2. Workforce planning and policy. This requires better data collection and an improved information infrastructure. In a 2014 editorial, Rod Hooker suggested that this is the golden age for PAs (about whom he was writing, although the same holds true for NPs) because US health care reform has identified our contributions to society and new policies place us upfront and center stage in producing labor solutions.9
It is time for our professions to do a better job in studying and reporting the important contributions we make in health care delivery. We need to have a place at the table—be it within a facility or at the state or federal level—whenever policy, utilization, and roles are discussed. Even if we as employees are subordinate to management in a particular setting, we should have a voice in how we are utilized in the workplace; we should ensure that those who make decisions—if we are not them—have the fullest picture of who we are and what we can do. It is not enough to use anecdotal evidence; we need to have data readily at hand that unequivocally support our assertions of value to patient care.
Hooker went so far as to call for the creation of a “physician assistant institute” to assist in the development and dissemination of reliable information about the profession. I think this is an idea whose time has come, but who will step up to the plate? If you are an NP, you may say, “What about us?” I would suggest this issue pertains to both of our professions—and in fact, this is an area in which I would encourage a collaborative effort. What a concept!
3. Ethics. In the past decade, there has been a renewed focus on maintaining an ethical culture in health care. As clinicians, we practice in an environment that affects the lives of everyone. Our patients and their family members expect high-quality care, patient safety, and use of the latest and most appropriate technology.
In the middle of this climate, we find a health care system that is probably the most entrepreneurial, corporatized, and profit-driven health system in the world. Most of our practice settings (outside the federal government) are for-profit entities. It is easy in this environment to fall victim to conflicts of interest and to acquire an economically oriented practice attitude.
If our first priority is the best possible health care for our patients, then integrity and ethical behavior naturally follow. Professionalism at its very heart places the patient’s interests ahead of our own. We must keep this in mind as we navigate the ever-changing health system.
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