July/August 2008

Transcription

July/August 2008

News
Official Publication of the California Academy of Physician Assistants
July/August 2008
If You Are a California PA
and You Haven’t – You Simply Must!
First Two Dates And Locations For The
Highly Anticipated
T
he peer pressure is on and the opportunity is here. Hundreds of
California PAs have already submitted 50-words or less for the
Honoring A Community of PAs Project. It’s quick and easy and really
a wonderful opportunity to feel good and make others feel good too.
Don’t miss this opportunity to share your gratitude. Whether in a big or
a small way, your life has probably been touched by a PA or two. Let us
know who you would like included in the Honoring A Community of PAs
wall display at the CAPA Conference. We will also print the submissions
(in smaller scale, of course) in the November/December issue of the
CAPA News.
Whether or not you are attending the CAPA Conference (and we hope
you are) you can still send in your submission and tell us about a PA
who has touched your life. Hundreds of PAs will be on hand in Palm
Springs to stroll along the giant PA Community displays, reading the
heartfelt sentiments. They do make you feel good. Some are simply
letting a PA know that they were there when it mattered. Some are
funny; some may bring a tear to your eye. Chances are we have one
with your name on it. Classmates remember each other’s support; PA
preceptors are honored for their patience and encouragement; colleagues
offer words of admiration for the example of exceptional patient care;
physicians, nurses and administrators take this opportunity to honor the
PA who makes their world a bit better.
You are an important part of the PA Community. Don’t be left out.
Honor a PA or two who has touched your life. We are looking for
hundreds more submissions. Send us yours today. It really takes less than
5 minutes. You may email them to [email protected] or fax them to
(800) 480-2272. We’ll even take it over the phone if you wish. 
Controlled Substances
Education Course
A Course Which Upon
Successful Completion
Will Allow You To Write For
Controlled Substances Without
Patient Specific Approval*
Wednesday, October 1, 2008
Wyndham Palm Springs
888 E Tahquitz Canyon Way
Palm Springs, CA 92262
(760) 322-6000
Sunday, October 12, 2008
Courtyard San Diego
Airport/Liberty Station
2592 Laning Road
San Diego, CA 92106
(619) 221-1900
See page 22 for
registration form
*California Code of Regulations Sections: 1399.541(h), 1399.610
and 1399.612. A PA may administer, provide, or issue a drug
order for Schedule II through V controlled substances without
patient specific approval if the PA completes specified educational
requirements and if his/her Supervising Physician delegates the
authority to them.
News
Editor
Gaye Breyman, CAE
Managing Editor
Jennifer Deane
Editorial Board
Miguel Medina, PA-C
Beth Grivett, PA-C
Bob Miller, PA-C
Larry Rosen, PA-C
Michael Scarano, Jr., Esq.
Proofreaders
Bonnie Dvorak, PA-C
Paula Meyer, PA-C
Nancy Nielsen-Brown, PA-C
CAPA Board Of Directors
President
Miguel Medina, PA-C
[email protected]
Immediate Past President
Tom Gaughan, PA
[email protected]
Vice President
Larry Rosen, PA-C
[email protected]
Secretary
Cherri Penne-Myers, PA-C, MSCS
[email protected]
Treasurer
Bob Miller, PA-C
[email protected]
Directors-At-Large
David Carter, PA-C
[email protected]
Eric Glassman, PA-C
[email protected]
Nancy Nielsen-Brown, PA-C
[email protected]
Kristen Woods, MPA, PA-C
[email protected]
Student Representative
Matthew Keane, PA-S
[email protected]
The CAPA News is the official publication of the
California Academy of Physician Assistants. This
publication is devoted to informing physician
assistants to enable them to better serve the public
health and welfare. The publisher assumes no
responsibility for unsolicited material. Letters to
the editor are encouraged; the publisher reserves
the right to publish, in whole or in part, all
letters received. Byline articles express the opinion
of the author and do not necessarily reflect the
views or policies of the California Academy of
Physician Assistants.
The CAPA office is located at:
3100 W. Warner Ave., Suite 3
Santa Ana, CA 92704-5331
Office: (714) 427-0321
Fax: (714) 427-0324
Email: [email protected]
Internet: www.capanet.org
©2008 California Academy of Physician Assistants
CAPA NEWS
“Under the Dome”
By Bryce W.A. Docherty, CAPA Legislative Advocate
“Here they come down the stretch …”
T
he Legislature is scheduled to adjourn at Midnight on Sunday, August 31st
but Democratic leaders have tentatively pushed that date up to Friday, August
22nd. The goal for moving up the adjournment date is to hopefully be present
and usher in U.S. Senator Barack Obama as their presumptive presidential
nominee at their national convention in Denver starting on Monday, August 25th.
The Republicans are less concerned about ending session early as their national
convention begins in Minneapolis on Monday, September 1st. Regardless, these are
in the waning days of session.
CAPA has had quite another legislative year as fellow physician assistant, Karen
Bass, has been elected Speaker of the California State Assembly. This position is
arguably the second most powerful position in California aside from Governor
Schwarzenegger.
Legislation that has already been signed by Governor Schwarzenegger includes
Physician Assistant Committee (PAC) sponsored AB 2482, authored by
Assemblymember Bill Maze (R-Visalia), which authorizes the Physician Assistant
Committee (PAC) to require a physician assistant to complete continuing
education as a condition of license renewal. This bill would prohibit the PAC from
requiring more than 50 hours of continuing education every 2 years and would
require the PAC to, as it deems appropriate, accept certification by a specified
commission or another qualified certifying body as evidence of compliance with
continuing education requirements.
Awaiting the Governor’s signature is AB 16, authored by Assemblymember Noreen
Evans (D-Santa Rosa), which requires health plans and insurers to provide clinically
appropriate medical care for women by covering an annual cervical cancer screening test
referred by a licensed health care practitioner (i.e., physician assistant). Furthermore,
this bill would require coverage for an immunization against the human papillomavirus
in accordance with recommendations of the Advisory Committee on Immunization
Practices to the Centers for Disease Control and Prevention.
CAPA has also played defense this year on many legislative measures and has secured
several amendments that protect the integrity of the physician assistant profession. Most
notably this year was AB 2398, authored by Assemblymember Alan Nakanishi (RLodi), which now simply increases the penalties for physicians and surgeons who violate
the corporate practice of medicine prohibition. CAPA requested amendments were
taken to delete all the on-site physician supervision requirements of physician
assistants performing cosmetic medical procedures or treatments. Therefore,
now the bill only focuses on fines and penalties for violating the corporate practice of
medicine by physicians and surgeons and MedSpas.
Still to come this year is an end to the $15.2 billion budget deficit stalemate. CAPA
remains engaged in these discussions to ensure that Medi-Cal rates are preserved and
that access to appropriate physician assistant medical care is maintained. Lastly, CAPA
continues to closely monitor the November General Election where nearly one-third of
the Assembly and Senate will change hands.
“If you miss a day ‘Under the Dome’– you miss a lot!” 
AB 2482 – The CME Bill Chaptered Into Law
by Bob Miller, PA-C, Professional Practice Committee Chair
A
B 2482 (Maze) authorizes the
Physician Assistant Committee
(PAC) to require a licensee
to complete a minimum of 50
hours of continuing education as a
condition of license renewal. This
was co-authored with Assembly
Speaker Karen Bass and was recently
Chaptered into law on
July 8, 2008 following
an unopposed trip
through the California
Legislature.
JANUARY 1, 2009
CME REQUIRED
Until this legislation,
there was no
requirement for
PAs in California to
document CME in
Section 3524.5
order to maintain
their PA license.
Although existing law requires
initial certification by the NCCPA
to obtain a PA license in California,
the NCCPA recertification, which
includes required CME, does not
need to be maintained to keep the
PA license. Only a handful of states
do not require some amount of
continuing education to maintain
a license. A large number of states
choose to recognize the NCCPA
certification as evidence of adequate
CME. And as you are aware, there
is a strong incentive (not having to
retake the PANCE) to keep your
certification current and most PAs
in California do. Only about 1520% of licensed California PAs do
not have their “-C.” This concept
is reflected in this bill which credits
current certification as evidence of
appropriate CME.
The two major components of this
bill as presented in the Legislative
Counsel’s Digest are:
1) The bill authorizes the
Committee to require PAs to
complete up to 50 continuing
education hours every two years
as a condition for license renewal.
2) The bill authorizes the
Committee to accept certification
by the NCCPA or another
qualified certifying body,
as evidence of compliance
with continuing education
requirements.
Arguments exist regarding the
predictive value and the validity of
mandatory CME as a measure of
performance in many professions.
However, the PAC feels strongly that
this legislation reflects the importance
of maintaining professionalism
and public protection. A licensee
should keep abreast of current
medical practices and community
care standards. Given that the
great majority of practicing PAs in
California do maintain ongoing
CME, this law will now hold the rest
to the same standard.
The actual language of the bill is as
follows:
THE PEOPLE OF THE STATE OF
CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 3524.5 is added
to the Business and Professions
Code, to read:
3524.5. The committee may require
a licensee to complete continuing
education as a condition of license
renewal under Section 3523 or 3524.
The committee shall not require
more than 50 hours of continuing
education every two years. The
committee shall, as it deems
appropriate, accept certification
by the National Commission on
Certification of Physician Assistants
(NCCPA), or another qualified
certifying body, as determined by the
committee, as evidence of compliance
with continuing education
requirements. 
Inside This Issue
“Under the Dome”................................................................2
AB 2482 – The CME Bill Chaptered Into Law..........................3
AB 3 and Medi-Cal: An Update..............................................4
Members to Mentors – Are You Interested?...........................6
CAPA Past President, Jim Delaney, PA-C Elected
Second Vice Speaker of the AAPA House of Delegates.............6
Join the Physician Assistant Committee Subscriber List............6
A New Leadership Year Begins...............................................7
CAPA at Napa.......................................................................7
The Remarkable Children of China
An Investment in Healing......................................................8
Honoring A Family of PAs!..................................................12
Honoring Jeremy Elkins,
Jeremy Elkins, PA-C – Found A Home Serving The Homeless......14
PAs Come Together.............................................................17
Controlled Substances Education Course...............................17
CAPA’s 32nd Annual Conference –
Honoring Our PA Community..............................................18
Featured PA Vendor at the PA MarketPlace..........................20
I’m PACing and Heading to the CAPA Conference.................21
Controlled Substances Education Course Registration Form....22
Optional Workshop Registration Form..................................22
2008 CAPA Conference Registration Form............................23
Running Along and Finding Friends.....................................24
Midlevel Practitioners?........................................................25
Greetings from the Heartland
Or, What We Did This Summer.............................................26
Success! 2nd Annual Legal Rights & Responsibilities for the
California PA Student Seminar 2008....................................27
“Surviving Clinical Rotations” Workshop..............................28
Welcome New Members......................................................31
Local Groups......................................................................31
In Memoriam.....................................................................31
JULY/AUGUST 2008
AB 3 and Medi-Cal: An Update
by Bob Miller, PA-C, Professional Practice Committee Chair
A
s you are aware, Assembly Bill 3
(Bass) mandated significant
changes for physician assistants
who provide medical services for
Medi-Cal beneficiaries. The two
major changes are:
1) The services that may be
billed when provided by a PA are
expanded considerably to include
those services, performed within the
PA’s scope-of-practice, which are
normally covered by Medi-Cal when
provided by a physician.
2) AB 3 also reduced the MediCal requirements for patient
chart review (it was 100%) and
cosignature (it was within 7 days)
by the supervising physician to
conform to, and be no more
restrictive than, current state laws
and regulations for PAs. This means
that the requirements for review and
cosignature may be a minimum of
5% within 30 days when working
with protocols or a more frequent
occurrence as determined by the
physician-PA team. Remember that
all Schedule II medications still
require a cosignature within 7 days.
Changes in legislation always take
some time before they are reflected in
regulation and/or policy. Regulations
are implemented to conform to new
laws but often require a sometimes
lengthy process to get there with
known, and unknown, barriers to
impeding the progress. AB 3 went
into effect on January 1, 2008. As
of this writing, we have not been
made aware of any steps taken by
the Department of Health Care
Services (DHCS) to comply with
the new legislation. We would like
to eliminate the potential confusion
regarding the content of the MediCal Provider Medical Services
Manual which has not been changed
to reflect the language of AB 3.
We have asked attorney Mike
Scarano, Jr., Esq., CAPA’s general
counsel, to communicate with
DHCS to inquire about action taken
thus far regarding AB 3. You will see
that the letter below was copied to
The Honorable Karen Bass, Speaker
of the Assembly and author of this
bill. We hope that Assembly Speaker
Bass will encourage the DHCS to
recognize the importance of this
new law and implement the changes
that went into effect more than 6
months ago.
ATTORNEYS AT LAW
June 5, 2008
11250 El Camino Real, Suite 200
San Diego, CA 92130
P.O. Box 80278
San Diego, CA 92138-0278
858.847.6700 TEL
858.792.6773 FAX
foley.com
CLIENT/MATTER NUMBER
999999-9999
Stan Rosenstein
Chief Deputy Director
Department of Health Care Services
Medical Care Services
MS 4000, P.O. Box 997413
Sacramento, CA 95899-7413
RE: Assembly Bill 3 ( Bass)
Dear Mr. Rosenstein:
We represent the California Academy of Physician Assistants, which has asked us to contact you
regarding the need for the Department of Health Care Services (“DHCS”) to make certain changes in the Medi-Cal
Provider Medical Services Manual and in Sections 51305 and 51476 of Title 22 in order to comply with Assembly
Bill 3, enacted as Chapter 376 in the 2007-2008 legislative session. That legislation, entitled the California Physician
Team Practice Improvement Act, was authored by Assemblywoman Bass and became effective January 1. It makes a
number of important changes in the law to enhance the ability of physician assistants and their supervising physicians
to provide care to medically underserved populations. Some of those changes require action by DHCS.
CAPA NEWS
First, Section 4 of the Bill (amending Business and Professions Code Section 3516(b)) increases the
number of PAs that a supervising physician can supervise at the same time in all settings from two to four. This requires
a change on page NON_PH 3 of the Provider Medical Services Manual, which currently states, “[a] single primary care
physician is limited to supervising two PAs.”
as follows:
Second, Section 7 of the Bill adds Section 14132.966 to the Welfare and Institutions Code, which reads
(a) Services provided by a physician assistant are a covered benefit under this chapter to
the extent authorized by federal law and subject to utilization controls.
(b) Subject to subdivision (a), all services performed by a physician
assistant within his or her scope of practice that would be a covered benefit
if performed by a physician and surgeon shall be a covered benefit under
this chapter.
(c) The department shall not impose chart review, countersignature, or other
conditions of coverage or payment on a physician and surgeon supervising
physician assistants that are more stringent than requirements imposed by
Chapter 7.7 (commencing with Section 3500) of Division 2 of the Business
and Professions Code or regulations of the Medical Board of California
promulgated under that chapter.
Parts (a) and (b) of this section were enacted to require DHCS to eliminate the outdated
limitations found on page NON-PH 5 of the Medi-Cal Provider Medical Services Manual, which sets forth a highly
restrictive set of primary care procedures that Medi-Cal covers for PAs. AB 3 recognizes that Medi-Cal should cover
the full range of services PAs are authorized to perform under state and federal law. Once implemented, this will bring
Medi-Cal payment policies in line with those of Medicare and private payors, which reimburse PAs for the full range of
services they are legally authorized to perform. We are therefore requesting that this section of the Manual be revised to
comply with AB 3.
Part (c) of new Section 14132.966 of the Welfare and Institutions Code was enacted to require
DHCS to eliminate Sections 51305(k)(1) and 51476(a)(7) of Title 22, which impose chart review and physician
countersignature requirements on PAs that go far beyond what is required by the Physician Assistant Practice Act or
the regulations promulgated by the Medical Board thereunder. Section 51305(k)(1) of Title 22 currently states that
“[s]ervices and entries in the patient’s health record by non-physician medical practitioners shall be reviewed by the
primary care physician within seven calendar days of the date of service.” Section 51476(a)(7) provides that “[r]ecords
of each service rendered by nonphysician medical practitioners . . . shall include the signature of the nonphysician
medical practitioner and the countersignature of the supervising physician.” In contrast, the PA Practice Act, as
amended by AB 3, simply requires that the supervising physician countersign 5% of a PA’s charts when the PA functions
pursuant to protocols approved by the physician. We are therefore requesting that these conflicting regulations be
deleted.
Please let me know if you have any questions or would like to discuss the foregoing.
Very truly yours,
R. Michael Scarano, Jr.
cc:
California Academy of Physician Assistants
The Honorable Karen Bass, Speaker of the Assembly
Continue to watch for further updates in the CAPA News and on the website at www.capanet.org. 
JULY/AUGUST 2008
Members to Mentors – Are You Interested?
by Nancy Nielsen-Brown, PA-C, Director-At-Large
J
uly 1 began a new year for the CAPA Board of
Directors and in that frame of mind I considered what
project could both make use of my “talents” and most
benefit our profession as a whole. A long term goal has
been to develop greater links among PAs.
This includes those seeking to enter the
profession as well. In the last issue of the
CAPA News, I wrote encouraging members
to become a PA Shadow. CAPA gets many
phone calls requesting a name of someone
willing to allow a shadow. (Shadow?
What’s a Shadow? – For those unfamiliar
with the term, a Shadow is someone who
follows another through a period of time in order
to understand their work or environment. It is
most often an applicant to PA schools) Currently
CAPA has four (yes, 4) names of members willing to be
shadows and there is no one in northern California at
all. The PA Program where I work interviewed over four
hundred applicants. Can you imagine how inundated
those brave and willing four CAPA members could be?
So, would you be willing to be a PA Shadow? It can be
whatever you are willing to give. The shadow doesn’t
need to go into the examination room with you, or take
up much time in the over-crowded day. Can you meet
with them for a brief discussion – sort of semi-shadow?
Can you be available to talk about the day-to-day realities
CAPA Past President, Jim Delaney, PA-C
Elected Second Vice Speaker of the AAPA House of Delegates
Congratulations, Jim. We are very proud of you!
CAPA NEWS
Other areas of mentoring are high on my developing
project list. So maybe you can’t be a Shadow. How about
becoming a mentor to a new grad? There is a real need
for mentors in specialty areas. They’re coming out now,
seeking role models, not preceptors. As a new grad I was
told by a mentor that I would learn more in my first
year out than in the entire program. Thank you, Janice
Tramel, you were right! How scary it was to suddenly be
the one who is supposed to know. I was very fortunate
to have some mentors. As the CAPA Conference project,
Community of PAs, clearly demonstrates, we all had
someone to help us along. Can you consider mentoring a
new grad?
I will be seeking members to be mentors. Be a link in the
chain of our profession. Contact CAPA, or me through
the CAPA office. As the old poster goes, “CAPA” wants
YOU! Our profession wants YOU! I want YOU to be a
mentor. I’ll be available at the CAPA Conference, tell me
how to find you. 
Join the Physician Assistant Committee
Subscriber List
D
uring AAPA’s recent 36th Annual
PA Conference in San Antonio, the
American Academy of Physician
Assistants House of Delegates (HOD)
elected James E. Delaney, PA-C, from
Fontana, as its second vice speaker. As
second vice speaker of the AAPA HOD,
James E. Delaney, PA-C
Jim is one of three elected leaders
and serves on the Academy’s Board of
Directors (BOD). He has previously served as director at
large on the AAPA BOD, and has served as a Reference
Committee chair for the AAPA House of Delegates and as a
member of the AAPA Quality Care Committee.
of PA practice? Or answer some of their questions for
half an hour, or offer an interview for the local college
newspaper? We need you. The PA profession needs you.
We can give suggestions about small, valuable bits of
mentoring you may not have considered. Contact CAPA
and talk to the staff or contact me about whatever bit
you feel comfortable doing with those seeking to join our
profession. Be a mentor, a shadow and touch the future.
T
he Physician Assistant Committee (PAC)
uses this subscriber list service to notify
anyone who is interested in receiving e-mail
alerts about major updates to the PAC’s
website, such as:
•
•
•
•
•
General Information
Committee Meeting Agenda Notices and Minutes
Regulation Updates
Legislation Updates
Newsletters
If you would like to subscribe to receive e-mail alerts from the
PAC, please visit http://www.pac.ca.gov/forms_pubs/online_
services/subscribe.html. There is no charge for this service.
A New Leadership Year Begins
by Miguel Medina, PA-C, President
O
n July 1, 2008 your newly elected Board of
Directors took office. That is also the day that
several Committee Chairs either began or were
reappointed to their Chair positions. This is an
energetic and dedicated group. I am honored to serve
as President for the next two years.
I graduated from the USC PA program in October
1977. I have had a wonderful career; my first job out
of school was in occupational medicine for 7 months.
I then moved on to family medicine for about 14
years. For the past 17 years, I have been an educator at
the Western University of Health Sciences Physician
Assistant Program. I have had the honor to train over
2,000 PAs during my time at Western.
I have had the unique opportunity to see our young
profession mature. Compared to other health care
professions, you could say that PAs are now toddlers.
We have made it past infancy, not without our bumps
and bruises. I look forward with pride to see our
continued growth. We would not be here if it were not
for our early leaders that had to foresight and courage
to plot our course. Many of our founding leaders
are now preparing for retirement and we need new
leadership. Please step forward and help us to set the
course for the future of our California PAs.
Our profession continues to grow and the future looks
bright. However, we must not be complacent. We must
be active participants
in molding our future.
The first way to get
involved is to make sure
you are a competent
provider and provide
the best possible care
to your patients. Keep
up with the current
medical information.
Be proud of being a
PA and make sure the
patient knows that a
PA provided their excellent care. You have an awesome
responsibility because in our young profession
any mistakes you make reflect on all of the PAs in
the State and across the nation. The next step in
your involvement is to continue to support CAPA
financially by continuing your CAPA membership as
long as you live in California and work as a PA. In
addition, we hope you will contribute to the CAPA
Political Action Committee. Please join us in our
Annual Conference in Palm Springs and also at the
CAPA at Napa conference. If you want to contribute
more of your time, come to one of our board meetings,
join one of our committees, and/or run for office. I
look forward to having open dialogue with the PAs in
California. Please e-mail me at [email protected],
say hi at our conferences and please let me know how
we at CAPA can be of service to you. 
2008 - 2009 CAPA
Board of Directors
Join us in Napa. We have developed an excellent education program
set in the beautiful, lush green Napa Valley and offer it to you at a very
reasonable price. CAPA is coming to Napa and you won’t want to miss it.
Saturday, February 21, 2009 – 9:15 a.m. to 4:30 p.m.
Napa Valley Mariott
3425 Solano Avenue
Napa, CA 94558
For additional information contact CAPA at: (714) 427-0321 or fax at: (714) 427-0324
Sponsored by the California Academy of Physician Assistants
Tentatively scheduled to coincide with the Napa Conference: Controlled Substances Education Course.
The Course will be held on Friday or Sunday. Date to be determined.
JULY/AUGUST 2008
An Investment in Healing
by Larry Rosen, PA-C, Vice President and PR Committee Chair
L
ife-altering experiences happen to all of us, in one
form or another. For me: the births of my children,
9/11, the day I met Joyce Davis, to name a few. They
redefine our priorities; humble us; shatter and rebuild the
emotional ingredients of the person we are or are about to
become. To my list, I would have to add my trip to China
in early April, an unforgettable and sobering experience.
It was sponsored by the Thanksgiving Studio in Hacienda
Heights.
The Medical Mission
Team
Thanksgiving
Studio (TS)
is a Christian
charitable
organization.
China is the
recipient of
their missionary
work, which
consists of
caring for
orphans,
supporting poor
students, and providing medical care for sick or disabled
children. Under the leadership of Tung P. Cheung, PAC, affectionately known as “TC,” a medical mission was
organized for April, 2008 and I was invited to participate.
I met TC on a medical trip to Baja with the Flying
Samaritans in September of 2007. TC works in the
dialysis unit at Garfield Medical Center in Monterey
Park. He had recently returned from China and brought
along an album of pictures showing the work his group
had done in the villages in a northern province. They
were heartbreaking glimpses of the suffering these
beautiful, unfortunate children deal with day after day.
He would be mounting another trip to China in April
and asked if I would like to come along. There was no
question that I did.
We left for Beijing on March 29th. There were 17 of us
including three physician assistants – TC, Amy Huang
from San Diego and me. There was one Chinese physician
from California, Dr. Hui Bao; four nurses, Irene, Pat,
Noya and Jennifer, four teachers; Kathy, Irene, Mama Lo,
and Jane, Thanksgiving Studio staff and translators.
A one-day layover preceded our two-hour flight to
Guiyang in the northern province of Guizhou. From
CAPA NEWS
there, it would be butt-rattling bus transportation to the
remote, mountain villages we were scheduled to visit
while basing out of a town called Guanzhai. We would
not return to the States until April 13th.
Each night on this extraordinary adventure, I would sit
on my bed and make diary entries to record the events
of the day. In reviewing those entries many weeks later, it
occurred to me to use excerpts from them to produce an
article for the CAPA News rather than attempt to recount
my experiences in typical, narrative form. My feelings as I
wrote them were immediate. Often, I was exhausted and
aching from the day’s work. The moments recorded on
my computer were more real than if I tried to remember
months later. I hope some of that comes through as you
read them.
Day 1
At the Air China check-in counter, LAX, 3 hours early
to secure an emergency row seat; 14 hour flight. Nice to
have the extra leg room. Very sweet Chinese lady looks at
my passport:
“You 72 years old?”
“Yes.”
“Too old. No more than 60 for emergency row.”
“60? Why?”
“Must be strong.”
“I am strong!”
“You look strong, that true, but sorry, no seat.”
Not a good beginning.
Two hours into the flight, page for a doctor. No one
responded. I did. Young Beijing guy in bathroom
with massive nosebleed, blood everywhere. Panicked
stewardesses. Surprisingly, very few medical supplies on
the 747. I paged for Tampax and Afrin. An hour later,
we had it controlled. Really nice guy. Graphic designer.
Wants to show me Beijing. Wish I had the time.
Day 2
Guiyang. 5 hours in bus to hotel in Zhi Jin Dong;
twisting, bumpy, steep drops on almost every turn. Angel,
the TS leader, got sick. No “restaurants,” no “bathrooms.”
Stopped because of accident ahead; Kathy, a teacher,
squatting in bushes along the road, me holding my coat
up to cover her. We are getting to know one another very
quickly.
Day 3
The village, Nayong, is bleak, poor, grey from coal smoke.
Set up in large dining room area of school. Temp about
40 degrees. Laid out medicine and Amy, TC, Dr. Bao,
and I began to see patients, several hundred. Picked up
local doc. Very helpful.
Some of the kids incredibly sad to see; scars,
hemangiomas, cleft palates. All filthy. All with brown
stained teeth, kids and adults. No dental or medical care.
Many skin rashes from dryness and dirt. Hair matted
and sticky. But the faces so beautiful, breaks your heart.
Runny noses common. Kids with grotesque deformities;
burns that were never treated, contracted scars restricting
arm and hand motion; bones broken that were never
set right. A child with a black, bulging eye. An 11-yearold girl with what appears to be scleroderma or severe
epidermalysis; massive crusted lesions on back and arms;
skin thin and scaling, no fingernails or toenails. Old
bandages matted down and stuck painfully to wounds.
Beautiful face, no smiles, hurting all the time. Almost lost
it with this child. She is in such pain all the time. A 12year-old boy complains of stomach aches every morning.
States he always wakes up with pain in his stomach. He
was thin, mal-nourished. I asked him if eating relieved the
pain. He said it always did. The kid was simply hungry.
Hunger pains. Sadly, he will have them again.
Day 4
Breakfast: hard-boiled eggs, noodle soups, bizarre
vegetable and fungi mushrooms. Delicious. Loaded into
cars and vans and off to the village high school.
Country so beautiful but achingly poor; shacks, rickety
villages, sprawling tilled hills, yellow with grass seed plants
and sweeping mountains in between. Our driver, like
a NY cabbie; honking, passing on steep, canyon turns.
Screaming his horn at people walking along the roadway
who pay no attention but no one gives him the finger.
Wonder if they know what that is? The women sing
missionary songs on the bus; lots of Christian influence
and references but no proselytizing, none of that. They
respect and allow my Jewish faith and we find humor in it
all. We are having so much fun together.
We see a ton of kids and some
adults who push their way in.
Lots of these kids have no visible
parents; orphans that live with
grandparents; some have parents
living elsewhere making a living
to support them. Some kids just
abandoned to the village.
Day 5
Dinner in another town, Hozhai;
a full-on chicken head in soup; really good, though. Pork
dishes, mostly thick bacon fat with small strips of meat.
Pork belly. Never ate that before. Not too bad. Could
have done without the pork ear.
At high school that evening, TS handed out scholarships
to 60+ students. Dr. Bao gave lecture on Hep B, in
Chinese. We treated all who wanted to be seen. Beautiful
kids. One said, “Welcome to China,” so proud of herself
and her English. All the kids got
vitamins and calcium. Many
exhausted, insomnia. These kids
go to school at 7:30 a.m. and stay
until 9 p.m., five days a week.
No sleep. Work weekends on the
family farm to harvest their own
food. Competition for university
very high. Need to push it all
the time. Kids grateful for the
medical attention. Very shy. Parents can make as little as
$2,000 a year. Scholarships are a couple hundred bucks;
helps with tuition, which the government makes them,
pay in their junior and senior high school years. Money
also used for food, books, just to live. Incredible. Planet
teeming with food and resources and so many suffer, not
just China. Why don’t we fix this?
Day 6
Early breakfast: soups, noodles, mushy eggs, weird
chicken pieces, sticky rice buns; all good. Amazing my
stomach is handling this stuff. Two hours in a bus on a
twisting, bumpy dirt road to an orphanage. Hundreds of
kids (we saw over 200) waiting. Have to remember many
of them have never seen a Caucasian. Lots of staring and
giggling when I took their picture and showed it to them.
They loved it and crowded around for more. “V” signs
Continued on page 10
JULY/AUGUST 2008
Continued from page with fingers? Not sure why. Feel like a new species the
way the kids look at you and follow you around but don’t
come too close. Some do, too curious to be shy.
Four providers in one packed, freezing room with meds
and interpreters. Many of the parents are illiterate;
children fill out their own intake forms. Many severely
maimed; scoliosis, cataracts, massive injuries that were
never treated in early childhood. Lots of scabies. Sad that
most we can’t do anything for. They walk miles to be
seen by us. Need to give them some hope or keep contact
continuity even if the news is bad. They expect you to
fix them. Everyone is given vitamins, minerals, calcium,
and anti-parasite meds. Despite deformities, faces are
incredibly serene and loving. Hungry for attention. Hard
to get them to smile or touch you
back. One boy incredibly shy,
refused to be touched or looked
at; 13 years old, father was 72
when he was born. Father pulled
his hair to get his attention. I
barked at him. Finally the kid
settled down, opened his eyes.
He had obliterating cataracts;
can barely see and is pushed to
do everything. Father thinks he’s
just stubborn; brought him here
because his stomach hurts.
Many inguinal hernias; one child
with six toes on his right foot and
a deformed left hand. Another
age 9; frenulum constriction; can’t
speak. So easy to fix this. Some
facial burns leave eyes unable to
close completely. One boy broke his left knee falling from
a tree at age 3; he’s now 12 and badly deformed. Walks
with makeshift crutches and probably will for life. Makes
it hard to think of cranky parents in N. Hollywood who
complain about having to buy Tylenol.
Day 7
Finally getting that I’m in China! The country is beautiful
and dreadful at the same time; intricate landscaping
and shades of green where vegetables grow; rice patties,
wheat, oxen, chickens, people carrying buckets of water
on balanced shoulder beams; old men sit by the roadside,
stringy beards to their knees, smoking delicately long
10
CAPA NEWS
pipes. Right out of “National Geographic.” The poverty
is staggering, as are the contradictions; little electricity
but many cell phones; thatched houses with satellite
dishes. Everyone is filthy; dirty hands with caked dirt
under fingernails. All have stained teeth from fluoride
toxicity, due to coal burning. They dig it themselves;
heat their houses with it, smoke their meats and cook
their food with it. The food variety, despite the poverty,
is impressive. 8-10 dishes at every meal; common and
uncommon foods prepared in interesting combinations
that produce bizarre tastes. Salted eggs; quartered
and served with the shell still on which I unhappily
discovered.
Forgot to mention…Kathy and Irene are doing lectures
on alcoholism, smoking, hepatitis, and cleanliness to
groups of 50-80 kids every day. All together, we’ve seen
almost 1,200 children.
There is holding hands and grace at every meal, nothing
overbearing. Maybe I’ll say grace one night. I like these
people a lot. They care about the children and are
committed to being of service. Warm, funny, sensitive and
unconditionally generous. Remarkable, all of them.
Day 8
Woke up with signs of conjunctivitis. Started meds. Cold
symptoms, mainly chest congestion from breathing coaltainted air. Z Packs. Lots of us. Breakfast, rice cakes, no
hot food in morning; into bus for 2 hour bone-rattling
ride to high school. Poor traction, misty weather, stopping
to push bus. Rocks laid for road base but no asphalt as
yet. Back breaking.
High school; curious kids again; not so many today, 160,
mostly well. Huge hydrocele, burns, hand deformities.
Another blind boy. Filthy toilets, really filthy. Outdoor,
squat toilets, no rails, just slots in concrete. No toilet
paper. Kids carry their own. Lunch was bananas, oranges,
macadamia nuts, some dried Chinese cherries.
Made two-hour trip from high school to blind boy’s
house. House, not really. He, his brother and father live
in a plastic lean-to; cook, sleep, live in an 8 x 8 area. No
wonder kids get so many scald burns. House next to them
too rotted out to live in. People freeze to death in winter
from lack of shelter. Neighbors came by to watch the
goings on. Jennifer, one of the nurses, is going to sponsor
the boy by paying some of his tuition for the school for
the blind. Good for her. Father of the boys is a doper.
No mother; she walked out on family. The “People’s
Government” not much in evidence in these mountains.
One child per family doesn’t apply here. Government
knows the children will become the caretakers. But many
kids are restless; know there is more for their lives. Had
lunch with an older man who beat his granddaughter
because she went to school and
didn’t help Grandma with the
chores. TC reasoned with him,
convinced him if she could one
day get a job, she could help out
more. He’ll try it out, for now.
Tung P. Cheung, PA-C
affectionately known
as “TC”
Welcome hot meal at hotel when
we got back at 8. Prioritizing
cases until 10:30. Who can we
help, who we can’t? Girl, age 11,
has daily seizures, 6-7. Can’t help
her. Cost of ongoing medicine
too prohibitive. Not a happy
decision to make. Eleven inguinal
hernias will get repairs. That’s
pretty easy. One urgent case, nonreducible, will get priority. We
select scar revision cases that will
improve lives. They will wait until
June or July. Complicated process getting them to the
bigger towns or cities for hospital care. God bless TC and
Thanksgiving Studio for making this all work.
Freezing in the room. Can’t figure out the heater, just
blows cold air. No heat in lobby or eating area. All eat
fully clothed, down jackets and all. We laugh and shiver.
Constipated. Maybe tomorrow. The thought of using a
Chinese squat toilet is simply unreasonable. Hot tea in
the room feels good on the throat. In bed with Lunesta at
11:15. Thinking of Joyce. Miss her.
Day 9
Missionary school that TS supports. All the kids outside
singing and clapping as we walked up the stairs to the
school. Colorful, traditional clothing. Wonderful kids,
practicing their English on us. 12 year boy adopted by
Steven and Angel; Le Phong Tuin, means “Spring.” That’s
what we call him. When he was three, his mother died.
Father remarried. His stepmother wanted her own child.
Only one child per family allowed in town where he
lived. She blinded him with a needle and threw him into
the street to die. TS rescued him and has provided for
him ever since. He’s bright and sweet, called me “Uncle
Yarry.” Hugging me, everyone, talking in fuzzy English.
Saw about 50 as patients then they put on a worship
celebration for us; songs and happy dancing. Much like
a hora. They pulled all of us up on stage to join them.
Really fun. They are so loving and open to friendship,
shaking hands, saying good-bye in English. Sang a
“shalom” song meaning “peace.” Nice thing to do.
Day 10
Stories from TC in the bus; 18-year-old boy stuck in his
village house when it caught fire. Burned on more than
80% of his body. Without pain meds, care or antibiotics,
family left him to die in the burned-out house. A villager
remembered Thanksgiving Studio and told family. Mr. Lee,
the agent in Quiyang, was notified and sent someone. They
found the boy dying, covered with flies and maggots. Lee
had him brought immediately to Bless China, the institute
in Kunming that does extraordinary humanitarian work;
rehabilitation, surgery, critical care, all private funding.
He got free surgery and rehab and survived. One of many
miracles happening every day in China.
Day 11
A few days will be blocked out for touring; Red Dragon
mountain, the Yangtze River, Shangri-La. First national
park in China. Beautiful but too much walking. Boat ride
across lake very boring. Pat and I went to upper deck.
Cold wind. Packed with Chinese people. Took a picture
of Pat and soon after one Chinese man wanted to take
a picture with her. Then with me, then with both of us
and his wife. Then others wanted to take pictures with us.
Forty-five minutes laughing and hugging as each person
up there, must have been about 80, took pictures with
us. Pat and I; Brad Pitt and Angelina Jolie; American
celebrities surrounded by tourist paparazzi. Hysterical.
Not a word of English except for the ever “sank you.”
How much fun was that?
Some shopping in Li Jang. Joyce would lose her mind
buying for kids and herself; silk and cashmere scarves for
$1.50. Looking for authentic cookbooks for Scott and
Bill. We’re back here again Friday. If I don’t find anything,
TC will get them for me in Kunming. He’s staying there
to wait for the kids we treated so he can arrange for their
continued care.
TC is amazing; makes bets at dinner about what we are
eating. Tonight beef heart. I thought it was tongue. He
bets money with you and, win or lose, the money goes
JULY/AUGUST 2008
11
Honoring A Family of PAs!
by Gaye Breyman, CAE, Chief Operating Officer
T
he PA Profession is over 40 years old. Old enough to
see the children of PAs enter and graduate from PA
school. We hope to start a series of articles featuring
“PA families.” The first of which is below. We know
of many married PA couples and we even know of one PA
couple who has a daughter who is also a PA. If you would
like to be included in this PA Family series, please email
me at [email protected] and let me know who you are.
As I hope you know, this year’s conference project is
Honoring A Community of PAs. We hope that those
who are part of a PA Family will send in their 50-word
or less submissions about their husband/
wife/child (after all, they have certainly
touched your life) and we will have a
special graphic/designation for them
along the walls of the Wyndham Hotel
and the Palm Springs Convention Center.
Please see the cover of this newsletter for
more information about the Honoring A
Community of PAs Project.
Gaye Breyman: George, what PA program
did you attend and when did you
graduate?
George Wright: USC 1982.
GB: In what area of medicine do you
practice?
GW: Family practice and emergency
Medicine.
Top: Peter Wright
visits with Bob
Sachs, PA-C and Joan
Stoykovich, PA-C at a
CAPA Conference in
the 80’s
GB: You have been coming to the CAPA
Conference for years. We even have a photo of you and
your son you shared from a CAPA Conference in the
late 80’s. Did you always bring the family to the CAPA
Conferences?
Bottom: Father and
daughter Stephanie
Wright and George
Wright
GW: We have attended the CAPA Conferences for about
25 years. In fact our Son, Peter just turned 25. He has
some great memories including golf in Palm Springs. The
CAPA origination is a family, so it feels like a reunion
every October.
GB: Your daughter, Stephanie, is at PA student at Touro
University. You must be very proud of her. I have met
her and she is just a delight. When did you first realize
that Stephanie was interested in medicine and more
specifically in being a PA?
12
CAPA NEWS
GW: At four years old, I helped her fill her Fisher Price
doctor bag with band-aids and antiseptic wipes. When
anyone got hurt playing she would run and grab her bag.
I’ve always encouraged her to follow her dreams and the
sky was the limit as far as her education was concerned.
She had a BA degree at 19 years old and loved school. She
always talked of medical school and had the love of school
and the potential to do anything she wanted academically.
I have always shared my passion of being a PA with her,
but I credit two of our long time friends who are both
physicians, in Santa Barbara who helped Stephanie realize
that her passion was patient care. They both shared that
they were secretly envious of me being a PA with a full
and balance life. They knew I had time to be an active
parent as well as a dedicated primary care provider.
GB: At this year’s CAPA Conference Stephanie will be
a Student Ambassador. I bet this will kind of be a “full
circle moment” for you. You brought the kids to CAPA
Conferences and now Stephanie will be there with her
blue CAPA Student Ambassador shirt on making sure
you have your conference badge on before you enter
a lecture. Any thoughts about her new role in this
wonderful Community of PAs?
GW: Last year we went to the CAPA Conference in Palm
Springs, CAPA at Napa Conference and the AAPA
Conference in San Antonio. We had so much fun
together. It will be great seeing her in the blue shirt, and,
cheering for her in the CAPA/Kaiser Student Challenge
Bowl and sharing in another outstanding CAPA
Conference. I am so proud of her and I love her very
much!
GB: Stephanie, you attend Touro University MSPAS/
MPH Program. How long is that program and when
will you graduate?
Stephanie Wright: Touro offers a three-year program. I will
graduate in Spring of 2010.
GB: Why did you decide to become a PA?
SW: I come from a family who values and believes in
equality for all people. Growing up, I observed my father
practicing medicine. I was completely enthralled watching
him develop x-ray films in the red room, prescribe
antibiotics, or stitch wounds. His experience spanned all
socioeconomic levels. My father treated each patient with
Continued from page 11
to Thanksgiving Studio. “Everyone’s a winner.” Took me
alone through old town. He knows everything; history,
products, prices, the people. Born in China, he loves it.
TC is our spiritual, medical, and historical leader. He’s
incredibly generous and sensitive. Feels he needs to work
on not micro-managing. Thank God he does it, though.
Can’t imagine getting through this trip without him.
Day 12
Craving a tuna
on rye toast with
The Children of China Need You …
French fries. Last
dinner together is
February 28, 2009 – March 14, 2009
really nice except
for the Yak cheese;
For More Information:
served with sugar.
Inedible; sour,
TC
rank, rotten(626) 552-6424 or
tasting. One of the
[email protected]
gals bought a bottle
of wine; I decide to
Larry Rosen:
do the grace; saying
(818) 389-5955 or
the Hebrew prayer
[email protected]
blessing the wine;
thanked everyone
Thanksgiving Studio:
for this wonderful
(626) 330-0787 or
experience; praying
for all of us that
[email protected]
we do not forget
what we had seen
and done here.
Too easy to remember the fun and good times. Work
needs to continue. The “Jewish guy” said grace! They
liked that. With all I’ve seen, have to remember not to
be too harsh on my patients. All is relative. Their pain
and angst may be different, less dramatic, but real all
the same. Gratefully, few have experienced the pain we
visit here.
Day 13
Beijing airport; 5-hour wait for the flight to LA.
Magnificent new airport, ready for the August
Olympics. A Burger King and a Starbucks! We gorge
on cheeseburgers and fries. And real drinkable coffee.
What a treat. Some are staying for a while to visit family,
others on different flights. Noya going back home to
Vietnam. Goodbyes are tender and painful. We have,
after all, become a family if only for a brief time. I will
miss all of them.
So, that, in condensed snippets, was my trip to China.
I put all my pictures up on a website. If you have any
interest in seeing more of them, you are welcome to go to:
www.flickr.com/photos/larryr.
This trip to China was my personal experience. In the last
issue of the CAPA News, members Kevin Robertson and
Eric Glassman wrote about their trip to the Dominican
Republic. So many PAs have had similar experiences;
Pamela Burwell, of Phoenix, Arizona won the 2008 AAPA
Humanitarian Paragon Award for her extraordinary work
in Central America and Africa. Past President of AAPA’s
Physician Assistant Foundation, Don Pedersen, traveled
to Thailand after the tsunami. William Gadea, PA-C, of
Modesto, California, another Paragon Award winner, was
honored for his work in Nicaragua and Guam. Many,
many more have used their skills to bring healing and
comfort to the underserved in countries like Russia,
Darfur, Mexico, and even here in the United States.
Here’s the best part: I came home from China a better
provider than when I left. An experience like this sharpens
your skills. It re-ignites your compassion for patients and
your pride in being a physician assistant. We get really
good at Botox and family practice and vein harvesting.
But we are trained to do so much more and the
opportunities to practice what we know are everywhere,
all over the world.
Think about making an investment in healing. Search
out the opportunities (I’ve listed a few below.) Put a
few weeks aside to go where you are desperately needed,
where your involvement will be welcomed, appreciated
and never forgotten. Many of our life-altering experiences
come to us uninvited. Here’s one you get to plan on your
own. It is a commitment you will not regret.
TC and Thanksgiving Studio are planning another trip
to China in March, 2009. Visit the CAPA website www.
capanet.org for more details. If you are interested, call or
email me. I am happy to answer any of your questions.
[email protected]
(818) 389-5955
For More Information:
http://www.aapa.org/international/practicing.html
http://fmignet.aafp.org/x53.xml
[email protected] (“TC”)
www.bajaflyers.com 
JULY/AUGUST 2008
13
Jeremy Elkins, PA-C – Found A Home Serving The Homeless
by Gaye Breyman, CAE, Chief Operating Officer
I
always love working the CAPA Booth at the Pri-Med
Conference in Anaheim. We always get a lot of PAs
coming by the booth to thank us for being there and
catching us up on what they are doing/where they are
working now. This past May, while at Pri-Med I met
Jeremy Elkins, PA-C. Jeremy was telling us about the
incredible clinic at which he works in Costa Mesa. Miguel
Medina, PA-C and Nancy Nielsen-Brown, PA-C also
were at the booth and they were
so proud of the work that Jeremy
was doing (they were two of his
instructors at Western U). I asked
him if I could come to the clinic,
take some photos and do an
interview.
Share Our Selves…
helping those in need
in Orange County
In July, I finally made it over and
was treated to a wonderful tour of
the entire facility. I was impressed
and moved by all who worked/volunteered there. It is a
very caring and positive bunch. I encourage you to visit if
you get the chance.
My interview with Jeremy follows:
Gaye Breyman: Jeremy, what did you
do before you entered the Western
University PA Program and what
year did you graduate?
Jeremy Elkins: I graduated from Point
Loma Nazarene University in San
Diego in 2002 and worked at Costco
and as a delivery driver for FedEx
while my wife finished her teaching
credential program at San Diego
State. I entered the PA Program
at Western in August of 2003 and
graduated in August of 2005.
Dr. Margarita Pereyda,
SOS Medical Director
and Jeremy Elkins,
PA-C, Clinic Efficiency
Coordinator
14
CAPA NEWS
GB: How did you hear about being a PA?
JE: The first time I heard about the PA profession was
when a PA sutured my split chin after a mountain bike
crash in high school. As my wife finished her schooling
after college, I was trying to decide what I “wanted to
do when I grew up” and was actually in the process of
becoming a firefighter. I had interviewed with several
departments already, and wanting to be confident in my
decision to pursue firefighting, I figured I should look
into a few other professions prior to endeavoring in that
career. I shadowed a PA and realized that I could probably
do this job and do it well, so I applied to PA school on a
whim really and was accepted.
GB: You mentioned that growing up your parents made
sure that you and your sister were exposed to those less
fortunate than you. How were they able to do that and
will you do that with your children?
JE: My parents were very intentional in the way they
brought my sister and me up. Our family wasn’t
incredibly wealthy, but very fortunate in that we always
had a roof over our heads and food on the table. I think
my dad was always really good about explaining how the
little things we took for granted like going on vacation,
buying new clothes for the upcoming school year or even
ordering pizza when my mom was too tired to cook were
not the norm for everyone. My parents made it a point
to pray for those less fortunate and more importantly,
routinely scheduled family outings to serve food at the
local homeless shelter. And yes, I absolutely intend to pass
these types of values on to my children. My daughter is
still a little young for any heavy conversations about social
injustice (she’s five months old) but she has already been
to SOS several times.
GB: Speaking of your daughter, I saw a photo of a
beautiful baby girl on your computer screen. What is
her name?
JE: Mia is the most life changing person I’ve experienced.
She recently learned how to spit rice cereal back at us as
we try to feed her.
SB: You actually asked for SOS to be one of your
rotation sites – requesting it as your final rotation
site. Why?
JE: When I was setting up my second year I wanted to
choose a final rotation in a setting where I could see
myself working. I figured that after 11 months of honing
my clinical skills I would present well and be a candidate
for a job should an opportunity be available. I knew going
into school that I had an interest in community health
so I chose SOS. Apparently my plan worked as I’ve been
here ever since!
GB: SOS Medical Director, Dr. Margarita Pereyda, was
your preceptor during your rotation at SOS. She speaks
so highly of you and told me that she and SOS have
“big plans for Jeremy.” She is excited about your growth
both clinically and administratively. They hope for you
to take on an even greater role in administration at the
clinic than you currently hold as the new CEC. Are you
looking forward to that?
JE: Well, the title of CEC makes me laugh. It is sort of
a joke between me and Dr. Chen our Associate Medical
Director. It stands for Clinic Efficiency Coordinator.
To me it sounds like I’m the hall monitor. Despite the
title, I’m looking forward to improving the efficiency
with which we see patients, ensuring that just because we
provide free care we still provide excellent care. It definitely
is not something I anticipated doing when I graduated
from PA school, but after “being in the trenches” so-tospeak for the last 2 ½ years I feel that it takes people who
understand the nuances of working with an underserved
population to assume the responsibility of working on
what’s flawed in our health care system. And, in our world
for that matter, instead of just complaining about it. (In
the past, I was inclined to simply do the latter, so this is a
process for me indeed.)
GB: I enjoyed meeting both Dr. Pereyda and Dr. Chen
very much. They both work for Hoag Hospital, a huge
supporter of the SOS Clinic. Hoag assigns them fulltime to the SOS Clinic and also provides a lot of support
in other ways as well. Could you share a bit about that?
JE: The clinic is its own entity but we work very closely
with Hoag Hospital and the Department of Community
Medicine. They provide SOS with two Medical Directors,
in-kind donations which include office and medical
supplies, and even medication for our dispensary.
The hospital also allows our patients to access services
whenever any diagnostic tests are needed. Most beneficial
in my opinion, however, is the relationship forged
between SOS and Hoag affiliated specialists who see our
patients for free when referrals are necessary.
GB: In the hour or two I spent at SOS I found that I had
a lot of misconceptions about the homeless population.
Over the 2 ½ years you have been at SOS, what have
you learned from your patients?
JE: I’ve learned that the face of poverty is incredibly
different than one might expect, and that most of us are
much closer to hardship than we might think. I had a
conversation the other day with a gentleman who came to
SOS who had been without his hypertension medication
for a week. When he came in he had a blood pressure
of 200/120 but was happy because in forgoing his
medications he had been able to afford gas money for the
week and had kept his new job.
GB: You have a dispensary at the clinic staffed by a fulltime pharmacist. Tell us how that impacts on patient
care given the population you serve.
JE: We are blessed to have a
dispensary and a full-time
pharmacist at the clinic. It
makes SOS unique in that
we can actually provide
patients the treatments we are
recommending. This sounds
simple but community health
can be frustrating sometimes
in that as a clinician you can
prescribe a medication but know
full well the patient is not going
to be able to afford it. To be able
to have patients leave with their
medications in hand helps me
sleep easier at night…and more
importantly benefits the patient.
GB: Tell us about the
coordination of services between
the clinic and the other departments of SOS?
JE: About the same time I was hired by SOS, the
Comprehensive Care Center was formed to provide case
management and counseling services. In addition they
link patients with Emergency Services, the SOS division
responsible for the distribution of food, clothing and
financial assistance. Medical providers can make a direct
referral to one of our case managers if we encounter
someone with needs that extend beyond medical care.
Top: Volunteers sort
and bag food for SOS
clients
Bottom: Staff and
volunteers assist
clients with needed
services
GB: On average, how many patients are seen at the clinic
each day?
JE: Our numbers wouldn’t make the CEO of a large HMO
happy and change on a daily basis given our staffing. We
sit down as a group and review our productivity often.
However, we always seem to reach a similar consensus that
as our patient care is routinely complicated by the fact that
most have been without preventive health care for a long
time and bring a myriad of social if not psychological issues
to the table…we can’t fit the type of care we seek to provide
into a model that doesn’t really allow for such variables.
JULY/AUGUST 2008
15
Jeremy Elkins, PA-C – Found A Home Serving The Homeless
GB: How many chronically ill patients does SOS treat each
month – on average?
JE: The last time we checked there were approximately
1,100 unduplicated patients designated as “chronic care
patients” at SOS. I’d have to say we see 250-300 of those
any given month.
“The best exercise of the
human heart is reaching down
GB: You don’t see Medi-Cal or
Medicare patients at the clinic,
true? What qualifies someone to
be seen at the SOS Clinic?
JE: True, Medi-Cal and Medicare
patients are not eligible for services
because they are technically
insured and have better access
Tim Russert
to health care than the typical
SOS patient. The most concise
way to explain those eligible for
services at SOS would be to say that we provide urgent care
services for any uninsured Orange County resident and
chronic care services for uninsured residents of Costa Mesa
and Newport Beach. If someone has a chronic illness we
typically try to bridge his/her care to a Community Clinic
in his city of residence. The only type of insurance we
accept is actually not insurance but a “safety net program”
called MSI (Medical Services Initiative.)
and picking someone else up.”
Editors Note: The Medical Services Initiative (MSI)
Program covers medical care for Orange County residents
ages 21 through 64 years who have limited or no other
financial resources for medical care. The scope of services
is limited to those services that protect life, and/or prevent
significant and permanent impairment in health status
and/or function. Financial eligibility is based on MediCal criteria, with an income cap at 200% of the Federal
Poverty Level. MSI also requires proof of residency and
U.S. citizenship, and offers covered services for a twelvemonth period at a time. The Medical Services Initiative
Division of the Health Care Agency acts as the payer and
administrator to hospitals, clinics, physicians, ambulance
companies, home health and other providers that serve
indigent persons.
GB: It was such a pleasure to see you at the clinic. To
see how the staff admired you and respected you. It is a
terrific group of people doing really important work. We
talked a bit about the fact that the pay for the clinicians
at the SOS Clinic is competitive and one can live a nice
16
CAPA NEWS
life while also serving the underserved. Do you have any
advice/words of encouragement for those who may want
to work in a Clinic like SOS?
JE: I honestly feel that you need to work in a setting where
you are passionate about the work you are doing. For some
clinicians, that might mean performing Botox injections
for a private dermatology practice. For others it might
be working in hospice providing care and compassion to
terminally ill patients. Neither of these would suit me. I
do well in community health because I am committed to
helping the underserved community. It sounds cliché but if
I encounter one patient who expresses his gratitude for the
care we provided when he had no other resources, it negates
the twenty complicated, difficult cases I saw before him.
Community health probably won’t pay what you can make
as a first assist in orthopedic or cardiothoracic surgery,
but if you work hard, are passionate about your job and
advocate for yourself when negotiating your salary, you can
make a comfortable living. The truest benefits of my job,
however, are not monetary. If anyone wants to volunteer at
our clinic we would always welcome your help!
GB: Thank you, Jeremy. I would encourage anyone
in the Orange County area to visit the SOS Clinic
and volunteer your services in any way you can. They
don’t just need health care providers. They need food
donations, school supplies, volunteers to help interview
potential clients, people to come and help sort and
distribute food, etc. Julie Larson is the Volunteer
Manager. She can be reached at (949) 650-0640 ext. 227
or you may print the volunteer application form from
their website. Visit www.shareourselves.org.
Editor’s Note: I have lived and worked in Orange County
forever and did know about 2-1-1 Orange County, a
nonprofit organization which provides a comprehensive
information and referral system that links Orange County
residents to community health and human services and
support. Designated by the California Public Utilities
Commission as the provider of this nationally recognized
service, 2-1-1 Orange County makes the system available
24 hours a day, seven days a week to the 3,000,000
residents of this community. Callers seeking assistance
dial toll free 2-1-1 from a landline and are connected
with certified, multi-lingual Information and Referral
(I&R) Specialists who utilize a robust database to provide
information on services such as: shelter/housing, prenatal
care, workforce development, government assistance
programs, child development assessment services, urgent
care, medical, dental and vision services and much, much
more. Other counties may have a similar network. 
PAs Come Together
by Cyndy Flores, PA-C, CME Committee Chair
Y
our CAPA CME Committee and CAPA staff
spend a tremendous amount of time and energy
planning the best CME conference just for PAs.
Each conference comes from our hearts and souls to
you.
Cyndy Flores, PA-C
There are many CME conferences
and many ways you can get CME,
but it is only at the CAPA Conference
where you will find the personal touch
and genuine caring that makes our
conference so very special. Since the
Committee is made up of PAs from all
over California and in many different
fields of medicine, we are able to create
a conference that is just for you.
You’ve been reading about some of the highlights we
have planned for you like the very popular 2 Minutes,
2 Slides, and 2 Questions; Legal Issues (always a
packed room); adult and pediatric dermatology
lectures; what you should know about malpractice;
women’s health; mental health and adolescent health. I
could go on and on, but the CAPA News is only so big.
As you may have seen by now, the conference
schedule is up on the web, so start planning your
conference now. Soon our lecture notes will be
appearing on the web. Why do we put them on the
web? After listening to our attendees and taking many
things into consideration, CAPA put the lecture notes
on the web to meet the needs of our attendees and to
do our part to protect our environment’s resources.
From what we hear – it’s working well and people
enjoy being able to reference the notes beforehand in
order to prepare their conference schedule.
The CME is only one part of the CAPA Conference!
What makes our conference so special is all the time
we spend creating activities to make sure you have
fun and have plenty of opportunities to hang out
with your colleagues, friends from school, and new
acquaintances.
The CAPA Conference has been recognized in
national magazines as being one of the most unique
conferences in the nation. Why? Because we provide
state-of-the-art lectures, a wide variety of hands-on
workshops and a conference where no detail is too
small to be attended to. No other conference even
comes close.
The CAPA staff, Board of Directors and CME
Committee have committed to bringing you the best
conference you will attend and hope that you take
advantage of the hard work that has gone into making
the CAPA Conference the BEST PA Conference in
the WEST.
So, keeping that in mind, the upcoming 32nd Annual
CAPA Conference is just around the corner! Our
lectures are set, the details are being attended to and
the fun is waiting for you! 
Controlled Substances
Education Course
San Diego
11:00 a.m. to 6:30 p.m.
Courtyard San Diego Airport/Liberty Station
2592 Laning Road
San Diego, CA 92106
(619) 221-1900
A Course Which Upon Successful
Completion Will Allow You To Write
For Controlled SubstancesWithout
Patient Specific Approval*
Check out the CAPA website or call the
CAPA office for complete details.
*California Code of Regulations Sections: 1399.541(h), 1399.610 and 1399.612.
A PA may administer, provide, or issue a drug order for Schedule II through
V controlled substances without patient specific approval if the PA completes
specified educational requirements and if his/her Supervising Physician
delegates the authority to them.
JULY/AUGUST 2008
17
CAPA’s 32nd Annual Conference – Honoring Our PA Community
spoke at the CAPA Conference. Don’t
miss this wonderful dinner and engaging
lecture. All you have to do is sign up in
advance for the Boehringer Ingelheim
Pharmaceuticals sponsored dinner
program on Friday evening set in the
majestic Palm Springs Convention Center
foyer. Advance RSVP is required (if you
sign up for the dinner, please be sure to
attend). Space is limited, so sign up when
you register for the conference. Medical
providers only please. This session is not
eligible for CME credit.
Wyndham Hotel
CONFERENCE HIGHLIGHTS
Friday, October 3 – Lunch
C
an you believe it!? It is CAPA Conference
time again. We are so excited about
this year’s program. We have brought
back many of the best speakers and added
a few new ones who have come very highly
recommended. We have 2 new hands-on
workshops: Wound Care and Clinical Update
on Intrauterine Contraception. We have
brought back Casting and Splinting after a
few years and we’ve kept your favorites which
always fill up fast: Joint Injection, Suturing,
Minor Surgical Procedures and Ortho Exam.
Enjoy two delicious dinner programs – one
on Thursday and one on Friday. These are
free and will fill up fast and they do require
advance RSVPs.
You should have recently received your
blue and black CAPA Conference brochure
in the mail with the beautiful San Jacinto
Mountains on the cover. Check out the
CAPA website at www.capanet.org for
complete information, to reserve your hotel
room at the Wyndham, to register for the
Conference and after September 1, to print
speaker notes to bring with you to the
conference. Call the CAPA office with any
questions you may have or to register over
the phone. Reserve your hotel room early as
the Wyndham will sell out.
We simply can’t wait to see you and to
experience another extraordinary conference
filled with PAs who will, as always enjoy,
embrace and Honor A Community of PAs.
18
CAPA NEWS
DINNER PROGRAMS
Thursday, October 2
7:00 p.m.
Advanced RSVP Required
DELTA 5 Dementia Education
Leadership in Alzheimer’s
Cap off your first day at the CAPA
Conference with a delicious dinner and
lecture. All you have to do is sign up in
advance for the Pfizer Pharmaceuticals
sponsored dinner program on Thursday
evening. Advance RSVP is required (if you
sign up for the dinner, please be sure to
attend). Space is limited so sign up when
you register for the conference. Medical
providers only please. This session is not
eligible for CME credit.
Friday, October 3
6:45 p.m.
Advanced RSVP Required
Diagnosis and Management of COPD:
A Treatable Long Term Progressive Disease
Dinner before the CAPA
Dance PArty? Of course.
And, we are so pleased
to welcome back another
of our favorite speakers.
Dr. Takkin Lo received
Takkin Lo, MD, MPH rave reviews when he last
Karen Bass,
Invited Guest
Speaker of
the California
State Assembly
and Physician
Assistant
At last year’s CAPA Conference, CAPA
honored physician assistant and California
Assembly member Karen Bass with its first
“Pride of the Profession” award. Seven
months later, on May 13, 2008, Karen
Bass was inaugurated as the 67th Speaker
of the California State Assembly, the first
African-American woman to hold that
office in the history of the United States.
The pride of the profession had, with
grace and humility, become the pride of
California. Speaker Bass has attended both
the 2006 and 2007 CAPA Conferences
and we hope the tradition will continue
this year. We have invited Speaker Bass to
address CAPA Conference attendees on
Friday, October 3, 2008.
Friday Night
The nightclubs of Palm
Springs can’t compete
with the PA PArty of
the Year. It is the place
to be on Friday night. We transform the
Wyndham Ballroom into PArty Central
with music that will please everyone. At
10:00 p.m. our American PA Idol show
begins. The PArty continues as PAs compete
and the audience votes to name the next
American PA Idol.
CAPA FAVORITE, JOHN BIELINSKI, JR., MS, PA-C
BACK THIS YEAR X 2
Thursday, October 2, 3:20 p.m.
Three-part (3-hour)
Secrets of Emergency Medicine
John Bielinski, Jr., MS, PA-C; received rave
reviews for the past two years so we have
brought him back to California for a new
and exciting 3-part series on Emergency
Medicine. You will leave this session
understanding the mindset of an emergency
medicine provider, with a workable
approach to treating emergent patients with
chest pain, shortness of breath, hypertensive
crisis, cardiac arrest, traumatic wounds
and infection. Trust John to make it
understandable, fun and ready to put into
practice!
The Last Lecture On the Last Day of the CAPA
Conference We Have Scheduled One of the Best
Speakers and Best Sessions For Last Stay and
be Inspired to Go Back to Work With Renewed
Enthusiasm For the Wonderful. Work You Do!
Sunday, October 5, 10:45 a.m.
Patient Satisfaction Survey
My PA is
Excellent!
Score High On Those Patient Satisfaction Surveys
- Be An Excellent PA!!
Providing medicine is much more than
applying medical literature, ordering
diagnostics and prescribing therapeutics.
Outstanding bedside manner is a choice;
it’s not a matter of nature verses nurture.
There are tangible, measurable techniques
to provide excellent service and to
make the patient feel more attended to.
A PA needs to be a master of human
interactions to be successful. We need
to maintain a professional and healthy
relationship with all of our co-workers,
from housekeeping to the CEO. Have
you ever tried to recruit the help of a
specialist when you know you have a
strained relationship with them, for
what ever reason? And, ultimately who
suffers? The patient. Being an excellent
PA strongly revolves around playing well
with others, be it the nurses, physicians,
the patient’s family, pharmacists and office
staff. This lecture will provide tangible
tools to form more effective relationships
and lead and inspire those you work with
to ignite their creative energies for the
good of the patient!
Saturday, October 4, 2:15 p.m.
3-Hour Wound Care Workshop
Sponsored by 3M, the speaker,
Michele R. Burdette-Taylor, RN-BC,
MSN, CWCN, CFCN, Ph.Dc was such
a hit at this year’s Napa Conference we
wanted to bring her back for a 3-hour
hands-on workshop. This workshop will
focus on Lower Extremity Ulcers caused
by arterial disease, venous insufficiency
neuropathy and pressure. The lecture
portion will include typical and complex
wounds. Participants will have handson opportunity to work with options
such as LE Compression Wrapping,
Compression Socks, ABI Indes/SemmesWeinstein Monofilament Testing and
Moist Wound Healing, etc. to treat these
types of wounds. Wound care is an area
that is constantly changing and relevant
to PAs in hospital and outpatient
practices. 
NEW
Honoring A Community of PAs
Don’t Miss the Opportunity to be Part of an
Awesome, Inspirational California PA Project
P
lease send quick email or note
via fax or U.S. Mail letting
us know about a PA who has
L
C
touched your life. Be it in a small
M
or big way, we hope you will seize
the opportunity to share your
gratitude with the California PA
Community. It will make you feel
wonderful – we promise!! Please
take just 3 minutes and write 50
words or less and let us know
about a PA who has touched your
life. Maybe they are your lunch buddy or the one who helps get you through
the stress filled days just by being there. Perhaps you haven’t seen or heard from
them in years, but you do remember that they made a difference in your life. Let
your supervising physician and others in your office know about this project.
We want to fill the hallways/walls at the CAPA Conference and the pages of the
CAPA News after the conference is over with these inspirational messages. Please
do it today. You may send emails to [email protected]. Fax to (800) 480-2272.
Check out the CAPA website for examples: www.capanet.org.
Martin Kramer, PA-C
Charese Fannin, PA-C
Lane Braver, PA-C
artin Kramer, PA-C
first taught me to be
a medical assistant
at a free medical clinic,
then demonstrated what
a great PA can be and do
just by being the skilled
and dedicated clinician
that he is. He made a
lasting and positive
impression on me.
Thanks, Martin!
harese Fannin has
been a PA with us for
over 15 years. She
is always caring while
she provides quality
medical care. Recently,
she has taken on more
administrative duties
and is now teaching
younger PAs how to
provide excellent,
compassionate
care. Thank you,
Charese, for your
amazing example.
ane Braver has been a
mentor and friend for 12
years. As a PA he is kind,
caring, and compassionate.
As an educator, he is a
tireless advocate not only
for his profession, but
for the lengths we all
need to go to help those
in need.
Shaun Partlow, PA-C
Richmond, CA
Mike Stephen, MD
Lynwood, CA
Chris Blanchfield, PA-C
Beaumont, CA
JULY/AUGUST 2008
19
Featured PA Vendor at the PA MarketPlace
by Lara Manchik, PA-C, CAPA Member
A
bout seven years
into my career
as an Emergency
Medicine PA, I showed
up to work in a crossover,
pinstripe scrub top and
matching scrub pants. I
simply wanted to wear
something a bit more
flattering – more upto-date, I thought. Yet
my supervising physician quickly said, “Go change. You don’t
resemble a clinician today, and it’s just not appropriate.” So there
I was again – drowning in the classic, faded, shapeless world of
unisex scrubs, and wondering who wrote the by-laws of scrub
wearing and where it might be published.
Graduating from PA school in 1999, almost a decade of wearing
frumpy scrubs and lab coats became a twisted comedy of getting
“ready” for work in a pajama-like uniform. I’ve always been
somewhat into fashion and style. At one point, I calculated that
I was spending 30% of my week wearing scrubs. I was so used
to it, but why?? Surely there must be a better option for female
clinicians. And when I couldn’t find one – I was fueled with
motivation to change that.
In June of 2006, I switched from working ER to Urgent Care
in order to devote more time and attention to developing the
Medelita concept. The goal was simple – to source the highest
quality fabrics and trim, with a focus on comfort and quality.
More difficult of a task – was to maintain the traditional features
of unisex style scrubs and lab coats, yet to introduce professionally
appropriate feminization and modern functionality.
This was a long and tedious process. I continued to work in
various Urgent Care settings evenings and weekends, in order
to make ends meet. During the week days, I would work with
20
CAPA NEWS
pattern makers, web developers, graphic designers, business
counselors, financial advisors, and mentors. I would go to trade
shows and textile classes in LA. I even flew to Asia in the middle
seat of the middle back aisle – and mysteriously arrived with
no luggage – in an effort to establish a strong relationship with
our chosen textile manufacturer. This was by no means an easy
process, nor had they offered Apparel 101 in my PA program
curriculum. This was all new to me. At one point I was regularly
using the analogy that I’d rather be taking care of a seizing 2 year
old than to go through the development process of starting an
e-commerce based manufacturing company.
But my colleagues kept motivating me to forge ahead. I was
able to establish wonderful partnerships with top performance
fiber companies, such as Optimer, Inc., Huntsman Intl.,
and Invista, so that our uniforms could really do something.
Moisture wicking, bacteriostatic, stain resistant, stain release,
anti-wrinkle – you name it. Anything that made sense to the
health care industry – I was determined to utilize. In May
of 2008, I launched the website www.medelita.com, to rave
reviews by the female clinician community. “Finally!” seems
to be the most common, welcomed response. To date, our
strongest customer has been physician assistants. This gives
me tremendous pride – to be able to offer my true colleagues a
uniform with abundant upgrades and a flattering, professional
appearance. We all deserve that.
So come take a look at our table at the PA MarketPlace. We’ll
be giving away Medelita tape measures and helping you to
find “your fit.” You are welcome to try on our scrubs and lab
coats. We’re offering complimentary shipping and custom
embroidery to customers who make a purchase at the CAPA
Conference. 20% of proceeds will go to the CAPA Political
Action Committee – an organization that I am extremely proud
to support. 
I’m PACing and Heading to the CAPA Conference
by Cherri Penne-Myers, PA-C, MSCS, Political Action Committee Chair
T
he CAPA PAC has another fantastic
event planned again this year at the 32nd
Annual CAPA Conference. This will
be our Fourth Annual CAPA PAC Silent
Auction, with some great items to bid on
during the Exhibit Hall on Friday afternoon.
A round of golf at Spyglass in Monterey will
be back, wine, books and lots more! The
Silent Auction will be held during the Friday
afternoon Exhibit Hall hours 2:30 p.m.
– 5:30 p.m. Winners will be announced
during the last lecture of the day.
Since our CAPA PAC theme is “It’s A
Jungle Out There,” the Prize Wheel will be
filled with slots for jungle animals. We will
have those infectious disease stuffed creatures
that everyone loves and much more!
This year we will be using a Nintendo Wii
and we will have something special for
everyone to be able to compete. The top three scoring individuals
will win trophies. So you can keep coming back to improve that
score and see your name at the top of the list!
The newest event at this year’s conference is
the CAPA PAC Reception. Anyone who has
donated $100 or more (since January 2008)
to the CAPA PAC will receive an invitation
to the reception on Saturday evening from
7:30 p.m. – 8:30 p.m. Come for food, wine
and to meet Bryce Docherty, our Lobbyist
from Sacramento.
I am still looking for Silent Auction items
so if have you something that you may
want to donate, I would certainly welcome
it. Maybe you have something you would
like to re-gift, or you a service or product
you might like to offer. Just call up the
CAPA office and they will guide you
through the donation process.
I want to thank everyone who has donated
so far this year to the CAPA PAC. I look
forward to seeing everyone at the CAPA
Conference in Palm Springs October 2-5. 
Oh yes, we will still have two opportunity drawing items! Didn’t
we have fun last year trying to find the tallest person to measure to
get the most tickets for just $20?
Don’t forget to purchase your fan to be used while supporting
your school during the Student Challenge Bowl. Cheer on your
old school team!
I Want PAs to Be Heard – To Create A Roar Heard Throughout the Jungle
 Cheetah  Leopard  Jaguar
 Bengal Tiger
 King/Queen
of the Jungle
Up to $50
$51 to $99
$100 to $149
$150 to $199
$200 or more
Support Levels:
Cheetah
Leopard
Jaguar
Bengal Tiger
King/Queen of the Jungle
Up to $50
$51 to $99
$100 to $149
$150 to $199
$200 or more
(Please photocopy this form and mail with donation.)
Name_____________________________________________________________________________________________
Address: _________________________________City___________________________ State_______ Zip_ ______________
Phone _ _______________________________ Email _______________________________________________________
Amount of cash/check/credit card donation: $________________
If donation is $100 or more please list employer__________________________________________________________________________________________
Please make checks payable to CAPA PAC. You may also pay by credit card. All contributions are voluntary. PAC ID # 981553


Exp. Date______________________
Signature_ ______________________________________________________________________________________________________________________
JULY/AUGUST 2008
21
Registe
ro
nline at:
www.c
apanet.
org
Controlled Substances Education Course Registration Form
Please select ONE seminar location:
 Wyndham Palm Springs - October 1, 2008 (Prior to the CAPA Conference)
 Courtyard San Diego Airport/Liberty Station - October 12, 2008
Name______________________________________________________________  PA-C
 PA
 Other_____________
Address_________________________________________ City_ ______________________State______ Zip Code_____________
Phone (____) _ ________________________________________ Fax (____)_ ________________________________________
Work Address____________________________________ City_ ______________________State______ Zip Code_____________
Work Phone (____) _ ____________________________________Work Fax (____)____________________________________
 CAPA Member - $90
 Non CAPA Member - $150
 Late Registration Fee after September 20, 2008 - Add $20
 Check enclosed (make check payable to CAPA)


Total Amount Due: $_ ______________
   
Name on Card__________________________________ Signature______________________________ Exp. Date___________

In accordance with the American with Disabilities Act, please check here if you have any special needs. You will be contacted by CAPA.
Mail completed Registration Form and make checks payable to:
California Academy of Physician Assistants . 3100 W. Warner Ave., Suite 3 . Santa Ana, CA 92704-5331
Phone: (714) 427-0321 . Fax: (714) 427-0324 . Toll Free Fax: (800) 480-2272
Optional Workshop Registration Form
THURSDAY SESSIONS – October 2, 2008
REGISTRATION INFORMATION - Please print clearly
Session 1 & Session 2 – 12:00 p.m. to 4:15 p.m.
Due to minimum attendance requirements, all workshops are subject to cancellation.
Those registering for the ACLS Recertification will not be able to attend any other
workshops on Thursday. Absolutely no refunds will be given after September 8, 2008.
Please fill out and include with your general conference registration form. Please
include a separate check so it can be returned if one or more of the workshops you
select are full. Your credit card will be charged for only those workshops that are
open at the time you register.
Advanced Cardiac Life Support (ACLS) Recertification
(4 hours Cat I CME)
$135
Session 1 – 12:00 p.m. to 2:00 p.m.
Basic Suturing (2 hours Cat I CME)
$45
Casting & Splinting (2 hours Cat I CME)
$45
Joint Injection (2 hours Cat I CME)
$45
Session 2 – 2:15 p.m. to 4:15 p.m.
Minor Surgical Procedures (2 hours Cat I CME) $45
Joint Injection (2 hours Cat I CME)
$45
Intrauterine Contraception (2 hours Cat I CME)
$45
22
CAPA NEWS
CHECK ONE:  PA-C  PA
DAYTIME PHONE
 PA-S
 OTHER___________________________________
FAX NUMBER
EMAIL ADDRESS
PAYMENT INFORMATION
Please register me for the selected workshops.
SATURDAY SESSIONS – October 4, 2008
Session 3 – 10:30 a.m. to 12:30 p.m.
EKG Interpretation (2 hours Cat I CME)
Orthopedic Exam (2 hours Cat I CME) Session 4 – 2:15 p.m. to 5:15 p.m.
Wound Care (3 hours Cat I CME) Session 4 – 2:15 p.m. to 4:15 p.m.
Advanced Suturing (2 hours Cat I CME)
Orthopedic Exam (2 hours Cat I CME) NAME
Total Amount Enclosed:
$45
$45
$60
$45
$45
$_ ___________
 Visa  MasterCard
CREDIT CARD NUMBER
SIGNATURE
__________
EXP. DATE
5
Meals
Includ
ed
2008 CAPA Conference Registration Form
BASIC COURSE – Save $55 by Registering by September 8th!
$360* – Basic Course (16 Hrs. Cat. I CME)
$250* – PA Student Basic Course (16 Hrs. Cat. I CME)
*ADD $35, if registration & payment are received after Monday, September 08, 2008
ADD $55, if registration & payment are received after Monday, September 22, 2008
COMPLIMENTARY DINNER PROGRAMS*
RSVP for the Thursday Dinner Program at 7:00 p.m.
DELTA 5 Dementia Education Leadership in Alzheimer’s
(Medical Providers Only)
RSVP for the Friday Dinner Program at 6:45 p.m.
Diagnosis and Management of COPD: A Treatable Long Term
Progressive Disease (Medical providers only)
ONE DAY – Save $35 by Registering by September 8th!
 $95* – Thursday Only (4 Hrs. Cat. I CME)
$125* – Friday Only (5 Hrs. Cat. I CME)
$125* – Saturday Only (5 Hrs. Cat. I CME)
 $50* – Sunday Only (2 Hrs. Cat. I CME)
 $65* – PA Student Thursday Only (4 Hrs. Cat. I CME)
 $80* – PA Student Friday Only (5 Hrs. Cat. I CME)
 $80* – PA Student Saturday Only (5 Hrs. Cat. I CME)
 $35* – PA Student Sunday Only (2 Hrs. Cat. I CME)
*ADD $25, if registration & payment are received after Monday, September 08, 2008
ADD $35, if registration & payment are received after Monday, September 22, 2008
GUEST REGISTRATION - Must be over 18 years of age
$120 – Guest - Meals & Exhibit Hall
*These programs are not eligible for CME
REGISTRATION INFORMATION - Please print clearly
FIRST NAME
LAST NAME
CHECK ONE:  PA-C
 PA
 PA-S
 OTHER____________________________________
HOME ADDRESS
HOME CITY
STATE
ZIP
ZIP
COMPANY NAME
(Includes 5 conference meals; 3 breakfasts, 2 lunches, access to the
Exhibit Hall, The Dance, American PA Idol and Challenge Bowl)
COMPANY STREET ADDRESS
Guest Name_______________________________________________
COMPANY CITY
STATE
HOME PHONE
WORK PHONE
MOBILE PHONE
EMAIL ADDRESS
PA PROGRAM
GRADUATION DATE
 $25 – Guest - Exhibit Hall Only
(Access to the Exhibit Hall only)
Guest Name_______________________________________________
NON-MEMBER REGISTRATION - California PAs & Students
Add $100 – CAPA Non-Member Graduate
(Includes CAPA Membership through 4/30/09)
 Add $10 – CAPA Non-Member Student
(Includes CAPA Membership through 4/30/09)
CONFERENCE SPECIAL INTEREST NETWORKING
A Chance to Meet and Greet Like-Minded PAs
Interested in meeting/networking with other PAs in one of the following groups?
Mark one of the boxes below and we will make sure that your conference badge identifies your interest. We will also have tables set aside for each group at meal functions
so you can sit with those who share your interest/experience.
Please select one only:
PA Entrepreneurs
PAs in practice for over 25 years (lovingly known as the Dinos)
First-time CAPA Conference attendees/new CAPA members
GENERAL INFORMATION
Included with Basic Course: Conference meals, Friday Night Dance PArty, Exhibit Hall
and Student Challenge Bowl. Registration badges are required for all events except the
Friday Night Dance PArty and the Student Challenge Bowl.
Vegetarian Meals Requested
accordance with the Americans with Disabilities Act, please check here
 Inif you
have any special needs. You will be contacted by CAPA.
PAYMENT INFORMATION
Basic Course:
$ ____________
After September 8, 2008*:
*ADD $35 if registration & payment are postmarked/faxed/emailed
$ ____________
after 9/8/08 or ADD $55 if registration & payment are postmarked/
faxed/emailed after 9/22/08
One Day:
$ ____________
After September 8, 2008*:
*ADD $25 if registration & payment are postmarked/faxed/emailed
$ ____________
after 9/8/08 or ADD $35 if registration & payment are postmarked/
faxed/emailed after 9/22/08
Guest Registration:
$ ____________
Non-Member Registration:
$ ____________
Total Amount Enclosed:
$_ ___________
 I paid the non-member price and do not wish to be a CAPA member

Visa

MasterCard
_ _________
CREDIT CARD NUMBER
NAME AS IT APPEARS ON CARD
EXP. DATE
SIGNATURE
Phone or fax registration: Mastercard or Visa only: Phone (714) 427-0321, Toll Free Fax: (800) 480-CAPA (2272). To avoid duplicate charges, please do not mail the original registration
form if you have faxed it or emailed it to the CAPA office. Mail registration form and make checks payable to: CAPA, 3100 W. Warner Avenue, Suite 3, Santa Ana, CA 92704.
JULY/AUGUST 2008
23
Running Along and Finding Friends
by Beth Grivett, PA-C, Legislative Affairs Coordinator
U
sually when I run, it is like an
escape from life. I don’t have to
worry about patients or about the
next crisis at work. I don’t have to
think about what is happening with one
of CAPA’s legisative bills or stress about
writing an article for the CAPA News!
I get out on the road, turn up my iPod
and get away from my daily stresses. It
is a time that I can think about things,
plan a vacation, and offer some words of
advice to my running partner (whether
solicited or not). Even more so during a
race. You can really get away from life and
just worry about getting one foot in front
of the other for one more mile. Except,
you also get the feedback from the crowd.
You hear the cowbells and the cheers from
the fans along the road. You get to see the
cheerleaders from the local high school and
all
the kids cheering on Mom
or Dad.
You AM
CAPANS708:CAPANS708
7/2/08
10:34
Cherri Penne-Myers, PA-C, MSCS
John Western, PA-C
get to see the “Go” signs and sometimes
some clever saying that a friend put on
a poster board to see how many people
will laugh at it! Every mile or so there is a
crowd with tables of Dixie cups filled with
water or Gatorade and lots of volunteers
that have been pouring away and handing
out cups since very early in the morning
and for hours on end. Thank goodness for
the
water
Page
1 folks!!
Then, every few miles or so there is an aid
station. Luckily, in my marathon career of
now 11, I have never had to visit one of these
stations for more than a little Vaseline for
those chaffed areas. But, these folks are busy.
And, the further along the course you get,
the hotter it gets and the more injuries there
are. During my last run, the Rock ‘N Roll
Marathon in San Diego, I was greeted at
one of these aid stations by some of my PA
friends and colleagues. At mile 14 there was
John Western, PA-C, Marie Caserio, PA-C,
Cherri Penne-Myers, PA-C, and Sally Tilsen,
PA-C. What a great showing of physician
assistants! They were hard at work taping
ankles, icing knees and getting transport
for some of the more serious cases of
hyponatremia and dehydration. Thank you
all so much for getting up SO early, fighting
the crowds and for volunteering to be there
to help those in need! You are awesome! 
As a Physician Assistant, you
shouldn’t play games with your career …
Protect your
Career & Future
With Professional Liability Insurance through HPSO.
You probably wouldn’t dream of taking risks with your future. But without the
right malpractice protection, that’s exactly what you’re doing! All it takes is one
complaint to the Medical Board, or one lawsuit against you, to place your license,
your career and financial future in serious danger.
So Make the right move … Apply for Professional Liability Protection Today.
Limits up to $1,000,000 each claim up to $3,000,000 aggregate, commensurate with
your supervising physician’s limits.
Coverage available to Physician Assistants through HPSO is underwritten
by a CNA Company, rated “A” (Excellent) by A.M. Best. CNA is fully
admitted as a licensed insurer in your state.
Visit hpso.com/capa7
For More Information and to Download an Application.
This program is underwritten by American Casualty Company of Reading, Pennsylvania, a CNA company and is offered through the Healthcare Providers Service
Organization Risk Purchasing Group. Coverages, rates and limits may differ in some states. This material is for illustrative purposes only and is not a contract. It is
intended to provide a general overview of the products and services offered. Only the policy can provide the actual terms, coverages, amounts, conditions and
exclusions. CNA is a service mark and trade name registered with the U.S. Patent and Trademark Office.
Healthcare Providers Service Organization is a division of Affinity Insurance Services, Inc.; in CA (License #0795465), MN & OK, AIS Affinity Insurance Agency, Inc.;
and in NY, AIS Affinity Insurance Agency.
© 2008 Affinity Insurance Services, Inc.
Questions? Call 1-800-982-9491
CAPANS708
Midlevel Practitioners?
by Miguel Medina, PA-C, President
A
t the 2008 American Academy of Physician Assistants’
House of Delegates, a resolution was passed
encouraging the use of the term physician assistant
when referring to PAs. In the past we have often been
grouped together with nurse practitioners and referred to as
midlevel practitioners. Although we share a lot of similarities
with our nurse practitioner colleagues, there are important
distinctions between the two professions. As time has passed
these differences are becoming more evident.
HP-3200.1.1 – AAPA believes competency-based
From our inception, physician assistants have had a unique
relationship with their supervising physicians. The team
concept has always been at the forefront of our practices,
with our patients as the focal point of the team. In October
2004, the American Academy of Nurse Practitioners
published a position paper recommending the conversion
of the terminal degree for advance nurse practitioners from
master’s degree to Doctorate of Nursing Practice (DNP) by
the year 2015. In this position paper it states that, “most
disciplines that prepare licensed independent practitioners
(LIPs) such as podiatrists, psychologists, optometrists,
pharmacists, osteopaths, medical doctors and dentists, prepare
them at a clinical doctorate level.” According to the American
College of Nurse Practitioners, in the United States, 22
states have NP practice laws that do not require physician
involvement. Twenty-eight states require documented
physician involvement. This can include collaboration,
supervision, or authorization. A nurse practitioner’s scope-ofpractice is controlled by each state Nursing Board. Physician
assistant practice is authorized by each state’s medical board.
Nurse practitioners can practice independently. Physician
assistants require physician supervision.
HP-3200.1.3 – AAPA recognizes that PA education is
In recent years a phenomenon of increased degree
attainment has overtaken many health care professions.
The doctoral degree in clinical practice is now becoming
common in many professions. With this increased degree
attainment, the call to become an independent practitioner
has been issued.
Earlier this year, the first clinical doctorate degree for PAs
was awarded by the U.S. Army in conjunction with Baylor
University. Army PAs received a Doctor of Science Physician
Assistant (DScPA) degree after successfully completing an
18-month residency in emergency medicine at Brooke Army
Medical Center at Fort Sam Houston in San Antonio, Texas.
How will the development of this new degree affect the
future of PA education?
The following are a series of policies from the AAPA
regarding PA education:
professional education at ARC-PA accredited entry level PA
programs followed by life-long learning has been a successful
formula for competent PA practice. [Adopted 2007]
HP-3200.1.2 – AAPA believes the ability of PAs to practice
and be reimbursed should not be compromised regardless
of the degree awarded upon completion of entry level PA
education. [Adopted 2007]
conducted at the graduate level and supports awarding
the masters degree for new physician assistant graduates.
[Adopted 2007]
The following are policy statements regarding the PhysicianPA team: “Physician assistants are health professionals
licensed or, in the case of those employed by the federal
government, credentialed, to practice medicine with
physician supervision. The AAPA believes that the physicianPA team relationship is fundamental to the PA profession
and enhances the delivery of high quality health care. As the
structure of the health care system changes, it is critical that
this essential relationship be preserved and strengthened.
The role of the physician assistant(s) in the delivery of care
should be defined through mutually agreed upon guidelines
that are developed by the physician and the physician
assistant and based on the physician’s delegatory style.” The
American Academy of Family Medicine policy states, “The
AAFP recognizes the dynamic nature of the health care
environment and the importance of an interdependent team
approach to health care that is supervised by a responsible
licensed physician.”
Clearly there is a philosophical difference between nurse
practitioners and physician assistants and it is important to
make the distinction between our professions. There are also
many commonalities that we share with our NP colleagues.
We should strive to continue to work together in harmony
with our NP and physician colleagues for the betterment of
our patients. It is important that we avoid the term midlevel
practitioner when referring to PAs and to use and be proud
of our title, physician assistant.
References:
•
Doctor of Nursing Practice (DNP): http://www.aanp.org/
AANPCMS2/LegislationPractice
•
NP scope of practice:http://www.acnpweb.org/i4a/pages/index.
cfm?pageid=3465
•
The Physician-PA team: American Academy of Physician Assistants.
2007-2008 Policy Manual. Alexandria, VA.
•
American Academy of Family Physicians. 1997-1998 AAFP Reference
Manual – Selected Policies on Health Issues. Kansas City, MO. 
JULY/AUGUST 2008
25
Students Students Students Students Students Students
Greetings from the Heartland…Or, What We Did This Summer
by Les Howard, PA, Program Director, SJVC PA Program
May
For the second time, in its five year history, the
SJVC PA Student Society has been named a Student
Academy of the American Academy of Physician
Assistant’s Outstanding Student Society of the Year.
The Outstanding Student Society Award recognizes
two Student Societies for outstanding service to the
profession in the areas of public education,
You Know You’re a PA-S
public service, promotion of diversity, and
professional involvement. Two Student
When You Wonder...
Societies are chosen as the award recipients.
The SJVC PA Student Society was judged
upon the following criteria: public service
accomplished by the Student Society; public
education by Student Society, activities that
promote diversity within the community and
the profession, participation in professional
and leadership activities at local, regional,
state, and national levels, and contribution to
the society’s own students and program. Our
faculty congratulates the students for a job well
done, recognition of their accomplishments and
contributions to the community and profession. http://
saaapa.aapa.org/resources/award-winners.htm.
June
What a month! We had one class graduating, one class
moving into clinicals and started working with the
incoming class. June 27th, was a busy day. It started
with the junior class “White Coat Ceremony,” a day
that they have worked hard to reach for the past year.
Considering they had just finished a week of finals
and a month of relentless testing (something like 732
questions on everything that had “…ology” at the end
of it). The Class of 2009 cleaned up pretty good as
they donned on their lab coats. Class President, James
McPherson, summed it up in his “State of the Class”
address when he said (and I paraphrase), “the class
was made up of a great bunch of people, who are a
pleasure to work with.” Faculty will have to agree, and
we can only hope that the “Platinum Crew,” as they
like to be called, will never change especially since they
are now officially seniors. I did appreciate the cake at
the reception. It had a classic “Les-ism” written in the
frosting…something about “malpractice” and their
future performance on clinicals.
26
CAPA NEWS
Then and hour later, the graduates of the Class of
2008, had their “Pinning Ceremony” in a reception
hall packed with family, friends, preceptors, and folks
who came to see them walk across the stage and be
recognized for their accomplishments. We called the
Class of 2008 the “Diamonds in the Rough” because
like diamonds, sometimes we had to put a lot of pressure
on some of them to get something precious (an inside
joke but I noticed that a few of them got the message
and now have a “C”...lol). It was moving for this old
PD to see these future colleagues step up and share
the moment with those who suffered and sacrificed as
much as they had for the past two years. Now there’s
only more test that they have to sit through, and so far
we are happy to report, that everyone that has taken
the PANCE so far is ready to start a new career as a PA.
Congrats you new PA-Cs and get your CAPA dues in,
you’re making money now.
We started something new at the program; we
conducted a “Pre-PA” program for the incoming classes
of 2010 and 2011. You might say we gave them a
taste of things to come. The students were exposed to
examples of curriculum, given didactic lectures, reading
assignments, testing with questions from old test banks,
lectures on study skills and test taking, a chance to
meet faculty, interact with new classmates, and gain
sage words of wisdom from current students and recent
graduates. The students braved the July heat of the
Central Valley and sat thru several Saturday’s getting
reams of paper on dermatology topics, taking copious
notes, sitting thru H&P, A&P, Patho and Diagnostic
studies lectures, videos, and the curse of all PA student
the dreaded PowerPoint presentations. They did so
voluntarily. Go figure. But some of them later told me
that they saw the method in the madness and it did help
ease some of the anxiety of starting the program because
they had a better idea of what to expect and had started
to form study groups early. That’s all a PD can ask for…
less “stressed out” students.
July
The sixth class officially has graced our classroom. That
first day, they all looked so bright and shiny. Some did
Success! 2nd Annual Legal Rights & Responsibilities for the
California PA Student Seminar 2008
by Kristen Woods, MPA, PA-C, Student Affairs Committee Chair and Director-At-Large
C
entral and Northern California PA Students from five
of the ten California PA Programs once again gathered
together under one roof on a sunny Sunday, May
18, 2008 in Oakland for the 2nd Annual Legal Rights
& Responsibilities for the California PA Student Seminar.
PA Programs in attendance included: Samuel Merritt
College MPA Program (Oakland), San Joaquin Valley
College PCPA Program (Visalia), Stanford University
PCA Program (Palo Alto), Touro University-California
MSPAS/MPH Program (Vallejo), and UC Davis FNP/PA
Program (Davis).
and resumes, negotiating employment, and reasonable
expectations for a new PA-C.
Once again CAPA leaders delivered! Miguel Medina, PAC (CAPA President and Faculty at Western University of
Health Sciences) and Bob Miller, PA-C (CAPA Professional
Practice Committee Chair, Treasurer, Past President and
Assistant Professor at USC Keck School of Medicine)
presented relevant, timely, and invaluable legal and practical
information especially important to the graduating physician
assistant student. Topics reviewed included: Review of
current California PA laws and regulations, Delegation
of Services Agreement (DSA), Protocols, Malpractice
insurance, How Not to get sued, Insurance billing,
Completing your California and DEA (Drug Enforcement
Agency) applications.
This year’s day-long seminar was free to
attendees and sponsored by the 5 programs
in attendance. Kristen Woods, PA-C
(CAPA Student Affairs Committee Chair
and Director-At-Large) organized the
seminar. New programming of the PA-C Panel was inspired
by Mercedes Barrutia Dodge, PA-C (CAPA Committee on
Diversity Chair, former Student Representative).
PA-C Panel was a hit! New programming this year included
a panel of recent grads as well as Mr. Medina and Mr. Miller
who spoke of their personal experiences in transitioning
from PA-S to PA-C and their day-to-day duties in various
areas of practice which included: Adult Medicine/Family
Practice, Emergency Medicine, Hematology-Oncology, and
Orthopedic Surgery. The panel spoke to PA-S issues such as:
choosing an area of practice, taking the PANCE, job searching
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Positive feedback! Those in attendance rated the seminar
with overwhelmingly positive feedback regarding the
speakers, seminar content, and handouts. Comments
included: “Thank you for organizing this
day.” “The handouts were very useful; I
am sure I will reference them when I am
graduating/applying for NCCPA exams and
jobs.” “Good food.” “The panel was great!”
See you next year! Keep an eye out for the 3rd Annual Legal
Rights and Responsibilities for the California PA Student
Seminar in Winter/Spring of 2009. Whether you missed this
year’s event, or want to refresh yourself on current PA laws
and regulations, we’ll see you there! Until then, good luck in
the classroom, and in clinic.
A personal thank you to CAPA for sponsoring lunch this
year, and to each of the 5 PA Programs for your financial
support of this important program. Thank you also to our
Panel Members for your time and valuable input!
Students today, Colleagues tomorrow… 
Hot Off the Presses … Second Edition of the California Physician Assistant’s and
Supervising Physician’s Legal Handbook
M
ichael Scarano, Jr., Esq. authored the California Physician Assistant’s and Supervising Physician’s Legal Handbook.
Newly updated, it answers scores of questions in a concise, clear fashion, with citations and appendices that
will permit practitioners to read the operative statutes and regulations for themselves. A must have for all California
practices employing PAs. Visit the CAPA website at www.capanet.org/legalbook.cfm for more information.
JULY/AUGUST 2008
27
“Surviving Clinical Rotations” Workshop
by Cynthia Booth Lord, MHS, PA-C, Assistant Professor and PA Program Director Quinnipiac University
You are in for a treat! AAPA President and Quinnipiac
PA Program Director, Cindy Lord has graciously allowed
us to reprint her handout from a “Surviving Clinical
Rotations” Workshop. Due to limited space, we are
printing the handout in four issues of the CAPA News,
Part 3 is below:
CLINICAL ROTATION BOOK LIST
Medical Spanish Made Easy. A.B. Anup, M.D. ISBN
0-9657083-0-6 ($18.99)
The Medical Letter (twice a month; now available for
Palm OS and Pocket PC) ($44.50/year)
Prescriber’s Letter (monthly) ($88; student rate
available)
Internal Medicine Pearls. (series) Sahn. ($23.00-45.99)
The Mont Reid Surgical Handbook. Elsevier. ($46.00)
Surgical Secrets/Medical Secrets (series) Mosby. ($22.99)
Surgical Recall. (series). Williams & Wilkins. ($37.95)
House Officer Series.(series). Williams & Wilkins.
($29.95)
Harriet Lane Pediatric Handbook. Mosby ($49.95)
The Washington Manual. A Little, Brown Spiral
Manual. ($39.95)
Sanford Guide to Antimicrobial Therapy –Yearly.
($12.95) Palm OS and Pocket PC ($27.50)
Principles of Primary Wound Management. Mike
Mortiere, PA. Clifton Publishing ($16.00)
Guide to Antibiotic Use in the Emergency Dept.
(Yearly) J. Bryan. Emergency Medicine Residents Assoc.
($37.00)
Clinician’s Pocket Reference-“Scut Monkey”. Appleton
& Lange. ($39.95)
• Tarascon Adult Emergency Pocketbook ($14.95)
• Tarascon Internal Medicine and Critical Care
Pocketbook ($14.95)
• Tarascon Primary Care Pocketbook ($14.95)
• Tarascon Orthopaedia Pocketbook ($14.95)
Pocket Guide to Commonly Prescribed Drugs. G.
Levine. Appleton & Lange. ($24.95)
Handbook of Commonly Prescribed Drugs.
DiGregorio. ($25.00)
Internal Medicine Clerkship Guide (Clerkship Guides
Series). Mosby. ($34.95)
CAPA NEWS
Intern Survival Guide. (Surgery, EM etc) ($9.50)
Physician Assistants Prescribing Reference (Quarterly)
($34.84)
Tarascon Pocket Pharmacopeia –Palm OS and Pocket
PC (Yearly) ($11.95)
• Tarascon Pediatric Emergency Pocketbook
($11.95)
28
Internal Medicine On Call. (series). Appleton & Lange.
($36.95)
Clinician’s Pocket Drug Reference-The Scut Monkey
Drug Manual (yearly). McGraw-Hill. ($9.95)
Clinical Survival Guide for PA Students. George
Broughton II, MD, PhD. Compass Publishing.
www.compasspublishing.org ($25.00)
Saint Frances Guide to Inpatient Medicine. William &
Wilkins. ($36.95)
Practical Guide to the Care of the Medical Patient.
Mosby. ($41.95)
Manual of Common Bedside Surgical Procedures.
Williams & Wilkins. ($57.00)
Practical Guide to the Care of the Critically Ill Patient.
Mosby. ($27.99)
Cope’s Early Diagnosis of the Acute Abdomen. William
Silen. Oxford Press. ($36.00)
Quick Cards Clerkship Series 3. Bourne
Medical Publishing. A 7 card pocket
reference set for students studying in the
field of medicine. The series covers all major
areas from surgery to psychiatry. There
is also an option to purchase Laboratory
Values card and/or Over-the-Counter Drug
card. ($23.95) www.medquickcards.com
7. Moser, Rodney: Primary Care for
Physician Assistants Self-Assessment and
Review. 2nd ed. 2001. McGraw-Hill. ISBN:
0-07-137015-3 ($34.95)
16. Papadakis, Maxine, McPhee:
CURRENT Consult Medicine 2007.
2006. McGraw-Hill. ISBN: 0-07-1472185
($64.95)
8. Zarbock, Sarah, O’Connell, Claire: A
Comprehensive Review for the Certification
and Recertification Examinations for
Physician Assistants. 2nd ed. 2004.
Lippincott Williams & Wilkins. (3rd ed.
Due May 2007. ISBN: 0-7817-6767-9.
($49.95). ISBN: 0-7817-4462-8 ($49.95)
17. Doherty, Gerard: CURRENT Consult
Surgery. 2005. McGraw-Hill. ISBN: 0-071423133 ($69.95)
9. Auth, Patrick and Kerstein, Morris:
Physician Assistant Review. 2nd ed. 2005.
Lippincott Williams & Wilkins. ISBN: 07817-5026-1 ($49.95)
19. Taylor, George: Board Buster Clinical
Cases: Steps 2 and 3. 2004. Lippincott,
Williams & Wilkins. ISBN: 1-405-104651 ($34.95)
1. Ferri, Fred: Ferri’s Clinical Advisor.
2007 ed. Mosby. ISBN: 0-323-04136-1
$79.95
10. Tallia, Alfred: Swanson’s Family
Practice Review. 5th ed. 2005. Mosby.
ISBN: 0-323030009 ($74.95)
2. Dambro, Mark: Griffith’s 5 Minute
Clinical Consult. 2007. Lippincott
Williams & Wilkins. ISBN: 0-7817-6334-7
($79.95
11. Habermann, Thomas: Mayo Clinic
Internal Medicine Board Review 20042005. 2004. Lippincott Williams &
Wilkins. ISBN: 0-7817-5773-8 ($99.95)
20. Schwer, William, Plantz, Scott, Embla,
G. Lewke: (Pearls of Wisdom) Family
Practice Board Review. 2006. Mc-Graw
Hill. ISBN: 007-146-4298 ($59.95*)
3. Rakel, Robert: Saunders Manual
of Medical Practice. 2nd ed. 2000. WB
Saunders. ISBN: 0-7216-8002-X ($99.00)
12. Ayala, Carlos, Spellberg, B.: Boards
and Wards: A Review for USMLE Step 2
& 3. 2003. Blackwell Publishing. ISBN10:
1405103418 ($36.95)
Maxwell Quick Medical Reference. (spiral
bound) Maxwell Publishing Co. ($7.95).
Pocket Medicine: The Massachusetts General
Hospital Handbook of Internal Medicine.
(Pocket Notebook; Ring-bound). Lippincott
Williams & Wilkins. ($44.95).
BOARD REVIEW BOOK LIST AND SOFTWARE
4. Miller, Anthony and Simon, Albert:
Appleton & Lange Review for the Physician
Assistant. 4th ed. 2002. Appleton & Lange.
ISBN: 0-0713-7544-9 ($42.95)
5. Irvine, David: Review Questions
for Physician Assistant Certifying
Examinations. 1998. Vol. 10. Parthenon
Publishing. ISBN: 1-85070-663-8 ($39.95)
6. Simon, Albert and Miller, Anthony:
Appleton & Lange’s Outline Review for
the Physician Assistant Examination. 2nd
ed. 2003. Appleton & Lange. ISBN:
0071402896 ($44.95)
13. Blueprints Q & A Step 1, Step 2 and
Step 3 series (Surgery, Medicine, OB/GYN,
Pediatrics, and Psychiatry). 2004. Blackwell
Publishing. ($17.95-$29.95)
14. Garfunkel, L, Kaczorowski, J: Mosby’s
Pediatric Clinical Advisor. 2002. Mosby.
ISBN: 0-323-01049-0 ($64.95). (2nd ed.
Due May 2007. ISBN: 0-323-03506X.
$99.95)
15. Lipsky, Martin: Family Medicine
Certification Review. 2003. Blackwell
Publishing. ISBN10: 1405103299 ($48.95)
18. Zaslau, Stanley: Board Buster Step
2. 2004. Lippincott, Williams & Wilkins.
ISBN: 1-4051-0385-X ($34.95)
*Also have series in Emergency Medicine,
General Surgery, Pediatrics, Internal
Medicine
21. Emblad, G. Lewke and Plantz, Scott:
(Pearls of Wisdom) Physician Assistant
Exam Review. 3rd ed. 2006. McGraw-Hill.
ISBN: 007-146-445X ($39.95)
22. Goldlist, Barry: Appleton & Lange
Review of Internal Medicine. Appleton &
Lange. ISBN: 007-138524-X ($34.95)
23. Wilbur, Jason, Graber, Mark: Family
Practice Examination and Board Review.
2005. McGraw Hill. ISBN: 007-1431-306
($69.95)
24. NCCPA Connect>Exams>PANCE>co
ntent blueprint>Sample Diseases/Disorders
by Organ System. http://www.nccpa.net/
EX_sample.aspx?r=pance 
JULY/AUGUST 2008
29
Honoring A Family of PAs!
dignity and respect, providing the same level
of medical care for all, regardless of their
social or economic standing.
In addition to being a wonderful clinician,
my father is a well-rounded person. It
was not until college that I realized it was
the PA profession that allowed him such
flexibility for his family. His knowledge and
dedication to the PA profession is evident
and inspirational. The CAPA Conference in
Palm Springs has become a family tradition.
Since I was about five years old, it became
a nightly tradition to ask about my dad’s
patients of the day. He would gladly do a
case presentation of the most interesting
patient he saw. These became progressively
more involved as I learned more about the
human body and disease processes. He
would teach me about drug classes, so that
I knew the five brand name SSRIs by age
twelve. He had a tremendous influence
on my decision to pursue a career as a
physician assistant. He is my hero and
my idol. He is someone I strive to be like
every day
GB: Your love and admiration for each other
is evident and so wonderful to see. Have
you decided in what area of medicine you
will work after you graduate?
SW: I have not decided what area of medicine
I will practice in. At this point in my studies, I
want a part of it all! My dream for the future is
to work with my dad and carpool to work.
GB: Having a PA dad has to be helpful in
getting you through some of the challenges
of the PA Program. As a PA student, what
is the greatest benefit of being the daughter
of a PA?
SW: Before every exam I call my dad on the
way to school. He helps me collate all the
information in my mind. His calming voice
reassures me and sticks with me during tests.
His pearls of wisdom are central in my study
group cramming session before the test. My
dad is a golden reference.
GB: At your program, do you see awareness
among your classmates that CAPA
membership is important throughout their
PA career?
SW: As my classmates realize that CAPA
is the longevity of the profession, more
students are taking an interest. We are
excited to compete in the CAPA/Kaiser
Student Challenge Bowl in October.
GB: I know you would like to get into CAPA
leadership in the future. Why do you feel
that is important and what benefits do you
see in serving in a leadership position?
SW: CAPA bridges the gap between the
world of health care and the world of
politics. Physician assistant avocation has
become an interest of mine. While I strive
to be a good clinician, it is a solid political
platform that will allow us to practice.
Thank you George and Stephanie. We’ll be
looking for you at the CAPA Conference in
October. 
Greetings from the Heartland…Or, What We Did This Summer
have that terrified look in their eyes, and
some looked like they were not sure what
they had gotten themselves into, but they
all came to work so it’s all good. Three
weeks into it (or a few major tests, quizzes,
write-ups, checklist and a health promotion
disease prevention project) they are still sort
of shiny, but are questioning how bright
they are, have started to develop an affinity
for caffeine, polite dinner conversation has
become treatment plans for Impetigo, and
some of their textbooks look like they have
hepatitis from all the highlighting. Things
are progressing nicely.
The seniors are traveling up and down
California 99 to their clinical rotations,
having those 40 patient days when nothing
resembles anything they read about in
30
CAPA NEWS
Current, being pimped, prodded, scutted,
and “abused.” When they come back to see
us on Friday’s, they talk about their week of
interesting cases, patients and preceptors.
It really is amazing to see those “clinical”
wheels turning in their heads; it sort of
reaffirms that they were listening to lectures
after all.
I was fortunate to attend one of the “Lunch
on CAPA” talks with the PAs at Family
Health Care Network. This is a really great
idea, and keeps CAPA leadership in touch
with the folks out here in the trenches.
Thanks to Mr. Bill Barreto, PA-C for
putting this together and thank you CAPA
President, Miguel Medina, for coming up
with the “Lunch on CAPA” concept and
taking the time to travel around the state
including the Central Valley. I enjoyed his
talk, meeting the PAs, and catching up
with several former students now walking
the walk and talking the talk. Good stuff, I
hope CAPA keeps it up.
August
This just in! SJVC was selected by the PAEA
to receive the Excellence Through Diversity
Award. The award will be presented in
Savannah, Georgia, on Thursday, October
30, 2008. Well, it’s been a busy summer and we are
preparing for the year ahead, hopefully it
will be another day in paradise. Who knows,
maybe this is the year the Challenge Bowl
trophy comes to Visalia. I can only keep
hope alive. Take care. 
Welcome New Members
Marcos Aird, PA-C
Mark Allen, PA-S
Ann Amores
Luis Archila, PA-S
Beth Barbera, PA-S
David Barsky, PA-C
Sarah Bobich, PA-S
Stephanie Brammer, PA-S
Nora Branning, PA-S
Nicholas Brecht, PA-C
Suzane Brian, PA-C
Jenna Cappello, PA-S
Jason Carter, PA-S
Lilia Castro, PA-S
Laura Cataldo, PA-S
Patricia Chamul, PA-C
Susan Chen, PA-C
Anne Clark, PA-S
Kia Cody, PA-S
Stephanie Conte, PA-S
Joseph Contreras, PA-C
Brian Cormier, PA
Stephanie DeJarnett, PA-C
JoAnn Deasy, PA-C
Richard Dehn, MPA, PA-C
Erin Del Rossi, PA-C
Sandi Delgado, PA-S
Timothy Faggionato, PA-C
Ira Felman
Sharon Finley
Veronica Galvan, PA-S
Shimeaka Garrett, PA-S
Jennifer Gartman, PA-S
Tawny Gorelick, PA-S
Cindy Hale, PA-C
Bert Halter, PA
Brad Hamann, PA-C
Jacqueline Hattar
Heather James, PA-S
Azita Javdanfar, PA-S
Brittany Jordan, PA-S
Lindsay Kozicz, PA-S
Jennifer Labrum, PA-S
Eric Ladenheim, MD
Gretchen Layman, PA-S
Matthew Ledges, MD
Kathleen Lin, PA-S
Noe Lopez, PA-S
Michael Luther, PA-C
Adam Marks, PA-S
Patricia McBride, PA-C
Onyebuchi McCrea, PA-S
Maureen McGhee, PA
Aaron Mendez-Gutierrez, PA
Jennifer Minassian, PA-S
Stacy Montz, PA-S
Nobuko Nakamura, PA-S
Kathleen Nelson, PA-C
Josephine Nguyen, PA-S
Jennifer Pavley, PA-S
Deanna Perez, MPAS, PA-C
Kelley Peterson, MMS, PA-C
Amy Risley, PA-S
Eva-Nannette Rueda, PA-S
5/24/08 through 8/1/08
Hillary Runnels, PA-S
Penny Sahatrungsinee, PA-S
Claudia Santana, PA-S
Sharmez Savoy, PA-S
Jennifer Schlack, PA-S
Vicki Shah, PA-S
Jocelyn Shim, PA-S
Ben Simpson, PA-S
Elizabeth Soria, PA-S
Veronica Soto, PA-C
Jennifer Starkey, PA-S
David Stewart, PA-C
Sarah Strube, DO, PA
W. Paul Theriot, PA-S
Elizabeth Thrasher, PA-C
Johnny Torres, PA-S
Reygil Trinidad, PA-S
Kathryn Trueheart, PA-S
Jennilyn Tuquero, PA-C
Irene Van Gaalen, PA-S
Susan Wagner, PA-C
David Wall, PA-S
Leslie Washington, PA-S
Julianna West, PA-S
Angela White, PA-S
Jennifer Whitlock, PA-C
Nicole Wilson, PA-S
Myrra Windau, PA-S
Bo Xu, PA-C
Jennifer Zimmerman, PA-C
Local Groups
1. Physician Assistant Society of
Sacramento (PASS)
Carlos De Villa, PA-C, PASS President;
(916) 396-7596, [email protected]
Atul Sharma, PA-C, MMS,
MPH, CHES; (916) 397-6035,
[email protected]
2. Contra Costa Clinicians Association
Brian Costello, MS, PA-C, ATC; (925)
689-8853, [email protected]
3. San Francisco Bay Area Physician
Assistants (SFBAPA)
www.sfbapa.com, PO Box 14096, San
Francisco, CA 94114-0096
Martin Kramer, PA-C; (415) 433-5359,
Fax: (415) 397-6805,
[email protected]
4. Bay Area Mid-Level Practitioners
Rose Abendroth, PA-C; (650) 697-3583,
Fax: (650) 692-6251, [email protected]
Matt Dillon, PA-C; (650) 591-6601,
[email protected]
5. Bay Area Non-Docs
Linda O’Keeffe, PA-C; (650) 366-2050,
[email protected]
6. Northcoast Association of
Advanced Practice Clinicians
Cathy Silver, PA-C; (707) 826-2830,
[email protected]
7. Stanislaus County NP/PA Network
Brian Cormier, PA-C; (209) 605-4966,
[email protected],
www.nppanetwork.com
8. Journal Club for PAs and NPs
(Fresno area)
Cristina Lopez, PA-C; (559) 875-4060;
Fax: (559) 875-3434, [email protected],
2134 10th St, Sanger, CA 93657
9. Tulare/Kings NP/PA Association
Steve Henry, PA-C; Pager: (559) 7494348, [email protected]
10. Central Coast Nurse Practitioners &
Physician Assistants
Kris Dillworth, NP; [email protected]
Mari Proksel-Downs, PA-C; (805) 9293898, [email protected]
11. So Cal PAs
Linda Aghakhanian, PA-C;
[email protected]
12. Orange County
Hung Nguyen, PA-C; (714) 846-8178;
[email protected]
13. Southern Inland Valley Empire Area
- PAP (Providers in Advanced Practice)
Lorna Laney, NP; (951) 206-0435,
[email protected]
14. San Gabriel Valley Local Group
M. Rachel DuBria, PA-C;
15. San Fernando/Santa Clarita Valley
Group
Jonah Tan, MPT, PA-C;
16. San Diego Area
Jeremy Adler, MS, PA-C;
In Memoriam
Philip Metzer, PA-C
1944 – 2008
Wichita State PA Class of 1975
P
hil Metzer, PA-C died suddenly on May 10, 2008. At the
time of his death, Phil was a staff PA with Southern California
Kaiser Permanente Medical Group (SCKPMG) working in
the Department of Family Medicine/Urgent Care since coming to
California in 1978. Phil was 64. A native of Kansas, Phil served in the
Navy as a Medical Corpsman, and after leaving the military worked
as an X-Ray Tech before enrolling in the Wichita State PA Program,
graduating in 1975. Prior to coming to California Phil worked
on the Alaska pipeline. Phil was an early CAPA member having
joined in 1978. He was proud to be identified as a California/CAPA
“dinosaur,” having been the 428th PA licensed in California. Phil was
respected by all that worked with him. He was humble, and loved
sharing his clinical skills and time with his colleagues, his patients and
his community. Phil’s passing is a great loss to his family, his patients,
his hundreds of students and to the PA profession.
Steven Jay Bergstrom, PA-C
1951 – 2008
USC PA Class of 1998
O
n July 5th CAPA lost one of its own–Steven Jay Bergstrom,
PA-C. He was a great PA, a devoted husband, father and son,
and a good friend. Steve was well-liked by everyone as he was
extremely kind, genuine and giving. He graduated from the USC
PA Program in 1998 and served briefly on the CAPA Board. Not
long after graduation, Steve and his family moved back to Illinois
where both he and his wife’s families live. He was employed as a
PA with Mercy Health Systems in Woodstock, Illinois in a Plastic
surgery group. Steve always put his family first. He is survived by his
wife Patti, daughters Rebecca and Tammy, his mother Margaret, his
two older brothers, his sister and many nieces and nephews Online
condolences may be left for Steve’s family by visiting his obituary at
www.esterdahl.com. 
JULY/AUGUST 2008
31
PA MarketPlace at the CAPA Conference
Do You Have a Product or Service You Would Like to Sell?
A
t the CAPA Conference in Palm Springs your 6 foot table in the PA MarketPlace is
free (October 3 & 4). All we ask is that 20% of your net sales/orders go to the CAPA
Political Action Committee (PAC) and that the product and/or service is safe and in
good taste, of course. At last year’s conference, one of the PA Programs sold t-shirts and a
PA who makes jewelry sold her beautiful handy-work. Both gave 20% of the sales to the
CAPA PAC and it was quite successful for all involved. We thought we would expand on
that concept.
Sign Up
Today!
Many PAs and/or their spouses have businesses which could benefit from sales to CAPA Conference attendees. We know of a PA who
makes beautiful soaps. Another who has a candle business and one who has a sign business. The authors or book collectors out there can sell
their books. Maybe your mate has a business and would like to fill some of their time selling while you are in the lectures.
For complete rules and information, please contact the CAPA office at (714) 427-0321. PAC ID #981553.
Drug Orders for Controlled Substances
First Two Dates And Locations For
The Highly Anticipated
Before AB 3
Controlled Substances Education Course
PAs are required to
obtain patient-specific
authorization (PSA) from
the Supervising Physician
(SP) prior to writing a drug
order for any controlled
substance.
After AB 3
After meeting education
standards set forth by the PAC,
PAs may write a drug order for
controlled substances contained
in their practice-specific
formulary – without PSA.
A Course Which Upon Successful Completion Will
Allow You To Write For Controlled Substances
Without Patient Specific Approval*
Wednesday, October 1, 2008
Wyndham Palm Springs
Courtyard San Diego
Airport/Liberty Station
$90 for CAPA Members
$150 for Non-Members
*California Code of Regulations Sections: 1399.541(h), 1399.610 and 1399.612. A PA may administer, provide, or
issue a drug order for Schedule II through V controlled substances without patient specific approval if the PA completes
specified educational requirements and if his/her Supervising Physician delegates the authority to them.
California Academy of Physician Assistants
3100 W. Warner Avenue, Suite 3
Santa Ana, CA 92704-5331
Address Service Requested
Presorted STD
US Postage
PAID
Long Beach, CA
Permit No 368

July/August 2008

Transcription

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