Over three decades ago, Dr. Thomas Bat opened his first primary care office in the Atlanta suburbs focused on "patient-centered care," long before that term became popular. Today, North Atlanta Primary Care has grown to include 10 offices, staffed by 24 physicians and 18 PAs – a testament to team-based care, and an environment that encourages building patient relationships over time.
As a PA in this practice for almost 14 years, I know the value of close collaboration with physicians and other PAs, and how it allows us to improve everything from workflow to communications and outcomes. PAs contribute to the practice and quality of care in many ways, including:
• Increasing access to care. PAs play a key role in treating acute patients on a walk-in basis. Our physicians have full daily schedules and we staff the office six days a week, seeing same day appointments including sick patients.
• Improving patient outcomes. Because we are available, patients receive treatment sooner. With the recent flu epidemic, we could start treatment as soon as possible, which reduces complications. That means less time away from work or school, which is important for individuals and families.
• Controlling costs. The ability to accept acute care patients six days a week reduces or eliminates visits to urgent care or a hospital emergency department. This can reduce costs since many insurers charge much higher fees for an ER visit that for a copay to the primary care office. Also, patient visits in this office will be documented in the electronic health record (EHR), whereas an emergency visit and treatment would not be included in the EHR for future reference.
• Counseling patients. PAs are educated in communications techniques and we may have just a bit more time to educate patients and their families. We make a point to ensure the patient understands and is engaged in the treatment plan. We also talk about preventive care and wellness to reduce re-occurrence and avoid new problems.
• Continuity of care. In this practice, PAs are encouraged to build relationships and develop our own patient population over time. I have a panel of patients that I have come to know well and they schedule appointments with me for physicals or to manage their chronic conditions. It is beneficial for patients to see a regular provider because continuity of care leads to improved outcomes.
• Incorporating technology into the patient plan. The EHR improves overall communication with providers. We also encourage our patients to use the portal for fast, anytime access to scheduling, lab results or prescription requests. Studies show that patients may only retain 40 percent of what providers tell them, so the portal provides an easy avenue for them to ask follow-up questions, which can improve adherence to the treatment plan.
One of the reasons this practice has been able to grow while maintaining a high level of patient satisfaction is that PAs here operate with a good bit of autonomy. We are empowered to practice at the top of our license in a setting that is conducive to our productivity. For example, we have many in-house labs and tests, from rapid flu and urinalysis to stress tests.
PAs are trained in performing stress and other tests, analyzing the results and explaining them to patients. This allows us to do many things in the same visit, which can reduce costs and help with more accurate diagnoses, reducing the length and severity of illnesses.
The incorporation of PAs builds dimension in a practice. Fifty years ago, Dr. Eugene Stead created the first PA program at Duke University to educate former military medics to work in underserved areas. Although today, PAs work in every specialty and clinical setting, primary care was the genesis of the profession, and I feel fortunate to work in this field because it gives me the ability to know my patients.
Oliver Heinle, PA-C, received a Master of Medical Science from the PA Program at Emory University. He has been certified by the National Commission on Certification of Physician Assistants since 2004.
