FPAR: Asking for the sale

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After the AAPA completed its FPAR survey, I welcomed hearing the task force's recommendations. Asking for the elimination of supervisory or collaborative requirements and requesting autonomous boards with the responsibility to admit, police, and govern our own has been a desire of mine for the full 44 years I practiced as a PA.
But as I read the task force's report, I became confused. I found a breakdown in logic and a failure to be professionally honest. I offer my comments on this conundrum for further discussion.
I tried to reconcile components of the task force's proposal. Forgetting about autonomous boards for a moment, I grappled with the illogic of two recommendations:
It is not possible to eliminate supervision and not be independent, and it is time for our profession to be honest about that.
This is a new version of trying to get something and not being direct when asking for it. Professionals take risks. Hopefully, these risks are carefully planned. This is not the time to worry about angering physicians (personally, I do not think we have as much physician support as many would think).
One thing I have admired about the evolution of NPs is their unabashed honesty in asking for what they want. In the early days of my career, NPs lagged behind PAs in number and employment. In short order, the reverse was true and it remains true today.
A PA colleague of mine tells me that the desire for autonomy is part of the social evolution of our profession—through policy and change, it will come. I reject the notion that we should keep our hands off the wheel. To quote Dale Carnegie, if you want something you must ask for the sale. He would also say that if we are afraid and cannot ask for the sale, perhaps we don't deserve it.
Joseph Marzucco, PA, PhD
Portland, Ore.
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