Advanced Practice Clinicians Career Helps Physician Assistant-Associate PA-C & Nurse Practitioner Employment helps Nurse Practitioner ARNP.

Wednesday, August 31, 2011

Robert Blumm Physician Associate





RobertBlumm



Robert Blumm Bob Blumm PA National Conference Speaker & Consultant

Looking at the past and the
future of Surgical PAs and NPs


 by
Bob Blumm, MA, PA-C, DFAAPA - August 30, 2011
 



Robert Blumm Bob Blumm PA Physician Associate Physician Assistant From
1999 to 2004, I served as the Liaison to the American
College of
Surgeons representing the AAPA. Part of my job was to attend all
general meetings of the College and particularly to be present at the
Allied Health meetings as this is where APCs were discussed and
decisions were born. This particular year of which I am writing was a
positive forward move as some of the most important people in the
College spoke to the issues of assistants at surgery. I am presently
discarding all of my writings and paperwork of the last 20 years at my
wife’s bequest but I am hanging on to a few so that I can do
what I am
attempting at this moment which is to bring the current APCs to an
understanding of our past history and the projections for the future.



On
Oct 13
, 1999 at 0830, a diverse group of practitioners and
administrators descended upon the Mascone center in San Francisco to
listen to four speakers who were the assembled first assistants from
every group that has this honor. This group consists of surgeons,
residents, PAs, NPs, CSAs, CSTCFAs, RNFAs, and Perfusionists, which at
that time made up the bulk of assistants at surgery. They were handed a
statement or Issue Brief: “The Surgical Physician
Assistant---A
Summary.” In addition to this brief, they received an article
from the
Journal of Trauma, Injury, Infection and Critical Care entitled:
”Use
of physician assistants (generic) as surgery, Trauma House staff at an
American College of Surgeons verified Level ll Trauma Center.”



Dr.
Fabri
of Florida, then Chair of this committee, opened the
meeting with
a 10-minute talk followed by Dr. Ralph Doerr, who spoke for 35 minutes.
Dr. Doerr spoke from his past experience as a Physician Assistant who
had now been a surgeon for 25 years but was thoroughly conversant with
the subject from a contemporary viewpoint at that time. Although some
of his slides were outdated, and even far more a decade later, he spoke
from the position of one of our strongest allies. The last two speakers
spoke on the Role of the Nurse Practitioner in a surgical practice and
the last on “Changing role of the CST in the
future.” What would have
been a lively discussion period was curtailed by the Chairman for
discussion the following year by this same assembled group and
additional new people from all surgical professions.



Dr Fabri made
the following statement: ”The total number of NP and PA
graduates exceed that of MD graduates.”



Thought:
what does the AMA and the ACS think of this? Is this a problem for
physicians? Do they perceive us to be a threat? How will they deal with
this statistic? Dr Fabri added, ”(at that time) 49 states
accept the
PA/NP model, have verified their job description and has authorized
their reimbursement for services rendered.” Thought: Is this
considered
competition? Is this considered a rationale for hiring APCs? Are they
calculating the deficit to MDs medical reimbursement if both of these
groups were independent?



Dr. Fabri
went on to say, “When MDs are
employed in the backdrop of global fees, it allows mid level providers
to perform preoperative exams, causes less confusion for family and
friends, there is greater documentation, more significant findings,
more detail and more communication.” Thought: Now
that’s an epitaph!
Dr. Fabri continued, ”In a surgical practice it would be
usual and
customary for a PA (and more recently additionally a NP) to perform and
report on all aspects of the pre-operative workup. The PA would give
the informed consent (now the duty of only the surgeon) as well, would
do per-operative teaching. PAs (and now NPs) would perform the
Discharge Directions; do moderation in the form of
“rounds.” They would
write the prescriptions for patients at discharge and during subsequent
visits, orchestrate the post-operative care in both the hospital and
the office.”



Thought:
MDs and DOs must give their own informed
consent. If PAs and NPs engaged in the informed consent it would be the
grounds for greater litigation's for these clinicians. From Dr.
Fabri’s
statements, some MDs can be led to believe that they can almost abandon
their patients. We need to educate PAs/NPs on this matter as we are the
secondary caregivers and the surgeon remains “Captain of the
ship.”



Dr.
Fabri:
“Surgery is teamwork. There is a greater
affinity to practice as
a team in surgery than there is in primary care. The College must look
at new and exciting ways to promote the team. ”Thought: Great
for PAs
and NPs but I consider the Primary Care providers to be an important
part of that matrix of the surgical team as they have a role in
understanding and communicating their health history and treatment and
can encourage the patient by being knowledgeable about the procedures.
This needs to be covered in our conferences such as those of the AFPPA
and the AANP and AAPA.



Dr. Fabri:
“Both PAs and NPs are listed
as having substantial involvement in the First Assistant
Role” Over
this past decade, this has proven itself to be true, and Fabri was
almost a prophet as his futuristic thinking relates to what has
happened up to 2011 and the inclusion of more PAs and NPs into the
surgical workplace. More than 2% of NPs are now in surgery, and their
numbers will increase precipitously, and 27% of PAs are in this
specialty.



Dr Doerr
than stated, “Issues to PAs relate to cost,
competition, accuracy quality and medico legal. All studies suggest
that PA employment improved access, efficiency and care. The added
benefit is that surgeons can perform more surgery.” Thought:
What’s to
say? That’s great! He then spoke of the future but the
numbers of PAs
and NPs were inaccurate as they were out of date and are even more out
of date in 2011 where there are 240,000 NPs and PAs .He projected that
there would be 65,000 PAs in 2006 and that was correct. He projects
that MD candidates will decrease. He has noticed that NPs are
increasing every year and almost double the PA number and lastly he
said that there would be lower compensation for MLPs.



The PEW
Paper suggested in that year that PAs should be considered as
incorporated into the medical staff of an institution. This is now a
reality in 2011. Present conditions (1999) will be modified as the
current system undergoes an overhaul—it has! MDs are seeing
Privilege
Changes as suggested by the Regulatory Board of hospitals and HMOs.
These institutions mandate verifiable training, education and
competence based upon a clinical practice over a two-year period. Those
Boards will determine the appropriate Scope of Practice, define
competency standards and perform practice audits. Dr. Doerr believes
that this will carry over to the PA/NP professions and that they too
will have mandated competency exams to maintain or add to their current
privileges.



Summary:
Dr. Cosgrove, then chief of Cardiovascular
surgery at the Cleveland Clinic and I spent fifteen minutes in private
conversation about PAs, who I was representing at this meeting. He has
an international reputation and is proud that in 1999 he had 55 PAs on
his team. I asked his opinion of their value and he stated that,
“Neither the hospital or he personally could do without
them.” Members
of the APACVS and Dana Gray told me that NPs are lumped into this
figure also which is interpreted as to their combined value. In closing
both then (1999) and today (2011) it is suggested that NPs and PAs
continue to develop a better relationship and strive to work in a
cooperative collegial manner. We are well on that road as we go to each
other’s conferences, share committee work and in general
realize that
our efforts to work as teammates will enhance patient care in the
United States.

 
           
           
           
           
           
 




The Parable of
the Talents


Bob Blumm, MA,
PA-C, DFAAPA

Robert Blumm Bob Blumm PA Physician Associate Physician Assistant The world
of
finance and the general economy took a surprise down spin a few years
ago when
the infamous Bernie Maedorf admitted to the fact the he could no longer
pay his
investor’s refunds as his Ponzi scheme had finally run dry.
More than 19
Billion Dollars was invested in his huge opportunity to guarantee large
dividends on a yearly basis whereas seemingly he and a few others were
the
recipients of this promise. Charitable institutions bought in, fund
managers,
hospitals, religious institution, an, in general, people with a dream
that soon
sounded too good. As early members pulled out, there was just not
enough
capital to reimburse the investors and his son’s had to turn
states evidence on
him. He received a 150 year jail sentence but the greater damage is the
he
destroyed people’s ability to trust. They had trusted him
with their entire
financial future and this misplaced trust created a bankruptcy
situation.

   
 The
parable
about the talents related to a rich man that gave three servants a
large sum of
money and told them to invest it wisely as he was going on a long
journey and
would return to check on their accomplishments. He gave one person 10
talents,
another five and the last person received 1. 
A talent was an amount of money so let’s
call it a million dollars. The
guy with the ten million bought a slew of Starbucks shops and people
came in
large numbers to purchase this superb $4.00 coffee and with his
investments he
doubled his 10 million which became 20 million. The fellow with 5
million
bought many Dunkin donuts enterprises and he charged two dollars for
his coffee
and 99 cents for his donuts. He managed to double his money and now
turned the
five million into ten million. The last servant, when approached my his
benefactor who had trusted him had placed the money in a safe mattress
because
he was concerned that his master was a hard task master and was
petrified of
losing the money. The master’s trust was certainly misplaced
as fear and lack
of imagination and creativity he did not even bring it to a bank with a
minimal
interest rating. This fellow lost it all and his one million went to
the person
who had made 20 million. This entire parable related to trust. What
would these
people do with their life and with his money?

   
 How
in the
word does this make a connection with the PA and NP communities? I have
sat on
many admissions boards and have listened to the earlier members of the
professions unfold their plan as it seemed like they would be looking
to change
the landscape of medical care in America by finding rural areas that
needed
their services or they would work with the geriatric populations. Years
later
we discovered that our trust was slightly misguided as they went into
surgical specialties,
large inner city and suburban practices and gained a reputation for
being
excellent providers. So, it’s true, they didn’t
follow the dictates of their
early game plan but they did use their training for the good of the
people and
entered new fields that embraced them with open arms. There was a small
group like
the guy with one talent, who took that medical knowledge, shifted
careers like
gears on a five speed and entered Law school or became creative in the
field of
Coding and broke down services to their multiple lower denominators to
increase
insurance reimbursement. This too is part of the American dream in that
you can
do and become anything as a citizen and the people who became affected
were
those that trusted their initial mission statement and those that lost
the
services of what could have been a good medical provider.

There are
many who like the ten talent person who have expanded their roles, have
gone on
medical missions, and have volunteered in disasters, functioned from
their
hearts not their pocketbooks. They are seen in oncology units,
geriatric units,
research, pediatrics, family practice. Some have become experts in
mental health,
in every sub-specialty of surgery, they placed their lot in learning
cardiology
and neurology and endocrinology so that they would be around to care
for the
baby boomers who would be utilizing all of their services. There is
also the
small number who joined the nation’s military so that they
could both care for
and actually be “in harm’s way” because
they had strong nationalistic pride. I
support all of my colleagues, PAs and NPs alike for your commitment,
dedication
and trust. You are making this a better health system and a stronger
America.
Let’s hope that out trust is not misplaced on a legislative
level by losing
what we have all planned on for our futures, Medicare and social
security. If
these stay intact we can feel the cozy blanket when we hit the cold
 Days.
 

 
           
           
           
           
           
   




Looking
at the
past and the future of
Surgical PAs and NPs


Bob Blumm, MA,
PA-C, DFAAPA

Robert Blumm Bob Blumm PA Physician Associate Physician Assistant From 1999 to 2004 I
served as the
Liaison to the American College of Surgeons representing the AAPA. Part
of my
job was to attend all general meetings of the College and to
particularly be
present at the Allied Health meetings as this is where APC’s
were discussed and
decisions were born. This particular year of which I am writing was a
positive
forward move as some of the most important people in the College spoke
to the
issues of assistants at surgery. I am presently discarding all of my
writings
and paperwork of the last 20 years at my wife’s bequest but I
am hanging on to
a few so that I can do what I am attempting at this moment which is to
bring
the current APC’s to an understanding of our past history and
the projections
for the future.

On Oct 13, 1999 at
0830, a diverse
group of practitioners and administrators descended upon the Mascone
center in
San Francisco to listen to four speakers who were the assembled first
assistants from every group that has this honor. This group consists of
surgeons, residents, PAs, NPs, CSA’s, CSTCFA’s,
RNFA’s, Perfusionists, which at
that time made up the bulk of assistants at surgery. They were handed a
statement or Issue Brief; “The Surgical Physician
Assistant---A Summary.” In
addition to this brief , they received an article from the Journal of
Trauma,
Injury, Infection and Critical Care entitles;”Use of
physician assistants
(generic) as  surgery,
Trauma House staff
at an American College of Surgeons verified Level ll Trauma Center.

Dr. Fabri of
Florida, then Chair of
this committee ,opened the meeting with a 10 minute talk followed by
Dr. Ralph
Doerr, who spoke for 35 minutes. Dr. Doerr spoke from his past
experience as a
Physician Assistant who had now been a surgeon for 25 years but was
thoroughly
conversant with the subject from a contemporary viewpoint at that time.
Although some of his slides were outdated and even far more a decade
later he
spoke from the position of one of our strongest allies. 
The last two speakers spoke on the Role of
the Nurse Practitioner in a surgical practice and the last on
“Changing role of
the CST in the future.” What would have been a lively
discussion period was
curtailed by the Chairman for discussion the following year by this
same
assembled group and additional new people from all surgical professions.

Dr Fabri made
the following
statement;”The total number of NP and PA graduates exceed
that of MD
graduates.”

Thought- what does
the AMA and the ACS
think of this? Is this a problem for physicians? Do they perceive us to
be a
threat? How will they deal with this statistic? Dr Fabri
added;” (at that time)
49 states accept the PA/NP model, have verified their job description
and has
authorized their reimbursement for services rendered.”
Thought- Is this
considered competition? Is this considered a rationale for hiring
APC’s? Are
they calculating the deficit to MDs medical reimbursement if both of
these
groups were independent?

Dr. Fabri went on to
say; “When MDs
are employed in the backdrop of global fees, it allows mid level
providers to
perform preoperative exams, causes less confusion for family and
friends, there
is greater documentation, more significant findings, more detail and
more
communication.” Thought- Now that’s an epitaph! 
Dr. Fabri went on to say;” In a surgical
practice it would be usual and
customary for a PA (and more recently additionally a NP) to perform and
report
on all aspects of the pre-operative workup. The PA would give the
informed
consent (now the duty of only the surgeon) as well, would do
pre-operative
teaching. PAs (and now NPs) would perform the Discharge Directions; do
moderation in the form of “rounds.” They would
write the prescriptions for
patients at discharge and during subsequent visits, orchestrate the
post-operative care in both the hospital and the office.”

Thought-MDs and Dos
must give their
own informed consent. If PAs and NPs engaged in the informed consent it
would
be the grounds for greater litigations for these clinicians. From Dr.
Fabri’s
statements some MDs can be led to believe that they can almost abandon
their
patients. We need to educate PAs/NPs on this matter as we are the
secondary
caregiver and the surgeon remains “Captain of the
ship.”

Dr. Fabri;
“Surgery is teamwork.
There is a greater affinity to practice as a team in surgery than there
is in
primary care. The College must look at new and exciting ways to promote
the
team.”Thought- Great for PAs and NPs but I consider the
Primary Care  providers
to be an important part of that
matrix of the surgical team as they have a role in understanding and
communicating their health history and treatment and can encourage the
patient
by being knowledgeable about the procedures. This needs to be covered
in our conferences
such as those of the AFPPA and the AANP and AAPA.

Dr. Fabri;”Both
PAs and NPs are
listed as having substantial involvement in the First Assistant
Role”  Over
this past decade this has proven itself
to be true and Fabri was almost a prophet as his futuristic thinking
relates to
what has happened up to 2011 and the inclusion of more PAs and NPs into
the
surgical workplace. More than 2% of NPs are now in surgery and their
numbers
will increase precipitously and 27% of PAs are in this specialty.

Dr Doerr than stated;
“Issues to PAs
relate to cost, competition, accuracy quality and medico legal. All
studies
suggest that PA employment improved access, efficiency and care. The
added
benefit is that surgeons can perform more surgery.”
Thought-What’s to say?
That’s great! He then spoke of the future but the numbers of
PAs and NPs were
inaccurate as they were out of date and are even more out of date in
2011 where
there are 240,000 NPs and PAs .He projected that there would be 65,000
PAs in
2006 and that was correct. He projects that MD candidates will
decrease. He has
noticed that NPs are increasing every year and almost double the PA
number and
lastly he said that there would be lower compensation for
MLP’s.

The PEW Paper
suggested in that year
that PAs should be considered as incorporated into the medical staff of
an
institution. This is now a reality in 2011. Present conditions (1999)
will be
modified as the current system undergoes an overhaul—it has!
MDs are seeing Privilege
Changes as suggested by the Regulatory Board of hospitals and
HMO’s. These
institutions mandate verifiable training, education and competence
based upon a
a clinical practice over a two year period. Those Boards will determine
the
appropriate Scope of Practice, define competency standards and perform
practice
audits. Dr. Doerr believes that this will carry over to the PA/NP
professions
and that they too will have mandated competency exams to maintain or
add to
their current privileges.

Summary: Dr.
Cosgrove, then chief of
Cardiovascular surgery at the Cleveland Clinic and I spent fifteen
minutes in
private conversation about PAs , who I was representing at this
meeting. He has
an international reputation and is proud that in 1999 he had 55 PAs on
his
team. I asked his opinion of their value and he stated that
“Neither the
hospital or he personally could do without them.” Members of
the APACVS and
Dana Gray told me that NPs are lumped into this figure also which is
interpreted as to their combined value. In closing both then (1999) and
today
(2011) it is suggested that NPs and PAs continue to develop a better
relationship and strive to work in a cooperative collegial manner.  We are well on that road
as we go to each
other’s conferences, share committee work and in general
realize that our
efforts to work as team mates will enhance patient care in the United
States.
 
           
       
           
       
          


 
           
       
           
       
 





A
Glimpse in the Mirror


Bob
Blumm, MA,
PA-C, DFAAPA


August 15, 2011

Robert Blumm Bob Blumm PA Physician Associate Physician Assistant
In my personal

diverse reading program, I am presently engaged in devouring Ian
McEwan’s Solar.
This novel centers on a Nobel Prize-winning physicist who is fast
approaching 60. Although he is no longer an academic titan, his
reputation allows him to collect huge speaking fees and impassively
head a government program to battle global warming. His personal life
is another matter. An incorrigible womanizer, he has chased off four
spouses with affairs and now a fifth wife has turned the tables on him.
The story begins when the main character, the physicist, takes a shower
and walks past a full length mirror and takes a glimpse at the person
who stands before him. His hair is gray and starts two inches above his
ears with the remainder bald. His chest has become soft and more
female, as if he has breasts. His abdomen, which was once flat in his
20-35 years, began to slowly go through a metamorphosis at 35-50: it
swelled annually by five pounds and he was caught “sucking it
in.” Now, the 50-60 demonstrates the effect of human blubber
on
the skeleton of a male and he is confronted with a collapsed penniculis
and has been unable to see his toes in a shower when looking straight
down for the last fifteen years. Suddenly, his self confidence drains
from him as the water drains from the shower. What am I trying to share
with the readers of this article?



Firstly,
we have a need to
occasionally place aside the medical literature and to read varied
novels which give us insights into the realities of life and make us
more interesting as professionals both to our peers and our patients.
Secondly, from the narrative, I was able to draw an analogy of the
effects of self discovery: glimpsing into a mirror, on both our
personal and professional demeanors. I can recall when both my wife and
kids chided me lovingly about “sucking it in,” as
obviously
they were far more aware than myself…the egotistical PA
moving
up the ladder of success, to a metamorphosis in my body habitus. What
became a joke later became a matter of concern to those who loved me
because I developed diabetes, hypertension and an enlarged heart. This
began to equate into concern and the idea that I didn’t care
about myself nor did I care that I had a family that loved me and that
wanted me to live well into my seventies or eighties and that, at this
rate, I was going to leave planet earth earlier than the timetable.
This did affect my self confidence to a degree and my ego lessened
because of the reality of the wages of lack of self control in diet and
exercise. I wore my shirts outside as to not bring attention to what
existed below my neck. I found it easy to become the butt of my own
jokes concerning weight as I saw I was a lost cause. How does this
relate to all of you normal PAs and NPs and your daily practice?



Perhaps
it’s an early wakeup call if you are at the “suck
it
in” stage of life. In that case, I am doing what I have
always
endeavored to accomplish: help my colleagues. But this also falls into
a practice setting because we are lacking the ability to set an example
for our patients who suffer from the same dilemma. We are not examples
of what we are preaching to them. It’s sort of like a surgeon
who
is trying to convince a balding patient to get a hair transplant, when
his own head looks like a shiny dome that can light the darkness. They
are saying to themselves, then why has he not visited a colleague who
does this procedure? For the obese patient, who is non compliant, it
becomes a constant source of worry, agitation and frustration to the
health care providers. My IM physician, Dr. Ed Hallal of Bay Shore, NY,
maintains a healthy morphology because he constantly encourages his
patients concerning diet and exercise.



Lastly,
what you think of yourself affects your ability to render the type of
care that is essential for a health care provider. Focusing on our
personal failures takes some of the steam out of our enthusiastic
approach to patient care and we lose the ego that is necessary for a
leader or clinician. To explain that remark more thoroughly, I mean to
say that all leaders, every one of them, have an ego and with it the
desire to be the best and to at least be successful in their
challenges. As clinicians, we desire to use our knowledge and skills in
a manner consistent with the other colleagues that we respect and to do
so without impediment. If we discover the impediment, we then chose to
focus on it and work hard on making changes. The old saying is that
“tomorrow is the first day of the rest of our
lives.” We
can change personally and encourage our patients to refrain from look
at past failures and look to future success. Our old stumbling blocks
can become stepping stones to success. So, the end of the message is
the same as the beginning. Slow down as we all work too hard, listen to
your family that loves you and stop long enough for self evaluation:
take a glimpse in the mirror.

 
           
       
           
       
           
       
           
       
           
 


Medical
Personnel Returning from
Combat Duty


Position
Paper sent by

Bob Blumm, PA-C Past President ACC





Robert Blumm Bob Blumm PA Physician Associate Physician Assistant I
am
sending this paper to all agencies
and
forums to serve as a reminder
that the ACC, which now serves NPs and PAs as an Advocate for the
professions scope of practice, did in fact publish a white paper to
honor and make a special pathway to those who served “in
harm’s way”
and upon returning to CONUS desire to further their education and
become either NPs or PAs. We feel that they have given a part of their
lives to serving in a time of war and that they deserve special
consideration when applying to programs of advanced practice
clinicians. The following is a joint effort of the executive committee
2-3 years ago demonstrating what we feel would best serve both
professions as a “thank you for a job well done.”



As we
all
know, America is involved in military action in the Middle East. This
has increased the use of all military nursing and medical personnel. It
has also exposed many of these caregivers to combat, trauma and other
medical experiences and training that they could not have received in
any other way.



The
physician assistant and nurse practitioner
professions have extensive roots in military medicine. In fact, the
first three PAs at Duke were Navy Corpsmen and the professions link to
the military endures up until today. It is the same with the nurse
practitioner profession, as many NPs were former nurses, medics and
corpsmen. Today, both the NP and PA professions enjoy commissioned
officer status in our armed services and are a vital cog in the wheel
of military health care.



The
American College of clinicians
recognizes these roots. Upon their return to our shores, nurses, medics
and corpsmen should be greeted warmly and praised for their sacrifices.
The College also thinks that their vital experience and training has
created a new pool of potential students for NP and PA education. Most
of these people possess the tools to become excellent leaders and
clinicians.



The
College asks all PA and NP programs to look
favorably on these veterans if they apply to their training programs.
We ask that every program work to allow these people get the
information needed to become NPs and PAs. We also request that our
members reach out to NP and PA programs in their areas to advocate for
their local returning veterans with military experience. In the near
future, the ACC will design an outreach program to inform potential
military of their post service opportunities as advanced practice
clinicians.



In summary, the College thinks
that we are
now at a
unique period where qualified combat and trained RNs, medics and
corpsmen will be returning to America. We would like to see those
veterans who feel that they would like to become PAs and NPs embraced
by the NP and PA professions, and we call upon our members to request
that their local training programs act favorably regarding these
applicants for future training.  

 
           
       
           
       
           
       
           
     




Interpreting Our Words
Concerning
Being

Advanced Practice Clinicians
 
  


    
by Bob Blumm,
MA, PA-C, DFAAPA - August 1, 2011
 
   



 
 
Robert Blumm Bob Blumm PA Physician Associate Physician Assistant When
you are a clinician, a speaker, a writer or politician you are faced
with the problem of becoming a target of another individual who has
different roots, different religions and traditions, different belief
systems in general. My mother in law called it
“Joseph’s
coat of many colors,” while a fellow called Saul of Tarsus
mentioned that he was “all things to all men.”
Sounds like Saul would have been an aspiring candidate for public
office as that
comment would make him a magician, an exaggerator, narcissistic or just
a liar. We are all different and our manner of speech reflects
something of who we are. I like to write articles that cause people to
gain insights but occasionally, because of my style or grammar or the
absence of editing from a specialist, I am challenged or subject to
slight scolding concerning the English language or perhaps the
individual will stop reading altogether on the assumption that if one
cannot put a sentence together intelligently then they are probably an
ignoramus and not worth reading. 



 
T
en
years ago I wrote an editorial and while speaking of being a PA I
described it as a "calling." Wow, that word calling can create a
“tremor in the Force.” In a scholarly manner, this
individual mentioned that he did not mean any disrespect but he had
never heard a child say,” Mommy I dreamed that I would be a
physician assistant some day.” As I relate his comment to
both
PAs and NPs, the follow-up was that he could not understand why anyone
would do the same work as a physician for a fraction of the pay, a
percentage of the respect and all the other fringe deficits that go
along with the job. He did have a dream though, as he mentioned that if
he were given the chance to convert his PA credential to an MD on just
a say-so, he couldn’t think of any reason to decline. I agree
to
a point as if tomorrow I became Bob Blumm, MD, I would be one of the
best advocates for the advanced practice clinician. He concluded his
remarks with “I just don’t get it and never did.
That’s why I haven’t practiced as a PA since
1982.”



 As
an author I am expected to reply to comments, so I apologized that I
had upset him by using the word “calling.” I then
added
that although you haven’t practiced for 20 years, I see that
you
still have an eye for detail. I mentioned that it’s a shame
that
we lost him as a colleague because somewhere deep beneath the surface
is the vestige of a PA. My reply was based upon his signature that
still was associated with the PA credential. I have discovered that PAs
and NPs choose to take this course of study for special reasons and
that they have no desire to become physicians. We certainly are
intelligent enough to become physicians but our decisions were made
upon things such as lifestyle, limited obligation to a practice
setting, less time in academic preparation, less malpractice insurance
and more time to make commitments to be functional parents or mates.
Some have even professed that they wanted to enter the work force
sooner to begin to care for the sick and oppressed. 



  Another
of the commonalities between PAs and NPs is that it is a first choice
occupation for some but for others they have served as other types of
medical or nursing professionals and this was yet another step up the
ladder and may have been a mid-life choice. What we share in common is
first that we have an inner commitment or calling or desire to help
humanity by healing wounds of sickness, injury and disease. We have a
commitment to continued learning and development of clinical skills and
a deep belief that what we do and our new skills will make us better
clinicians and even more of an influence on the health crisis that we
face as a nation and over the earth. I think that many of my colleagues
share my emotions and given a choice would make the same decision. Be
proud of who and what you are, as you have studied and sacrificed so
that you could become bread for those who are hungry and need to be
touched by a health care provider who cares.


 
 
           
       
           
       
           
       
     

Sound
the Trumpet, Our
Forgotten Weapon

Bob Blumm, MA, PA-C,
DFAAPA

July 31, 2011

Robert Blumm Bob Blumm PA Physician Associate Physician AssistantLong before the days
of telecommunications, military leaders used three
strategies to inspire their troops. First, Commanders in the field
would lead from the front and be an example and an inspiration as they
became vulnerable and visible to both their armies and those of other
countries. Secondly, the spoils of victory were displayed in the form
of captives, riches and colors. They were not only displayed but they
were shared with the troops. Lastly, there was the sound of the trumpet
as it was the means of communication and inspiration. The trumpet
awakened them, called them to arms, signaled when to turn or charge and
gave forth the sound of victory.



Today,
I am sounding a trumpet
utilizing one of the best sites to help PAs to find jobs and make mid
career decisions. I am utilizing a website that has blessed many and
continues to be a source of blessing as PAs find a livelihood. There
are no hidden agenda here and Bill and Karen would like to see a few
people that really care take the time to write an article or blog so
that we are all communicating. But is there anything to communicate
about? As our profession continues to expand there will always be new
issues, important matters, difficult choices and a need to share our
views. This is where you and I come in. We can share our thoughts
agreeing or disagreeing respectfully for the purpose of bringing the PA
profession forward.



I
don’t
need to elaborate on the spoils of
war as every PA can look into their own state and observe the actions
taken by volunteer leaders to expand legislatively and to protect our
profession from attacks from other professions. Louisiana is an example
of a recent attack and the response is needed from that
state’s PAs and
their brothers and sisters in the profession across the nation. I am
personally very involved with a committee of eight members and possibly
two more in a drive to change our name from assistant to associate. The
websites are carrying the news and there are places for you to
communicate and send your personal message to the AAPA. We have over
two thousand messages sent from PAs in one week.



All of
the
advances that you are observing are due to the fact that there are
volunteer leaders on a state, specialty and national front. The time
spent is beyond your imagination but the fruits of our labors become
evident to our members. Leaders need to lead from the front and
sometimes take a stance that is important for the profession although
members sometimes disagree or are not looking to the future. Leaders
need to communicate with their members, their boards and with other
leaders across the country such as we are proving with the name change
issue. This is becoming the handiwork of this generation of PAs as they
move into a place of leadership and servant hood. That’s
really what it
is all about, serving one another.



The
last strategy for an
effective tactical victory is to sound the trumpet. It is an excellent
means of internal communication and requires the cooperation of every
website, every journal and every PA who has an address book of other
PAs. The trumpet is the tool used to declare unity, pride and victory
to the PA universe. This website is willing to be utilized as are many
others because this issue will be brought to a successful conclusion.
It remains our job to advertise our profession, to tell our patients
who we are and what we do by proclaiming the fact that we are indeed
caregivers and a part of the answer for a health care system that is
spinning out of control. So sound the trumpet and send your letter and
let it be a proclamation of what you believe and desire for the future
of our profession.  *** www.associatenamechange.com*** 

 
           
       
           
       
           
       
           




Dilemmas,
Opportunities,
and
Solutions in Common


Robert
M. Blumm, MA,
RPA-C


Copyright
2002 Jobson
Publishing, LLC. Reprinted with permission by Clinician Reviews.

Introduction
 Comparing
notes with an
NP educator/clinician at a national consultants' meeting inspired this
veteran PA to consider ways the
PA
and NP professions can team up to address their shared challenges.



Robert Blumm Bob Blumm PA Physician Associate Physician AssistantFor
me, this has been an exciting two years. I've had the opportunity to
travel to sites around the country, comoderating at national
consultants' meetings for a major pharmaceutical company. It was great
to meet and befriend so many practitioners from so many places.

This
also was my first chance to meet Margaret
Fitzgerald, MS, APRN, BC,
NP-C, an NP educator and practicing clinician-and my comoderator.
Margaret and I enjoyed the opportunity, together with some of the
meeting participants, to dismantle many of the walls that exist between
the PA and NP professions. Throughout our dialogue, I was reminded that
we share common dilemmas and common opportunities-and reflected that
together, we can find common solutions.

Our
Shared Dilemmas


NPs and PAs share the issue of credibility, thanks to our powerlessness
to be properly tracked by the pharmaceutical industry. How can we be
credible when so many pharmacists unilaterally override us as the
prescriber?

Apparently,
doctors experience this, too. I recently had a prescription filled at a
chain drug store. Printed on my medication bottle, to my amazement, was
the name of the first physician on the prescription slip-not the name
of my cardiologist. The pharmacist had not made this choice because of
a bias about my cardiologist's credentials (she is not a PA or an NP),
and hopefully, not because of her gender; it was simply because another
physician was listed first on her prescription pad.

We
first
addressed this issue at the 1994 Clinicians'
Conference in
Connecticut, but to this day it remains a seemingly insurmountable
problem. Would it be possible for our two professions to take on this
issue-and perhaps come up with a satisfactory solution? Remember, there
is strength in numbers.

Our
reimbursement problems, too, persist. I applaud the American Academy of
Physician Assistants for its fine work in getting PAs approval for
Medicare reimbursement-and the American Academy of Nurse Practitioners,
the American College of Nurse Practitioners, and other NP organizations
for diligently pursuing these matters on behalf of NPs. Yet until we
have universal reimbursement, until every insurance company in the land
is mandated to pay for services provided by an NP or a PA, then we
remain restricted and our professions are weakened.

This
coming year will bring increased malpractice insurance rates for both
PAs and NPs. Here, because of dramatic increases in our numbers, our
patient loads, and our vulnerability, we shall share a fate similar to
that of our physician colleagues.

The
Opportunities

During the rapid metamorphosis of health care, each new challenge can
be translated into an opportunity to promote ourselves and extend our
overlapping roles. The burden of higher malpractice insurance premiums
has impacted all of us-particularly the ob/gyn physicians. There is an
acknowledged need for tort reform and a lowering of the malpractice
ceiling. And yet, at the same time that we "nonphysician" clinicians
partner with our physician colleagues to help, we must also consider
the opportunity this situation presents. For instance: In cases where
NPs and PAs share insurance companies, perhaps we could offer to help
create a top-notch risk reduction course or program that will include a
10% premium reduction for each PA or NP who attends it.

With
the growing shortage of physicians and
declining enrollments in medical
schools, a dark cloud is forming on the horizon. Like Dave Mittman,
publisher of this journal (and my contemporary, friend, and colleague),
I shudder to look into the crystal ball. There, 20 or 30 years in the
future, we see ourselves sharing a geriatric suite at University
Medical Center. Who will be caring for us, and with what credentials?
Will they be compassionate toward us in our motorized wheelchairs, or
will they consider us a burden? And who will be staffing critical care
areas? Will their roles change? Clearly, we must move together toward a
vision of health care as we hope to see it!

An
additional opportunity arises with the proposed
maximum 80-hour
workweek for physician residents. It will be nice for residents to
"have a life," but they will pay for it in experience-or the lack
thereof. I can only reflect on my personal knowledge in surgery and
emergency medicine; but after you've worked grueling hours and been
pressed to the max, it's that ruptured abdominal aortic aneurysm at 3
AM that defines you and shows just how far you can really go. I've been
there; I've felt that adrenaline surge. And I've found within myself
the ability to run yet one more mile-to find gold at the end of the
rainbow when the patient emerges from the hospital 10 days later.

"We
pay a price to gain a prize." It concerns me that despite the potential
payoff of reduced errors, residents may pay the price of lost
experience.

Common
Solutions


How does all this affect each of us, personally and professionally? And
how do we respond?

Regarding
the ob/gyn crisis, we can demonstrate our commitment to the health care
team by extending our hands and becoming active partners with our
physician colleagues in the realm of tort reform and other malpractice
issues. By doing so, perhaps we can dispel the medical societies' fears
and doubts concerning "midlevel providers." Of course, this may take
time.

Meanwhile,
if ob/gyn physicians continue to drop obstetrics, this could be
catastrophic for the many women who need prenatal and complete ob/gyn
care. NPs and PAs will be affected, too-but they can choose to become
part of the solution. The care needed for women to bear healthy babies
may well be provided by certified nurse-midwives and by PAs and NPs who
practice in ob/gyn. These NPs and PAs may then be motivated to pursue
postgraduate studies, further qualifying them to take up the slack and
fill in the holes-as we have so often done in the past.

Likewise,
we must find our fit in the shortfall of medical care that will result
from the 80-hour workweek for residents. Residency programs are closing
almost as rapidly as malpractice companies. Hospitals, medical centers,
and government-funded agencies will all need to reach out to other
qualified providers.

We
are those qualified providers
.

Surgical
PAs function as first assistants and perform well in surgical intensive
care. The new role of hospitalist has been successfully filled, thanks
to board-certified internists and other physicians working in teams
with NPs and PAs; this model has proven itself. In emergency
departments, experienced PAs and NPs performing in a resident-like role
successfully meet the challenges of overcrowding, dumping, and
unnecessary visits.

Conclusion


Nurse practitioners and physician assistants are still the answer to
the American health care crisis. We have the education, the experience,
the commitment, the passion, the tools, the enthusiasm-and the
numbers-to make a difference. If we each take one step forward, America
will soon hear the marching steps of thousands from both of our
professions, with thousands of voices expressing the urgent medical
care needs across our country. Maybe then, people will no longer ask,
"What is a PA?" or "What is an NP?"-because they will have experienced
firsthand the excellent treatment that defines our roles.



Where
do we fit in the vision that I have described? Where do we see
our respective and collective professions in the next three years? The
next ten? Are we ready to risk becoming proactive, working toward a
healthier America-starting today? I, for one, vote yes. Together, let's
make the years 2001 to 2010 known as the Decade of Progress, forged by
our professions!



Robert
M. Blumm has practiced in plastic surgery for 30 years and owns a
private first assistant business. He acts as a preceptor to PA students
from the State University of New York-Stonybrook, the New York
Institute of Technology in Westbury, and Touro College in New York
City. Currently Chairman of the Surgical Congress of the American
Academy of Physician Assistants (AAPA) and the AAPA Liaison to the
American College of Surgeons, Mr. Blumm is a past president of the New
York State Society of Physician Assistants and the American Association
of Surgical Physician Assistants. 

 
           
       
           
       
       

Copyright
2002 Jobson Publishing, LLC. Reprinted with permission by Clinician
Reviews.


Physician Associate: A Change
Whose Time Has Come


Robert Blumm Bob Blumm PA Physician Associate Physician Assistant

We,
the undersigned physician assistant
leaders assert that the time to
change the name of our profession has arrived. While we can debate much
about a name change, we have all agreed to the below statements and
thoughts. We also fully agree that the name change advocated below will
advance the profession. We call on the leaders of the profession and
all PAs to announce and start to implement this change as soon as
possible. We are leaders who believe it is increasingly unwise to wait
longer to make this long-needed change. Collectively, the below-signed
PAs have given much of their lives to the profession and are dedicated
to its advancement.



Why We Need a Change

Our
profession’s original name was physician associate.
Physicians
demanded that “associate” be changed on the grounds
that it
did not properly describe the desired scope of PA practice. Forty years
later we have outgrown the "assistant" title. It no longer accurately
represents the profession. It is inaccurate and confuses consumers. The
title is misleading and carries negative connotations which we can and
should avoid. As we move into a new model of healthcare delivery it is
of the utmost importance that our profession’s name
accurately
describes our role.



Why a Change Is Justified

-- The PA role
is truly one of partnership; of association and collegiality. We work
as associates and have for many years. Our profession’s
birth-name in 1965 was physician associate.



-- “Physicians
assistant” is a generic term. It can mean anything: a person
in
the office that bills patients, a records assistant, the person that
sets up and cleans the exam room, all the way to a certified, licensed
PA. The profession must move from this generic name to one that aptly
and more accurately describes our function



-- In our
society, "assistant" denotes a technical job, not a profession.



-- PAs are held to the same legal and medical standards as physicians.



--
The title is confusing and misleading to our patients and the public in
general. Since the name practically guarantees that
“physician
assistants” will be confused with “medical
assistants”, patients are at risk of thinking they are
receiving
substandard care or expect that after the
“assistant” a
physician will also be seeing them. Most times this does not happen,
nor does the physician or the PA expect it to happen. It is time to
have the name mirror the reality that exists.



-- The
internationalization of PAs is important to the profession. Having to
explain that the common meaning of the name
“assistant”
under-represents our true practice is a barrier, in international
forums, to full understanding.



-- The above problems also may
keep prospective applicants and others away from becoming PAs as they
would not want to go through extensive schooling only to become
someone's assistant.



-- Almost all professions at the level of
training of a PA (pharmacy, PT, OT, NP) are or soon will be at the
doctorate level. Our education and practice is professional, as should
be our title.



-- “Assistant” obscures the PA's true
role in the practice. Physicians who might otherwise consider a PA do
not hire one as they feel they need someone more than just another
"assistant".



-- All professions should be able to name their
profession. “Physician Assistant” both demeans and
misrepresents our profession. It is time to claim the name that is both
appropriate and our birthright and discard the one that was forced upon
us.



The Process

-- The profession, ideally through the AAPA
Board or HOD, should immediately adopt a policy that states that
"Hereafter the profession will work to be retitled "Physician
Associate," as it more accurately reflects the profession in the 21st
century".



-- If the Board or House is reluctant to do this on
their own, then the entire profession should be polled using the AAPA's
full database.



-- This renaming can be done over a number of
years, with the ability reserved to use either title in the interim if
necessary, depending on state legislation, etc.



-- The PA
profession should advise organized medicine that this change is not an
effort for independent practice but is a move to more accurately
describe the scope and status of the profession and place it at a level
where it belongs. It should also be explained that the name physician
associate had been chosen for us by organized medicine to represent the
PA profession 45 years ago. PAs should stress that after 45 years of
delivering quality medical care across the entire spectrum of practice,
we are choosing a more appropriate name and that we would expect
nothing less than the full support of organized medicine, which will
also benefit from the change.



-- PA programs should include the
name physician associate whenever possible--along with the title
physician assistant if need be.



-- “Physician Associate” allows us continued use of
the initials "PA", which are well-known to the public.



--
“Associate” does not imply that PAs are equal to
physicians. Associate professors are not full professors. Associate
deans are not full deans. There are precedents for this.



-- The profession should consider funding State-level efforts to effect
this change.



--
The argument that a change will open laws at the State level is a
hollow one. This action can be introduced as a "cosmetic" name change
amendment which will have no impact on PA practice law. If opposed, the
profession can educate the legislature as to the source of the
opposition, that we are asking for no increased privileges, and the
current title is confusing consumers and others



-- This name
change should be done BEFORE the profession embarks upon any large
public relations campaign. We can effectively brand the profession
through the use of the new name, avoiding any confusion of our status
when compared with medical, podiatry, chiropractic and other assistants.



Therefore,
we the undersigned PAs declare that because of the above reasons and
more, the PA profession should adopt the name "Physician Associate" and
begin an educational campaign to other medical professionals and the
public regarding Physician Associates.



1. Robert M. Blumm, MA,
PA-C, DFAAPA, Immediate past president APSPA, Past president AASPA,
Immediate past president ACC, Past president NYSSPA, Past AAPA Liaison
To ACS, ACC Liaison to ACS, Past Chair Surgical Congress AAPA,
Editorial Board Advance for PAs, Clinician 1, Advanced Practice Jobs,
past editorial board member Physician Assistant, Clinician News,
Author, National Conference Speaker, Consultant, Paragon Award Winner
Physician /PA Team, John Kirklin M.D. Award for Excellence in Surgery



2.Robin
Morgenstern, PA past AAPA Secretary, past president Illinois Academy of
PAs, past Director of the PA Program of Cook County Hospital, Chicago,
Past Midwest Advertising manager Clinician Reviews Journal.



3.Maryann
Ramos, MPH, PA-C, Founding President NJSSPA, Secretary of the AAPA
House of Delegates, Delegate or Alternate for many years; Current
Member, Nominating Committee; Current Legislative Chair for Physician
Assistants for Latino Health - Puerto Rico; Past President American
Academy of Physician Assistants in Occupational Medicine; Established
Liaison between occupational physicians and PAs and Affiliate PA
Membership in ACOEM; Awarded the Meritorious Civilian Performance
Medal, US Army Medical Corps, 2008; Past Federal Civilian PA of the
Year 2002(AAPA Veteran's Caucus); Past PA of the Year (AAPA President's
Award 1980)



4.Blaine Carmichael, MPAS, PA-C, DFAAPA, Co-Founder
Association, Past president, Vice President and current Delegate at
Large of Family Practice Physician Assistants, Founder Bexar County PA
Society, Founder, Que Paso - What's Happening PAs of San Antonio,
Moderator of PRIMARY PA forum, Board Member, American College of
Clinicians, Founding member of PA History, Texas PA of the year, 1990,
has published widely and speaks at many national, state and local PA
conferences



5. Dave Mittman, PA. Past AAPA Director, Past
President NY State Society of PAs, Co-Founder and creator Clinician
Reviews Journal and Clinician 1. Medical Communications Expert. First
PA in the USAF Reserves. Lifetime PA Achievement Award/President'sAward
NJSSPA and NYSSPAAAPA National Public Education Award Winner-1983



6.
Frank Rodino, PA, MHS, Past Public Education Chair AAPA, Past NYSSPA
President. Currently President and CEO Churchill Communications: A
Medical/Scientific Communications Company



7. Thomas Roselle, PA-C Past NYSSPA Consultant, PA Entrepreneur, Clinic
Owner



8.
David M. Jones, PA-C, MPAS, DFAAPA, Member, Past Governmental Affairs
Council, AAPA Legislative Co-Chair for at least 10 years, Oregon
Society of PAs (Chair for the 2009 session), Past President of OSPA
(twice), AAPA Co-Rural PA of the year 1988; second term as a member of
the PA Committee, Oregon Medical Board



9. Roy Cary, PA-C, DFAAPA
Co-founder and past president of The American Academy of Physician
Assistants in Legal Medicine. Co-founder in Cary & Associates,
LLC
and holds a position as Senior Partner. Mr. Cary is also a member of
the Physician Assistant Advisory Committee of the Nevada State Board of
Medical Examiners. Retired Air Force Major.



10. James R
Piotrowski, PA-C, MS , DFAAPA , Co-founder Association of Neurosurgical
Physician Assistants , Past president of ANSPA , Past Vice President
and board member of FAPA , Co-founder of the FAPA-PAC , Past member
Florida BOM PA Committee, Past Trustee of the AAPA PAC and Chairman of
the AAPA-PAC , Past PA member of the council of AANS and CNS, Past
editor of the ANSPA 's Journal.



11. Lisa D' Andrea Lenell, PA-C,
MPAS. Internal Medicine PA, Adjunct Faculty Midwestern University,
National Radio Host ReachMD XM160



12. Michael Halasy, MS, PA-C Health Policy Analyst/Researcher Author of
well known PA Blog



13.
Gary Falcetano, PA-C, Bariatric Medicine, Stockton NJ, Managing
Director – Collaborative Clinical Communications, LLC.
Captain
(Ret.) US Army Reserve, Past Group Publisher Clinician Reviews /
Emergency Medicine / Urgent Care, journals.



14. Charles O'Leary,
PA-C, Hominy Family Health Center [FQHC], 35-year practice same site;
LTC [Retired] US Army/OKARNG [2 tours Afghanistan, awarded BSM/CMB];
past-OAPA Vice-President, Past OAPA Newsletter Editor, 1992 Oklahoma
Rural PA of Year, OU-Tulsa Medical College PA Preceptor, Past Hominy
School Board President, Past Commander American Legion Post 142



15. Gerry Keenan PA-C, MMS, Emergency Medicine, Bar Harbor, Maine



16.
Martin Morales, PA MHA. Director, Physician Assistant Services, Long
Island Jewish Medical Center / North Shore LIJ Health System.



17. Stephen E. Lyons MS, PA-C, W .Cheyenne Clinic Coordinator, Take
Care



18.
Robert Nelson, PA-C. Executive Director, Island Eye Surgicenter, LI,
NY. Administrator a various surgicenters in NY metropolitan area,
Author, Speaker, Director at Large-Outpatient Ophthalmic Surgery
Society, Member Corporate Development Planning Committee OOSS,
Consultant, Surgical PA 30 years.



19. Eric Holden, PA-C, MPA,
EMT-P 23 years of practice in emergency medicine.Member of state,
federal, and international disaster medical teams. Medical provider at
level 1 and 2 trauma ctrs, HMO's, community E.D.'s, rural/under served
E.D.'s, and solo provider at high acuity inner city facility. Author of
multiple articles in peer reviewed medical journals.



20. Rebecca Rosenberger, MMSc, PA-C, Current President AAPA-AAI



21. j. Michael Jones, MPAS-C, Chair PA Section American Headache
Society, Director Cascade Neurologic-Headache Clinic..



22.
Pamela Burwell, MS, PA-C. Distinguished Fellow, AAPA .Founder and
Director, Peacework Medical Projects. AAPA Humanitarian of the
YearArizona PA of the Year



23. Eleanor H. Abel, RPAC, MS, CRC
Upstate Medical University, Syracuse-current District B Director At
Large, NYSSPA. Liaison and membership chair for NYRCA. Medical provider
with 22 years of experience in Hematology/Oncology and previously
employed in Surgery and also Physical Medicine and Rehabilitation.
Specialize in pain management, advocacy for people with disabilities,
Past coordinator and current assistant coordinator for the NYSSPA
Public Education Committee



24. Ronald H. Grubman, PA-C Founder,
Conmed Inc., 1984. President and CEO for 23 years. Conmed acquired and
currently a public company on the NYSE. 25. Ken Harbert, Ph.D., CHES,
PA-C, DFAAPA Dean, School of Physician Assistant Studies. South
College, Knoxville, TN



26. Eric Schuman, MPAS, PA-C. Adult &
Pediatric Neurology Kaiser Permanente Portland, Oregon. Adjunct
Assistant Professor, Oregon Health & Science University
Physician
Assistant Program



27. Charles A. Moxin, MPAS, PA-C, DFAAPA, Past
President Association of Family Practice Physician Assistants, Past
AAPA HOD delegate for Family Practice, Past Editorial Board member for
Arthritis Practitioner, Author, National Conference Speaker,
Pharmaceutical Advisory Board member



28. Kenneth E. Korber, PA
PhD(c): Director of Strategic Development - CE Outcomes LLC, Curriculum
Architect - First PA Postgraduate Fellowship in Cardiovascular Care,
Clinical Associate University of Illinois College of Medicine, Past
Member Board of Directors: Association of PAs in Cardiology, Member -
Association of Postgraduate PA Programs, Founder - AAPA Medical Writers
Special Interest Group; former Faculty - AAPA Chapter Lecture Series.



29.
Kenneth DeBarth, RPA-C, Past President NYSSPA, Past NYSSPA Newsletter
Editor, Past Secretary/Treasurer South Dakota Academy of PAs, founding
editor SDAPA newsletter, past chair AAPA Professional Practices and
Relations Committee, former owner Heuvelton Medical Group, NY.



30.
Ryan O'Gowan, PA-C, FAPACVS. Acting Manager, NP/PA Critical Care
Workgroup. Program Director Physician Assistant Residency In Critical
Care

Umass Memorial Healthcare



31. Chris Hanifin, PA-C. NJSSPA Immediate Past President



32. Cindy Burghardt, MS, PA-C, Nephrology PA for Renal Associates, San
Antonio, Texas.



33. John Sallis, MBA, MMS, PA-C PA consultant -Negotiation management



34.
James Doody, PA-C Director of Pediatrics and Primary Care 1st Health
Centers, Assistant Clinical Professor University of Colorado Health
Science Center, former Director of Pediatrics Lake Grove School,
Editorial Board Member Physician Assistant Magazine, Provider liason
Medical Home Initiative for State of Colorado.



35. Karen Fields, MSPAS, PA-C Founder of Medical Mentoring
(medicalmentors. net); Cofounder PAWorld.net



36. Richard Mayer, PA. Vice President Provider and Network Development.
Lenox Hill Hospital, NY NY



37.
Sharon Bahrych, PA-C, MPH, listed in Marquis’s
Who’s Who of
American Women, published author of 60 lay and medical journal
articles, state and national CME presenter,co-founder of APAO, clinical
trials researcher with a NIH rated grant, currently working on a PhD.



38. George Berry, MPAS, PA-C. Pediatric Trauma Coordinator Regional
Pediatric Trauma Center, Schneider Children's Hospital

North Shore-Long Island Jewish Health System



39.
Lisa F. Campo, MPAS, PA, DFAAPA; Past President NYSSPA. Former Chief
Delegate/ delegate AAPA HOD; former Committee member Wagner College PA
Program Advisory and Admission Committees; President LCFC-LLC
Consulting; Advanced Clinical Physician Associate the Mount Sinai
Medical Center; practicing PA 30 years.



40. Kristina Marsack, PA-C, President, Association Plastic Surgery PAs,
past-Treasurer, APSPA



41.
John W. Bullock, PA-C, DFAAPA. Past Chief Consultant to the US Air
Force Surgeon General for Physician Assistants, Founding member and
past Vice President of PAs in Orthopaedic Surgery. AAPA Federal
Services PA of the Year.



42. William Gentry, MPAS, PA-C Senior Physician Assistant-Neurology
Audie L. Murphy Veterans Medical Center



43. Harmony Johnson PA-C, MMS President, PAs for Global Health



44. Cristobal E Perez, PA-C Faculty Associate, Department of
Neurosurgery. UTHSCSA



45. Frank Crosby, PA-C One of first PAs to practice in UK



46. David L. Patten, PA-C, COL, SP, TXARNG. Deputy Commander for Texas
Medical Command



47. Michael France, CCRC, MPAS, PA-C, Director of Clinical Research,
Alamo Medical Research, MAJ USAF Retired



48.
Robert L. Hollingsworth, DHSc, MS, PA-C. Owner, Sole Provider Red
Springs Family Medicine Clinic, N.C. Preceptor for the Physician
Assistant Programs at Methodist College in Fayetteville, N.C, Duke
University in Durham N.C. and East Carolina University, in Greenville,
N.C. Active preceptor for several Nurse Practitioner Programs within
the state. Former Instructor: Methodist College Physician Assistant
Program



49. James C. Allen, IV, MPAS, PA-C, DFAAPA; Director,
Physician Assistant Clinical Training Programs, University of Texas
Medical Branch-Galveston/Correctional Managed Care; Former Secretary
Bexar County PA Society 2003-2005; Dual Certified Aerospace
Physiologist; US air Force Aerospace Physiologist of the Year 2003;
Past President Towner-Shafer Society, US Air Force 1993-1994; Retired
US Air Force Major



50. Michelle Ederer, MA, RPA-C Past President, New York State Society
of PAs  

 
           
       
           
       
           
       
           
       
           
       
           
       






Bob Blumm Robert M. Blumm has
received national recognition as a distinguished fellow of the American
Academy of Physician Assistants (AAPA). He is the past president of the
Association of Plastic Surgery Physician Assistants, and was
past-president of the American Association of Surgical Physician
Assistants, past president of the American College of Clinicians and
NYSSPA, as well as Chairman of the Surgical Congress of the AAPA. In
addition, Bob received the John Kirklin MD Award for Professional
Excellence from the American Association of Surgical Physician
Assistants. Along with his associate, Dr. Acker, Bob was the first
recipient of the AAPA PAragon Physician-PA Partnership Award. He has
been a contributing author of three textbooks, written 150 plus
articles and is a sought out conference speaker throughout the United
States.








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