Letters to the Editor

A nurse practitioner cautions PAs to maintain their reputation for quality care, rather than debating the need for a title change.


I am a nurse practitioner who applauds your discussions regarding a name change in the PA profession. It may be true that some change in your title could be advantageous to the profession, but I feel compelled to ask: At what cost?

I have been a nurse for 35 years and have seen a fair amount of change, discussion of change, backlash from change, political disruption secondary to change, and the ever-present reversal of change. I agree with nurse practitioner Lesa Walker (Clinician Reviews. 2011;21[11]:5-6), who said she is often asked, “So you are like a PA?” This is telling. The public has come to accept the definition of “PA” as a standard in health care delivery.

In years past, it was not unusual to hear patients say, “I want to talk to a ‘real doctor’” (ie, not an NP or a PA). That has largely changed. I hear comments every day that indicate to me that patients would rather see an NP for certain things than to see their physician. They have come to understand the function of the NP and the additional attention they can often derive by seeing someone who practices a little differently than an MD does. They also know when to see a physician and access that particular set of skills.

I think the same is true for the PA. You have graduated from an “unknown” to a formidable factor in health care delivery. People know you as “PA,” and they understand your function enough that the “assistant” attached to your name is irrelevant in the care you provide, the suffering you ease, and the healing you contribute to.

Please do not further confuse the public as to your identity just when they have come to know who you are and appreciate what you do. The health care delivery system is already complex enough for the public (and more so for the elderly, the infirm, and the disenfranchised). Your identity is cemented and your name is known not by the “assistant” nomenclature attached, but by your deeds.

Spend your valuable time increasing your practice parameters, reimbursement, prescriptive authority, and access to patients in need, not seeking better recognition for self. As you have already seen, recognition will come with excellence in practice—not changes in title.
William Gause, MSN, ANP, Colton, CA

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