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74 Cards in this Set
- Front
- Back
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When was the first PA Class? And where?
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Started 1965 graduated in 1967 from Duke University.
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Why did the PA concept emerge?
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* Strategy to cope with a shortage of physicians.
* Increased demand for health care services. * Mal-distribution of providers |
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Who was included in the first PA class?
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3 Navy Corpsmen
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What changes in the healthcare delivery added to success of the PA concept?
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Scientific breakthroughs, new medical specialities and subspecialities, overgrowth of hospitals and hospital services.
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What did President Johnson contribute?
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"Great Society Program" was the beginning of the "war on poverty" an attempt by the federal government to reach out to the underserved.
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What is the Health Manpower Act?
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Developed and funded new programs
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What was the original concept?
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* Brief duration of generalist training
*Physician supervised * Medical Model (basic sciences courses followed by clinical skill development) |
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What is AAPA?
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American Academy of Physician Assistants
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What is KAPA?
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Kansas Academy of Physicians Assistants
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What is the PA scope of practice?
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The physician delegates to the PA, only those acts which the physician believes can be competently performed by the PA based on the PA's background, education, skill, and experience.
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What is the PA credentialing process?
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* Attend and graduate from an accredited PA program.
* Pass the NCCPA exam * State Registration and Licensure * 100 CME hours every 2 years, 50 from Cateogory 1 and 2 * Recertification exam every 6 years. |
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Define culture.
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The integrated pattern of human behavior that includes thoughts, communications, actions, customs, beliefs, values, and institutions of a racial, ethnic, religious, or social group.
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What is cultural competency?
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* A set of academic and personal skills that allows us to increase our understanding and appreciation of cultural differences between groups.
* We need to be culturally competent in health care for people of diverse backgrounds, homelands, languages, and beliefs. |
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What are some "other" healing beliefs held by cultures.
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* "Hot/cold" beliefs - not related to temperature.
* Dermabrasive procedures: coining or spooning * "Cupping" - forming ecchymosis |
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What are some western medical influences that other cultures may not accept?
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* Venicpuncture
* Surgery * Injections * Western medicine - may be too potent and pt's may reduce amount |
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What are some different cultures? Subcultures?
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* Hispanic, Asian, Middle Eastern, Native American, etc.
* Women, homo's, Teens, Gangs, Rural, Inner city, etc. |
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What are some global health care issues?
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* HIV and AIDS
* TB * SARS * Biological terrorism * Avian flu |
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What is COGME?
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Council on Graduate Medical Education
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What is HIPAA?
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Health Insurance Portability and Accountability Act of 1996
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What are the 3 areas of primary care?
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* Family Medicine
* Pediatrics * General Internal Medicine |
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What are 3 issues confronting the PA Profession?
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* Medical Information - widely available on the internet. Which is accurate?
* Profit - Stockholders, companies, and highly paid practitioners are all stake holders. The patient's welfare comes first. * Loss of Autonomy - managed care, malpractice suits...? |
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What is NCCPA?
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National Commission on Certification of Physician Assistants
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What is ARC-PA?
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Accreditation Review Commission on Education for the Physician Assistant - Accrediting body for PA Programs
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What is SAAPA?
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Student Academy of American Academy of Physician Assistant
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How much does medicare pay?
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Services provided by the PA's in all practice settings at the rate of 85% of the physician fee schedule.
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How much does medicaid pay?
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State determined. In Kansas 75% of the physician fee.
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What is "Incident To"?
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Reimbursement of 100% by medicare if: 1) seen in office, 2) physician sees patient on initial visit and establishes diagnosis.
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What is the surgery fee paid by medicaid?
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85% of the first-assistant fee (.85 x 16 = 13.6%)
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What are the roles of PA's in primary care?
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* Pt makes appointment with PA
* PA makes decisions for care * PA develops ongoing relationships * May care for entire family * Earned income easily identified * Broad knowledge - know a little about a lot |
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What are the roles of PA's in specialty practices?
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* PA is more of an extension of the physician
* Usually do not have own patients * Provide peripheral care or support services * Harder to identify income to practice * Can be challenging to develop ongoing relationships * Focused knowledge - know a lot about a little |
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What are the 4 main bioethical principles?
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* Autonomy
* Beneficence * Nonmaleficence * Justice |
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What kinds of PA degrees can you get?
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* Master's
* Bachelor's * Associates * Cartificates * Programs range from 12-57 months |
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What are the PA Education Models?
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* Hospital based - all clinical training
* Full time, part time options * Combined military programs * Four year curriculum * Medex model - 18 months community based * ND - 12 months,one physician, only RN's admitted |
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Who funds PA institutions?
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* State funded
* Private institutions * Federal Training Grants * Other - private foundations, industry |
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Describe PA faculty?
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60% are PA's
40% are non-PA's |
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How many CME hours are required for PA's?
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100 hours every 2 years
* 50 are cateogory 1 - preapproved * 50 are cateogory 2 - self learning; on your honor |
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What are malpractice issues PA's get involved with?
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* Lack of adequate supervision - documentation
* Untimely referral * Not following protocol Failure to diagnose * Inadequate examination * Parental Consent when treating minors * Restraints and seclusion * Negligence/abandonment |
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What is PHI?
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Protected Health Information
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What are patient rights regarding PHI?
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Patient may have/request:
* Restrictions on use of PHI * Alternative forms of communication * Access to their own PHI * Access to disclosure of PHI * Amendments to their PHI |
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What are the fundamental principles of medical professionalism?
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* Primacy of patient welfare
* Patient autonomy * Social justice |
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Define professionalism.
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Conduct, aims, or qualities that characterize or mark a profession or a professional person.
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What is the ultimate goal of professionalism?
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* Honor patients
* Earn their trust * Provide the best and most appropriate care possible * Understand and recognize that your personal values and beliefs can impact the care you provide. |
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What is altruism?
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patient interest comes first
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What is OSCE?
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Objective Structured Clinical Exam
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Physician assistants hold in their responsibility...
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the health, safety, welfare, and dignity of all human beings.
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Physician assistants uphold the tenets of ...
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patient autonomy, beneficence, nonmaleficience, and justice
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Physician assistants recognize and promote...
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the value of diversity.
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Physician assistants treat equally...
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all persons who seek their care.
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Physician assistants hold in confidence...
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the information shared in the course of practicing medicine.
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Physician assistants assess their personal capabilities and...
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limitations, striving always to improve their medical practice.
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Physician assistants actively seek to expand...
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their knowledge and skills, keeping abreast of advances in medicine.
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Physician assistants work with...to provide...
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other members of the healthcare team
compassionate and effective care of patients |
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Physician assistants respect...
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their professional relationship with physicians.
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Physician assistants share and...
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expand knowledge within the profession.
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What are the differences between the living will and a durable power of attorney?
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* The living will is a statement of personal values, and only applies when a person has been diagnosed as "terminal" by 2 physicians.
The durable power of attorney is useful in cases when one may not be terminal, but will never recover enough to live a life meaningful to them. Neither takes effect until the person can no longer make, or communicate, decisions for themselves. |
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What are the 3 advance directives?
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* Living will
* Durable power of attorney * DNR |
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What is a DNR order, what is included?
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* Limits emergency care
* No CPR * Does NOT limit other medical care, such as antibiotics, pain medications, or comfort carfe * Can be revoked at any time * Must be assigned by the attending physician (the pt's PCP) |
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What is the Patient Determination Act of 1990?
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Requires the hospital to provide written information to adult patients re: rights to make decisions regarding their own healthcare
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When is a living will effective?
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* 2 physicians must examine the patient and determine that the patient has a terminal illness
* They must agree that death will occur whether or not the medical intervention is done. * The form is not effective if the pt is pregnant |
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Where should you put copies of the advance directives?
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Several places: family physician, hospital, attorney, and family members.
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What are patients rights concerning advance directives?
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* Information about their medical condition, diagnosis, prognosis, and possible treatments.
* Refuse any treatment * NOT make advance directives, it's their choice. |
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When can one change their mind about an advance directive?
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Any time
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What are rules for licensure in KS?
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* Pass NCCPA
* Maintain CME's * Renew license annually * Have a supervising physician and a back-up * Have protocol on record at KSBHA |
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What must you do concerning hospital credentials?
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- Apply to hospital credentials committee for staff priveleges
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What are PA's liberties/allwances in the state of KS?
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* Two PA's per physician
* Short protocol * Prescriptive privelege (may require a DEA #) * Supervised (at least 30 min by phone) * Physician actively practices medicine within state. *DR annually reviews drug protocol * Reports any disciplinary actions * Signs all pt encounters (at least every 14 days) * Reviews pt charts within 48 hours of emergent care by PA |
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What is cultural competency?
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A set of academic and personal skills that allows us to increase our understanding and appreciation of cultural differences between groups
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What is APAP?
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Association of Physician Assistant Programs.
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What is the purpose of HIPAA?
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* To allow people to keep their insurance when they change jobs
* Prevent health care fraud and abuse * To promote electronic healthcare transactions and streamline claims processing * PRIVACY - protect patient information |
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What did COGME commission?
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AGPAW - Advisory Group on Physician Assistants and the Workforce
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What are AGPAW's recommendations?
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* Increase federal support for PA programs
* Funding should give priority to PA programs that succeed in placing PA's in primary care settings * Policy initiatives should include removing legislative obstacles to PA clinical practice on federal and state levels |
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Who said, "Education is what survives when what has learned has been forgotten" ?
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BF Skinner
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When was the national certification exam first given?
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1973
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Who is eligible to take the certification exam
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All graduates of an accredited PA program (This was placed into effect in 1986)
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When did the ARC-PA begin?
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1971
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