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Evolving Scope of Practice: Physician Assistants Weigh In

Jon McKenna | December 2, 2022 | Contributor Information

Physicians and physician assistants (PAs) both enjoy high demand as the country deals with shortages of healthcare professionals. Meanwhile, expanded practice roles for PAs have been quickly gaining traction. The need for doctors and PAs to work effectively together constantly rises. How is it going?

More than 770 PAs who work with physicians and/or PAs told us about their working relationships with those professionals and how they changed during the COVID-19 pandemic. They also expressed their thoughts about PAs' expanding practice abilities.

Previous Medscape reports gave physicians' opinions on working relationships with both nurse practitioners (NPs) and PAs and addressed working relationships through the eyes of NPs.

(Note: Some chart data in this presentation do not add up to 100% because of rounding.)

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Evolving Scope of Practice: Physician Assistants Weigh In

Jon McKenna | December 2, 2022 | Contributor Information

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Evolving Scope of Practice: Physician Assistants Weigh In

Jon McKenna | December 2, 2022 | Contributor Information

By a huge margin, PAs characterized their working relationship with doctors as "very good" or "good." Physicians returned the compliment to physicians nearly as frequently (91%).

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Evolving Scope of Practice: Physician Assistants Weigh In

Jon McKenna | December 2, 2022 | Contributor Information

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Evolving Scope of Practice: Physician Assistants Weigh In

Jon McKenna | December 2, 2022 | Contributor Information

Nearly 2 in 3 PAs said that their working relationship with doctors amid pandemic pressures — from enforcing mask and vaccination policies to crazed, short-staffed schedules — emerged mostly unchanged.

As for physicians' opinion, an even greater share (74%) felt that their working relationship with PAs was unaffected. Doctors were somewhat less likely than were PAs to say the relationship either improved or worsened, somewhat or a lot (19% and 7%, respectively).

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Evolving Scope of Practice: Physician Assistants Weigh In

Jon McKenna | December 2, 2022 | Contributor Information

On average, PAs and physicians graded one another quite similarly for the quality of their patient treatment. 74% of doctors were satisfied, to varying degrees, with PAs' patient interactions. Another 14% of physicians were neutral, and 12% were somewhat or very dissatisfied with how PAs work with patients.

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Evolving Scope of Practice: Physician Assistants Weigh In

Jon McKenna | December 2, 2022 | Contributor Information

Once again, doctors and PAs evaluated one another's work interactions in similar terms here.

Nearly 8 in 10 PAs were somewhat or very satisfied with how physicians work collaboratively with other members of the healthcare team. Meanwhile, 75% of physicians said the same of PAs and/or NPs.

And PAs were dissatisfied, to varying degrees, with the way doctors work with staff around as often as physicians were with PAs and/or NPs (10%).

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Evolving Scope of Practice: Physician Assistants Weigh In

Jon McKenna | December 2, 2022 | Contributor Information

Fifty-seven percent of PAs found fault with doctors' calls on patient treatment at least sometimes. From the other side of the aisle, 80% of physicians had issues with a PA's treatment occasionally or often, and 19% said rarely.

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Evolving Scope of Practice: Physician Assistants Weigh In

Jon McKenna | December 2, 2022 | Contributor Information

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Evolving Scope of Practice: Physician Assistants Weigh In

Jon McKenna | December 2, 2022 | Contributor Information

Fifty-seven percent of PAs found fault with doctors' calls on patient treatment at least sometimes. From the other side of the aisle, 80% of physicians had issues with a PA's treatment occasionally or often, and 19% said rarely.

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Evolving Scope of Practice: Physician Assistants Weigh In

Jon McKenna | December 2, 2022 | Contributor Information

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Evolving Scope of Practice: Physician Assistants Weigh In

Jon McKenna | December 2, 2022 | Contributor Information

Physicians were emphatic on this issue. About 9 in 10 said that their workplaces provide enough in the way support such as personal protective equipment (PPE), mental health programs, and sufficient staffing.

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Evolving Scope of Practice: Physician Assistants Weigh In

Jon McKenna | December 2, 2022 | Contributor Information

When we put that question to PAs and asked about specific support efforts, they were strongly favorable when it came to PPE and other safety equipment. The majorities of PAs who felt workplace mental health programs and staffing efforts are adequate were significantly smaller.

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Evolving Scope of Practice: Physician Assistants Weigh In

Jon McKenna | December 2, 2022 | Contributor Information

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Evolving Scope of Practice: Physician Assistants Weigh In

Jon McKenna | December 2, 2022 | Contributor Information

Around 1 in 5 states now characterize the physician-PA relationship as collaborative rather than supervisory, according to the American Academy of Physician Associates. Medscape asked both PAs and doctors what they thought of this trend.

Nearly 8 in 10 PAs saw this trend in a positive light, and none of those surveyed felt it is a negative development. However, physicians were less enthusiastic (19% positive, 57% neutral, 23% negative).

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Evolving Scope of Practice: Physician Assistants Weigh In

Jon McKenna | December 2, 2022 | Contributor Information

With the overwhelming majority of PAs answering yes, this was another question that showed a sharp division with physicians. Only 39% of doctors thought more states should give OTP to PAs and 61% said that they shouldn't.

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Evolving Scope of Practice: Physician Assistants Weigh In

Jon McKenna | December 2, 2022 | Contributor Information

Strong majorities of both doctors and PAs said they have experienced a patient's expressed desire to consult with a physician rather than a nurse. Seventy-six percent of doctors said that yes, they have experienced this kind of pushback from patients.

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Evolving Scope of Practice: Physician Assistants Weigh In

Jon McKenna | December 2, 2022 | Contributor Information

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Evolving Scope of Practice: Physician Assistants Weigh In

Jon McKenna | December 2, 2022 | Contributor Information

PAs and doctors characterized their patients' response to PAs' expanded practice abilities differently. Physicians said that patients are somewhat to very favorable only about half as often (41%). They depicted that patient reaction as somewhat to very unfavorable much more frequently (27%) than PAs do.

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Evolving Scope of Practice: Physician Assistants Weigh In

Jon McKenna | December 2, 2022 | Contributor Information

Only about one third of PAs agreed with the idea that they collaborate better with one another or NPs than with doctors. An even smaller share of doctors (19%) answered this question yes, indicating that they firmly feel a more effective team pairs them with a PA.

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Evolving Scope of Practice: Physician Assistants Weigh In

Jon McKenna | December 2, 2022 | Contributor Information

Of note, physicians more often (55%) felt both PAs (in career development) and patients (in quality care) benefit when a PA earns a doctorate, residency, or fellowship. The 35% who were unsure shows that many PAs have difficulty evaluating the pros and cons of advanced degrees.

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Evolving Scope of Practice: Physician Assistants Weigh In

Jon McKenna | December 2, 2022 | Contributor Information

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Evolving Scope of Practice: Physician Assistants Weigh In

Jon McKenna | December 2, 2022 | Contributor Information

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Medscape Physician Assistant Career Satisfaction Report 2022

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