The American Academy of Family Physicians (AAFP) recently announced its intent to study whether nurse practitioners (NPs) and physician assistants (PAs) should -- or would want to -- become nonvoting members. AAFP's Congress of Delegates decided not to create a new dues-paying membership category for NPs and PAs.
According to Medpage Today, AAFP's Reference Committee on Organization and Finance believed the number of allied health professionals that belong to other primary care physician organizations is small and that "the implementation cost would be significant for the small number of members that join the AAFP." The Committee also expressed concern "about the divisiveness of the issue for the physician-based organization, and noted the difficulty of tracking NPs and PAs to ensure they are working with an active AAFP member," Medpage reported.
Ultimately, the reference committee recommend the resolutions be referred to the AAFP Board of Directors for further study. The Congress of Delegates agreed.
Outgoing AAFP President Jeffrey Cain, MD, told MedPage Today the NP/PA-membership issue has come up previously.
Thomas Weida, MD, of Hershey, Pa., the delegate who introduced the resolutions on NPs and PAs, said he wanted to provide the allied health professionals access to AAFP's continuing medical education (CME) opportunities. "The academy has been founded on CME, and I think our CME is a high quality," Weida told MedPage Today. "We can then start working together on developing solutions to the challenges that face patients in care delivery and patient-centered medical homes."
This idea is increasingly important as many of the pillars of healthcare reform include team-based care, collaboration, and integration among healthcare providers—whether through the patient centered medical home (PCMH) or Accountable Care Organizations.
Moreover, the significant increase and influx of patients that will have health insurance over the next few years coupled with an unaddressed physician shortage leaves the possibility that NPs and PAs will fill those gaps—making interprofessional CME even more appealing.
Interprofessional CME is already a reality on the CME stakeholder side, with several CME providers receiving dual accreditation for physicians, nurses and/or pharmacists. Thus, the framework to offer interdisciplinary CME is already in place and can only be enhanced and improved as physicians, NPs and PAs work closely together to use the skills and knowledge they can gain from such education. Moreover, interprofessional CME may also offer unique opportunities for these healthcare providers to interact and exchange ideas and best practices for managing patient care.
The head of the American Academy of Physician Assistants strongly supported the measure, Weida said. He added that he was pleased with the result of Tuesday's action. Weida said that he did expect the resolution "to be accepted this first time around" but "the pendulum will swing as we realize the value of working together." Despite the resolution not being adopted, the AAFP maintained that NPs and PAs must work in teams with physicians and not independently.
Incoming AAFP President Reid Blackwelder, MD, told the Congress of Delegates in an address Monday that family physicians must work together -- not against -- NPs and PAs to meet patients' needs.
"Perhaps one of the most important aspects of this discussion is to recognize that ultimately the scope-of-practice issue is not a battle, it's not us against them, it's not good or bad, it's not right or wrong, even though this is often how the discussion is framed," Blackwelder said. "The truth is that each member of the team is critical and has important roles to play, but we are not interchangeable."