Michelle DiBaise, DHSc, PA-C
Director at Large Platform Statement
I am running for the position of Director-At-Large of the PAEA Board of Directors. I am a Professor at the AT Still University PA Program in Mesa, Arizona. I have a passion for improving the diversity of our profession as well as a commitment to training students to provide outreach to underserved communities. I was awarded an nccPA Health Foundation grant for Oral Health Education among the underserved in 2015, the Society for Teachers of Family Medicine Smiles for Life Research Award in 2016, and a PA Foundation Impact grant in 2017, which focused on care coordination and integrated practice in the homeless population undergoing substance abuse rehabilitation. In addition, I collaborated with representatives of two in-state universities to develop a free clinic providing interprofessional care to the homeless of central Phoenix. My experience in obtaining federal funding includes co-authoring an HRSA Primary Care Training and Enhancement (PCTE) program grant entitled, Physician Assistant Training in Primary Care: A Multi-Faceted Approach to Increase PA Student Recruitment from Underrepresented/Veteran Populations and Primary Care Training and Placement of Graduates in Medically Underserved Populations. This multi-year project was approved for $1 million in funding.
Over my 26 year career as a PA, I have served in a number of leadership roles for the Profession. These include:
- Chair and Member, PAEA Governance Council, 4 years
- Director at Large, AAPA Board of Directors, 4 years
- President of 4 constituent organizations (COs) Nebraska, Iowa, Arizona, and Society of Dermatology PAs
- Vice President, Chief Delegate and Graduate Advisor of the Student Academy of the AAPA, 6 years
- Delegate HOD for four separate COs for 20 years
These opportunities have allowed me to develop strong knowledge of policy development and implementation. My specific strengths include strategic planning and visioning, budgeting, public speaking, and team collaboration.
I believe that access to loan forgiveness for PA faculty and improving PA program funding streams are two of the most significant issues facing our profession at this time. I have long been an advocate for the profession, and am comfortable and experienced in connecting with legislators to ensure that these issues are prioritized by congressional policy developers. If elected, I will advocate for our member programs. I will bring an open mind and passion to the Board in service to the membership. I would be honored to serve as Director At-Large of the PAEA Board of Directors.
What attributes characterize a high-performing Board member and which of these attributes do you possess?
High-performing board members should bring a constellation of attributes including, an ability to scan the environment for threats and opportunities, assist with strategic visioning, and align and prioritize the board focus while at the same time safe-guarding the mission and vision of the organization. High-performing board members should be objective, open and honest, and able to communicate effectively with board members, staff, and the membership. A high-performing board member should be adaptable and have the courage to innovate. This innovation must be balanced by continuous performance monitoring and quality improvement measures. A high-performing board member is skilled in the use of metrics and benchmarking to assure continuous quality improvement in the development and delivery of products and services, governance and operation, and relationship building. Over my 26 year career as a PA, I have served in a number of leadership roles for the PA Profession, allowing me to develop these attributes. I possess a strong knowledge of policy and the skill sets of environmental scanning, strategic visioning, budgeting, public speaking, and team collaboration. I am not afraid to take on innovative projects, but I temper this courage in innovation with attention to outcome metrics and quality assurance measures. I have participated in self-assessment measurements allowing for self-reflection and growth in my ability to effectively communicate and objectively listen to other members.
The AAPA House of Delegates recently passed a resolution titled Optimal Team Practice that calls for the elimination of state laws and regulations that require a PA to have and/or report a supervisory, collaborating, or other specific relationship with a physician in order to practice. What changes, if any, do you think will need to occur in PA education to prepare new graduates to practice in an OTP environment?
The passage of the OTP resolution has potential implications for PA education. Three of the recommendations specific to team practice, autonomous state boards, and direct reimbursement for PA services are not new territory for PAs. The fourth recommendation, elimination of the supervisory/collaborative relationship with a physician as a provision of licensure, may require changes in who we recruit into PA programs and how we train them. Many students choose the PA profession for the flexibility of practice and the ability to serve as a member of a team with physicians. Producing PA graduates who have more autonomy from the outset of practice will potentially lead to a lengthening of training or required "fellowships" after graduation. The net effect may be a decrease in practice flexibility, increased student debt, and could potentially imbue ill will among our physician colleagues. Damaging the PA-physician relationship may have serious implications for clinical rotation site recruitment and retention. Critical training site shortages may worsen if physicians refuse to train PAs, assuming that the PA will take that knowledge and practice independently. On the plus side, there is time to see how all of this will play out in the next decade. In fact, before the final AAPA OTP resolution language was published, the AMA passed their own resolution against OTP. Further, state legislative change will be slow, which may allow us time to plan for modifying program curricula and policy in alignment with changes to professional practice and regulation.
Describe a significant challenge you have faced as a leader and the strategies you used to respond effectively.
While searching for a way to provide interprofessional (IP) education to students in a real world environment, I was fortunate to have the opportunity to collaborate with a number of health professions programs to develop a free clinic in the medically underserved central Phoenix corridor. This clinic would offer multiple benefits from providing continuity of care to the homeless clients; decreasing state costs by diverting clients from the ER; providing experience to pre-health students; and modeling IP care to health professions students. This tri-university project encountered many roadblocks in the early developmental stages. As one of the co-founders, I worked collaboratively to negotiate between key stakeholders, identify resources, anticipate outcomes, and design metrics for success. I served as advisor to the student committee responsible for fundraising and grant writing. I worked to obtain facility licenses, facilitated the execution of a three-university affiliation agreement, and obtained a federal medico-legal liability waiver. It took two years and required frequent student re-training due to turnover. We faced naysayers due to the length of time it took to open the clinic doors. In the end, with continued focus on the end goal and perseverance in the presence of obstacles, our core group of students and faculty came together to create a diverse team of interdisciplinary professionals. The diversity of the involved disciplines, university collaboration, and breadth of community partner engagement made this project a success, but also helped develop my skills as a collaborative leader and advocate for IP practice and education.
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