This article is more than 5 years old. Information may no longer be current.
Would a PA help my practice?
Click Here to Manage Email Alerts
If you’ve ever tossed this question around with your partners, your spouse or your buddies, you are not alone. I am frequently asked this question by CEOs, COOs, HR directors, and Medical Directors — not to mention physicians, surgeons, and even other mid-level providers. I am a PA-C, licensed by my state medical board, certified in general medicine by the National Commission on Certification of Physician Assistants, and specializing in orthopedics.
Really, if you’re even considering the idea of a PA, you should back up a step or two and see if you can identify what it is you hope to gain with the addition of any non-physician provider to your practice.
What do I want to gain?
- An extra set of skilled hands to help my clinic flow better?
- Increase my practice volume?
- Increase my bottom line?
- Improve my call schedule?
- Other?
Though it might seem to be an obvious question, it is actually a crucial one. Not all service providers can do all things, and you want to hire the kind of provider that best meets your goals.
For example: PAs are licensed by your state — often by the same medical board that licenses you — to practice medicine under a supervising physician. Although this varies slightly from state to state, typically a PA can — with your permission and under your protocols — see, evaluate, diagnose and treat patients in your practice. If it’s beneficial to the practice, they can have their own panel of patients, with you as the supervising physician of record. They can also serve as initial providers if you like, treating and screening for ultimate entry into the surgical end of the practice. They can take first call with you as backup, prescribe medications, order physical therapy and other treatment modalities, refer to specialists and back to primary care, recommend and perform joint injections, cast, brace, splint, first assist in surgery, write hospital orders, and round on patients. PAs may come to you fully trained with years of orthopedic experience, or they may come to you as providers from another arena, thirsty for new skills and experiences.
PA-Physician Matching
Physician supervision is a key part of hiring a PA, and takes many forms: face to face, electronic, telephone, teleconference and chart review, to name a few. Sometimes level of review is designated by the medical or licensing board, sometimes by a hospital’s bylaws or other regulations. In our practice, I have functioned across the spectrum. Two years ago I came out to help establish a new orthopedics clinic with visiting surgeons, in partnership with a larger teaching university in another city. This year we added two permanent surgeons to the practice. I do everything listed above, and consult with both my supervising physicians and other physicians on a regular basis, using all of the modes listed above. At the other end of the spectrum, I have very successful peers in orthopedics who only treat hospital patients, and others who see pre- and postoperative clinic patients, cast/brace/splint/inject, and triage for the surgeons. Perhaps not the most maximized use of a PA, but a benefit to the practice nevertheless, and often the stepping stone to incorporating a PA into the practice growth plan.
You will find generally trained PAs as well as specialty-trained PAs. If you supplement your PA's skills to think, diagnose and treat like you do, your PA can do virtually whatever you ask them to do once approved by the state licensing board. In addition to whatever clinic and hospital review systems you have in place, the licensing board will usually monitor your PA’s license, performance, complaints, etc. — just like they monitor yours.
Other non-physician providers, such as OPAs, have a very limited scope of practice. This was outlined quite well in a recent article in Orthopedics Today, and is also nicely summarized in the links shown below. Nurses and MAs as well have limited scope of practice which are probably much more familiar to you. You can see how it is important to look first at what you hope to gain by bringing a non-physician provider into your clinic. Match your goals to the kind of provider you really need.
If you decide that what you need is a PA and not another type of extender, remember that you will have a PA that has been licensed in your state, trained in the same medical model as you, with the same diagnosis/treatment algorithms as you, the same physical exam skills, and the same good sense of judgment. PAs relish a good physician-PA relationship, and a good PA will always come to you for additional wisdom and treatment guidelines if something is outside of their skills, knowledge base, or resources. The choice of a PA, for the right practice, is an investment into a different kind of partnership that not only supplements but helps build a practice in the direction you want to grow.
So … you tell me:
Would a PA help your practice?
Jennifer Van Atta, MS, PA-C, is happy to answer any questions or refer you to additional resources, and can be reached at JenniferV@mcmc.net