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AMA Response Statement

The Academy of Doctoral PAs (ADPA) is addressing the American Medical Association’s (AMA) fallacious narrative that their #StopScopeCreep campaign is about patient protection in their now deleted campaign posts. The AMA has asserted that patient safety and care is their goal. The ADPA would like to remind the AMA that, according to the Institute of Medicine, patient-centered care is defined as “providing care that is respectful of, and responsive to, individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions.” (1)  This approach requires a true partnership between individuals and their healthcare teams. One where the individual’s needs and aspirations drive both healthcare decisions and how outcomes are measured. Providers – not just physicians – drive this patient-centered model. As the New England Journal of Medicine Catalyst aptly reports, these patient-centered models push health systems to reconsider traditional healthcare delivery models. (2) Attacking professionals with similar scopes of practice does not meet these definitions of patient-centered care and directly conflicts with the claimed purpose of AMA’s messaging. 

The AMA’s archaic belief that the only safe healthcare is “physician-led team based care” not only lacks supporting science and research, it disingenuously ignores other qualified, highly competent members of the healthcare team it purports to lead. AMA physicians prejudicially push the narrative that those with the most clinical training should sit atop the healthcare hierarchical pyramid, conspicuously leaving out the fact that physicians have ample clinical training but no required leadership training within traditional medical school curriculum. (3) The ADPA strongly asserts that those with the most training and experience in leadership should be leading the healthcare team. 

Finally, this false and malicious narrative does nothing more than hurt the very group of people the AMA professes to defend by making individuals fearful of accessing healthcare by providers not in the AMA’s professional faction. Physician Assistants are masters- and doctoral- trained professionals that practice medicine in all medical specialties and subspecialties. The PA training model is based on the training of World War II physicians. PAs have an average of 3,100 patient contact hours prior to entering PA school, amass an additional 2000+ clinical hours during PA school, and obtain an average of over 112 weeks of medical education for the master’s degree. (4) The clinical PA doctoral degree typically requires another practicum, as well as additional clinical, research, and healthcare training, lasting an additional 48 weeks or longer. In contrast, physician education requires 130 weeks of medical education and only a minority have any prematriculation clinical experience. (5,6)

PAs provide care when physicians are unwilling. PAs increase patients’ access to care. PAs provide proven, competent care in every healthcare setting. Removing antiquated legislation further improves patients’ access to the care they need, while improving the administrative burden on the healthcare system and using the healthcare labor inputs in the most efficient manner possible. In short, PAs are not detrimental to patients’ health. PAs are America’s biggest healthcare success story.

Sincerely,

The ADPA Board of Directors


References

1. Washington, D.C.: National Academies Press; 2001. http://ebookcentral.proquest.com/lib/liberty/detail.action?docID=3375215.

2. What is patient-centered care? NEJM Catalyst. 2017.

3. Kristen R, Michael N, Thorndyke Luanne E, Fischer Melissa A. Preparing medical students to be physician leaders: A leadership training program for students designed and led by students. MedEdPORTAL. 2019;15. https://doi.org/10.15766/mep_2374-8265.10863. doi: 10.15766/mep_2374-8265.10863.

4. Cai D. By the numbers 30th report on physician assistant educational programs in the united states. Physician Assistant Education Association. 2015.

5. Shah R, Johnstone C, Rappaport D, Bilello LA, Adamas-Rappaport W. Pre-matriculation clinical experience positively correlates with step 1 and step 2 scores. Advances in medical education and practice. 2018;9:707-711. https://pubmed.ncbi.nlm.nih.gov/30310346https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6165731/. doi: 10.2147/AMEP.S173470.

6. Mowery YM. A primer on medical education in the united states through the lens of a current resident physician. Annals of translational medicine. 2015;3(18):270. https://pubmed.ncbi.nlm.nih.gov/26605316https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4630550/. doi: 10.3978/j.issn.2305-5839.2015.10.19.

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