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NCCPA Launches CAQ Program for PAs in 5 Specialties

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   August 10, 2011

The National Commission on Certification of Physician Assistants (NCCPA) has launched a certificate of added qualifications (CAQ) program for certified physician assistants (PA) practicing in cardiovascular and thoracic surgery, emergency medicine, nephrology, orthopedic surgery, and psychiatry.

The nation could face a shortage of up to 150,000 physicians in the next 15 years, according to the Association of American Medical Colleges. One solution to help bridge this workforce shortage is to enable healthcare professionals such as nurse practitioners and PAs to work at their highest capability.

PAs are certified and licensed healthcare professionals who practice medicine as part of a healthcare team under the direction of a physician. This new CAQ program will help give physicians and executives hiring PAs added confidence in the PAs' knowledge and capabilities in these five specialty areas, thus improving their chances for employment.

"The CAQ recognition program was developed in response to PAs and physician groups that approached us from two different perspectives," said Janet J. Lathrop, MBA, president and CEO of the NCCPA. "One desire was to have some documentation to be able to show the hiring physician that they, as PAs, were in fact knowledgeable in certain specialty areas." The second desire was "to give the hiring physicians—this was especially true in emergency medicine—the assurance that these PAs had the experience in ED medicine to come and jump in at a level of acuity a little bit higher than the average person," she explains.

By earning a CAQ, PAs can build on their NCCPA generalist certification, which is a basic prerequisite for the voluntary CAQ program. The first CAQ exams will be administered in September. In order to complete the CAQ program, PAs must meet licensure, education, experience, and exam requirements.

The NCCPA is currently researching additional specialties that it could develop CAQ recognition for, says ­Lathrop, but the organization doesn't want to get ahead of itself.

"We just started advertising the program in January," she says, adding that the NCCPA already has a couple hundred PAs who have signed up for the program, which is right on target with its expectations.

"We look for products that show we are capable," said Carey Stratford, a PA practicing in Springfield, VT, who has been working in the ED for the past 30 years. "For someone like myself, who is established, it is unlikely to add upward mobility or salary, but demonstrates mastery. For less experienced PAs, however, it will have value to a lot who are in the first few years of their career and looking to transition to ED medicine."

Physician assurance

Physicians also are very supportive and seem to universally back this program, says Stratford, who is scheduled to take the first exam in September.

"It provides a standard. Physicians know that they can expect a certain degree of competency from this individual. They look at it as being something that is core to the practice of ED medicine," he says. "As you are looking for candidates, you have a standard that you can look for and it supports the profession. They have said it will give the PA who has gone through this a leg up."

Lathrop agrees. "We seem to be a society that really ­appreciates the need for backup in this litigious world."

A PA fresh out of school is trained in general medicine, but then he or she goes off and works with physicians, many of whom are specialists.

It makes sense that the PA over the years would become specialized and therefore would like to have some form of recognition above and beyond his or her generalist credential, says Lathrop.

And it is not just physicians who are looking for assurance. "If I am a hospital credentialer, the more documentation and assurances I have from a national organization that someone is knowledgeable and capable, the better I feel," says Lathrop.

In the world of medicine, many healthcare professionals can earn multiple credentials after their name. But PAs currently have (and will continue to have) only one generalist credential. "It was important to deliver something that would satisfy [PAs' and physicians'] needs while maintaining our generalist credential," says Lathrop. But offering additional CAQ documentation that shows PAs' expertise in a specialty is essential to help them further their careers in the industry, she explains. This is something that the PAs have clamored for.

"We are also hopeful that it will help some PAs move into different areas that they may not have been able to move into easily before, such as psychiatry and nephrology," says Lathrop. PAs have struggled to break into those fields of care because they lacked confirmation that they had the knowledge and skills to work in these specialties. The generalist credential wasn't sufficient, she says. PAs in those two specialties asked for our [the NCCPA's] help to provide documentation that would demonstrate their specialty skills.

"Our hope is that now these PAs will be able to provide this recognition and that they will be more employable and hired in these areas," Lathrop says.

Carrie Vaughan is a senior editor with HealthLeaders magazine. She can be reached at

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