Over the course of my 30 years as a PA in general pediatric practice, I have treated infants from the first newborn visit through their adolescence and entrance to adulthood, developing strong and trusted relationships with children and parents alike.
Today's primary-care practices are straining to meet the rapidly growing demand for services. More than one in three children, about 45 million, are now covered by Medicaid; and with the U.S. Supreme Court's ruling in King v. Burwell upholding tax subsidies for health insurance, practices in all states are looking for ways to ensure quality and access, especially for the nation's youngest patients.
There are three important ways certified PAs can help physicians and their practices.
1. PAs help busy physicians by addressing seasonal increases in patient demand, providing high quality care for new patients, while maintaining their own panel of patients. PAs can treat acute illness during peak times, like allergy and flu seasons, and also help to manage heavy demand for physicals and immunizations when patients need to go back to school.
After a busy summer of camp physicals, PAs are heavily involved in sports physicals. We obtain a history that includes the salient points of past injuries, concussions, chronic respiratory disease, diabetes, seizures, and congenital heart disorders. In our office, we also recommend a baseline EKG for varsity athletes. Of course we weigh the benefit vs. the cost and welcome discussion with patients on any test or lab study we recommend.
As a certified PA, I am usually the only provider in our walk-in care clinic which is open on weekday evenings and Saturday morning. There, I treat patients requiring routine care for common pediatric complaints — earache, rash, fever, sprain, sore throat, etc. — so children can get same-day care and possibly avoid the emergency room.
2. PAs educate and counsel patients. Patients want to be heard and have their concerns addressed. PAs often have more time to speak with patients, listen to their concerns, and provide patient education, resulting in the patient feeling understood and attended to during the encounter.
Most public schools mandate that students have required immunizations completed prior to matriculating in the system. While we have seen the backlash from parents worried about long-term adverse effects and opting out of routine immunizations for religious or personal reasons, the tide is turning. California just passed a law that will eliminate immunization exemptions based on personal beliefs for children in child care and public and private schools starting in 2016. I expect we will see others follow suit.
In the meantime, in Connecticut where I work, immunizations are typically updated three times during a student's elementary and high school years. Because of their track record in caring for and communicating with patients, certified PAs are in a good position to reassure patients who suspect traditional immunizations and question their necessity.
With newer immunizations, like the HPV vaccine, we counsel parents who may be in denial about teenage sexuality or worry about the vaccine's impact on future fertility. We counsel not only to get vaccinations, but to get them at the recommended times.
We also talk to teenage athletes who try to delay a vaccine, like tetanus, because their arm will be sore and they have practice that day. Many parents will agree with their adolescent to come back in a week or two, but sometimes that doesn't happen. We make time to explain why it's important and it's worth doing now as "out of sight, out of mind" can cause problems if injuries occur.
3. PAs maintain and increase the revenue stream. A PA who builds trusting relationships with patients engenders strong patient satisfaction, and this leads not only to patient retention but new patients as well, since word-of-mouth recommendations are the best references.
On average, PAs in primary care earn an average of 50 percent of a physician's salary but can handle most patient complaints. Thus, the services PAs provide versus the employment cost make the PA model self-sustaining in today's competitive and regulated healthcare marketplace and can ensure the long term viability of the practice.
Of course, it's not just about costs. Practices that employ PAs also appreciate that PAs are highly educated and must pass a rigorous certification exam administered by the National Commission on Certification of Physician Assistants (NCCPA) to be licensed by the medical boards in all 50 states and the District of Columbia. Then they follow a course of ongoing study and periodic recertification exams to stay current on the latest in medicine. Studies show they score high marks for patient satisfaction and for quality of care. PAs can help your business thrive.
Brian Maurer, PA-C, holds a Certificate of Added Qualifications in Pediatrics from NCCPA, a credential that requires experience and CME in the specialty, an attestation to his skills from a physician, and passing a national Pediatrics Specialty Exam. He is also an affiliate member of the American Academy of Pediatrics.
This blog was provided in partnership with the National Commission on Certification of Physician Assistants.