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All Radar Units Focused on PAs and NPs
by Bob Blumm, MA, PA-C, DFAAPA - April 20, 2010
There was a time in the history of the Physician Assistant and the Nurse Practitioner professions that these two providers were invisible or beneath the radar. Who knew what a PA was? Who knew what the credentials NP meant? The patient world was fairly ignorant of these terms as were many of the legal firms. Most legal firms thought them to be somewhat of a blur between medical assistants and LPNs. They probably rendered almost no patient care other than taking vital signs or changing Band-Aids and maybe drawing blood. Did they have culpability? Probably not! Did they have malpractice insurance? Most likely no! They served in hospitals and offices along with janitors, secretaries, runners, mail clerks, etc.
During the past five years, there has been a ripple in the force. PAs and NPs, through their state and national organizations, presented bills through proper legislative channels, won major privileges such as the ability to examine a patient, order labs and x-rays, interpret those tests, create a treatment plan, write prescriptions for medications including Schedule ll and lll drugs and fill out insurance forms and be paid for their medical services at a diminished rate from that of a MD or DO. They had many positive patient outcomes and were well accepted by patients because they spent more time in educating the patient.
Neither of these groups had a three to five year residency so they became proficient by years of practicing and sometimes through making an error, which cost the patient a delay in healing or an extended hospitalization. But their colleagues, the doctors made some of the same errors and were legally responsible. In some states NPs were permitted to practice independently while in most they were required to collaborate with a physician. Today, the latter is a minority situation. PAs practice under a dependent relationship where a physician serves as their supervising physician but what that came down to was that both entities could be served for a malpractice suit such as “failure to diagnose or failure to treat.” Attorneys quickly discovered that both NPs and PAs were responsible for medical care and for failure to perform according to an accepted standard, therefore the invisible became visible and the radar screen lit up with hundreds of new “sightings.”
This represents the past and the present and will be magnified in the future. Surgical PAs have a motto: “A surgeon’s best instrument is a surgical PA”. The more popular a group becomes, the stronger a profession is, and the greater the privileges and the enlargement of scope of practice creates greater visibility. If you are a PA or an NP what is the most important tool in your medical bag? As a PA who has practiced for forty years I can endorse the philosophy that the best tool is a professional liability insurance policy that has the ability to give me the protection that I need when my care has been noticed on the radar screen. It is my responsibility to protect myself and my family by purchasing a policy that will not forgive my error but will defend my thinking and support me with excellent counsel and a PA expert witness who will defend my actions if they were appropriate. Unfortunately no PA is perfect and all may at one time in their professional life be served with a summons for the care they rendered to a patient. When that time comes in your career, be prepared, own a policy with your name on it personally. That’s the only real defense you can count upon in the future.
Robert M. Blumm has received national recognition as a distinguished fellow of the American Academy of Physician Assistants (AAPA). He is the past president of the Association of Plastic Surgery Physician Assistants, and was past-president of the American Association of Surgical Physician Assistants, past president of the American College of Clinicians and NYSSPA, as well as Chairman of the Surgical Congress of the AAPA. In addition, Bob received the John Kirklin MD Award for Professional Excellence from the American Association of Surgical Physician Assistants. Along with his associate, Dr. Acker, Bob was the first recipient of the AAPA PAragon Physician-PA Partnership Award. He has been a contributing author of three textbooks, written 150 plus articles and is a sought out conference speaker throughout the United States.
The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
