Next Steps
Jay: OK. Some housekeeping issues.
Jennifer: the weather isn't nice. Please check with your flights and see if they are cancelled. Please don't worry about a place to stay. If you are carpooling - who is going to the airport around 3:30PM? 3:00PM? Who's going at 4PM. 4:30PM?
The computer behind the front desk is free for checking in.
Jay: We are going to vote on the three options developed here. Should the non-PAs vote? I don't want to vote. I agree with that. If someone wants to pay for my vote please let me know. [laughter]
The MDs should vote and the DOs should vote.
I'm going to read the three options.
Option 1: We endorse the medical model of post-graduate clinical education and training for PAs. Therefore we conclude that it is unnecessary for the PA profession to adopt the clinical doctorate.
Option 2: We recommend full professional support for advanced education to enhance knowledge and clinical skills which includes the option of earning a post-graduate, PA clinical doctoral degree.
Option 3: We recommend that the PA profession support the option for colleges and universities to offer post-graduate non-professional specific professional doctorates (such as doctor of medical science or doctor of health science) as part of a group of options available to PAs for career development. This could be a "clinical doctorate" but no PA specific.
Number three does not include a clinical doctorate. Does this include a clinical doctorate? It's a full array of options which includes a clinical doctorate but it's not PA profession specific doctorate. You would not be a doctor of PA. It cannot be doctor of a PA. It's a professional degree.
A clinical doctor is an example of a professional doctorate. But this precludes the option of being a PA specific doctorate.
Should option #2 should say that it includes the option of getting a PA specific doctorate?
When we vote on these do we want a clear majority? Yes. Should we have a run off? Yes.
Get the top two and eliminate the bottom then re-vote. Is the option that comes out from the run-off process OK being this group's recommendation? Yes. Ok, this voting process will determine the recommendation.
This is an attempt by the group to make everyone happy. The reason we said professionals is the Baylor program is offering a doctor of science and that is not a clinical degree. Should the degree be X or Y - but this is the first round that says the degree is not a clinical degree.
We will clarify the justification which will happen after this.
Are we ready to vote?
What 3 denounces is the DPA - a clinical DPA - but it doesn't denounce a clinical doctorate; it supports Baylor's program. The Baylor degree is a Doctor of Science for Physician Assistants in Emergency Medicine or orthopedics. A doctor of health policy is a non-profession specific degree. This is supporting an option for colleges to offer a non-profession specific doctorate.
We're all going to be asked to change the title of the degree. A clinical specialty specific doctorate?
The masters degree as a terminal degree would be obviated if we had a PA specific doctorate. You can have a clinical doctorate but don't call it PA anything so that it doesn't change my options with a Masters degree.
Number 3 denounces the current doctorate degree at Baylor.
Number 2 should say a post-graduate PA clinical doctorate degree.
Voting
Option 1: 13
Option 2: 7
Option 3: 18
Voting Run-off
Option 1: 13
Option 3: 23
Option 3 is the recommendation of the group.
The sponsor group can put together a final statement and then what?
Bob: The next steps:
Thank you very much. It was a painful discussion but you are the best people to have that discussion. We'll work with the presidents of the organizations and put out a summary of the recommendations. We'll take these recommendations and we'll come up with a final document that consists of the recommendations, the justifications and the action plans.
We need to express that there are differences. We would send this to you guys first and then take that and make that available to the rest of the stakeholders. We'll try to get that to you within the next week.
We should include the word agony. Despite the agony we are all looking for the same thing - to grow professionally and personally and to take better care of our patients. The devil in the details will be worked out. We've given our profession a starting point and that's a priceless product.
Short cuts to the result of each team's work:
Team 1 | Team 2 | Team 3 | Team 4 | Team 5 | Team 6 | Team 7 | Team 8
Team 1: Summarized Recommendations
We recommend continuing to promote diversity and multiple pathways and that be maintained for entry into PA programs. We recommend the Masters degree as both the entry level and terminal degree for PA practice.
We recommend all this happen by 2012. There shall not be a PA specific clinical doctorate. We recommend the re-affirmation of the Physician/PA partnership.
We heard from the group that it would be good to come up with a degree name that no one is using. We think it's important that Physician Assistant is in the title. PA practice might be the thing that means something.
We don't want some programs to have the aha that they are ahead of us!
We're suggesting the Masters of Physician Assistant Practice.
We struggled with the timeframe. We got some information from folks. If you are just changing the name of the degree than that's an easy thing to do. We also thought that we weren't interested in advertising that we are moving to a Masters degree in the same timeframe that nurses are moving to a doctorate.
The programs that aren't going to match up - can they change in this time frame? The people that haven't done it haven't done it out of resistance.
I'm wondering if the MD/DO bridge will require a lot of work and that's only going to benefit only a small number of people?
45% of practicing PAs answered yes they would consider a bridge program.
These are recommendations coming out of a think tank group. These are general recommendations. I would encourage the sponsor group to look at the language. Invite medical schools to explore options for including PAs into medical school. If you name it as a bridge who are we to do that? We are just saying that we would like medical schools to consider this as an option.
Team 2: Action Plan
The statement itself - who is it going to come from? It would go to the AAPA and PAEA membership. It would go to constituent organizations and it would be wise to send this to the deans of colleges and universities and other stakeholders in organized medicine.
Putting out a statement to them would be appropriate.
After that there is no particular order to the rest of this.
There was a lot of discussion about diversity and how we want to respect that and improve it. Working towards the recruitment of diversity to serve under served populations.
Standardization of the Master's degree - PAEA needs to help programs with what all this means. Then it's the conversion to the Masters degree. PAEA would support these programs to do this.
Implementation would be more towards letting the public know (AAPA) and the constituent organizations; getting them ready for any legislative changes that might need to be made. There are regulatory issues to be worked out. There is also the grand fathering issue.
Marketing and branding = it will be important to send the right messages about our education and the value of that. Meeting within the profession and targeted leaders throughout the house of medicine will be very important.
We talked about additional opportunities that we don't have going now. We would need to work hard to bring this out as an action plan. There are other parts of the equation to make this happen.
The bridge - let's consider calling it something else. Let's get a task force together to gather data and we'd include representatives from organized medicine and get their ideas before going forward and developing a model to see if this is an opportunity to consider.
Team 6: Terminal Degree
Here you go.
We're going to get focus groups together - that will take about three months to talk about defining what a terminal degree is.
They will give you data and then it will take about 6 to 9 months to generate a report.
If you don't have enough data then you do a survey and then you make your recommendations.
That will take about 18 months.
Team 7: Guidelines for a Clinical Doctorate
We recommend we assemble a broad range of educators to develop an agenda for developing continuing advanced educational models.
We got tied in to the title.
Survey academic institutions and regulatory agencies. Develop the model that is consistent with what we've already said. Obtain survey data which exists already as well.
We need to gather the information from programs, the skills that are taught, assess what students do on rotation and what their skill levels are. Find out from employers about future skill needs as well.
We need to talk to clinicians to find out what their gaps are.
This lists out some research questions.
What are the gaps in knowledge? How is a PA is perceived? What are the benefits of graduate studies and a clinical doctorate? What are the complications and implications of all of this? Explore other models of clinical doctorates so we can understand what we need to do both in the short term and the long term.
