Test Block 1 Flashcards
What are the origins to the assistant to Dr. concept?
- 1650: Feldshers (german millitary assistants)
- 1778: Loblolly boy (john wall) to assist medical officers
- 1803: Officiers de Sante in France to assist military and civillian medicine
- 1891: First army “medic” at Ft. Riley
1950: comminity health aids in alaska
What was significant to the maturation of the assistant concept in 1940?
Dr. Amos Johnson of NC employed and trained Henry “Buddy” Treadwell
In 1942, medical schools developed what?
fast track medical degrees (including emory where dr. eugene stead worked)
Significance to the maturation of assistant concept in 1957?
Dr. Stead now at Duke, works with Thelma Ingles (RN) to establish a masters for Nurse Clinicians - denied accreditation
1959 & 61
shortage of medically traned personel and need for mid-level provider (from Dr. Hudson)
Who trained firement to work in the cath lab at Duke in 1962?
Dr. Henry McIntosh
When did Dr. Stead decide that ex military would fit his 2 year program?
1964
When did Duke accept their first class?
1965 (all corpsmen)
Who were the 4 PA students in the first every class at duke?
Don Guffey (didn’t gradulate), Vic Germino, Dick Scheele and Ken Ferrell - were given certificates
Chlamers-Francis v Nelson
CA 1936; ruled for defense that administering anesthesia under direction of Dr was not practicing medicine w/o license
Magit v Board of Medical Examiners
CA 1961; ruled against Magit that Dr could not use an inlicensed person to deliver anesthesia
Shasta Co. v Whittaker
CA 1966; ruled against whittaker (medic in nam) as unlicensed person practicing medicine under Dr. George Stevenson
What case alerted physicians, medical boards and others that enabling legislation was needed?
Shasta Co v Whittaker
Who and when was the first enabling legislation passed?
CA; passed in 1970
NC relied on AG until writing an exception of PAs into medical practice act in what year?
1971
In 1977 what rule was passed in NC?
nurses could not accept orders from a PA – later corrected in same year
When were PAs enabled to be on medical board in NC?
1993
In 2000, what PA was elected President of NC Medical Board?
Wayne Von Seggen
When was the PA Practice act passed in OK?
1972
Where was the first surgeon’s assistant program and when was it established?
University of Alabama - 1967 (only one still exsists)
What was the first PA program to offer a degree instead of a certificate, and who established it?
Alderson-Broaddus College in WV - established by Dr. Hu Myers in 1968
When was the medex program established at the Universit of Washington?
1969 - by Dr. Richard Smith
Oklahoma Academy of PAs (first state wide chapter) was established by who and when?
incorporated in 1974 by Whittaker, click, olenberger, moore and demasters - held 1st CME in same year
active in statute, reimbursement, privleges, prescriing, liaise w/ other groups
What is the national organization for PAs
American Academy of PAs; founded in 1973; have to attend conference if member
Who are the OK presidents of AAPA?
Stanhope, Fox, Godkins, Gerbert
What associated give creditation to programs?
Accreditation Review Commission on Education for the PA (ARC-PA)
Organization that represents programs
PA Edcuation Association (PAEA)
NCCPA
National Commission on Certification of PAs; 1974
Who do you apply for liscensing through?
Oklahoma State Board of Medical Licensure and Supervision (OSBMLS); never want to be called in by them
What organization represents physicians and is not friendly with PAs?
Oklahoma Sate Medical Association
When was enabling legislation passed in OK?
1972 - year the 1st PA grads left OU; addition of Section 519 to Title 59; allowed for the certification of PAs and directed medical board to write rules
What was the first major rivision to the 1972 act?
1993; Dan Fox; allowed PAs to be “transmitters”; defined scope of practice; allowed ruraly practice w/o Dr on site
What were the subsequent revisions to the ‘72 act, led by Dr. McNeil?
‘97: certified –> liscenced
‘98: transmitters –> prescribers; prescribing shcedule III-V drugs
‘01: schedule II drugs for immediate admin; sign handicap permits; refer to PT; can’t employ Dr
When was the major rewrite of the ‘93 act?
2015
Malpractice is an unwarranted departure from acceptable medical practice resulting in . .
INJURY to a pt
What are some common causes of malpractice claims?
failure to diagnose; improper treatment; delayed diagnosis; improper surgery; drug injury; failure to f/u
Why do patients sue?
savvy patients; unrealistic expectations; suit happy public; pt or family anger; LoC; billing issues; provider attitude
What is the most important tool for risk managment?
communication = good bedside manner
What are other tools for good risk management? ;
f/u test results; provide info; arrange f/u; document; informed consent; don’t over optimize prognosis; avoid criticizing work of others; stay w/i scope; no telephone consultations; use every technique; ensure pt knows fees and services
Occurrence malpractice insurance
what we have as students and want when we start working; covers incidents during coverage period regardless of when they’re filed
Claims made insurance
initially cheaper; covers incidents that happen and are filed only during coverage period; need tail; avoid them
