History of the PA Profession Flashcards

(71 cards)

1
Q

why was the concept of PA developed?

A

there was inadequate healthcare (general need, physician shortages, developing technology)

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2
Q

how did russian feldshers develop?

A

they were originally German military assistants to “barber surgeons” . . they were military field surgeons. often they were the only healthcare providers in the rural community (low cost healthcare)

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3
Q

what do the feldshers serve as now in russia?

A

NP’s or PA’s

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4
Q

define “feldsherism”

A

using non-physician providers for primary care in developing countries. they apprenticed physicians and provided care in rural areas.

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5
Q

Barefoot doctors emerged from what country?

A

China

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6
Q

during this cultural revolution of 1966, why did chairman Mao send physicians to do?

A

he sent physicians to the fields to work, leaving peasants without medical personnel

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7
Q

what was the training of barefoot doctors?

A

3 months of on the job training in the villages where they served when not working in the rice fields

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8
Q

what was the emphasis of barefoot docs?

A

common disseases

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9
Q

non-physician providers from which 2 countries make up a large part of the healthcare system

A

china and russia

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10
Q

where did the origins of the NP profession and PA specialty begin?

A

university of colorado — child health associate program

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11
Q

what was the concept of Puerto Rican Practicantes?

A

to provide medical care to rural areas

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12
Q

who were Loblolly boys?

A

(1814) naval crewmember who assisted ship’s surgeon and carried stuff to sick shipmembers, collected amputated limbs, provided coal for heating, and gave the surgeons buckets of sand so they wouldnt slip on blood

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13
Q

who was a surgeon’s steward?

A

(1842) trained in basic medicine and served on large ships

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14
Q

where did the role model for the urologic PA start?

A

Cleveland Clinic (in the 30’s and 40’s) - informally trained surgical provider working in urology

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15
Q

where did vivian thomas help perfect the techniques of CT surgery?

A

Johns Hopkins (in the 40’s)

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16
Q

what happened to people’s standards after the Bolshevik Revolution?

A

they increased! people wanted a higher standard of care so the feldshers were considered 2nd class medicine. but its ok! they got re-trained and served side by side with physicians in urban areas. they became alternatives to physicians in underserved areas.

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17
Q

why was it great to be a feldsher?

A

tuition free, no expenses, jobs provided.

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18
Q

after how many years of practicing were the feldsher’s eligable for med school?

A

3 years

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19
Q

what is the current trend for feldshers?

A

feldsher educators, continuing medical education

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20
Q

how long was the training for barefoot doctors?

A

3-6 months

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21
Q

what did the barefoot doctors focus on in their training?

A

basic hygiene, preventative medicine, family planning, and common illnesses

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22
Q

how does one acquire the title “Village Doctor”

A

gotta pass an exam (can we call ourselves Village Docs yet?)

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23
Q

why was 1966 a crazy year for the barefoot doctors?

A

many medical schools closed, reduction in length of training, about 1/5 of barefoot docs eventually entered med school

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24
Q

so the barefoot docs are still around today. but what do they do?

A

they focus more on private, fee for service practices charging for medications.

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25
where are there currently PA equivalents?
canada, the netherlands, austrailia, south africa, taiwan, great britain, scotland
26
which two universities use their pa schools to train PAs or similar degree overseas
university of utah and george washington university
27
US PAs overseas
missionary, relief, and other non-governmental organizations, corporations, US armed forces, other gov positions (peace corps, CIA)
28
T/F: young physicians are moving into primary care
False. they are moving into specialties
29
T/F: small towns are gaining primary care physicians
False. they are losing primary care physicians.
30
T/F: hospitals are shifting toward services
true
31
T/F: federal and state governments are becoming concerned about the growing need for practitioners
true
32
what year did US surgeon general identify shortage of medically trained personnel?
1959 (fun fact: same year that hawaii became the 50th state!)
33
what did charles hudson say in 1961?
he had an editorial in JAMA calling for a mid level provider from ranks of former military corpsmen. now there is funding from the feds and state gov
34
timeline of the PA profession... pneumonic : people in indiana eat in expensive mansions. (just switch the last two words for the correct order - PIIEIME)
P: precedent events and prototype period (1650-1960) I: Ideological period (1960-1965) I: Implementation period (1966-1972) E: evaluation and standardization (1973-1980) I: Incorporation period (1981-1990) M: Maturation and consolidation (1991-2000) E: expansion and integration period (2001-present)
35
what were the 3 prototype pa programs?
* Duke (1965) * University of Colorado - Child Health Associate Program (1966) * University of Washington - MEDEX program (1969)
36
who is the father of the PA?
Eugene Stead, MD
37
what was Eugene Stead tryina tell everyone?
basically that we needed a new midlevel provider between a doc and a nurse that would assist MDs in a broad range of practice settings and be trained in a relatively short time frame and be basically the coolest type of people you'll ever meet.
38
who was the RN that Stead paired up with at Duke?
Thelma Ingles, RN.
39
who shut down what could have been the beginning of the NP movement?
the national league of nursing. they said that delegating medical asks to nurses was inappropriate
40
how long did it take stead to get people on board with his ideas?
two years
41
october 1965 - how many students admitted to Duke's program? who were they? how many years was this program?
4 ex-corpsman of the Navy. 2 year program
42
T/F: dukes program meant to train the PAs to be generalist assistants
true!
43
what was the role of the employing physician?
to ensure competence and further development of skills
44
negotiated performance autonomy
basically PAs work under the MD so the MD is liable for the PAs activities
45
what is the medical model?
basic science, pathology, clinical skills via medical instructors..... ALTHOUGH it was expected that new employers would spend more time with patient edu and preventative measures
46
who's responsible for designing the {fun and enjoyable} pa curriculum?
E. Harvey Estes, MD. Director of Community of health sciences. in sept of 1967, the PA program moved to dept of health sciences and broke away from the dept of medicine
47
Where did the child health associate program start? when? who?
U of colorado (1968) with henry silver MD and loretta ford RN
48
who were henry and loretta recruiting?
nurses and other applicants with diverse backgrounds for 5 years (later changed to 3) training to assist peds physicians. began as NP program then expanded to all areas and enrolled non-nurses.. considered to be the basis for NP programs
49
what were the prerequesites for the child health associate program?
At least 2 years of college (now had individuals without prior medical experience entering for PA training) After 2 years, they received a BS After the 3rd year, they received a MS First program to offer a postgraduate degree*******
50
MEDEX program - what year? who? how long?
university of washington (1969) - richard smith, MD. started as a 1 year program but later changed to 2.
51
how was medex different than duke program?
students had to have sponsoring physician who agreed to be their mentor, the students' training was largely on the job
52
Alderson-Broaddus (Phillippi, West Virginia): 1968.. what was it?
Hu Myers MD established a program and incorporated a campus hospital to train people w/o medical experience. Like Child Health Associate in Colorado, offered access to non-military candidates. Students enrolled directly from high school (differed from other programs) ********First program designed to give both a liberal arts education and training as physician assistants, became the first college to offer a baccalaureate degree to its students.
53
is the alderson-broaddus program still accredited?
na. it lost its accreditation in 2009.
54
where was the first specialty program developed? what kinda specialty?
U of Alabama. surgical PAs (1967). 2 year program with entire focus on surgery and subspecialties
55
what was the issue with this specialty program in alabama?
they quickly realized that entry-level PA training needed to offer a broader base of generalist practice (probably a good idea)
56
who offered more specialized training in urology, ortho, and pathology?
ensen
57
who was the pioneer of cardiac surgery?
Dr John Webster Kirklin
58
what happened in 1971 besides Charles Manson receiving the death penalty?
COMPREHENSIVE HEALTH AND MANPOWER TRAINING ACT. - legislation provided funds for med school and pa training programs to meet shortage of medical personnel. $$$$$$$$$$$
59
when did AMA recognize the PA profession and begin to work on its national certification?
1971
60
how many current accredited programs are there currently?
196
61
T/F: the APAP and AAPA can stop the development of new program
False. neither of them can stop this
62
who carries out the accreditation process?
Joint Review Committee (JRC-PA); which became the Accreditation Review Committee (ARC-PA) which was part of CAHEA
63
when did ARC-PA become INDEPENDENT accrediting agency for educational PA programs?
2000 (same year that backstreet boys came out with their millennium album. classic)
64
what does AAPA do?
1968 - Initiated by students from Duke Emerged as a single voice of the profession which was critical for the development of essential standards, and accreditation of programs. Constituent chapters comprised of individuals. Publishes JAAPA
65
what is the difference between AAPA and APAP?
AAPA is made up of individuals, whereas APAP is made up of PROGRAMS.
66
who was the first advisor of APAP?
Harvey Estes, MD.
67
what is the new name for APAP since '05?
PAEA (physician assistant education association). provides a program directory for applicants and was originally created as a network for member programs to work on curriculum development.
68
Silver at University of Colorado wanted to call them.....
syniatrists
69
smith at washington wanted to call them
MEDEX
70
duke and yale wanted to call them
physician associate (rejected in 1970)
71
the take away from this powerpoint:
Profession has matured and changed in U.S. over the past 50 years Military men to academic women Programs like Duke, Colorado, and Washington set foundations for successful proliferation and maturation of PA programs Success has been through strong relationship with MD’s since the beginning With increased credibility has come debate over specialization, titles, degrees, recertification process Gold standard for training and certification is passing the NCCPA exam (PANCE) and graduation from an ARC-PA accredited master’s program