Patrick Killeen, MS, PA-C, may have just taken the reins as President of the American Academy of Physician Assistants (AAPA), but he is no stranger to leadership roles. His extensive resume includes tenures as President of the Society for PAs in Pediatrics and as the AAPA Liaison to the American Academy of Pediatrics. But for Killeen, one of the significant highlights was serving as President of the Student Academy of AAPA (in 1986-1987): “Without that,” he says, “I don’t think I would have continued in the track that I did.”

As he commences his newest role, Killeen found time to answer a few questions for Clinician Reviews.

CR: What have you learned during your tenure as President-Elect that will shape or inform your presidency?

Killeen: The past year was all about health care reform. Like no other year previously, that was the hot issue. So what I learned is that we have to be very, very organized as a profession, in order to be at the table and not “on the table,” as people say. If you’re not sitting there talking about your profession, then your profession may not be noted. In the past year, in my opinion at least, the Academy has done a great job promoting what the PA profession should be doing within health care reform, without talking about the Democratic or Republican side, but rather in reference to how PAs should practice.

[On a more personal note,] Steve Hanson, the current Immediate Past President, gave me some great advice in reference to looking at the future. It was “Do everything you need to do in the moment, because the big picture is overwhelming.” And it’s really true. When you look at everything you have to do as a profession, oh my gosh, it’s so much work to be done. But if you live in the moment to get done what you need to do right now or be at the table you need to be sitting at today, you’re going to make great progress. That’s probably the best advice he gave me.

CR: What impact do you foresee health care reform having on your profession? How might PA practice change as a result?

Killeen: It’s going to be about primary care. The Obama administration just announced that about $250 million will be going to health care reform in the primary care workforce. And we know that 15%, or about $32 million, of that is going to go to PA education, and that’s going to focus on primary care.

To me, it’s amazing that PAs are already recognized, with other providers such as nurse practitioners, as being primary care providers in a medical home or chronic care management model. Those are things that weren’t acknowledged at the federal level prior to health care reform. For the PA profession, it’s placed us with a great opportunity to make an impact in primary care.

When you talk about throwing 32 million [previously uninsured] people into the primary care pool and looking at where they are getting their care—no longer, hopefully, in emergency rooms—I think PAs, NPs, MDs, and DOs are really going to have to look at their patient mix—and reimbursement has to be appropriate for that patient mix…. So for right now, I think the focus is going to be on looking at increasing the patient load and looking at appropriate reimbursement.

CR: Personally, which initiatives are you most excited about working on during your time in office? What are your own goals for your presidency?

Killeen: For me there are two things, the first being the implementation of health care reform and all the different venues we have to look at. That’s probably our biggest thing, because again, if we’re not at the table, we’re not going to be the people who are able to implement changes.

And the second thing is research on the PA profession. I’m excited about working to develop extensive research on how PAs impact patient care, patient care outcomes, compliance to medications, compliance to smoking cessation and obesity interventions. Those are the types of things that we really need to look at. The PA profession has some of that information. But if you were to ask, “Is there one study that tells everything you need to know, or one great study that’s kind of the blueprint [for the profession]?” that would be a hard one to pick. I think this research agenda will allow the profession to really target some areas of clinical expertise, in addition to how they affect patient outcomes.

Patients need to understand that they’re receiving quality care and that it’s effective and safe; those same issues can be noted by other health care providers, insurers, and people who are doing appropriate reimbursement for physician services [provided] by a PA—because you’re in a team. As always, PAs have talked about a team approach, an interdisciplinary approach, to care. And I think that component needs to really be pushed out there, how the team approach improves patient care. In reality, the PA profession, and NPs and other groups, talk about it, but is there one really great sentinel study? That would be a difficult thing for PAs or NPs, to promote one study or one topic area that made a big impact.

CR: How would you rate the current level of recognition the PA profession has with the public? How can we increase public awareness of PAs?

Killeen: We need to do more. But overall, when you look at the profession and its marketing and public relations component, with regard to patients, I would say that the profession has slowly increased that knowledge base within the past five years. And, partly because of health care reform, we have groups like Money magazine listing the PA profession as the second-best career and Forbes.com listing ours as the best master’s degree to receive. Those media pieces are huge for the profession. And it’s really exciting to see that finally come to fruition, so the public can see that information out there.

But it doesn’t mean that every patient you see has a full understanding about your profession and its all-encompassing components. We do have a way to go, but I think as a profession we’ve made some significant strides. When you look at the future of the profession, it’s very bright. We talk about PAs’ numbers increasing and about being noted by all these different organizations—I think that says a lot.

Now, we have to take all that information and bring it down to a patient care level. I think the Academy is great at creating coalitions with other health care organizations—like the American Medical Association, the American Academy of Family Practitioners, the American Academy of Pediatrics—and at getting the message out to legislators. But we need to take all that information and then filter that through to the general public as well.

CR: How can we increase collaboration between PAs and NPs at all levels (national, state, individual practice settings)?

Killeen: I think there are some great opportunities there. We know that PAs and NPs work very well together clinically. But I think we do have to reach across the aisle at the state and national levels, when we talk about how we can work in teams, when we talk about the team approach to medicine or the interprofessionalism of medicine for patient care.

I think that’s something that we need to improve on, because we’re all talking about the same thing: How do we approach patient care within a medical home? How are we going to get preventive care and information out there?…. There are some great areas regarding patient care and patient advocacy that we can partner on—obesity being one of them. What kind of programs on obesity are the NP state and national organizations working on? That affects so many other aspects of life, such as hypertension, cholesterol, etc. And those are the types of partnerships that I think our profession and the NP profession should be really looking at, some of those clinical practice issues where we really make a great impact on patient care.

CR: What other message(s) do you have for your colleagues?

Killeen: I think the biggest, and the most difficult, thing is to volunteer. It doesn’t matter if you’re an NP or a PA, you need to have some component of your life to volunteer. I don’t care if it’s with the United Way or a gay and lesbian medical association—some type of group that you work with, because as a PA or an NP you’ll make a huge impact with any type of volunteer [activity]. If it’s an hour a week, that’s a huge impact for some individuals—and the more you can give, the better impact you can make. And that can be at the state level, professional level, or national level.

That’s something I’ve always done; I sort of grew up with the thought that you volunteer, you help out at church, you do your activities, because it’s the right thing to do. I would like to see more people do what they think is the right thing, by volunteering in something that they’re really passionate about. It doesn’t have to be medicine. It could be hockey or some other sport or something. But volunteering for it, being the parent who does that, makes a big impact, in comparison to the parent who is unfortunately too busy or is overwhelmed with life and activities as well.

Meet Your Leaders—Part 1: AAPA