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IMPORTANCE OF IMMUNIZATIONS
In Developing Countries
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A review of UNICEF and WHO literature illustrates why we shouldn’t take immunizations for granted. Worldwide, over 100 million children are immunized every year by age one. Public health programs reach approximately 83% of all children, preventing 2-3 million deaths per year. Even with this huge accomplishment, nearly 1 in 5 children are under-immunized or unimmunized. These children often live in city slums or remote sites where they don’t have access to routine healthcare, are frequently ill, and often not in school. UNICEF does a profound service by buying and providing approximately 2 billion immunization doses per year to 1/3 of the world’s children, many of whom are impoverished. A major obstacle to reaching such children is training local health care workers and establishing a quality ‘cold chain’ (icebox/chest) with a stable vaccine temperature, and the capacity to store and dispense a large number of doses.
Obviously, immunized children grow up healthy and are protected against highly contagious and life threatening diseases. Major nationwide vaccination ‘campaigns’ are often combined with sanitation, potable water, and improved health care delivery components. For example, a measles-rubella campaign in a tropical country can be coupled with handing out insecticide-treated bed nets to prevent malaria, along with Vitamin A supplementation (as an estimated 190 million children under age five are deficient), and a mass drug administration deworming (targeting soil transmitted helminths and schistosomiasis). Such campaigns have a profound positive impact. In Nepal, an initiative targeted 10 million children under five against polio and measles (which is still a major killer). A campaign in India has a goal of vaccinating 134 million! The “WHO Global Vaccine Action Plan” provides a worldwide framework to prevent millions of pediatric and adult deaths in 194 countries.
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IMPROVING COMMUNITY HEALTH |
Advocating for Immunization Coverage in Underserved Populations
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Ziemowit MazurEd.M, MS, PA-C | Assoc. PA Program Director - Rosalind Franklin Univ.
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A report issued by the Institute ofMedicine in 2002, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, brought attention to the fact that minority populations in the U.S. consistently suffer from disparities in health. This disparity extends to therates of immunization in both adolescent and adult minority population. The gaps in immunization rates are especially glaring in those 65 years of age and older and those with chronic conditions. With coverage rates hovering around 70% for adults, identifying and addressing barriers to protect everyone against vaccine-preventable infectious diseases should be an imperative for all healthcare providers.
Major disparities in vaccination rates of influenza, hepatitis B, and pneumococcal vaccine have been identified, with high-risk groups across all races and ethnicities adversely affected. Exact reasons for large ethnic and racial gaps in immunization rates are not clear, but can include the following:
- Limited access to healthcare services
- Cost, including reimbursement rates
- Knowledge gaps in availability and benefits of vaccinations by providers
- Communication barriers, including language and culture
- Provider’s lack of knowledge on immunization disparities
So what can PAs do to address this crucial public health issue?
- Advocate for and take part-in immunization programs that subsidize costs, provide easy access, and focus on educational needs
- Understand immunization standards and schedules
- Offer immunizations at convenient sites within your local community
- Deliver educational interventions aimed at improving knowledge, attitudes and skills of fellow providers
All PAs, regardless of their specialty, play a crucial role in improving the overall health of our communities. By becoming advocates for providing appropriate and timely immunizations, especially the most vulnerable, we can do our part in assuring a healthier community.
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Ziemowit MazurEd.M, MS, PA-C is IAPA’s Delegate to HOD of AAPA. Ziemowit works on a mobile health clinic that offers medical services to underserved and underinsured, including immunizations. He also volunteers at the Interprofessional Community Clinic, a clinic offering free primary care services to the local community. He is an Associate Program Director at the Rosalind Franklin University’s PA Program, North Chicago, IL.
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President's Perspective: Why IAPA Matters
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Jennifer Orozco, MMS, PA-C, DFAAPA | IAPA President 2016-17
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A lot of people ask me, “Should I join the IAPA - does my membership really make a difference?” My answer is a resounding YES! If we have learned anything from our nursing and physician counterparts, it’s that there is strength in numbers. An organization’s strength comes from their members, the more members, the stronger they are. Most people don’t realize the behind-the-scenes work that our board members and executive team do on a daily basis. There are daily threats from outside groups trying to change our practice act to exclude PAs from current legislation. IAPA strives to be aware of these and other issues affecting PAs and works diligently to educate and advocate on behalf of all PAs in our state. The following are just a few of our accomplishments since the beginning of this year:
- Creation of the IAPA Insider—a digital bi-monthly newsletter just for members.
- A formal letter was sent to the NCCPA about the IAPA’s concerns for the new PANRE model.
- Participated in the 1st annual PA “Lobby Day” in Springfield to bring awareness to PAs and PA practice. The IAPA board and lobbying team met with many different state senators and representatives to discuss our PA Rules and Regs clean-up bill.
- IAPA President-Elect Mindy Sanders was asked to sit on a task force to develop rules and regulations around the Prescription Monitoring Program (PMP) and the passing of HB1—Heroin Crisis Act.
- In April 2016, SB 2900 “The PA Rules and Regulations Clean-Up Bill” passes unanimously out of committee and now has over 12 sponsors in both the house and the senate!
- Attended preliminary meetings with the Illinois State Medical Society (ISMS) to modernize the PA Practice Act which is set to expire next year!
- Planning for a HUGE 2-day CME event on October 21st and 22nd. IAPA will be offering over 16 Category 1 CME credits, holding an open-public board meeting, and host numerous social activities.
Besides the list above, IAPA has developed numerous business and industry partnerships, improved our communication with members by going digital, and improved our financial stability. We have a board of innovators and thought leaders who are committed to taking Illinois PAs to the next level. So YES - your membership matters! Spread the word -we need your support! Help us continue to give PAs a voice in Illinois.
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Jennifer Orozco is President of IAPA. She is the Director of PA Clinical Practice and Director of Clinical Education at Rush University, Chicago.
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Kristine E. Burgess, MS, PA-C | Rosalind Franklin University | PA Program
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Northwestern's PA Program hosted the IAPA Student Professional Development and Challenge Bowl on Saturday, April 16th. The event planning was complete by Kris Healy, MPH, PA-C (Northwestern), Kristine Burgess, MS, PA-C (Rosalind Franklin), and IAPA Student Representatives (Midwestern- David Kunz, Northwestern- Samantha Jo Thompson, Rosalind Franklin- Sarah Alfson, Rush- Kristopher Bridgeman, & Southern Illinois- Jacob Ribbing).
The Student Professional Development entailed presentations to prepare students for the transition from school to the workforce. Presentations included: Preparing Your CV or Resume- Kris Healy, MPH, PA-C (Northwestern), PANCE Preparation, Licensure & Contract Negotiations- Don Diemer, DHSc, PA-C (Southern Illinois), and "A Day in the Life of a PA: Experiences as a New Graduate in Hospitalist Medicine" - Alex Kendall, MS, PA-C (Rosalind Franklin).
Following the Professional Development Program, all five PA Program had students participate in the IAPA Student Medical Challenge Bowl Competiton which was well attended by faculty and students from all programs. Three students per program competed to answer medical knowledge question over the course of multiple rounds of competition. The final round was between Southern Illinois (reigning champs) and Rosalind Franklin. Southern Illinois won the competition for their second year in a row!
Congratulations to Southern Illinois University's PA Program for their Challenge Bowl victory and thank you to the faculty and students for their participation in the event!
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Springfield Scene | Legislative Update
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Mindy Sanders, PA-C | IAPA President- Elect [Chair, Legislative Committee]
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On April 5th 2016, 12 Illinois PAs went to the State Capitol in Springfield on behalf of the Illinois Academy of Physician Assistants (IAPA) for the group's first ever lobby day. The group met with several state legislators with the intent of promoting Senate Bill 2900, which will update the Rules and Regulations for PAs. Sponsored by Senator Iris Martinez, SB 2900 was approved by the Senate Licensed Activities Committee on April 6. Mindy Sanders, IAPA President Elect, and Dan Shomon, IAPA lobbyist, were present for the hearing and prepared to answer questions from legislators. April 21, SB 2900 unanimously passed the Senate 58-0 and is now headed to the House. During Lobby Day, we were able to speak to several Representatives and discussed a bipartisan co-sponsorship. We look forward to being just as successful in the House. This legislation will affect PA practice for each of us and we are very excited to see such tremendous progress!
During Lobby Day, the team also met with key agency leaders from Illinois State Medical Society (ISMS), Illinois Society for Advanced Practice Nursing, and Illinois Department of Professional and Financial Regulation. IAPA has been successful in developing relationships with such organizations that will be key to our success in the political arena. We are focusing on developing meaningful partnerships which will help us move closer towards our goals and promote a climate in Illinois that allows us to be proactive for our patients.
While at the Capitol, PAs were able to speak with legislators about the PA Practice Act sunset as well. As you may know, our PA Practice Act will sunset, or expire, December 31, 2017. IAPA has begun analyzing the Practice Act and will accept guidance from AAPA in regards to model legislation. In order to continue practicing as a PA in IL, we must get this Act rewritten and renewed. If there was ever a time that IAPA needed you, it is now. Every membership dollar counts. Moving a legislative agenda forward is no small task. Support from the PAs in Illinois that we represent is paramount.
IAPA has also been diligently working with Illinois Medicaid to ensure that all PAs can be enrolled and recognized providers. PAs are able to enroll now in Medicaid through the IMPACT website. Discussions with Illinois Medicaid leaders have been productive and we will continue to advocate for our profession.
Illinois State Medical Society has asked for IAPA to support HB 6562. IAPA Legislative Committee has reviewed this legislation and has posed questions in regards to some of the specifics listed in the bill. We are awaiting a response from ISMS.
HB 5938 is in regards to tuitions assistance for medical professionals that are employed within Veteran’s Homes. IAPA has recommended that PAs are added to the medical professionals that are eligible to receive this.
SB 345 was brought forth by an anti-vaccine group that believes a link may exist between autism and vaccines. IAPA is opposed to the legislation, as is ISMS, because it is not an accurate representation of evidence based medicine. You may read additional information about any of the above legislation HERE.
The IAPA is the only organization in Illinois that works to monitor, create and expand the practice privileges for licensed PAs in the state. The Illinois Academy of Physician Assistants serves as the primary resource on and for the PA profession in the state of Illinois, committed to advocacy, education and the highest quality of patient care.
To become a member of the IAPA please visit the IAPA website. If you are already a member of the IAPA and would like to become more involved, contact IAPA Executive Director Elizabeth Schumacher.
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Rosalind Franklin Hosts FREE Symposium
Rosalind Franklin University is hosting a symposium on June 8th (from 7:30am - 12:30pm) "Population Health: Models and Implications for Healthcare Education and Practice". This half-day program will include expert panel, breakout discussion groups, and networking. Continuing education credits can be earned by participating in the symposium and lunch will be provided. For more information or to register for this no-cost event - CLICK HERE.
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The STUDENT Section | Reflections on Life as a PA Student
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Michael Thomopoulos PA-S2 | Rush University - Physician Assistant Studies
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Often times in second year we find ourselves, as students, similar to satellites orbiting Earth. Thousands of miles per minute we cycle with the knowledge that our signal is emitting, unsure of the precise endpoint to transmission. Just as first year comes hurdling to finality the sprint toward clinical rotations begins. You quickly find that the certainty settling in at the end of one rotation is the welcoming committee for the novelty of the next. Welcome to the life of a PA student!
I thought with my infinite experience of 9 months in clinical rotations I might take a moment to reflect and offer unsolicited advice on the keys to success in your second year rotations. Firstly, as if this is not already ingrained in your mind, embrace change. Learning to be indispensable and flexible on constantly shifting rotations will afford you experiences that otherwise might have been missed. Offer to do urine dips, immunizations, blood draws etc. In short, do everything allowed by your preceptor and ask to for more. This will set you apart from others and give you greater insight into the daily worklife of various professions. The creed of the profession is to provide excellent care in a team based setting. There is no better time to exemplify these virtues than during training. We are given the opportunity to learn from all disciplines, make mistakes, all the while having zero liability. There will never be a time following graduation as pure. Additionally, look up the interesting case(s) you experience. Nothing compares to reading about a disease in a textbook and anchoring that process to a real life scenario. (Hence all the vignettes in testing).
Learn to maximize the utility of any rotation. Regardless of the interest level there is something to be learned at any given facility. Given the opportunity for a mulligan I would be more assertive in trying to do as many procedures as possible. The attending/resident/PA for any given rotation may be incredible, however the onus of education starts and ends with the student. In many instances I realized I could have been more involved and taken advantage of learning opportunities had I been more vocal in the beginning of any given rotation, don’t be afraid to ask to do anything.
Lastly, while there is no single great resource for studying - I have utilized Pance Prep Pearls. While (in my opinion) there is much to be desired regarding organization; used in conjunction with the PAEA blueprints/topic list, it is an excellent resource for focused study. The one detractor of this text is the necessity to review multiple sections for a single EOR exam, however this seems common among most texts. Ideally, practice questions are excellent in creating a multi-faceted review. The Kaplan Q Bank is an excellent resource that can be curated to areas of greatest need, thus providing high yield practice based study. Lange Q&A is another book with over 1000 practice questions. By combining these two methods one can organize the material into a manageable chaos.
In comparison, if first year is a twelve round fight with Wladimir Klitschko, second year is regaining consciousness. (You may even be able to reconnect with those elusive things called friends and family) Studying is still omnipresent and however seemingly impossible, is actually welcomed at times. Study frequently and early on in each rotation and EOR Exams will make for easy fodder in comparison to the 3 tests per week of first year. I hope that at some point my missteps make way for your ease and I wish for all students, incredible experiences and countless opportunity for personal growth.
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