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New Year, new resolutions ...

Posted By Sam Dyer, Saturday, January 4, 2020

Happy New Year!

I've heard this and said it a bunch over the last week! I hope the New Year is good for you and you are able to keep your resolutions!

I have several goals:

  • Do a better job at writing this blog and for articles for the Orthopedics Today
  • Start a podcast
  • Expand PAOS CARES outreach program
  • Have 3 successful meetings
  • Have our first ever MSK U/S workshop (which will be a stand alone workshop later in the fall of 2020-stay tuned)
  • And as always play more golf!!

This is just a quickie blog post, but I wanted to thank each and every one of our members for supporting us and helping us keep our organization rolling. I also want to throw a big thank you out to all of our BOD and those who do work for our BOD - we could not be a successful organization without you!

I hope you all have a safe and prosperous New Year! Don't forget to look to us for your CME needs, conferences or online content.


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Home again

Posted By Sam Dyer, Monday, September 2, 2019

Hello all.

I am glad to be home again-it was a long week away in San Antonio. We spent many hours working and meeting, and some down time for fun. Just a recap of a few meeting highlights:

  • We had over 25 hours of conference presentations covering a wide variety of orthopedic topics.
  • There were several workshops including fracture fixation, MSK ultrasound, casting and splinting, graft prep, a cadaver wet lab, and bone health. There was also an update on coding and billing.
  • Many attendees spent some time on the property at the lazy river water park.
  • We had 36 golfers participate in a scramble on the AT&T Oaks course.
  • There was a tequila tasting night and a guided walk through the woods (this is a large property).
  • We had bus shuttles taking attendees to the river walk/Alamo for some R and R.
  • There were numerous sponsored meals both by the PAOS and industry as well as a welcome reception for attendees and active/retired military.

And a recap of PAOS board meeting and board networking:

  • I am happy to announce that the SLM scholarships are now funded for 15 years-even if we don't contribute any more money to it (we will continue donating money as long as we can, FYI).
  • We are working on a plan to make the scholarships sustainable forever and possibly increasing the awards down the road.
  • We raised $2200 from San Antonio golf outing games and an Ipad raffle with 100% of proceeds going to the SLMS.
  • We received a record number of student scholarship applicants this year (66). These were narrowed to the top 6 and presented to the BOD to choose the top two (see next bullet). As all six were outstanding, the PAOS BOD and scholarship committee decided to award consolation prizes of two years of membership to the 3rd-6th place applicants.
  • Congratulations to Miguel Serrato MS, PA-S, ATC, OTC, and Liana Berkowitz PA-S1, ATC, LAT, CSCS who were the scholarship winners this year. Each received a $5000 award and were flown out to the meeting to receive their awards and present their work.
  • As an organization, we are fiscally sound and will be meeting with financial advisors to help guide us toward long term viability.
  • I met with many industry representatives and all are interested in supporting PAs in ortho. I hope that this will translate into better future offerings for our conferences and educational platforms both hands on and online.
  • As is customary for the PAOS, we donated $5000 to a local charity-this year the Fisher House of San Antonio. Erik Zielinski, manager of the San Antonio Fisher House made a presentation to the attendees about the Fisher house program and what it does. Here is a link to the local program.
  • There were several poster presentations and all were outstanding. I am so proud of this work and that it has grown so much in the last few years. We also voted to award 1st 2nd and 3rd place prizes for those voted the best by the CME committee. Congratulations Captain John Gagnier, MPAS, PA-C, Captain Tania Didas, MPAS, PA-C, and Major Tyson Baines, MPAS, PA-C.
  • We are having a special election for the south central regional director position-this announcement will be mailed to members in the region soon. Look for an opportunity to vote on this in the next few weeks.
  • We plan to continue the annual practice and salary survey indefinitely in its current format. We also have assigned two board members to review the content and questions to try and make it even more meaningful to members.

I think that covers most everything. There is so much work from so many people to make these meetings happen, I would be remiss not to thank them. At the risk of leaving anyone out, let me just say thank you to everyone who played a part in making this meeting successful and helping to grow and educate our membership. I'm already looking forward to Denver!

Take care,


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Happy Anniversary to us...happy anniversary to us! Join us at our 20th annual meeting in San Antonio!!

Posted By Sam Dyer, Monday, July 1, 2019

PGA tour stops here-the Valero Texas Open

Lazy river, water slides, fun!!

Greetings! I wanted to write a quick blog entry while I am in between patients. I am so excited to go to this meeting! It is such a beautiful place and a fun and relaxing time. I also looked at the website for the Marriott; the current rack rate is $479 a night. How much for PAOS attendees in our block? $189. You just can't beat this price for this type of luxury accommodation. Hurry and make your reservations now before we sell out! I see many of you agree as we are rapidly filling reservations. Don't delay, get your spot now!

I also looked at the list of speakers today, reviewed the workshops, and I tell you, it doesn't get much better than this! Check out these mini sessions and workshops: A PA primer for new PAs, Topics for PAs in administrative roles, Topics for PAs in education, Fracture description from pediatrics to pathologic, fracture fixation (basic and advanced), MSK ultrasound, casting and splinting, graft preparation, wet labs (cadaver practice) hip and knee arthroplasty, bone health, coding and billing, MSK exam (upper and lower extremity). Folks, you won't get this level of education at any other meeting. If you are looking for the knowledge, AND hands-on practice and skills you need to be an effective APP in orthopedics, this is it. I didn't even go over the course syllabus-fracture management, arthroplasty, foot and ankle topics, spine talks, sports med, shoulder, knee, hand and wrist. There will be reimbursement talks, networking, poster presentations of PA research, and more! We will have a variety of most everything! I'm sure some think I am over promoting this, but you really have to go to one of these meetings! I can't help but get excited thinking about it!!

OK, what else is new (other than San Antonio). Well, the LMS is fully functional. Even if you don't need any more CME, please go check it out and let us know what you think. Go to the PAOS home page, login, and click on the CME link in the title bar and follow the learning center. If you need some CME, there are both self assessment exams and AV recordings that you can buy (discounted for PAOS members). If you want to refresh/update your knowledge on various topics, there are over 50 videos (that was my last count, I think more than that now) that are FREE to watch for PAOS members!! These are recordings from prior meetings that are no longer valid for category 1 CME, but are still valuable resources for your knowledge and reference. AND you can count the time spent as category 2. Guys, this member benefit alone is more than worth the cost of PAOS membership! You just can't beat this deal!

I am happy to announce our scholarship committee is working diligently on the applications we received this year. I think we received over 60...I am going to suggest to our BOD and the SLM BOD that we further this effort! Thanks to Krista Bartlett, every PAP in the US has been contacted and is aware of our awards. We also have close to 200 PA student members as a result! Now that is something! As always, we will be raffling an iPad in San Antonio with 100% of proceeds going to the SLM fund. Your generosity helps us maintain this program and helps our future colleagues come along. Thank you all in advance who help to make this happen.

I am working hard to get San Antonio charity clinics to attend our complimentary MSK injection workshop in August. I've written extensively on PAOS CARES, our outreach program-see prior blog posts. I hope we have a successful turnout-if you are interested in doing workshops in your community please contact Elizabeth Darr, Chris Merchant or myself and we will help you put it together.

Steven Kelham and Randy Pape (SE and SC regional directors) did not run for office this year. We wish them farewell and good luck in whatever path life takes them, and we appreciate their service to PAOS. We also welcome Josh Porter who will be taking Steven's place as SE regional director. And since we are in the south central neck of the woods in a couple of months, let us know if you are interested in the SC regional director position. I do not want to leave this position vacant. Come by the registration desk and let us know if you are interested-I think we will have a special election.

Well that's all I've got for now. I hope you can come to San Antonio and join us! It is going to be awesome!

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Another great meeting

Posted By Sam Dyer, Saturday, May 18, 2019

Hello from Charlotte!

I am typing this as I sit at the registration desk in Charlotte. We have 224 registered attendees, and to a person I have heard nothing but good comments about the lectures and accommodations. Thanks Scott Rheinecker and Elizabeth Darr for putting this together. Also Chris Carrier thanks for creating the event app. A job well done! I am always impressed at the quality of the content and variety of talks at these meetings. It definitely fills a gap. We will have the AV recordings ready in about 6 weeks. These are an excellent resource for you and an easy way to get CME on the go. Please consider it for your educational needs.

I am a broken record; our LMS is still not live! I am very ready for this to happen, but it is beyond my control at this point. I am told that the actual production site is up, but there are still a few bugs being worked out. Any day now....we will send out an eblast to membership once it goes live. When we finally do have this available, you, as members will have an awesome new benefit. All of our prior AV recordings that have expired for category 1 CME will be available in a resource library. This means that as a member, you will enjoy full access to the entire AV library from prior conferences. I cannot believe what a great reference this is and I'm very excited about this benefit! I ask for your patience please, just a little bit longer...

I wrote an on boarding manual and have loaded it on the LMS. It is designed for new hires and/or PAs who are new to orthopedics. I typically precept new hires in my practice and have been told that it is useful in their early days. I hope that you find this to be the case and are able to use it in your practice.

Moving forward to the next big thing-August in San Antonio. There are already close to 100 attendees signed up for our annual meeting! Crazy! We anticipate a fun week of lectures, golf, river walk, tequila tasting, star gazing and of course the lazy river water park! I hope you make plans to come-it is a great destination and is family friendly if you want to have a combined meeting and family vacation. Sign up early and save some $$. And this is really, REALLY cool as we don't offer these often-there will be a wet lab where you can practice on cadavers. You won't get this at many meetings so please come out and take advantage of some great hands on practice.

Thanks again to all involved in making Charlotte an ongoing success! I hope to see you floating down the lazy river at the JW Marriott in San Antonio in a few months!

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AWESOME CME course May 17-19, 2019

Posted By Sam Dyer, Friday, April 19, 2019

This is a reminder to all of you who deal with orthopedic injuries and trauma on a routine basis-we will be hosting a long weekend conference in Charlotte in a few weeks. We already have over 200 attendees signed up but there is still room for a few more. Don't delay, sign up soon while there is still space available! This is going to be a great conference! You can find more information and view the brochure on under cme. I hope to see you there.

I am happy to say that thanks to the efforts of Krista Bartlett, we have reached out to every PA school nationwide to inform them of our offerings. As a result, we have the largest number of student members, EVER! We also have OVER 60 applicants for this years SLM scholarships, another record! I am very proud of these accomplishments, and look forward to congratulating the scholarship winners. Good luck to all of you who have entered!

Regarding our LMS: I have to apologize. I feel like I have let you down and I hate this! We were supposed to have this system online and functioning weeks ago, but there has been one issue after another and it is still not ready. I am hoping to roll this out by next month.... For all of the attendees who are awaiting the SA from Arizona, I apologize to you. We want to have this content in the LMS so that we do not have two separate systems to keep track of. I ask for your patience and we will get it to you asap!

Apparently setting up a LMS is not only a problem for us, but the AAPA as well! We have been working with the educational team at the AAPA since last fall to get our Nashville AV online for non PAOS members. Here (click on the word Here) is the link to the Nashville AV in the CME catalog on the AAPA website.This is the first of our offerings in our collaboration with the AAPA. I am hoping this increases our exposure as an organization and gets our quality ortho cme out to a larger audience.

The ballots are now closed for 2019 PAOS BOD elections. Good luck to all of you who submitted an entry for the respective positions available in this years elections.

If you can't make it to Charlotte this year and have room for one meeting, please keep in mind our annual meeting in San Antonio this August. This will not only be a great conference with lots of skills labs on site, but also we are working on a cadaver wet lab! We don't have these often but it is an awesome benefit! Also, the JW Hill Marriott resort and spa is a great destination for families. For you golfers, the PGA tour stops here at one of the two championship level courses on property (The Valero Texas open). Best of all, you can get two things for the price of one; a great conference and a fun family vacation! Nothing like floating down the lazy river in an inner tube with a pinkie droo in your hand! And I didn't even mention the Alamo and the river walk!

I hope you are having a good spring and thanks for your membership! Until next month...

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Texas PA practice update, please respond-link included

Posted By Sam Dyer, Thursday, March 21, 2019

TAPA posted the following information on their website regarding the proposed rule change listed in my last blog post: As of this writing, I do not know if there has been a vote to adopt the proposal by the Texas MB. If you have not responded, please (respectfully) voice your concerns by sending a message to the link listed below in this paste from the TAPA website.


We have learned that the Texas Medical Board will be postponing the adoption of rule 193.21 until at least the late Spring or early Summer.

This rule would have removed the ability for a physician to delegate the reading, interpretation and diagnosis of medical conditions based on radiologic studies- thereby making a significantly negative impact on the practice of PAs across the state.

There will be a stakeholder meeting later this Spring regarding this rule, and you can be assured that TAPA will be present to make sure PA practice is protected.

Thank you to everyone who has contacted the Texas Medical Board about this rule so far! You can continue to contact them at the address they have provided-

We’ll continue to monitor this situation closely, and will provide more information as it becomes available.

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The Texas Medical Board proposed rule would cripple orthopedic PA practice in Texas

Posted By Sam Dyer, Saturday, February 23, 2019
Updated: Saturday, February 23, 2019

I am writing this today to post a letter written by Ben Kocher, PAOS vice president, to the Texas Medical Board. Our orthopedic colleagues in Texas are being faced with a rule change that would significantly impact their ability to practice. Please take time to read about it on the TAPA site and respectfully respond to the TMB with your comments and concerns.



From the Physician Assistants in Orthopaedic Surgery (PAOS) Board of Directors:


It has come to our attention that the Texas Medical Board (TMB) has proposed a rule change regarding Physician Assistant (PA) practice that we believe would be significantly detrimental to PAs in the state of Texas, especially to our orthopaedic colleagues.  As the primary constituent organization for PAs in Orthopaedic Surgery within the American Academy of Physician Assistants (AAPA), representing over  2,000 specialty-practice PAs nationwide, the organization opposes TAC 193.21(d) and supports the Texas Academy of Physician Assistants (TAPA) position on the rule. 


Texas Occupational Code 204 requirements for PA scope of practice are reliant on radiologic procedures to perform diagnosis, develop treatment plans, oversee progression of care, and determine treatment efficacy and endpoints.  These processes are extensively required to practice orthopaedic care and practiced daily by PAs throughout the United States and in Texas.  Patients currently treated for fracture management or palliative joint therapies would be delayed from appropriate care if orthopaedic surgeons were required to supervise at bedside for every reduction or injection. Further, NCCPA-derived PA student curriculum requires initial radiologic didactic and clinical training under physician supervision prior to graduation and certification. AAPA and the American Society of Radiologic Technologists (ASRT) further identify a framework for training in ionizing radiation/fluoroscopy that has been published since 2009. Intentionally broad or vague language contained within Texas Administrative Code for radiologic procedures performed by physician assistants contributes to this continuum of misunderstanding. Texas Occupation Code Section 601.056 regarding Medical Radiologic Technologists incorporates licensed physician assistant authority for performance of radiologic procedures, including those deemed dangerous or hazardous. The key component to updated language is the need to act inherent as a privileged provider that interim evaluation of radiologic imaging provides. Delaying care for the final/formal read by a qualified physician in all cases is not in the best interests of injured patients seen by PAs working in orthopaedic services.  


PAOS is unaware of any evidence that reading or interpreting radiologic studies in the delivery of care by a PA, while working within practice agreement and granted organizational privileges, is harmful to patients.  Across the U.S., PAs in Orthopaedic Surgery rely heavily on ordering and interpreting radiologic modalities to provide comprehensive musculoskeletal healthcare, as well as emergent stabilization of musculoskeletal injuries.  Restricting the ability of PAs to leverage and interpret radiologic modalities may prevent stabilizing treatment of musculoskeletal injuries and could lead to harmful outcomes.  These roles are imperative in rendering life and limb saving measures to musculoskeletal injuries and conditions.      


PAOS stands with TAPA in its request to reject Rule 193.21(d) of the Texas Administrative Code.  Rejecting this code ensures that PAs are able to order and interpret radiologic studies during management of musculoskeletal injuries and conditions.  It furthermore prevents disruption of treatment and prevents potential endangerment of the patients they PAs serve.


Comments and questions for this email may be directed to Benjamin K. Kocher, Vice President, PAOS and can be reached via phone at (443) 910-4489 or by email at bkkocher@gmail.





 Board of Directors



Physician Assistants in Orthopaedic Surgery, Inc.

PO Box 10781

Glendale, AZ 85318

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Membership milestone

Posted By Sam Dyer, Thursday, January 24, 2019

2019 already? Well I guess I should say that at the beginning of the month as January is going by so fast. It seems the older I get, the faster the times rolls by, the more gray shows up, the more I look forward to the weekend...

But those are subjects for another time. The main subject of this post is membership. I am proud to inform you that we have reached a significant milestone and one that I have been looking forward to for some time. We are over 2000 active members strong! I am so happy about this and I want to thank each and every one of you for your loyalty and belief in PAOS and helping to support our mission.

Last fall in Nashville it was my privilege to meet the founder of the PAOS, Joe Lindahl. For those that don't know, our student scholarships are named after his wife, Susan. When I first saw him walking down the registration hall, he had a look of incredulity on his face, checking out all of the displays, reading the research papers, and taking in the size of the audience in the main lecture hall. Later, when I had a chance to meet and talk with him, he kept telling me how incredible it was-the growth of our organization. It is pretty impressive when you think of it. Imagine a handful of orthopedic PAs who wanted to form a dedicated constituent organization so many years ago and comparing it to where we are now.

Anyway, I want to thank you all for supporting us. We couldn't be where we are and doing what we are doing without you!

Our student membership segment is also growing well, and that is an awesome thing! I have to mention one of our BOD here, as she has been working diligently at contacting PA programs across the nation to let them know about us and our scholarships. Krista Bartlett, our SW regional director deserves the credit for this. Thank you Krista. This has been something I have wanted to do since being elected. I want to engage students who are interested in orthopedics before graduation so they know about us and our offerings. This is where the future of our profession/organization lies and is why we need to cultivate a relationship in the early stages. We are working on student BOD positions and should have these going soon.

Other updates:

Conferences: In addition to the member update of 2019 members for 2019 (seriously, that was the count a few minutes ago), we are sold out for Arizona. Way to go everyone involved! Charlotte is also going to be a great meeting - orthopedic trauma  for general orthopedics. Registration for that will open the first of February, so make sure you sign up as we expect it to sell out-that has been the ongoing theme for the last several meetings. We will be in a different hotel than the last couple of years in a more lively area in Charlotte. It will be a great meeting! And I am told that the speaker lineup for San Antonio this fall is already taking shape. Can't wait to revisit the river walk. And the floating river, floating on a tube with a pina colada in hand. And championship level golf courses right outside the hotel...paradise! Plan your trip now and bring the family for a nice vacation-its a great way to get your cme and relax at the same time! Whatever meeting works for your schedule, make your plans now to come get some quality cme that is way more relevant  to your practice than anything else out there. And that is not just blowing smoke, it is the truth! I think that's another reason why our membership is growing so well.

LMS: We are plugging along with this. I am hoping to have it up and running in the next couple of weeks. I know I have been talking about this for awhile, but it is going to be a nice benefit for you once we get it going. Not only will there be a more user friendly way to do your online cme, we are also going to develop a library of 'old' AV recordings. You won't be able to use these for category 1, but they will count as category 2. And only PAOS members will be able to access this. For those who ask "what else do you get for being a member"? How about unlimited access to all of our 'expired' AV recordings for reference and category 2? Now that is another reason to sign up!

Salary survey: The annual practice and salary survey is now online for members. Check it out to see where you compare to colleagues across the nation, your region, or even your state. Thank you to all who participated in this survey, you make it more meaningful to all of us.

I could go on, but that is enough for now. You all take care and stay warm-spring is just around the corner!

Sam Dyer, PA-C, MHS

President PAOS




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Let it snow...let it snow...let it snow.....

Posted By Sam Dyer, Monday, December 10, 2018

Happy December everyone!

I am writing this on a snow day which means most everything in my area is closed. It is beautiful! The good news is that I get a free day, the bad news is that when I go back to work I will be crazy busy with all the DRFs, back injuries, and multitude of other trauma associated with slippery conditions. I am enjoying the relative peacefulness right now though. It's sometimes difficult to relax and take a minute to enjoy ourselves given the go go go world we live and practice in. It's good to sit back and take a deep breath and just be for awhile. I hope you and yours are doing well and making plans for holiday time off with family and friends. I wish you all a safe and relaxing holiday season and a prosperous new year!

Quick updates:

There is still room for you at our inaugural February meeting in Phoenix. What a respite from the cold months! Register now to get the best rates!!

We've had a great response to the practice and salary survey-thank you for your efforts. Look for the completed report in the near future.

The building of our learning management system (LMS) is well underway. We hope to go live with this early in the new year, stay tuned.

Nashville AV (PAOS in the Music City) recordings are now available on the PAOS website-look under the CME section. If you need some hours before the end of the year, or can't go to a live meeting, this is a great option. Remember, you only have to watch the videos and complete an evaluation, post tests are no longer required!

I again wish you all a safe and happy holiday season.

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Happy Thanksgiving!

Posted By Sam Dyer, Monday, November 19, 2018

Happy Thanksgiving!

For this post, I am copying a write up from our BOD secretary (Karla Frick) on Thanksgiving and what are you thankful for? I hope you take a minute to read it and enjoy the message.

Please don't forget about Arizona in February-we have sold almost half of the seats already!

And make sure to respond to the practice and salary survey when you get the email, it is such an important thing to do for our organization!

I hope you all have a safe holiday and get to spend some quality time with your friends and family!

Here is Karla's write up, enjoy!



What are you Thankful For?


This week we celebrate Thanksgiving and reflect back on what we are thankful for.  Like many of us, we have become so wrapped up in our daily lives that we forget to be thankful.  Patients, supervising physicians, staff, schedulers, spouses/partners, kids, extended family and friends all seem to occupy our daily thoughts and focus. It’s often not easy to remember to take time and be thankful for all that we have and all that we are.  But I’m positive that if we all don’t slow down and stop to just simply give thanks, that time will continue to fly by and at the end, we will have missed our chance to enjoy the simple things and be thankful for it all. 


I challenge each and every one of you to sit down for just a couple minutes this week and be sure to thank all of those who impact every part of your life.  Thank your significant others for being patient when your days run long.  Thank your patients for trusting in you.  Thank your staff for putting up with you, especially on those days when nothing goes right.  Thank your kids for making you smile and laugh. Thank your surrounding family and friends for always supporting you.  Take time to even thank someone you don’t even know.  But mostly take time to be thankful of yourself.


It is a known quality that most physician assistants are selfless.  That we try to please everyone else first.  We make sure that our physicians are always happy, that our patients are treated well and with respect, that our staff is helped and supported, that when something goes wrong, we are the first to take blame (after anesthesia of course)!  It becomes exhausting after a while.  So, please, remember that you are worth being thanked.  That your sacrifice to help others is not forgotten and that you should be proud and thankful for all that you are.  


Here are some quotes that may help you reflect on this time of year.


"Let us be grateful to people who make us happy; they are the charming gardeners who make our souls blossom."--Marcel Proust


"I may not be where I want to be but I'm thankful for not being where I used to be." -Habeeb Akande


"As we express our gratitude, we must never forget that the highest appreciation is not to utter words, but to live by them." -John F. Kennedy


"Acknowledging the good that you already have in your life is the foundation for all abundance." -Eckhart Tolle


"If you want to turn your life around, try thankfulness. It will change your life mightily." -Gerald Good


"Make it a habit to tell people thank you. To express your appreciation, sincerely and without the expectation of anything in return. Truly appreciate those around you, and you'll soon find many others around you. Truly appreciate life, and you'll find that you have more of it." -Ralph Marston


"But Thanksgiving is more than eating, Chuck. You heard what Linus was saying out there. Those pilgrims were thankful for what had happened to them, and we should be thankful, too. We should just be thankful for being together. I think that's what they mean by Thanksgiving, Charlie Brown." - Marcy


And I want to give thanks for our organization (PAOS) and their dedication to try to constantly improve our profession.  Their desire to reach out to the community and give back through CARES.  Their desire to give back to the profession with the Susan Lindahl Scholarship.  To our members who advocate for all other PAs in our profession.  To all my co-workers and board members who are dedicated to make our organization successful.  But mostly I want to give thanks for those who have served before me and paved the way for all physician assistants.  I am blessed to work in a profession that I love and I am so excited for all that is to come in the New Year. 


I hope that you truly have a blessed Thanksgiving week and holiday season and that you are able to reflect on what you are thankful for. 


Please feel free to post what you are thankful for.  We would love to hear your stories!!


Karla Frick, MPAS, PA-C



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