Still a New Day at AAPA: Q&A With Bill Leinweber

The profession has grown dramatically, and it’s time for us to sit down with representatives of our constituent organizations and make sure that we’re working in the best model that we can to have the fullest impact at the local and the national level.

CR: How will AAPA address the increased movement by PAs from primary to specialty care?

Leinweber: If you step back and look at primary health care in its totality, the reality is that the demand for PAs continues to outstrip the supply. When you look at health care reform and the strong focus on primary care, I don’t think we’re necessarily going to see any immediate lessening of demand for PAs in specialty areas at the expense of growth in the primary care arena. So our challenge will be to grow that pie in totality.

We worked to have incentives built into the health care reform legislation that would encourage PA programs to participate in grant programs and other efforts that would really reward them for growing the number of PAs who choose primary care as their specialty, and to incentivize students who choose that path by increasing opportunities through the National Health Service Corps and loan forgiveness programs. Those things matter.

When you look at the primary care challenges of the country, the challenges that MDs or DOs face in terms of trying to grow the cadre of individuals going into primary care aren’t all that different from what we face. It comes down to quality of life, the compensation that’s tied to that particular kind of medicine, opportunities for advancement, flexibility.

Those are all issues that we’re going to have to address. We’ve begun to do that, but we’re going to have to work with organized medicine to continue to push for a shift in how the country rewards and positions primary care.

CR: How will AAPA provide support to PAs in specialties, while maintaining its commitment to primary care?

Leinweber: There are 24 specialty organizations that have a charter agreement with AAPA and are represented in our House of Delegates. We work closely with our specialty organizations; we collaborate with them, increasingly, on continuing medical education (CME) programs that they provide to their members.

The AAPA will work with the Society of PAs in Pediatrics, for example, and work to bring the American Academy of Pediatrics to the table so that we can contribute to shaping the delivery of programs that are of value to PAs in particular specialty fields. I certainly see us continuing to do that.

We completely recognize that the demographic has shifted. Our statistics now show that 35.7% of PAs identify themselves as practicing in primary care. So, that means almost 65% are in a specialized field. That’s a reality that we look at and we shape our services accordingly.

But considering how things are moving nationwide, relative to a reformed health care system, we very much feel the need, the pressure, and the obligation to do everything we can to grow those primary care numbers.

CR: What opportunities do you see for PAs to partner with NPs?

Leinweber: We are doing some partnering now in the form of joint CME programs that we’ve conducted in the past couple of years with the American Academy of Nurse Practitioners and various doctor specialty groups. For instance, there was a boot camp last August with the Society for Hospital Medicine. We will collaboratively put on programs that are designed to serve the CME needs of PAs and NPs primarily, although physicians can participate as well. Those have been tremendously successful. We certainly want to continue to do that.

On the legislative front, I think there is value in PAs and NPs working collaboratively wherever we can at the federal level. Wherever we have common messages that support our various legislative goals, we’re certainly open to that. I think when you start to look at the state level and where health care is delivered, on the front lines, things become a little more challenging because we don’t answer to the same regulatory body at that level.

But our philosophy is, the country has an enormous need in terms of individuals requiring care from qualified, competent providers. We need many more PAs, we need more NPs; there are very important and distinct roles that we play. And wherever we can work together to bring the wherewithal of our respective professions to improve health care and health care delivery, I think we need to be open to that and look for those opportunities.