PA History Midterm 2020
PANCE registration fee
$550
NCCPA develops & maintains...
- PANCE ($550) - PANRE ($350) - Specialty CAQ exams ($350) - Maintains CME records for PAs ($130/yr)
Who can offer Category 1 CME?
-AAPA -AMA (providers accredited by ACCME) -AOA -AAFP -Royal College of Physicians & Surgeons of Canada, College of Family Physicians of Canada, or the PA Certification Council of Canada
Qualifications for a PA to be eligible for prescriptive authority?
-Complete min. of 500 clinical hrs prior to graduation -Hold active unrestricted license issued by LSBME -Be authorized to prescribe as delegated by SP -Apply for controlled dangerous substance & register w/ the DEA
Services a PA-C can legally perform in Louisiana
-Diagnose -PEC -Examine pts -Prescribe meds -Create care plan
States should do what to support OTP?
-Eliminate legal requirement for a specific relationship btwn a PA, physician, etc. -Create a separate majority PA board to regulate PAs or add PAs to the board -Authorize PAs to be eligible for direct payment
Reasons for the inception of the PA profession
-Improve & expand access to healthcare. -Provide medical care to remote populations where none existed -Meet military and public health needs -Shortage of PCPs following WWII
Services a PA-C cannot legally perform in Louisiana
-Manage chronic pain -Call time of death -Sign death certificate -Perform surgery -use stimulants to treat obesity -Participate in execution
CAQ Requirements
-need Cat 1 specialty CME -1-2 yrs clinical experience -procedures & pt. case experience in speciality area -pass CAQ exam
4 principles of bioethics
1) Autonomy 2) Beneficence (do good) 3) Non-malfeasance (do no harm) 4) Justice (treat all pts the same)
Clinical rotations required by PA students
1) Family medicine; 2)Emergency medicine; 3) Internal medicine; 4)Surgery; 5) Pediatrics; 6)Women's health (inc. prenatal & gyn); 7) Behavioral & mental Health
Six Key Elements of Modern PA Practice Act
1) Licensure (as regulatory term) 2) Full Rx 3) Scope determined at practice site 4) Adaptable supervision/collaboration requirements 5) Chart co-sign determined at practice level 6) Physician may practice w/ unlimited # of PAs **LA does not followed #6
Each ____ certification cycle is divided into ______ ______-year "periods"
10 five, 2-yr periods
Once you pass the PANCE you are certified for....
10 years
During each period, you must earn a total of _____ CME hours. ____ Cat 1 CME credits + _____ cat 2 CME credits
100 CME hour 50 Cat 1 50 cat 2
Number of questions & cost of CAQ
120 questions; $350
Charles L. Hudson, MD
1961 - Dr. who first proposed the idea of a PA in the Journal of the AMA "advanced medical assistant w/ special training, intermediate btwn that of the technician & of Dr., who could not only handle many technical procedures but could take some degree of medical responsibility."
1973
1st national PA exam administered by NBME
PANCE test results typically arrive within ___ _______ of test date.
2 weeks
Number of questions on PANRE
240
PANCE minimum score range to pass
350-390 *no standard minimal score
2017
50th anniversary of the profession AAPA House of Delegates passes Optimal Team Practice OTP: new policy that will make a profound difference in expanding access to care & aligning the PA profession to meet modern healthcare needs.
How long do you have to take the PANCE after graduation (from ARC-PA accredited program)?
6 yrs. - able to take PANCE max of 6 times total. After either, the individual loses eligibility to take. Only way to establish eligibility is to enter into & complete an unabridged ARC-PA accredited PA program.
PANCE can be taken no earlier than _____ days post graduation date from accredited PA program
7
Highest possible PANCE score
800
Organization that publishes the annual PA salary report; as well as CME opportunities/conferences.
AAPA
Organization that works at state & federal levels, on healthcare reform, & on reimbursement issues.
AAPA
PAs with significant accomplishments & exemplary careers can apply to become a fellow member of this orgnaization
AAPA
The professional society of the PA profession in the US
AAPA
Cost of AAPA and LAPA student dues
AAPA - $75 fee covers until graduation LAPA - $35 for 2 yrs
2008
AAPA identifies Six Key Elements of Modern PA Practice Act. RI is the 1st state to adopt all elements.
1968
AAPA is incorporated. American Association of PAs --> changed to American Academy of PAs
1971
AMA recognizes the PA profession. 1st 6 states pass legislation authorizing PA practice.
Accrediting agency/organization that protects the interest of the public & PA profession
ARC-PA
Organization that can place a PA Program on probation or revoke its accreditation status.
ARC-PA
Organization that defines standards for PA education programs in the US
ARC-PA
Organization that ensures PA programs maintain compliance
ARC-PA
This organization can grant PA programs provisional or continuing accreditation through site visits.
ARC-PA
ARC-PA stands for...
Accreditation Review Commission on Education for the Physician Assistant
Medical error that reaches the patient & causes harm
Adverse Event
2000
All 50 states authorize PA practice when MS passes legislation to recognize PAs
AAPA stands for...
American Academy of Physician Assistants
AMA stands for...
American Medical Association
Near Miss
Any event that could have had an adverse patient consequence but did not & was indistinguishable from an adverse event in all but outcome
When can a PA-C act without the supervision of a physician?
Assist in life threatening emergencies & situations such an man-made & natural disasters or physician emergency relief effort
Structure of the AAPA
Board of Directors = governing body House of Delegates = policy making body Student Academy - has own structure/leadership: Assembly of Reps & Student House of Delegates
What kind of local anesthetics can a PA administer? not administer?
CAN admin local anesthetics SQ (digital blocks or topic) when delegated by SP CANNOT admin: perineurial, pericurally, epidural, intrathecal, IV unless they are a CRNA
Allows the PA to achieve recognition for specialty skills, knowledge, & experience. Demonstrates skill/knowledge beyond entry level PAs.
Certificate of Additional Qualification (CAQ)
Assessment of the most basic medical & surgical knowledge and skill
Certification
How should a medical error by managed?
Clinical Incident ----> Identify ----> Immediate Action ----> Notify (in charge) ----> Disclosure (tell pt) ----> Report ----> Investigate ----> Change ----> Monitor ----> Evaluate
Who is the current president of the AAPA
David Mittman
1st PA program was established
Duke University 1965 4 Navy Hospital Corpsmen (1st class graduated in 1967)
Contributions of the PA profession in areas of primary & specialty care
EDUCATION: educating others HOSPITALS: Improving delivery of care LEADERSHIP: differences at institutional & system-wide levels MILITARY: critical to health of US military NON-PROFITS: join/form to expand reach & make a difference for communities at home & around the world OFFICE PRACTICE & CLINICS: practice in med. & surg. practices of all types/sizes from the most adv. multi-specialty practices to free clinics SURGERY: ~20,000PA-Cs; provide vital care before, during, & after surgery UNDERSERVED POPULATIONS: need were going unmet; often remote areas but can be found w/n large urban centers
Founder of the PA profession
Eugene A. Stead, Jr. (1965)
Negligence
Failure to meet the standard of care reasonably expected of an average provider qualified to take care of said patient. Care that fell below the standard expected of peers in their community
Who are the LA members on House of Delegates (3 seats)?
Falba Rebecca Clawson Emilie Davis
2016
First of AAPA's Six Key Elements of Modern PA Practice adopted in all 50 states OH adopts use of the term "licensure," = highest recognized standard of medical providers
Negligent Adverse Event
Injury caused y substandard medical management
What are claimed as category 2 CME?
Journal readings Teaching/precepting students Clinical research activities Professional meetings (peer reviews, department meetings, organizational edu. activities/presentations)
If a PA has a question about general practice in Louisiana, it is advised that they contact this organization?
LAPA
This organization has smaller regional groups that may meet for monthly meeting/activities (ex: pharmaceutical rep dinners)
LAPA
This organization would lobby for changes to state laws/regulations regarding PA practice.
LAPA
This organization's purpose is to strengthen the role of the PA in the State of Louisiana
LAPA
Current leaders of this organization are: Roderick Clark, MD (President) Vincent Culotta, MD (Exec Director) Lawerence Cresswell, DO, JD (Director of Investigations)
LSBME
Licensing organization for MDs & PAs in LA and other allied health professionals
LSBME (Louisiana State Board of Medical Examiners)
LAPA stands for...
Louisiana Academy of Physician Assistants
LSBME stands for...
Louisiana State Board of Medical Examiners
Medical error algorithm
MED. ERROR --> reaches pt --> NO HARM Med. Error --> reaches pt --> Harm = ADVERSE EVENT Med. Error --> does NOT reach pt = NEAR MISS
Number of times the PANRE can be taken
Max of 4 attempts: Up to 2 times in the 9th & 10the years of recert. cycle & up to 3x in the 10th yr.
How are CME requirements fulfilled?
Must log 100 CME credits that are earned within the 2 yr period ending on the December 31st at 11:59pm PST. of the certification expiration year ex: certification expires in 2020, then CME must be earned btwn MAY 1, 2018 & December 31, 2020.
Every 2 years, PAs must log their CME records on this site.
NCCPA
In Louisiana, PAs must become certified by what organization
NCCPA
Organization responsible for ensuring PAs meet clinical knowledge & skill requirements for entry level & ongoing maintenance
NCCPA
Organization that develops & maintains the PANCE & PANRE (recertification exam)
NCCPA
This organization develops speciality CAQ exams for PAs who work in those various medical specialties.
NCCPA
This organization is the only certifying agency for PAs in the US
NCCPA
Does the PAs supervising physician have to be physically present?
NO, but the SP & PA must have the capability to be in contact via phone or other communication device.
NCCPA stands for...
National Commission on Certification of Physician Assistants
Medical Error that DOES NOT reach the patient
Near miss
When can PANCE registration be submitted?
No earlier than 90 days PRIOR TO to graduation date
1987
OCTOBER 6TH - National PA Day was celebrated for the 1st time in honor of the 20th anniversary of the 1st graduating class of PAs
PA week dates?
October 6-12
1967
October 6th - The 1st PA class graduates from Duke University PA program
How many times can you take the PANCE in one year?
Once in a 90-day period or 3x/yr... whichever is fewer
Subcommittee of SBME is the...
PA advisory committee
Certified PAs are designated by...
PA-C
Program that ALL PA programs in the nation are members of
PA-EA
Organization that is responsible for collecting, publishing, & disseminative information regarding PA education/programs.
PAEA
Organization that provides RESOURCES to faculty, applicants, & students.
PAEA
National certifying exam for PAs
PANCE
PANCE: _____ questions, _____ blocks, _____ minutes of breaks
PANCE: 300 questions 5 blocks 45 min. of total breaks ALSO the PANCE is computer-based, timed, based on "content blueprint", & question format of clinical vignettes & pictures
1992
PAs are commissioned in every health branch of the US military
1977
PAs in certified rural health clinics begin receiving Medicare reimbursements.
2010
PAs named in Patient Protection & Affordable Care Act (ACA) as one of 3 healthcare professionals - MD, PA, NP
2007
PAs obtain prescriptive authority in all 50 states & DC. Indiana was last to pass law.
1997
PAs recognized as Medicare covered providers (in all settings)
PAEA stands for...
Physician Assistant Education Association
FranU PA program current leadership - director, academic director, medical director, clinical coordinator
Program Director - Sarah Deyo, PA-C Academic Program Director - Ben Erwin, PA-C Medical Director - Chad Braden, MD Clinical Coordinator - Michael McIntosh, PA-C **program director must be a PA-C or MD
At the end of your certification cycle, you must do what?
Re-certify by taking the PANRE
3 types of CME category 1
Regular *required Self-Assessment (count as 1.5 credit) Performance Improvement (count as 1.5 credit)
Any private citizen/member of the public can view disciplinary actions taken against a PA (or MD) on this organization's website
SBME
If a patient wanted to file a complaint against a PA, they would contact which organization who would then investigate the complaint
SBME
Organization that can revoke or restrict a PAs license or fine the PA for failure to comply with state laws/rules
SBME
PAs apply for licensure with this organization
SBME
PAs must renew their license ANNUALLY with this organization
SBME
This organization creates rules for PA practice & issues reprimands if not followed.
SBME
This organization published rules regarding opiate prescribing laws/rules
SBME
What types of drugs can a PA prescribe in LA?
Schedule II, III, IV, V Legend drugs Sample drugs
How are category 1 CME earned?
Seminars, conferences, & online. Ex: Journals w/ CME activities (test), conferences, renewing certifications (CPR, ACLS)
Responsible to licensing & disciplining of PAs
State Board of Medical Examiners (SBME)
PAEA mission
To pursue excellence, foster faculty development, advance the body of knowledge that defines quality education & patient-centered care, and promote diversity in all aspects of PA education.
Adverse Event
Unintended harm/injury to patients caused by medical mgmt rather than as a result of disease process that results in measurable disability, prolonged hospitalized, or both
What determines the PA's scope of practice in LA?
Whatever is delegated by the supervising physician.
Can a PA volunteer services to a non-profit?
Yes if the PA receives ZERO COMMISSION & is performing services under the supervision & presences of a licensed physician.
If you fail the PANCE, when can you retake it
after 90 days
Legend drugs
any drug or drug product that states on the label as required by the FDA that "dispensing is prohibited without prescription"
Does FranU have provisional or continuing accreditation & through what year?
continuing accreditation through 2020? 2024? (next site visit is 2023 per franu pa site)
Medical Error
failure of a planned action to be completed as intended (an error of execution) or the use of a wrong plan to achieve an aim (an error of planning) Unintended act (either omission or commission) or one that does not achieve its intended outcome Deviations from the process of care, which may or may not cause harm to the patient
When should the PANRE be taken?
may be taken in 9th or 10th yr of your certification cycle (you must pass it by your 10th year)
Scoring on the PANCE is based on....
the number of correctly answered questions