AAPA

What should be AAPA's role in addressing health care disparities?

President-Elect

• Patti Pagels MPAS, PA-C
• Robert Wooten PA-C

Treasurer

• Linda Contreras MPAS, PA-C
• Bruce Fichandler PA

Director At Large

• Michael Doll MPAS, PA-C, DFAAPA
• Lawrence Herman MPAS, RPA-C, DFAAPA
• Sandra Keavey MPAS, PA-C

Patti Pagels, MPAS, PA-C: "Initially the Academy should begin by advocating for research that helps to clearly identify the disadvantaged group(s). We must also support research into which strategies will most likely correct health disparities. Secondly, we must collaborate with other organizations to address the social determinants of health (social, economic, and equitable access to health care) that contribute to health inequities. It is critical that AAPA support solutions that include input from those who experience the health inequities. Too often health inequities are addressed from an academic point of view without ever giving the communities involved a seat at the table. Finally, we must educate our members in the meaning of health inequity. We must provide them with practice strategies that include addressing health disparity at the office, health system and health policy level."

Robert Wooten, PA-C: "AAPA should take a leadership role in addressing health care disparities. The Academy can provide educational tools and resources to PAs to help raise awareness and enhance their abilities to identify and eliminate these disparities. The Heads Up Project, created by the AAPA Committee on Diversity, is a prime resource that can be shared with others. In my role as a representative to the Commission to End Health Care Disparities, I have shared this program with the multiple organizations that make up the commission. The program has been well received and will be used as resource for others. The Academy has the ability to bring together people from across the health care, political, educational, and governmental spectrums to talk about this major issue. This could be done in the form of a conference or a summit on eliminating health care disparities."

Linda L. Contreras, MPAS, PA-C: "AAPA can help address the multiple issues surrounding health care disparities by:
• Partnering with our physician colleagues on the Healthy Peoples 2010 goal to eliminate disparities in health care.
• Developing community-based outreach programs to targeted populations in order to educate and provide information on health care topics and prevention efforts. This can be done in communities and shared with PA programs. PAs can serve as mentors to students.
• Heightening PA awareness of how one's individual bias of race, religion, education, income, ethnicity and sexual orientation influences the delivery of care.
• Developing and utilizing educational programs at CME conferences covering the multiple issues related to health care disparities to enhance the awareness of potentially vulnerable populations.
• Encouraging the use of IT-based electronic medical records that utilize built-in health care prevention reminders at patient encounters to order mammograms, glycemic control studies, and routine foot exams in diabetics.
• Working with legislators to improve the capacity and the numbers of health care providers in rural and underserved areas."

Bruce Fichandler, PA: "I would continue our involvement in the numerous coalitions that we have singed on to and I would look for more of them, as well as ways we can participate in those coalitions beyond just written support. We need to continue to lobby hard for support of Title VII monies, which in part, is designed to increase minority under-representation in health professions. I strongly supported the request by our representative to the AMA Commission to End Health Care Disparities to help host a meeting ($37,000), which we did. We need to further promote things like the Heads Up Project, designed to put the faces of minority health care workers out to the public on buses and elsewhere. We are working to have representatives from the National Medical Association and the Hispanic Medical Association at our annual meeting in Atlanta. We need to give full support to our liaison to the NMA and strengthen our ties with that group to foster collaborative opportunities to decrease health care disparities."

Michael C. Doll, MPAS, PA-C, DFAAPA: "I believe the Academy's greatest ability to decrease health care disparities is by supporting health care coverage for the millions of our fellow Americans who currently do not have any coverage. The areas of the country that are most adversely affected by the lack of health care coverage (inner cities and remote, rural areas) must be the focus of the profession.
Therefore, we must partner with inner city and rural health care systems to give scholarships to pre-PA students. In return, those newly trained PAs would work in those areas for a predetermined period of time. By increasing the number of PAs in inner cities and remote rural areas, we can decrease some of the disparities of care. Lastly, PAs must always be willing to find ways to educate and orient those patients who are illiterate, do not speak/understand English or unable to understand/comprehend what we are attempting to teach them."

Lawrence Herman, MPA, RPA-C, DFAAPA: "Disparities are pervasive in our health care system. We are only beginning to understand the magnitude of differential burden of illness in populations with special health care needs, such as minority children and poor patients with disabling chronic illnesses. Health care disparities are costly. Poorly managed care or missed diagnoses result in expensive and avoidable complications. The personal cost of disparities can lead to significant morbidity, disability and lost productivity at the individual level. At the societal level, easily treated and common problems left inadequately treated can result in significant burden of disease. There are complicated interrelationships between race, ethnicity, and socioeconomic status that may result in health care disparities. While the relationships between these factors may seem theoretical, a better understanding of the underlying factors that result in disparities could better target improvement efforts aimed at reducing disparities."

Sandra Keavey, MPAS,PA-C: "AAPA's role addressing health care disparities is to advocate for patients and the PA profession. Many suggestions have been made and now the efficacy of these potential solutions needs to be reviewed. As a stakeholder AAPA needs to take a critical look at the proposed solutions and be sure they help our patients. Regardless of differences on this issue, AAPA should remain active working toward solutions, compromise when necessary, but always progress toward a solution that reduces the health care disparity in our country. AAPA needs to ensure that PAs are identified as part of the solution for improving access to care, patient safety, reimbursement and other barriers that interfere with the reception and delivery of health care. This is done by closely reviewing language of resolutions, policies and legislation to be sure it is not exclusionary or fails to identify PAs when other health care providers are listed."

Next Thursday: With the political face of America having an ever more diverse appearance, do you believe the Academy's membership, leadership and the profession emulate this diversity? If not, how would you propose the Academy increase the diversity of membership, leadership and the profession?

Today is one of a series of posts related to the 2010 General Election of the AAPA Board of Directors. Each Thursday between now and April 1 (the day voting begins) and throughout the voting period (April 1-30) we'll be posting a question on PA Pro NOW for each of the candidates to answer. We encourage you to join the discussion by posting your own questions, comments and opinions about the future of AAPA and your profession.

Want to know more from the candidates? Post your own question or comment related to PAs and health care disparities.