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PA Profession > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

What were the early professions that resembled a PA?

A

Feldshers - Russian military

China’s Barefoot Doctors - used for rural healthcare needs

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2
Q

Who started the first PA program?

A

Dr. Eugene Stead

Duke University

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3
Q

What was MEDEX?

A

A program formed by Dr. Richard Smith that focused on deploying medical students to underserved areas

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4
Q

What was the first program to offer PA as a master’s program?

A

Child Health Associate PA Program directed by Dr. Henry Silver

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5
Q

When was the AAPA formed and who was the first president?

A

Formed in 1968

William Stanhope was first president

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6
Q

What were the three purposes of the AAPA?

A

Educate the public about the profession
Provide education for PAs
Encourage service to patients and the medical community

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7
Q

How many PA programs are located in Ohio?

A

13

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8
Q

When did Mount Union gain accreditation by the ARC-PA?

A

September 2008

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9
Q

What are the roles of a PA?

A

Elicit medical history
Order and interpret lab tests
Develop a therapeutic plan
Patient education

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10
Q

How many accredited PA programs are in the US?

A

226

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11
Q

What are the three hallmarks of PA professionalism?

A

Respect - Treating all how you would like to be treated
Compassion
Integrity - doing right thing when people are not around

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12
Q

What is intellectual honesty?

A

Don’t claim that you know things that you don’t

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13
Q

What are the Big Four PA national organizations?

A

American Academy of Physician Assistants (AAPA)
National Commission on Certification of Physician Assistants (NCCPA)
PA Education Association (PAEA)
Accreditation Review Commission on Education for the PA (ARC-PA)

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14
Q

Where is the AAPA headquartered?

A

Alexandria, VA

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15
Q

What is the function of the AAPA?

A

Provides support to PAs on Political Matters

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16
Q

What is the function of the NCCPA?

A

Provides national certification exams

Lone credentialing agency for PAs in the US

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17
Q

How often is the PANRE taken?

A

Every 6 years after graduation, transitioning to every 10 years

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18
Q

What is the Six-Year-Six-Attempts rule?

A

You get six attempts, at least three months apart, over six years to pass the PANCE

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19
Q

What are the requirements for maintaining certification?

A

Need 100 CME credits every 2 years

50 of 100 must be category 1

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20
Q

Who was the founding program director at Mount Union?

A

Sharon Luke

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21
Q

What is the function of the ARC-PA?

A

Protect the public by ensuring that PAs are not graduated unprepared

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22
Q

What are the six major areas of PA competencies?

A 
Medical knowledge
Interpersonal and communication skills
Patient care
Professionalism
Practice-based learning and improvement
Systems-based practice
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23
Q

What are the most basic requirements for state credentialing?

A

Graduation from an accredited PA program

Passage of PANCE

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24
Q

Who oversees the Ohio PA laws?

A

State Medical Board of Ohio

Ohio Association of PAs

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25
Q

When was the OAPA formed?

A

1978

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26
Q

What was the importance of the law passed in 2006 by the OAPA?

A

Scope of practice expanded
Prescriptive privilege
Overseeing physician can be 60 minutes away

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27
Q

What was the importance of the law passed in 2012 by the OAPA?

A

PAs can pronounce death

Add Schedule II drugs to PA formulary

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28
Q

What was the importance of the law passed in 2015 by the OAPA?

A

Elimination of the 60 minute rule

Three PAs can work under one supervising doc at once now

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29
Q

What is malpractice?

A

Alleged professional misconduct or lack of ordinary skill in performance of a professional act

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30
Q

What is the history of health insurance?

A

First started in 1850 by Franklin Health Assurance
1929 Baylor Hospital in Dallas began to cover costs of teachers hospitalization
Coverage numbers went up during WW2 because companies attracted employees by paying for health care

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31
Q

What is indemnity insurance?

A

Pays based on charges

Patients have almost unlimited choices of providers

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32
Q

Why are indemnity insurances plans typically called 80/20 plans?

A

The insurance company would cover 80% and patient would be expected to cover the remaining 20

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33
Q

What is basic indemnity coverage?

A

Covers hospital care and some physician services

34
Q

What is major medical indemnity coverage?

A

Covers inpatient and outpatient and often prescriptions

35
Q

What is comprehensive indemnity coverage?

A

Includes both basic and major medical

36
Q

What did the RAND health experiment show in 1984?

A

Free healthcare does not result in better health care

37
Q

What is managed care?

A

Health care systems responsible for both the financing and delivery of health services

38
Q

What percent of Americans are enrolled in plans with some form of managed care?

A

90%

39
Q

What does managed care mean for physician pricing?

A

Physicians are not able to set their own prices, however they are guaranteed a certain number of patients by the health maintenance organization
Physicians will want to focus on health education because they wont want to see patients as often

40
Q

Why did managed care begin to become more appealing than indemnity care?

A

Rising cost of healthcare fueled this

Patients were paying copay rather than 20%

41
Q

What is capitation?

A

Prepaid agreement to care for patients as often as needed

Physicians paid per member per month

42
Q

What are the different kinds of managed care?

A

Staff model
Group model
Network model

43
Q

What is the staff model of managed care?

A

HMO employs doc who serve beneficiaries

Strictly managed

44
Q

What is the group model of managed care?

A

HMO contracts with a multi-specialty physician group to provide all services to members

45
Q

What is the network model of managed care?

A

HMO contracts with more than one group of doctors

46
Q

Which type of insurance is less managed?

A

Preferred provider organization

47
Q

Who does medicare cover?

A

People over 65
Disabled
People with end stage renal disease
Federally funded

48
Q

What are the different parts of medicare?

A

A - hospital benefits
B - covers professional and outpatient services
C - managed care
D - prescription drug benefit

49
Q

Who is covered in Medicaid?

A

Covers low income
Largest groups are women and children
Monitored at state level

50
Q

What are DRGs?

A

Diagnosis related groups

Hospitalization and pay is based on diagnosis

51
Q

What part of medicare do services provided by PAs fall under?

A

Part B

52
Q

What are the conditions of incident to that PAs fall under for health insurance?

A

Physician treats all new medicare patients
Physician is physically on site when PA provides care
Established patient with new medical problems are treated by the physician

53
Q

What did the BBA 1997 state?

A

PAs could charge 85% of the physician fee for seeing the patient

54
Q

What is an NPI?

A

National provider indentifier

Required for all PAs who treat medicare patients

55
Q

What is the name of the form used to bill medicare for services?

A

1500

56
Q

What are donut hole drugs?

A

Meds not covered in Medicare part B

57
Q

What are the primary factors for E&M coding?

A

History
Physical examination
Medical decision making

58
Q

What are the categories of E&M codes?

A 
Outpatient
Inpatient
Consulation
Emergency Department
Nursing home
Rest home
Home visits
59
Q

What are the four descriptors used to indicate the extent of evaluation done?

A

Problem focused
Expanded problem focused
Detailed
Comprehensive

60
Q

What does problem focused consist of?

A

Chief complain

Brief history of present illness

61
Q

What does expanded problem focused consist of?

A

Chief complaint
Brief history of present illness
Problem pertinent system review

62
Q

What does detailed evaluation consist of?

A

CC
HPI
Extended ROS
Pertinent PMH, FH, or SH

63
Q

What does comprehensive evaluation consist of?

A

CC
HPI
Complete ROS, PMH,FH, and SH

64
Q

What are the different descriptors of medical decision making?

A

Straight-forward
Low
Moderate
High

65
Q

What is the requirement for a patient to be considered “new”?

A

Not seen in three years

66
Q

What are the elements of medical decision making?

A

Diagnosis and treatment options
Data reviewed
Risk

67
Q

What is quality improvement?

A

Analysis of performance and systematic effort to improve it

68
Q

What is the history of quality improvement?

A

Based on theories of Deming and Juran
Used in 1980s by Japanese auto industry
Used in 1990s by American manufacturers and health care industry

69
Q

Why is Qi so important?

A

More people die a year from medical errors than MVAs, breast cancer or AIDs

70
Q

What are the problems in health care quality?

A

Overuse

Underuse mistakes

71
Q

What is the FADE QI model?

A

Focus
Analyze
Develop
Execute

72
Q

What are proxy measures?

A

Can’t measure something specifically so you measure something similar

73
Q

What is the difference between process and outcome?

A

Outcome - does it make a difference

Process - how the system works

74
Q

What is the PDSA model?

A

Plan
Do
Study
Act

75
Q

What is the difference between QI and research?

A

QI is confidential and focuses on improving care

Research is published and presented and tests new methods to create general knowledge

76
Q

What is the difference between QI and performance improvement?

A

QI - focuses on quality of care

Performance improvement focuses on administrative systems

77
Q

Why would a consultation be done?

A

Providers need expert opinion
Managed care limits scope of practice
Patients cannot make self referrals
Patients need referral chains

78
Q

What is the most common referral?

A

Radiology

79
Q

What are the challenges of healthcare in rural areas?

A 
Accessibility
Availability
Health disparities
Lack of health insurance
High poverty rates
80
Q

What is the definition of rural health care?

A

Areas of open country with populations less than 2500

81
Q

What are the challenges of inner city practice?

A

Language barriers
Homelessness
Increase in communicable diseases
Facilities provide for city and nearby suburbs
Varying beliefs surrounding health and illness

82
Q

What is the LEARN model?

A

Listen to patients perception of problem
Explain your perceptions and treatment strategy
Acknowledge and discuss differences in perceptions
Recommend treatment with respect to patient’s cultural perceptions
Negotiate agreement

PA Profession (2 decks)

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