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Behavior Science 1 > BSC Exam 1 > Flashcards

BSC Exam 1 Flashcards

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1
Q

Dr. Charles Hudson

A
  1. One of the first physicians to suggest that non-physician clinical support personnel be trained and used to help alleviate a growing disparity between supply and demand for health care services.
  2. For his role in promoting the training of physician assistants, the American Academy of Physician Assistants (AAPA) made him an honorary member three months prior to his death in 1992.
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2
Q

Henry Lee “Buddy” Treadwell (1940)

A
  1. Non-physician provider trained by Dr. Johnson
  2. His training and experience used by Duke; “PA concept”
  3. Opted out of taking the exam
  4. In 1970 Duke named him honorary PA
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3
Q

Dr. Eugene Stead

A
  1. 1964 coined term Physician Assistant
  2. 1965 Founded 1st program at Duke University
  3. PA Day is his BDAY October 6
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4
Q

Dr. Richard Smith

A
  1. In 1968 he relocated to the University of Washington to create the first MEDEX program in the country.
  2. Dr. Smith joined Dr. Eugene Stead, Jr. at Duke University and Dr. Hu Myers at Alderson Broadus College as one of the early pioneers introducing a new health care provider – the Physician Assistant – into the American Health Care System.
  3. Dr. Smith helped replicate MEDEX Physician Assistant programs in eight university medical centers, programs training physician assistants for 46 states.
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5
Q

Dr. Henry Silver

A
  1. Began the first pediatric nurse practitioner (PNP) training program in the USA.
  2. 1968- Henry K. Silver, MD, establishes the Child Health Associate (CHA) Program at the University of Colorado (a PA program with emphasis on pediatrics).
  3. The Child Health Associate program was the first PA program to offer its graduates a master’s degree.
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6
Q

Congress Woman Karen Bass

A
  1. 1st PA in the US House of Representatives
  2. 1st AA woman elected as speaker of the California House (2008-2010) prior to US Congress election
  3. USC graduate (former faculty member)
  4. Director of HCOP and Project Prepared- increase the number of individuals from educationally or economically disadvantaged backgrounds that enter health and allied health professions programs.
  5. Helped establish and run the Community Coalition in 1990 in response to the 1980’s crack cocaine epidemic that devastated South LA.
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7
Q

1957-1970

A

1st PA class at Duke (1965)

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8
Q

1971-1980

A
  1. 1972 APAP (The Association of Physician Assistant Programs) formed curriculum; founded in 1972 by a group of concerned program faculty who saw a need to address the important issues of accreditation, certification, and continuing education of physician assistants
  2. The Association changed its name to the Physician Assistant Education Association (PAEA) on January 2006 to reflect its expanded array of services to member programs
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9
Q

1981-1990

A
  1. Specialization trend
  2. 1986 reimbursements of PA services under medicare Part B
  3. 1987 NCCPA (National Commission on Certification of PAs)
    introduces the process of re-certification by exam
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10
Q

1991-2000

A
  1. Increase in PA programs from 45-114
  2. Increase in Masters programs
  3. 1991 AAPA National Medical Challenge Bowl
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11
Q

2001-2010

A

2001-APAP ( Association of Physician Assistant Programs) uses CASPA ( centralized application system)
2007- Indiana allows PAs to prescribe medications
2010- Obama signs ACA to increase coverage doubling the projected need for PAs; PAEA president Dr. Lohenry and 6 PAs go to white house conference

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12
Q

2011-Present

A

2011- NCCPA (National Commission on Certification of Physician Assistants) develops CAQ (The CAQ is a voluntary credential that Certified PAs can earn in seven specialties)
2013- PA 10 sought after profession
2014- VA hospitals increase PA
2019- Indian Health Services updated manual–> PA exercise autonomy

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13
Q

Feldshers (1650)

A
  1. Physician assistant (PA) prototype; originally German military medical assistants.
  2. Introduced into Russian armies by Peter the Great in the 17th Century to serve as healthcare personnel at a time of physician scarcity, feldshers provided medical services throughout the Russian Empire and later Soviet Union.
  3. Russia wanted people to be trained and provide primary care
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14
Q

“loblolly boys” (1798)

A
  1. Enlisted man, John Wall, is assigned by the US Navy as a “loblolly boy” to assist medical officers on the USS Constellation.
  2. 1799-Congress passes a bill authorizing the Navy to use hospital mates modeled after the “loblolly boys” of the British Royal Navy to assist physicians in care of sailors.
  3. 1800s-Name changed to Surgeon’s Stewards then to apothecary, and again to bayman, and then in the early 20th century to Hospital Corpsman.
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15
Q

Johanna Maria Heden (1863)

A
  1. Swedish Midwife and a trained female surgeon

2. 1st licensed female “feldsher in Sweden

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16
Q

Capt. John Van Renssalaer Hoff (1891)

A
  1. Operates first company of “medic” instruction for members of the Hospital Corps at Fort Riley, Kansas.
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17
Q

1898

A
  1. “U.S. Navy Hospital Corps” is signed into law by President William McKinley on June 17, 1898
  2. Due to Spanish-American War
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18
Q

1940

A
  1. Community Health Aides are introduced in Alaska to improve the village health status of Eskimos and other Native Americans.
  2. Amos N. Johnson, MD employs Henry “Buddy” Treadwell as a technician and, over time, trains him as a “doctor’s assistant” to work in his rural- based general practice in Garland, NC.
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19
Q

1942

A
  1. Dr. Stead develops 3 year, fast track medical curriculum to educate physicians at Emory University for military service
  2. Served as a model for PA education at Duke University in 1965 where Dr. Stead founded 1st PA program
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20
Q

Academic Integrity

A
  1. Responsibility and Honesty in education
  2. The Moral Code of Academia
  3. Behavior and actions within the classroom and beyond
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21
Q

Intellectual Honesty

A
  1. Making honest choices and decisions in the acquisition of knowledge
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22
Q

Professionalism

A
  1. Set of characteristics that embody a particular profession
  2. PAs- intelligent, good judgement, honest, interpersonal skills
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23
Q

PA Residency Programs
Pros?
Cons?

A

Pros

  1. More experience when you go to clinicals
  2. Helpful if you want to change careers
  3. Increase in salary

Cons

  1. Make less money as a resident and work longer hours
  2. Delay amount of PAs entering workforce thus decreasing number of PAs delivering care
  3. More competition
  4. Less regulation
  5. Not knowing how to work with us
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24
Q

Doctoral Degree
Pros?
Cons?

A

Pros

  1. Standard role opportunity, give more independence
  2. Higher salary
  3. Increase education making PAs more well rounded Ex. clinical management, leadership roles

Cons

  1. Be in school longer, higher loans
  2. Controversy over the title
  3. Tension in the workforce; leadership roles
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25
Q

Name change
Pros?
Cons?

A

Pros

  1. Term assistant doesn’t reflect our scope of practice
  2. Clear up the role of PA - Physician Associate
  3. Keeps name/initials the same (PA)
  4. International recognition
  5. International alignment

Cons

  1. Costly-money can be spent elsewhere
  2. Can cause a rift with PA and doctors
  3. Might change our scope of practice and privileges taken away
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26
Q

Optional Team Practice
Pros?
Cons?

A

Pros

  1. Autonomy
  2. Increase access to rural practice w/o physician supervision
  3. Less administrative burden = getting hired more ( PAs may be eligible for direct reimbursement for certain procedures/screenings)

Cons

  1. Change in the model of PA education
  2. Physicians are concerned with misdiagnosing; lack support from physicians
  3. AMA wants to work in groups but wants physicians to be leaders
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27
Q

Open Notes
Pros?
Cons?

A

Pros

  1. A separate platform where patients have access to notes
  2. Increases patient engagement, gives them more control and confidence
  3. Patients can make corrections on their charts
  4. Can share information with family members

Cons

  1. Medical Terms may be misinterpreted
  2. Providers have to make more time for open notes
  3. Providers may not document the full extent of record; be more gracious with their terms
  4. The patient can take offense to certain terms Ex. Obese patient
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28
Q

ARC-PA role?

“Accreditation Review Commission on Education of the PA”

A
  1. Recognize and approve programs that meet/maintain standards that qualify graduates for medical practice and Provides them with credentials
  2. 260 Programs accredited in the US
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29
Q

Six components of the Accreditation Process

A

Provisional Accreditation

  1. 6-12 months before students enroll
  2. First-class nears graduation
  3. 18-24 months later. Finally granted “Accreditation Continued” status

Continued Accreditation

  1. Programs submit self-study report (how and what are we doing?) 2-3 years before validation visit
  2. ARC-PA gives feedback on SSR ( Application for continued accreditation submitted)
  3. Validation Visit (Every 10 years)

Commission reviews all materials –> accreditation status assigned

USC SITE VISIT WAS IN SPRING 2019 (NEXT IN 2029)

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30
Q

NCCPA ( National Commission On Certification Of Physician assistants)
Est. 1974

A

Role

  1. Protect patients and the public
  2. Ensure PAs maintain knowledge and skills to practice safely and effectively ( PANCE/PANRE EXAMS +CME Requirements)
  3. Provide “ Blueprint” of topics to guide students and schools on what to teach
31
Q

PA Certification Process

A
  1. Pass the PANCE Exam ( 300 questions; 5 blocks of 60); can take as early as 7 days after graduation; 6 years after graduating
  2. PANCE PASS= NCCPA Certificate (PA-C)
  3. Maintain continuing education hours (CME) every 2 years
  4. Recertification exam every 6-10 years (gives you 4 chances) - if you don’t pass must retake within 2 years
    * as of 2014, the new policy is every 10 years for new grads
32
Q

CME CREDITS

A
  1. 5 CYCLES OF 2 YEARS EACH (10 YEARS)
  2. Must log 100 CME credits online (at least 50 category 1)
  3. Submit a certification fee
33
Q

AAPA (American Academy of Physician Assistants)

[Est. 1968]

A
  1. National professional society for PAs
  2. Represents 123,000 PAs
  3. Their efforts made Rx regulation favorable for PAs

Role

  1. Advocacy (Federal Level)
  2. Legislative (State Level)
  3. Insurers
  4. Health Systems
  • House of delegates voted for a name change so the board of directors can acknowledge it

Membership Includes:

  1. Salary Report
  2. Advocacy
  3. Education
  4. Data
  5. Billing Issues
34
Q

CAPA ( California Academy of PAs)

A

Role

  1. State-specific issues/laws; CAPA is constantly monitoring and taking action on legislation that can affect PA Practice here in California Ex. SB697 which places fewer restrictions and increases professional dignity
  2. Membership
  3. Advocacy
  4. Education

** CAPA-sponsored SB 697 becomes law on Jan 1, 2020. SB 697 expands the prescription authority of PAs by eliminating specific physician supervision requirements and by eliminating the requirement that the supervising physician’s name and contact information appear on prescriptions of a PA.

35
Q

PAEA (Physician Assistant Education Association)

Est. 1972

A
  1. The Association was founded in 1972 as the Association of Physician Assistant Programs.
  2. PAEA is the only national organization representing physician assistant educational programs in the United States
  3. Mission: leadership, innovation, and excellence in PA education.
36
Q

PA Scope of Practice in California

A
  1. Prescribe, Diagnose, and conduct PE

2. Any medical service except certain ophthalmological and dental procedures ( BPC Section 3502c)

37
Q

Who issues our PA license?

A
  1. PA Boards [Physician Assistant Board (PAB) in California]

2. 48 states confer a PA “license”

38
Q

Who issues our PA certification?

A
  1. NCCPA ( National Commission On Certification Of Physician Assistants)
  2. Must have initial certification by taking the PANCE
  3. Not everyone requires you to have a PA-C
39
Q

Supervising Physician is now called?

A

Collaborating Physician

40
Q

“Collaboration” means?

A
  1. The process by which a PA and one or more physicians/surgeons or other qualified healthcare providers jointly contribute to the health care and medical treatments of patients, with each “collaborator” performing actions they are licensed to perform.
41
Q

What is a delegation of services agreement?

A
  1. Implies hierarchy

2. The previous relationship between SP and PA

42
Q

Delegation of services agreement is now called?

A
  1. Practice agreement
43
Q

PA Practice Act; what does it mean?

A
  1. Put forth by the CAPA ( California Academy of PAs)
  2. Does not limit PA to the practice of the Physician ( Ex. Doctor has family practice; PA may practice OBGYN if they have previous experience)
  3. Physicians are not required on Rx
  4. No co-signature on medical records required
  5. NO DSA instead PRACTICE AGREEMENT
44
Q

Identify and define: Standard of care

A
  1. Evidence-based medicine
45
Q

Who or What allows us to prescribe medications?

A
  1. People who give state medical board PA license determines what you can prescribe as a PA
  2. Controlled substances –> DEA-Drug Enforcement Agency
46
Q

Do Physician Assistants prescribe medications?

A

In California we “issue/furnish” drug orders.

47
Q

What’s a drug order?

A
  1. An order for Rx or medical device which is dispensed to or for a patient and the order is issued and signed by a PA
  2. It’s basically a prescription!!
  3. We “furnish or order a drug”
  4. MC prescribed: Glucometer
  5. Always acting on behalf of your supervising/collaborating physician
48
Q

Scheduled Drugs vs Nonscheduled drugs?

A
  1. Scheduled Drugs-“controlled substances”; controlled by DEA, regulated by FDA
  2. Nonscheduled Drugs-everything else!; regulated by FDA ONLY
49
Q

PA Rx Pads MUST have?

A
  1. Printed/ stamped name and license # of PA
  2. Signature of PA
  3. NEEDS PA’s DEA # ONLY IF CONTROLLED SUBSTANCE ( COLLABORATING PHYSICIAN CAN SAY NO TO RX CONTROLLED SUBSTANCES)
    * ** Physician my limit drug orders to only oral, electronic, or written if they deem necessary (practice specific)
50
Q

Is collaborating physician information and signature required on PA prescription pad?

A
  1. NO!

2. Per PA Practice Act, physician printed name, address, and telephone number NO LONGER REQUIRED!!!

51
Q

Who’s the DEA?

A
  1. Drug Enforcement Agency
  2. Police for controlled substances.
  3. Determines the drug’s abuse potential and how it should be regulated.
  4. Providers, pharmacies, drug manufacturers must be registered with the DEA
52
Q

What are controlled substances?

A
  1. Substances accepted for medical use in U.S that have abuse potential and likelihood of causing dependence when abused
  2. “Scheduled drugs” - 5 categories (I-V)
  3. SCHEDULE II MUST BE WRITTEN ON A TAMPER-RESISTANT PRESCRIPTION FORM
  4. Schedules III-V, oral and fax orders permitted
53
Q

Can PAs prescribe controlled substances?

A
  1. Yes, if PA has taken an approved controlled substances course and it’s allowed on THE PRACTICE AGREEMENT.
  2. No, if a PA has not taken the course. Prior apporval is needed for all controlled substances.
54
Q

Schedule I examples?

A
  1. Heroin, LSD, Marijuana, Meth “Ecstasy”- high abuse potential
  2. CANNOT BE WRITTENT BY PAS!
55
Q

Schedule II examples?

A
  1. Narcotics: Hydromorphone (Dilaudid), Methadone, Oxycodone (Oxycontin), Fentanyl
  2. Non- Narcotics (stimulants): Amphetamin (Adderall), Methamphetamine, Methylphenidate (Ritalin)
  3. Has both high psychological and physical dependency
56
Q

Marijuana is scheduled ___ drug?

A

Schedule I

57
Q

Oxycodone (Oxycontin) is scheduled ___ drug?

A

Schedule II

58
Q

Hydromorphone (Dilaudid) is scheduled ___ drug?

A

Schedule II

59
Q

Methadone is scheduled ___ drug?

A

Schedule II

60
Q

Fentanyl is scheduled ___ drug?

A

Schedule II

61
Q

Amphetamin (Adderall) is scheduled ___ drug?

A

Schedule II

62
Q

Schedule III examples?

A
  1. Narcotics: <90 mg of codeine include Tylenol with codeine, Buprenorphine (Suboxone)
  2. Non-Narcotics: Benzphetamine (Didrex), Ketamine, Anabolic steroids
  3. Less potential for abuse than Sched I or II
  4. May lead to high psychological dependence
63
Q
  1. Tylenol with codeine is schedule ___drug?

2. Is it good for pain?

A
  1. Schedule III

2. Not great for pain

64
Q

Buprenorphine (Suboxone) is scheduled ___ drug?

A

Schedule III

65
Q

Benzphetamine (Didrex) is scheduled ___ drug?

A

Schedule III

66
Q

Anabolic steroids is scheduled ___ drug?

A

Schedule III

67
Q

Schedule IV examples?

A
  1. Alprazolam (Xanax), Carisoprodol (Soma), Clonazepam (Klonopin), Lorazepam (Ativan) and Midazolam (versed)
  2. low abuse potential compared to scheduled III
  3. All non-narcotics
68
Q

Alprazolam (Xanax) is scheduled ___ drug?

A

Schedule IV

69
Q

Schedule V examples?

A
  1. Cough medicines with <200 mg/100 mL of codeine Ex. Robitussin AC and Phenergan with Codeine
  2. Low abuse potential compared to schedule IV
  3. Preparations containing limited amounts of narcotics
70
Q

CA Prescription Drug Monitoring Program called?

A

CURES 2.0

71
Q

What is CURES 2.0?

A
  1. Controlled Substances Utilization and Evaluation Systems
  2. CA Prescription Drug Monitoring Program
  3. Provide patient’s activity report for providers
  4. Helps identify “doctor shopping”
  5. ONLY IN CA ( other states have similar programs)
72
Q

Practice agreement should state?

A
  1. Name of the PA that may furnish Rx orders
  2. Which drugs/devices may be furnished/ordered
  3. Under what circumstances
  4. The extent of Physician Supervision
  5. METHOD OF PERIODIC REVIEW OF THE PA’s COMPETENCE (Ex.6 months, yearly, etc.)
  6. Whether schedule II can be ordered and for which pt types ( Dx. condition, etc)
73
Q

What is California Pharmacy Law?

A
  1. Allows pharmacists to accept a drug order issued by a PA

2. Recognize PA as “prescribers”

74
Q

Do you need a DEA licence to be able to issue drug orders?

A
  1. NO

2. Only for controlled substances.

Behavior Science 1 (1 decks)

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