Vote for Beth Smolko, DMSc(c), MMS, PA-C – Making a Difference in Leadership
I am excited to be running for Director-at-Large of the AAPA Board of Directors and I would like to respectfully ask for your vote.
I have been serving as your AAPA Director-at-Large since 2016 and there is still so much the profession needs to accomplish. Last year, our profession took a monumental leap into the future by adopting Optimal Team Practice (OTP) in the AAPA House of Delegates (HOD). I was a member of the Joint Task Force on the Future of PA Practice Authority and one of the original authors of the 2016 FPAR (OTP) resolution. The real work on OTP, however, is just beginning. We have tremendous strength in our state CO leaders and members, who are moving mountains to create better practice laws in their states. As someone who has been on this journey since the beginning, I think it is important to highlight this is no small task, and I am deeply committed to making sure states will continue to have the Board’s support.
In the past year, I decided to take a different role in our profession by becoming the founding PA Program Director for Frostburg State University. Since starting this role, I have seen the tremendous challenges facing PA educators in our country. At the forefront, there is fierce competition for clinical sites to a national shortage of PA educators; and the ability to provide quality educational experiences for PA students is becoming more and more difficult. These seemingly never-ending challenges are countered, however, by the excited faces of students who can’t wait to be a part of what we have all been fortunate to call our profession. We need to not only teach them the basic sciences, clinical medicine, etc., we must teach them what it means to be a PA, our own unique identity as health care providers, and give them a belief in themselves as full-fledged clinicians. We need to teach them to function in the healthcare system of tomorrow. We need to reinforce that we believe in working as a team (i.e., physicians, nurses, social workers, physical therapists, etc.) but we are also competent clinicians that need to take responsibility for our own work. Our students won’t have all the answers the day they graduate from our institutions, but just as other professions graduate competent clinicians that keep learning as they work, so will PA graduates.
In thinking of our profession and the future of our students, I believe we need to create a committee to evaluate the impact of a change in professional title for PAs. It is an idea that has been batted down time and again but the arguments against “name change” are tired and untested. It is time for us to look forward to the future of our profession. I believe we need to take an objective look at whether or not a change in our professional title could benefit PAs. A task force, similar to OTP, and with input from our sister organizations (PAEA, ARC-PA, and NCCPA) and other major stakeholders could help in truly assessing the value of a title change. We should hire a marketing firm to come up with a number of titles for the profession and test how the public would respond to them. We cannot, however, continue to say a “title change” is wrong for the profession if we don’t have the objective evidence to support that assumption.
I have always worked to keep our profession moving forward. With your help, we will continue the “heavy lift” we have started and see more of it completed. I was always told that if you want something you should ask for it. I want to continue the work we’ve started and serve AAPA members on the board of directors. Please vote for Beth Smolko for Director-at-Large.
- How would you explain what Optimal Team Practice is, and its implications for the PA profession and for patients?
Optimal Team Practice (OTP) is an update to the AAPA Guidelines for State Regulation of PAs. It is composed of four pillars: team-based practice, removal of formal supervisory agreements and replacement with collaboration decided at the practice-level, separate majority-PA boards to regulate PAs, and direct reimbursement for PAs.
OTP is ultimately a way to increase patient access to health care. PAs are extremely well educated and trained in the practice of medicine. With our level of expertise, PAs cannot sit back and allow communities to go without care because of antiquated regulations.
OTP is an update that has been needed for a long time for PAs to practice at the top of their education and license. OTP strongly supports working in teams, but the composition of those “teams” may be physicians, nurses, psychologists, physical therapists, social workers, etc.
The requirement for “supervision” is an unnecessary burden to PAs and physicians. Allowing PAs and physicians to determine the level of collaboration at the practice level is essential to PAs maintaining parity with other professions and prevents physicians and PAs from being harmed by paperwork infractions.
Also, as many of us know, physician boards of medicine have held our profession back for too long. PAs should be the authority on PAs. PAs should be regulated by PAs. No other profession has our best interests at heart.
Finally, the “hidden provider” syndrome needs to end. PAs need direct reimbursement which recognizes the PA contribution to the U.S. health care system.
- What is your position on Optimal Team Practice (OTP)? What do you view as the most challenging hurdle(s) to overcome in the implementation of OTP? As a Board member, what strategies would you offer as a means of overcoming these challenges?
As one of the original authors of FPAR (the precursor to OTP) and a member of the Joint Task Force on PA Practice Authority which created OTP, I strongly support and have advocated for OTP. The most challenging hurdle depends on the state and the circumstances. For example, some physicians have seen the advantage of not having to take responsibility for another professional’s work and are in favor of OTP. Another physician may find OTP to be an encroachment of their profession. Some state legislators have expressed interest in PAs having OTP in order to free up qualified and experienced healthcare providers that can improve access to health care for their constituents. From one state to the next, the opposition or support of OTP by the medical boards and legislatures differ. One of the biggest challenges, however, is getting our own profession to be knowledgeable about OTP. The AAPA communications team has done a very good job, but we need to find a way to reach PAs who might not be members to help them understand how OTP can help them increase access to care for patients. We also need to engage PAs who are not currently members of AAPA and ask them to join. There is strength in numbers and AAPA is the only membership organization representing all PAs.
- What is your primary motivation for wanting to become a Board member? As a member of the Board, what initiatives would you bring to the Board’s work and how do these initiatives support the critical role PAs play in today’s healthcare marketplace?
My primary motivation for wanting to become a Board member is to continue the work that is currently in motion and help mold the vision of what’s to come. I want to make sure states that are committed to OTP have the support from AAPA that they need. I want to support our staff in pursuing reimbursement that recognizes a PA’s worth (no more “hidden provider”). I also want to respect those in the profession who want an objective assessment of our professional title.
I also want to create more professional liaison positions to develop relationships with other medical organizations and to give more opportunities to members that want to develop leadership skills. I would love to see PAs not only ask for support from other organizations but give support as well.
- We all have connections through our professional networks. Can you explain how, as a Board member, you would proactively engage your network to further the work of AAPA and the PA profession?
As Board members we are not able to represent just one group of people but must consider the needs of the collective membership. However, through my years of experience and leadership I have gained great relationships with many groups and it is through broad relationship-building that I have been able to leverage support for initiatives like collaboration and OTP. By using social media, blogging, and good old fashioned phone calls, I try to engage my colleagues in and get them excited about our profession.
- What non-PA organizations are critical partners to moving the PA profession into the future, and why? What are the “4 Orgs” and how should these organizations interact in the best interest of the profession?
AANP – American Association of Nurse Practitioners – we have a lot of common legislative and professional interests and it is much easier to work together toward those common goals than to fight each other to get things accomplished. We need a dedicated liaison to the AANP.
AHA – American Hospital Association – American PAs are often left off of AHA panels of experts for white papers and we see the absence of PA leadership in many hospital systems. The lack of representation of PAs in hospital C-suites holds back our profession.
NAM – National Academy of Medicine (formerly the Institute of Medicine) has written a number of white papers on the impact of other professions which has propelled those professions forward legislatively. We need more organizations to study our profession’s quality and impact on patient care.
The “4 Orgs” are the AAPA, PAEA, ARC-PA and NCCPA. We all have a different mission and vision that impacts the PA profession. We need to work together to create the strongest profession we can. We should not let go of our individual missions, but we need to work on better communication when we differ in our vision or strategic goals.
- How do you define and implement leadership in your work environment? What leadership skills do you call upon when challenged on a deeply held belief?
As a founding Program Director, I have had to set the standard for what a PA is for my university. I have had to work with every area of the university to develop the PA program including: facilities, IT, HR, Admissions, Registrar, Executive Leadership, Library Science, Finance, Assessment, faculty senate, etc. in addition to working with community partners for clinical affiliations and community support. A large part of my job entails creating cooperation among these different areas and moving them toward a common goal.
I have found that when I believe in something strongly, I am often not alone. I trust my instincts and try to understand an issue from several different viewpoints. I surround myself with friends who bolster me, colleagues that challenge me, and a family that loves me. I have also learned to forgive myself when I fail.
Henry Ford believed in creating an affordable 8-cylinder engine (cast in one piece) even when people with a lot more education told him it wasn’t possible. He told the engineers to keep trying and they ultimately achieved the impossible. So, what can the PA profession do if they believe in the impossible? Vote for me, Beth Smolko, and we will find out together.