Physician assistants (Pas) addressed a broad range of issues ? including overcrowding in emergency departments, retail clinics, reparative therapy, retail-based clinics, deceptive health care advertising, and apologizing for adverse outcomes ? during the 35th annual conference of the American Academy of Physician Assistants (AAPA), meeting in Philadelphia through May 31.

PA delegates to the House of Delegates (HOD), the policy setting arm of the AAPA, adopted the following resolutions and policy papers.

? There were 110 million patient visits to U.S. emergency departments in 2004, up 18 percent from previous years. However, the number of emergency departments decreased by 12.4 percent during that same time period, resulting in increased patient waits time (boarding admitted patients) which ultimately impacts the ability of patients to receive lifesaving emergency care. AAPA supports regulatory oversight that requires the reporting of boarding information to the Centers for Medicare and Medicaid Services. This information also should be made public. The Academy will work with physician groups and others to create solutions to this national crisis.

? Retail or in-store clinics are the latest response to consumer demand for cost-effective, convenient health care. Growth of these in-store clinics are expected to rise substantially within the next few years, significantly impacting the delivery of patient care. Delegates reaffirmed existing AAPA policy on retail clinics reinforcing Physician-PA team involvement in patient care and calling for ongoing access to and supervision by physicians. AAPA endorses the establishment of referral systems for appropriate treatment if the patient?s condition is beyond the scope of services provided by the clinic and; calls for physicians within the community to be accessible to address continuity of care issues and to encourage patients to have a permanent medical home.

? The HOD voted to oppose attempts to ?cure? homosexuality and adopted the following resolution about reparative therapy: ?The American Academy of Physician Assistants opposes any psychiatric treatment directed specifically at changing sexual orientation, such as ?conversion? or ?reparative? therapy which is based upon the assumption that homosexuality per se is a mental disorder or based upon the a priori assumption that the patient should change his/her sexual orientation.?

? The relationship between a patient and provider is based on honesty and trust. Health care providers have an ethical responsibility to put patients? needs above their own and should not use deceptive practices or claims in any way. The HOD approved a policy paper that Government Affairs and Reimbursement examined the issue of false and deceptive advertising, including a review of reports about truth-in-advertising standards for pregnancy counseling centers. The paper states that ethical providers should make every effort to ensure that their patients are exposed to accurate information so they can make informed choices about treatment options.

? Stemming the causes of medical errors requires disclosure and analysis ? a transparency and openness of communication that are currently missing in health care today. AAPA believes that patients deserve complete and honest explanations of adverse outcomes and apologies for medical mistakes. AAPA also supports changes in laws that encourage PAs and other health care providers to apologize without incurring increased personal liability.

Past AAPA President Pam Scott announced that the Society for the Preservation of Physician Assistant History will formerly become the historical arm of the AAPA on July 1, and all administrative functions for the Society will be performed by AAPA staff.

Physician assistants are licensed health professionals who practice medicine as members of a team with their supervising physicians. PAs deliver a broad range of medical and surgical services to diverse populations in rural and urban settings. As part of their comprehensive responsibilities, PAs conduct physical exams, diagnose and treat illnesses, order and interpret tests, counsel on preventive health care, assist in surgery, and prescribe medications.

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