Why Physician Associates Need More Than One Accrediting Body: Learning from the NP Model

Introduction

The Physician Associate (PA) profession has evolved significantly over the past decades, yet the certification system has remained relatively static. Currently, the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) holds a monopoly over certifying PA programs in the United States. While this system has ensured a standard level of professional competence, many in the PA community are beginning to question whether a single certifying body can adequately represent the diverse roles and needs of modern PAs. Drawing from the nurse practitioner (NP) model, where multiple accrediting bodies coexist and thrive, this article argues in favor of creating more than one accrediting body for PA programs.

The NP Model: A Case Study in Flexibility and Choice

Nurse practitioners in the U.S. benefit from a range of certification options, including the American Association of Nurse Practitioners Certification Board (AANPCB), the American Nurses Credentialing Center (ANCC), the Pediatric Nursing Certification Board (PNCB), and the American Association of Critical-Care Nurses (AACN) for individual NP certification. Each board offers certification pathways that align with different professional focuses and specialties, and all are accredited by the Accreditation Board for Specialty Nursing Certification (ABSNC) or the National Commission for Certifying Agencies (NCCA) (AANPCB, 2024; ANCC, 2024).

This structure gives NP students flexibility to choose certification exams that best match their training and career goals as well as programs that meet their specific objectives. For example, Family Nurse Practitioner candidates can choose between AANP and ANCC exams depending on which better fits their clinical and academic background (Schadewald, 2020).

Benefits of Multiple Accrediting Bodies for PA Programs

1. Flexibility and Personalization

A multi-board certification model would allow PA programs to choose model tailored to their strengths and professional objectives. This would reduce bureaucracy and improve alignment between academic programs and certification standards. The American Academy of PAs (AAPA) has already explored this idea, citing the need for a system that prioritizes patient care over burdensome recertification processes (AAPA, 2021) for PA certification. Likewise, program models would be much the same..

2. Academic and Professional Diversity

Just as NP boards emphasize different aspects of nursing (e.g., clinical knowledge vs. research and theory), PA program accrediting bodies could develop models that recognize diverse educational paths for PAs. A new certifying organization might emphasize interprofessional collaboration, specialty practice, or healthcare leadership, thus encouraging PA programs to diversify their curricula.

3. Innovation Through Competition

Competition among certifying bodies can lead to improvements in overall program design, technology, and education options. NP boards, for example, have pioneered new question formats and flexible recertification models that cater to real-world practice settings. Extrapolating a similar shift in the PA program certification landscape could stimulate more dynamic, relevant credentialing approaches.

4. Broader Professional Representation

With only one certifying body, the perspectives influencing PA program certification remain limited. Multiple boards could incorporate insights from clinical educators, specialty societies, and collaborators. This would make program certification more inclusive and representative of the full PA community.

Addressing the Counterarguments

Skeptics may argue that more certifying bodies would be confusing with current state statutes or weaken professional standards. However, the NP model disproves this concern. All NP certification programs are held to rigorous, consistent standards by the NCCA or ABSNC, and all are equally accepted by state licensing boards (NCCA, 2024).

Similarly, new PA program certifying bodies would need to meet the same accreditation benchmarks. Licensure laws could be updated to recognize these changes if needed, ensuring uniform recognition across the profession.

Conclusion

The profession of Physician Associates is too diverse and dynamic to be served by a single program certifying body. Drawing from the successful example set by nurse practitioners, the PA field stands to benefit from a competitive, multi-board certification system. Such a structure would bring more flexibility, innovation, and professional representation, all while maintaining high standards of patient care.

Call to Action

PA leaders, educators, and practitioners should advocate for the development of alternative program accrediting bodies that meet national standards. By supporting multiple paths to PA program certification, the profession can foster a more inclusive, flexible, and future-ready workforce.

References

1. American Association of Nurse Practitioners Certification Board (AANPCB). (2024). Retrieved from https://www.aanpcert.org/

2. American Nurses Credentialing Center (ANCC). (2024). Retrieved from https://www.nursingworld.org/our-certifications/

3. AAPA. (2021). AAPA announces plan to develop alternative certification pathway. Retrieved from https://www.aapa.org/news-central/2021/03/aapa-announces-plan-to-develop-alternative-certification-pathway/

4. National Commission for Certifying Agencies (NCCA). (2024). Institute for Credentialing Excellence.Retrieved from https://www.credentialingexcellence.org

5. Schadewald, D. (2020). AANP vs. ANCC: What’s the difference? The Nurse Practitioner Journal. Retrieved from https://journals.lww.com/tnpj/fulltext/2020/10000/aanp_vs_ancc__what_s_the_difference_.7.aspx