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| Physician/PA Teams---What does the PA expect from the physician? |
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by Bob Blumm, MA, PA-C, DFAAPA - October 9, 2011
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The relationship between the PA and the physician is similar to a marriage. I would hope that a female PA responds with her view as I am speaking from the position of a male and my expectations may differ from that of the feminine gender. All marriages require communication, affirmation, honesty, sharing responsibilities and in general, a lot of hard work. There is a very real progression from dating to living together and finally until making the relationship legal by culminating in marriage. Years ago I heard a comment that rings true until this day: "marriages are not made in heaven but come in do it yourself kits.” This requires a commitment by both individuals to give 100% toward the contract or the marriage. So what do I consider a six point plan for a PA/Physician contract in theory?
A. Recognition- the only manner in which a spouse can gauge the relationship is with feedback and affirmation. One of the differences between a marriage and a contract between a physician and a PA is the fact that one of these scenarios has a lead partner and the other requires joint consideration and respect. In case you haven’t guessed, a medical contract has a lead partner. The lead partner has the obligation to affirm good work, commitment, excellence as a diagnostician, patient acceptance and other incidentals such as dress, grooming, interaction with the other staff and nurses and completeness of charts and dictations. There is nothing wrong with praising an employee for a job well done.
B. Responsibility- There should be a clear delineation of responsibilities with a scope of practice and a method of providing guidelines and education that will make the PA a more engaging and competent member of the team.
C. Respect- It should not require a statement but, nevertheless, it is important for the physician to appreciate that the PA is an extension of the physician and her/his concern for the practice. Never, never, never should a physician throw his/her PA under the proverbial bus nor criticize the PA in the presence of a patient. If the workup was not as perfect as expected and the differential diagnosis was not as broad as the physicians, this needs to be handled in the privacy of a closed room, not in the presence of a patient. Both parties need to be aware of their educational differences and respect each other’s abilities as well as their shortcomings. Mistakes are opportunities for both the PA and the physician to learn, both about a disease and about each other’s area of expertise.
D. Professional knowledge- Professional knowledge is gained by continuing education, by seeing a varied practice load, not just sore throats and earaches and, mainly, by mentoring and discussion of complex presentations.
E. Trust- The physician needs to learn to trust the PA if there are guidelines and protocols in the practice. Chart review is a manner of discovering if this essential plan is being followed and is an opportunity for both parties to dialogue concerning approaches and the practice protocol in dealing with a patient problem. If the physician is going to walk into the room after the PA has examined a patient and repeat an exam on a continuing basis, this would make PAs true “assistants” and demean their title as well as their value and trust.
F. Profit sharing- Discussion on this topic should be approached after six months of observing the relationship. If the PA is an aggressive first to come and last to leave type of person, then this should be recognized and discussion can ensue as to added benefits, income, CME or other perks such as a private plane (only kidding.)
These are fundamental essentials of a good working relationship
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 300 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.
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| Bob Blumm (Amityville, NY) |
on 05 Feb 2012 at 10:07 pm |
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I'd be for it. Preaching to the choir never gets new converts.
Bob |
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| Marcos A. Vargas,MSHA,PA-C (Flushing,MI) |
on 05 Feb 2012 at 3:52 pm |
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Bob:
A great article, one that should be published in as many physician blogs as allowed. Oh by the way, thanks for the private plane idea...one of those perks never thought of (just kidding)! |
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