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American Academy of Physician Assistants

Washington, DC
May 28, 2013

Good morning.  Thank you, Robert, for that introduction.  It’s a pleasure to be here today with so many physician assistants, and students training to become physician assistants—along with all the nurse practitioners, physicians, and others who are here today as well.

It was just 46 years ago that our nation’s first graduating class of physician assistants earned their degrees from Duke.  But over those 46 years, your profession has grown from a new idea to an indispensible part of our health care system.  And today—with nearly 100,000 certified P.A.s hard at work across the country—it’s difficult to imagine how our hospitals, health centers, and clinics would be able to function without you.

That’s because the work you do is critical to our nation’s health.  Every day, in every community, families depend on you to help them overcome the daily health challenges we all face.  They rely on you to protect their toddlers from the flu with a vaccination.  They rely on you to teach their teenagers about developing healthy diet and exercise habits.  They rely on you to help their elderly parents manage their blood pressure.  Every day, they rely on you—and entrust you with the health of their loved ones.

That’s true across the whole range of medical specialties.  And it’s true in every part of the country.  But nowhere is it more true than in those areas where barriers to care are at their highest.  In medically underserved communities—and particularly in rural areas—P.A.s are often a lifeline for patients who might not have regular access to doctors and nurses.

So it’s vital that we do everything we can to bolster the work being done by P.A.s.  And it’s not only because a robust P.A. workforce enhances our health care system as a whole.  It’s also because of those small towns and rural communities across the country that rely so much on the care that P.A.s provide.

That’s why I’m so pleased that the focus of your conference today is on creating pathways for veterans—many of whom come from those very communities that would benefit greatly from the presence of a stronger P.A. workforce.

We have a responsibility to ensure that those who risk everything so that we can live full, free lives have the opportunity to do the same once their military service comes to an end.  We have a duty to serve those who served us.  And the P.A. profession has always been a leader in creating opportunities for veterans returning to civilian careers.  After all, that first graduating class of physician assistants 46 years ago was made up entirely of Navy corpsmen.

Our Administration has made a commitment to support that legacy, and continue the proud tradition of veteran enrollment in P.A. training programs.

Since 2011, we’ve drawn on the expertise of our monthly work group, which was formed specifically to help overcome the obstacles faced by veterans as they transition to civilian P.A. careers.

We’ve created grant incentives for P.A. training programs to engage in veteran recruitment, retention, and training.

And we’ve recently partnered with the Department of Defense to promote the hiring of veterans in advanced medical occupations, including P.A. positions.

That work is important not only because it enhances opportunities for our service members, but because it also strengthens the P.A. profession as a whole.  And we’re going to need our P.A. workforce to be as strong as it can be—because as quickly as your profession is growing in terms of numbers, it’s growing in importance even faster.

P.A.s already play a critical role in our health care system.  And that role is only going to get more prominent as we look forward to the future of care in this country.

That’s because the Affordable Care Act is putting us on a path to a better, smarter health care system—one that places a greater emphasis on the sort of coordinated, team-based care practices to which P.A.s are especially vital.  It’s an historic transformation.  And it’s already well underway.

In the past few years, we’ve seen providers begin to adopt innovative new care models in greater numbers than ever before.  The use of electronic health records has doubled since 2008—in fact, more than half of all American doctors now use them.  And we’ve begun to change incentives that used to reward providers for delivering unnecessary and duplicative care while punishing those who kept patients healthy and out of the hospital.

These changes are already translating into significant improvements in Americans’ health.  Central line bloodstream infections—one of the most common kinds of medical errors—are down more than 40 percent nationally since 2008.  Hospital readmissions in Medicare have fallen dramatically in the past year, resulting in an estimated 70,000 fewer unnecessary return trips to the hospital with dangerous and costly complications.  And perhaps most promising of all, growth in national health care spending has fallen to a 50-year low.

All across the country, care delivery is becoming more efficient, more effective, and more innovative.  And as we move toward a system that emphasizes coordination and team-based care, the result is that P.A.s are becoming increasingly central to the experience of many patients.

We knew that would be the case.  That’s why we made sure that the health care law invested in P.A. education programs in order to expand enrollment and produce an additional 600 P.A.s by 2015.  The President’s budget for next year takes that commitment even further by proposing new investments that would increase our primary care workforce by 1,400 P.A.s over the next five years.  And thanks to funding for loan repayment and scholarship programs made possible by the health care law and the Recovery Act, we’ve nearly tripled the number of P.A.s serving vulnerable communities as part of our National Health Service Corps.

Of course, solving the problems in our health care system requires more than strengthening our health care workforce and transforming care delivery.  That’s why the law also expands access to affordable health insurance, so that more Americans have the opportunity to benefit from the quality care you help provide.

On October 1st, a new Health Insurance Marketplace will open for enrollment in every state.  These Marketplaces are going to give millions of Americans a better way to shop for health insurance that fits their needs and their budget.  They’ll have all the information people need to easily compare coverage options.  Discrimination against pre-existing conditions will be banned.  And for many people, there will be tax credits that will help provide an immediate break on the costs of insurance.

One of the big effects of the Marketplaces will be to create competition in the health insurance market that will actually benefit consumers.  Instead of competing to sign up only the healthiest people, or to sell plans with only the skimpiest benefits, insurers will have to compete to offer the best coverage at the lowest price.

This could make an enormous difference in the lives of your patients.  But here’s the key point: just because these new Marketplaces exist doesn’t guarantee that people will take advantage of them.

It is absolutely critical that we reach out to uninsured Americans and get them ready to sign up for coverage on October 1st.  And you can start right now by visiting to sign up for updates that you can share with your patients, coworkers, family, and friends.

As P.A.s, many of you have substantial experience serving communities with high numbers of uninsured.  You understand that many of these folks have a lot more on their minds besides health insurance.  Some of them have been locked or priced out of the health insurance market for so long, they’ve come to believe that affordable coverage will never be within their reach.

Connecting the patients you serve with the quality health insurance they need may be the single best thing you can do to advance their health.  You are trusted sources who can help answer their questions, and educate them about the new options that are coming their way.  You can let them know what having health insurance could mean for their long-term health and financial security.

You’re used to strengthening your communities by providing care.  Now, you have an incredible opportunity to strengthen your communities by providing vital information.

The more Americans we can reach out to and get signed up, the healthier this country will be.  When kids get good coverage, they are more likely to get the vaccinations they need.  When adults get good coverage, they have a greater opportunity to get the preventive care—like mammograms and prostate screenings—that will keep them healthy.  When families get good coverage, the results ripple through our communities.  We want everyone to have the chance to take advantage of the quality care that you provide.

For too many years, our health care system was moving in all the wrong directions—perpetuating high costs, bad outcomes, and fragmented care.  But Americans today are more likely to have chronic illnesses that demand careful management.  They’re more likely to have multiple conditions that require coordinated care between physicians, nurses, and P.A.s.  We were in desperate need of a health care system smart enough, accessible enough, and affordable enough to meet those needs.

Thanks to the health care law, that system is already on the way to becoming a reality.  But we know there’s a lot of work left to do – and we need you to keep making your voices heard.  I understand that CDC has an exhibit that will be open right after we’re finished here with more information about our National Ambulatory Medical Care Survey.  And I urge you to respond to the survey if you’re selected for it; we’re hopeful that will be an important tool to help us incorporate your feedback as this transformation moves forward. 

As we continue our transition into a new era of integrated, patient-centered care, we’re going to be counting on physician assistants to play a huge role in delivering the promise of a stronger, smarter health care system to the American people.

We have a once-in-a-lifetime opportunity to put affordable health insurance within the reach of every American family.  And we need your help to get that done.

I look forward to working with you to make it happen.  And I thank you for all that you do for your patients and for the health of our country.