Dear Representative/Senator (Last name)

I am a Veteran, a constituent and a Physician Assistant (PA) in the Veterans Health Administration (VHA). I am deeply concerned about the current state of Veterans access to VA health care. Demand for health care providers is rapidly outpacing supply at every level.   Nationwide physician shortages are expected to balloon to 62,900 doctors in five years and 91,500 by 2020, according to the Assn. of American Medical Colleges work force projections. The number of U.S. medical school students going into primary care has dropped 51.8% since 1997, according to the American Academy of Family Physicians (AAFP).

Physician Assistants can and should be a big part of the solution to this problem.   The PA profession was born out of necessity to meet the increasing needs for primary health care providers during the late 1960’s. The PA profession has a special relationship with Veterans. The first PA graduates were Veterans. The VA hired one of the very first physician assistants to graduate in 1967. Today, there are over 2000 PAs employed by the Department of Veterans Affairs, making the VA the largest single employer of PAs. In the VA system about a quarter of all primary care patients treated are seen by a PA. Since the first graduating class at Duke University in 1967, PAs have been treating Veterans and providing many of the same services that physicians offer—filling a critical need.

PAs are recognized as the number five Critical occupation with in the VA; however the VA is simply not competitive with the private sector when recruiting and retaining PAs. The main reason for this is there are 30,000 PA job openings nationwide and the VA simply cannot compete with salaries when compared to the civilian sector. One easy solution, which is within the authority of Acting Secretary Sloan, is to including the PA occupation in the VHA Locality Pay System. This inclusion would enhance recruitment and retention by mandating an annual salary survey and adjust pay accordingly to ensure competitive salaries.

It is important to note that the Veteran Service Organizations Independent Budget FY2014 recommends that Congress request a specific VA plan on including PAs in the Locality Pay System or legislate specific pay provisions to address the long-standing problem with PA recruitment and retention. The VSO IB also recommends that VA should implement recruitment and retention tools targeting the Education Debt Reduction Program (EDRP) and the Employee Incentive Scholarship Program (EISP) to include PAs.

An additional constrain to recruitment and access is that many VA facilities only post midlevel provider positions for Nurse Practitioners (NP) which effectively eliminates 50% of eligible applicants. I urge you to mandate that the VA list all midlevel provider positions for both PAs and NPs.

As always we appreciate your ongoing support of Veteran’s issues and look forward to working with you


(name, title, home address)

February 9, 2014

Dear Colleagues;

As we begin a new year I want to reflect on what has been accomplished and look forward to where we are headed.  Thanks to the painstaking work of Mr. Denni Woodmansee and the VA PA Field Advisory Committee we have a new PA Utilization Directive.  This new directive is leaps and bounds ahead of the prior utilization directive.  Gone is the term “supervision”!  The new directive has PAs collaborating with physicians and practicing with varying degrees of autonomy as part of a team.  This reflects how we have been practicing all along.   I recently had a teleconference with AAPA and all the Uniformed Services PA leaders to discuss the changes set forth in the new directive and how we could capitalize on “the rising tide”.   This new directive has prompted AAPA to look at reworking much of their documentation.  Additionally, the Uniformed Services PA leadership is working to incorporate the language from our new directive.    What a WIN for our profession!  Don’t be surprised if this new directive has a ripple effect on other healthcare professions.  As a result of the new utilization directive, the PA PSB at San Antonio met with our Chief of Staff office and we have started rewriting the PA Scope of Practice.  I have been tasked to use the utilization directive to write our local policy.  I would encourage all of you to read the directive, meet with your service chiefs and chief of staff and lead from the trenches.

For those that have been following the PA Forum, you probably noticed the resurgence of frustration (some would use different expletives here) over the PA-NP pay disparity.  This is an issue that VAPAA has been and will continue to push forward.  There are basically two roads to travel:

1. We can bombard our elected officials in Congress to put pressure on the Secretary to include PAs in the Nurses Locality Pay System.  This would be the easiest and quickest way to start correcting the pay disparity.  It likely would not bring total parity but would be a step in the right direction.  To do this I need all VA PAs, VAPAA members and none members to become involved by emailing their elected officials and asking them to contact the VA Secretary.  I will provide the template and language that I feel would be most effective.

2. We can work with Congress to pass a VA PA Pay reform bill much like the VA Nurses did with the Nursing Pay Act of 1990.  I believe this path will be the longest and hardest, especially when you consider that Congress is unable to agree on anything and has passed very few bills of any real substance over the past several years.  I’m sure they would disagree with me that but I do have freedom of speech.

I think we can travel both paths, at least for the foreseeable future.

VAPAA will be the guests of the Society of Army PAs (SAPA) at their annual conference, 28 April through 2 May 2014, please plan on attending.  During the SAPA Conference, we will have our Annual Board of Directors and General Membership meetings along with quality CME and you can visit with old friends and make some new ones.

VAPAA Elections are just around the corner.  The offices of President and Vice President as well and three (3) Directors will be on the ballot for 2014-2016.  Please consider becoming more intimately involved in your organization.

We are in the final stretch of a much needed and long overdue Bylaws revision which will return power to the members.  Thanks to Rubina, Mike, and Denni for all the hard work!


Jim Cavanaugh, PA-C
President VAPAA



Physicians prefer PAs in two separate polls
AAPA 18 July 2013
Healthcare staffing company Jackson Healthcare recently released its annual report, "Filling the Void: 2013 Physician Outlook and Practice Trends." The report found that PAs were the providers that physicians most preferred working alongside, with 35 percent preferring PAs — up from 31 percent last year.

Additionally, an informal survey in the July 2013 issue of The Hospitalist found that physicians in hospital medicine believe PAs are the most helpful coworkers for hospitalists. The survey ranked PAs first out of five possible answers. 

This was sent to us by a friend. It is a terrific example of Veterans helping others!!!

This is what veterans do...


The Atlanta School of Sleep Medicine will be offering continuing education for physician assistants again this fall and we hope you will pass along this information to your members.      

Advanced Management of Sleep Disorders for Nurse Practitioners & Physician Assistants - $625  

September 7-8, 2013 - Atlanta, GA

12.5 hours of AAPA Category 1 CME/12.5 contact hours (AANP)  

This course is developed specifically for nurse practitioners and physician assistants with 3-6 months of experience working in sleep medicine or completion of the Atlanta School's introductory course Sleep Medicine for Nurse Practitioners & Physician Assistants.   

For more information or to register, visit:  


Sleep Medicine for Nurse Practitioners & Physician Assistants - $625

November 2-3, 2013 - Atlanta, GA  

12 hours of AAPA Category 1 CME/12 contact hours (AANP)

This course is developed specifically for nurse practitioners and physician assistants to integrate their skills into a sleep medicine practice. The curriculum also showcases ways in which the physician extender can play a pivotal role in many specialties by learning more about sleep medicine.

For more information or to register, visit:

Please let me know if you have any questions.

Thank you,

Kish Woodward

Program Coordinator
Atlanta School of Sleep Medicine & Technology
1100 Johnson Ferry Road, Suite 580
Atlanta, GA 30342
Office: (678) 651-2004

Fax: (678) 651-2025

Cell: (404) 405-2409

This e-mail address is being protected from spambots. You need JavaScript enabled to view it


I think every VA PA deserves recognition for the outstanding health care they provide our nation's Veterans every day!

Although VAPAA had to cancel the 2013 CME Conference, we felt “the Awards must go on”.  There were many great PAs nominated and the voting was very close.  It gives me great pleasure to announce the

2013 VAPAA Awards winners.

Outstanding Clinical PA Award:

Laura Hart, PA-C
Salem, Virginia

Outstanding PA Leadership Award:

Russell Callender, PA-C 

Houston, Texas

$500 will be sent to each award recipient's charity of choice in their name and additionally, each recipient will receive a check from VAPAA for $500.


VAPAA will make arrangements for the individual awards to be presented to these outstanding PAs by their Chiefs of Staff.

Keep up the superb work!

Jim Cavanaugh
President VAPAA

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