The PA Name Game

A successful marketer has to “burn” their way into the mind of the public by narrowing the focus to a single word or concept. The most effective words are simple and benefits oriented, and have a clear meaning. I am not sure that assistant in this case has a clear meaning—at least, not the one we want. Moving to associate has the potential for us to “brand” our name. It will no longer be generic, and it is clearly more descriptive of where PAs are as a profession today.

The Law of Exclusivity: Two professions cannot own the same word (or name) in the public’s mind. This is where the term assistant causes the biggest problem, since many health professions—particularly medical assistants, nursing assistants, anesthesiology assistants, and surgical assistants—share that title as well.

On the other hand, the term associate isn’t exactly unique either: There are associate deans, associate partners, and associate professors. I would argue, though, that (a) the term associate isn’t widely used in health care as a job title and (b) associate is usually used as a descriptor rather than as the name of an actual profession. Marrying physician to associate certainly clarifies the phrase and creates a new name that could be leveraged to send a powerful message about our role and our relationship to the physicians with whom we work. When thinking of that name, I refer you back to the laws of perception and focus.

The Law of Unintended Consequences: You are probably familiar with this one, the idea that actions have effects that are unanticipated or unintended. Economists, social scientists, and strategists have heeded this law for centuries. It is also true that politicians and popular opinion have largely ignored it.

This is a law that we cannot afford to ignore. One could say (and many have) that we have worked long and hard to ingrain the physician assistant name in state and federal statutes, hospital bylaws, public service announcements, the public consciousness, etc, and many wonder if changing the name now would have negative consequences for the profession.

Some have postulated that changing the name would be a huge task that would eat up millions of dollars and years of time. I think this a bit of an overstatement.  (Easy for me to say, right?) Others say that changing assistant to associate may just be a “cosmetic” or “technical” fix with state legislators, hospital administrators, and third-party payers.

As a PA who has been involved in state legislative efforts for more than three decades, I tend to favor the latter viewpoint. With the right support (and the right timing), the change could be fairly barrier-free. It is often done in legislatures when names of organizations, certification bodies, and others are changed. Getting rid of the apostrophe-s years ago is a case in point. When this happened, we changed our name in state legislatures throughout the country; it did not cost millions of dollars, and there were no significant attacks on our scope of practice.

The biggest perceived barrier, of course, is the support of physicians, particularly the American Medical Association, the American Osteopathic Association, the American Academy of Family Physicians, the American College of Surgeons, and the rest of “organized medicine” (see law of perception). However, if we convince these groups that a name change would not alter the scope of practice nor signal a move for independent practice, then we may be able to engender their political support.

If the perception is otherwise, it could be problematic. However, PAs have become strong members of the health care team, and I think physicians and federal agencies recognize our importance in being part of the solution to caring for the 34 million new patients who will soon enter the system. 

I must also mention that without the active support of the AAPA, the Physician Assistant Education Association, and the National Commission on Certification of Physician Assistants, the name change issue will likely die on the vine. The old saying that “we should hang together or certainly we will hang separately” makes an important and serious political statement. I call on state and national PA leaders to listen to their constituents on this issue.

Many prominent PAs have spoken eloquently on the name change issue. Robert Blumm suggested, “The word assistant no longer reflects what we do or who we are as a profession.”² Vic Germino, one of the first three PAs in the country, has said: “PAs are associated with physicians in ways that enhance their ability to practice with their particular population of patients, whether that enhancement involves assisting in surgery, managing chronic illness, doing preventive and educational care, practicing in underserved areas to extend the physician’s ability to reach more patients, or doing research. We use our variety of skills and our knowledge and education to function as associates and colleagues in these and other ways. Clearly, the level of independence (with supervision) of most PAs today is far beyond the generic term assistant that has been applied to health care workers with as little as six to 12 weeks of training.”³