Since the first class of ex Navy Corpsmen in 1965, physician assistants (PAs) have become an integral part of healthcare in America and abroad. Today there are over 120,000 PAs in the United States, providing more than 400 million patient encounters a year.
What is a PA?
Physician Assistants are trained medical providers that often function autonomously and consult with a collaborating physician or specialist as needed. PAs are trained in the medical model just as their physician colleagues. One of the founders of the profession, Dr. Eugene Stead, based PA education on the fast-tracked training of physicians during the Second World War. Today, PAs practice in every medical specialty with almost 25% practicing in primary care.
Several published studies indicate that patient outcomes are no different with a PA at the helm versus a physician. Patients also love their Pas, with over 90% stating in a 2014 Harris poll that PAs are trusted providers and improve access to quality care.
Historically, PAs have been employed by physician practice owners, and PAs worked under the supervision of the physician. Regulations vary widely between states. As the number of physician entrepreneurs declines, however, PAs are proposing a new approach to team based care called Optimal Team Practice.
Optimal Team Practice
Under Optimal Team Practice, PAs would not be required to have an agreement with a specific physician in order to practice, which would enable practice-level decision-making about collaboration. Nurse practitioners (NPs) have successfully lobbied for such regulations in over 22 states plus the District of Columbia. This new proposal benefits PAs, patients, and physicians, in addition to updating 50-year-old practice laws. Several states, including Rhode Island and North Dakota, are in various stages of passing such legislation.
How will these changes affect the physician-PA relationship? In many ways, they won’t. PAs are still committed to team-based care and will continue to collaborate with physicians of all specialties when a case exceeds the training and experience of the PA. But in other ways, the physician-PA relationship has already changed and will never be the same.
The Decline of Private Practice
Consider that when a physician directly employs a PA, the practice cares for more patients and generates more revenue. The physician-employer directly benefits from the employment of the PA. But since 1983, there has been a 38% decline in private practice ownership. As more physicians become employees, outdated practice laws still require a physician to supervise and assume some liability for fellow PA employees. In these cases, physicians are often not involved in the recruitment and vetting process and receive no extra compensation for their role in supervising. No one wants to be responsible for the actions of another, especially when that responsibility is not, and often cannot, be adequately compensated.
Tips for Hiring PAs & Verifying Clinical Competence
Whether a physician is directly hiring the PA or simply participating in the interview process, ensuring that the PA is a competent clinician is paramount. Consider the following resources to verify a PAs credentials and certifications:
- State licensing boards
- National Commission on Certification of Physician Assistants (NCCPA)
- National Practitioner Data Bank (NPDB) for malpractice and adverse actions history
- AMA Physician Profile Web site
- Current certificates for ACLS, BLS, PALS, etc
- Drug Enforcement Agency (DEA)
- A copy of any recent hospital privileges
- References from colleagues, employers, and co-workers (including nurses and MAs)
As healthcare in America continues to evolve, also make sure to review your state’s practice act for any updated rules and regulations.
Once a hiring decision is made, a delegation of services will need to be drafted and either kept on site, submitted to the state board of medicine, or both. This document outlines the PA’s scope of practice which must coincide with the scope of the supervising or collaborating physician.
Whether you are a physician or an administrator, you can help develop a positive perception of your new hire both in the office and among your patients. Present the opportunity to see the PA as a positive one. Be ready to explain and promote team-based practice. Know the plan for care coordination and trust in the PA’s thorough education and training to speak for itself.
More Info on Hiring Physician Assistants
PA Job Advertising: https://www.hospitalrecruiting.com/pricing-information/
View our PA Job Board: https://www.hospitalrecruiting.com/jobs/Physician-Assistant-Jobs/