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Musings about the strengths of teams


The commonalities between PAs and physicians far outweigh the few differences that we have.

Editor’s Note:Physician Practice’s blog features contributions from members of the medical community. These blogs are an opportunity for professionals to engage with readers about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The opinions are that of the writers and do not necessarily reflect the opinions of Physicians Practice or UBM.

Having recently returned from the annual meetings of the American Academy of PAs (AAPA) and the AMA House of Delegates (HODs), I find myself pondering our professions’ histories and futures, individually and together.

Of course, these musings all come through the filter of my life experiences, including 20 years in the two Houses, which does, I think, give me some authority to comment. I have attended a dozen AMA HODs as an AAPA leader, and since the early 1990s, I have attended the AAPA HOD either as a delegate or a house officer, including three years as Speaker. Currently, I attend the AMA House as AAPA liaison, where my role is to develop and expand ties between the PA and physician professions.

In mid-May of this year, I attended my own HOD, where AAPA reaffirmed its policy on Optimal Team Practice (OTP), a policy that has been a bone of contention with some of our physician colleagues. Last year, PAs were the focus of an AMA resolution opposing independent practice by PAs, introduced largely in response to OTP, which, incidentally, is not about independent practice. The OTP policy calls for laws and regulations that:

  • Emphasize PAs’ commitment to team practice;
  • Authorize PAs to practice without an agreement with a specific physician-enabling practice-level decisions about collaboration;
  • Create separate majority-PA boards to regulate PAs, or give that authority to healing arts or medical boards that have as members both PAs and physicians who practice with PAs; and
  • Authorize PAs to be directly reimbursed by all public and private insurers.

I have always had great respect for my physician colleagues and am proud to work in concert with them. The AMA HOD consists of over 600 delegates from across the nation, 

representing various walks of life, geographic entities, and specialty concerns

. It is interesting to note that the leadership of the AMA continues to diversify with the elections of Barbara L. McAneny, MD, the fourth woman to serve as AMA president, and Patrice Harris, MD, the first African-American woman to hold the office of president-elect.

In addition, the breadth and depth of the AMA’s interest in community and public health is unparalleled by any other medical professional organization. The AMA’s HOD considers hundreds of policies twice yearly, including new policies and updates to old policies. Topics include healthcare reform, diversity, healthcare disparities, LGBTQIA+ issues, reproductive issues, poverty, immigration policy, and gun safety, among others. The detail and the passion of testimony in reference committees is inspiring and is a testament to physicians not only doing their homework but standing up to protect and defend those in our society who are not powerful and cannot defend themselves. 

This brings me to the point of my musings and this blog. The commonalities between PAs and physicians far outweigh the few differences that we have. In fact, the history of physicians and PAs working together in teams spans more than half a century and will continue into the foreseeable future, as far as I can see. Over my history of attending the policy setting body of the AMA, it has been my desire to partner with physicians on the many health issues confronting our communities and nation much more often than not

In my personal opinion, and in the opinion of the AAPA, OTP makes health care teams more efficient and less burdensome to physicians. This allows for more time to do what really matters in medicine-which is to care for patients and make their lives and the lives of their families better. By now, PAs have a long history of service and have proven our utility and flexibility in the health care systems of the United States and the world.

I love going to the AMA HOD to renew past acquaintances, make new physician friends, and to help my physician colleagues better understand the PA role in our health care system. The job is getting easier, given that there are 123,000 PAs now practicing in the United States in virtually all of same settings and specialties as physicians.

Many AMA delegates now have first-hand experience working with PAs and on teams with PAs, and this can only be a harbinger of good things to come for the future of medicine in the United States.

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