I've been putting off making any comments in regards to specialty certification, until now. I just received word that I passed my recertification exams, so the pressure is off.

I have been a PA for a little over 30 years; 26 of those years were spent as an ENT PA. I can tell you that I'm happy ENT was not one of the privileged specialties to be selected for "certification."

My thoughts about certification and recertification are ambivalent at best. To test me on something I have not done in 26 years is not being fair to me or to our profession. Something else needs to be done. I don't know what that something is, but there needs to be a change.

I disagree with the notion of "once a PA, always a PA." Those of us who have worked exclusively in a certain specialty for several years would probably not be able to transfer to a different specialty very easily (without additional training) and be able to function properly right off the bat. You don't see a pathologist set up practice as a dermatologist from one day to the next. If that was to happen, we would be putting patients at high risk for a bad outcome, and that should go for physician assistants as well.

If the NCCPA specialty certification is not going to replace the current certification/recertification process, then I do not see the value of it. Why should I pay and take an exam that counts and then go on to take an additional exam at an additional cost and it will not count? I doubt that employers are even thinking about it now. I honestly see this as a money-making opportunity for the NCCPA, though I'm sure that many will disagree with me.

After 30 years as a PA and 26 years as an ENT PA, not a single person has officially asked my opinion in regard to specialty certification. Yes, I have seen the commentaries and invitations to participate in a discussion, but I don't consider them bona fide solicitations for an opinion. At this point I think we need to go to square one and begin from scratch. I don't mean re-invent the wheel but take a look at ALL PA specialties and see what would be best for each. I think the "once a PA always a PA" mentality is archaic; we need to move on to the 21st century.

Specialties are here to stay. I don't see too many PAs going back to primary care once they leave a specialty. I also don't see the AAPA endorsing the specialty certification process, because they stand to lose a lot of members and suffer financially.

I don't want to ramble any more, but I thought I'd get this off my chest.

Miguel Valdez, PA-C

President and Past President '09-10, AAPA Veterans Caucus

Groveland, Mass.

PA specialty certification was the topic of an article I wrote for ADVANCE for Physician Assistants about eight years ago. Specialty certification puts PAs at risk of losing their ability to work in numerous practice settings.

Many have weighed in on this possible consequence of PA specialty certification, and many think there is nothing to fear. But I am most concerned about the PAs that have entered the field in the past 10 years who may never have the privilege of entering other sub-specialties. Perhaps the words of the former liaison from the American College of Surgeons, Stanton Nolan, MD, FACS, affected me more than I could imagine. When speaking of specialty certification for the PA profession, he said, "I am not sure what they will gain, but I am sure what they will lose."

As chief of cardiothoracic surgery, Nolan can practice in thoracic, vascular and cardiac surgery. But as a surgical PA, I can be in thoracic surgery one day, ob/gyn the next, general surgery the day after and orthopedics and plastic surgery at the end of the week. Whenever I want to expand my horizons and try something different, I can go to the ER or family practice. That is what I call a full professional life with the opportunity to become skilled in multiple fields.

I am going to bring up some questions from my previous article and make a few comments with the goal of challenging your thinking on this issue. We cannot afford to be apathetic and keep our heads in the ground like ostriches. Rather, we need to be proactive and write our state and specialty organizations with the purpose of voicing our opinions.

Questions from past article:

• Is the PA profession interested in the safety of the public? If so, do we think that the present caregivers who work in specialty areas are minimally educated or incompetent as compared to a PA who passes a specialty exam?
• Thinking long term, what are the possibilities of some PAs losing their jobs because they didn't take an exam?
• We know who writes, safeguards and administers the exams, and we know how often we may need to re-certify (possibility of 10 years). We also know who will become financially enriched, and that there needs to be a committee to decide on an application requirement (which has been accomplished as I write). I think well enough of the NCCPA to believe that they are not doing this for financial gain, as I was on the Ad Hoc Committee for Recertification in 2002 for the NCCPA when this idea surfaced. They can be challenged concerning a conflict of interest, although I do not think this to be the case.
• How many of the interested candidates wish to take this exam for another certificate or rating or because they may be weak in primary care? As a surgical specialist I know that I am not as strong as my colleagues in family practice, yet I do have the ability to work in this area on a somewhat lesser panel of disease entities.
• Is there a defined body of knowledge, minimum standard of education and special skill set that can be universally tested? Does this necessarily mean that they have greater competence? And how will competence be tested, particularly in an operating room?
• Will there be an expected percentage of greater outcomes or best practices that become evident because of this testing?
• Above all, there should be no statement that infers that there is no other manner in which to have the same degree of competence. This would be professional suicide for many in our profession.

These are the concerns I have heard and shared with my colleagues. I am willing to be the target of those who differ in opinion; I do this willingly for a profession I love.

Bob Blumm, MA, PA-C, DFAAPA

Past President AASPA, APSPA, ACC, NYSSPA

Editor's Note: Below is a blog post from Glen E. Combs, MA, PA-C, 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.

When NCCPA's specialty certification becomes a permanent feature of the PA profession, our practice lives are going to be affected and our very livelihood may be threatened.

We depend on favorable reimbursement policies, hospital privileges and employment opportunities. Could the NCCPA specialty certification program affect these coveted features of the PA profession? In my opinion, the answer is clearly YES. Controlling agencies that impact our profession will take notice of this new credential and will transfer the same NCCPA gold standard afforded to the entry-level primary care certification examination - the Physician Assistant National Certification Examination (PANCE). Reference to the new "specialty certification" will be misunderstood and misplaced. It is rather unthinkable that the NCCPA would spend one dime on marketing a plan to declare that the "specialty certification" is different in quality to the PANCE. Qualifying for "specialty certification" will not be on the same level of the PANCE, though controlling agencies will assume that the specialty certification is a testament to the "specialty" PA's clinical competence. A false assumption.

Frankly, I am proud of the integrity and public service that the Commission has provided to the PA profession since its inception.  For over 30 years the NCCPA has done an outstanding job in promoting the PA profession and protecting the public from unqualified practitioners. The Commission has opened doors to secure state PA-enabling legislation. It has given needed creditability to many of our congressional challenges. It is an organization that is made up of many powerful physician organizational representatives that interact and support the PA physician team concept. The NCCPA is one of the most influential PA organizations of the 21^st century, and we should take pride in its accomplishments.

Furthermore, the Commission is perfectly suited for validating the entry level PANCE, but I cannot see that it has the ability or knowledge to put together a specialty examination for the identified PA groups, namely psychiatry, emergency medicine, orthopedics, cardiothoracic surgery and nephrology. It will take expert specialty clinicians to size up the individual PA specialty practice perimeters and create an exam that reflects the actual activities of specialist PAs. If even possible, exam development will cost hundreds of thousands of dollars. Getting agreement on core specialty knowledge will be a difficult and onerous task. Once the exam becomes available, specialty PAs are going to have to prepare intensively in order to pass the examination. The cut score may have to be lowered significantly to insure that the 80,000 PA examinees pass the examination in order to continue to practice in their chosen discipline. Will passing an online specialty exam prove clinical specialty competence? How will state medical boards react to a PA who has unfortunately failed this new certification examination? And, how will the exam stand up to intense scrutiny by a plaintiff's attorney in a malpractice law suit? OK, specialty PA: What makes you so special?

NCCPA no longer contracts the testing support services of the National Board of Medical Examiners. The Commission has brought the examinations, PANCE and PANRE, in-house. Taking on field testing and demonstrating the desired psychometrics needed for exam validity and reliability will be a Herculean task. Many of us are skeptical that obtaining 25 CME hours in a given specialty will have much impact on practice behaviors. Keeping patient logs is a reasonable requirement, but who will be responsible for reviewing thousands of log sheets for correctness and give feedback to the candidates?

Historically, specialty organizations have been looked upon as the gold standard for passing judgment on clinical competence of their own colleagues who are likeminded and favor the promotion of their medical/surgical specialty. These organizations are referred to as American Boards. The boards use a very extensive and scientifically-based program to distinguish a candidate who goes the extra mile and demonstrates acceptable peer review beyond basic entry-level requirements. Many of these boards require a formal accredited residency or clinical mentorship before the candidate is eligible to sit for their specialty board examinations

Setting up a viable and prestigious credentialing board to recognize a PA's commitment to learn new clinical knowledge beyond basic entry-level competencies only makes sense to me. Offering a formal twelve-month online program coupled with a practice mentor/evaluator to oversee the formal specialty education of the PA candidate should be considered as a viable alternative to the NCCPA's new specialty certification program. Using this alternative program, the PA would be allowed to make a PA salary while at the same time use the technology of distance e-learning to acquire their new credential--PA board recognition. Support for the PA's efforts to complete board recognition requirements would come from the employer.

Developing a PA specialty board that would raise the bar on PA specialty standards of care has a number of appealing features. For the lack of a name let's call this PA board the American Board of PA Practice or ABPAP. This new proposed organization would be designed to assist the PA to deliver higher care standards and add greater value while carrying out physician services. ABPAP would not be a testing agency, nor would it be a quasi-regulating organization. It could represent an institute of higher clinical learning specifically for the advancement of the PA profession. The new electronic institute would become a central depository of specialty content, evaluation methodologies and a powerful search engine that could be used to support the candidate's efforts to complete a prescribed list of learning objectives that would be required for specialty board recognition.

Patients want the best care their physician and PA can provide. Experience and knowledge is what they are counting on in seeing their providers. They want to know that their doctor and PA know what they are doing. They want assurances that the team of health care providers has the experience and ability to heal and care for their disease or condition. Most importantly, they want to be assured that the PA/physician clinical team has a record of positive outcomes. Patients could not care less if the provider has passed or failed an examination or registered 25 hours of specialty CME. Have you ever been asked what you scored on your NCCPA examinations or asked if you've fulfilled your CME requirements? I think not.

Here's the rub: 1) Where is the accountability and creditability that supports this new NCCPA PA credentialing process? 2) Will the specialty certification offered by the NCCPA demonstrate acquired advanced specialty knowledge? 3) Will it have any substantial benefit to society? 3) Is this a program that we all can get behind and feel proud of?

The creation and establishment of the American Board of PA Practice would represent a viable alternative to the presented NCCPA specialty certification program. ABPAP would be an organization run by specialty PAs for PAs whose whole purpose would be to elevate PA practice standards while promoting the PA profession from within. Demonstrating added value to PA services and a commitment to life long learning seems to me a better use of our finite resources and precious time.

Editor's Note: Below is a blog post from Jeff Trimble, PA-C, 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.

I have been a PA for 20 years--I graduated from the University of Oklahoma in 1989. My class of PAs was trained in primary care, and that was fine with us. I did receive my extra gold label for surgery and primary care at that time, but it offered very little when applying for and landing my first job.

I have truly seen changes in the PA profession since that time. ADVANCE editor Michael Gerchufsky wondered in his Webcast ("The PA Voice in Specialty Certification" - 8/13/09) why older PAs have failed to comment on the changes to our profession. It's because we have not been forced to yet. 

We want to practice our profession and live our lives without interruption. Until that is threatened or no longer possible, we will continue to be silent. The current health care debate in Washington has brought us out in a very strong way, but the current changes in the profession itself have made little impact on us.

That is why we remain silent. When it hits us in the face, then we will speak out. It seems the academics can do what they want to with the profession as long as we--the silent majority--are not impacted.

I realize it might be too late at that point. ADVANCE helps us by keeping us informed, as you have on this issue. Thank you for that, but don't be surprised by our lack of response.

Jeff Trimble, PA-C

Atlanta, Ga

Editor's Note: Below is a blog post from Paul S. Fogel, DPM, PA-C, 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.

After reading editor Michael Gerchufsky's editorial on specialty certification, I feel compelled to introduce to the discussion the cynical viewpoint of a recently retired PA. I hope you find the humor in all of this, as I have. It is laughable, to say the least. 

A graduate of Long Island University/Brooklyn Hospital, I have worked as a PA since 1973. Back then we had great ideas and predicted a great future for medicine. I soon found out that was a joke. No one knew what to do with a PA. Others weren't even sure what I was there for. I worked in the ICU, with the crash team, did autopsies, started IVs, took H&Ps, administered shots and IV drugs, performed CPR, and fixed air conditioners, beds and cardiac monitors. I also scrubbed in for surgery as first assistant, handled post-op care, and scrubbed in as an assistant for eye, oral, general, rectal and podiatric surgery. 

Back then NCCPA did not exist. I worked for a couple of years in a dead-end PA job--at the time, PAs made no more than $15,000 annually, and usually less-and later elected to go to podiatry school. In 1973, it seems that only two out of 10 people understood the role of the PA. Now maybe three out of 10 people know. Great marketing. If Wal-Mart was that good, they'd have been out of business years ago.

I was certified in 1973 but did not renew my license after I started practicing as a podiatrist. After 15 very difficult years trying to build a private practice, I quit podiatry. Medical malpractice insurance and finances were the problem. I had no rich relatives and did not want loans to persist for what I considered a profession in which I was a loser. Because I could, I re-established myself as a PA. I had to re-take the PANCE. The first two times I failed the physical exam portion. I was told to retake that portion and try it again from the viewpoint of a student, not a clinician. Finally, on the third try, I passed. The following year they dropped the physical portion from the exam.

Meanwhile I had, at extra cost, passed the "specialty" boards that were offered at that time in surgery and medicine. Joyfully, I considered a bright future. I found a great position in oncology in 1996. The next time I was up for NCCPA certification, I found that they now considered those specialty boards I had taken unacceptable. What a joke. What a waste of time studying and extra money for the exams.

I am retired now and also recently re-certified, so I will never have to be re-certified again, as I have no plans to practice here in Pennsylvania, where malpractice insurance is the highest in the nation. There are 10 PA programs in my area that offer master's degrees, and there are very few jobs available other than the usual burnout CT surgery and orthopedics. Maybe you can explain why I had PAs with their master's degrees working as surgical house PAs doing resident scut work. They had to tolerate terrible hours, call, animosity and low pay, while NPs were working in teams with the docs and making $80,000 or more fresh out of a two-year program.

I think the NCCPA is made up of a bunch of money-grabbing slugs that think they are some real HOT stuff. It seems many of its directors have never worked as a PA in the field. Some will object to this observation, but I think that PAs have been sold out by legislators like the NCCPA, AAPA, and all of those who have helped perpetuate the myth that NPs work hand-in-hand with PAs to improve health care in the nation. What a bunch of propaganda and crap. NPs have slowly moved themselves into a position of power where they are assuming the role as primary care providers. I once had an NP as an oncology patient. She insisted on telling me how much more qualified and knowledgeable NPs are than PAs, all while I was taking her history.  

I predicted the downfall of podiatric surgery years ago, knowing that the economy would drive the orthopods to take foot surgery back, and I predict that NPs will begin seeing patients on their own nationally and sending their harder cases and questions to the remaining physicians and specialists who, hopefully, will have PAs working with them. I wish you and your colleagues luck. I don't think all the "specialty" designations will do a damn bit of good.

Keep pushing for PhDs for PAs and see how many enemies you can make. Many nurses have PhDs. Are they going to start hiring PAs to do their clinical work while they sit on the phone giving NURSING advice to families?

Will PAs with PhDs have their own offices? Will they be instructors for master's programs? Are they able to do more clinically? Will they command more money? If so, to do what, exactly? Certainly not what PAs were created for at Duke.

I think specialty boards represent another way for the ailing NCCPA to pick up a few bucks and drain PAs of whatever money they break their backs to make. After they get as many PAs as they can convinced or scared enough to take those tests, they'll discontinue the specialty certification process after a while. That is, until the next regime comes in and thinks of another cool marketing scheme. Geez, get me a T-shirt for that.

Can you tell me who will decide if the specialty certificate means anything to a prospective employer? Most will not even know what it means or even care. Some of the PAs are so out of touch with reality. It reminds me of how surgical residents acted and thought of the profession. After they got out into practice, real life was a rude awakening. Not all podiatrists would be doing the heart surgeries they did as residents and helpers.

Pennsylvania was one of the first states that accepted PAs, and I still have to explain what a PA is to patients and folks I meet. How come everyone knows what an NP is? CVS has Minute Clinics, and they will not hire PAs because we need a physician supervisor. That might change when the NPs lobby to allow NPs to supervise PAs.

I'm glad I'm out and wish you all the best. Sorry you got the short end of the stick. Is there specialty certification for that?

Respectfully and sadly submitted,

Paul S. Fogel, DPM, PA-C

D.O.P.E. (Doctor Of Practically Everything), M.O.N. (Master of Nothing)

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.

Editor's Note: Below is a blog post from Michael C. Doll, MPAS, PA-C, DFAAPA, FAPACVS, president of APACVS, 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.

Since the NCCPA issued its news blast on August 11, 2009, several conversations have taken place about the new voluntary specialty certification process. Many PAs have expressed fears that certification may become mandatory in order to work in specialty practice.

First of all, let me remind you that for years the NCCPA issued an elective recertification surgery exam that was separate from the core recertification exam. I took the surgery exam twice and nobody (i.e. hospital credentialing department) ever asked me if I was certified to do surgery.

Having said that, times are different and some of my fellow PAs are now being asked the question, "What allows you to do surgery?" Case in point: a well-seasoned California-based cardiac surgery PA relocated to another state. His initial attempts to achieve hospital-based privileges at his new job were denied until he could present documentation of competency to assist in surgery and perform bedside procedures. Just saying, "Well, I've done it for years" was simply not sufficient. A letter of support from his supervising physician did not assist him in his pursuit of obtaining privileges. The documents that this PA eventually presented to his hospital credentialing committee were a procedure log, attendance of procedure-based training courses and fellowship status within his subspecialty.

Fortunately, this issue of PAs having trouble obtaining privileges is not commonplace, but it is occurring with more frequency. The Joint Commission, State Boards of Medicine and credentialing committees are becoming more focused on clinicians proving competency. Therefore, PAs will need a way to show some element of competency or ability to do surgery (or ER, or dermatology, or even psychiatry).

In addition, over the last couple years, groups not part of the NCCPA have attempted-and failed-to format specialty boards for PAs. I believe that the NCCPA started to feel external pressure to develop a specialty certification process.

I applaud and totally support the NCCPA's effort to "dip their toe in the water" by coming up with a recertification process that meets more of the diverse subspecialty needs within our profession, both medical and surgical. The analogy that I have used for years with regards to the recertification process is that the NCCPA only put out one antibiotic (meaning one recertification test) that all patients (PAs) were required to take.

But, as with medication use, not all persons can take the same medication. I believe this is true for the current singular recertification process. Will the NCCPA dive deeper into this subject in the future? That remains to be seen. In the meantime, do not be afraid to jump into this new, but still voluntary, recertification process.

Michael C. Doll, MPAS, PA-C, DFAAPA, FAPACVS

President APACVS

Editor's Note: Below is the first blog post from a PA on the topic of specialty certification. This one comes from Rick Rohrs, PA-C, DFAAPA, past president of the AAPA and past president and past chairman of the NCCPA. 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.

I was quite surprised to see the NCCPA roll out this program for PA specialty certification. During a time when the potential for extensive regulatory change exists, the last thing we need is ambiguity about what constitutes a PA of any specialty.

A few years ago the NCCPA held a summit on this very issue, and it was promised that they would never go down the route of certification but rather some type of recognition for those PAs that have demonstrated extensive skills in a particular specialty. I understand the need for recognition and support it, though I think it would be far safer for such recognition to come from the respective PA specialty societies.

The NCCPA is the gold standard for certification. This is what makes a specialty moniker from them so distressing. The NCCPA is present in every state law, and it would not require much to have restrictive medical boards begin to require one of these five designations in order to practice in those respective specialties. Because there is no mention of grandfathering PAs who have demonstrated lifelong experience, they could quickly be forced into sitting for this exam. Insurers, malpractice attorneys and hospital credentialing bodies will also have a field day with this. The NCCPA will have absolutely no control over what the marketplace does with a credential they confer.

Recent data by the AAPA continues to demonstrate that our profession, while no longer grounded in primary care, remains extremely mobile within specialties. Our growth is a direct reflection of the ability of PAs to quickly adapt to changing needs and market conditions. The proposed specialty certification could risk this forever. Many PAs could be forced, at significant expense, to maintain multiple specialty designations or perhaps work for a much lower salary because they are not "boarded." Individuals working to gain the requisite experience to sit for these exams will most likely be paid at a lower rate as well. As an employer of many PAs, this would make perfect business sense.

When the NCCPA decided to eliminate the surgical exam, it was because each year fewer than 500 PAs were taking the exam and the NCCPA was losing significant revenue. Despite widespread dismay from the surgical community, the exam went by the wayside. I am interested to know how examinations that may have far fewer potential candidates could possibly be fiscally viable. I would certainly hope that PANCE and PANRE fees will not be used to develop exams for the few PAs in nephrology and psychiatry.

I look forward to the dialogue between the AAPA and the NCCPA as this moves forward. The first order of business, at a minimum, is to wait until the dust settles on the current health care reform debate prior to introducing any such significant changes to our professional designations.

Rick Rohrs, PA-C, DFAAPA

Past President AAPA

Past President/Chairman NCCPA

Baltimore

We hope to provide such a forum with this blog, and we encourage you to comment on your colleagues' entries with your own ideas and responses. If you feel strongly for or against PA specialty certification and would like to be a guest blogger, please contact Heather Simons at hsimons@advanceweb.com.

It's your profession. Now here's your chance to express your views about its future and learn what your colleagues think.

Browse the links below for more information on PA specialty certification:

News: NCCPA Announces First 5 PA Fields to Be Specialty-Certified

Editorial: On Specialty Certification

Podcast: Specialty Certification is Coming