Redefining Professional Identity: The Transition from Physician Assistant to Physician Associate

The decision to alter the PA profession title from "physician assistant" to "physician associate" sprang from a desire to properly represent the PA's duty and had been planned for some time. In May 2021, the American Academy of Physician Assistants (AAPA) formally adopted the new title.?

In this edition of "Credentialing Insider," we delve into a transformative moment in healthcare history.

A New Era for PA Professionalism: The Official Shift to Physician Associate

AAPA has successfully completed the legal formalities necessary to alter its corporate name to American Academy of Physician Associates, Inc. This transition, however, is only the beginning.?

The procedure of changing a professional title is difficult. It consists of a variety of autonomous groups, as well as federal and state legislative and regulatory agencies. It will require some time to properly implement the title change.?

Here are some of the next steps:

• AAPA is currently changing its name, branding goods, assets, and digital tools to match the new title. Given the amount of platforms and assets that must be updated, the diverse audiences they serve, and the legal issues, both physician assistant and physician associate are projected to continue in use for many years.

• The purpose is to foster collaboration among the national authorities that oversee PA education and certification, as well as all of the profession's component groups. At the moment, the National Commission on Certification of Physician Assistants (NCCPA), the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA), and the Physician Assistant Education Association (PAEA) all use "physician assistant" in their titles, as do the profession's state chapters. The following organizations have taken on the new name:

Geriatric Medicine PAs

Academy of Physician Associates in Cardiology

Physician Associates for Latino Health

African Heritage Physician Associate Caucus

Physician Associates for Oral Health

Association of Physician Associates in Obstetrics and Gynecology

National Association of Physician Associates in Cannabis

• Each state has a PA chapter in charge of carrying out local name changes. Each state entity must comply with the legal and regulatory procedures for implementing the name change at its location. AAPA is collaborating with every state to assist put these improvements into action.

• AAPA continues to collaborate with other medical groups and associations as the profession's rebranding process advances.

Industry Perspectives: Navigating the Reactions to the PA Title Change

While the majority of PA professionals support the reform, certain members of the medical field have criticized it.?

An American Medical Association statement expresses worry that the name change would cause confusion for patients. It claims that the decision is an attempt to transition to more independent practice. The American Academy of Dermatology and the American Osteopathic Association both expressed similar concerns.?

The title change is intended to better represent the function of the PA in today's modern healthcare practice. PAs are highly qualified healthcare professionals that do more than simply help with clinical practice. Instead of confusing patients, the physician associate title defines the position of the professional they are visiting.?

In response to concerns that the title change suggests a shift away from the physician-led style of practice, the profession reiterates its commitment to the team-based approach for which it is recognized.

AAPA launched a new marketing campaign ("PAs Go Beyond") in May 2022 to educate patients and stakeholders about the importance of PAs in today's chaotic and overburdened healthcare system.?

Navigating New Norms: When to Embrace the Title of Physician Associate

PAs should only refer to themselves as physician associates if the state that governs their licensing and practice has officially embraced the new term. Otherwise, physician assistants should continue to use the title.

?Here are a few reasons to choose an acceptable title:?

• Using the improper title may result in serious legal or regulatory ramifications.?
• Institutions which employ PAs may consider incorrect usage of the title a breach of professional bylaws and regulations, which may result in disciplinary action.
• Malpractice insurers may refuse coverage based on the misuse of the professional title.
• Premature usage of the new title may cause problems with licensure and municipal government.?

Using the PA title is an effective tactic for two reasons: Most patients refer to physician assistants as PAs, and the PA term encompasses both physician assistant and physician associate.?

Of course, if a more detailed explanation of the PA title is necessary, PAs should utilize the term physician assistant in all professional and clinical contacts unless advised otherwise by their regulatory organizations.??

Parallel Paths: Navigating the Title Change and Scope of Practice Evolution for PAs

The new title has no bearing on the PA's scope of practice. Unlike the altering regulations and bills that were actively signed and approved during the course of the previous year. The title change and the extension of the PA area of practice are connected but separate projects.

About a dozen states have submitted legislation to change PA practice rules, including amending or removing clauses requiring physician supervision or participation. This contains measures passed by the Colorado and Montana legislatures, as well as current legislation in Illinois, Indiana, Maryland, New York, and Tennessee.

• Arkansas SB 112: Authorizes Physician Associates (PAs) to be recognized as treating providers for insurance purposes, enabling them to bill and receive payment for healthcare services directly.

• Arizona HB 2043: Eliminates the requirement for PAs with at least 8,000 hours of clinical practice to have a formal written agreement with a supervising physician.

• Montana HB 313: Transitions the PA-physician relationship from one of supervision to collaboration, removing the written agreement requirement for PAs with over 8,000 hours of practice.

• South Dakota SB 175: Proposed to allow PAs to practice independently, including diagnosing and treating patients, and prescribing medications. However, this bill was not passed.

• Colorado SB 083: Updates state law to allow most PAs to collaborate with physicians instead of working under direct supervision, offering more flexibility in meeting healthcare needs.

• Iowa Senate Studies Bill 1142: Seeks to repeal the mandate that PAs operate under the supervision of a licensed physician.

• Maryland SB 167: Requires PAs to have a collaboration agreement with a physician, moving away from a delegation agreement model.

• New York Assembly Bill (AB) 7725 & SB 5520: AB 7725 would designate PAs as primary care practitioners within Medicaid-managed care plans. SB 5520 proposes allowing PAs to provide medical services under a physician's supervision after practicing for more than 3,600 hours, with a two-year expiry post-implementation.

• Washington HB 1917 & SB 5633: HB 1917 integrates Washington into the PA licensure compact, allowing eligible PAs to practice across compact states. SB 5633 shifts the requirement from a practice agreement to a collaboration for PAs with physicians or physician groups.

Should these measures become legislation, PAs will have more professional independence. Yet, this does not imply that PAs are going to work as physicians. A PA will have to meet specific qualifications. Allowing PAs to practice with a broader scope while requiring less supervision will increase access to medical services in all states.

Across the States: A Look into the PA Compact

In 2023, three states (Delaware, Utah, and Wisconsin) adopted the PA Compact legislation. Governor Jay Inlsee has signed HB 1917 into law, making Washington the latest state to join the PA Licensure Compact.

After seven states have adopted the compact model law, the compact is going to be activated, which will begin the process of operationalizing the compact and granting rights to practice.

Virginia's H.B. 324 and West Virginia's S.B. 667 are currently available for governor's action. Oklahoma's measure, H.B. 3781/S.B. 1654, passed both chambers with companion legislation and is now pending further action.

Legislation is also pending in 11 other states:

• Tennessee (H.B. 1862)
• Colorado (S.B. 24-018)
• Maine (L.D. 2043)
• Michigan (H.B. 5117)
• Minnesota (H.F. 2623 / S.F. 2394)
• Nebraska (L.B. 823)
• New Hampshire (S.B. 486)
• New York (S.B. 7711 / A.B. 8172)
• Ohio (S.B. 28)
• Rhode Island (H.B. 7083)
• Vermont (H.B. 572)

Forward Together: Embracing Change and Fostering Growth in PA Practice

The transition from "physician assistant" to "physician associate", fueled by the collective ambition to accurately mirror the essential and dynamic role PAs play in our healthcare ecosystem, marks a momentous stride forward. With the AAPA spearheading this change, we're not just witnessing a mere alteration in nomenclature but a redefinition of what it means to be a PA today.

The journey ahead is paved with legislative changes and regulatory updates across various states, reflecting a broader acceptance and adaptation to this new identity. These modifications are not just titular but are foundational, potentially reshaping the scope of practice, autonomy, and the very essence of PA-led patient care.

Amid these transformative times, the role of efficient and precise credentialing becomes paramount. Ensuring that PAs are recognized according to their new titles, and more importantly, according to their expanded capacities and roles, necessitates a meticulous and forward-thinking approach to medical licensing and credentialing.

Our mission is to simplify PA licensing and credentialing.?

Our dedicated team remains at the forefront, navigating these changes with precision and care. We're following the evolution, ensuring that our PAs, and the healthcare organizations they serve, remain compliant, empowered, and ahead of the curve.