I'm back in Pennsylvania after two days at the AFPPA Fall CME Conference and Exhibition at the Arizona Grand Resort in Phoenix. Upon my arrival at the conference, I was excited to hear the organization had broken all previous attendance records, with nearly 600 registered attendees. And with speakers, exhibitors and guests, there are more than 600! This was my fifth AFPPA conference, and they're always exciting. The speakers are great, and it's fun to catch up in person with all the PAs I've spoken with througout the previous year.

On Wednesday morning, I was honored to present the fifth annual Family Practice PA of the Year award to Karen Kushner of Chico, Calif. For a profile of Karen, click here. And if you'd like to see some photos, check out our Facebook page. Be sure to check back with ADVANCE for more about the award presentation, including quotes from Karen's inspiring acceptance speech.

In addition, check out AFPPA's Twitter feed and conference blog.

A.T. Still University Arizona School of Health Sciences (ATSU-ASHS) alumnus Geoffrey Hoffa, PA-C, was recently named to the Arizona Regulatory Board of Physician Assistants (ARBoPA) by Arizona Governor Jan Brewer. He will replace Randy Danielsen, PhD, PA-C, dean of ATSU-ASHS, who has just completed his maximum two terms on the board.

"When completing a term on an important regulatory board, it is always great to see younger, energetic people come forward," said Dr. Danielsen. "In this case I am even more thrilled to see an ATSU-ASHS PA alumnus of Mr. Hoffa's caliber appointed to this prestigious board by Governor Brewer."

Hoffa was appointed to the board on Oct. 9, and will attend his first quarterly meeting on Nov. 18. While serving on the ARBoPA board, which licenses and regulates over 1,000 Arizona PAs, his job will be to ensure public safety through adherence to practice laws and rules. He also sees it as an opportunity to serve the public by helping to attract much-needed health care professionals to Arizona through modern, forward-thinking health care practice rules that will benefit the physician/PA partnership.

"I am currently pursuing efforts at broadening my contacts locally and around the nation to seize the opportunity which has presented itself in the current health care debate," said Hoffa. "As a leader and consultant, I will persist to push the profession forward, as well as continue to expand my role as a community leader. I believe the two efforts share the common goal of ensuring quality, affordable healthcare."

After graduating from ATSU-ASHS, Hoffa worked in solid organ transplant for over five years at the Mayo Clinic Hospital in Phoenix. He started his own independent contracting business, Hoffa Health Care, in 2008, and continues to hold leadership positions with the Arizona State Association of Physician Assistants, lobbying and serving as a delegate at the national level.

Since early 2009, Slava Makler, PA-C, BS, and Nadia Fakira, RN, BA, MA, have dedicated their time to improving patient care on the neurosurgical floor where they work at Florida Hospital in Orlando.

With the goal of inspiring passion and reigniting a love of learning in their colleagues, Makler and Fakira created an educational board that displays models and descriptions of the most common prodecures. The board, which now hangs in the hallway on the neurosurgical floor, was unveiled on Monday, November 2, 2009.

In conjunction with the educational board, Makler and Fakira have planned inservice lectures that will further educate caregivers on the basics of spinal surgery and review anatomy and neurological assessment. Additionally, the board provides inquiring patients with easy-to-understand, 3D models of the skeleton and the corresponding procedures.

"Our goal is to improve the patient care on our unit by sparking excitement and thirst for knowledge, which we hope our efforts will inspire," Makler says. "In addition, the board will be a wonderful patient education tool, which could be utilized by the entire medical team. Most of the patients I see post-op ask, 'What exactly was done to me?' Instead of drawing it on paper, now we can show the patients an actual model of their procedure." 

Makler and Fakira began working on the educational board in early 2009.

Makler and Fakira begin mounting the educational board on the wall of the neurological floor at Florida Hospital in Orlando.

The board will serve to educate caregivers and patients about the most common neurological procedures.

What do you think? Would a resource like this prove useful in your facility?

In honor of Halloween, we share with you today a spooky medical anomaly courtesy of the NPR Health Blog. "Ghost in the Brain: An 'Apparition Hemorrhage'" features a CT scan of a 68-year-old man in a deep coma. Though the doctors suspected brain hemorrhage, they were unprepared for what they saw--a "spectral image" appeared on the scan. You can view it here.

The massive hemorrhage in the man's brain was deemed irreversible by surgeons, and his family decided to withdraw respiratory care. The man died shortly after, according to the blog post.

Neurologist Joshua Klein of Brigham and Women's Hospital was involved in the case and spoke with NPR about the strange image:

To me (the image) looked like a ghost. That's exactly what I thought it was. At first I was thinking, "Is this the angel of death?" I was showing it to my colleagues. They were calling it an "apparition hemorrhage."

Read the full interview here.

What's the strangest thing you've seen on a CT scan? Have you ever come across an apparition hemorrhage?

Ralph W. Rice, MPAS, PA-C, associate professor and associate director of the Wake Forest University PA program in Winston-Salem, N.C., recently told ADVANCE that the university's board of trustees has approved its proposed MMS-PhD program.

The program, which would combine the PA program's master of medical science degree with a PhD in clinical and population translational science, would accept three to five of each class of 56 PA students each year, at most.

According to Rice, the first class of students will be able to enter in 2010. We’ll let you know more about applying when information is available.

For more information, read our Making the Rounds story in our October issue.

In an article posted today, orthopedic surgeon and TIME Magazine writer Scott Haig discusses the nation's shortage of surgical assistants--and slights PAs as overly expensive and potentially inadequate "alternatives" to a surgical resident or fellow. 

In "The Case of the Missing Assistant Surgeon," Haig notes that surgery has become as unattractive to new doctors as primary care, thus resulting in a shortage whereby hospitals have "resorted to" hiring PAs:

Many programs have resorted to hiring physician assistants (PAs) - they're like surgical residents who never graduate - to provide support when no residents are available to cover the cases. PAs can be a truly great help, but they don't have the mind-set of a doctor who stands - or will soon stand - in the lead position. When there's trouble, that mind-set is invaluable. And in surgery, sometimes there is trouble.

Later in the article, Haig claims that PAs are often too expensive and hospitals lack the funds to cover shortages:

Hospitals that are flush can hire PAs to assist; the one where I work does. But most can't afford the hefty expense of PAs. Even the hospitals that have the funds don't have enough to hire PAs for every case. So I often end up begging older colleagues or a surgeon waiting for the start of his own case for a "freebie"; I'm playing on goodwill, friendship or the promise of his eventually getting a paying case.

Read the full article here.

Surgical PAs: Dr. Haig seems to harbor a degree of distrust for the PAs he and other surgeons work with. Do you or have you felt this sort of tension from physicians you've worked with?

This was the first event the Society has held after being approved by the American Association of Physician Assistants (AAPA) and the University's Student Government Association earlier this year. It was also the first event the PA class of 2010 put together own their own. "Our workload is extensive, so we can only fit in one extracurricular," said Alex Wicker, the Society's Vice President.

"This is Alex's baby," Laura D'Angelis, the Society's President said. She was very pleased with how hands-on the drive was for the PA students. "We're more involved with helping out. Be The Match lets us interact with the people registering, which is such a great opportunity," she said. "They are very helpful, knowledgeable, and so nice about the whole thing."

Read the full article here.

Michigan PA Todd Chisholm resigned from his position at Hiawatha Behavioral Health on Monday morning as an apparent protest to the way that patients are being dropped, which is due to the source of funding rather than lack of need.

He addressed the Chippewa County Board of Commissioners:

“First and foremost,” said Chisolm of his reason for resigning, “is an administrative decision to try and discharge almost all non-Medicaid patients from the mental health system; specifically, indigent patients, privately insured patients and Medicare insured patients.”

Chisholm says that the approximately 120 dropped patients across three counties, which he indicated are the result of an attempt to survive in a poor economy, will fail in their new settings. He also predicted a bad outcome in the form of suicides, homicides or death by self-neglect.

“I was basically told that the discharges needed to happen and that all cases had been ‘cleared,’ as feasible, by their chart reviews,” said Chisolm, detailing the results of a meeting last week with the administration which prompted his resignation. “I was also told that Pathways Mental Health (based in Marquette) has virtually already succeeded in discharging all, or at least almost all, Medicare clients. If this is true, my thought is: Shame on them.”

Link to full article

"The cost of medical care for inmates in Westmoreland County Prison is going up."

But only in the short term, and to the benefit of PAs. The Pennsylvania prison has made a one-year deal with Naphcare, Inc., the facility's Alabama-based, longtime health care provider, which will increase what the county is expected to pay in 2009 by 5%. According to an article in The Tribune, "the additional money will pay for a physician's assistant to replace a duty nurse, which officials said will reduce health care costs."

Having a physician's assistant there in person gives us the ability to do more than just a nurse, said Commissioner Tom Ceraso, who serves as chairman of the county prison board.

The PA on regular duty will handle medical services that otherwise would have been farmed out to local hospitals, the article reports, including writing prescriptions and performing minor procedures.

"In the end, we can save money through this," Walton said.

Read the full article here.

The Georgia Association of Physician Assistants is extending PA week to last the entire month of October. To that end, GAPA has recently placed billboards in the state to raise awareness of the personal attention patients receive from Georgia’s PAs.

In addition, GAPA has created a public service radio message and contacted media outlets throughout the state to spread the message of breast cancer awareness. The organization is also sponsoring programming throughout the month on every public radio station in Georgia.

Look for them along I-75 north of Atlanta at Delk Road, on I-75 in Macon at Mercer University Drive and along Riverside Drive, in downtown Augusta on Walton Way, and on I-516 in Savannah, near the Highway 17 exit. The GAPA message is also appearing on several digital billboards in the Macon area.

GAPA Web site

An article in today's Times Leader, a newspaper serving northeast Pennsylvania, focuses entirely on physician assistants. In honor of PA Week, which starts today, "The PA is in" tells the story of Justine Samanas, a PA at Mercy Special Care Hospital in Nanticoke:

Justine Samanas is spending her workday seeing patients, listening to descriptions of their aches and pains, prescribing medication, setting up tests and doing some basic surgical procedures in the Nanticoke office of family medicine where she works.

No, she's not a doctor. She's a physician assistant.

And if the recent enrollment figures in area colleges are any indication, many area residents will be treated by a physician assistant in various health settings - including their doctor's office, urgent care center or hospital emergency room - in the future. Maybe even instead of a family physician.

In addition, the article explains the history of PAs, the role of PAs and the path one takes to become a PA. Though the reporter does mention that PAs can't set up their own practices, which we know isn't always the case (read ADVANCE's coverage of Stu Jones, PA and practice owner), this article covers more of the facts than I've seen in the majority of stories that reference PAs. In fact, there is even a paragraph correcting the common mispronunciation and spelling of the PA title.

Read the full article here, and bask in the glory of being a PA! Happy PA Week!

Sixteen years ago, Jim Ginter, president of the Wisconsin Academy of Physician Assistants and an ADVANCE author and peer reviewer, received a new kidney and discovered a new path in life. In an article in the Sheboygan Press, Ginter discusses the hereditary kidney disease that left him in need of dialysis at age 30 and the young organ donor who saved his life. The experience inspired Ginter to overcome his distaste for hospitals and pursue a medical career:

Going from a "fainter" to a patient, and now to a physician assistant, has taught me how to see things from each perspective. I can relate better to my patients because I know what they are going through. I had that foley catheter in my bladder, that NG and ET tube down my throat. I waited anxiously for a transplant.

Ginter emphasizes the importance of organ donation and encourages readers to consider becoming an organ donor, particularly during National Physician Assistant Week, Oct. 6-12. In the U.S. less than 30% of eligible citizens are organ donors.

 Link to the full article.

Here at ADVANCE, we’ve been following Ohio PA Earl Morse and his organization, Honor Flight, since its inception in 2005. I'm excited to share this recent feature article in The New York Times about one of Honor Flight’s largest trips yet:

The idea for Honor Flight came from Earl Morse, who was a physician’s assistant at a Veterans Affairs clinic in Springfield, Ohio, when the World War II Memorial opened in 2004.

“I would see my World War II veterans some three, six months later, and I’d ask them if they’d gone to see it,” said Mr. Morse, a veteran of the Air Force and now the president of Honor Flight. “Three hundred of them, and not one of them had been to it. Reality set in. They were never going.”

Link to The New York Times article

Link to previous Honor Flight coverage in ADVANCE

Link to Honor Flight’s Web site

Greg P. Thomas, PA, MPH, AAPA senior vice president for education, membership and resource development, will take part in “Time to Talk CARDIO: Creating A Real Dialogue In the Office,” a Webcast that takes place tomorrow morning at 8 a.m. EST. He will discuss implementation of the program with former surgeon general Richard H. Carmona, MD, MPH, FACS.

Time to Talk CARDIO advisory board members will present the innovative program to various medical societies, government organizations and patient advocacy groups in Washington, D.C. Attendees can learn more about the evidence-based research used to develop the program, the online communication skill-building tool and preview preliminary in-clinic research findings.

To register, click here.

In a move that gets the ball rolling for health care reform, Montana Sen. Max Baucus has released America’s Healthy Future Act of 2009. While the bill is not yet complete, it contains several provisions in favor of physician assistants:

The bill treats physicians, PAs, and NPs very similarly in the new patient models of care, including funding for “physician, nurse practitioner, or physician assistant-led home-based primary care programs with demonstrated expertise in serving high-cost beneficiaries with multiple chronic illnesses and functional disabilities.” The bill recognizes PAs in incentives for chronic care management bonuses in Medicare Advantage; fully integrates PAs in new patient care models; and makes PAs eligible for primary care provider bonuses. Additionally, the bill amends the Medicare statute to allow PAs to order skilled nursing facility care and to provide hospice care for Medicare beneficiaries.

Read more from AAPA here.