To NCCPA From a PA in North Carolina

As a PA who has practiced for nearly 21 years, I am writing to express my concern about the NCCPA’s proposed changes to the PANRE process.  I have practiced dermatology since shortly after graduating from PA school. Like my fellow PAs, I took the PANCE when I graduated and then, because I was no longer connected with general medicine and spent all my time and CME efforts concentrating on learning my specialty, I did my next two recertification exams using Pathway II.  While this was time-consuming and made me relearn a large portion of general medicine that I would have no use for in my daily work day, I was able to pass these without incident.  Then, to my horror, you took this option away.

My third recertification took place at a testing center.  I passed, but only after having to spend numerous hours away from my family and hobbies studying and taking money out of my CME budget through work to attend a “refresher course” to prepare. This meant that any dermatology oriented CME that I had planned to accumulate during that year was completely wiped out. But, as a PA who is paid strictly on production, that took an entire week of income out of my pocket as well.  Since I usually see 35-40 patients per day, 4.5 days a week, this became a costly endeavor and I would estimate that the loss in revenue alone was over $3,000.

The advent of the SA and PI portion of the CME requirements has been bad enough.  There aren’t enough of either of these types of CME available to me that are applicable to my daily work and the cost of this added burden in both time and money is significant.  Now the NCCPA wants to add to our burden yet again, by making us continue with the current requirements and test every two or three years with take home tests and take a specialty test every 10 years.

I have yet to see any data produced that shows that we are so untrusted as providers that such extensive testing is warranted or that our malpractice rate is so much higher than either MDs or NPs that we need to be tested and remediated at a higher rate.  In fact, I would hazard a guess that the opposite is true.  And yet, the NCCPA insists that this more aggressive, extensive CME requirement and testing cycle is needed as patient protection and to keep us up to date on general medicine.

The only thing that you are testing when I take the PANRE is my ability to re-teach myself general medicine.  It takes me out of my clinic and from my patients.  It costs me income and time away from my family and increases my stress level exponentially.

In North Carolina I have the option of dropping the certification and remaining licensed.  I am strongly considering this option as I feel that this process is becoming more and more punitive.  I have to say that I can foresee a future where other PAs become so disillusioned with this process that they retire or where potential PA candidates choose another profession in order to avoid this nightmare.  Which, of course, will only make the nursing lobby and NPs stronger.

What a shame for a valuable profession like PAs to be killed by its own certifying body.