T he 2010 legislative year is coming together nicely with a single CAPA-sponsored bill which addresses a number of

issues. Senator Fran Pavley (D-Santa Monica) is the author of the bill with the principal co-author Assemblyman Nathan Fletcher (R-San Diego). Since the introduction of the bill,

NewsNewsOfficial Publication of the California Academy of Physician AssistantsOfficial Publication of the California Academy of Physician Assistants

May/June 2010

SB 1069 Makes Its Way To The Assembly by Beth Grivett, PA-C, Legislative Affairs Coordinator

The Magazine\

Senators Lou Correa (D-Santa Ana) and Gloria Negrete-McLeod (D-Chino) have both signed on as co-authors. SB 1069 has now passed through the Senate and is on its way to the Assembly. So, what does this bill hope to do?

• Allow PAs to perform the physical exams and other medical services necessary to complete and sign the forms in many situations including for children to carry epi-pens and take their medications while at school

• Allow PAs to sign the forms necessary to order amplified telecommunication devices for the deaf and hearing impaired

• Allow PAs to perform pre-employment physicals for community college employees

• Advise school districts to accept a form signed by the physician or PA for pre-participation physicals for student sports

• Allow PAs to complete and sign forms to order durable medical equipment and home health services as well as State Disability Insurance

• Set a statute of limitations for accusations against the license of a PA

This bill does not increase the scope of practice of physician assistants in this state and that is why it’s strongly supported by the California Medical Association and numerous physician specialties. It is another bill that was necessary to allow PAs to continue our practice, but to do so in a much more cost-effective and efficient manner. During your busy day, it doesn’t make sense to spend time standing around waiting for your supervising physician to sign a form. And, we shouldn’t have to make our patients return to the office at a later date or even hour because the physician is not immediately available to sign a form. You can watch the progress of this or other bills which CAPA is supporting through the CAPA website under the “Legislation” tab.

CAPA Legal Counsel, Michael Scarano, Jr., Esq. and CAPA Legislative Advocate, Bryce Docherty

Passing the Batonby Miguel Medina, PA-C, President

M y term as CAPA President will end on June 30. It has truly been an honor representing California PAs during the past two years.

I owe a great deal of gratitude to all the board members with whom I have had the privilege to work with during my tenure. I also want to thank my predecessors, Tom Gaughan, PA-C and Jim Delaney, PA-C for their leadership and guidance. It has been a great time to be CAPA President; CAPA has made significant legislative progress

with the passage and implementation of AB 3 in 2008, AB 356 the Radiology and Fluoroscopy bill and SB 171 in 2009. All this legislative success would not have been

Continued on page 24

2 CAPA NEWS

EditorGaye Breyman, CAE

Managing EditorJennifer Deane

Editorial BoardMiguel Medina, PA-CEric Glassman, MHS, PA-CBeth Grivett, PA-CBob Miller, PA-CLarry Rosen, PA-CMichael Scarano, Jr., Esq.

ProofreadersPaula Meyer, PA-C

CAPA Board Of Directors

PresidentMiguel Medina, PA-Cpresident@capanet.org

President-ElectEric Glassman, MHS, PA-Cpresident_elect@capanet.org

Vice PresidentLarry Rosen, PA-Cvicepresident@capanet.org

SecretaryCherri Penne-Myers, PA-C, MSCSsecretary@capanet.org

TreasurerBob Miller, PA-Ctreasurer@capanet.org

Directors-At-LargeDavid Carter, PA-Cdirdavid@capanet.org

Beth Grivett, PA-Cdirbeth@capanet.org

Matthew Keane, MS, PA-Cdirmatt@capanet.org

Greg Mennie, PA-C, MSeddirgreg@capanet.org

Student RepresentativeAdam Marks, MPA, PA-Sstudentrep@capanet.org

The CAPA News is the official publication of the California Academy of Physician Assistants. This publication is devoted to informing physician assistants to enable them to better serve the public health and welfare. The publisher assumes no responsibility for unsolicited material. Letters to the editor are encouraged; the publisher reserves the right to publish, in whole or in part, all letters received. Byline articles express the opinion of the author and do not necessarily reflect the views or policies of the California Academy of Physician Assistants.

The CAPA office is located at:3100 W. Warner Ave., Suite 3Santa Ana, CA 92704-5331Office: (714) 427-0321Fax: (714) 427-0324Email: CAPA@capanet.orgInternet: www.capanet.org©2010 California Academy of Physician Assistants

NewsNews Congratulations Incoming 2010-2011 CAPA Board of Directors

President Eric Glassman, PA-C

Vice PresidentLarry Rosen, PA-C

SecretaryCherri Penne-Myers, PA-C, MSCS

TreasurerRobert Miller, PA-C

Director-At-LargeBeth Grivett, PA-C

Director-At-LargeMatthew Keane, MS, PA-C

Director-At-LargeAdam Marks, MPA, PA-S

Director-At-LargeGreg Mennie, PA-C, MSed

Student RepresentativeJennifer Baltazar, PA-S

Term July 1, 2010 – June 30, 2011

Peter Aronson, PA-CStephanie Bowlin, Ed.D, PABeth Grivett, PA-CMatthew Keane, MS, PA-CMiguel Medina, PA-CCherri Penne-Myers, PA-C, MSCSLarry Rosen, PA-C

Congratulations to the 2011 AAPA House of Delegates

Term July 15, 2010 – July 14, 2011

At The Table

Eric Glassman, MHS, PA-C, CAPA President Elect at the CAPA Booth at the Pri-Med West Conference in Anaheim, CA on May 6 - 8, 2010.

Steve Klompus, PA; Assemblymember Jose Solorio and Beth Grivett, PA-C at a Reception on March 25, 2010 in Honor of Assemblymember Solorio

Past CAPA President and Current Chair of CAPA’s CME Committee, Cyndy Flores, PA-C, Completed Ironman Utah on May 7, 2010

For those of you who don’t know, that means you:

Swim 2.4 MilesBike 112 MilesRun 26.2 Miles

Congratulations, Cyndy!!

Cyndy finished in 15 hours 31 minutes!

MAY/JUNE 2010 3

Incoming 2010-2011 CAPA Board of Directors ......................2At The Table.........................................................................2Congratulations to the 2011 AAPA House of Delegates ..........2Cyndy Flores, PA-C, Completed Ironman Utah .......................2“Leg-U-Cation” ....................................................................3Independent Contractor or Employee? ..................................4Facey Medical Group Welcomes CAPA ...................................6If You Want To See Change In Sacramento, Start PACing .......8Karen Bass is Running For Congress! ....................................8Sylvia Surgical Assistant, Inc.…Branching Forward .............10Sharing Our Selves – .........................................................11

CAPA’s 34th Annual Conference - Poster Project ...................12CAPA’s 34th Annual Conference ..........................................14Controlled Substances Education Course at the CAPA Conference ...............................................................17Thank You, Miguel Medina .................................................18Patient Assistance Programs Are Severely Underutilized Let Your Patients Know There Is Help Available ...................21California ENT PAs: Let’s Talk! .............................................21Do It Don’t Injure Yourself ................................................22Spread The Love, Recruit A Colleague ................................23Changing Carriers: What PAs Should Know ..........................25

The Gift of Hope That Gives It Right Back ............................26CURES ...............................................................................26Taming the Clinical Monster: Step 1. Developing a Good Preceptor Relationship ..............27Special Student Track at the CAPA Conference .....................27Calling All PA Students .......................................................28What’s Going On At…Loma Linda University? ....................29Student Challenge Bowl Sign Up Now ..................................29Congratulations Graduates .................................................30Welcome New Members .....................................................31Local Groups......................................................................31

Inside This Issue

I have been volunteering for CAPA, working on legislation since I can remember – I think it has been

about ten years off and on. I took a little time to be CAPA President and I took another little time to be a mom, but all-in–all, about ten years ago, I was cajoled into the position of Legislative Affairs Coordinator and I love it. I had a revelation this year that I want to share with my fellow CAPA members. When I first signed on with CAPA as Chair of the Government Affairs Committee,

I asked Cyndy Flores, PA-C, then CAPA President, what the job was all about. She told me that we try to introduce legislation as needed and protect against threatening legislation, but mostly we really needed to educate folks about what a PA is so they have a better understanding of our profession. Sure enough, we introduced some important legislation and won some important battles to protect California PAs. But, really, it was true that a good portion of the time I spent in Sacramento was all about educating. Educating not only the legislators but their staff. Legislators rely heavily on their staff to research and understand the issues so they can help to brief them on issues which relate to legislation. Most legislators have a staff person who deals specifically with issues relating to health care. The time spent with Legislative Aides is almost as important as time spent with the legislator. When we met with legislators and/or their staff, the first question we asked was, “Do you know what a PA is?” Inevitably, they would nicely say; no, they really didn’t know. Or, they would say something like, “Well, it’s sort of like a nurse practitioner, right?” As

frustrating as it was, most of my job was educating these decision-makers about our profession. I really didn’t mind once I realized how much work there was to do.

Fast forward to 2010. CAPA has great representation. We have an amazing Legislative Advocate, Bryce Docherty, who truly understands PAs, knows where we came from and where we are going. Bryce is really working full-time for CAPA – just don’t tell his other clients! We are also blessed with our Legal Counsel of over 20 years, Mike Scarano, as well as our volunteer Professional Practice Committee Chair, Bob Miller, PA-C, both of whom review regulations and statutes behind the scenes to make sure the legislation for which we are advocating is meaningful, practical, in our best interest and, well…legal.

So now, the revelation I want to share. I have worked with multiple legislators and multiple staff members from the Medical Board of California, the Governor’s office and many of the government departments in my capacity as Legislative Affairs Coordinator for CAPA. We have

“Leg-U-Cation”

by Beth Grivett, PA-C, Legislative Affairs Coordinator

Continued on page 9

PAs

Quality Care

AccessTeam Practice

4 CAPA NEWS

Independent Contractor or Employee?

by Bob Miller, PA-C, Professional Practice Committee Chair

So, you say you’re an independent contractor. My first question is, “Have you met the criteria to define your role as that of an ‘independent contractor’ rather than one of an ‘employee?’” Over

the years, I have been comfortable in discussing many aspects of PA practice when member inquiries come to my desk. We have enjoyed numerous conversations about PA laws and regulations, about reimbursement for your services and all matters of scope-of-practice. However, when the discussion comes up about the complexities of

determining independent contractor status, I turn to CAPA’s Legal Counsel, Michael Scarano, Jr., Esq. from the firm Foley & Larder, LLP.

Several recent member phone calls have convinced me that now is a good time to raise this topic, once again. So I will again lean on Mr. Scarano to clarify this issue for those of you who are considering independent contractor status. As you will see from the following excerpt, defining yourself as an independent contractor without meeting the appropriate criteria could result in an unpleasant audit and potentially substantial penalties for both the PA and the employer. In addition, barriers to efficient reimbursement arise when billing issues complicate the arrangement – such as billing through the supervising physician. All of these issues, and more, should be well thought through prior to launching your career as a contractor.

The following was written by Michael Scarano, Jr. and is excerpted from Chapter 9 of the California Physician Assistant’s and Supervising Physician’s Legal Handbook, Second Edition. I believe that every PA practicing in California should have this valuable handbook in their office as a reference.

security tax (including the employer’s share), the expense of mandatory disability insurance is avoided.

Treating a PA as an independent contract may seem desirable to the employer, since this theoretically saves the employer from having to contribute to the employer’s share of social security tax, pay state and federal unemployment tax, provide workers’ compensation insurance or provide health insurance and other benefits which the employer may provide to persons classified as “employees.” Often the employer agrees to pass on these savings to the independent contractor PA in the form of higher wages.

However, under the laws governing the various withholding

and benefit programs discussed above, an employer does not have unfettered discretion in determining whether to classify a worker as an “employee” or an “independent contractor.” Although various laws provide several different definitions of “employee,” as a general rule an “employee” is a person who is subject to the direction and control of the employer not only as to the results of the work, but also as to the details and means by which the work is accomplished. In contrast, a true “independent contractor” is an individual who is hired to perform a particular task or achieve a specific result while working more or less independently.

b. Test for Employee Status. In determining whether an individual should be treated as an “employee,” the IRS and other relevant agencies may examine a variety of factors, including, but not limited to, whether the worker’s services are integrated into the employer’s business; whether the employer hires, supervises or pays any assistants required by the worker; whether the employer establishes the worker’s hours; whether the worker performs work on the employer’s premises and uses employer’s equipment or tools; whether the worker submits regular oral or written reports to the employer; and whether the employer pays the worker’s business expenses. One additional factor is whether the worker performs services for only a single employer; under a “matching audit” program that the IRS has previously implemented, it is more likely to audit any employer from whom an independent contractor reports all of his/her wage income. If any one or more of the other factors listed above exist, the IRS may claim that the individual should have been treated as an employee and impose back taxes, as well as interest and penalties

From Chapter 9 of the California Physician Assistant’s and Supervising Physician’s Legal Handbook excerpted and reprinted with permission.

Chapter 9PAs as Independent Contractors

a. Contractors Compared to Employees. A common question asked by PAs is whether they can structure their relationships with their supervising physicians or the organizations for which they work as independent contractors, rather than employees. An independent contractor’s wages are not subject to income tax, social security (FICA) or state disability insurance withholding by the employer. Although an independent contractor is responsible for paying his own income and social

MAY/JUNE 2010 5

Independent Contractor or Employee?

by Bob Miller, PA-C, Professional Practice Committee Chair

in some cases. This may also lead to an audit by the State Employment Development Department (“EDD”), resulting in additional liability.

c. Traditional Employment Situations. As a general rule, the relationship between a supervising physician and his PA in a traditional private practice setting will likely be deemed to fit within the definition of an “employee.” Under the Physician Assistant Practice Act, a supervising physician has both the right and the duty to control the PAs clinical activities. The fact that a PA may practice somewhat independently does not necessarily make a difference; employees in many settings work independently, subject to the right of the employer to intervene and assert control over their activities. It is the right of the employer to do so which is most significant for purposes of these rules. In addition, many of the secondary factors discussed above will point in the direction of employee status in a typical private practice setting.

d. Penalties for Inappropriate Independent Contractor Status. Although a PA who is inappropriately treated as an independent contractor will generally not be subject to fines or sanctions so long as the PA pays taxes appropriately, the employer is at a significant risk. For example, even

if the PA has paid his/her income taxes, the employer may nevertheless be liable for taxes that should have been withheld, as well as interest and penalties in some cases, in the event of audit by the IRS. The employer will also be responsible for unemployment tax payments which should have been made if audited by the EDD. The EDD, which is sometimes alerted by the IRS when it finds a problem, may also assess interest and penalties. Further, if the PA is injured on the job, the employer may be required to pay workers’ compensation benefits plus penalties out of general assets, in the absence of workers’ compensation insurance coverage. If the employer does have coverage, the carrier may sue the employer for back premiums based on the PA’s 1099 income.

While the penalties under all of these laws are primarily directed at employers, they can also have a negative impact on the PA, even if the PA has paid his/her own taxes. For example, the employer may seek to recoup penalties or other payments it is required to make from the PA. Although the employer may not be entitled under the law to do so, especially if the PA has paid his/her own taxes, at a minimum, an audit of his/her employer and potential fines can have a negative impact on the entire practice and the relationship between the parties.

e. Permissible Independent Contractor Situations. In certain less traditional practice settings, it may be permissible for a PA to be treated as an independent contractor. For example, if a PA provides first assisting services for a number of separate medical practices or health facilities on a part-time basis, this would be more likely to survive scrutiny as a valid independent contractor situation. Each case must be considered individually in light of the overall facts and circumstances.

Another way to approximate independent contractor status is for the PA to form a personal service corporation (e.g., a PA corporation or general business corporation). The PA will be the sole shareholder of the corporation will also be an employee of the corporation. The corporation will be a contractor of a medical practice or other employer, which will pay it without withholding taxes. As the PA’s employer, the corporation must withhold taxes and comply with other requirements imposed on employers. Although there have been isolated situations in which the IRS or other agencies have challenged whether such arrangements were bona fide, as a general rule a properly set up and maintained personal service corporation will withstand scrutiny as a legitimate independent contractor.

Second Edition of the California Physician Assistant’s andSupervising Physician’s Legal Handbook

M ichael Scarano, Jr., Esq. authored the California Physician Assistant’s and Supervising Physician’s Legal Handbook. Newly updated, it answers scores of questions in a concise, clear fashion, with citations and

appendices that will permit practitioners to read the operative statutes and regulations for themselves. A must have for all California practices employing PAs. Visit the CAPA website at www.capanet.org/legalbook.cfm for more information.

California

PhysiCian assistant’s

and suPervising PhysiCian’s

legal handbook

S E C O N D E D I T I O N

C A L I F O R N I A A C A D E M Y O F P H Y S I C I A N A S S I S TA N T S

R. Michael Scarano, Jr.

Foley & Lardner LLP

CAPA General Counsel

6 CAPA NEWS

Facey Medical Group Welcomes CAPA

by Larry Rosen, PA-C, Vice President and PR Committee Chair

A s of April 2010, CAPA has done 14 “Doc–to Doc” presentations promoting

physician/physician assistant team practice models across the state. In response to a letter received from one of our members, CAPA did

its 15th such presentation for the Facey Medical Group in Mission Hills. It turned out to be one of our finest.

Shannon Chavez, PA-C a graduate from Lock Haven University, was looking for a position. She contacted Facey Medical Group and found out that, although they had hired

nurse practitioners in the past, they had never hired a physician assistant. CAPA contacted Pat Horanberg, Facey’s Administrative Director of Operations. Pat was eager to arrange an educational program for her physicians and staff.

Unlike events we had produced in the past, where we hosted a nice dinner for 40-75 attendees, this was our first opportunity to present to a single medical group. We met in the afternoon in the company conference room with 25 doctors, staff and administrators present, including Dr. Fredrick Russo, President of Facey Medical Group and Bill Gil, President and CEO, Facey Medical Foundation.

The CAPA team consisted of Dr. Al Ray, Family Medicine, Kaiser

Permanente, San Diego and a welcome repeat panelist for CAPA; also Dr. Raffi Minasian, a nephrologist practicing in Glendale. Christine Ayvazyan, PA-C, who works with Dr. Minasian, was also in attendance.

Key presenters from CAPA were Beth Grivett, PA-C, Legislative Affairs Coordinator, and a family practice PA in Newport Beach and Robert Miller, PA-C, Professional Practice Committee Chair and PA group leader at the Hemostasis and Thrombosis Center, Childrens Hospital Los Angeles. Beth spoke about the history of our profession, from our beginnings in 1967. Bob concentrated on laws, regulations and reimbursement issues affecting PA practice in California.

What made this presentation so effective was its intimacy. The room was small. We improvised a lectern and had a projector and screen for the PowerPoint presentation. Everyone sat around the conference table or on folding chairs lining the walls. Some people stood. Questions were encouraged at any time during the program. And, there were many.

Facey is considering adding non-physician practitioners to their urgent care and ortho specialties. Could PAs hit the ground running? How extensive was their training? Are PAs trained in specialty models? How long would it take to train a PA on the job? How was supervision defined? What are the salary requirements for PAs?

The questions were probing and insightful. This was not a group of people who had come for the Filet Mignon and Baked Alaska. Pervasive was a genuine interest in raising their awareness about a medical professional with which they were unfamiliar. The meeting lasted more than two hours. We were confident that they got what they came for.

Drs. Ray and Minasian spoke eloquently about their passion for team practice with PAs. In glowing terms, Dr. Minasian described how he had met Christine five years ago when she had done a training rotation with him. He hired her immediately after graduation and personally trained her in clinical nephrology and dialysis. It would be several years before she would see patients on her own. Before the Facey group, he described Christine now as an essential component of his medical team, assisting in the design of treatment protocols, supervising the operation of dialysis units and lecturing on his behalf to students and practitioners alike. “She is an exceptional provider.”

As a Kaiser Permanente family medicine physician for nearly 30 years, Dr. Ray has trained and collaborated with dozens of physician assistants. He takes pride in the fact that his PAs are warmly accepted by his patients and eminently capable of handling

“Pervasive was a genuine

interest in raising their

awareness about a medical

professional with which they

were unfamiliar. The meeting

lasted more than two hours.

We were confident that they

got what they came for.”

MAY/JUNE 2010 7

Facey Medical Group Welcomes CAPA

by Larry Rosen, PA-C, Vice President and PR Committee Chair

April 20, 2010

Ms. Shannon Chavez, PA-CCanyon Country, CA

Dear Shannon,

Over the past few years, CAPA has done more than a dozen “Doc-to-Doc” events where we invite physicians who work with PAs to address an audience of physicians who do not. Thanks entirely to you, on Thursday, April 15, we did our first such presentation for a single medical group; Facey.

Your email to CAPA was forwarded to me and I called Pat Horanberg, Facey’s Administrative Director of Operations. She related to me her conversation with you and was eager to invite us to Mission Hills to educate her physicians and administrators about team practice with physician assistants. We jumped at the opportunity.

Our presentation was done by two physicians who practice with PAs; Dr. Albert Ray, a family medicine physician in San Diego and Dr. Raffi Minasian, a nephrologist practicing in Glendale. Speaking with them was Beth Grivett, PA-C, CAPA’s Legislative Affairs Coordinator and Robert Miller, PA-C, CAPA’s Professional Practice Committee Chair.

Facey, as you well know, is an organization that has in the past hired nurse practitioners but not physician assistants. The questions that followed our presentation were mostly directed toward supervision issues, salaries and training. Our audience was varied; administrators, physicians and staff. All chose to come on their own, including Facey’s Medical Director, Dr. Russo and the Facey Medical Foundation President, Mr. Bill Gil.

It went very well. Pat was pleased. Our panel was pleased. Most importantly, I feel the attendees left with all of their questions answered and hopefully most of their reservations concerning the hiring of PAs put to rest.

None of us can predict when, if ever, the Facey Medical Group will consider adding physician assistants to their health care teams. But because of you contacting CAPA about your own experience with Facey, we were able to realize a physician education opportunity that we would not have normally considered.

For all of us at CAPA, who work very hard to expand physician assistant practice in California, we thank you for taking the time to further educate us about what is going on in the workplace. It was a privilege to act on your behalf and for the well being of all California PAs, who, one day, might find employment at Facey Medical Group because of you.

Warmest regards,

Larry Rosen, PA-CVice-President, Public Relations Chair

the routine demands of a family medicine practice in a large institution. “PAs know their limits; they know when to bring me in. That’s key to the relationship.”

Time will be the arbiter of whether or not we were successful. Both Drs. Ray and Minasian were emphatic about how critical the need will be for more and more medical providers, especially in family practice. As health care reform evolves, the inventory of new patients will be staggering. Physician assistants offer an economical, effective solution to an organization like Facey which will need to absorb a greater patient population and continue to remain viable.

For CAPA, this too was a learning experience. A smaller group venue allows us to better assess where the resistance lies. We can more easily read the faces of our audience and direct discussions to eliminate the myths of PA practice and supervision. To that end, you need to be proud of CAPA leaders, Beth Grivett, PA-C and Bob Miller, PA-C. They have honed their presentations to be concise and illuminating. They field questions with confidence and an expertise developed from years as practicing physician assistants and guardians of CAPA’s mission to serve its members.

Facey Medical Group has 11 clinics in the San Fernando and San Gabriel Valleys. We are grateful to them for inviting CAPA into their home and allowing us to present our message of team practice with physicians and physician assistants. Special thanks to Pat Horanberg who recognized an issue which required clarification for her health care providers and staff and acted upon it.

California Academy of Physician Assistants

3100 W. Warner Avenue, Suite 3 • Santa Ana, California 92704-5331(714) 427-0321 • Fax: (714) 427-0324 • www.capanet.org

8 CAPA NEWS

I f you receive the CAPA News, you are a CAPA member and we are grateful for your support.

When joining or renewing with CAPA this year, did you contribute to the CAPA PAC? Remember that CAPA PAC contributions are voluntary. We cannot draw funds from your membership dues to put toward the CAPA PAC. We must seek specific contributions.

I would like to thank all those who have ever contributed to the CAPA PAC Your contributions have made a difference. We hope that you will continue to support the CAPA PAC. Our goal is for each and every PA in California to give an amount equal to one hour’s

pay. That would be an incredible accomplishment for California PAs. However, contributions of any size are appreciated and will help us to reach our goal.

Just as we have the Auto Pay Option for membership dues, you may also have your contribution for the CAPA PAC on the Auto Pay plan with your membership dues. Your contributions are deducted on a quarterly or annual basis.

Our Annual CAPA Conference in Palm Springs is not that far off, October 7-10. We are looking for items for the CAPA PAC Silent Auction such as: textbooks, services (i.e., dermatology services), gift baskets, rounds of golf and jewelry. Last year, we had many generous donations. Thank you in advance for your support and contribution. Please feel free to contact me at secretary@capanet.org.

If You Want To See Change In Sacramento, Start PACing

by Cherri Penne-Myers, PA-C, MSCS, Political Action Committee Chair

I Want PAs to Be Heard – To Create A Roar Heard Throughout the Jungle (Please photocopy this form and mail with donation.)

Name ____________________________________________________________________________________________

Address: ________________________________City __________________________State ______ Zip ______________

Phone _______________________________ Email ______________________________________________________

Amount of cash/check/credit card donation: $ _______________

If donation is $100 or more please list employer _________________________________________________________________________________________

Please make checks payable to CAPA PAC. You may also pay by credit card. All contributions are voluntary. PAC ID # 981553

Exp. Date _____________________

Signature ______________________________________________________________________________________________________________________

Cheetah Up to $50 Leopard $51 to $99 Jaguar $100 to $149 Bengal Tiger $150 to $199 King/Queen

of the Jungle $200 or more

Karen Bass is Running For Congress!

Use the form on page 9 to send a check to CAPA so that we can bundle donations and let her know that the support came from

California PAs. Please make checks payable to “Karen Bass for Congress” and fill out the required information completely. Mail to CAPA at 3100 W Warner Ave, Ste 3, Santa Ana, CA 92704.

Donations of any size will be most appreciated and will help to make a difference.

CAPA’s

Political Action Committee

MAY/JUNE 2010 9

“Leg-U-Cation”

Continued from page 3

Tear off and enclose check payable to “Karen Bass for Congress”Mail check with completed form to CAPA at 3100 W Warner Ave, Ste 3, Santa Ana, CA 92704.

Contributions are limited to $2,400 per individual per election. The primary and general elections are separate elections, so individuals may give up to a total of $4,800 for both elections.

Name: _______________________________________ Address: ______________________________________________________

Email Address: _________________________________ Phone Number:_______________________ Amount donated: ___________

Employer*: _____________________________________________________________Occupation*: __________________________

*To comply with Federal law, contributors are required to provide their employment information. If you are retired, please enter N/A under Employer and Retired under Occupation; if a homemaker, please enter N/A - Homemaker; if self-employed, please enter “Self-Employed” under Employer and describe your line of work under Occupation.

indicated that in his discussions with physicians, his understanding is that physicians have grown to depend on PAs to keep their practices going strong and he is very supportive of our profession.

I walked out of the hearing taken aback a little. I felt good. I felt as if our hard work was paying off. As I reflect on the years I and many CAPA leaders and CAPA members have spent educating staff and legislators about PAs, I think they finally get it. I think of all of our members. I think of you out there providing that exemplary care to someone you

may not even realize is a California Senator. You and the care you provide is what we can point to when we explain what we do everyday as we provide care in PArtnership with our supervising physicians. As a result of your good care and CAPA’s multi-faceted approach to educating the public, the outcome is that these lawmakers are finally understanding our profession and liking what they see. And, they will begin to understand how vital PAs are as part of the solution to our growing health care delivery challenges.

Due to term limits and just the nature of elections with legislators winning and losing seats, our work in educating legislators and their staff will never end. Our steadfast commitment to keeping PAs on their minds and making sure that CAPA representatives are at the table in Sacramento will never end. Your membership in CAPA is the fuel that allows us to continue the work we do on your behalf.

Thank you!

made it a priority at CAPA to be “at the table.” So, even if a meeting isn’t specifically about PAs, we are trying to be involved in health care legislation and health care decisions which are good for our supervising physicians and, ultimately, for our patients. For this year, we have introduced a great piece of legislation, an update about which you will see elsewhere in this magazine. I went to the Senate Business and Professions Committee hearing on April 12 with the anticipation of the routine, brief interrogation about the bill. Our bill started in the Senate so this was the first hearing. The committee actually didn’t have a big list of bills to review. The committee members, all Senators, had enough time to discuss not only our bill, but the profession in general. I was struck by the support I felt for our profession, even by Senators with whom we do not have a close relationship. Senator Jenny Oropeza (D-Long Beach) made a point in the hearing to state that the care she had received personally from a PA was exemplary. Senator Mark Wyland (R-Escondido)

“As a result of your good care and CAPA’s multi-faceted approach to educating the public, the outcome is that these lawmakers are finally understanding our profession and liking what they see.”

10 CAPA NEWS

Three years ago, I started a corporation called Sylvia Surgical Assistant, Inc. This was

just an idea I had to bring in extra income to pay off my debt. I wasn’t expecting it to grow as quickly as it has. When I started, I put myself further in debt; not realizing that setting up this corporation would be expensive. But I had a plan and that plan involved helping patients, providing quality care to my community, as well as to the patients who needed care. All of a sudden, it seemed possible.

Physician assistants open doors for physicians and surgeons who need assistance in their practice. I am a physician assistant who has been working in the operating room assisting surgeons. On a month-to-month basis, while under the supervision of my surgeon, I came to realize that there is a future in assisting surgeons as a side business. I observed many surgeons talking to the operating room supervisor to see if an extra hand was available for them to get help in the operating room theatre. I realized then that there is a high need for surgical assistants. This is when I started my research. I spoke with my supervising surgeon and asked him if it was possible for me to assist other surgeons on a part-

time basis to increase my income. My supervising surgeon encouraged me to pursue this task. My first obstacle was to make sure I would be reimbursed for my services. I spoke with a biller who gave me information on billing my patient’s insurance.

This is when the idea of starting a physician assistant group practice started. As I continued to fill out applications to all the various insurance companies, I realized that the insurance companies did not credential physician assistants. In order for me to be compensated for a first assistant in surgery, the supervising surgeon would need to submit my claim with his/her claims and then they would write a check out to me. This was not in my plan to have the surgeon write me a check. One major challenge of having a surgeon’s office write out a check is that I have to be proactive and aggressive to ensure I am reimbursed for my services.

I decided to take it a step further and looked into starting a corporation, which would include a medical director. By having a medical director, it would allow me to be an employee of the corporation. A corporation can bill insurance companies for services rendered. After I set up my corporation, more applications still needed to be filled out. I had to register with the Medical Board of California to obtain a license to own a business and register with the Secretary of State to own this practice.

I have been working on my business for three years. I have overcome many challenges. My biggest challenge has been reimbursement. Currently, my business is credentialed with Medicare and Blue Cross. I am currently working on credentialing

with Blue Shield and Aetna. I have two medical directors who oversee all PAs who are members of Sylvia Surgical Assistant, Inc. Not only does the medical director oversee the PAs, but they also participate in the training of the PAs.

One may ask, “How does the medical director aid in training PAs?” One of our medical directors is an orthopedic surgeon who specializes in total joint replacement. If a PA is interested in becoming an independent contractor with Sylvia Surgical Assistant, Inc., I arrange to credential them at various hospitals. After the credentialing process is complete, their training begins. The PA is allowed to go into the operating room with our surgeon and he/she is educated and trained to assist the surgeons. The PA training includes: learning various total hip and knee implants, proper scrubbing, gowning and gloving, the use of suturing (closing wounds), learning the proper way to reduce hip intraoperatively, writing surgical orders, preventing the risk of complications, and also learning computer navigation for hip replacement. Once our medical director feels that a PA is prepared to assist other surgeons, the PA will be assigned to a surgeon who needs an assistant.

Because Sylvia Surgical Assistant, Inc. has over ten surgeons who are consistently asking for assistants, we are considering adding additional PAs to the practice. At this time, we are focusing only on orthopedic surgeons. However, we plan to branch out to other specialties. I am proud to say that this organization is moving forward. I have many PA friends who work as an independent contractor; but on the other hand, they have the surgeon’s office do their billing.

Sylvia Surgical Assistant, Inc.…Branching Forward

by Cecil Reyes, PA-C, CAPA Member

Continued on page 11

MAY/JUNE 2010 11

Sylvia Surgical Assistant, Inc.…Branching Forward

Currently, I have a full-time job outside of Sylvia Surgical Assistant, Inc. I am only available on a part-time basis to assist other surgeons. Because of the valuable services we provide to these surgeons, they arrange their surgeries to be done on the weekend so they can have trained, professional and experienced PAs assist them.

For the future, we are focusing on expanding our business. We will consider PAs who are motivated, dedicated and willing to learn to become part of our practice. I offer you this opportunity to contact me if you feel this is an organization you want to be a part of.

Thank you, CAPA, for allowing me to write this article for the CAPA News and share my surgical

assisting corporation that I have developed with my fellow CAPA members. Overall, it was not an easy task to set up but definitely worth it.

I can be reached by email at creyes@newportortho.com or sylviasurgical@yahoo.com. If you are interested in viewing our website, which is still under construction, please visit www.sylsa.com.

I look forward to hearing from you.

Continued from page 10

Sharing Our Selves –

by Cyndy Flores, PA-C, CME Committee Chair

What is an SOS? A cry for help or something PAs do everyday? PAs share of

themselves everyday – whether it is a response to a disaster, to volunteering at a local health fair, to working with the homeless, to promoting national Breast Cancer Awareness month and so many other things. This year’s CAPA Conference will offer a unique opportunity to share what you are doing to better your career opportunities, your community, your state and/or the world!

While October is still many months away, your CAPA Conference Planning Committee (CPC) has been hard at work with conference calls and emails. This hard work is starting to come together and our schedule is being filled with lots of great speakers and topics. This volunteer committee has given CAPA many great speakers – this is the epitome of PAs choosing the speakers and topics for PAs. I have been very impressed with the seriousness the committee has taken to make sure they create the best possible conference for you. Equally as impressive has been the

See page 12 for information on the SOS Poster Project.

We Provide the Easel

Your PA Training and Unique Talents Provide

the Content

And, the CAPA Conference is the

Forum to Share Our Selves!

creativity this group has shown. There are topics and areas of PA interest that we’ve never thought of before and this committee is bringing them to you.We will be bringing you new topics and speakers, but not to worry – we will still have many of your favorite speakers returning this year to your conference. We have many people working on the “fun” part of the conference…after all, what would the CAPA Conference be without the FUN?!

The construction is done and the Renaissance Palm Springs is gorgeous! The CAPA Conference is typically the first conference of the year at the hotel so we will be one of the first big groups to enjoy all of the new surroundings and amenities the Renaissance Palm Springs will have for us.

CAPA knows your CME can come from many places, but there is only one conference in California that is planned by PAs for PAs, the only conference that brings you poolside CME and the only conference you need to attend this year!

12 CAPA NEWS

Sharing Our Selves

S S...---...

W e have done a lot of fun and innovative things at the CAPA Conference over the years. A few years ago we held the TEAMING WITH PRIDE event where

hundreds of photos of you and your supervising physicians were submitted to highlight TEAM practice. We also did Community of PAs which allowed you to write a bit about a PA who touched your life. Both were huge successes because California PAs want the opportunity to SHARE.

This year during PA Week we gather for CAPA’s 34th Annual Conference in Palm Springs. In addition to the beautiful location and the terrific speakers – we will again strive to provide you with an opportunity to share a bit about yourself and what interesting things you are doing as a PA. With your help, we will all learn about some new, different and incredible work done by California PAs. After the conference, we will use this information to create press releases and feature stories to submit to the media. It seems like PAs never get enough good press – don’t you agree?

So, let us know by way of a “poster project” what you are doing either at work or outside your work setting, using your PA training/medical skills.

Some examples: • Serving on a Hospital Committee• Volunteering/Working at a Community Clinic• Serving with California State Government• Volunteering with Doctors Without Borders or

similar groups• Serving As Lead PA For a Large Clinic or Practice• Working On A Military Base• Volunteering In Another Country to Provide

Needed Medical Care• Serving As Administrator in a Medical Setting• Volunteering at a Camp, Providing Care for

Children/Adults• Serving as Coordinator of a Medical Research

Project• Starting/Running a Business as a Consultant For

Geriatric Care, • Surgical Assist, House Calls, other Exciting

Projects

We hope you get the idea. The thing to remember is we don’t even know what we don’t know. What wonderful, innovative and exciting things are you doing? Now is not the time to be shy or humble. Your colleagues need to know and be inspired and encouraged by what you are doing. PA students need to know the possibilities! The people of California and California legislators need

CAPA’s 34th Annual Conference Poster Project

A Place to

Celebrate the PA Profession and

,

MAY/JUNE 2010 13

CAPA’s 34th Annual Conference Poster Project

See you in Palm Springs!

Poster Deadlines:Deadline for your poster if you are bringing it with you to the CAPA Conference: October 8, 2010 at 9:00 a.m.

Deadline for your poster if you are shipping it to the CAPA Office: Wednesday, September 29, 2010

Photo of the SOS Poster Larry Rosen, PA-C will bring to the CAPA Conference. When sending us this photo Larry wrote, “Wonderful project! This took me all of 15 minutes to put together. And, it was great fun to revisit the pictures and memories of those two extraordinary weeks in China. I hope others will take a few minutes to share their personal stories about how fortunate we are to practice medicine in this profession.”

to know! And, it all starts at the CAPA Conference in Palm Springs during PA Week 2010!! We hope you will SHARE a bit about your SELF!

Keep it simple. Make it easy and let us know what you are doing to better your career opportunities, your community, your state and/or the world!

It is about the work you are doing, not the poster. We aren’t looking for elaborate or expensive posters (however if you have them or would like to produce them, you are welcome to). We are creating an area in the CAPA Exhibit Hall which has scores of easels (provided by CAPA) ready and waiting for your poster. You can keep this simple and use a piece of foam core you buy at any office supply store and affix some photos and descriptive text/logo telling us a bit about what you want to share. Now is the time to brag a bit about yourself and/or your project. The poster should be no larger than 36 x 36. Standard size is usually about 28 x 22. Note: If the organization you are highlighting is a 501(c)(3) organization, their name will be entered into a drawing and they could win a $500 donation given in your name.

CAPA will be awarding certificates to all who submit a poster and we will be following up after the conference for more information. We will use your information to highlight your work in the CAPA News. We will also produce articles we hope will become “PR/press opportunities” for some of the projects. We want and need to know what you are doing so we can “get the word out.” You are probably as frustrated as we about the lack of good press for PAs. We want PAs to be widely recognized and honored for the good things they are doing!

If you have any questions or suggestions about this project, please contact the CAPA office. We are anxious to talk with you and learn more about your poster project. We are here to help you and all California PAs shine.

CAPA’s 34th Annual Conference October 7-10, 2010 Palm Springs, CA

Sharing Our SelvesS S

Beautiful, Brand New Renaissance Hotel – Same Wonderful Location!

Welcome Home to the Wyndham Renaissance Palm SpringsWe’re back in Palm Springs and, yes, you will still set your GPS to 888 Tahquitz Canyon Way. But, when you walk into the beautiful, new Renaissance Palm Springs, it will feel a bit like a palace. It is simply beautiful. It doesn’t even seem like it could be the same place.

That is until you see the friendly faces of the staff, many of whom have been there greeting CAPA Conference attendees for several years. It still has a warm and friendly feel combined with the signature Marriott Renaissance level of service.

The frosting on the cake is you get to enjoy it all at pre-renovation, Wyndham rates. Years ago, the CAPA board made the decision to sign a contract through 2013 given the information that a major renovation was eminent. Their wise planning and your loyalty and patience over the years has paid off greatly. The fun and the feel of the CAPA Conference remains – the setting is more beautiful and even more perfect for us.

If you are a CAPA Conference “regular,” we can’t wait to see your face when you see the spectacular, new Renaissance Palm Springs. If you have never been to a Palm Springs CAPA Conference or it has

been a while, this is your year!! Come join the party and enjoy the New Renaissance Palm Springs.

You will want to reserve your hotel room now as it will most assuredly sell out. The CAPA room rate for a standard room is just $162. Over $100 less than the normal rate in October! Bring the family (they have added a sandbox next to the kiddie pool) and there are beautiful new cabanas at the pool as well. Call the Renaissance today to reserve your room. (760) 322-6000. You may also reserve your room online through the CAPA website at www.capanet.org/palmsprings.cfm.

We have some exciting new things planned this year. We look forward to seeing you in Palm Springs!!

Sharing Our Selves SOS … --- …We are very excited about this year’s CAPA Conference where we will be highlighting and celebrating all things PA! There is simply nothing like the CAPA Conference. The setting: Palm Springs and the beautiful new Renaissance Palm Springs and Palm Springs Convention Center offer a wonderful, community-building gathering place. And, the group dynamic created by all of you makes the CAPA Conference a one-of-a-kind conference experience. CAPA has a great time creating the ultimate PA experience while learning a lot, hanging out with friends and colleagues and enjoying beautiful Palm Springs. It doesn’t get much better than that. Within the next few weeks we will have the preliminary program up on the CAPA website.

Some highlights for this year …

Friday, October 7 at 9:00 p.m.CAPA Dance and American PA Idol CompetitionPalm Springs Convention CenterThe nightclubs of Palm Springs can’t compete with the PA PArty of the Year. It is the place to be on Friday night. We transform the spectacular Palm Springs Convention Center lobby into PArty Central with music that will please everyone. At 10:00 p.m. our American PA Idol show begins. The PArty continues as PAs

RENAISSANCE®HOTELS & RESORTS

Just

$162 a night!

MAY/JUNE 2010 15

CAPA’s 34th Annual Conference October 7-10, 2010 Palm Springs, CA

Sharing Our Selves...---...

compete and the audience votes to name the next American PA Idol. The Dance and American PA Idol Competition are included with your registration and guests are welcome to attend at no charge. There will be a cash bar. This really is an event you won’t want to miss!

Saturday, October 8 at 5:45 p.m.Student Challenge Bowl and 3rd Annual Student Challenge Bowl Cheerleading CompetitionRenaissance Hotel Pool Deck

One of the major highlights of the CAPA Conference is the Student Challenge Bowl held on the deck of the beautiful, newly renovated Renaissance Hotel pool. It doesn’t get much better than this. Come and cheer on your favorite PA Program. To sign up your team, visit the CAPA website at www.capanet.org/studentchallenge.cfm.

The Cheerleading Competition is another Student Challenge Bowl highlight. This competition is open to all PAs – students and/or graduates. Visit www.capanet.org/cheerleading.cfm and sign up your team today!

Alumni ReceptionsIf you graduated from a California PA Program, contact your school and see if they will be hosting an alumni reception on Saturday evening. We know that several schools have already started to plan their alumni event at the CAPA Conference. Check with your school to see what you can do to make this year’s alumni reception even better.

APPLICATION FORM

Name _________________________________________

Address ________________________________________

City __________________________St ____Zip ________

I will be performing: solo as a duet a group of _______

Would you say that your voice is (don’t be modest): Absolute perfection! Everyone tells me I have a great voice Just okay Not that great, but I love to sing and can get a crowd going

Which category best describes your style of singing? Pop/Top 40 Rock Country Western Gospel Easy Listening Jazz Rhythm and Blues Broadway Show Tunes Rap/Hip Hop _____________________________

Title of songs (please choose 3) which you would be interested in singing:

1) ____________________________________________

2) ____________________________________________

3) ____________________________________________

16 CAPA NEWS

CAPA’s 34th Annual Conference October 7-10, 2010 Palm Springs, CA

Sharing Our SelvesS S

Special Interest Groups at the CAPA ConferenceMeet and Greet Those Who Share Similar Professional Interests and Experience. We Make That Connection Easy For You!There are a lot of reasons to attend conferences. One of the major benefits of the CAPA Conference is that it is a great place to network with hundreds of California PAs.

If you let us know that you are interested in one of the following 3 areas, we will make sure that your conference badge identifies you as such. We will also have tables set aside for each group at meal functions so you can sit with those who share your interest/experience.

We have received requests for the following 3 areas. We are open to others. Just let us know and if we have enough people interested, we will add that to the list.

PA Entrepreneurs

PAs who have been in practice for over 25 years (lovingly known as the Dinos)

First time CAPA Conference goers/new CAPA members

Flying to the CAPA Conference?Fly Into Ontario (45 minutes from Palm Springs)

Try Southwest Airlines. We checked Southwest.com and found roundtrip fares from Sacramento/San Jose/Oakland to Ontario for $160. We added a sweet little Sebring Convertible for 4 days ($200) – come on, you deserve it! Or, a compact car for ($90) – more money for shopping in Palm Springs!! Total for roundtrip airfare and car can be as low as $250!!

Fly Directly To Palm SpringsYou can fly directly into Palm Springs. Check with United or Alaska Airlines. We checked United.com and found roundtrip flights from Sacramento/San Francisco/Oakland/San Jose to Palm Springs for $184 - $274 per person. There is a free shuttle to and from the Renaissance Hotel and since you are staying downtown, almost everything is within walking distance.

Controlled Substances Education Course at the CAPA Conference

If you have not yet registered for the Controlled Substances Education Course and wish

to do so, we will be holding a course on Wednesday, October 6 at the Renaissance Palm Springs.

This course will sell out quickly, so register online today at www.capanet.org!

We will be holding this course on an on-going basis in various locations throughout the state. Future course dates and locations will be available on the CAPA website as soon as they have been confirmed.

10/6/10

Please give us a call or send us and an email.

Email: capa@capanet.orgPhone: (714) 427-0321Fax: (800) 480-2272

Thank you!

Heard

Any Great

Speakers

Lately?

MAY/JUNE 2010 17

CAPA’s 34th Annual Conference October 7-10, 2010 Palm Springs, CA

Sharing Our Selves...---...

A Place For You, Family and Friends to Sell Goods and Services While at the CAPA Conference

A t the 2008 CAPA Conference we launched the PA MarketPlace. As part of the PA Community conference theme, we

encouraged PAs to bring their own, their family’s or friend’s goods and services to the PA Community. And, in return for a free table in the PA MarketPlace, we requested a 20% donation of all net sales go to the CAPA PAC*.

Well, it was a huge success for all involved. 1) We raised money for the CAPA PAC, 2) conference attendees got to do some fun shopping while at the conference and 3) those

who brought their goods and services to the MarketPlace made some money and thoroughly enjoyed the experience. A win, win, win!!

This year we hope to expand the number of PA MarketPlace participants. If you, or your family or friends have a product or service that you believe will be of interest to PAs, please contact the CAPA office for more details at (714) 427-0321 or e-mail at capa@capanet.org. The space is free. We do request that you donate 20% of the net sales to the CAPA PAC.

*CAPA PAC ID#981553

PAM A R K E T P L A C E

18 CAPA NEWS

When You Look Up Commitment in the Dictionary, You Just Might Find Miguel Medina’s Picture There! When You Look Back At Great President’s of CAPA, His Picture Will Be There Among The Best!

by Gaye Breyman, CAE, Chief Operating Officer

com·mit·ment Pronunciation: /kə-‘mit-mənt/ Function: n 1. The state of being bound emotionally or intellectually

to a course of action or to another person or persons2. the act of committing, pledging, or engaging oneself3. a pledge or promise; obligation:4. engagement; involvement

O n June 30, 2010 Miguel will have completed his term as CAPA President. He is the first President to serve for two full years. Quite a commitment, indeed!

Miguel does nothing unless he gives it his all and his CAPA Presidency is just the latest example of his dedication to excellence

Miguel moved to the United States with his family in 1960. He worked hard and was and is a devoted son. Miguel served in the United States Army in 1973-74. He was one of the early

graduates from the USC PA Program in 1977. He met and married the beautiful Martha Medina, PA who served on the CAPA Board as Student Representative in 1992. Martha lost a valiant struggle with breast cancer in 1994 survived by her loving husband and two special little girls. Miguel was Martha’s rock and became a single father to his beautiful daughters Melissa and Michelle. The best dad in the world according to “his girls” and all who have had the pleasure to be part of their lives. His commitment to see his girls through the heartbreak of losing their mom and to ensure they

were brought up with all of the love and joy and values that Martha and he had hoped for, was steadfast. They are now accomplished, happy young women who look out for their dad.

Miguel has been committed to educating PAs for the past 18 years at Western University. He is loved and admired by students and faculty. In 2008, the Western University College of Allied Health Professions and the College of Osteopathic Medicine of the Pacific honored Miguel with a luncheon at the CAPA Conference. It was quite a tribute!

Miguel’s commitment to California PAs and CAPA is to be admired as well. He served as the Chair of the Committee on Diversity for several years before taking on the role as President. He is a natural leader, or maybe he just makes it look that way. He does what needs to be done and makes people want to do more and work harder. He tirelessly travels around the state meeting with PAs for “Lunch On CAPA,” a program he created so he could sit with small groups of PAs to hear what they want and need from CAPA. He visits almost all (if not all) PA programs each year to lecture and to hear what is on the minds of future PAs. He has attended each and every Controlled Substances Education Course held by CAPA (about 15 to date) and he helped to guide and develop the course creation. He also makes it a priority to meet with/take to dinner each board member and committee chair once each year to get some one-on-one time and to see where they are with their goals and objectives. This is in addition to the day-to-day duties of CAPA President. (A volunteer, uncompensated position.)

In the midst of all of this he has a little time to play competitive tennis, travel a bit and take lots of photos. And, then there is his best friend, Fred. When his youngest daughter went off to college, she left Fred for Miguel to take care of. I think she knew they would bond. They are truly a great team.

I have had the privilege to serve under 20+ Presidents (usually one each year!) and the time we spend “in the trenches” is always exciting. Miguel’s leadership style, integrity and abiding commitment have made the past two years incredibly productive and so much fun! I know that the PAs who

Miguel Medina pictured with his mother, older brothers and sister in 1960 passport

Miguel with daughters Melissa and Sister Emily

MAY/JUNE 2010 19

When You Look Up Commitment in the Dictionary, You Just Might Find Miguel Medina’s Picture There! When You Look Back At Great President’s of CAPA, His Picture Will Be There Among The Best!

by Gaye Breyman, CAE, Chief Operating Officer

have served under his watch have experienced the same thing. Below are comments from a few of them:

As incoming President, I have huge shoes to fill and I hope that I will be able to do half the job that Miguel has done for CAPA. He is an amazing individual and I am so fortunate to be able to be President-Elect under him for a year to learn how to best serve CAPA as he has as President for the past two years.Eric Glassman, PA-C

I have a great affection for Miguel Medina. His qualities of leadership and fellowship are admirable, in keeping with a man of great character. When I grow up I want to be just like him. Larry Rosen, PA-C

Thank you, Miguel, for your vision and values, your strength of character, your patience and wisdom, and your ability to get things done. It was a pleasure to serve as a Committee Chair during your presidency. Hail to the USC PA Program Class of 1977!!! Warmest regards.Janice Tramel, MS-HPE, PA-C

It was great having Miguel as President for two years. He was always available to answer questions or pitch in and help with committee work. Thank you, Miguel, for all the donations and assistance with the CAPA PAC. It was greatly appreciated.  Cherri Penne-Myers, PA-C, MSCS

Miguel has taught me much about patience and the importance of remembering what is important to CAPA and the California PA. Lessons that will serve me well in all I do. I am most thankful to have had the pleasure of serving under Miguel’s leadership and guidance, thank you Miguel!  Cyndy Flores, PA-C

Miguel responded to CAPA’s need for a two-year leadership role as President and we are all the better for it. He has earned the respect of his colleagues by confronting issues with confidence and by providing sage guidance to the Board. Bob Miller, PA-C

Miguel’s heartfelt commitment to CAPA and California PAs during his CAPA Presidency has truly set an example for leaders to come. Miguel is an honest and good man. His patients are lucky to have him and so have we been to have him on the CAPA leadership team. Kristen Woods, MPA, PA-C

Miguel has made great impact on me through his leadership, kindness, dedication and courage. I will be forever grateful to have met such a great friend in this PA profession.  Mercedes Dodge, PA-C

Miguel has led discussions at board meetings on important issues which continue to shape our organization and the direction of the profession. He has gone beyond the call of duty, especially to help to bring our Controlled Substances Education Course to reality and get the majority of PAs in the state certified. I truly appreciate his dedication and devotion. Beth Grivett, PA-C

Miguel is not going away. He will serve on CAPA President, Eric Glassman’s cabinet and he will also serve as Chair of the Committee on Diversity. He will continue to attend and moderate each Controlled Substances Education Course and I know he is just a phone call away for all of us if we need him.

I f you haven’t received email from CAPA lately, we may have an incorrect email address or your computer may be blocking an unknown sender. Please add the following to your address book to keep from blocking our important emails:

capa_action_network@capanet.org and webmaster@capanet.org. Please keep the CAPA office informed of your current email address by logging onto the CAPA web-site and updating your member profile by clicking on “Your Profile” in the top right hand corner.

Set Your Computer/SPAM Filter So You Can Receive E-Mails from CAPA

Thank You Miguel! You Served The PAs of California Well!

C

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CMY

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NicotineAddictionAd_final.pdf 10/26/2009 2:49:57 PM

MAY/JUNE 2010 21

W e will soon do a

series of articles on the resources available to patients who cannot afford their medications. The resources are out there, but millions of dollars of available help through these programs is

being left untapped due solely to the lack of utilization. Below are just two links that will provide a quick start to the available programs.

Helping You Help Your Patients Get Their Medicine

www.rxassist.orgHelp your patients obtain free or low-cost medications and learn more about safety net programs for the uninsured. Patient assistance programs (PAP) are run by pharmaceutical companies to provide free or reduced price medications to people who cannot afford to buy their medicine. RxAssist offers a comprehensive database of these patient assistance programs, as well as practical tools, news, and articles so that health care professionals can find the information they need.

For a directory of patient assistance programs: http://www.rxassist.org/pap-info/default.cfm

www.pfizerhelpfulanswers.comPfizer Helpful Answers is a family of assistance programs for uninsured and underinsured patients who need help getting their Pfizer medicines. These programs provide Pfizer

Patient Assistance Programs Are Severely Underutilized Let Your Patients Know There Is Help Available

California ENT PAs: Let’s Talk!

by Bernadine Sonnier, PA-C, CAPA Member

I am the first physician assistant to work in the Department of Otolaryngology at USC

Healthcare Network, a teaching facility with residency programs. As the department’s first PA, I refer to myself as a trail blazer, a pioneer and a ground breaker. Frankly, I use these terms to describe myself because they seem to glamorize my experiences as a struggling PA. My current position has taught me that I cannot become complacent thinking that the practice strides which PAs have made will remain intact without advocacy.

I am told that PAs who perform ENT procedures do so mainly in

Midwestern states. Is this true? I am searching for insight into the field of PAs in otolaryngology. How many PAs work in otolaryngology in California? What is their scope of practice? Are there PAs mentoring other PAs? Has anyone faced challenges with skill development while working with medical residents? What are your favorite ENT resources? Are their any CME opportunities? What is the future outlook for PAs working in otolaryngology? Is their a community of ENT PAs in California? If not, can we develop one? Please email me at bernie586@sbcglobal.net.

medicines for free or at a savings to patients who qualify. Some programs also offer reimbursement support services. One of the programs found at Pfizerhelpfulanswers.com is the Pfizer MAINTAIN Program (Medicines Assistance for Those who Are In Need) provides free Pfizer medicines to qualified patients, delivered right to their

home. This program can help eligible patients who have recently become unemployed and are uninsured continue receiving their Pfizer medicines.

Let your patients know that help is available and applying to one of the PAPs is perhaps easier than they think.

22 CAPA NEWS

Do It Don’t Injure Yourself

by Greg Mennie, PA-C, MSed, Director-At-Large

The following is a brief overview of a research article in process by the author. Reprints or use without written permission by the author is strictly forbidden.

Do-It-Yourselfers (DIY’ers) are getting braver!

Home remodeling projects and maintenance, once exclusively the domain of experienced

professionals, are now routinely performed (or at least attempted) by novice homeowners. The availability of tools and building products increases the

likelihood that patients seen in primary care offices may be involved directly in the remodeling process. According to the Joint Center for Housing Studies at Harvard University, home improvement projects rose steadily until 2007 when it began a downturn of 16%. It should not be as dramatically affected as the new home building market, thus individuals may be likely to hold onto their existing properties and/or purchase foreclosures which may require some level of remodeling.

So why talk about this to California PAs?

California is one of the highest per capita spending areas for home remodeling. Along with all that remodeling comes the Common Do It Yourself (DIY) injuries. The most recent data from NEISS injury surveillance of hospitals across

America, noted Common DIY tools contributed to close to 300,000 injuries in 2007. This is just the tip of the iceberg as a variety of injuries sustained by homeowners including hearing loss from loud power tool exposure; minor injuries treated at home; undetected lead and asbestos exposure; asthma/COPD exacerbations from chemicals, toxins and dust may not be captured in any monitoring statistics. This also doesn’t include the potential second-hand exposure risk that family members may encounter during a remodeling project.

Step away from the saw!

As home DIY projects become more sophisticated and the equipment more powerful, patients and their family members may be increasingly at risk for injury. We as health care providers are a potential source of injury prevention information and the first line of treatment in the office or urgent care. Certainly, some medical practitioners are well versed in the tools and products commonly used in home maintenance and remodeling. However, it may be helpful for other providers to

Come to the 34th Annual

CAPA Conference in Palm

Springs, October 7 – 10, 2010,

to hear the entire lecture on

injury prevention for home

remodelers.

Target Audience for Do-It-Yourself Safety Counseling

Young Married CouplesNew Home Buyers (within 18 months of purchase)New Parents Empty NestersRetirees ElderlyPatients With Specific “at-risk” DisorderProperty Speculators

TABLE 1

The author painting everything but the walls.

MAY/JUNE 2010 23

Do It Don’t Injure Yourself

by Greg Mennie, PA-C, MSed, Director-At-Large

educate themselves about the home remodeling hazards their patients face. The building and corporate worlds have the Occupational Safety and Health Administration (OSHA) and other governmental oversight, and our patients have us. Now, before everyone bemoans another “thing” we have to do, I would submit that DIY counseling already does exist and most of us practice it on a routine basis without realizing that’s what we’re doing. The American Academy of Pediatrics (AAP) noted in its 1998 policy on lead screening that nearly 74% of privately owned and occupied homes are suspected to contain lead-based paint. Children are most vulnerable to the hazards of lead and are frequently exposed to lead dust during remodeling. The American Academy of Family Physicians (AAFP) recommends lead screening and some states mandate this. Both organizations offer patient education material and screening guidelines for providers, thus DIY counseling tools already exist!

One more thing.

Summer is rapidly approaching, which means time for remodeling projects because of great weather and time off. I’ve gathered up all the information to help you as a provider target those individuals who are most likely to undergo a remodel project (table 1), and what co-morbidities may put someone at risk (table 2). These tools should help you quickly target those who would benefit from at least a quick review of medicines, and or counseling points for safety and hazard avoidance to minimize risk of injury to themselves or family members.

Visual Disorders Cataracts Poor Vision Macular DegenerationDiabetic Retinopathy

Balance/Gait Disorders NeuropathyAutonomic DysfunctionVertigoGait Disturbances

Cardio-Pulmonary DisordersCOPDEmphysemaAsthmaDysrhythmia

Dermatologic DisordersAtopic DermatitisEczemaPhotosensitivity

Hearing DisordersDecreased HearingTinnitus

Musculo-Skeletal Disorders DJD Osteoarthritits Repetitive Use SyndromesTendonitis

Neurological DisordersSeizure DisordersCVA

Psychological Disorders ETOH Substance Abuse

IatrogenicMedications-New-Adjusted

TABLE 2

Target “At-Risk” Disorders for Do-It-Yourself Safety

We hope you will SPREAD THE LOVE with a PA who is not a CAPA member. Let them know

the importance of CAPA membership. Share with them the work we do to promote and protect PA practice here in California. As our numbers grow, our resources grow.

Help us to continue to do the work we do for California PAs; both large and small. Recruit a new member (be sure they include your name when joining) and remain a CAPA member throughout your entire career as well.

Spread The Love Recruit A Colleague And Receive A $25 Certificate

♥ www.capanet.org/recruit.cfm ♥

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n, support, attract, PArtnership, progress, prevail, victorious, patients, unity, admiration, a�ection, pride, connection,

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, passion, heart, spirit, alliance, secure,

24 CAPA NEWS

possible without the hard work of our Legislative Affairs Coordinator, Beth Grivett, PA-C and our Legislative Advocate, Bryce Docherty.

It has also been quite a road trip with the Controlled Substances Education Course. The CAPA-sponsored course has educated over 2,600 PAs on the proper utilization of controlled substances. I have enjoyed traveling

Passing the Baton

the state and meeting many of my hardworking colleagues along the way.

Next year, I will continue to be actively involved in CAPA. I have been appointed Chair of the Committee on Diversity for the 2010-2011 term. I will also continue to travel with the Controlled Substances Education Course as moderator.

I look forward to passing the baton to our incoming President, Eric

Glassman, PA-C. It is encouraging to note that several of our board members and our incoming President are from a younger generation of PAs. The future of our profession depends on the active involvement and contribution of all the sectors of our profession. Keep in touch and I hope to see you in Palm Springs in October or on the road with the Controlled Substances Education Course.

CAPA’s 34th Annual ConferenceOctober 7-10, 2010

Optional Workshops, October 7 and 9

Controlled Substances Education CourseOctober 6, 2010 – Prior to the CAPA Conference

CAPA’s home away from home is looking a bit more like a palace! The renovation is complete and the Wyndham Palm Springs is no more. A new and very much improved CAPA Conference experience awaits you at the Renaissance Palm Springs. And, the

special CAPA Conference Rate is just $162! You may reserve your room today.

See Pages 14 –17

Continued from page 1

MAY/JUNE 2010 25

You may want to consider two options in the event you change from a claims-made policy with one insurance company

to another - or your claims-made policy is cancelled, non-renewed or replaced by an occurrence policy.

Extended Reporting Period Endorsement The first option, known as an Extended Reporting Period Endorsement or “Tail” coverage, allows you to report a claim to your prior insurance company after the policy has ended. It provides protection for covered claims that arise out of incidents that occurred during the policy period, up to the date the policy ended.

You must pay an additional premium for Extended Reporting Period coverage-possibly as much as two or more times your current year’s premium. Some insurance companies offer this endorsement at no charge - if certain special policy conditions are met by the policyholder.

Prior Acts CoverageThe second option is known as Prior Acts Coverage. Many insurance companies offer this option to protect insureds who had claims-made coverage immediately prior to the current policy period, but with a different insurance company - and who did not purchase an Extended Reporting Period Endorsement from that company when the policy ended.

Prior Acts Coverage protects against claims arising out of incidents that happened before the inception or effective date of a new policy. Some companies may charge an additional premium for this coverage.

Don’t Leave Yourself at RiskThe bottom line is, learn the details of your claims-made coverage so you know that you are adequately covered and you are not caught unaware. Policies can vary by insurance carrier. You could be left with a gap in coverage by

letting your policy lapse or changing your policy from carrier to carrier.

Question/Tip: If employed, does the contract with your employer stipulate that your employer will purchase tail coverage for you to cover any future claims after you leave or retire? Many PAs do not consider this in their contract until it’s too late.

This risk management information was provided by Healthcare Providers Service Organization (HPSO), the #1 provider of professional liability insurance for over 1 million healthcare professionals, and is now offering the same quality coverage, financial strength and level of service to Physician Assistants. The professional liability insurance policy is administered through HPSO and underwritten by American Casualty Company of Reading, Pennsylvania, a CNA company. Reproduction without permission of the publisher is prohibited. For questions, send an email to service@hpso.com or call 1-800-982-9491. www.hpso.com.

My child is home sick. Barely get to the office on time. Waiting room ispacked. The office manager is out on vacation. Meet with supervisingphysician to discuss patients. Grab stethoscope. In first room is 3-year-old Emma. Pink eyes, a cough and ear infection. “Gifts” from daycare.Record on chart. Next room. A pleasant 55-year-old woman in noacute distress. She describes a new cough and onset of chest pain.Order EKG, chest x-ray and labs. Minor emergency of the day –16-year-old Sammy fell off his skateboard while ‘performing an Ollie.’

Suture knee and write prescription for the pain. Fifteen minute breakspent getting caught up on paperwork. Supervising physician e-mailed

an article titled, “In a courtroom, your documentation can be your bestfriend or worst enemy.” Good thing I have HPSO!

Make sure your story has a happy ending.

This program is underwritten by American Casualty Company of Reading, Pennsylvania, a CNA Company.Healthcare Providers Service Organization is a division of Affinity Insurance Services, Inc.; in CA (License #0795465), MN and OK, AIS Affinity Insurance Agency, Inc.; and in NY, AIS Affinity Insurance Agency.©2010 Affinity Insurance Services, Inc. E-8102-310-CAPA

A physician assistant’s story…

Now withnew expanded

benefits!

Professional Liability Insurancefor Physician Assistants

888.273.4686www.hpso.com/capa3

E-8102-310-CAPA:E-8102-310-CAPA 3/1/10 1:37 PM Page 1

Changing Carriers: What PAs Should Know About Their Claims-Made Policy

26 CAPA NEWS

Two years ago, I had the honor

of traveling with an international aid organization, Christian Medical & Dental Associations, to

Honduras where we spent a week delivering free basic medical care to the impoverished citizens of the countryside. Most had only seen a doctor or dentist once or twice in their life, if at all, and the line to consult with us at our makeshift clinics stretched out the door and around the corner of the building. I was struck by the enormity of the problem. How could a dozen medical and PA students and a handful of providers put a dent in the health care needs of this population in just a few days? The patients I saw answered my question for me. From the mundane to the life threatening, we were able to give these people something extremely valuable – hope for the future.

The Gift of Hope That Gives It Right Back

by Mercedes Dodge, PA-C, Committee on Diversity Chair

One memorable case was a nine-year-old girl who came in with a thyroglossal duct cyst on her neck. The opening was the size of a dime and chronically infected. The doctors she had seen throughout her life told her mother that there was nothing that could be done, except to keep the opening clean. However, we were lucky to have a skilled pediatric surgeon on our team who knew that the girl’s troubles could be solved with a brief and simple surgery. Luckily, we found a nearby operating room where our surgeon was able to close the opening for good. The girl is now able to lead a normal life. In other cases, we were able to provide people with hope in simpler ways. For many, we were able to give the simple gift of sight, not by curing the blind, but by distributing eyeglasses which had been recycled by their original owners. Others took advantage of the free pharmacy we set up, obtaining antibiotics, diabetes medications and other drugs which we sometimes take for granted.

Though we were there for only a short time, we were able to improve the lives of hundreds. It was an amazing experience that continues to impact me to this day. I highly encourage PAs and PA students to volunteer abroad. You will be shocked at the state of health care in the developing world, but you will also be so glad you decided to help. For those who are interested in volunteering abroad, the following websites may be of interest to you:

• National Health Service Corps’ Student/Resident Experiences and Rotations in Community Health (SEARCH) http://nhsc.hrsa.gov/search/

• LIGA International http://fresnoflyingdoctors.org

• Christian Medical & Dental Associations http://www.cmda.org

• MedMissions http://www.medmissions.org/

• Flying Samaritans www.flyingsamaritans.net

Mercedes Dodge, PA-C and a Honduran girl.

CURES: Those Attending CAPA’s Controlled Substances Education Course Consistently Note CURES As The Number One Greatest Resource Provided

The state’s database known as the Controlled Substance Utilization Review and Evaluation System, CURES, contains over 100 million

entries of controlled substance drugs that were dispensed in California. The online PDMP system makes it much easier for authorized prescribers and pharmacists to quickly review controlled substance information via the automated Patient Activity Report (PAR) in an effort to identify and deter drug abuse and diversion through accurate and rapid tracking of Schedule II through IV controlled substances. In order to obtain access to the PDMP system Prescribers and Pharmacists must first register

with CURES by submitting an application form electronically at https://pmp.doj.ca.gov/pmpreg/. In addition, your registration must be followed up with a signed copy of your application and notarized copies of your validating documentation which includes: Drug Enforcement Administration Registration, State Medical License or State Pharmacy License, and a government issued identification. You can mail your application and notarized documents to:

Bureau of Narcotic Enforcement (BNE) Attn: PDMP Registration P.O. Box 160447 Sacramento, CA 95816

Students Students Students Students Students Students

MAY/JUNE 2010 27

The didactic year lays the medical foundation which allows you to excel as a

PA student while in your clinic rotations. It can be a difficult transition from the classroom to a hospital or clinical environment. Throughout the didactic year, your instructors were there to guide you while you performed physical exams, discussed diagnostic testing and built a list of differential diagnoses. Rest assured, you are not alone as you rotate through clinical sites. There is someone who will direct you through those turbulent waters, your clinical preceptor. This is one of the most essential

relationships to master while in your clinical year. Not only does it allow for an easy transition, but it can open doors for you as a practicing PA.

Clinical preceptors are unique in the fact that they take students into the most intimate part of their professional career. While many of us think of the preceptors patients as another disorder to learn or another procedure to complete, clinical preceptors have built a trusting and close relationship which is unique to medical providers and their patients. It takes a lot of trust for a preceptor to let a student loose in their practice. Students will find that this trust varies from rotation to rotation and really depends on the relationship that the student develops with their preceptor. Over the course of the past year, I have found that establishing a trusting and open relationship with my preceptor created an environment which has been both educational and rewarding. We all know how important first impressions are, especially after interviewing for PA school. The same rule applies when contacting your clinical preceptors. It is important to contact them well in advance to your arrival; some schools suggest a week or two before you start your rotation. While talking to you preceptor, try to get a picture of the setting in which they are practicing. For instance, is your preceptor’s patient population a certain ethnic group,

socioeconomic class or do they see a lot of a certain diagnosis? Most of my rotations took place in a rural setting where clinics saw a high volume of uncontrolled, non-compliant diabetics and most patients were migrant farm workers. With this knowledge, I read a great deal on management of diabetic patients and gathered information which gave me insight into some of the difficulties providers have when treating this population. This not only made the transition easier, but allowed me to connect with the patient population.

Most of my clinical preceptors asked for my medical resume upon arrival, but for those who did not, I made sure I gave them one on my first day. Most of the time, the only interaction the preceptor has had with a student has been on the phone or via email. Presenting them with a resume on arrival gives them a snap shot of your educational background, work experience and past accomplishments. Making your past experiences more transparent may provide your preceptor with insight into what you, as a student, are more comfortable doing. Medical resumes can also clue preceptors in on what skills they many need to concentrate on while you are rotating there.

After the preceptor has a good feel of your background, it is good to discuss how you fit into

Taming the Clinical Monster: Step 1. Developing a Good Preceptor Relationship

by Adam Marks, MPA, PA-S, Student Representative

Special Student Track at the CAPA Conference

We will again have a special series of lectures and

we hope a workshop for PA students. There is no additional charge for this wonderful

student experience at the CAPA Conference. Mark your calendars for the CAPA Conference, October 7 – 10, 2010 with the special Student Track on Friday, October 8, 2010 and watch for more details.

Jon Machado, PA-S; Robert Cardenas, PA-C; William Barreto, PA-C and Adam Marks, MPA, PA-S

Continued on page 28

Students Students Students Students Students Students

28 CAPA NEWS

Taming the Clinical Monster: Step 1. Developing a Good Preceptor Relationship

wall; the preceptor will give you the resources you need to grow as a practitioner. So, you have been in your rotation for a couple of weeks and things are going smooth. You are seeing your own patients and giving case presentations. Now what? A good way to gauge how you are doing in a clinical rotation is to ask your preceptor directly. Half way through the rotation, the preceptor should know your strengths and weaknesses as a provider. Be upfront and ask. Then take the criticism and build on it. There is nothing more gratifying than to have your preceptor tell you, “Your suturing has really improved over the last couple of weeks.” This tactic accomplishes several things: it lets your preceptor know that you are taking the rotation seriously, it gives you a gauge on what you need to work on and finally, it gives a potential employer reassurance that you are teachable. Lastly, before leaving your clinical site, evaluate your experience. Ask yourself, “Do you get along with

the office staff? Do the supervising physicians support their new mid-levels? Do you like working with the patient population? Does this site provide an environment where you will be able to provide quality medical care to your patients?” There will be a lot more that goes into your decision of where you want to practice, but these types of questions will allow you to reflect upon your experience while the feeling of being a practitioner at that site is fresh in your mind. If you find that this rotation is a site that you would enjoy working at, don’t be afraid to mention it and leave your resume with the site supervisor. Your clinical rotations should be a time when you can find your place in medicine while garnering as much medical knowledge as possible. Clinical preceptors will guide you down the road of medical education exposing you to the environment and giving you pearls along the way. The relationship between you and your preceptor should resemble an important relationship that you will have later on in your career as a PA; that of a physician assistant and their supervising physician, a relationship based on trust and mutual respect with the goal of providing quality health care to the clinic’s patient population.

For more information on clinical etiquette, visit the AAPA’s website on Rotation Do’s and Don’t’s at http://www.aapa.org/student-academy/current-students/rotation-dos-and-donts.

their practice as a student. For example, some preceptors like students to see patients with them for a while before they cut them loose. Others will hand you a chart and send you into the room within the first couple of hours. If you feel comfortable seeing patients and the preceptor asks, do not be afraid to politely reply, “I feel comfortable seeing patients on my own and giving you case presentations afterward.” More times than not, I have found that after seeing a patient or two with my preceptor, he will ask me what I think about seeing my own patients. I will usually let my family practice preceptors know that I am comfortable seeing patients on my own and that I know my educational limits. I reassure them that if I feel uncomfortable with a patient’s condition, I have no problem asking for help. Remember you are the student; it is not your job to know how to treat every patient. Your job is to push the boundaries of your knowledge and upon hitting your educational

Continued from page 27

Calling All PA Students

Apply today to serve as a CAPA Student Ambassador at this year’s 34th Annual Conference in Palm Springs on October 7-10,

2010. The deadline to apply is July 1, 2010. For complete information, please visit the CAPA website at: www.capanet.org /studentamb_page.cfm.

Students Students Students Students Students Students

MAY/JUNE 2010 29

The 14th Annual CAPA/Kaiser Student Medical Challenge Bowl will be held Saturday, October 9,

2010, poolside at the Renaissance Palm Springs from 5:30 p.m. – 7:00 p.m. There will be a cash prize for the winning team: $250 for their Student Society. CAPA will provide other prizes like t-shirts and

gift cards. The winning team will also be able to display the official Challenge Bowl Trophy at their PA program.

To sign up, to go the student section of the CAPA website (www.capanet.org). We look forward to seeing you there.

Student Challenge Bowl Sign Up Now

by Matthew Keane, MS, PA-C, Student Challenge Bowl Coordinator

Continued on page 30

W ell, for starters, there is a new Program Director. As of January 2010, Christy

Eskes, MPA, PA-C, took over the chair of this growing program. Christy is also an alumnus of the Loma Linda PA Program, which is celebrating its 10 year anniversary and will be the featured program during Homecoming Weekend in April. The faculty is putting together a video, “Called to Serve,” which will chronicle the PA program over the past 10 years, focusing on their mission “to provide graduate PAs the skills they need to fulfill their calling to serve their communities, whether local or abroad.” Christy has a background in exercise physiology and worked as an EMT before going to PA school. Since graduating in 2003, Christy has worked in family practice and urgent care clinics, and began precepting students in 2005. She joined the Loma Linda faculty as Didactic Coordinator in February 2009, and maintains a

clinical practice in a clinic for the underserved where she continues to see patients one day per week to keep her skills up and give back to the community. She recently began a doctorate program in health sciences with an emphasis on Physician Assistant Studies through A.T. Still University and states she looks forward to utilizing the information gained to continually improve the Loma Linda PA Program and to expand her own knowledge base. Please join me in a conversation with Christy Eskes.

Q: What is the most rewarding aspect for you of being a PA educator?

A: I love seeing the “light bulb” moment when the concepts we are teaching come together for a student, whether during the didactic year or in the clinical setting. It is also extremely rewarding to see our graduates come back to the program

to teach – while they are passing on their knowledge and experience to the next generation of PAs, it serves to challenge and motivate our current students.

Q: What is your biggest challenge as a Program Director?

A: For our program, the biggest challenge is space. We desire to grow our program but we are so limited by physical space that we can only expand by small increments. When our program first began 10 years ago, we had 13 students. We have since doubled in size, with 26 students in the current didactic year. With these increases, however, we are utilizing the same classrooms with the same amount of space. We have maximized the space as much as possible and

What’s Going On At… Loma Linda University?

by Tana Rhodes, MS, MPA-C, PA Program Relations Committee Member

Christy Eskes, MPA, PA-C

Students Students Students Students Students Students

30 CAPA NEWS

What’s Going On At…Loma Linda University?

use other resources on campus to help off-set this, but it remains a challenge nonetheless.

Q: What do you see for the future of PA education in the next 5-10 years?

A: With the focus on health care reform, PA education will need to be able to adapt to meet the needs of the community at large. This will require much flexibility on the part of PA programs. While increasingly more PAs are entering specialty fields upon graduation, there needs to be continual emphasis on primary care as this is where PAs will likely be most needed as reform is enacted.

Q: What role do you see for PA organizations like CAPA in PA education?

A: I remember going to a CAPA Conference when I was a student. I felt so connected to the profession and felt that the conference confirmed my desire to become a PA. I encourage all of our students to become CAPA members so they can begin to identify with the profession and begin to get involved in the grassroots part of our profession. The program uses CAPA as a resource when we discuss the specific laws governing PA practice in California and we point students to the website for additional information. For us, CAPA and other similar organizations play a vital role in educating our students about the profession. We have full confidence in the information we provide as we know it is current and well-researched.

Continued from page 29 Q: How can CAPA and PA programs better work together to help PAs and PA students in California?

A: CAPA is a great way for programs to get together and discuss common issues to improve PA education across the state. We would love to see even more collaboration among programs in California through CAPA-sponsored conferences and events.

Q: What can alumni and students look forward to hearing about in upcoming newsletters or events?

A: One of the highlights of our program is our Spanish curriculum. Because our program is situated in Southern California, our students frequently encounter patients who only speak Spanish. In response, the program began a Medical Spanish course a few years ago that focuses on basic conversational skills and medical

terminology that our students can use during their clinical rotations and beyond. A unique feature of this curriculum is a Spanish Immersion practicum. Between the didactic and clinical year, the students travel to Mexico and spend a week there reinforcing their language skills and experiencing the culture. While living with host families, they attend classes at a local international university in the mornings and spend time in the hospital in the afternoons to gain appreciation for how medicine is practiced in another country. We have found that this fosters greater understanding of this particular culture and its medical practices and beliefs so they can better relate to patients with this background in the clinical setting.

We wish Christy and the Loma Linda PA Program all the best and appreciate Christy’s time and commitment to training our next generation.

Congratulations Graduates

CAPA would like to congratulate all students graduating from the Physician As-sistant Programs across California. Best wishes as you prepare to take the NCC-PA PANCE exam, and begin your career as a PA. We look forward to working

with all of you as our colleagues as we continue to advocate for our profession.

Congratulations to the 2010 Graduates of: Charles R. Drew University of Medicine and Science Loma Linda University of Health Sciences Riverside County Regional Medical Center/Riverside College Samuel Merritt University San Joaquin Valley College Stanford University, School of Medicine Touro University - California, College of Health Sciences University of California, Davis University of Southern California, Keck School of Medicine Western University of Health Sciences

MAY/JUNE 2010 31

Welcome New Members

March 9, 2010 through May 14, 2010

Erika Adame, PA-SMari Aguaristi, PA-CHeather Amitrone, PA-CLani Antonio, EMT-PAlexandra Ard, PA-SLuke Ardill, PA-SMarianne Arild, PA-SAlina Attai-Biedebach, PA-CPatricia Barreto, PA-CEmily Battista, PA-CArmando Baza-Vargas, PA-CAlfonso Becerra, PA-CLaura Behrends, PA-SRobert Bell, PA-CFlorin Bilauca, PA-CJennifer Boxter, PA-SLaura Brennan Sally Brooks, PA-CTria Brummond, PA-CAnn Bui, PA-CEmily Buria, PA-SCeleste Callinan, PA-SBruce Callister, PA-CJohnny Caraballo, PA-SDaniel Cardwell, PA-SMerilynn Cariaga, PA-CMelissa Carlton, PA-CErin Carnahan, PA-CAndrea Carter, PA-SStephen Caso, PA-SNoel Chavez, PA-CRose Christensen, PA-SRenee Christenson, MPAS, PA-CWilliam Chu, PA-CLinda Chung, METiffany Clark, MS, PA-CSilvia Corzo, PA-CFrank Croal, PA-CMaximillian Cruz, PA-CRobert Cunningham, MPAS, PA-CGary D’Aluisio, PA-CMichael Davalos, PA-CShawn Davison, PA-CTierra Dela Cruz, PA-SDenise Donahue, PAEsther Duran, PA-CKaren Dvorkin, PA-SChristine Elder, PA-CJohn Erro, PA-CJessica Faerber, PA-SMahmood Fathollazadeh, PA-C, Ph.DMiriam Ferreira, PA-C, MMSPaige Fitzgerald-Smith, PA-SRobert Frankel, PA-CMatthew Freitas, PA-CGail Gabourel, PA-CAlice Gaunt, FNPJennifer Gilbert, PA-SMegan Gilroy, PA-SSharon Girard, PA-CRebecca Glusac, PA-SLizabeth Gonzalez, PA-SMelissa Goralka, PA-CMike Gottus, PA-C

Jehan Goubran, PA-CRachel Gray, PA-SChristina Gray, PA-CAndrea Grossi, PA-CAaron Guerra Won Ha, PA-SAngela Hamilton, PA-CJanet Han Kimberly Hanks, PA-CRodica Haq, PA-CJohn Hardin, PA-CBilliana Hardy, PA-CKelly Heath, PA-CLiliana Hernandez, PA-CVinh Ho, PATrevor Holloway, PA-CMary Holmes, PA-CTrenton Honda, PA-CVictoria Howard, PA-CStephanie Huang, PA-STherese Ibrahim, PA-SElda Ilia, PA-SJesse Jacquez, PA-CNicole Johnson, PA-CAndrew Josiah, PAKathy Kai-Jie Hu, CPT, PA-SJacob Kalscheur, PA-CChaim Kaplan, PA-SBenjamin Kaska, PA-STiffany Kaufman, PA-CTaren Keller Anthony Kelly, PA-CElizabeth Kerlick, PA-CVasco Kidd, PA-C, MS, MPHLauren King, PA-SShelley Kirby, PA-SLeah Kirsch, PA-CFelicia Kosanovich-Brennan, PA-CDavid Lague, PA-CPamela Lambert, PA-CGrace Landel, PA-CMichele Langford, PA-CJustin Latino, PA-SKatlin Le, PA-CJaime Luna, PA-CMalinda Lydon, PAAidan Maguire, PA-CSheila Maher, PA-CAlexis Manneh, PA-SArezou Mansourian, PA-C, MSPAS, MPHThomas Markiewith, MPAS, PA-CElisa Martinez, PA-CWendy Mazursky, PA-CDarlene McGovern, PA-CPatrick McGrath, PA-CMarcella McPeek, PA-CJigna Mehta, PA-CJennifer Michael, PA-SAngela Mignea, PA-CAnna Mikhaylishin, PA-SMelissa Mixon, PA-SNafiseh Moghadam, PA-CJames Moles, PA-STraci Morgan, PA-C

Christopher Morris, PA-SSarah Morse, PA-SLisa Nazar, PA-SStephanie Ngo Nicole Nguyen, PA-CAlissa Nguyen Katrina Nguyen, PA-SKaci Orosco, PA-CMichael Outslay, PA-CMadhubhai Patel, PASihuor Peak, PA-CTeresita Pearce, PA-CAnna Petrik, PA-SMichael Price, PA-CRobert Ramirez, PA-CElvia Ramirez, PA-SKaren Ratcliff, RDFelix Regala, PA-SEmily Rhoads, PA-CDarren Richards, PA-STerra Riley, PA-CSandro Romero, PA-CJaime Salvatierra, PA-CJulie Shryock, PA-CNatalia Slabchak, PA-SBernadine Sonnier, PA-CShawnna Sopp, PA-CKristin Sothard, PA-CRebecca Souza, PA-CJack Sperry, PA-CLauren Stark, PA-SJane Stracner, PAMaria Teresa Suarez, PA-CMalin Sullivan, PA-CJodi Tarutis, PA-CKaren Theophile, PA-CMichelle Thomsen, PA-SChristopher Tilton, PA-CAnthony Tkac, PA-CMartin Tolosa Joanna Torre, PAThai Tran, PA-CLisa Tshuma, PA-CWilliam Turner, PA-CLaurie Tyler, PA-SJessica Valdez, PA-CKenneth VanDerBeck, PA-SEdgar Vargas, PA-CStephanie Vetterli, PA-CDina Villapudua, PA-CTomas Viskanta, PA-CHung Vu, PA-CJennifer Wallace, PA-CJeremy Wellman, PA-CJulie Wiley, MPA-CWhitney Woydziak, PA-CElizabeth Wright, PA-SLakshmi Yerneni, PA-CCaleb Youngblood, PA-C

1. Redding Area PA/NP AllianceSummer Ross, PA-C; (530) 275-5747summerross@hughes.net

2. Physician Assistant Society of Sacramento (PASS)Carlos De Villa, PA-C, PASS President; (916) 973-6185, pasocietyofsac@yahoo.comAtul Sharma, PA-C, MMS, MPH, CHES; (916) 397-6035, pasocietyofsac@yahoo.com

3. Sacramento Area NP and PA AssociationA. Lynne Wittekind, PA-C; (530) 906-1238, sanppaa@sanppaa.org, lwittekind@earthlink.net, www.sanppaa.org

4. Contra Costa Clinicians AssociationBrian Costello, PA-C; (707) 651-2705, brianc510@comcast.net

5. San Francisco Bay Area Physician Assistants (SFBAPA)www.sfbapa.com, PO Box 14096, San Francisco, CA 94114-0096Martin Kramer, PA-C; (415) 433-5359, Fax: (415) 397-6805, mkramersf@hotmail.com

6. Bay Area Mid-Level PractitionersRose Abendroth, PA-C; (650) 697-3583, Fax: (650) 692-6251, rosepard@aol.comMatt Dillon, PA-C; (650) 591-6601, mattdillon42@hotmail.com

7. Bay Area Non-DocsLinda O’Keeffe, PA-C; (650) 366-2050, lindapac@aol.com

8. Northcoast Association of Advanced Practice CliniciansJohn Coleman, PA-C; (707) 845-6008, streetdrag49@sbcglobal.net

9. Stanislaus County NP/PA NetworkBrian Cormier, PA-C; (209) 605-4966, briancor@verizon.net, www.nppanetwork.org

10. Journal Club for PAs and NPs (Fresno area)Cristina Lopez, PA-C; (559) 875-4060; Fax: (559) 875-3434, clopez875@aol.com; 2134 10th St, Sanger, CA 93657

11. Tulare/Kings NP/PA AssociationSteve Henry, PA-C; Pager: (559) 749-4348, msh649@sbcglobal.net

12. Central Coast Nurse Practitioners & Physician AssistantsKris Dillworth, NP; ccnppa@yahoo.com

13. So Cal PAsLinda Aghakhanian, PA-C; want2heal@hotmail.com

14. Orange CountyHung Nguyen, PA-C; (714) 846-8178; nhy52@yahoo.com

15. San Gabriel Valley Local GroupM. Rachel DuBria, PA-C; (818) 744-6159, racheldca@aol.com

16. San Fernando/Santa Clarita Valley GroupJonah Tan, MPT, PA-C; (818) 634-0007, jotptpa@yahoo.com

17. San Diego AreaJeremy Adler, MS, PA-C; (619) 829-1430, jadler@simplyweb.net

Local Groups

California Academy of Physician Assistants3100 W. Warner Avenue, Suite 3Santa Ana, CA 92704-5331

Address Service Requested

Presorted STDUS Postage

PAIDTorrance, CA

Permit No 102

CAPA’s 34th Annual ConferenceOctober 7-10 Optional Workshops, October 7 and 9

Renaissance Hotel, Palm Springs, CA

Sharing Our Selves

S S...---...

Controlled Substances Education CourseOctober 6, 2010 – Prior to the CAPA Conference

See Poster ProjectPage 12