CPT Christopher Cordova, PA for the 3rd Squadron, 61st

Cavalry from Fort Carson, Colorado, received a Silver Star for

his actions at a Combat Outpost (COP) Keating in Afghanistan.

The award ceremony was conducted on 8 April 2010.

CPT Cordova was present at COP Keating early October

2009 when the planned closure was to take place. This was a

well known event by the enemy who staged an attack on 3 & 4

October and overran OP Fritzche and parts of COP Keating.

There were an immediate amount of KIAs and wounded and

the Aid Station was destroyed. MEDEVAC was not possible

for approximately 12 hours forcing CPT Cordova and his

medics to care for multiple critically wounded individuals while

simultaneously providing defensive fire to prevent COP Keating

to be completely overrun.

CPT Cordova is credited with saving the lives of 12

wounded Soldiers and even transfused blood from other

Soldiers during this action in order to maintain several

individuals that otherwise would not have survived that

extreme amount of time.

For the sixth time in 29 years an Army Ranger has

been selected as the US Army Surgeon General’s

Physician Assistant Recognition Award Winner. CPT

Andrew D. Fisher is assigned to 1st Battalion, 75th

Ranger Regiment, Hunter Army Airfield, Georgia. He

was selected for his bravery in combat and his life saving

skills. Read further on page 2.

General Stanley McCrystal

presents CPT Cordova his

Silver Star

Cordova Earns Silver Star

I N S I D E T H I S

Cordova earns

Silver Star

1

Surgeon General’s

PA of the Year

1/2

New PA Chief 3

New NG Chief 3

PAs in Command 4

Reserve Chief Bids

Farewell

5

Specialist Corps

Update

6

IPAP update 7

PA training of

Army Medics

8/9

News from Home 10

Ranger Selected Surgeon General’s PA of the Year

SAPA JOURNAL The Society of Army Physician Assistants

A Civilian Organization Representing Army PAs

M A Y / J U N E 2 0 1 0 Vol. 21, NO. 2 A P O I N T S O F

I N T E R E S T :

PA earns Silver Star

Surgeon General’s

PA of the Year

Newest Senior PA

Newest NG PA

PAs in Command

PO Box 07490

Fort Myers, FL 33919

Phone & Fax

239-482-2162

Article courtesy Major Kathy Schultz,

XO SP Corps

P A G E 2

“CPT Fisher

moved forward

to assist with

clearing the

objective. “

All The Way!

Ranger Receives Award (cont) Below is the nomination information provided to the SP Corps by the 75th Ranger

Regiment.

CPT Fisher distinguished himself throughout the inclusive dates as a Ranger

Physician Assistant who saved numerous lives on the battlefield in Afghanistan and

Iraq, during two separate combat deployments. His lifesaving interventions and

leadership provided during multiple intense firefights are shining examples of what a

Physician Assistant brings to the fight. He not only acted heroically in combat, his

daily performance as a health care provider, leader, and mentor to his medics directly

translates into his battalion having more combat power now and for the foreseeable

future.

On September 30, 2009, while deployed in support of OEF, CPT Fisher was

attached to a Ranger platoon during a raid. During their infiltration the platoon

received effect machine gun fire while sustaining one critically injured Ranger. CPT

Fisher provided lifesaving care and prepared the casualty for evacuation. As the

assault force moved toward the objective, a firefight ensued. The platoon medics

weapon malfunctioned and CPT Fisher moved forward to assist with clearing the

objective. During exfiltration, a Ranger stepped on a pressure plate IED and was

killed instantly. However, 6 Rangers were wounded , four critically. Without regard

for his own safety, CPT Fisher moved to the site and assisted with retrieval of the

wounded. He established a casualty collection point, triaged the wounded, and

performed numerous lifesaving medical interventions. He coordinated movement to

the CSH via tactical aircraft.

On 29 October, CPT Fisher responded to a downed Marine assault helicopter.

He established a CCP and provided lifesaving measures. His actions saved the lives

of 2 crew members. CPT Fisher lives the words of the Ranger Creed and exhibits the

Army Values. His dedication to Rangers and his medics is unsurpassed.

Courtesy 75th Ranger Regiment

S A P A J O U R N A L

New Physician Assistant Chief Announced

P A G E 3 V O L . 2 1 , N O . 2 A

The Surgeon General, has selected LTC John E. Balser to serve as the 6th

Chief of the Physician Assistant Section/Assistant Corps Chief of the Army

Medical Specialist Corps, as well as the Physician Assistant Consultant to the

Surgeon General.

LTC Balser is the commander of the 240th Forward Surgical Team (FST)

(ABN) Fort Bragg, NC, and currently deployed in support of Operation

Enduring Freedom. He succeeds COL Michael A. Robertson, currently the

commander of the 31st Combat Support Hospital, and also deployed in

support of Operation Enduring Freedom. LTC Balser will assume his new re-

sponsibilities no later than 20 July 2010.

LTC Balser has provided a message for distribution to Army PAs.

I am humbled to be chosen the new consultant and Deputy Corps Chief. As a

group, we have the most diverse background of various experiences that we

can bring to bear in support of the Warfighters. We are known as dependable

and willing to do the tough jobs. As a group, we work behind the scenes and

need to continue the outstanding job we do day in and day out providing the

best care we can to the Soldiers we support.

LTC Tanya F. Moore has been named the newest Reserve Component PA Chief.

Below is a brief biography.

LTC Tanya Moore was born in Greensboro, North Carolina. Her father was an Army Officer, thus she moved all

over the United States. She graduated from the University of North Carolina at Greensboro with a BS in Community

Health Education and received her Physician Assistant training at Wake Forest University. She was originally

commissioned a Second Lieutenant in the Signal Corps in 1982. She served as a platoon leader, company executive

officer in Heidelberg Germany and Schwabish Gmund Germany, Company Commander, Assistant S-3 at Fort Bragg,

NC, Training with Industry Hughes Aircraft Company, Fullerton California, and Project Officer at Fort Gordon,

Georgia. LTC Moore left active duty and joined the reserves in 1997. She then served as Executive Officer to the J-5

at US Space Command. She resigned her commission as a Signal Officer in 2000 and was reappointed as a First

Lieutenant in the Army Medical Specialist Corps. Her assignments include IMA to Evans Army Community Hospital,

mobilization as Chief of Military Medicine at DeWitt Army Community Hospital, Fort Belvoir Virginia, and Team

Leader with the 7225th Medical Support Unit in Greenville, South Carolina. Lieutenant Colonel Moore holds a

Bachelor of Science Degree in Community Health Education, Physician Assistant certification from Wake Forest

University, and a Masters of Medical Science in Hospital Medicine and Critical Care from Alderson Broaddus College.

LTC Moore’s awards and decorations include the Bronze Star, the Army Commendation Medal (6th Award), Army

Achievement Medal (4 Oak Leaf Clusters), National Defense Service Medal with Bronze Star, South West Asia Service

Medal with three Bronze Service Stars, Kuwait Liberation Medal (Kuwait), Kuwait Liberation Medal (Saudi Arabia),

Global War on Terrorism Service Ribbon, Armed Forces Reserve Medal with M Device (2nd Award), Overseas Service

Ribbon, Armed Forces Reserve Medal with Ten Year device and the Parachutist Badge. She currently resides in

Greensboro, North Carolina with her husband and her three daughters.

New Reserve Component PA Chief

“ I

represent

all of you

and in

order to

go

forward, I

will need

your

input”

LTC Balser

LTC Balser (black shirt) directing his

FST staff during a trauma event

P A G E 4

COL Piper Bids Farewell COL Frank Piper, Reserve Component PA is retiring after 28 years of service. The

SAPA staff wishes him happiness and prosperity in life and all future endeavors.

Below is a farewell message from the chief.

Having served in this capacity for the past 2 1/2 years, I have enjoyed every

minute. While officially retired, I hope to keep in touch and maintain the friendships

I have been honored to have over the past 28 years of my Army Reserve career.

Frank Piper, MS, MPAS, PA-C

COL (R) USAR

COL Piper has provided a duty description for the Reserve Component PA

Consultant, which is presented below.

His duties and now those of LTC Moore include being a Drilling Individual

Mobilization Augmentee (DIMA) to the PA Corps providing leadership / mentorship

to RC Physician Assistants , and is a liaison between the Army Reserve PAs and the

AC Physician Assistant Consultant to the OTSG. He/she serves as the senior PA RC

representative to the PA Section Chief on all issues related to RC PA manage-

ment The DIMA serves as liaison between RC PAs and RC Corps Chief on all things

affecting 65Ds. Other important duties include establishing and maintaining formal

and informal communications with the RC PA community and the PA Section Chief,

participating in the development and implementation with the SP Strategic Plan and

Balanced Scorecard as appropriate, and in conjunction with SP XO and IMA to the

Chief of the SP Corps maintain a database of mobilized/deployed SP PAs in support of

GWOT, OIF, OEF. He/she also coordinates issues of RC force structure with AC

Chief PA and RC rep at APPD.

S A P A J O U R N A L

P A G E 5

COL Michael A.

Robertson, PA-C,

commander of the

31st Combat Support

Hospital (CSH), Fort

Bliss, TX, has recently

deployed February

2010 in support of

Operation Enduring

Freedom.

COL Michael A. Robertson receiving a

thank you gift from the Commander of an ANA Soldier who had a head injury and was cared for at the Kandahar Regional

Medical Hospital

LTC Balser First PA to Command FST in Combat

COL Robertson First PA to Command CSH in Combat

LTC Balser is the commander of the 240th Forward Surgical Team (FST) (ABN) Fort Bragg, NC, and currently deployed in

support of Operation Enduring Freedom. He

succeeds COL Michael A. Robertson, currently the commander of the 31st

Combat Support Hospital, and also deployed in support

of Operation Enduring Freedom.

S A P A J O U R N A L

COL Robertson and staff visit

Kandahar Regional Medical Hospital

LTC Balser (third from left) and his Forward Surgical Team

Iron Majors

P A G E 6 V O L U M E 1 , I S S U E 1

Congratulations to the following PAs selected as Iron Majors by the

Army Medical Specialist Corps. The Iron Major award is given to

Promotable Captains and Majors who have displayed outstanding

leadership skills, the ability to mentor junior officers, and who can

foresee and participate in the future growth and potential of the SP

Corps.

The following 3 PAs received this award for 2010:

Major Dave Bauder

Major Robert Heath

Major James Jones

Courtesy Army Medical Specialist Corps

Below is a description of the Retired Army Medical Specialist Corps Association provided by the AMSC. The

Retired Army Medical Specialist Corps Association (RAMSA) was established in 1983 to facilitate communication and

camaraderie among current, retired and previous members (not retired) of the Army Medical Specialist Corps

(AMSC). Goals of RAMSCA include: Providing networking and social opportunities for its members; supporting the

goals of the AMSC, helping to preserve the history of the AMSC, recognizing the literary, educational, artistic, and

community service of its members; providing scholarships and research grants. Who is eligible to join RAMSA? Any

current or past member of the AMSC.

The following is the website for RAMSCA: http://ramsca.org/

Per Special Pay, Human Resources Directorate

The DTM 09-009: Consolidation of Special Pays for Licensed Clinical Psychologists, Licensed

Social Workers, Physician Assistants, & Veterinarians is coming to the final stages of

implementation within the Army. Budget limitations for new programs & the implementation

instructions requiring several rewrites/reviews is near completion. The final ALARACT

message for implementation should be released in April 2010, with authority retroactive to 1

Oct 2009.

Courtesy Army Medical Specialist Corps

Special Pay?

Retired Army Medical Specialist Corps Association (AMSCA)

Show Me

The Money!!

SP Update

Major Jones (second from left)

P A G E 7

”our next move was

to extend the

length of the

program from 24 to

29 months.”

Interservice Physician Assistant Program Update

Update from the Interservice Physician Assistant Program

For those of you have not visited the “Schoolhouse” in a few years, there are some big

changes at the IPAP. We have dramatically increased the size of the program, which has

resulted in several changes. In 2007, the Army, Navy, Air Force and Coast Guard all came

to us stating they needed increased graduates. The increased need came from the wartime

demand and the fantastic job the PAs were doing down range. Of course, PA excellence

on the battlefield comes as no surprise to you.

We gained approval from the Health Care Interservice Training Advisory Board (HC

ITAB) that oversees our multiservice program to expand class sizes from 60 to 80

students, an increase of 60 more students starting the program each year. In order to do

this, we needed larger classrooms and laboratory space. By the end of 2008, we had two

new classrooms that seated 100 students. We also had three additional rooms with exam

tables, and oto-ophthalmoscopes to train 100 students at a time. Each of the three lab

rooms also had a Smart board at the end to allow video and interactive web utilization.

The staff has also grown. We now have 14 Army, 5 Air Force, 3 Navy, 1 Coast Guard and

6 civilian faculty. Maria Charles has many more PAs to keep in line now. This expansion

preparation was accomplished during 2008 and in January, 2009, we started training 123

RA, 30 ARNG, 9 USAR, 37 USAF, 29 USN and 4 USCG students. These classes are

spread out over three trimesters, just as before. We have not changed the curriculum,

though we have added more labs to many of the classes that emphasize problem based

learning as opposed to pure didactic (PowerPoint) instruction.

Our next move will be to extend the length of the program from 24 to 29 months.

Medical education has increased at a tremendous rate. Most all civilian PA programs now

average 29 months in length. Our faculty took a critical look at our curriculum and

determined that 33 credits per semester or 100 semester hours in one year was too

much, too fast. Rather than cut back on any classes, we proposed to HC ITAB that we

add another semester to the first year that allows the coursework to be spread out. We

also proposed adding another month to the clinical phase to accommodate increased

hospital education requirements and provides time for leave during the second year.

Students will have more study time and not just prepare each day for the next test. Also,

in a time where military families are stressed by wartime missions (60% of our students are

OIF/OEF veterans) we need to allow more time for maintaining the family. The HC ITAB

members approved the extension to 29 months on March 26th, 2010. The change also

means that as we continue to start a class every four months, we will end up with four

classes at FSH for Phase 1. The AMEDDC&S will now have to prepare a fourth classroom.

Other work must be done, but for the most part the only visible changes will be students

attending four semesters with a shortened day of classes and more study time.

COL William Tozier,

Director IPAP

S A P A J O U R N A L

Training and Sustaining 68Ws: The Physician Assistants Role

P A G E 8 V O L U M E 1 , I S S U E 1

The backbone of Army Medicine, particularly in a deployed environment, is the 68W Health Care Specialist. These

combat medics are trained in a 16 week training program at Fort Sam Houston. The Department of Combat Medic

Training trains approximately 8000 68W students per year in this course. Students are taught over 140 different

critical skills during this training program. They begin with six weeks of Emergency Medical Technician-Basic training,

and must successfully complete the National Registry of Emergency Medical Technicians-Basic examination. Following

the EMT portion of the course the students then enter the Tactical Medicine portion of the course. These 10 weeks of

training begin with the basic understanding of how the environment differs in a tactical situation versus a civilian

scenario.

Medics are given numerous lectures to understand the knowledge basis of the MOS. However, the primary focus is on

learning and becoming proficient in the many hands-on skills required to save lives on the battlefield. Consequently,

with a limited number of military instructors we must ensure that each student has been trained and validated on each

of the skills needed to save lives in combat. Being trained during Initial Entry Training does not make these individuals

proficient in these skills over time. It will require additional training in their unit to fully grasp and maintain their skills. I

recall the days when all of my medics were tasked out to perform jobs and details that were not medical in nature.

Many hours spent in the motor pool did not make these individuals more competent and confident in their medical

skills. It becomes imperative that the unit medical officer continue this training and validation of skills as time goes by

and the medic migrates away from the learning environment and more towards the general life of a garrison Soldier.

This brings me to my next point. Over the past 5-6 years we have seen a trend for the enlisted medic to have to take

on more roles of an independent practitioner. That lone medic with a forward platoon on a Contingency Operating

Base, the sole medic in support of an isolated artillery battery, or the transition team medic who is the sole provider

for his team is sometimes the only medical provider in the area. This is not a role the 68W is trained for. In addition to

providing life saving care for traumatic injuries they have the day to day function of the “Doc” for routine sick call

problems. How do they develop these skills? We used to have Medical Proficiency Training (MPT) where the medics

would spend 60-90 days at the hospital or clinic to gain additional medical knowledge that they were not getting in the

battalion. However, I don’t believe this program still exists, and if it does, the limited scope of practice of the 68W in a

MTF precludes them from being fully utilized and learning new Primary Care skills.

Most unit medical officers (Physician Assistants) are assigned to a maneuver or support battalion. While in garrison,

they are frequently required or tasked to work in the Troop Medical Clinic or one of the Family Medicine Clinics on

post. While this is technically a MEDDAC function they frequently utilize division assets for the bulk of troop medicine.

So if the battalion medical officer is at the TMC seeing patients, how are the unit medics getting trained? Not only do

they need to sustain their trauma skills, but how do they learn the skills necessary to provide routine sickcall to

Soldiers in their unit? The unit leadership must realize this valuable asset is being supplanted to support other organi-

zations which is detrimental to the battalion. Command leaders from the Battalion, Brigade, and even the Division

Surgeon must weigh in and insure the medical assets organic to the maneuver units are available to provide training and

guidance to unit medical assets. If the unit has an organic battalion aid station or medical company, then the medics

must work with the PA or MD in the unit area to learn the necessary fundamentals to understand an independent type

of practice and know when someone is really ill and needs evacuation, or has a minor illness they can take care of.

The Department of Combat Medic Training provides a week long program in “Limited Primary Care”. The students

LTC (Retired) Don Parsons

P A G E 9

“The long tradition of

enlisted medics

progressing up

through the ranks and

eventually applying

for and being

selected for PA school

has gone the way of

the dinosaur.”

Combat Medic Training (continued) get classes on medical documentation, EENT disorders, abdominal disorders, respiratory

disorders, MS disorders, and even some dermatology. However, this is really just the basics.

Providing care in the unit area gives the medic the ability to work with the unit medical officer

and observe his technique. Classes by the unit medical officer on different disorders, history

taking, and physical exam techniques are all areas medics need work on. If the medical officer

does not provide this training then a lot more Soldiers will enter the evacuation channels. In my

last field assignment I was the PA in a Field Artillery Battalion. We had a small area in the base-

ment of the barracks where we conducted sickcall every day. I did not have an office but

worked among the several cubicles we had to see patients in (This was in the days before

ALTHA). The medics would get the chart with vital signs recorded and start the subjective and

objective part of the exam. I would come by and consult with the medics on what they had

asked and recorded in the way of physical findings. We would then go into a little more depth

of history and physical exam so they could observe how I conducted a history and physical.

This way they learned to perform these skills themselves. We went over a treatment plan to

include medications and disposition of the Soldier so that they started to develop some

capabilities and confidence in their skills. This paid big dividends when we deployed or even

went to the field. I didn’t have to see every sore throat or knee pain, unless the medic had

some question about the patient that they were not comfortable with. Today many of the unit

PA’s are too busy in the MEDDAC clinic to train their medics. They seldom give classes on

medication, or the proper way to examine a knee. How then do we expect these medics to

develop skills to provide care to the Soldiers in their unit?

I understand all about JACHO and the regulations that govern patient care. However, in a

deployed environment the unit medical officer cannot be everywhere that the Soldiers are.

Who is going to take care of them if they get injured or ill? The medic who is out there with

them will have that responsibility, and it is our job to train them to be able to provide capable

and competent care in any situation. Battalion PAs must schedule time in their unit to train their

medics, and validate their skills; this should be reinforced by both the Brigade Surgeon and the

Division PA and Surgeon.

The long time tradition of enlisted medics progressing up through the ranks and eventually

applying for and being selected to PA school has gone the way of the dinosaur. Today the

selectees are primarily officers from backgrounds other than medical, and they do not have the

same tradition of ensuring the enlisted medics are fully trained to care for Soldiers in an isolated

assignment. In fact, many of these candidates have never performed the functions of a medic. It

is time for PAs to relook at the training and sustainment of the enlisted medic. Unit medical

officers must make this a priority in their already busy daily schedule. The medical platoon

leader needs to ensure his personnel are getting the training they need to sustain their skills.

Without this continued training and sustainment these fine Soldiers will not be able to reach

their full potential. LTC (R) Donald Parsons is the former director IPAP.

S A P A J O U R N A L

News from Home

P A G E 1 0 V O L U M E 1 , I S S U E 1

Retirements

Promotion/Recognition

Special events/Occasions/Training

This section is under construction

and requires input from SAPA

members.

SAPA OFFICERS SOCIETY OF ARMY PHYSICIAN ASSISTANTS

P O Box 07490, FT. MYERS, FL 33919-6402

Phone and Fax - 239-482-2162

Executive Director: Harold E. Slusher, PA-C

Address and phone as above, e-mail - hal.slusher@juno.com

SAPA Web Page: http://www.sapa.org (Webmaster: Orie Potter)

PRESIDENT Stephen W. Ward, PA-C

email: swardpac@ctvea.net

PRESIDENT ELECT Sherry Womack, Major, SP, PA-C

IMMEDIATE PAST PRESIDENT Pat Malone PA-C

SECRETARY Karen McMillan, PA-C

email: kl4u@comcast.net

TREASURER James L.C. Miller, PA-C

e-mail - jmillx2@earthlink.net

DIRECTOR, ACTIVE DUTY ARMY PAs Theresa Martin, Capt., SP, U.S. Army

e-mail

DIRECTOR, US ARMY NATIONAL GUARD PAS Nolan Wright, Capt., Texas State Army National Guard

e-mail:

DIRECTOR, US ARMY RESERVE PAS LTC (R) Frank Piper, Jr., PA-C

e-mail; Fchiefs@sbcglobal.net

MEMBERSHIP DIRECTOR Paul Lowe, PA-C

EMAIL: lowepw@earthlink.net

SAPA CONFERENCE STAFF CONFERENCE COORDINATOR: Bob Potter, PA-C

PO Box 623

2Monmouth, IL 61462

SAPA Voice Line: 309-734-5446

Fax: 309-734-4489

e-mail: orpotter@aol.com

CONFERENCE REGISTRAR: Bob Potter, PA-C Info for Bob Potter same as immediately above

ASST. CONFERNECE COORDINATOR: David M. Paulson, PA-C

e-mail: DNORSK3@aol.com CO-REGISTRAR: Judy Potter

DECORUM AND MORALE: Nicole Potter

e-mail: pottercats@aol.com SALES AND MARKETING: Stephen Ward, PA-C,

Bob Egbert, PAC, Tom Matherly, PA-C

MODERATORS/AUDIO/VISUAL: LCDR Irwin Fish, PA-C

SAPA JOURNAL STAFF Editor: Major John F. Detro, MPAS, PA-C

email: john.f.detro@us.army.mil

COMMITTEES SCHOLARSHIPS/AWARDS

LTC-R Donald Parsons, PA-C (Chair) COL -R Sherry Morrey, PA-C CW4-R Marvin W. Cole, PA-C

LTC Donald Black, SP, PA-C POC for Captain Sean P. Grimes

Physician Assistant Educational Scholarship Award)

email: donald.black@se.amedd.army.mil

SAPA HISTORIAN William Long, PA-C

MINORITY AFFAIRS Karen McMillan, PA-C

PUBLIC EDUCATION Harold E. Slusher, PA-C

PROFESSIONAL WELLNESS Michael Champion, PA-C

LEGISLATIVE AFFAIRS Harold E. Slusher, PA-C

DELEGATES TO AAPA HOUSE OF DELEGATES Pat Malone, PA-C (Chief Delegate)

Stephen W. Ward, PA-C

ACADEMY LIASON COL Pauline Gross, SP, PA-C

e-mail: pauline.gross@us.army.mil

COMMUNICATIONS/ELECTRONICS Stephen Ward, PA-C

Irvin Fish, PA-C

Bob Potter, PA-C

The SAPA Journal staff and SAPA Board of Directors encourages membership participation in this publication. Feel free to use this

forum to present your views on any topic you desire. The publication of clinical articles on any subject is also solicited, however, to reduce

our workload, we do request articles be presented typed, double-spaced format, and on CD, Microsoft Word format. The editor

reserves the right of final acceptance of articles as well as the right to serialize articles which are too lengthy to be included in a single issue.

Articles will be accepted via email.

The SAPA Journal is the official publication of the Society of Army Physician Assistants. The views and opinions expressed herein are not

necessarily those of the editors, SAPA, the SAPA Board of Directors or the Department of the Army unless explicitly expressed as such.

This is not an official Army Publication.