Standards Matter: PAs and Certification Maintenance

June 21, 2016

Testing is more than an objective measure of knowledge. Certification tests are also valuable learning tools that are more effective than study alone.

Recently, articles have been published that suggest that "physician extenders" are not held to appropriately high standards in terms of education and/or ongoing certification. Given the breadth and depth of the care PAs provide across all specialties and settings, we are in fact held to high standards for certification and certification maintenance throughout our careers.

The public has high expectations of healthcare providers and relies on regulatory and certifying bodies to establish policies to provide assurance that we maintain a level of knowledge to provide safe, effective care. Physicians and employers rely on certification as one measure of a PA's currency of knowledge ability to provide quality care to your patients.

In support of those stakeholders, National Commission on Certification of Physician Assistants (NCCPA) strives to maintain a strong and valid certification program to ensure that certified PAs are staying up to date amid rapid scientific and technological advances while serving the interest of their patients.

The NCCPA certification maintenance process requires that certified PAs earn 100 CME credits every two years, now including credits earned through self-assessment and performance improvement CME activities. It also requires PAs to pass a rigorous timed and proctored exam every six to 10 years covering a broad base of general medical knowledge. This allows PAs to be certified as generalists and gives them flexibility to move among specialties.

In fact, NCCPA's 2015 Statistical Profile of Certified Physician Assistants - with workforce data on over 90 percent of all certified PAs-shows that over 70 percent are practicing in specialties outside primary care. A strong generalist education has allowed those PAs to move into every clinical setting and specialty area, where they collaborate with physicians and others to provide high quality care.

This move into specialty practice has prompted the NCCPA board of directors to consider new approaches to the recertification exam that would include some form of testing in both core medical knowledge and the PA's chosen field of practice.

In an era where standardized testing in schools is receiving pushback from parents and when some physicians are questioning their own exam processes, this proposal has received a fair amount of attention. Testing can be controversial in a culture where "every kid gets a trophy."

Yet there is evidence that when structured correctly, testing is even more than an objective measure of knowledge. Those tests are also valuable learning tools that are more effective than study alone. An effective recertification model includes a comprehensive approach that involves multiple paths to learning and assessment - both CME and exams that are associated with improved practice.

Testing is in the news regularly because few people like to be tested. I don't like it either but I know I have to test, and I accept this as part of my professional commitment to patients, employers, insurers, and state medical boards - all with a stake in our combined success.

NCCPA is still soliciting input from stakeholders as part of its due diligence to inform the board's decision about potential changes to PA recertification. Whatever the outcome, you can be assured that we take our responsibility as the profession's certifying body very seriously. We understand our obligation to you, to patients, and to those we certify.

I welcome your comments. When you are hiring a PA, does this rigorous certification process provide you with a level of assurance that those who want to join your practice are knowledgeable and skilled providers? Don't your patients deserve to be treated by providers who are continually measured and who continually measure up?

Certified PAs do that.

Dawn Morton-Rias, EdD, PA-C, is the president and CEO of the National Commission on Certification of Physician Assistants (NCCPA). Morton-Rias has been a certified physician assistant for more than 30 years. Learn more at www.pasdothat.net.