5 ways to form a strong alliance with your PAs

There are approximately 125,000 physician assistants (PAs) currently practicing in the United States. Their expertise is vital to virtually all aspects of medicine—provided they are set up to succeed by their supervising physicians.

Like any relationship, the alliance between a physician and PA takes consistent effort to realize its full potential.

Communication

Physicians must always make themselves available for consultation with PAs. The extent of PA involvement with patients depends on the case’s complexity. One key measure of success with respect to the physician—PA relationship is a clear understanding of roles.

According to the physician assistant program at the University of Washington Medicine, “The role of the physician assistant(s) in the delivery of care should be defined through mutually agreed upon guidelines that are developed by the physician and the physician assistant and based on the physician’s delegatory style.”

The physician must acclimate the PA to their supervising methods and style of leadership, in addition to routinely reviewing delegated patient services and practice guidelines.

On a related note, patients should always be aware whether they are being cared for by a PA or a physician at any visit.

Patience

Clinic and hospital staff are often busy, but it is imperative to find the right time for the physician to answer a PA’s concern in full—and that often requires patience on the part of the PA. Physicians must often educate PAs, which also takes time. 

“The best teachers are also the ones who understand the value of a teaching moment,” wrote Stephen Pasquini, PA-C, in a post published on Physician Assistant Life. “Waiting to get an answer to your question may be the number one deterrent to asking a question. But I will encourage you to dig deep and have patience. I can remember these moments (and there were lots of them) but it was always worth it. I learned something that I now probably use every day.”

Constructive criticism

Criticism is important to any working relationship, but a line is crossed when the criticism becomes patronizing or belittling. When providing feedback to a PA, the physician must be respectful and provide critical analysis while remaining kind. 

Demoralizing a PA can undermine the entire relationship. On the other hand, the physician should not blindly praise everything that a PA does, especially in areas where improvement is needed. Ultimately, it’s a delicate balance.

If the PA does an excellent job, then praise is absolutely called for. Encouragement is critical, and kind words can help facilitate patient care.

Growth

Nobody likes to be stymied in their responsibilities. In time, it’s important to let a PA spread their wings and operate at their full potential.

According to the CompHealth blog, “There should be a consistent growth pattern to the relationship between the collaborating physician and the PA or NP [nurse practitioner]. With time, this will increasingly build trust. Expanding the scope of practice in the clinical setting should occur more and more, and in time, the PA or NP should be practicing to the ‘top of his/her license.’”

Respect

It’s no surprise that every healthcare professional benefits from respect. One important way for a physician to show respect is to refer to PAs using the right terminology. 

For years, PAs (and NPs) have been referred to as “mid-level” providers or “physician extenders.” These terms, however, can result in umbrage, and rightfully so. 

PAs and NPNs perform high-quality and dedicated services that deserve support and recognition. One way to appreciate them is to refer to them as advanced practitioners. After all, the term mid-level providers can connote some “middling” level of competence or care, which reflects poorly on the entire practice.

Sources: 

1. Scope of PA practice. University of Washington Medicine.

2. Pasquini S. The PA and Supervising Physician Relationship: 5 Must Haves!. Physician Assistant Life.

3. Shock L. The most critical relationship on the healthcare team. CompHealth Blog. October 24, 2018.