New Role in Connecting PAs and Physicians

In approximately one month, I embark on a new role in physician assistant (PA) leadership. This new role comes as I wind down my career, one in which I have served in a number of leadership positions on the state, national and specialty level.

This spring, I was appointed the liaison from the American Academy of PAs (AAPA) to the American Medical Association. This is a leadership position to which I have always aspired. I will be the diplomatic connection between the AAPA and the AMA, as we together try to navigate the increasing complex healthcare system in the U.S.

The physician and PA professions have long been "attached at the hip," in both form and function.  However, the form and function of this relationship has been drastically altered by time and experience. PAs have come into their own since 1967, when the first class of PAs graduated from Duke University. No one could have predicted the success and diversity of the PA profession, nor its penetration into virtually every specialty and subspecialty in which physicians practice.

The 100,000 plus practicing PAs in the U.S. are a vital resource in the delivery of healthcare. We practice in physician-led teams. We are acculturated to team practice. But within that team, PAs are trained and experienced to practice medicine with a significant level of autonomy, in every healthcare setting that you can imagine.

With this expansion, some friction has been created, but physician who work closely with PAs and recognize their utility. One friction point has been the "supervision" of PAs, which applies last century rules and regulations, to modern medical practice.

That will make my role a challenge, putting it mildly. PAs are committed to team practice on physician-led teams. However, in that team, PAs work best when decisions about team practice are made at the team level. One size doesn't fit all. I have been a practicing PA for nearly 37 years. My function within our team of one surgeon and two PAs is vastly different than a new graduate PA. The parallels with physician practice are the same. There is a significant difference from a physician and surgeon who has just finished residency, and one of 20 years of practice experience.

Medicine is evolving rapidly. Resources are stretched to the brink. The AMA House of Delegates (HOD) is the policy and philosophy setting deliberative body for medicine and physicians. Twice a year, they meet to make policy for the physician profession and elect their leaders. This policy and philosophy guides the AMA in its response to the changing healthcare system, the nation, and the world. It will be my job to work closely with my physician colleagues to ensure that the policy and philosophy of the AMA has the input of the AAPA during deliberation and formation by the AMA HOD. I always have been of the opinion that together, PAs and physicians, we are stronger.

The relationship between physicians and PAs has to evolve along with the evolution of the healthcare system if we together have any hope of effectively meeting the  needs of our patients. . We must evolve together to remove barriers to effective team practice and function, and give the practice team the ability structure itself in the most effective and efficient manner.

I have my work cut out for me. It is not easy to manage our respective and intertwined roles within the healthcare system in the U.S. Luckily, my long professional experience as a PA in both practice and leadership will help me. I will work to bring my full experience to the table in making physician-PA teams stronger.