by James D. Hundley, MD<\/p>\n
A Case for Encouraging, not Discouraging, Orthopaedic Assistants<\/p>\n
\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 A wise person has been quoted as saying, \u201cFor every action there is a good reason and then there is the real reason.\u201d\u00a0 I wonder if something like that that may apply to the position being taken by the American Academy of Physician Assistants (AAPA) in regards to the American Society of Orthopaedic Assistants (ASOA).\u00a0 As I understand it, the AAPA has taken a position opposing the licensing of Orthopaedic Assistants based on brand infringement and an inadequate knowledge base.\u00a0 Is it really about patient care or is it about turf protection?<\/p>\n
In the first case, the ASOA has conceded the use of the word \u201cPhysician\u201d in the name of their organization.\u00a0 They are no longer the American Society of Orthopaedic Physician Assistants but are now the American Society of Orthopaedic Assistants.\u00a0 Thus, that argument has become moot.\u00a0 If there is an argument against their knowledge, based on my my long-term experience with an Orthopaedic Physician Assistant (OPA) and many years as a member of the National Board for Certification of Orthopaedic Physician Assistants I beg to differ.<\/p>\n
The OPA with whom I worked for over thirty years was highly knowledgeable and served as a valuable member of our team.\u00a0 His services in the operating room, the hospital, and the office were invaluable.\u00a0 He not only made me more efficient, he made me better, which allowed us to deliver better patient care.<\/p>\n
My role on the National Board was helping to update the written certification examination every two years.\u00a0 This process was directed by a nationally known, professional educator and performed by board certified Orthopaedic Physician Assistants and Board Certified Orthopaedic Surgeons.\u00a0 The questions and answers were evidence-based, pertinent, and difficult.\u00a0 As with other boards, candidates were required to have a certain amount of experience before being allowed to sit for the examination.\u00a0 From my detailed review of the questions, both experience and appropriate education were required to pass it.<\/p>\n
The issue that should be getting the attention of all medical organizations is the impending growth in medical manpower needs.\u00a0 The population is aging; we hear that 10,000 Americans turn age 65 every day.\u00a0 Population growth is outstripping the growth of medical providers.\u00a0 Medical schools will not be able to keep up with the number of physicians needed.\u00a0 New schools are being opened and old ones are expanding, but they simply cannot turn out enough additional physicians quickly enough.\u00a0 I believe that the void will have to be filled with physician extenders.\u00a0 The greatest numbers will be physician assistants and nurse practitioners but I believe that there will be an important role for trained orthopaedic assistants as well.<\/p>\n
The roles will be different and physician assistants should well know that.\u00a0 Their roles and, therefore their licenses, are different from physicians.\u00a0 Orthopaedic assistants will have to perform within their licenses, too, and I believe that they are prepared to do so.<\/p>\n
So why is it important for Orthopaedic Assistants to be licensed by their states?\u00a0 Along with being certain that they are certified and qualified, the issue of payment is huge.\u00a0 If they are not licensed, third party payers will not pay for their services.\u00a0 That means that the surgeon would have to pay for the assistant out of the ever-diminishing compensation he receives for a surgical case.\u00a0 Alternatively, he could use another surgeon as an assistant a level of compensation higher than an OA.\u00a0 Thus the surgeon is incentivized to involve another surgeon in his case at a greater cost to the system and at reduced efficiency; the other surgeon should be treating his own patients.\u00a0 If an OA can assist just as well (often better in my experience) the above arrangement makes absolutely no sense.<\/p>\n
My message is simple:\u00a0 Stop obstructing the licensing of Orthopaedic Assistants.\u00a0 Encourage it!\u00a0 There is plenty of work to go around now and there will be more in the future.\u00a0 Our medical system will need all of the help it can get.\u00a0 We need highly trained Orthopaedic Assistants and they need to be licensed and adequately compensated.<\/p>\n