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Professional Practice Issues
Suggested Topics and References
The AAPA's Professional Affairs staff has identified the following listing of professional practice topics and associated AAPA resources. The list is intended to assist PA programs with meeting the requirement regarding the PA role and professional issues found in the Accreditation Standards for Physician Assistant Education. This listing is not comprehensive and is just one of many resources available.
In addition to the resources listed here, other valuable resources include current and past leaders of the profession, state constituent chapters, and specialty PA organizations. Another resource is the Cumulative Index to Nursing and Allied Health Literature (CINAHL). This index, which reviews hundreds of allied health publications including the Journal of the AAPA, is available at most medical libraries or online at www.cinahl.com (for a fee).
Further information is available through the American Academy of Physician Assistants. The AAPA Web site at www.aapa.org is a comprehensive and up-to-date source of information on the profession. AAPA publications can be purchased online at the AAPA Store (www.aapa.org/aapastore). Academy documents that are not available through the AAPA Web site are available from AAPA staff by calling 703/836-2272, ext. 3207 or 3220.
American Academy of Physician Assistants
950 N. Washington St .
Alexandria, VA 22314-1552
703/836-2272
CME / Recertification AAPA position paper: "Continuing Medical Education and the Physician Assistant Profession." Adopted 1993. Discussion on many aspects of continuing medical education including research, competency, methods, and the scope of PA professional education. Found in the AAPA policy manual online at www.aapa.org/policy/cme-and-PA.html or available from AAPA staff, ext. 3207.
AAPA position paper: "Professional Competence." Adopted 1996. Paper explores the concept of professional competence, especially continuing competence. Found in the AAPA policy manual online at www.aapa.org/manual/16-ProfCompetence.pdf
or available from AAPA staff, ext. 3207.
Alexander LM. "Preparing for the Recertification Exam." JAAPA 10(1)73-77, Jan. 1997. Brief article about preparing for recertification. Available online at www.jaapa.com.
Goltzer SZ. "Taking the National Board and Recertification Examinations: Strategies for Success." JAAPA 7(2)134-138, Feb. 1994. Test-taking and studying tips for preparing for the recertification exam. Available from AAPA staff, ext. 3207.
Yturri K, DaVanzo J. et al. "Maintaining Your Professional Competence." JAAPA 11(8)25-32, Aug.1998. Roundtable discussion of the concept of professional competence including the maintenance of continued competence as a PA in clinical practice. Available online at www.jaapa.com.
A comprehensive resource on all aspects of the NCCPA certification process with detailed information on the exam cycle, preparation, CME, and recertification available at www.nccpa.net.
Current certification review courses list available at www.aapa.org/cme/review-cert.html.
Review materials for the PA National Certification Exam and PA National Recertification Exam available online at www.aapa.org/cme/reviewresources.html.
Coding / Fraud AAPA issue brief: "Medicare's Final Rule on Billing Requirements for Teaching Physicians: The Effect of the Rule on Physician Assistants." August 1996. Discussion of specifics concerning billing requirements for PAs and teaching physicians. Available online at www.aapa.org/gandp/teach.html.
Sparks TL. "Avoiding Fraud and Abuse Pitfalls." An online multimedia resource by a leading health care attorney. Available online at www.aapa.org/gandp/3rdparty.html#sparks.
Delegation of Service / Team Concept AAPA policy H-P-3400.1.3 regarding the importance of team practice to the PA concept. Found in the AAPA policy manual online at www.aapa.org/manual/profession.pdf
AAPA issue brief: "The Physician-PA Team." June 2007. Describes the key elements of team care. Available online at www.aapa.org/gandp/issuebrief/pateamb.pdf.
AAPA News article: "Trust, Respect Make Physician-PA Team Work." 2001. Feature story about a particularly effective PA-physician team. Available from AAPA staff, ext. 3002.
Rosen L. "The Physician-PA Team, Selling an Idea that Works." JAAPA 15(2)52-53, Feb. 2002. Describes AAPA resource designed to educate physicians about PAs through local presentations. Available online at www.jaapa.com.
Kelly P. "PAs, Specialists in Team Medicine." JAAPA 12(9)6-9, Sept. 1999. Explains the effectiveness of the team care model in providing quality patient care. Available online at www.jaapa.com.
Kohlhepp W. "Contemporary Concepts of Physician Supervision." JAAPA 16(6)48-51, June 2003. Examines the unique meaning of "supervision" in PA practice. Available online at www.jaapa.com.
Education The AAPA policies on student and PA graduate education can be found in the AAPA policy manual at www.aapa.org/manual/profession.pdf
The PAEA journal Perspective on Physician Assistant Education is available online at www.paeaonline.org.
Accreditation Standards for Physician Assistant Education. A listing of standards used in accrediting programs that educate PA students. Available online from the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) at www.ARC-pa.org.
AAPA position paper: "Continuing Medical Education and the Physician Assistant Profession." Adopted 1993. Found in the AAPA policy manual at www.aapa.org/policy/cme-and-PA.html. Examines the role of CME as a professional requirement and means of ensuring quality patient care.
PAEA publication: Physician Assistant Programs Directory. Complete listing of all currently accredited PA programs and other useful information for applicants. Available online through subscription at www.paeaonline.org/directory/index.htm.
AAPA issue brief: "PA Prescribing: Education and Delegation." June 2007. Reviews prerequisites, curricula, and national certification concerning prescribing. Available online at www.aapa.org/gandp/issuebrief/prescrib.pdf.
AAPA issue brief: "Physician Assistant Education, Preparation for Excellence." June 2007. Describes the educational model of PA training. Available online at www.aapa.org/gandp/issuebrief/education.pdf.
AAPA Education Council, "In a Growing Profession, Implications for PA Education." JAAPA 9(5)84-96, May 1996. AAPA's Education Council and the Association of Physician Assistant Programs outline the growth of the profession, associated challenges, and strategies for meeting these challenges. Available online at www.jaapa.com.
AAPA Education Council, "Entitlement Funding for PA Education Programs." JAAPA 7(10)551-552, Sept. 1994. AAPA position paper on the status of entitlement funding of programs. Available from AAPA staff, ext. 3207.
Fasser CE. "Historical Perspectives of PA Education." JAAPA 5(9)663-670, Oct. 1992. A historical review of other international assistants and of the PA education process. Available from AAPA staff, ext. 3207.
Glicken A. "PA Education in an Evolving Health Care System." JAAPA 5(10)16-26 Oct. 2002. An examination of factors shaping both PA education and the US health care system. Available online at www.jaapa.com.
Wendel OT, Danielsen RD. "Obstacles and Opportunities in Distance Education: A New Paradigm in Teaching and Learning." Perspective on Physician Assistant Education 12(4), Autumn 2001. Available online at www.paeaonline.org.
Bowlin SD, Gugelchuk GM. "The Use of Retention Strategies in Physician Assistant Programs to Retain and Graduate Minority Students." Perspective on Physician Assistant Education 11(1), Winter 2000. PA program directors interviewed about their use of retention strategies for minority students. Available online at www.paeaonline.org.
Employment and Contract Negotiation AAPA publication: Contacts & Contracts: An Employment Guide for Physician Assistants, 4th Edition, 2002. Guide includes information about job opportunities, recruiters, resumes, the interview process, and elements of a well-structured employment contract. May be purchased online at the AAPA Store (www.aapa.org/aapastore).
AAPA publication: Hiring a PA. 2002. Provides information for employers about the educational background of PAs, along with the scope of responsibilities and practice. Includes pre-employment checklist, information about state regulations, national certification, malpractice coverage, employment agreements, and compensation.
May be purchased online at the AAPA Store (www.aapa.org/aapastore).
AAPA article: "Anatomy of a Contract." This article outlines basic points to consider in writing an employment contract. Available online at www.aapa.org/gandp/anatomy.html.
AAPA article: "Pre-Employment Checklist." The AAPA recommends this checklist to help analyze your employment options when you begin your job search, features questions to ask before making an employment decision. Available online at www.aapa.org/gandp/checklist.html.
AAPA Online Resource: PA Job Link. Comprehensive employment resource, allows PAs to post resumes and search for jobs by specialty. Also features a well-organized collection of information about PA practice and regulations for educating potential employers. Online at www.aapa.org/joblink/candidates.html.
Hohman JA. "How to Find the Job You Want." JAAPA 14(12)51-52, Dec. 2001. Ideas and strategies for taking charge of your employment search. Available online at www.jaapa.com.
AAPA article: "Guide for New Physician Assistant Employers." Thorough but concise discussion of the steps from deciding to hire a PA to building a successful physician-PA team. Available online at www.aapa.org/gandp/paempguide.pdf.
Ethics AAPA Policy: Guidelines for Ethical Conduct for the PA Profession. Found in the AAPA policy manual online at www.aapa.org/manual/23-EthicalConduct.pdf
AAPA Policy H-P-800.2.5. Adopted May 2003. Regards nondiscriminatory care for AIDS/HIV patients. Found in the AAPA policy manual or available from AAPA staff, ext. 3207.
AAPA position paper: "Ethics in Managed Care." Adopted 1997. Found in the AAPA policy manual and published in JAAPA 10(10)27-37, Oct. 1997. Explores the complex issues of ethics in the expanding area of managed care. Available online at www.aapa.org/gandp/ethics.html.
AAPA position paper: "End-of-life Decision Making." Adopted 1997, updated 2001, reaffirmed 2004. Found in the AAPA policy manual. A thorough review of end-of-life issues and the role PAs can play in the continuum of care. Ethical aspects of this topic are discussed. Available online at www.aapa.org/manual/19-EndofLife.pdf.
Kole LA. "Conflicts and Quandaries in Caring." JAAPA 9(6)9-12, June 1996. Editorial on ethical conflicts and issues associated with managed care. Available online at www.jaapa.com.
Glover JJ, Bundschu R, Caton L, et al. "End-of-life Decisions, Marking out a Place for PAs to Stand." JAAPA 8(8)48-58, Aug. 1995. AAPA Professional Practice Council roundtable discussion of end-of-life issues led by bioethicist Jacqueline J. Glover. Available from AAPA staff, ext. 3207.
AAPA Professional Practice Council: "Exploring the Ethical Relationship between Pharmaceutical Companies and Physician Assistants." JAAPA 5(3)209-215, March 1992. AAPA Professional Practice Council roundtable discussion on the topic of pharmaceutical companies and relationships with PAs. Available from AAPA staff, ext. 3207.
Federal Regulations AAPA position paper: "Federal Funding for Embryonic Stem-Cell Research." Adopted 2002. Explains AAPA's support for stem-cell research. Found in the AAPA policy manual and available online at www.aapa.org/manual/30-PB6StemCellResearch.pdf.
AAPA's Political Action Committee (PAC). Online at www.aapa.org/gandp/pac/index.html.
AAPA Government Affairs Staff: "Getting to Know Your Member of Congress." JAAPA 6(8)572-574, Sept. 1993. Advice on how to contact federal legislators and present a clear message. Available from AAPA staff, ext. 3207.
Koch S. "PAs in the National Health Service Corps." JAAPA 7(9)643-651, Oct. 1994. Reviews the status of PAs in the National Health Service Corps. Available from AAPA staff, ext. 3207.
Genova N. "Getting Involved Again: a New Experience for a Veteran PA." JAAPA 14(9)6-9, Sept. 2001. The author describes how she became a political force for the PA profession at the state and federal level. Available online at www.jaapa.com.
Lavia L. "EMTALA: A General Guide for the Physician Assistant." JAAPA 15(9)15-19, Sept. 2002. Discusses the federal EMTALA law and its relevance to PAs practicing in emergency departments. Available online at www.jaapa.com.
Health Care Systems AAPA position paper: "Health Care System Reform." Adopted 1991, Amended 1999. Found in the AAPA policy manual and available online at www.aapa.org/policy/health-care-sys-reform.html. A review of the national health care debate of the early 1990s and AAPA position on national health care reform.
AAPA publication: Physician Assistant Third Party Coverage for PAs. 2006. Comprehensive summary of third-party coverage policies affecting PAs. Covers rules, regulations and billing procedures for physician services provided by PAs.
May be purchased online at the AAPA Store (www.aapa.org/aapastore).AAPA position paper: "Physician Assistants' Role in Health Promotion and Disease Prevention." Adopted 1994. Details the important role played by PAs in patient education and prevention. Available online at www.aapa.org/manual/14-HealthPromo.pdf.
AAPA position paper: "Physician Assistants and Clinical Practice Guidelines." Adopted 1997, reaffirmed 2004. Details AAPA's position on the use of clinical practice guidelines and addresses disease state management issues. Available online at www.aapa.org/manual/17-ClinPracGuidelines.pdf.
AAPA issue brief: "Medical Unions and Physician Assistants." April 2002. An overview of unions and workplace actions in medicine, outlines some critical issues for PAs who are faced with or considering unionization. Available online at www.aapa.org/gandp/med-unions.html.
AAPA issue brief: "Independent Practice Associations (IPAs): A Primer for Physician Assistants."
Jan. 2003. A guide to help PAs understand the structure, function, and role of IPAs. Available online at www.aapa.org/gandp/ipas.html.
History of the PA Profession Estes EH. "The PA 'Experiment' After 25 Years: What Have We Learned?" JAAPA 5(9)714-16, Oct. 1992. Dr. Estes comments on the PA profession and its origins. Available from AAPA staff, ext. 3207.
Stanhope WD. "The Roots of the AAPA." JAAPA 5(9)671-678, Oct. 1992. Mr. Stanhope reviews the milestones and accomplishments of the AAPA's first decade. Available from AAPA staff, ext. 3207.
Carter RD. "Sociocultural Origins of the PA Profession." JAAPA 5(9)655-662, Oct. 1992. Author reviews the sociologic, economic and political pressures that shaped the PA profession in the 1960's. Available from AAPA staff, ext. 3207.
Smith RA. "PAs and the Health Care Revolution: An Interview with Richard Smith, MD." JAAPA 6(1)54-55, Jan. 1993. Dr. Smith, a founder of the profession, answers questions about the PA concept and profession. Available from AAPA staff, ext. 3207.
Society for the Preservation of PA History. Resources and articles on the history of the PA profession. Available at www.aapa.org/pahistorysociety/.
Carter RD. "An Office to Study, Preserve and Present the History of the Physician Assistant Profession." North Carolina Medical Journal 11(3)185-187, 2000. Available online at
www.aapa.org/pahistorysociety/.Carter RD, Strand J. "A Young Profession Celebrates its Birth in North Carolina ." North Carolina Medical Journal 61(5)249-256, 2000. Available online at www.aapa.org/pahistorysociety/.
Hospital Privileges / Credentialing AAPA publication: Physician Assistants and Hospital Practice. 2002. Comprehensive information on the practice of PAs in hospitals, including policy statements from national organizations, model hospital bylaws, and a sample credentialing form. May be purchased online at the AAPA Store (www.aapa.org/aapastore).
AAPA position paper: "Guidelines for Amending Medical Staff Bylaws." Adopted 1987; amended 1993, 2003, and 2007. Guidelines to assist physicians and PAs in seeking amendments to hospital medical staff bylaws to authorize the granting of clinical privileges to PAs. Found in the AAPA policy manual and in the AAPA publication, PAs in Hospital Practice and available online at www.aapa.org/manual/05-MedStaffBylaws.pdf.
AAPA issue brief: "Physician Assistants in Hospital Practice: Credentialing and Privileging." November 2006. A concise synopsis of PA hospital practice issues, including bylaws, credentialing, and privileging. Available online at www.aapa.org/gandp/issuebrief/hospital-new.pdf.
AAPA issue brief: "Denial of Hospital Privileges: Antitrust Implications." August 2001. Information on antitrust issues pertaining to PAs and denial of hospital privileges. Available online at www.aapa.org/gandp/antihosp.html.
AAPA publication: Reduced Resident Hours Call for Creative Solutions: Hire Physician Assistants. 2003. Information on why hiring a PA to make up reduced resident hours in hospitals is a good solution. Available online at www.aapa.org/gandp/housestaff.pdf
Impairment AAPA position paper: "Drunk Driving, the Legal Criteria." Adopted 1991. A brief discussion of the Academy's position on drunk driving and recommendations for blood alcohol levels. Found in the AAPA policy manual online at www.aapa.org/policy/drunk-driving.html or available from AAPA staff, ext. 3207.
AAPA position paper: "Physician Assistant Impairment." Adopted 1990; amended 1992, reaffirmed 2004. Discusses a range of issues concerning impairment and PAs. Found in the AAPA policy manual online at www.aapa.org/manual/13-Impairment.pdf
AAPA publication: "Developing an Impairment Committee: A Guide for AAPA Constituent Chapters." Jan 2003. A guide on how to implement an impairment committee within the state chapter. Available from AAPA staff, ext. 3207.
Mott JS, Borden SL. "The Impaired PA." JAAPA 7(9)682-684, Oct. 1994. A discussion on issues of impairment and physician assistants and the current status of the AAPA and state chapters in dealing with impaired providers. Available from AAPA staff, ext. 3207.
Paine SJ. "Legal Issues Surrounding Professional Impairment." JAAPA 9(12)16-19, Dec. 1996. This article reviews the signs and events that might lead a PA to suspect impairment and suggests approaches to addressing the problem of the impaired colleague. Available online at www.aapa.org/gandp/impair.html.
AAPA Professional Practice Council: "Treating the Substance Abuser." JAAPA 10(1)61-77, Jan. 1997. Part two of two articles on issues of drug abuse. Emphasis placed on identification, treatment, management, and pain control. Available online at www.jaapa.com.
International Medical Graduates AAPA Professional Practice Council report: "Maintaining Standards for Legal Recognition of Physician Assistants." March 1995. Detailed report exploring attempts by other health care providers to be recognized as PAs without meeting the profession's established standards. Available from AAPA staff, ext. 3207.
AAPA position paper: "A Challenge for the Physician Assistant Profession: Report of the AAPA Task Force on Unlicensed Medical Graduates." JAAPA 6(1)65-72, Jan. 1993. A 1993 task force report adopted as policy by the AAPA House of Delegates. The paper provides historical overview, explores role played by organized medicine, federal government and others and provides recommendations on the appropriate steps needed to become a PA. Also available in the AAPA policy manual or online at www.aapa.org/manual/01-UnlicMedGrads.pdf
Cawley JF. "PAs and IMGs: The Educational Solution." JAAPA 5(1)5-7, Jan. 1992. Editorial exploring options to the debate concerning international medical graduates. Available from AAPA staff, ext. 3207.
Fasser C, Smith, QW. "Foreign Medical Graduates as Physician Assistants: Solution or Threat?" JAAPA 5(1)47-52, Jan. 1992. Explores issues related to employing foreign medical graduates as PAs. Available from AAPA staff, ext. 3207.
Bottom WD. "Unlicensed Physicians as PAs: Policy Implications for the Profession." JAAPA 4(2)97-101, March /April 1991. Editorial discussing the issue of unlicensed medical graduates in Florida and related public policy concerns. Available from AAPA staff, ext. 3207.
International Practice Issues AAPA's International Site is found at www.aapa.org/international.html. It features a wealth of information for PAs interested in volunteering in another country, looking for international employment, and using their skills in under served countries. Contents include ethical guidelines, information for students and for international medical graduates interested in US practice.
AAPA Policy H-P-3700.3.2 Licensure Eligibility for Foreign-Trained PAs. Adopted 2004. Available online at www.aapa.org/manual/profession.pdf.
AAPA Policy H-P-3700.3.1. Guidelines for PAs Working Internationally. Adopted 2001. Available online at www.aapa.org/manual/profession.pdf.
AAPA Policy H-P-3300.2.5. Adopted 1991, amended 1996, reaffirmed 2001. The AAPA encourages physician assistants to practice in medically underserved areas, both domestic and foreign. Available online at www.aapa.org/manual/profession.pdf.
Legislation The Legislative Action Center is a resource available at http://members.aapa.org/vocus/index.htm with information on state and federal legislation affecting PAs. The Legislative Action Center also features helpful information for PAs preparing to lobby their representatives.
AAPA's Legislative Agenda for the 110th Congress is available online at www.aapa.org/gandp/agenda_110congress.html.
AAPA publication: Physician Assistants: State Laws & Regulations. Tenth Edition, 2006. Three-hundred page, comprehensive summary of state laws and regulations authorizing physician assistant practice. Foreword includes AAPA policy, "Guidelines for State Regulation of Physician Assistants," AAPA model state legislation for physician assistants, summary chart of practice requirements, and a listing of physician assistant state regulatory authorities. May be purchased online at the AAPA Store (www.aapa.org/aapastore).
AAPA publication: "Model State Legislation for PAs." July, 2002. Model state legislation to be used as a template for PA practice regulations. Available online at www.aapa.org/gandp/modelaw.html.
AAPA publication: "Guidelines for State Regulation of Physician Assistants." June, 2006. Proposed guidelines for state regulation of PA practice. Available online at www.aapa.org/manual/06-GuideforStateRegs.pdf
AAPA publication: "Physician Assistant Scope of Practice." June 2007. An explanation of what elements factor into the duties a PA can perform: education/experience, state law, facility policy, and delegatory decisions made by supervising physicians. Available online at www.aapa.org/gandp/issuebrief/pascope.pdf.
AAPA Publication: "Taking Charge: State Government Affairs Handbook ." February, 2005. A resource guide for state chapters concerning all aspects of the state legislative process. Available on the "Members Only" section of the AAPA Web site at www.aapa.org/members/cor-pubs/takecharge.pdf.
AAPA Publication: "Team Building: Developing Effective Organizational Relationships ." September, 2003. Provides a wealth of strategies and suggestions for developing partnerships with other state organizations. Available on the "Members Only" section of the AAPA Web site at www.aapa.org/members/cor-pubs/teambldg.pdf.
Genova N. "Lessons Learned From Service to the State Licensing Board." JAAPA 15(12) 8-11, Dec. 2002. Insights from working with medical board officials on issues affecting PAs. Available online at www.jaapa.com.
Managed Care AAPA position paper: "Health Care System Reform." Adopted 1991, amended 1999. A review of the national health care debate of the early 1990's and AAPA position on national health care reform. Found in the AAPA policy manual and at www.aapa.org/policy/health-care-sys-reform.html.
AAPA position paper: "Physician Assistants as Medicaid Managed Care Providers." Adopted 1996; amended 1997, reaffirmed 2004. Discussion supporting PAs as qualified providers for services under Medicaid managed care programs. Found in the AAPA policy manual and at www.aapa.org/manual/15-MedicaidMngedCP.pdf
AAPA position paper: "Ethics in Managed Care." Adopted 1997. Explores the complex issues of ethics in managed care. Found in the AAPA policy manual and online at www.aapa.org/policy/ethics-mnged-care.html.
AAPA position paper: "Managed Health Care and Rural America." Adopted 1997, amended 2004. Looks at issues specific to rural health and how managed care may expand into this area. Found in the AAPA policy manual and online at www.aapa.org/manual/21-RuralUSMangedHC.pdf.
Also available online at www.jaapa.com.
Davis A, Griffin D, Kahwaty B, et. al. "Managed Care: What Issues Do Clinicians Face in an Evolving System?" JAAPA 10(9)18-43, Sept. 1997. Roundtable discussion by clinicians discussing the future trends and direction of managed care. Available online at www.jaapa.com.
Davis A. "Managed Care: The Future Is Upon Us." JAAPA 9(12)47-53, Dec. 1996. An update on multiple managed care issues as they pertain to PAs and their practice. Available online at www.jaapa.com.
AAPA Policy H-P-3400.1.1 "The Physician-PA Relationship in a Managed Care Environment." Adopted 1999. Available online at www.aapa.org/manual/profession.pdf.
Medical Jurisprudence / Malpractice Younger P, Conner C et al. Physician Assistant Legal Handbook. Gaithersburg, Maryland. Aspen Publishers, Inc., 1997. An excellent resource on the legal aspects of many issues affecting PAs including licensure, scope of practice, liability, quality assurance and risk management, medical records, credentialing and peer review, employment, and third party coverage. May be purchased online at the AAPA Store (www.aapa.org/aapastore) or by contacting Aspen Publishers, 800/234-1660.
AAPA publication: Managing Risk Through Quality PA Practice: A Guide for Health Care Providers. 1994. Guide to potential risks and practical precautions in patient care as well as liability insurance, risk management, quality assurance and peer review. May be purchased online at the AAPA Store (www.aapa.org/aapastore).
AAPA summary: Legal Opinions on Physician Assistant Orders. June 2002. Clear, concise summary of state attorney general, regulatory agency, and court opinions on the authority of PAs to issue medication and patient care orders to nurses. Call 703/836-2272, ext. 3207.
AAPA position paper: "Guidelines for the Physician Assistant Serving as an Expert Witness." Adopted 1977; amended 1987, 1991, 2001, reaffirmerd 2004. Practical discussion on serving as an expert witness. Includes excellent end notes. Found in the AAPA policy manual and at www.aapa.org/manual/07-ExpertWitness.pdf.
Danielsen RD, Condit D, Potenza A. "The PA as an Expert Witness." JAAPA 10(5)87-100, May 1997. A journal article discussing medical, legal, and ethical principles to be aware of when acting as a PA expert witness. Available online at www.jaapa.com.
Davidson J. "A Look at Leading Malpractice Risk Issues." JAAPA. 9(3)23-24, March 1996. A brief look at the four primary areas of malpractice risk for PAs. Available online at www.jaapa.com.
Legler C. "What You Must Know about Discontinuing Care." JAAPA 9(5)24-31, May 1996. This article describes situations in which the PA may need to terminate the clinician-patient relationship and provides suggestions for steps to take when doing so. Available online at www.jaapa.com.
Mott JS, Borden SL. "The Impaired PA." JAAPA 7(9)682-684, Oct. 1994. A discussion on issues of professional impairment. Available from AAPA staff, ext. 3207.
Paine SJ. "Legal Issues Surrounding Professional Impairment." JAAPA 9(12)16-19, Dec. 1996. This article reviews the signs and events that might lead a PA to suspect impairment and suggests approaches to addressing the problem of the impaired colleague. Available online at www.aapa.org/gandp/impair.html.
Brock R. "The Malpractice Experience: How PAs Fare." JAAPA 11(6)93-94, June 1998. This journal column presents data on PA malpractice experience from the National Practitioner Data Bank and makes some broad comparisons to NPDB reports on physician experience. Available online at www.aapa.org/gandp/pamalpct.html.
Other Professional Relationships AAPA position paper: "A Challenge for the PA Profession - Report of the AAPA Task Force on Unlicensed Medical Graduates." Adopted 1992, reaffirmed 2004. Thorough review of issues concerning unlicensed medical graduates. Emphasis is placed on those graduates who wish to become PAs. Paper includes specific state examples and recommendations by the AAPA. Found in the AAPA policy manual and available online at www.aapa.org/manual/01-UnlicMedGrads.pdf
AAPA Policy H-P-3700.3.2. Licensure Eligibility for Foreign-Trained PAs. Adopted 2004. Available online at www.aapa.org/manual/profession.pdf.
Kole L. "The Nursing Shortage is Everyone's Problem." JAAPA 16(5)9-12, May 2003. Examines the impact of the nursing shortage on PAs and the health care system in general. Available online at www.jaapa.com.
Postgraduate Programs Association of Postgraduate Physician Assistant Programs publication: National Directory of Postgraduate Physician Assistant Programs, 8th ed., 1997. Complete listing of PA postgraduate training programs including admission requirements, deadlines, location, stipends awarded, and other useful information. List of accredited postgraduate programs available online at www.paeaonline.org or available from PAEA staff, ext. 3415.
Asprey D., Helms L. "A Description of Physician Assistant Postgraduate Residency Training: The Resident's Perspective." Perspective on Physician Assistant Education 11(2), Spring 2000. A study examining the role of postgraduate residencies in postgraduate PA education from the perspective of program participants. Also available online at www.paeaonline.org/perspective/asprey.pdf.
Practice Management AAPA publication: Managing Risk Through Quality PA Practice: A Guide for Health Care Providers. 1994. Guide to potential risks and practical precautions in patient care as well as liability insurance, risk management, quality assurance and peer review. May be purchased online at the AAPA Store (www.aapa.org/aapastore).
AAPA policy brief: "Clinical Practice Guidelines." May 1997, reaffirmed 2004. Discussion of clinical practice guidelines, disease state management, critical pathways, and concerns about application of guidelines to practice. Available online at www.aapa.org/manual/17-ClinPracGuidelines.pdf.
AAPA issue brief: "Physician Assistants and Protocols." April 2001. Explores the issue of protocols. Includes definitions and AAPA recommendations for guiding physician-PA team practice through practice descriptions and means other than protocols. Available online at www.aapa.org/gandp/protoc.html.
DeFacio L. "Quality Management: New Toolbox for Better Medicine." JAAPA 10(2)27-33, Feb. 1997. Introductory article explaining the basics of quality management. Available online at www.jaapa.com.
Applegate MB. "Patient Satisfaction: A Critical Vital Sign." JAAPA 10(2)93-96, Feb 1997. Discussion of monitoring patient satisfaction as an important component of practice management. Available online at www.jaapa.com.
Davidson J. "Take a Positive Approach to Peer Review." Argues that a good quality assessment program includes effective peer review in order to reduce error, failure, and potential liability. Available online at www.aapa.org/gandp/peer.html.
Online resources of interest to PAs exploring business options available at www.aapa.org/gandp/business-resrc.html.
AAPA publication: Hiring a PA. May 2002. Comprehensive information on hiring and employing PAs, written with the concerns of first-time employers in mind. Also useful for educating prospective employers about PA practice. May be purchased online at the AAPA Store (www.aapa.org/aapastore).
Prescribing and Dispensing
AAPA issue brief: "PAs as Prescribers of Controlled Medications." June 2007. Overview of PAs, controlled substances, and patient care. Available online at www.aapa.org/gandp/issuebrief/meds.pdf.
AAPA issue brief: "PA Prescribing: Education and Delegation." June 2007. Overview of educational prep for prescribing by PAs. Available online at www.aapa.org/gandp/issuebrief/prescrib.pdf.
AAPA issue brief: "The Role of Chart Co-Signature in Physician Supervision of Physician Assistants." June 2006. A piece outlining the evolution and role of chart co-signature between PAs and supervising physicians, including guidelines for PAs to follow. Available online at www.aapa.org/gandp/chart_cosignature.html.
Giessmann TJ. "Identifying and Avoiding Medication Errors." JAAPA 10(10)13-17, Oct. 1997. Overview of common errors in prescribing and documentation. Available online at www.jaapa.com.
Gara N. "Regulation of Physician Assistant Prescribing." JAAPA 3(1)71-78, Jan 1990. Provides a historical review of state regulations concerning PA prescribing. Information was current as of 1990. Available from AAPA staff, ext. 3207.
Professional Associations AAPA Policy Manual. Includes AAPA constitution and bylaws and Academy policies and position papers. Online at www.aapa.org/manual/index.html.
AAPA Membership materials, available online at www.aapa.org/memship-cat.html and from AAPA staff, ext. 3001.
Professional Title Stead EA. "Debate over PA Profession's Name Rages On." JAAPA 5(6)459, June 1992. An editorial from 1971 by Dr. Stead on a potential name change. Stead, often considered to be the "father" of the PA profession, is a professor emeritus of medicine at Duke University School of Medicine. Available from AAPA staff, ext. 3207.
Strand J. (moderator) "Two Sides Make Their Case: Replace the 'Assistant' in Physician Assistant?" JAAPA 12(5)63-72, 98-101, May 1999. A lively roundtable discussion of the PA title issue. Available online at www.jaapa.com.
Young M, Kole L, Baranowski J. "Label it Big and Juicy: A Report on the 1999 AAPA Annual Conference in Atlanta." Includes coverage of the title issue as debated in the HOD. Available online at www.jaapa.com.
AAPA Professional Practice Council, "Naming the Profession." JAAPA 7(7)521-25, July/August 1994. Report from the PPC that examines the multiple issues involved in changing the name of the profession. No policy is stated, but provides a good synopsis of the issues involved. Available from AAPA staff, ext. 3207.
Schneller E. "A PA by Any Other Name." JAAPA 7(10)689-92, Nov. 1994. Editorial by a professor of health administration and policy in the College of Business at Arizona State University and counselor of health professional education. Schneller provides background and insight into the name change debate that was going on in 1994. Available from AAPA staff, ext. 3207.
Bolland KJ. "Assessment of Health Profession Name Changes: Implications for PAs." JAAPA 7(10)720-727, Nov. 1994. Article presents research on the question of the title change by reporting data from other health professionals on the factors that motivated name changes in those professions. Available from AAPA staff, ext. 3207.
Reimbursement AAPA publication: Third Party Coverage for PAs. 2006. A comprehensive summary of third party coverage policies for PA medical services. Includes information about rules, regulations, and billing procedures for coverage of physician services provided by PAs. May be purchased online at the AAPA Store (www.aapa.org/aapastore).
AAPA position paper: "Physician Assistants as Medicaid Managed Care Providers." Adopted 1996, amended 1997, reaffirmed 2004.. Discussion supporting PAs as qualified providers for services under Medicaid managed care programs. Available online at www.aapa.org/manual/15-MedicaidMngedCP.pdf.
AAPA issue brief: "Medicare Provisions Affecting Physician Assistants in the Balanced Budget Act of 1997." August 1997. Provides congressional and AAPA explanation of this important legislation. Available online at www.aapa.org/gandp/bba.html.
AAPA issue brief: "Coverage and Payment for Services: Antitrust Issues." August 1997. Discussion on antitrust issues and third-party insurance companies. Available online at www.aapa.org/gandp/antitr2.html.
AAPA issue brief: "Third Party Reimbursement for Physician Assistants." May 2007. A synopsis of reimbursement issues of Medicare, Medicaid, private insurance and TRICARE (formerly CHAMPUS). Available online at
www.aapa.org/gandp/issuebrief/3rdparty.pdf.
AAPA issue brief: "Physician Assistants as Shareholders in Professional Corporations." October 2003. A brief discussion of broad issues of PAs as shareholders in PCs. Available online at www.aapa.org/gandp/shrhldr-procorp.html.
AAPA issue brief: "Antitrust Implications of Negotiating with Third Party Payers." May 1996. Questions and answers about negotiating with third party payers. Available online at www.aapa.org/gandp/antitrst.html.
Role Definition AAPA policies H-P-100.1- H-P-100.2.4. Definition of "Physician Assistant." Found in the AAPA policy manual or online at www.aapa.org/manual/index.html or available from AAPA staff, ext. 3207.
AAPA issue brief: "The Role of Physician Assistants in Evaluating and Certifying Health Status." March 2006. Discusses the educational preparation, standard of care, and PAs' ability to certify health status of patients. Available online at
www.aapa.org/gandp/issuebrief/ibevaluate.pdf.
AAPA issue brief: "Physician Assistants and Orthopedic Physician Assistants: The Distinctions." February 2004. Explains difference in training and practice of surgical PAs and OPAs. Available online at www.aapa.org/gandp/issuebrief/opas.pdf.
AAPA issue brief: "Physician Assistants and Anesthesiologists Assistants: The Distinctions." February 2005. Outlines the distinctions between PAs and AAs in areas of education, practice, and certification. Available online at www.aapa.org/gandp/issuebrief/aas.pdf.
Frary T. "A New Definition of 'Physician Assistant.'" JAAPA 9(1)22-27, Jan. 1996. A brief explanation of elements of the definition of "physician assistant" passed by the AAPA House of Delegates in May 1995. Available from AAPA staff, ext. 3207.
Davis A. "Remember Who You Work For." JAAPA 9(6)15-18, June 1996. Commencement address given to University of Southern California PA Program in 1995 by Ann Davis , PA-C. She discusses ten pearls she learned from patients. Available online at www.jaapa.com.
Jones PE , Cawley JF. "Physician Assistants and Health System Reform, Clinical Capabilities, Practice Activities, and Potential Roles." JAMA 271(16)1266-1272. April 27, 1994. Concise review of the profession on many levels including education, funding and federal initiatives, clinical settings and services, comparing with NPs, roles for and barriers to practice. Available from AAPA staff, ext. 3207.
Genova N. "Expanding Our Concept of the Medical Literature: The Value of the Humanities in Medicine." JAAPA 16(3)61-64, March 2003. Reflections on the art of medicine and the humanistic dimensions of clinical care. Available at www.jaapa.com.
Rural Health Issues AAPA policy brief: "Rural Health Clinics." May 1997, amended 2004. An overview about rural health clinics and the challenges for future success as well as AAPA recommendations for improvements in the federal program. Available online at www.aapa.org/manual/20-RuralHealthClinics.pdf.
AAPA policy brief: "Physician Assistants and Innovative Solutions for Rural Hospitals." May 1997. Succinct report on the problems of rural hospitals and models for improving care in these areas. Available online at www.aapa.org/gandp/rhos.html.
AAPA position paper: "Managed Health Care and Rural America." Adopted 1997, amended 2004. Examines issues specific to rural health and managed care. Available online at www.aapa.org/manual/21-RuralUSMangedHC.pdf.
AAPA issue brief: "Meeting Rural America's Needs: PA Presence Remains Strong." July 2003. Brief report noting practice trends of PAs in rural areas. Available online at www.aapa.org/gandp/rural.html.
Martin K. "An Urban-Rural Comparison of Patterns of Physician Assistant Practice." JAAPA 13(7)49-72, July 2000. Article explores the role played by PAs in extending care into an underserved rural community. Available online at www.jaapa.com.
Specialization and Specialty Practice AAPA issue brief: "Physician Assistants in Allergy and Immunology Medicine." February 2005. Presents case studies of the varying roles of PAs in allergy and immunology practice. Available online at www.aapa.org/gandp/issuebrief/asthma.pdf.
AAPA issue brief: "Physician Assistants in Otolaryngology." October 2007. Examines PA practice in ENT and otolaryngology. Available online at www.aapa.org/gandp/issuebrief/ent.pdf
AAPA issue brief: "PAs in Dermatology." October 2007. Examines the diverse roles of PAs in dermatology practice. Available online at www.aapa.org/gandp/issuebrief/derm.pdf.
AAPA issue brief: "PAs and Cardiology." October 2007. Overview of PA cardiology practice. Available online at www.aapa.org/gandp/issuebrief/cardiology.pdf.
AAPA issue brief: "PAs in Emergency Medicine." September 2004. Detailed information including charts and graphs on PA emergency medicine practice. Available online at www.aapa.org/gandp/issuebrief/emergency.pdf.
AAPA issue brief: "PAs in Gastroenterology and Hepatology." May 2004. Overview of PAs in the field of GI practice. Available online at www.aapa.org/gandp/issuebrief/gastro.pdf.
AAPA issue brief: "PAs in Nephrology." March 2007. Examines PA practice in the field of nephrology. Available online at www.aapa.org/nephrology.html.
AAPA issue brief: "Occupational Medicine PAs: Promoting Employee Health." April 2007. Examines the many facets of PA care in the field of occupational medicine. Available online at www.aapa.org/gandp/issuebrief/occmed.pdf.
AAPA issue brief: "PAs in Oncology." May 2005. Describes the work of PAs in various areas of oncology. Available online at www.aapa.org/gandp/issuebrief/oncolog.pdf.
AAPA issue brief: "PAs in Orthopedic Surgery." July 2006. Overview of PAs in the field of orthopedic surgery. Available online at www.aapa.org/gandp/issuebrief/orthosurg.pdf.
AAPA issue brief: "PAs in Obstetrics and Gynecology." March 2007. Describes the roles of PAs in women's ob/gyn and primary care treatment. Available online at www.aapa.org/gandp/issuebrief/womenh.pdf.
AAPA issue brief: "PAs in Pediatrics." September 2006. Discussion of PA pediatric care in a range of settings. Available online at www.aapa.org/gandp/pediatrics.html.
AAPA issue brief: "PAs in Psychiatry." December 2006. Discussion of the role of physician assistant practice in the field of mental health. Available online at www.aapa.org/gandp/issuebrief/psych.pdf.
AAPA issue brief: "PAs in Radiology." April 2007. PA practice in radiology described. Available online at www.aapa.org/gandp/radiology.html.
AAPA issue brief: PAs in Rheumatology." October 2007. A discussion of the use of PAs in the field of rheumatology. Available online at www.aapa.org/gandp/issuebrief/rheumatology.pdf.
AAPA issue brief: "Physician Assistants and Radiology Practitioner Assistants: The Distinctions." October 2002. Useful delineation of the differences between PAs and RPAs. Available online at www.aapa.org/gandp/rpas.html.
AAPA issue brief: "PAs in Surgery." August 2007. Detailed treatment of PAs role in surgery. Available online at www.aapa.org/gandp/issuebrief/surg.pdf.
AAPA issue brief: "Physician Assistants and Anesthesiologists Assistants: The Distinctions." February 2005. Outlines the distinctions between PAs and AAs in areas of education, practice and certification. Available online at www.aapa.org/gandp/issuebrief/aas.pdf.
AAPA issue brief: "Physician Assistants and Orthopedic Physician Assistants: The Distinctions." February 2004. Explains difference in training and practice of surgical PAs and OPAs. Available online at www.aapa.org/gandp/issuebrief/opas.pdf.
AAPA issue brief: "Introducing Surgical PAs." August 2001. Details the financial and patient-care benefits surgical PAs offer surgeons. Available online at www.aapa.org/gandp/intro-surgicalPA.html.
Ottley RG, Agbontaen JX, Wilkow BR. "The Hospitalist PA: An Emerging Opportunity." JAAPA 13(11)21-28, Nov. 2000. Explores reasons behind the growth of hospitalist PAs. Available online at www.jaapa.com.
AAPA position paper: "Flexibility as a Hallmark of the PA Profession: The Case against Specialty Certification." Adopted 2002, reaffirmed 2007. Argues against specialty certification for PAs as a hindrance to PA versatility and mobility within medicine. Available online at www.aapa.org/manual/24-ProfessFlexibility.pdf.
State Regulations AAPA position paper: "Guidelines for State Regulation of Physician Assistants." Adopted 1988; amended 1993, 1998, 2001, 2005, and 2006. General guidelines on state governmental control of PA practice. Clarifies key elements of regulation and provides suggestions on areas for improving state regulation of PAs. Found in the AAPA policy manual or online at www.aapa.org/manual/06-GuideforStateRegs.pdf
and from AAPA staff, ext. 3207.
AAPA publication: "Model State Legislation for Physician Assistants." Model state legislation to be used as a template for PAs. August 2005. Available online at www.aapa.org/gandp/modelaw.html.
AAPA position paper: "Physician Assistants as Medicaid Managed Care Providers." Adopted 1996, amended 1997, reaffirmed 2004. Discussion supporting PAs as qualified providers for services under Medicaid managed care programs. Available online at www.aapa.org/manual/15-MedicaidMngedCP.pdf.
AAPA issue brief: "Standardization of Regulatory Terms: Licensure for Physician Assistants." July 2006. Discussion about different types of state regulation with an emphasis on licensure. Available online at
www.aapa.org/gandp/issuebrief/licensure.pdf.AAPA issue brief: "Ratio of Physician Assistants to Supervising Physicians." April 2004. Discussion on the number of PAs per supervising physician in the changing health care environment. Available online at
www.aapa.org/gandp/issuebrief/ratio.pdf.
AAPA publication: Physician Assistants: State Laws & Regulations. Tenth Edition, 2006. Three-hundred page, comprehensive summary of state laws and regulations authorizing physician assistant practice. Foreword includes AAPA policy, "Guidelines for State Regulation of Physician Assistants," AAPA model state legislation for physician assistants, summary chart of practice requirements, and a listing of physician assistant state regulatory authorities.
May be purchased online at the AAPA Store (www.aapa.org/aapastore).Gara N. "Physician Assistants' Participation in Professional Regulation." JAAPA 1(1)48-52, Jan. 1988. AAPA's Director of Government Affairs discusses the current status of state regulation and the involvement of PAs in the process. Available from AAPA staff, ext. 3207.
Statistics and Trends AAPA publication: "2007 AAPA Physician Assistant Census Report." Oct., 2007. Contains current information on all aspects of the profession. Includes data on practice status, gender trends, ethnicity, age, geographic distribution, and many more useful categories. Available online at www.aapa.org/research/07census-intro.html and from AAPA staff, ext. 3802.
AAPA information update: "Projected Number of PAs in Clinical Practice as of January 2007." Nov. 2006. Estimated numbers of PAs who will be in practice in 2007. Discusses methodology of estimate and shows solid state by state statistics. Available online at www.aapa.org/research/06number-clinpractice06.pdf.
AAPA information update: "Number of Patient Visits Made to Physician Assistants and Number of Medications Prescribed or Recommended by Physician Assistants in 2006." Nov. 2006. Information on patient visits to PAs and use of prescriptions. Includes a breakdown by specialty and review of methodology. Available online at www.aapa.org/research/06rx.pdf
AAPA publication: "Physician Assistant Trends, 1991-1998." A useful reference tool on the PA profession divided into three distinctive types of information: historical data on the size of the profession, cross-sectional data, and detailed PA data within states and regions for 1998. 1999 Edition.
Availble through the AAPA online bookstore at www.aapa.org/aapastore .Strand S. "Anticipating the Profession's Future." JAAPA 15(10)51-54, Oct. 2002. A discussion of forces shaping the future of the PA profession. Available online at www.jaapa.com.
Multimedia Resources Partners in Medicine Videotape Series. Informative, promotional presentation on the profession designed for three different audiences. Three editions: General public, students, and physicians. May be ordered online at the AAPA Store (www.aapa.org/aapastore) or by calling 703/787-8044.
Partners in Medicine Slide Show. Thirty-one color slides and accompanying script describing the PA profession. May be ordered online at the AAPA Store (www.aapa.org/aapastore) or by calling 703/787-8044.
Other Resources for PA Information AAPA publication: Annotated Bibliography of the Physician Assistant Profession. 4th edition. An annotated bibliography containing concise summaries of studies, books, reports, and medical journal articles on the PA profession published between 1986 and 1993. Available online at www.aapa.org/gandp/1193-bibliography/index.html.
AAPA publication: Addendum to the Annotated Bibliography, 1993-1999. 2000 edition. Companion to the Annotated Bibliography. Contains descriptions of recent books, journal articles, studies, and reports on PAs, categorized by practice setting, specialty, and other topics. Available online at www.aapa.org/gandp/1993-1999bibliography/index.html.
AAPA publication: Q and A about Physician Assistants. Brochure designed for patient and general public education.
May be ordered online at the AAPA Store (www.aapa.org/aapastore).AAPA publication: Los Asociados Medicos. A Spanish-language version of the Q and A information brochure.
May be ordered online at the AAPA Store (www.aapa.org/aapastore).AAPA publication: Mini Brochure. A wallet-sized brochure describing the PA profession and including space to record medical information. May be ordered online at the AAPA Store (www.aapa.org/aapastore).
AAPA publication: Physician Assistant Facts. A fact sheet on the PA profession, including a basic overview of the profession, information on educational requirements, reimbursement, and the quality of PA services. Available from AAPA staff, ext. 3513, 3501.
Journal of the American Academy of Physician Assistants. Back issues contain many useful articles on all aspects of the profession. Indexed in the Cumulative Index to Nursing and Allied Health Literature (CINAHL). Select articles are indexed in Medline. Available online at www.jaapa.com.
Ballweg RM, Stolberg S, Sullivan EM (eds): Physician Assistant: A Guide to Clinical Practice. WB Saunders, Philadelphia, PA, 2003. 800/545-2522.
Hooker RS, Cawley JF. Physician Assistants in American Medicine. WB Saunders, Philadelphia, PA, 2003. 800/545-2522.
Pew Health Professions Commission and Center for Health Professions and University of California, San Francisco. Charting a Course for the 21st Century: Physician Assistants and Managed Care. A report by the Physician Assistants Task Force on the Impact of Managed Care, chaired by Ruth Ballweg, PA-C, MPA. Includes historical background; discussion of emerging issues in PA education, practice and regulation; and policy recommendations. Available from The Center for the Health Professions, University of California, San Francisco, 415/476-8181. An executive summary is available online at www.futurehealth.ucsf.edu/compubs.html.
Last Revised: 10/19/07
