Term
| Who began the idea of the PA profession? |
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Definition
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Term
| What year did Dr. Stead's PA proposal become improved? |
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Definition
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Term
| What important organization endorsed the PA Profession? |
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Definition
AMA
(American Medical Association) |
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Term
| What year did the AMA endorse the PA Profession? |
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Definition
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Term
| Whad did the endorsement encourage states to do? |
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Definition
| Encouraged medical boards to pass laws permitting PAs to enter medical practice. |
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Term
| What was the Allied Health Professions Act of 1966? |
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Definition
| Promoted programs to train new types of primary care providers. |
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Term
| When was the NCCPA incorporated? |
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Definition
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Term
| What did the NCCPA immediately take over and implement? |
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Definition
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Term
| What did the Omnibs Reconciliation Act do? |
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Definition
| Coverage of PA services in hospitals, nursing homes and as assistants in surgery. |
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Term
| What year was the Omnibus Reconciliation Act put in place? |
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Definition
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Term
| What does PACKRAT stand for? |
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Definition
| Physician Assistant Clinical Knowledge Rating & Assessment Tool |
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Term
| How many times can you take the PANCE Exam? |
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Definition
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Term
| How many years do you have to take and successfully pass the PANCE? |
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Definition
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Term
| How many questions are on the PANCE Exam? |
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Definition
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Term
| How many sets of questions are on the PANCE and how many questions are in each set? |
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Definition
| 4 Sections and 90 Questions/Set |
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Term
| How many minutes do you have to complete each section of the PANCE exam? |
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Definition
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Term
| How is the six year certification cycle divided? |
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Definition
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Term
| How many hours are needed of CME's for each cycle? |
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Definition
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Term
| The re-certification exam is divided into what two dimensions? |
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Definition
| Organ Systems and Knowledge/Skills |
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Term
| What are the categories tested on the PANCE and PANRE that count for the highest % of the test? |
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Definition
History Taking/Performing Physical Examinatin 16%
Formulating Most Likely Diagnosis 18%
Pharmaceutical Therapeutics 18%
Cardiovascular 16%
Pulmonary 12%
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Term
| What is one concern about the PA entry-level doctorate program? |
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Definition
| It would lengthen PA education and thus decrease the perceived advantage of the current short and efficient PA programs. |
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Term
| What model of education is used for a PA school? |
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Definition
| The medical model of education |
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Term
| How does the medical model used in PA school compare to the educational model used in Nurse Practioner School & Medical School? |
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Definition
| The medical model of education used in PA school is congruent to that used in Medical School meaning that there is a similarity in medical reasoning used by both Physician's and PA's |
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Term
| How is the role of the PA determined in clinical practice? |
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Definition
| A PAs role is determined by the precepting Physician's delegatory style. |
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Term
| Describe the hallmark's of the PA/Physician relationship. |
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Definition
| The clinical relationship between the PA and the Physician is guided by frequent consultation, referral & review of the PA practice. |
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Term
| What is the AAFP's policy on the relationship between the PA and the Physician? |
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Definition
| All PAs must be supervised by a responsible licensed physician. |
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Term
| What is the benefit of the PA profession to suprevising Physician? |
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Definition
| PAs provide medical care similar in quality to that of physicians at less cost to the hospital or practice, but at the same profit to the hospital or practice. |
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Term
| What is the central principle behind a successful PA/Profession relationship? |
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Definition
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Term
| What is the PA first and foremost? |
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Definition
| A representative of the physician, treating the patient in the style and manner directed by the Physician |
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Term
| Whar are the basics of the PA/Physician relationship? |
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Definition
| Mutural RESPECT, Mutual understanding of the STATUTES that the govern the PAs, Mutual understanding of the PAs scope of practice, Mutual COMMUNICATION, Mutuatl Understanding of each others STRENGTH'S & WEAKNESS |
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Term
| ***What does "Supervision" in the state of Florida mean?*** |
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Definition
| Requires the easy availibility (Telecommunications) or physical presence of the licensed physician for consultation and directions of the PA |
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Term
| How many PAs can a Physician supervise in their practice? |
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Definition
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Term
| When was the concept of DRGs (Diagnosis Related Groups) introduced, who introduced it & what is it? |
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Definition
In the 1980s
Medicare introduced it
DRGs are a way to standardize hospital resources (ex:How to deal and what to order for pelvic pain?) |
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Term
| What was the impact of DRGs? |
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Definition
| Have had a tremendous impact on hospitals in terms of lost revenue and the shift began away from in-patient care. |
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Term
| In the 90's what caused PAs and NPs to be hired as "house officers" in hospitals? |
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Definition
| The number of post-graduate residency slots were reduced in the 90's |
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Term
| How does the residency program for medical school students compare to the PA school rotation? |
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Definition
| Lower turnover rate, greater familiarity with dept. procedures, more clinical experience than 1st and 2nd year residents. |
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Term
| ***In 2003 the Accreditation Council for Graduate Medical Education adopted common program requirements that have a major impact on clinical residencies and rotations, what were the requirements?*** |
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Definition
| To restrict resident work weeks to an avg of 80 hrs over 4 wks and the longest consecutive period of work to 30 hrs. |
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Term
| How does medicare reimburse a hospital for services rendered in a hospital by a PA during clinical rotations? |
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Definition
| Medical services completed in a hospital by a PA either employed by a hospital or not will be reimbursed 85% |
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Term
| ***What is the definition of Primary Care?*** |
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Definition
| Described by the Federal Gov't as Internal Medicine, General/Family Medicine and Pediatrics |
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Term
| What determines the value of a PA to a practice? |
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Definition
Final Contribution = QPPP
Q-Quality of care given
P- Physician's quality of life
P- Patient satisfaction
P- Patient adherence to therapeutic plan |
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Term
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Definition
| Multiple encounters with PA/ARNP/MD as long as they are within one day and at the same facility. |
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Term
| How can practices get around the 85% coverage for care given by a PA and still get the full physician rate? |
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Definition
| "incident to" and shared visit billing. |
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Term
| Under what conditions does Medicare require chart co-signatures? |
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Definition
| Pre-admissions & Pre-surgery (H&P) |
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Term
| Describe "incident to" billing? |
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Definition
| Allows an office or clinic providing service performed by the PA to be billed under the physician's name (payment @ 100%) Can't be used in hospitals or nursing home's, unless there is a separate physician office (ex: Doc pop in head every 3-4 visits a month) |
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Term
| In the ER, what are guidelines for "Split Billing"? |
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Definition
| Services provided by the PAs and Physicians on the same day may be combined and billed at 100% |
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Term
| What are the guidelines of shared visits? |
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Definition
1. only can be used for Evaluation and Management visits
2. Must work for the same entity (common employer)
3. Must be reflected in Medical Record |
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Term
| What is the requirement of PA reinbursement in a skilled Nursing Facility? |
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Definition
| Same office in the sense that electronic communication is sufficient, BUT the physician MUST perform the comprehensive visit. |
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Term
| What are the guidelines for reinbursements in reference to home visits? |
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Definition
| Visit must be made in the patients home, the pt does not have to be considered homebound, medical necessity muse be documented. |
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Term
| How much does a PA get reimbursed for being a surgical-assist? |
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Definition
PAs are covered @ 13.6% of surgeon's fee (Physician's who assist only receive 16% of surgeon's fee)
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Term
| What do you need to understand about your value when negotiations arise? |
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Definition
Remember "CCCPP"
C- Cost
C-Charges
C- Collections
P- Productions
P- Physician productivity |
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Term
| What factors put Physicians/PAs at risk for being sued? |
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Definition
| Ineffective Communication with patients! |
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Term
| What are the primary reasons people sue, that we have control in preventing? |
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Definition
People felt the doctor was not completely honest or lied.
People found that they couldn't get anyone to tell them what happened. |
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Term
| What does the Florida Law say about apologies in relation to Liability? |
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Definition
Expression of sympathy, benevolent gestures or sense of benevolence relating to the pain, suffering or death of a person or family member is inadmissable as evidence in civil action lawsuit.
However a statement of fault, which is part of or in addition to any of the above SHALL BE ADMISIBLE!
DON'T SAY SORRY |
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Term
| In the first study carried out by Kathleen Mazor Ed.D., when were the pts most satisfied? Did the type of medical error effect the outcome? |
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Definition
Pts were most satisfied whe physician's fully disclosed their errors to patients & when the clinical outcome from the error was less serious.
The type of medical error DID NOT have an impact on the outcome. |
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Term
| What are the most likely scenarios in which the pt would FORGIVE the physician after medical error? |
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Definition
1. Pt didn't tell the doctor everything
2. Pt had an unusual condition
3. An emergency situation contributed to error
4. Doctor had bad advice |
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Term
| Whar are the most likely scenarios in which the pt would NOT FORGIVE the physician after medical error? |
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Definition
1. Doc did not follow up
2. Doc did not know the info needed
3. Doc was not thorough enough
4.Doc was keeping cost down |
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Term
| What do pts want the MOST after medical error? |
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Definition
1. Immediate disclosure
2. Preven reoccurence
3. Full details about mistake
4. Want to be told in person about error
5. Sincere apology |
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Term
| What are the top 5 things pts agree on concerning physician errors? |
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Definition
1. Always tell your patients about error
2. Financially compensate for error
3. Expect that docs WILL make mistakes
4. Pts have some responsibility in health care & decreasing errors (Patient be their own advocate)
5. Patient has a right to expect NO errors from the Doc |
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Term
| Who recogized National PA Day and when is it? |
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Definition
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Term
| Army PAs will receive a doctor of science physician assistant (DScPA) degree after successfully completing? |
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Definition
| An 18 month residency in Emegency Medicine |
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