LAS VEGAS -- Grassroots efforts to increase physician assistant autonomy are being blocked by the certifying organization for PAs, a charge that ignited a firestorm at the conference here on Monday afternoon.
The conflagration began following an AAPA session on recertification, aka Maintenance of Certification.
States trying to advance bills to remove PA license restrictions were "blindsided" by National Commission on Certification of Physicians Assistants (NCCPA) lobbyists who, in some cases, destroyed years of work crafting legislation and educating legislators, charged , president of the Nevada Academy of Physicians Assistants.
Byers told ľֱ that his experience convinced him of the difficulties involved in making a case for PAs with state legislators.
"When you've got a group that brings in opposition from within the profession, it undermines the whole foundational process of time that we've spent with each legislator and the confidence that we're trying to build within the profession."
"Their legislation dies and they're back at ground zero," he said.
Not so countered president and CEO of NCCPA.
"NCCPA is not a membership organization. It is a certifying body ... We have to support initiatives that protect the public interest. To the extent that they are in line with what PAs want that's very nice, but that's secondary," she said. "We have a 40-year history of providing certification and recertification programs that are well-respected and well-accepted, not only by the medical community, but the public as well as the other stakeholders groups."
Regarding the most significant concerns about its lobbying efforts, Morton-Rias said the group's only reason for "registering opposition" is to prevent states from reducing the standards of practice while also expanding the scope of practice, she explained in a telephone interview. An NCCPA public relations person was present during the interview.
Byers said the NCCPA blocked a West Virginia bill aimed at easing limitations on PA practice and it also opposed recommendations from a 2014 , also recommended increasing the use of PAs and encouraging states to review legislation and "consider actions to increase the future supply of PAs."
The NCCPA noted in a follow-up email that it encouraged , not because it opposed the bill’s scope of practice provisions, but rather out of concern for language that aimed to “lower standards.â€
Meanwhile, Byers said AAPA leaders are considering establishing their own certifying body, which has put NCCPA on alert.
"The perception is that [NCCPA] is against the ropes," said Byers, "And it's in response to them lobbying in direct opposition to the progression of the PA profession in the future."
"We're not up against the ropes," Morton-Rias said. "We're having uncomfortable conversations."
Regarding the most significant concerns about its lobbying efforts, Morton-Rias said the group's only reason for "registering opposition" is to prevent states from reducing the standards of practice while also expanding the scope of practice.
In a phone interview last week, president and chair of the board of directors for the AAPA and and executive director of Physician Assistant Services at the Cleveland Clinic, criticized the NCCPA's efforts to block PA bills in Illinois and New Mexico, as well as West Virginia.
The NCCPA's insistence on "high stakes exams" for recertification was "jeopardizing the ability of PAs to practice," Pagel said.
She applauded the NCCPA's announcement that it would test alternative models to recertification other than these exams.
Byers added that he's "guardedly optimistic" about the prospects for PAs maintaining certification.
Some PAs at the meeting here suggested the possibility that the NCCPA collaborate and negotiate a new certification plan.
However, Morton-Rias called that approach a "slippery slope."
"As an accredited certifying body, we have the responsibility of developing certification and recertification process that are reflective of the profession. That's our responsibility to do. We can't negotiate with others. That's a violation of accreditation."
A press representative for the NCCPA also pointed out, in a follow-up phone call, that having the NCCPA negotiate its certification or recertification requirements would violate antitrust laws.
While the NCCPA will not negotiate certification requirements, it does invite discussion on all issues regarding PA practice and from all stakeholders especially PAs, the organization stressed in a follow-up email.