Partner with PAs to fight burnout

Every morning, my collaborating physician and I start the day with a high five. That nonverbal communication not only sets a positive tone for the day but also symbolizes the great partnership we have developed in less than a year.

There’s a great exchange of knowledge between my collaborating physician and me, and we’ve built a symbiotic collaborative that’s reduced his daily load and has allowed me to flourish as a clinician. I have also had the opportunity to start new programs that improve patient-centered care and align with my passion to educate patients.

Forty-two percent of physicians reported feeling burnout, according to a U.S.-based survey of 15,000 physicians across 29 specialties. One way to address physician burnout is to add competent, highly qualified physician assistants (PAs) to share the workload. More than 131,000 certified PAs partner with physicians and other allied health professionals to expand access to care in urban centers, suburbs, and underserved communities, according to data provided by the National Commission on Certification of Physician Assistants (NCCPA).

Here are six things to consider before adding a PA to your team:

Set realistic expectations in advance.

My collaborating physician was the sole provider in his outpatient cardiology practice, so we spoke for a few months before I started working with him. During these frequent phone calls, we discussed our medical philosophies, approaches to patient care, and my role at the practice. We eventually dove into details of office logistics, schedules, and ancillary tasks, such as managing the practice’s online presence. I also shadowed him to see how he interacted with patients and observed office operations.

Have a shared understanding of professional roles and responsibilities.

A PA’s scope of practice is determined by education and experience, state law, employer policies, the needs of the practice, and the facility itself. Among other tasks and duties, PAs perform physical exams, interpret test results, diagnose illnesses, prescribe medications, and manage treatment plans.

Although each MD/PA practice team varies, my collaborating physician and I have a written practice agreement that spells out how I participate in patient care. If we agree that something should be added or changed, the agreement can easily be updated at any time.

I initially began seeing follow-up patients, but I have progressed to having my own patient panel. I consult with my collaborating physician often, especially for more challenging patients. I have away taken some of his burden, so he doesn’t have to spend as much of his evenings interpreting test results. I can also see his patients when he’s out of town, taking an extra consult, or performing rounds at the hospital. Additionally, the practice is now more often able to accommodate patients’ schedules by offering same-day appointments.

Foster an environment where PAs feel comfortable to bring forth new ideas.

My collaborating physician is very open to suggestion. For instance, I established semimonthly shared medical appointments where three to 10 patients can sign-up for a one-hour group appointment on a particular topic. During that hour, I provide education about chronic disease management. Afterward, I meet with each patient one-on-one for a brief exam.

Explain to patients how PAs will be involved in their care.

My collaborating physician is very focused on creating a team-oriented environment. Shortly after my arrival, he started sending every new patient to me for follow-up visits. Now, he introduces me as part of his team during his initial visits with patients and informs them about how I’ll be involved in their care. This allows patients to understand who I am and accept me as an active participant in their care.

Embrace our generalist education for a different perspective.

As a PA, I’m educated in the general medical model, which allows me to examine problems through a broad lens. My collaborating physician appreciates the rigorous requirements for maintaining PA certification. He knows he can ask my opinion and gain a different perspective. As a PA and health education specialist, I bring a background of public health, health education, and promotion to the practice.

Be a mentor.

Physicians can provide guidance, additional knowledge, and opportunities to allow PAs to become better clinicians. PAs typically undergo about a year of full-time clinical rotations in a variety of settings, but there may be specialty specific medications or tests that we did not encounter during our training. Be available to consult with your PA if they have questions about medications or tests, especially at the beginning.

Adding a PA to your team can decrease physician burnout, provide professional camaraderie, enhance patient care, increase accessibility of care, grow practice revenue, and improve your work-life balance. All of these benefits ensue without sacrificing the quality of care you offer.

In fact, even better clinical outcomes are possible when you recruit a new team member. Physicians who empower PAs to fully participate in the patient care process and practice at the top of their license can look also forward to a collaborative partnership that benefits one another as well as patients.

Sheila Hautbois, PA-C, MPH, works at Morris Cardiovascular and Risk Reduction Center in Chester, Va. She is a certified health education specialist with experience providing screenings, seminars, and health coaching for chronic disease prevention and reversal. Outside of work, the mother of three enjoys exercising, playing flute, and fostering kittens for her local animal rescue organization.

This blog was written in conjunction with the National Commission on Certification of Physician Assistants.