Last Updated 2 May 2020
Death and dying are central to our past, present and future as a profession.
The Gospel of John says, “Unless a grain of wheat dies and falls into the ground it remains only a single seed; but if it dies, it provides more seeds.”
The PA profession was born on a field of blood and proven its merit during its first twenty years: most PAs were military-trained medics & corpsmen and having learned their skills in combat, were committed to excellence. They followed orders; were quick and proficient.
By the arrival of their second decade, PA programs were expanding their educational range. We went from being “accepted providers” to “legitimately trained providers” by scholarly leaders who led us to higher and higher levels of achievement: a Master’s Degree and now, a Doctorate of Health Science.
We have faced numerous challenges, among them our need to prescribe and authority to establish specialty groups. We have spent thirty years wrestling with our public identity and have, thus far, been largely unsuccessful. In the early days of the Covid-19 pandemic, PAs felt thwarted and constrained.
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The Healthcare System was Unprepared
This current attack on our healthcare system has exposed old, entrenched realities but also offered new promises for the future with successful expansion in privileges; which have been at least, temporary.
Our need is to prove that what has been done in a crisis can save healthcare for the future.
The pandemic has brought forth apocalyptic fear for many Americans, while exposing grave weaknesses in our healthcare infrastructure.
Healthcare providers have suffered from insufficient PPE, masks, coverings. There were too many administrators with N-95 masks. Federal supplies were promised but did not arrive. Nursing homes became “death traps” for our honored elderly and criminal acts have been alleged.
Anti-telemedicine was debated (on state and national levels) but finally acknowledged as an important protocol for our New World. Telemedicine is here to stay. But most critically, the nation now realizes the vital importance of our PA workforce to fight in ICUs and other specialty areas. A new birth has begun.
The New American Healthcare System
At least twenty states set aside their restrictive laws for PAs and welcomed them into healthcare systems to function uninhibited, with prescribing authority. Governors of the nation stood behind the PA profession; suddenly, we were no longer invisible.
Licensed PAs were granted cross-state authority to practice in other states than their own. And talk about lateral mobility: Dermatology PAs became ICU PAs. Everyone became savvy with vent care and though there was a problem getting vents, many states started sharing their ventilators.
There were not enough ICUs and hospital beds, but the federal government sent two ships and the military started setting up military hospitals in tents, in abandoned buildings, in schools and stadiums. FEMA did an excellent job. Military PAs, nurses, technicians and physicians all did their part.
There has been a new birth of hospitalist and critical care PAs. PA students became licensed in states before graduation – and state to state reciprocity has happened. PAs, like all medical professionals, have experienced the total exhaustion – akin to war zones with mass causalities – from the exponential explosion of Covid-19 cases.
New Liability for PAs
In this crisis, America’s PAs have rediscovered their mission, pride, strength and boundless skills, becoming the ultimate professionals which they have always been.
What else have PAs learned? We have discovered that we can fall victim to broken promises. During this pandemic, many PAs traveled from other states (particularly when they were excessed at their last place of employment) and were promised by agencies that they could go to places like NYC and fight the disease for $150.00 an hour.
When poverty knocks on our front door, this is an exciting prospect, and many are the stories of PAs who discovered that it was just another ploy. Many PAs, NPs and physicians were lured to other states that were experiencing a crisis to understand that their malpractice insurance was taken care of and that they could not be sued for their services during the pandemic.
The reality is and was, that they are most often covered by limited liability insurance which falls short of the promise of blanket security.
Limited liability insurance is not too helpful if you lacked the professional expertise that was required for your care of a patient. In a pandemic, everyone is asked to work beyond their present scope of training, and most do so very well – but in the life and death drama of patient care, the liabilities can be enormous, and some errors may result in death.
Call to Action: Protect Yourself
Every healthcare provider needs to realize that in a few months many families will no longer remember the smiling or compassionate face of their healthcare professional but may well seek restitution for a life lost or the next decade spent in an extended care facility.
Do you know for certain that you are properly protected? Or are you in for a dark, rude awakening? You can contact your national association and speak to their insurance department who will check with providers.
If we own our own malpractice insurance policy that has been vetted for its strength & quality and endorsed by our organization, we need not be fearful.
My national association, AAPA, has endorsed such a policy. Although I hope never to endanger a patient, I am comforted that the full power of CM&F’s malpractice policy and their 70 + years of medical malpractice expertise is standing beside me. With unsurpassed financial strength ratings of A++ Superior (A.M. Best), this is the highest quality malpractice insurance available. During this challenging time of uncertainly, I can practice confidently knowing that my future is in good hands with CM&F.