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The next chapter

Section Editor(s): Reed, Harrison MMSc, PA-C

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Journal of the American Academy of Physician Assistants: March 2020 - Volume 33 - Issue 3 - p 13
doi: 10.1097/01.JAA.0000654020.01828.25
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In January, a massive stack of boxes appeared on my desk. I cut them open to find rows of hardbound books that held every issue of JAAPA ever printed. For a new editor in chief, this was a 200-lb welcome basket.

As I placed each volume, year by year, onto my bookshelf, I cracked a few open. Each turn of the page was a peek through a curtain into another time. The clinical articles, the editorials, and even the advertisements offered a glimpse of the PA profession's past.

Some things don't change much. I skimmed past a 1994 commentary debating the merits of a professional name change and a 1995 message from an AAPA president outlining the optimum approach to team practice. Even back in the 1980s, there were calls for more autonomy and warnings of burnout. Change the font and update a few pictures and you might not even realize you were reading into decades past.

But in other ways, the mark of time was clear. An advertisement proclaimed the virtues of a potent new wonder drug: ciprofloxacin. Leaders wondered how to cope with managing a profession nearing 40,000 members. Educators debated the merits of pushing the profession toward the baccalaureate degree.

It's easy to turn those faded pages into a novelty, to poke fun at outdated design techniques and fashion choices. And I know one day, some future editor will probably look at the work I produce and have a chuckle. That's the joy and terror of working in the public record: our words always age, but they never disappear.

The purpose of JAAPA, however, is not to become a time capsule. When it rolls off the presses, every issue of the journal represents the contemporary voice of the profession. It may transcribe history, but it does so in real time, without hindsight or revision. The mark it leaves is merely a byproduct of its mission: to empower patient care by giving PAs the best-available information.

Still, with more than 3 decades of work laid out in front of me, it was hard not to wonder what tales we might weave into the larger PA tapestry. Like the clinicians in those old pages of JAAPA, we do not set out to leave a flawless legacy, but to show that we acted as honorable stewards of the moment we occupied.

In this particular moment, we are entering a new chapter. The PA profession is no longer infantile. One of the JAAPA issues that I leafed through was published the month I was born. That means, for the first time ever, JAAPA is older than its editor in chief. That fact alone offers proof that the profession has marched into a new phase of maturity with its own unique concerns.

In 2020, the number of practicing PAs will reach 140,000. Another 10,000 new PAs will graduate each year. There are over 250 PA programs in existence with more planned to launch. In a span of decades, PAs have transitioned from a relative rarity to a ubiquitous component of the healthcare workforce.

The strength of our numbers comes with a new responsibility. We are no longer just an upstart band of pioneering professionals. Our identity has become more complex and requires more nuance.

As much as we push the boundaries on what we can accomplish, we also must tend to the territory that we occupy. As much as we need innovation and advocacy, we also need maintenance and governance. As much as we need enthusiasm, we also need restraint. As much as we seek the rewards that our profession offers, we also must seek opportunities to serve our colleagues and communities.

In this next chapter, we face a shift in what connects us as PAs. As the settings and specialties in which we work become more varied, we are unified less by our job descriptions and more by our underlying values. Our common ground is not what we do, but why we do it.

And if that drive comes from a sincere dedication to the good of our patients, our communities, and the world—and is untainted by ego and greed—then we will never have to worry about how future PAs view this chapter. Because the importance of those principles will never fade, no matter how much dust collects on the pages.

Copyright © 2020 American Academy of Physician Assistants