Chief PAs and diffusion of PA innovation

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As the newly appointed chief clinical consultant for physician assistants for the Indian Health Service, I took particular interest in the two 50th anniversary series articles published in the June 2017 issue: “Chief PAs—A seat at the table,” by Sobia S. Hussaini, MHA; Marc Moote, MS, PA-C; Carol Hildebrandt; and Benjamin Reynolds, MSPAS, PA-C, DFAAPA, and “Diffusion of PA innovation: Risk-taking vs. safe bet,” by Christine M. Everett, PhD, MPH, PA-C, and Alicia Quella, PhD, PA-C.
The interrelated concepts of leadership, innovation, and risk-taking were particularly salient in these two articles in regards to how they have affected the PA profession and how they may influence the profession for the next 50 years.
I was encouraged that leadership opportunities in the PA profession are growing, that as a profession we are nearing the “tipping point” of diffusion, and was both impressed as well as inspired by the profiles of Moote and Reynolds. However, I found it sobering that despite these advances, we are still outnumbered 2:1 by APRNs while they continue to rapidly diffuse throughout the healthcare system and gain full-practice authority at the exclusion of PAs. The article seemed to advocate for a future of blended APRN and PA leadership roles but it remains unclear to me how that would benefit the future of the PA profession.
I was discouraged by the fact that optimal team practice and recertification requirements were not addressed in the article and that the overwhelming message for future PA leaders seemed to be to play it safe in “low-risk settings” before stepping up for specified leadership opportunities. This message seemed in direct conflict with the take-home message about the future of continued PA innovation and diffusion.
I asked myself how can the information in these articles further my goal of making the Indian Health Service a model for PA practice across all states and agencies? What additional leadership skills would I need to develop to be successful?
If we are to advance our profession, we need PA leaders who are not afraid to take risks, who understand that leadership does not require a title, and that rather than wait for opportunities, PAs should do what they have done since becoming a healthcare profession 50 years ago: identify gaps, identify inefficiencies, and make them better.
I would hope that JAAPA continues to highlight PA leaders and chief PAs throughout our profession and that these articles include PAs working outside of academic and private healthcare sectors, such as PAs working in the uniformed services, federal services, and state agencies. Leadership, innovation, and risk-taking have brought us near the tipping point for our profession, and only through those same actions will we break through to the next level. The question remains: are we ready?
Benjamin Olmedo, MMSc, PA-C
Lieutenant, US Public Health Service
Santa Ynez (Calif.
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