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A Note About Updates to the FAQs

Given the complexity associated with implementing a title change, and as we learn more during meetings with stakeholders, AAPA will be updating these FAQs on a regular basis. Please check back frequently for updated content. For questions not covered here, please email [email protected].

For media inquiries related to the title change, please contact [email protected].

Title Change Investigation

Why did AAPA undertake a Title Change Investigation (TCI)?

Title change has been the subject of discussion within the PA profession for many years. There has been a long-standing concern about the disconnect between the PA profession’s brand identity – which includes title – and the role of PAs in day-to-day medical practice . . . that the title does not adequately reflect their role and responsibilities in delivering quality healthcare to patients.

The decision by AAPA’s House of Delegates (HOD) to change the PA title was the result of a methodical process that unfolded over the course of three years and was informed by rigorous and substantial research by independent experts.

What was the goal of the TCI?

At the root of title change discussions was the fact that the title “physician assistant” does not accurately describe to patients what the profession does, nor does it convey the value of PAs within the healthcare team and healthcare delivery system.

What was the process and conclusion of the TCI?

Please refer to the November 2020 Final Report to the AAPA House of Delegates, which includes input from WPP, the firm hired to conduct the investigation (to include Kantar, Kantar Research, and Landor); AAPA, the national professional organization; and Foley & Lardner LLP, AAPA’s external legal counsel.

Title Change Vote: 2021 AAPA House of Delegates Meeting

What is the AAPA House of Delegates and why did they discuss the title change at their meeting?

The House of Delegates (HOD) is the policy-making body of AAPA, responsible for enacting policies establishing the collective values, philosophies, and principals of the PA profession. This authority is delegated to them under AAPA’s Articles of Incorporation. The HOD is comprised of elected representatives from 57 state and federal service chapters, 26 specialty organizations, 10 caucuses, and the Student Academy.

The formal title of the profession is acknowledged in an AAPA policy. Therefore, it was the responsibility of the HOD to consider any changes to this policy.

It was the 2018 HOD that passed a resolution requesting that the Board of Directors “contract with an appropriate independent consulting/research firm(s) to investigate state/federal, financial, political, branding aspects and alternatives to the creation of a new professional title for physician assistants that accurately reflects AAPA professional practice policies.”  This policy resolution initiated the Title Change Investigation, which concluded with an extensive report to the 2020 House of Delegates. At that meeting, delegates were charged with returning to their respective constituencies to begin the next phase of this process – discussing the current policy that titles the profession “physician assistant” and returning to the May 2021 HOD Meeting with any proposed changes to that policy.

What was the resolution the HOD voted on?

HOD delegates, board members, representatives of PAEA, ARC-PA & NCCPA and AAPA members met in a reference committee hearing on May 21, 2021 to debate and discuss proposed resolutions. On May 24, the AAPA House of Delegates (HOD) passed a resolution affirming “physician associate” as the official title of the PA profession by a majority vote of 198 to 68.

Next Steps for the Profession

What happens next?

AAPA will begin the implementation phase of the title change and will update members and nonmembers as this process unfolds. The AAPA Board of Directors supports the will of the House of Delegates and has met with senior management to begin implementation of the HOD policy on title change.

Can the AAPA Board of Directors overturn the decision of the HOD regarding the title change?

No. Per AAPA Bylaws, Article VII, Section 1(j), the role of the Board of Directors is: “To review and determine, on no less than an annual basis, how to implement those policies enacted by the House of Delegates on behalf of the Academy that establish the collective values, philosophies, and principles of the PA profession. If it determines that implementation of one or more such policies will require an inadvisable expenditure of Academy resources, or is otherwise not presently prudent or feasible, the Board shall, at its earliest convenience, report to the House the reasons for its decision.”

What is the timeline for changing the title?

A great deal of planning is now required in order to implement the decision to change the title as implementation requires a significant commitment from the profession and its associated entities in terms of financial obligations, resource allocations, and legislative and regulatory efforts. More research and conversations need to occur before a timeline can be finalized. For more details on a potential 5-year implementation timeline and estimated costs, please refer to the November 2020 Final Report to the AAPA House of Delegates.

What will the estimated cost be?

The estimated cost in the final Title Change Investigation report is $21.6 million. This estimate was based on discovery, research, and environment at the time of publication. For details, please refer to the Financial Impact Analysis section of the November 2020 Final Report to the AAPA House of Delegates, pg. 81-85.

Does the title change signify a move toward independent practice for PAs?

No. PAs remain deeply committed to team-based care with physicians and other providers.

How will AAPA educate the public about the title change?

AAPA will create a branding campaign to educate all stakeholders on the new title. This campaign will demonstrate the vital role that PAs play across the healthcare landscape. It will likely include media relations, advertising, communications toolkits for our key audiences, and more – with the goal of facilitating brand awareness around the PA role in healthcare.

It’s also vitally important that all PAs take part in showcasing the PA brand. Brand can be reflected in those very personal and caring conversations you have with a patient, and then that patient shares with their friends, family, and colleagues. Here are some more examples of how a brand might be showcased:

  • Brand is the stories shared via earned media or paid media focusing on medical interactions a patient has had with a PA that has resulted in successful treatments in conjunction with real compassion.
  • Brand is showcasing a PA on a panel of experts at a hospital conference where s/he is providing perspective, learnings, and education on how the healthcare system can deliver high-quality care to patients.
  • Brand is a media story featuring a PA working with an indigenous population in Alaska, bringing preventive care to a place in the U.S. that has been ignored – providing these patients with the hope that they too can lead healthy lives.
  • Brand is a social influencer or entertainer who is your patient – and they tell the story of how the best value in healthcare needs some attention. The PA, who has been part of their healthcare team, is the one who made the biggest difference in their care. Their true partner in wellness.
  • Brand is a major network interview with a PA astronaut and her thoughts around the future of healthcare.
  • Brand is partnering with corporations or medical celebrities who can amplify PA voices and tell your stories to bigger audiences.
  • Brand is sitting on an esteemed National Panel at a revered medical organization to represent the profession on a body of work that will impact the way primary care is delivered.
  • Brand is research (AAPA or PA) that provides insights into how mental health can best be addressed with patients during well visits.

The PA brand is who you are and what you do each day to deliver on your purpose. Those interactions, stories, and your devotion to your patients will serve to educate and elevate the PA role in healthcare.

How will this affect the pursuit of other AAPA priorities like Optimal Team Practice (OTP)?

Pursuit of legislative initiatives such as OTP will continue to be determined by PA state chapters. Each state chapter will make its own determination about pursuing the title change and elements of OTP. OTP remains a top priority of AAPA and funding for state chapter grants will be evaluated in this process.

How does the title change affect AAPA’s 2021-2025 Strategic Plan?

In developing the plan, AAPA made sure the strategy was flexible enough to enable us to pivot as necessary to account for the variety of possible outcomes with both the Title Change Investigation and Optimal Team Practice.

Do PAEA, NCCPA and ARC-PA agree with this change?

Each organization prepared a report for the HOD on the impact of a potential title change on their respective organization. Each organization will make its own decision about implementation. AAPA is committed to working with all PA organizations to ensure ease and accuracy of adoption.

Are the other PA organizations supporting title change?

We continue to work with PAEA, NCCPA & ARC-PA on the complex implementation of title change.

Do AAPA’s Constituent Organizations have the choice not to pursue the title change?

Each state chapter and specialty organization will make its own determination about pursuing the title change. We believe it is important for the profession to have a unified title, however, as well as unified voice. For that reason, we will be working with each state chapter to help them move forward with the change when they are ready.

How will this change impact my AAPA membership?

AAPA will continue to provide the same high-quality resources and services to its members as the organization implements a title change. We are committed to our mission, values, and plans to support and lead the profession.

When will AAPA update, websites, or other social media accounts with Physician Associate or American Academy of Physician Associates?

AAPA has filed necessary paperwork to change the organization’s name from American Academy of Physician Assistants to American Academy of Physician Associates. This process may take some time and updates will be provided on the title change website. Once the organization’s name is officially changed, any necessary adjustments to AAPA’s social media accounts will follow.

Legal Considerations

Several questions about the title change require legal expertise. AAPA’s external legal counsel, Foley & Lardner LLP responded to the following questions focused on state or federal laws and regulations.

What if my state changes the title but I want to remain a physician assistant? Alternatively, what if my state decides not to change the title but I want to be called a physician associate?

Your employer will dictate what you are to be called in your employment setting. This will also depend on how your state implements the title change. AAPA is developing model state legislation that would allow for a period of time for both titles to be used. After that, and again depending on the specifics of state law, you may be required to use the official licensed title. AAPA does not have the authority to force a title change on any individual, state, or organization.

On the federal level, will this change affect laws that mention PAs specifically, including the legislation authorizing PAs to receive direct pay?

We will need to pursue changes to federal law to change the title in federal laws and regulations. We do not think there will be an impact to the reimbursement of services performed by a PA. We are not advocating for any change to scope of practice. But we are advocating for a comprehensive “search and replace” at the federal and state levels to cause a global shift in terminology. This will take some time, and some jurisdictions may be slower than others. Consequently, we expect the title change will be a cosmetic change only, and that payers should continue to reimburse PA services.

Will changes to the language in federal laws be necessary before a PA can practice under the new title?

No. Authority to practice is governed by state law, except in situations such as the Veterans Administration, Indian Health Services, etc. The right to practice should not be impacted by a delay in a federal legislative or regulatory change.

For states that have recently passed legislation modernizing PA laws, will this change undo the pending changes to law?

The AAPA House of Delegates’ policy change to the PA title will not change anything that is currently on the books until a state decides to pursue a title change.

Can PAs start calling themselves “physician associates” now?

AAPA’s legal counsel, Foley & Lardner LLP recommends that PAs refrain from representing themselves as “physician associates” at this time. Our view is based on the following:

  • Implementing the new HOD policy is going to be complex, challenging, and take many years to complete. There are many intertwined considerations that require thoughtful due diligence to ensure we do not jeopardize any aspect of implementation. It would be unwise for the profession to appear to be out in front of state and federal legislatures and regulators. The next few years of work will be critical and must be strategically undertaken. Winning and keeping allies will be essential. The profession should not do anything to make this already-challenging process harder.
  • Prematurely using the term “physician associate” in a medical setting could be interpreted as the PA stepping beyond their current license. This could subject the PA to a regulatory challenge or discipline from their state licensing board or an attorney general’s office action. Other professions looking to hold back the PA profession may seize upon such premature usage to file complaints with the regulators.
  • Employers or healthcare facilities where the PA has privileges could view the action as a violation of policy, procedure, or professional staff bylaws.
  • There may be professional malpractice issues if adverse outcomes are linked to perceived “informed consent” violations from patients who claim they believed they were being treated by a physician. A malpractice insurer could use this as an excuse not to cover the claim.