bldg. 1975 Zonal Ave Los Angeles, CA 90089
Saturday, August 25, 2012 Samuel Merritt University Fontaine Auditorium, Health Education Center 450 30th St Oakland, CA 94609
*California Code of Regulations Sections: 1399.541(h), 1399.610 and 1399.612. A PA may administer, provide, or issue a drug order for Schedule II through V controlled substances without patient specific approval if the PA completes specified educational requirements and if his/ her Supervising Physician delegates the authority to them. Courses will be canceled if minimum number of registrants is not met.
Comments From Previous Courses Newport Beach—November 1, 2009 “Both speakers were excellent. Mr. Adler especially was clear and concise and provided numerous practical tools and advice for handling complex situations involving patients that truly need opioids and tips for identifying diversion attempts.”
La Jolla—March 6, 2010 “This course was very interesting and helpful. Well worth my time (aside from CME’s and the certificate). The slides printed in the handouts were a very useful reference.” “Thank you, the course answered many questions for me today and reassured me about my approach to dispensing controlled substances. I can’t wait to sign up to use the CURES system, we will be on our way to hopefully identifying problem patients and getting them help.”
Sacramento—July 24, 2010 “Sensational! PA/Physician driven education is paramount in the PA profession. Thank you!” “I learned some new things and reviewed others. Great course! Thanks!”
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CAPA NEWS
Palm Springs—September 21, 2011 “Enjoyable yet informative presentations from Dr. Lowe and Jeremy Adler, PA-C. Both instructors made the topics discussed interesting and applicable. Thank you!” “Excellent course, I learned a lot. I will use this information next week when I return to work. Very helpful. Thank you.”
Los Angeles (USC)—January 16, 2010 “Enjoyed both lectures; very good personal experiences injected into each lecture. Both lecturers complimented each other. Catering was a good choice.” “Going home and back to work with some very helpful tools! Thank you both!” “The course was informative and helpful. I learned new things I was not aware of in the use of prescribing controlled substances. Thank you!”
Cont Subs rolled ta Co nces on Suurse nday
One-Day Conference in Napa at the Napa Valley 6 Hours of Cat. I CME
Saturday, February 25, 2012 8:45 a.m. - 4:30 p.m.
CAPA at Napa
Register online at www.capanet.org
Sponsored by the
Join us in Napa. We have developed an excellent educational 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!
Program
California Academy of Physician Assistants Application has been made to the American Academy of Physician Assistants (AAPA) for 6 hours of Category I CME credit. Approval is pending.
Registration Form
Registration
Name________________________________________________________
8:00 a.m. – 8:45 a.m.
Continental Breakfast and Exhibits
PA-C PA PA-S NP MD/DO Other___________________
8:45 a.m. – 9:40 a.m.
PA License #___________________________________________________
Perspectives in Rheumatoid Arthritis for the Physician Assistant Robin K. Dore, MD
9:40 a.m. – 10:30 a.m.
5 Can’t Miss EKGs Jennifer Carlquist, PA-C
State________________________________ Zip Code_________________
8:00 a.m. – 8:45 a.m.
Look Behind the Mask of Depression: Latest Updates, New Medications and Case Presentations Jeffrey A. Applebaum, MD, FAAFP 10:30 a.m. – 11:20 a.m.
11:20 a.m. – 12:05 p.m.
Break and Exhibits
12:05 p.m. – 1:05 p.m.
Choosing Empiric Antibiotic Therapy in Children Tim Nicholls, MD
1:10 p.m. – 1:25 p.m.
President’s Address and Presentations
1:25 p.m. – 2:25 p.m. Lunch (not eligible for CME) Hereditary Angioedema Speaker TBA 2:30 p.m. – 3:20 p.m.
Evaluation of Liver Tests JoAnn Deasy, PA-C, MPH
3:20 p.m. – 4:15 p.m. Vascular Complications of Type 2 Diabetes Susan Cornell, BS, Pharm.D., CDE, FAPhA, FAADE 4:15 p.m. – 4:30 p.m.
Prize Drawing and Closing
Address____________________________City________________________
Phone (____)___________________ Fax (____)_______________________ Work Address__________________________________________________ City_________________________________________________________ State________________________________ Zip Code_________________ Phone (____)___________________ Fax (____)_______________________ CAPA Member - $110 Non-Member - $200 PA Student - $50 Late Registration Fee after February 1, 2012 - add $20 Bring a Guest to Lunch - $25 (must be over 18) Name(s)_________________________________________________ Vegetarian Meal Required
Total Amount $______________
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.
6 Hours Category I - CME Credit Applied For
Mail Registration Form and make checks payable to:
Application has been made to the American Academy of Physician Assistants (AAPA) for 6 hours of Category I CME credit. Approval is pending. Courses will be canceled if minimum number of registrants is not met. The planners and sponsors of this function claim no liability for the safety of any attendee while in transit to or from this event. The planners and sponsors reserve the right to change speakers and/or cancel the event due to unforeseen circumstances without penalty. The total amount of any liability of the planners and sponsors will be limited to a refund of the registration fees.
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
CAPA
or Register online at: http://www.capanet.org
NOVEMBER/DECEMBER 2011
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CAPA Launches Prescription Drug Discount Card to Help Californians Access/Afford High Quality Health Care
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ifficult economic times are forcing many Californians to make difficult choices every day about whether to continue taking medication or to feed their families and pay rent, while many Californians are simply unable to afford quality health care in the first place. To help expand access to high-quality, cost-effective care for all California citizens, CAPA has PArtnered with NeedyMeds, a national non-profit organization, to launch a prescription drug discount card that will help Californians lower the costs of their medications and other health care services. The discount card is free and can be used by all California families to save up to 80% off the cost of prescription medications. CAPA will rely on its members and participating allied health care providers and health groups to help distribute the card. Call (714) 427-0321 or email the CAPA office at capa@capanet. org to receive a supply for your practice. You may request up to 500 cards. We will send them to you at no charge. Contact us today for your supply. Below are a few common questions about the prescription discount card, as well as additional useful background information.
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CAPA NEWS
Why is CAPA launching a prescription drug discount card? Part of CAPA’s core mission is to expand access to high-quality and cost-effective care for all Californians. The CAPA drug discount card will help reduce out-of-pocket costs for California consumers, help patients stay healthy, and reduce long-term health costs for California families. “At a time when all California families are trying to stretch their budget dollars, every little bit helps. CAPA hopes that all Californians, but particularly those from vulnerable or low-income communities, will use the discount card to help afford treatment and stay healthy,” said CAPA President, Eric Glassman. “Ensuring that all Californians have access to high quality care is not only the right thing to do from a health perspective, but also makes good financial sense. When patients are healthy or are effectively managing their conditions, it can mean lower long-term health care costs in the form of fewer treatments or fewer visits to doctors and emergency rooms that are often associated with worsening conditions.” The CAPA drug discount card will help keep costs manageable while also helping to ensure that Californians stay on their doctor-prescribed treatment regimes. CAPA hopes that all Californians, but particularly those from vulnerable or low-income communities, will use the discount card to help afford treatment and stay healthy.
Who can use the CAPA drug discount card? Anyone. The CAPA drug discount card is free and open to all Californians. There are no income, insurance or residency requirements, and no fees or registration process is needed to use the card. One card
can be shared with friends and family members, or patients can print their own from www.capanet.org.
Where can patients use the CAPA drug discount card? The drug discount card is accepted at over 60,000 pharmacies nationwide, including Walmart, CVS, Walgreens, Rite Aid, and other regional chains and local stores. To locate pharmacies in your area that will accept the CAPA/NeedyMeds card, please visit the NeedyMeds website www. needymeds.org/drugcard/index. htm and search for participating pharmacies by zip code.
Can patients use the CAPA drug discount card in conjunction with insurance? No, patients cannot combine the card with insurance. The card can, however, be used instead of insurance if the insurance has no drug coverage, there is a high deductible, there is a low medicine cap that has been met, there is a high copay and the card offers a better price, of if a consumer is in the Medicare Part D “donut hole.”
How do consumers use the CAPA drug discount card? To use the CAPA drug discount card, a California consumer simply presents the discount card to his or her pharmacist along with the desired prescription, at which point the pharmacist will tell the consumer how much can be saved using the card. For more information about the CAPA Prescription Drug Discount Card, or to download a copy of the card, please visit: www.capanet.org. For more information about medical assistance programs, please visit www. needymeds.org.
Most Physicians Don’t See PAs as Major Liability Risks by Alicia Gallegos, July 6, 2011 issue of American Medical News, reprinted with permission
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he majority of emergency physicians do not believe physician assistants, when properly supervised, pose a higher risk of medical negligence than other health professionals, says a study published in the June issue of the Journal of the American Academy of Physician Assistants.
Seventy-five percent
The study, based on a 2009 survey of American College patient satisfaction, of Emergency Physicians memcompared with 65.2% bers, found that 67.9% disagreed in 2004. that PAs are more likely than doctors to cause negligence. The same survey sent to ACEP members in 2004 found comparable results, with 71.6% of doctors saying PAs do not pose increased liability risks. The two surveys were based on 724 responses.
said PAs increase
The 2009 study showed that 81.8% of doctors disagreed that PAs were more likely than physicians to be sued, a slight decrease from 84.3% in 2004 (www.ncbi.nlm.nih.gov/ pubmed/21682175/). Few studies have previously examined physicians’ perceptions of PAs and their liability risk, said study co-author James Stoehr, a professor with the Midwestern University physician assistant program in Glendale, Ariz. Researchers wanted to learn how doctors felt about PAs as well as analyze work-force trends among physicians and PAs. From 2004 to 2009, the number of doctors practicing with PAs increased by 26%, according to the study. The number of doctors directly supervising PAs in the emergency department rose by 19%. A significant correlation was found between perceived risk of medical negligence by PAs and the number of years physicians had practiced with PAs.
“As with the 2004 data, as physicians gained more experience with PAs, their perceived risk of PAs [committing] medical malpractice decreased,” Stoehr said. The survey also asked doctors whether PAs contribute to patient wait times and overall patient satisfaction. Ninety-one percent in 2009 agreed that PAs reduce wait times, an increase of 6% from 2004. Seventyfive percent said PAs increase patient satisfaction, compared with 65.2% in 2004. Despite PAs being relatively new to the medical scene, it’s apparent physicians’ opinions of PAs are improving as their relationship grows, said study co-author Mark Hyde, a PA at the University of Utah Huntsman Cancer Institute in Salt Lake City. “The key that we really want to emphasize is the physician and PA team approach [in medicine],” he said.
Celebrating PA Week 2011
NOVEMBER/DECEMBER 2011
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This seminar is not sponsored by or affiliated with the California Academy of Physician Assistants
Students Students Students Students Students Students Keck School Expands PA Program Reprinted with permission from USC’s Back to News & Publications, Tuesday, October 18, 2011
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Physician assistant student Jessica Lee chats with passersby at Harry and Celesta Pappas Quad on Oct. 6. Lee helped staff a booth aimed at educating people about the role of physician assistants as part of Physician Assistant Week. Photo by Jon Nalick.
s the demand for health care professionals grows, physician assistant (PA) programs across the country are expanding. The USC Primary Care Physician Assistant Program received a $704,000 expansion grant from the Health Resources and Services Administration (HRSA). The grant allows for four additional students in each class over the next three years, bringing the class size to 54, and provides each of those additional students with $22,000 to be applied to their tuition over two years. The USC Primary Care Physician Assistant Program has been continually accredited for the past 35 years and will graduate its 40th class in 2012. There are currently 159 accredited PA programs
in the United States, with another 42 seeking accreditation over the next four years, according to Kevin Lohenry, who earlier this year succeeded Anne Walsh as director of the USC Primary Care Physician Assistant Program. “The shortage of health care providers that is projected for 2020 is behind the big push for this expansion,” said Lohenry. Lohenry took part in a workforce taskforce for the PA profession this past spring and says it is predicted that less than a decade from now the U.S. will see a shortage of 91,000 physicians across primary care and specialties. The shortage is due to overall population growth compounded by the aging baby boomer set and more than 30 million people gaining access to health care through the Affordable Care Act. “The PA profession has been looking at this to try to determine what we should be doing as part of that team
Students Celebrate PA Week with a Community Health Fair
practice,” Lohenry said. “We recognize that there is a need for our profession to expand, but there is also a need to break down barriers to expansion in our profession as well.” A number of states, including California, limit the number of PAs a physician can supervise. Lohenry said those laws may change as more patients require access to health care and become more comfortable with non-physician providers. The average PA student graduates with a master’s degree in 26 months. Given medical school’s greater investment of time and money, the PA program provides an attractive alternative to prospective students. The program also offers greater flexibility to switch specialties after graduation. As the program grows, it will remain dedicated to recruiting students from diverse backgrounds so that a number of them can be deployed to underserved communities.
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people. Together with students from the other graduate programs within USC and Keck, they also provided free glucose tests, visual acuity tests, blood pressure screenings, diabetic foot check, and numerous educational booths. Impressively, services were offered in both English and Spanish by students from different medical professions working side-by-side as a team, or even better, as part of the same Trojan family.
Determined to offer as many free services to this underinsured LatinAmerican community as possible, our students secured enough free flu shots from the County of Los Angeles to vaccinate over 100
The program would like to recognize the following student leaders from the Class of 2013 who made this event a success: Sara Coburn, Kimberly Ely, Jessica Lee, Kristina Lynch, Ali Marcus, Diana Nguyen, Isabelle Pamart-Tran, Victoria Pittman, and Jiami Zhang Uy. These students comprise USC’s student chapter of the national PA organization (AAPA). We would also like to express our appreciation to the students from our Trojan family in the schools of Dentistry, Pharmacy, and Occupational Medicine who helped make this event a success. Go Trojans!
by Jessica C. Lee, PA-S, CAPA Member
tudents from the USC Physician Assistant program conducted a health fair on October 1, 2011 at the Barrio Action Youth and Family Center in El Sereno, one of many underserved surrounding communities. They named this event the “ProActive Health Fair” to reflect their desire to promote preventative medical care and the PA profession during PA Week, October 6-12. This was the first interdisciplinary health fair of its kind for the PA Program involving, not only students from the USC Primary Care Physician Assistant Program, but also students from the USC Schools of Pharmacy, Dentistry and Occupational Therapy.
NOVEMBER/DECEMBER 2011
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Students Students Students Students Students Students PAying for PA School by Joy Dugan, PA-S, Student Representative
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re you nervous about the high cost of your PA education? For many of us, it’s something we just try not to think about until we get the first bill in the mail after graduation. Fortunately, numerous opportunities are available to help pay off the cost of tuition both as a student and after graduation. One of the benefits of being a CAPA student member is you are
eligible to apply for one of the 3 $1,000 scholarships available. To apply, you currently need to be in good academic standing and enrolled in a California PA program, a California resident and demonstrate financial need. (See CAPA Student Scholarships information below.) AAPA also has multiple scholarships available through the PA Foundation for AAPA student members. Applications are being accepted for The Annual PA Foundation Scholarship. Check out the AAPA’s website for more details at http://www.aapa.org/ about_aapa/philanthropy/resources/ item.aspx?id=1872.
You can also get a little money while on rotations if you do a CalSEARCH rotation. California Student Experience and Rotations in Community Health or “CalSEARCH” is funded by the U.S. Department of Health and Human Services and Health Resources and Services Administration (HRSA) through the National Health Service Corps (NHSC). The mission of this program is to “increase the recruitment and retention of culturally competent, community oriented health professionals in California’s community clinics and health centers (CCHCs).” In exchange for rotating at a CCHC,
CAPA Student Scholarships The Ruth Webb Minority Scholarship $1000 Scholarship
Ruth Webb served as program director for the Charles R. Drew University PA Program for several years, and was actively involved with numerous local, state, and national professional organizations. She was not one to sit back and let others do the work. She took a very active role doing committee work. She served as Vice Chair of the Board on Medical Quality Assurance, member of the Physician Assistant Examining Committee, member of the California Council of PA and NP programs, and founding member of the LA County Joint Practice Advisory Council on NPs and PAs. Known for “keeping it real,” she would do whatever it took to help students achieve the goal of becoming a PA-C.
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CAPA NEWS
The Ray Dale Memorial Scholarship $1000 Scholarship
Ray Dale served as Executive Officer of the Physician Assistant Committee from 1980-2000, and was instrumental in the development and growth of CAPA as an organization representing our profession. Working with the Department of Consumer Affairs, he would give CAPA good counsel and support regarding legislative issues, and would help by acting as our “lobbyist” and “attorney” when CAPA could not afford one. He contributed his time and his efforts to the growth of the PA profession and protection of its consumers.
The Community Outreach Scholarship $1000 Scholarship
This scholarship will be awarded to a student who is currently in good academic standing and has demonstrated community outreach and other philanthropic activities as a student. Student Members of CAPA currently enrolled in primary care PA Programs located in the state of California are eligible to apply for CAPA scholarships. The deadline to apply for the three $1,000 CAPA Scholarships is December 31, 2011. Please visit the CAPA website for an application and for eligibility requirements.
Students Students Students Students Students Students SJVC Trifecta Winners of the 2011 Student Challenge Bowl you will receive a $700 grant. You must implement a small publichealth type community project (e.g., create an informational pamphlet on Diabetes, nutrition, etc.) and complete a 3-5 page report about your experience. The Indian Health Services also has programs to help pay for your loans as a student and after graduation. If you are a member or descendent of a federally-recognized American Indian or Alaska Native Tribe, band or community, you may qualify for Indian Health Services Scholarship Program. Loan repayment programs are available, up to $20,000 per year after taxes, for any U.S. citizen interested in working for the Indian Health Service. Opportunities are available within California. The National Health Service Corps (NHSC) offers scholarships and loan repayment programs to help recruit PAs and other medical professionals to work in Health Professional Shortage Areas (HPSAs). The NHSC Scholars Program will fund tuition, required fees, education costs, and a monthly stipend for related expenses in exchange for service at a NHSC site. A 1-year service commitment is required per scholarship year with a 2-year minimum. The NHSC Loan Repayment Program requires a 2-year full-time commitment for a $65,000 disbursement to be applied to your student loans. Half-time service commitments are also available, 2-year commitments receive up to $30,000, while 4-year commitments receive up to $60,000. Similar to the NHSC, the State of California also has a State Loan
Repayment Program with various service terms and loan repayment programs. There are also numerous opportunities with the Air Force, Army, Marines, Navy, and National Guard for debt relief in exchange for your service. Check out their individual websites for specific opportunities and requirements.
Winners of the CAPA Membership Growth/ Pizza Party Contest Winner of the 2011 American PA Idol Competition, Stephanie Rolfo, PA-C; SJVC Graduate
Thank You to Our 2011 Student Ambassadors
In the next CAPA News, I will be interviewing PAs participating in the NHSC and Cal-SEARCH program. Good luck in your application to each of these programs.
Links: CAPA: http://www.capanet.org/ members-only/scholarships/ Cal-SEARCH: http://www.oshpd. ca.gov Indian Health Services: http://www. ihs.gov/JobsCareerDevelop/DHPS/ scholarships/index.cfm NHSC: http://www.nhsc.hrsa.gov/ loanrepayment/ PA Foundation: http://www.aapa. org/about_aapa/philanthropy/ resources/item.aspx?id=1872 SLRP: http://www.oshpd.ca.gov/ HWDD/SLRP.html
Sarah Coburn, PA-S......................................USC Joy Dugan, PA-S.........................................Touro Autumn Fingerson, PA-S.............................Touro Zach Hathway, PA-S...................................Touro Coleman Ho, PA-S......................................Davis Ismah Jawed, PA-S...................................Western Teah Kerr, PA-S........................................Western Stephanie Mireles, PA-S................................USC Alissa Nguyen, PA-S.................................Western Sarah Schrader, PA-S................................... Touro Natalie Shitara, PA-S.....................................USC Saloni Swarup, PA-S.................................Western Jessica Walters, PA-S.......................... Loma Linda Olivia Wu, PA-S..........................................Touro
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Students Students Students Students Students Students Touro Student-Run Health Clinic Celebrates One Year of Service by Matt McCartt, PA-S, CAPA Member
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pressure, blood glucose monitoring, Osteopathic Manipulative Medicine, immunizations, health education and referrals.
October 6th, 2011, the clinic celebrated its one year anniversary of serving the Vallejo community. Over the course of the last year, the clinic has served many people in the community by providing much needed health care in Vallejo,
To celebrate its success with the community, SRHC hosted a Grand Opening Event on October 26th at the SRHC’s home, the Norman C. King Community Center. The event included cooking demonstrations, health education, Youth Olympic events and many health resources from the community. The SRHC looks forward to continued expansion of its services and serving the Vallejo community for many more years.
ince October 6th, 2010, the Student Run Health Clinic’s (SRHC) mission has been to create an interprofessional student run free clinic that focuses on improving access to health care for Vallejo residents while improving the clinical and educational skills of students at Touro University California.
sponsoring and attending many area health fairs and expanding their services to meet the needs of Vallejo. Students from all disciplines spend their Thursday afternoons serving the community in an interprofessional learning environment under supervision of the SRHC’s dedicated clinical preceptors. The SRHC provides screening physical exams, medication review, blood
Project Homeless Connect by Sarah Schrader, MS, PA-S
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n the rainy morning of October 6, 2011, the community of Vallejo came together for Project Homeless Connect. At this event, held at a Union Baptist Church, the homeless were provided a variety of services that included: HIV testing, haircuts, veterinary services, dental health, BP, blood sugar screening, legal help, employment services, free books, and the list goes on.
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CAPA NEWS
Touro University California Physician Assistant students participated in this event by providing blood pressure and blood glucose screenings, as well as, condom giveaways and patient education. All this was done under the supervision of Dr. Ingrid Lopes, a College of Osteopathic Medicine professor at Touro who is also the primary preceptor at Touro’s Student Run Health Clinic. Zach Hathaway, a second year Touro PA student felt
that the event “Was an amazing opportunity to get out into the community and work with people who really need it. It really helps to affirm why you came to PA school.” Zach helped organize Touro’s involvement and helped contribute to the overall success of the event. About 25 students volunteered at the event, which provided services to about 70 homeless individuals.
Welcome New Members
Local Groups
August 10, 2011 through November 28, 2011 A. Alabi Akinloye, PA-C Bhavana Akotia, PA-C Sheena Allen, PA-S Samantha Almeida, PA-S Sally Ammar, PA-S Avril Ampudia, PA-S Carrie Anderson, PA-C Maude Anderson, PA-C Lindsay Arellano, PA-S Natalie Armstrong, PA-S Kiran Aulakh, PA-S Scott Barker, PA-S David Baro, PA-S Darice Barr, PA-S Pamela Bassett, PA-C Dina Bateman, PA-C Manivanh Baum, PA-S Victoria Bayliss, PA-S Brett Bergman, PA-S Jennifer Black, PA-S Andrew Bloom, PA-S Roy Blumenstrauch, MD Teresa Boenig, PA-S Kendra Bosscher, PA-C Helen Brady, PA-C Ronald Browne Katherine Buchert, PA-S Vira Budnevska-Sira, PA-S Earla Burnett, MS, PA-C Letantia Bussell, M.D. Abby Cappadona, PA-S Brianna Cardenas, ATC, PA-S Sarah Carr, PA-C Ericka Carranza, PA-S Jessica Carswell, PA-S Mayra Castaneda, PA-S Vagan Chakarian, PA-S Chelsea Chambers, PA-C Suvesh Chandiok, MD Ana Chang, PA-C Margot Chase, PA-C Julie Chau, PA-S Tait Christensen, PA-C Patricia Church, MS PA-C, MS, ATC Mary Clause, PA-S Christianne Cobb, PA-S Jennifer Collins, PA-S Anne Condas, PA-S Carly Cooksey, PA-S Jamie Cooper, PA-S Beatriz Cordoba, PA-S Ruth Cortes, PA-S Xochitl Cubero Randall Culler, PA-S Rasha Dabbousi, PA-S Nora Davidian, MSPAS-C Meghann Delahooke, PA-S Jon Depolo, PA Leah Dixson, PA-C Ian Donahue, PA-S
Ronan Donnelly Jose Duarte, PA-S Victoria Duclon, PA Gilian Dudley, PA-C Lea Dunn, PA-C Jennifer Ebertshauser, PA Letty Echeverria, RN, PA-S David Eschler, PA-S Gretel Espina, PA-S Fabian Esqueda, PA-C Travis Falasco, PA-S Dina Farzan Nickeshia Ferron, PA-C Stefanie Forrester, PA Jennifer Forthman, PA-C Madison Franken, PA-S Luz Anabelle Frausto, PA-S Braulio Fregoso, PA-S Jo Ann Friedrich, PA Kimberly Gaines, PA-C Gaby Galindo, PA-S Sunaina Ganesh, PA-S Esther Gayoba, PA-C Tim Gengembre, PA-C, PhD Anahita Ghodsian, PA-S Robert Gibson, MPA, PA-C Robert Ginther, PA-S Robbin Gonzales, PA-C Cindy Gonzalez, PA-C Eric Guevara, PA-C Joseph Gutierrez, PA-C Regina Ha, PA-S Courtney Hamada, MSPA-C Carolin Hara Kurt Harris, PA-S Claire Hayati Jennifer Hayhurst, PA-S Melanie Hedgeman, PA Jennifer Henderson, PA-S Iris-Bianca Hernandez, Rebecca Hernandez, PA-S Diana Herrera, PA-S Ashley Hicks Serenity Holden, PA-S Shana Holman, PA Melinia Honjo, MPAS, PA-C Katie Hoogstrate, PA-S Elizabeth Hoyt, PA-S Chris Jaco, PA-C AJ Jhatu, PA-S Jessica Johnson, PA-S Marcie Johnson, PA-S Jeremy Johnston, PA-C Julia Karnoski Allison Kennedy, PA-S Linda Kim, PA-S Diana Kirchmann Raquel Knutson, PA-S Lindsay Kozicz, PA Ngin Lam, PA-S
Sheila Lau, PA-S Alex Le, PA-S Jihyun Lee, PA-C Julia Liepmann, MS, RPA-C Jenna Lightfoot, PA-C Jeffrey Lin, PA-S Maria Lin, PA Melnda Liou, RD, PA-C Vivian Lo, PA-S Christopher Loera, PA-S Christine London, PA-S Trang Lu, PA-S Linda Luong, PA-S Vangie Luong, PA-C Kassandra MacPherson, PA Elika Mandegari, PA-S Jordin Marousis, PA-C Allison McClay, PA-S Kenesha McGruder, PA-S Megan McKiernan, PA Tracy McWhorter, PA-C Ashley Melton, PA-S Leah Merrin, PA-S Jessica Meyers, PA-S Michiko Miller, PA Haleigh Mistry, PA-S Alan Moelleken Michelle Molchanov, PA-S Gerardo Murguia, PA-S Lindsay Murphy, PA-C Eriko Nakajima, PA-S Erica Navarro, PA-S Kaitlyn Nguyen, PA-C Kyle Norton, PA-S Gennady Nosovitsky, PA-S Natasha Ohta, PA-S Leah Ordinanza, PA-S Lawrence Owusu, PA Jennifer Paeske, PA-S Reena Pardiwala, PA-S Keri Park, PA-S Julie Pascualy, PA-C Lisette Peralta, PA-C Alicia Perez, PA-S Frederick Perez, Marilyn Perez, PA-C Gerald Pernak, PA-C Sarah Pertschuk, PA Tung Phan, PA-S Erica Phillips Izola Phillips, PA-S Kelly Piazza, PA-S Erik Poast, PA Andrea Pogue, PA-C Alexander Porto, PA-S Elizabeth Poss, PA Mollida Prak, PA-S Glennise Pratt, PA-C Adam Prince, PA-C Jaclyn Repay, MD
Megan Riley, PA-S Julia Robinson, PA-S Evangeline Rodriguez, PA-S Jessica Rogers, CCHT David Rojas, PA-S Alana Rushton, MS PA-C Marcie Ryan, PA-C Matthew Schneider, PA-S Robert Schofield, PA-C Stefan Schulz, PA-C Elisabeth Schulze, MS, PA-C Erika Schwartz, PA-C Jessica Serata, PA-S Jacquelynn Shank, PA-S Sumit Singh, PA-S Roger Skebelsky, PA-C Ingrid Stabinski-Cox, PA-C Lauren Stokes, MPH, PA-C James Strafford, PA-C Julie Strohsahl III, PA-S Noreen Styliadis, PA-C Shannon Sullivan, PA Ali Taat, PA-S Lauren Tatum, PA-S Kathryn Temple, PA-C Jeweleeh Tieu, PA-S Erica Tong, PA-S Brian Tran, PA-S Felicia Trasca, PA-S Carrilin Trecker, PA-S Jeanette Trejo, PA-S Hesper Tsai, PA-S Bhavik Upadhyay, PA-C Nicolaas Van Leeuwen, PA-S Jessica Vanderkallen, PA Joseph Vanderlinden, MD Larry Vandermolen, PA-C Penny VanPatten, PA-C Joshua Vera, PA-C Michelle Viray, PA-S Maddie VonderSchmidt, PA-S Joyce Wagner, PA-C Kimberly Waller, PA-C, CDE, CCD Yuli Wang Alexander Welzig, PA-S Pamela Whiteley, PA-S Carolan Whitney, PA-S Lauren Williams, PA-S Heather Willis, MPAP, PA-C Christel Witt, PA-S Michael Wlodarski, PA-S David Wolman, PA Lillian Woo, PA-C Travis Young, PA-S Lisi Zeng, PA-S
1. Redding Area PA/NP Alliance Summer Ross, PA-C; (530) 275-5747 summerross@hughes.net 2. Physician Assistant Society of Sacramento (PASS) Carlos De Villa, PA-C, PASS President; (916) 973-6185, pasocietyofsac@yahoo.com Atul Sharma, PA-C, MMS, MPH, CHES; (916) 397-6035, pasocietyofsac@yahoo.com 3. Contra Costa Clinicians Association Brian Costello, PA-C; (707) 651-2705, contracostapas.com 4. San Francisco Bay Area Physician Assistants (SFBAPA) www.sfbapa.com, PO Box 14096, San Francisco, CA 94114-0096 Martin Kramer, PA-C; (415) 433-5359, Fax: (415) 397-6805, mkramersf@hotmail.com 5. Bay Area Mid-Level Practitioners Rose Abendroth, PA-C; (650) 697-3583, Fax: (650) 692-6251, rosepard@aol.com Matt Dillon, PA-C; (650) 591-6601, mattdillon42@hotmail.com 6. Bay Area Non-Docs Linda O’Keeffe, PA-C; (650) 366-2050, lindapac@aol.com 7. Northcoast Association of Advanced Practice Clinicians John Coleman, PA-C; (707) 845-6008, streetdrag49@sbcglobal.net 8. Stanislaus County NP/PA Network Brian Cormier, PA-C; (209) 605-4966, briancor@verizon.net, www.nppanetwork.org 9. Stockton Midlevels Emma Calvert, PA-C; stocktonmidlevels@gmail.com 10. Journal Club for PAs and NPs (Fresno area) Cristina Lopez, PA-C; (559) 875-4060; Fax: (559) 875-3434, clopez875@aol.com; 2134 10th St, Sanger, CA 93657 11. Tulare/Kings NP/PA Association Steve Henry, PA-C; Pager: (559) 749-4348, msh649@sbcglobal.net 12. Central Coast Nurse Practitioners & Physician Assistants Kris Dillworth, NP; ccnppa@yahoo.com 13. So Cal PAs Linda Aghakhanian, PA-C; want2heal@hotmail.com 14. Orange County Hung Nguyen, PA-C; (714) 846-8178; nhy52@yahoo.com 15. San Gabriel Valley Local Group M. Rachel DuBria, PA-C; (818) 744-6159, racheldca@aol.com 16. San Fernando/Santa Clarita Valley Group Jonah Tan, MPT, PA-C; (818) 634-0007, jotptpa@yahoo.com 17. Coachella Valley Physician Assistant Group Matthew Keane, MS, PA-C; mkeanepas@gmail.com 18. San Diego Area Jeremy Adler, MS, PA-C; (619) 829-1430, jadler@simplyweb.net
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California Academy of Physician Assistants 3100 W. Warner Avenue, Suite 3 Santa Ana, CA 92704-5331
PRSRT STD US POSTAGE PAID SANTA ANA, CA PERMIT NO 949
Address Service Requested
One-Day Conference in Napa at the Napa Valley 6 Hours of Cat. I CME
CAPA at Napa Saturday, February 25, 2012 8:45 a.m. - 4:30 p.m. Register online at www.capanet.org
Sponsored by the
California Academy of Physician Assistants
Controlled Substances Education Course for PAs urs 6 Ho Cat. I CME
Sunday, February 26, 2012 Napa Valley Marriott 3425 Solano Ave Napa, CA 94558 (707) 253-8600
Saturday, April 28, 2012 University of Southern California Health Sciences Campus Mayer Auditorium, Keith Administration Bldg. 1975 Zonal Ave Los Angeles, CA 90089
Saturday, August 25, 2012 Samuel Merritt University Fontaine Auditorium, Health Education Center 450 30th St Oakland, CA 94609