A Letter to the NCCPA
In a letter to editor Michael Gerchufsky, Todd Bruce, PA-C, FAPACVS, writes that he is "very concerned about the path the NCCPA is taking our profession down." In response, Bruce sent a letter to the NCCPA, voicing his concerns about PA specialty certification. "I hope that it is not too late to reverse this dangerous process," he says. Below is a copy of the letter Bruce sent to the NCCPA.
To whom it may concern,
I am deeply concerned about the path the NCCPA has decided to travel regarding specialty certification. As a PA for over 14 years, working in both primary care and a specialty, I feel that this decision has drastically changed our profession and eliminated our biggest advantage: our flexibility.
I completely understand, and agree with, the need to be able to document our training, skill and expertise in a given specialty. However, this certification process will at the same time create the precedent for limiting movement between specialties.
First, you state that this is a "voluntary" process. (This is) true in that you still require the PA-C as the primary certification. But what employer, given the choice between someone with specialty certification and someone without, is going to consider the person without the certification? Therefore, in order to compete for a job, it would not be "voluntary;" I would be forced to obtain this certification.
Secondly, you state that in order to prevent this from being a barrier to entry into a specialty you only have to complete one of the four requirements to consider yourself a "candidate" for specialty certification. I must disagree. This will be a barrier as three out of the four requirements require you to have a job in the specialty. A case log and years of experience obviously require a job in the specialty. While it is possible to obtain specialty CME while not working in the field, it is unlikely to be funded by your employer. Finally, if you take and pass the specialty exam without working in the field, what does the exam validate?
What the NCCPA has done is double my certification requirements. Now I will have to take and re-take two certifying exams, with double the fees and new CME requirements.
Let me give you some perspective on myself and why I feel this way. I graduated from SUNY Stony Brook in 1995 and entered family practice. I would make the argument that if this is the path we are taking, specialty certification, then family medicine should also be treated as a specialty. We all know that after PA school we have a background but are nowhere near proficient in medicine. It takes several years of on-the-job training in family medicine and a mentor before we are proficient. What, then, is the difference between that and any other sub specialty? After eight years of family medicine, when I changed to cardiothoracic surgery, the same rules applied. I had a good background of information, and it took on-the-job training and a mentor to make me proficient.
I would also point out that it is my primary care training and background in family medicine that make me a good cardiothoracic PA. It is my ability to treat the whole patient-not just their heart-that makes me a valuable member of our team. I believe this holds true in any specialty, and any PA who doesn't recognize or value that primary care training is not someone who I would want taking care of me or my family.
I believe there are other models, such as the Fellow designation, that allow PAs the ability to document their experience and expertise in a specialty, without creating a barrier or increased certification burden. I would strongly encourage the NCCPA to reconsider this process.
I believe my years as a PA in both primary care and cardiothoracic surgery give me a unique perspective on this issue. If I can be of any assistance to the NCCPA, please feel free to contact me. Thank you for your support of the PA profession and for your time in listening to my opinion.
Professionally,
Todd Bruce, PA-C, FAPACVS
Greeley, Colorado
Editor's Note: This is a guest blog post on the subject of PA specialty certification. Check back each Monday for a new post, and please feel free to leave comments. If you would like to contribute a blog entry, e-mail assistant editor Heather Simons at hsimons@advanceweb.com. Thanks.