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Exam 1 Flashcards

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1
Q

What were the early professions that resembled a PA?

A

Feldshers - Russian military

China’s Barefoot Doctors - used for rural healthcare needs

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2
Q

Who started the first PA program?

A

Dr. Eugene Stead

Duke University

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3
Q

What was MEDEX?

A

A program formed by Dr. Richard Smith that focused on deploying medical students to underserved areas

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4
Q

What was the first program to offer PA as a master’s program?

A

Child Health Associate PA Program directed by Dr. Henry Silver

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5
Q

When was the AAPA formed and who was the first president?

A

Formed in 1968

William Stanhope was first president

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6
Q

What were the three purposes of the AAPA?

A

Educate the public about the profession
Provide education for PAs
Encourage service to patients and the medical community

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7
Q

How many PA programs are located in Ohio?

A

13

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8
Q

When did Mount Union gain accreditation by the ARC-PA?

A

September 2008

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9
Q

What are the roles of a PA?

A

Elicit medical history
Order and interpret lab tests
Develop a therapeutic plan
Patient education

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10
Q

How many accredited PA programs are in the US?

A

226

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11
Q

What are the three hallmarks of PA professionalism?

A

Respect - Treating all how you would like to be treated
Compassion
Integrity - doing right thing when people are not around

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12
Q

What is intellectual honesty?

A

Don’t claim that you know things that you don’t

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13
Q

What are the Big Four PA national organizations?

A

American Academy of Physician Assistants (AAPA)
National Commission on Certification of Physician Assistants (NCCPA)
PA Education Association (PAEA)
Accreditation Review Commission on Education for the PA (ARC-PA)

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14
Q

Where is the AAPA headquartered?

A

Alexandria, VA

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15
Q

What is the function of the AAPA?

A

Provides support to PAs on Political Matters

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16
Q

What is the function of the NCCPA?

A

Provides national certification exams

Lone credentialing agency for PAs in the US

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17
Q

How often is the PANRE taken?

A

Every 6 years after graduation, transitioning to every 10 years

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18
Q

What is the Six-Year-Six-Attempts rule?

A

You get six attempts, at least three months apart, over six years to pass the PANCE

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19
Q

What are the requirements for maintaining certification?

A

Need 100 CME credits every 2 years

50 of 100 must be category 1

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20
Q

Who was the founding program director at Mount Union?

A

Sharon Luke

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21
Q

What is the function of the ARC-PA?

A

Protect the public by ensuring that PAs are not graduated unprepared

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22
Q

What are the six major areas of PA competencies?

A 
Medical knowledge
Interpersonal and communication skills
Patient care
Professionalism
Practice-based learning and improvement
Systems-based practice
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23
Q

What are the most basic requirements for state credentialing?

A

Graduation from an accredited PA program

Passage of PANCE

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24
Q

Who oversees the Ohio PA laws?

A

State Medical Board of Ohio

Ohio Association of PAs

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25
When was the OAPA formed?
1978
26
What was the importance of the law passed in 2006 by the OAPA?
Scope of practice expanded Prescriptive privilege Overseeing physician can be 60 minutes away
27
What was the importance of the law passed in 2012 by the OAPA?
PAs can pronounce death | Add Schedule II drugs to PA formulary
28
What was the importance of the law passed in 2015 by the OAPA?
Elimination of the 60 minute rule | Three PAs can work under one supervising doc at once now
29
What is malpractice?
Alleged professional misconduct or lack of ordinary skill in performance of a professional act
30
What is the history of health insurance?
First started in 1850 by Franklin Health Assurance 1929 Baylor Hospital in Dallas began to cover costs of teachers hospitalization Coverage numbers went up during WW2 because companies attracted employees by paying for health care
31
What is indemnity insurance?
Pays based on charges | Patients have almost unlimited choices of providers
32
Why are indemnity insurances plans typically called 80/20 plans?
The insurance company would cover 80% and patient would be expected to cover the remaining 20
33
What is basic indemnity coverage?
Covers hospital care and some physician services
34
What is major medical indemnity coverage?
Covers inpatient and outpatient and often prescriptions
35
What is comprehensive indemnity coverage?
Includes both basic and major medical
36
What did the RAND health experiment show in 1984?
Free healthcare does not result in better health care
37
What is managed care?
Health care systems responsible for both the financing and delivery of health services
38
What percent of Americans are enrolled in plans with some form of managed care?
90%
39
What does managed care mean for physician pricing?
Physicians are not able to set their own prices, however they are guaranteed a certain number of patients by the health maintenance organization Physicians will want to focus on health education because they wont want to see patients as often
40
Why did managed care begin to become more appealing than indemnity care?
Rising cost of healthcare fueled this | Patients were paying copay rather than 20%
41
What is capitation?
Prepaid agreement to care for patients as often as needed | Physicians paid per member per month
42
What are the different kinds of managed care?
Staff model Group model Network model
43
What is the staff model of managed care?
HMO employs doc who serve beneficiaries | Strictly managed
44
What is the group model of managed care?
HMO contracts with a multi-specialty physician group to provide all services to members
45
What is the network model of managed care?
HMO contracts with more than one group of doctors
46
Which type of insurance is less managed?
Preferred provider organization
47
Who does medicare cover?
People over 65 Disabled People with end stage renal disease Federally funded
48
What are the different parts of medicare?
A - hospital benefits B - covers professional and outpatient services C - managed care D - prescription drug benefit
49
Who is covered in Medicaid?
Covers low income Largest groups are women and children Monitored at state level
50
What are DRGs?
Diagnosis related groups | Hospitalization and pay is based on diagnosis
51
What part of medicare do services provided by PAs fall under?
Part B
52
What are the conditions of incident to that PAs fall under for health insurance?
Physician treats all new medicare patients Physician is physically on site when PA provides care Established patient with new medical problems are treated by the physician
53
What did the BBA 1997 state?
PAs could charge 85% of the physician fee for seeing the patient
54
What is an NPI?
National provider indentifier | Required for all PAs who treat medicare patients
55
What is the name of the form used to bill medicare for services?
1500
56
What are donut hole drugs?
Meds not covered in Medicare part B
57
What are the primary factors for E&M coding?
History Physical examination Medical decision making
58
What are the categories of E&M codes?
``` Outpatient Inpatient Consulation Emergency Department Nursing home Rest home Home visits ```
59
What are the four descriptors used to indicate the extent of evaluation done?
Problem focused Expanded problem focused Detailed Comprehensive
60
What does problem focused consist of?
Chief complain | Brief history of present illness
61
What does expanded problem focused consist of?
Chief complaint Brief history of present illness Problem pertinent system review
62
What does detailed evaluation consist of?
CC HPI Extended ROS Pertinent PMH, FH, or SH
63
What does comprehensive evaluation consist of?
CC HPI Complete ROS, PMH,FH, and SH
64
What are the different descriptors of medical decision making?
Straight-forward Low Moderate High
65
What is the requirement for a patient to be considered "new"?
Not seen in three years
66
What are the elements of medical decision making?
Diagnosis and treatment options Data reviewed Risk
67
What is quality improvement?
Analysis of performance and systematic effort to improve it
68
What is the history of quality improvement?
Based on theories of Deming and Juran Used in 1980s by Japanese auto industry Used in 1990s by American manufacturers and health care industry
69
Why is Qi so important?
More people die a year from medical errors than MVAs, breast cancer or AIDs
70
What are the problems in health care quality?
Overuse | Underuse mistakes
71
What is the FADE QI model?
Focus Analyze Develop Execute
72
What are proxy measures?
Can't measure something specifically so you measure something similar
73
What is the difference between process and outcome?
Outcome - does it make a difference | Process - how the system works
74
What is the PDSA model?
Plan Do Study Act
75
What is the difference between QI and research?
QI is confidential and focuses on improving care | Research is published and presented and tests new methods to create general knowledge
76
What is the difference between QI and performance improvement?
QI - focuses on quality of care | Performance improvement focuses on administrative systems
77
Why would a consultation be done?
Providers need expert opinion Managed care limits scope of practice Patients cannot make self referrals Patients need referral chains
78
What is the most common referral?
Radiology
79
What are the challenges of healthcare in rural areas?
``` Accessibility Availability Health disparities Lack of health insurance High poverty rates ```
80
What is the definition of rural health care?
Areas of open country with populations less than 2500
81
What are the challenges of inner city practice?
Language barriers Homelessness Increase in communicable diseases Facilities provide for city and nearby suburbs Varying beliefs surrounding health and illness
82
What is the LEARN model?
Listen to patients perception of problem Explain your perceptions and treatment strategy Acknowledge and discuss differences in perceptions Recommend treatment with respect to patient's cultural perceptions Negotiate agreement

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