The time has come,” the Walrus said,
“To talk of many things:
Of shoes—and ships—and sealing-wax—
Of cabbages—and kings—”

From “The Walrus and The Carpenter”
by Lewis Carroll

The time has come to talk of an international congress of physician assistants. The physician assistant profession is growing, and nowhere is this growth more dynamic than outside the United States.1 Lessons learned from 4 decades of experiments provide a template for PA education on a global scale. This is most evident in the United Kingdom and the Netherlands. Taken together, these two countries have created nine PA programs; there are another three in Canada and three in South Africa. More programs are in development in these countries, sub-Saharan Africa, and elsewhere.2 Many institutions are leading the way in the education and innovative use of PAs. Around the world, academics, social scientists, and researchers are documenting PA behavior and promulgating new information about health care delivery.

The body of medical workforce scholars is growing, and the exchange of PA information has accelerated since the new century began. Some of this information flow has taken place through the American Academy of Physician Assistants (AAPA) and the Physician Assistant Education Association (PAEA), with other PA organizations and individuals serving as consultants.

PA experts outside the United States are providing information to other countries as well. On a larger stage, the World Congress meets annually to supply information on employer management of human resources in health care.3 Over the past few years, the PA phenomenon has been a topic of increasing interest at a World Health Organization meeting, an international Health Economics Association meeting, and the annual Employer Health & Human Capital Congress. As other countries recognize the value that PAs can provide, they meet on a regular basis to disseminate their experience. Perhaps the PA movement is a success that deserves its own international audience.

Such an international PA congress could develop a number of goals that would benefit society in many countries. I propose the following objectives: (1) foster the role of the physician assistant; (2) monitor and analyze the changes occurring in medical workforce shortage areas; (3) identify advances and new trends in medical team delivery; (4) identify innovations in the education of PAs; and (5) serve as a clearinghouse for new information.

Many types of international congresses exist. Medicine alone has dozens (eg, the International Congress of Aviation and Space Medicine has been around for half a century). An international congress of physician assistants could be comprised of a president, vice president, director, and secretary general, all with specific functions and roles. Such a congress could meet biennially in Brussels or Zurich, where political events are unlikely to eclipse the agenda and where the location would be central to the majority of attendees.

Promoting information exchange among scientists and professionals interested in the fields of organizational efficiency, comparative and outcomes research, population health, and education would be an important objective. Within the framework of plenary and thematic sessions, as well as workshops and poster sessions, specialists from everywhere could present a review of challenges and solutions. An exhibition, along with the conference, could bring together thousands of professionals and management officials from around the world to promote new and novel products. Such a forum presents opportunities for manufacturers to present their products to new users.

The concept of PA organizations looking beyond their domestic boundaries is taking hold. The AAPA, in a bold move, will hold their 2012 annual conference in Toronto, Canada. This is the first time the Academy has held its annual conference outside the United States and represents an “international handshake” with the country that developed the second PA movement. A few years earlier, the PAEA held its annual meeting in Quebec City. Furthermore, PAs are a feature at an International Innovation in Healthcare conference that occurs annually in Heathrow, England.

New initiatives are never easy, and such work requires a great deal of interaction. However, new thought leaders have emerged among PAs in several countries; and for them, the world is smaller and easier to access. The growing complexity of health care delivery requires youthful thinkers, unburdened by the clunky history of early PA development, to look ahead. It is this generation that will write the next chapter of the PA movement. JAAPA

Roderick S. Hooker, PhD, PA, is a rheumatology researcher, Medical Services, Department of Veterans Affairs, Dallas, Texas.

REFERENCES

1. Hooker RS, Hogan K, Leeker E. The globalization of the physician assistant profession. J Physician Assistant Education. 2007;18(3):76-85.

2. Mullan F, Frehywot S. Non-physician clinicians in 47 sub-Saharan African countries. Lancet. 2007;370(9605):2158-2163.

3. World Congress. Strategic Leadership for the Health Care Industry. http://www.worldcongress.com. Accessed November 5, 2009