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Wisconsin: A Key Player in the 2018 AAPA House of Delegates

Tuesday, June 12, 2018   (0 Comments)
Posted by: Julie Doyle
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Wisconsin:  A Key Player in the 2018 AAPA House of Delegates

by Julie Doyle, MPAS, PA-C, DFAAPA

It was another groundbreaking year at the AAPA House of Delegates (HOD) which met during the AAPA annual conference in New Orleans May 18-23, 2018! Several resolutions were acted upon that will continue the forward momentum of our profession. And this year, the Wisconsin delegation took a much more active role in seeking positive change for PAs in our state and nationwide.

The Wisconsin group consisted of six delegates and one alternate that were voted upon the previous year.  There was strong statewide representation with Tom Nigbor and Paula Havisto from the northern region, Kim Shefchik from the eastern region, Jeff Oryall from the southwest region, Eric Elliot and myself from the southeast region.  Anton Bruenig represented the students. 

Wisconsin participation in the HOD is important and necessary. The HOD has the sole authority on behalf of AAPA to enact policies establishing the collective values, philosophies and principles of the PA profession. Representatives from 57 constituent chapters, 26 specialty organizations, eight caucuses and the student academy act as the collective voice of the PA profession. Delegates are apportioned according to the number of AAPA members within a state.

"It is crucial for PAs practicing in Wisconsin to understand that the strength of our association membership determines the number of delegates we are assigned. In order for Wisconsin to have a voice in shaping the future of our profession, it is incumbent upon all Wisconsin PAs to join and support both WAPA and AAPA,” WAPA President, Eric Elliot, said.

The Wisconsin delegation helps move the profession forward

Along with Ohio, Wisconsin co-authored resolution B-14 which requests that the AAPA Board of Directors contract with an independent marketing and PR firm to investigate the creation of a new profession title for physician assistants that accurately reflects utilization and practice. Why would Wisconsin sponsor this resolution? The answer is simple. Wisconsin PAs want a title that more accurately describes what we do. WAPA surveyed membership and the response was overwhelming: Wisconsin PAs do not believe that our current title correctly depicts our role in health care. The delegation listened and brought forth this resolution which passed by a significant margin. “I was completely amazed at the universal support at AAPA for title change, including the AAPA Board Members,” chief delegate Tom Nigbor said.

Title change has been a topic that has been discussed in the HOD many times. There has never been a consensus on what that title should be or if we even need a new title. This year’s resolution is unique in that it will answer both questions.

“Collectively it seemed we all wanted to have a valid research study from an outside marketing firm which investigates the creation of a new title,” delegate Paula Havisto said.

The results of the study will be reported to the 2019 HOD.

Title Change and OTP in Wisconsin

HOD passed OTP (Optimal Team Practice) in 2017, a policy which calls for laws and regulations that remove PA practice barriers. The policy affirms a PAs commitment to team practice but also permits PAs to practice without ties to a specific physician, to regulate our own profession, and to be directly reimbursed by all public and private insurers. WAPA is moving forward with bringing OTP to Wisconsin. In the past year, the WAPA Advocacy team has been meeting with state administrators and legislators.  During those conversations, it quickly became apparent that our current moniker is a hindrance. The term “assistant” does not connote autonomous medical decision making and seems contradictory to the tenets of OTP. 

WAPA leadership feels that the policy of OTP needs to remain strong and intact.

However, resolution B-15 (introduced by Texas, Rhode Island and Virginia) would amend the policy HP-3500.3.4 entitled “Guidelines for State Regulation of PAs.” The authors of B-15 felt that the amendment would more clearly emphasize that OTP was not a stepping stone to independent practice. Wisconsin delegates did not agree with the changes in language. Elliot testified against this resolution due to concerns that it would “harm OTP and derail many of the much needed reforms that Wisconsin PAs are pursuing.” Two-thirds of the House agreed that changes to OTP could jeopardize the success of legislative efforts. The resolution was rejected and OTP was reaffirmed in the 2018 House of Delegates.

The Delegate Experience

Several of the delegates, including myself, were new. I was driven to participate after watching OTP pass in the 2017 HOD. That moment gave me great hope for the profession. It became clear to me that the AAPA understands that PAs are struggling in a changing health care marketplace and the organization is doing something about it. I realized that I needed to be part of the move to maintain the viability of our profession. Nigbor had a similar belief, applying to HOD to help make Wisconsin a better place for PAs to work.

“I have great concern for PAs becoming less competitive in the market,” Nigbor explained, noting that there is preferential hiring of nurse practitioners due to more the restrictive regulation of the PAs. 

In contrast, two of the delegates, Shefchik and Oryall, had many years of experience in the HOD. Shefchik noted that she enjoyed the opportunity to be a part of the decisions that affect our profession. “It’s interesting that the same topics come up time and again, but this year the resolution to explore title changed was moved forward.  I am proud to be part of the delegation that co-sponsored this resolution.” 

Oryall agreed, saying, "Attending the HOD allows me to listen and gain perspective regarding PA profession practice issues. It is an honor to represent Wisconsin PAs at a national level.” 

Representing the students, Breunig felt humbled to be allowed to serve as a delegate alongside experienced PAs. He sees this as a reflection of the progressive thinking of our profession to allow students a voice in determining not only the path of PA education, but also the profession as a whole.

Regardless of new, experienced, or student, all the Wisconsin delegates are proud to have served as a representative voice for our membership.  President-elect Streit reflects that many decisions made at HOD have not been supported by the majority of practicing PAs. “I am very proud that WAPA is leading the nation in surveying members on important issues and taking the voice of Wisconsin PAs to the HOD.” 


To see a summary of resolutions and actions, click here:

To learn more about how the AAPA House of Delegates works, click here:

To learn more about WAPA legislative efforts, click here:

To support WAPA legislative efforts, click here: 

To contact a Wisconsin delegate or WAPA leadership, email