This article was originally published in the January 2016 issue of PA Professional.
Great Progress on AAPA’s ‘Just Say PA’ Initiative
By Steven Lane
Discussions about the title of the PA profession are almost as old as the profession itself. In recent times, the issue has been debated at the House of Delegates (HOD) at least three times since 1998, including at the 2012 HOD, when a proposal to create a taskforce to consider the issue was ultimately voted down, and again in 2015. Numerous editorials have laid out arguments on all sides. But one thing that almost all PAs have always been able to agree on is that they are, well, “PAs.” And over the nearly 50-year course of the profession, the term PA has become widely recognized in the healthcare community and by patients.
“The word ‘assistant’ simply does not do justice to what PAs do in their practices these days,” says AAPA President Jeffrey Katz, PA-C, DFAAPA. “In my practice I diagnose patients, treat illnesses, and counsel patients on their path to wellness. And tens of thousands of PAs around the country do the same.”
“My guess is that few people would choose to call the profession ‘physician assistant’ if we were starting it today,” says AAPA CEO Jennifer L. Dorn. “But we are fortunate that the term PA is so widely embraced by patients and providers alike. So let’s use it. There is no doubt that it would be highly complicated to legally change the name in potentially hundreds of state and federal laws and regulations.”
AAPA’s contract lobbyist Heather Meade, with Washington Council Ernst & Young, agrees. “Pursuing legislative revisions can be very risky,” she says. “Other healthcare groups, who may have agendas that conflict with what we want for PAs, may seize the opportunity to capitalize on the process in ways that could ultimately harm the practice of PAs. What’s more, for legislation to be revised there typically has to be a public benefit in doing so, and it would be difficult to make that case. Finally, the investment in time and political capital required to pursue a title change could detract from AAPA’s ability to achieve its larger goal of removing PA practice barriers.”
Leading the Way
Over the past few years the AAPA Board of Directors and leadership have built on this recognition of the widespread acceptance of PA. At the November 2014 Board meeting, robust discussions led to a significant rethinking of the language that AAPA uses to talk about PAs. The result was the first-ever PA Communications Guide that made PA the primary way of referring to the profession in AAPA communications. At the Leadership and Advocacy Summit (LAS) last March, constituent organization (CO) leaders enthusiastically embraced this change, as well as the HOD-approved language used to describe the relationship between PAs and physicians—“collaboration” rather than “supervision.”
As then-AAPA President Larry Herman put it in his address to the 2014 HOD, “We are branding the hell out of ‘PA’!”
At the encouragement of some COs, AAPA recently took this initiative one step further and decided to eliminate the use of “physician assistant” altogether, in all but strictly legal contexts.
“We had a resounding consensus as a team that we need to be clear, focused and more aggressive in encouraging use of PA,” said Katz, who is also chair of the Board. “It is of utmost importance that we apply efforts to generate widespread use of PA without ‘physician assistant’ in all of our communications and initiatives to reinforce the use of the abbreviated title. And we are doing that.”
AAPA Director-at-Large David Mittman, PA, DFAAPA, a longtime advocate of reimagining the profession’s title, is supportive of the change. “I see this as a good compromise that can bring the profession together,” he says. “The day will come when the patient will ask, ‘What does PA stand for?’ and we’ll say, ‘Well, it used to stand for physician assistant but we felt that term did not fully describe what we do.’ So we chose to just use our initials: PA. But the real answer is, ‘I practice medicine. I’m here to take care of you. How can I help you?’”
“If people ask me what PA means, I say it means I am a medical practitioner,” says Elizabeth Prevou, PA-C, MPH, Student Academy of AAPA president and a recent graduate of The George Washington University PA program. She is working administratively in a clinical practice while she waits for her license. “I am training our office staff to ask patients if they want an appointment with a PA. No one ever says, ‘What is a PA?’”
Spreading the Word
The decisions by the Board and CO leaders at LAS set in motion a concerted campaign to establish the use of the PA initials everywhere, from Twitter hashtags to the AAPA logo. The PA Communications Guide was shared with all AAPA members, COs and PA program directors, as well as to the leaders of sister PA organizations and other stakeholders. Over the past year, AAPA has been working on removing all references to “physician assistant”—except those in historical documents—from its website and its media relations staff have been working with their contacts and media outlets to encourage them to use PA exclusively.
AAPA no longer spells out “physician assistant (PA)” on first usage, and encourages others, if they have to spell it out at all—for an audience not familiar with PAs, for example—to write “PA (physician assistant).” AAPA staff have also been providing support to COs on replacing “physician assistant” with PA on their websites and other communications. More than 30 COs now use PA exclusively on their websites, except in the official names of their organizations.
And this too is changing. The California Academy of PAs (CAPA) recently became the first chapter to remove “Physician Assistants” from its name and now uses its new name on its website and in other communications. CAPA Immediate Past President Jeremy Adler, MS, PA-C, DFAAPA, has long been a champion of using PA and has spoken on the issue at several conferences (click on the video link above to see his recent presentation at the 2015 CAPA meeting). “I’ve been talking about this for years, that we own ‘PA,’” says Adler. “We have discussed among our leadership: ‘What does ‘assistant’ do for us? We realized it does not define what we do.
CAPA is not changing its name legally at this point, Adler noted, though it is researching the process for doing so and this is a possibility in the future. “Our articles of incorporation have not changed; it’s more about repositioning the PA profession. The perception is more important at this point.”
The Rhode Island Academy of PAs (RIAPA) is also making good progress on using PA in its communications, says Jim Carney, PA, DFAAPA, RIAPA immediate past president. “We sat down with a great designer from Rhode Island School of Design, gave her the PA Communications Guide, and asked her to come up with a new logo that uses ‘PAs’ and not “physician assistants,” Carney said. “We’re looking forward to seeing what she comes up with. And we’re chipping away at the website, looking at everywhere we need to replace ‘physician assistant.’ It’s an ongoing process, but we are headed in the right direction.”
The move toward using PA will continue to gather steam as AAPA further ramps up its communications and advocacy efforts. But the building blocks appear to be firmly in place.
“The most important consideration in whether to use an acronym or initialism is whether it is already well recognized,” says Mike DiFrisco, a marketing consultant who has written and spoken frequently on this topic and is founder of the consulting firm BrandXcellence. “If there is equity in those initials, there is a benefit there. Everybody knows what IBM and BMW are even if they don’t know what the letters stand for.”
While the transition can take time, DiFrisco cautioned, perceptions can change remarkably in a few years: “AARP [formerly the American Association of Retired Persons] formally changed its name 12 years ago, and now some people have no idea what AARP used to stand for. With any rebranding it takes time to be inculcated in the consciousness. The important thing is to infuse meaning into those initials. It will take some time and work but it sounds like it’s the right thing to do.”
For AAPA, the next step is to focus attention on the next circle of stakeholders and partners. AAPA communications and marketing staff have developed a detailed plan for working with national organizations, business partners, employers and media outlets to encourage the use of PA and to change licensing agreements where needed.
But the most important work will probably be done at the grass roots level, by PAs everywhere.
This can work if we all do it,” says Mittman. “It’s really incumbent on all state and specialty organizations and every PA to go on Facebook and LinkedIn and their practice websites and change their profile information to PA from ‘physician assistant.’ And we should all use PA whenever we talk about the profession or introduce ourselves to patients.”
“I’m willing to give it a shot,” he added. “I am 100 percent behind the effort. Let’s really take it on as individuals and give it our best shot.”
Steven Lane was senior writer at AAPA until 2016. He can be reached at slane@PAEAonline.org.
VIDEO: Watch California Academy of PAs President Jeremy Adler’s presentation, “Influencing the Position of the PA Profession,” at the 2015 CAPA meeting in Palm Springs.