Jump to content
Premed 101 Forums

PAs key members of ‘team’ model of care in pediatric offices

PAstudent

Recommended Posts

future_doc Newbie

future_doc

Posted
Posted

Good read :)

 

PAs key members of ‘team’ model of care in pediatric offices

Kristy Kennedy, Correspondent

 

When the office is swamped on Monday mornings and pediatricians get behind, Chris Barry, PA-C, M.M.Sc., keeps appointments moving by serving as a floater.

 

“Parents don’t like to wait, especially when they have a sick child,” said Barry, a physician assistant (PA) at a practice in Raleigh, N.C. He also is medical liaison from the American Academy of Physician Assistants (AAPA) to the Academy and a board member of the Society for Physician Assistants in Pediatrics.

 

Barry, who also sees his own patients, considers physician assistants an important part of the health care team. Pediatricians agree.

 

“What is nice for pediatricians is that the team model of care is what they (PAs) do,” said Jack Percelay, M.D., M.P.H., FAAP, AAP liaison to the Accreditation Review Commission on Education for the Physician Assistant. “It’s a collaborative working relationship with physicians.”

 

A changing landscape

 

Experts say “mid-level” health care providers such as PAs and nurse practitioners will play a more prominent role in medicine as medical coverage increases with the Affordable Care Act.

 

In fact, the Bureau of Labor Statistics estimates the number of PAs will increase from about 83,500 now certified by the National Commission on Certification of Physician Assistants to about 104,000 by 2018.

 

“Physician assistants will expand the available pool of clinicians that help care for all members of society,” Dr. Percelay said.

 

About 2% of PAs work in general pediatrics, while nearly 50% are working in family medicine or surgical subspecialties, according to the AAPA. But Dr. Percelay anticipates PAs will play a greater role in pediatrics because they are a good fit.

 

While PAs need a supervising physician in order to practice, they can diagnose, order lab tests and X-rays, write prescriptions and manage acute conditions. All have prescribing privileges, although state laws differ on how much oversight is required. For instance, some states require a physician to sign off on some prescriptions like controlled substances. Since 2010, PAs have been eligible to become national affiliate members of the Academy.

 

The practice of using PAs is more common in different parts of the country. For instance, Denver has strong numbers because of a well-known three-year program at the University of Colorado. “It certainly is a potential source for pediatricians to look at,” Dr. Percelay said. “If you’re an office looking to hire a PA, one good way to identify top talent among recent grads is to offer to be a preceptor. You can identify people who will best fit into your practice.”

 

Dr. Kurtz

Wanting to expand his practice, Michael L. Kurtz, M.D., FAAP, hired his first PA 15 years ago after working with a Colorado program that educated PAs. “We had very personal experience and knowledge of individuals,” Dr. Kurtz said. “They were a known commodity.”

 

Substantial training required

 

PA programs typically are 27 months long, require more than 400 hours of basic sciences, 75 hours in pharmacology, 175 hours in behavioral sciences and about 580 hours in clinical medicine. Also, PA students must complete more than 2,000 hours of clinical rotations with an emphasis on primary care in ambulatory clinics, physicians’ offices and acute/long-term care facilities, according to the AAPA. Then, a national exam must be passed and state licensure obtained.

 

Recertification requires additional education and passing an exam every six years. PAs earn an average of $90,000 a year, according to the AAPA.

 

“They know their stuff very well,” said Dr. Kurtz, whose practice has 10 pediatricians, eight PAs and two nurse practitioners.

 

Dr. Kurtz said doctors and mid-level providers on his staff see the same kinds of patients and work collaboratively. “We lean on each other for interoffice consultations, and I’m just as likely to ask a PA something because that may be their expertise,” he said.

 

Kimberly Thomas, PA-C, who works with Dr. Kurtz, said the independence she receives combined with the office teamwork makes her job fulfilling. “It’s a mutual good,” Thomas said. “I have a lot of independence and a lot of respect for my colleagues. They also really profit from that because their business is thriving because of the model they are providing.”

 

Thomas sees about 20 patients a day and does everything the physicians in her practice do. “The (pediatricians) trust me and know I will come to them if there is a need. There certainly have been times where I’ve diagnosed something my colleagues missed,” Thomas said, remembering a 3-year-old with gallstones and a baby she diagnosed with Turner syndrome. “It has to do with being a good, careful medical provider.”

 

Because PAs can change jobs within the medical field, they often have specialized training in different areas that can benefit pediatric offices, Dr. Percelay said. For instance, a PA who worked in gynecology could perform pelvic exams or one working in orthopedics might offer expertise in sports medicine. “It’s having a variety of providers to meet the needs of your patients,” Dr. Percelay said.

 

While PAs can fill specific needs in offices, their most important role is providing good care, Barry said.

 

“A good PA is one who keeps that in mind and truly cares about the patients,” he said. In turn, practices that stress respect, collaboration and some independence for experienced mid-level providers are most attractive to PAs.

 

“We want to use our abilities to the maximum,” Barry said. “It all comes down to providing quality care for our patients.”

Link to comment
Share on other sites

Archived

This topic is now archived and is closed to further replies.

Go to topic listing
×
×
  • Create New...