Can You Afford Not to Consider Physician Assistants?

The presence of Hospitalists has given physicians in private practice the ability to concentrate on seeing patients in their offices and not care for hospitalized patients. Similarly, a Physician Assistant can free up a physician's time by handling patient history and physicals, diagnosing illnesses, ordering lab tests, and prescribing medications. This enables the physician to focus on caring for patients with chronic and complex illnesses. PAs also enable the physician to work fewer hours, share call, and provide medical care to more patients.

HealthLeaders Media of June 2009 states that GI, Orthopedic Surgery and Dermatology specialists, whose services are increasingly in demand, can resolve bottlenecks in their appointment calendars and increase revenue dramatically by using Physician Assistants to help treat patients. Although third-party payers have varying reimbursement schedules for PAs, "when these clinicians independently provide services, Medicare typically reimburses at 85% of the physician reimbursement rates." Outpatient services are billed under Medicare's "incident to" physician care provisions, which pay at 100% of the physician's reimbursement rate as long as the following conditions are met:

• The specialist physician is physically on site at the time the PA provides care
• The specialist physician personally treats and diagnoses the patient on their first visit, although the PA provides subsequent care
• The specialist physician treats and diagnoses patients with new conditions, although the PA may provide subsequent care
• The specialist physician remains involved in the patient's care

The scope of practice of Physician Assistants is determined by their sponsoring and supervising physicians. By using the guidelines established by the American Medical Association (AMA), the PA and physician work as a team. Although a PA has autonomy and can work in a facility where the physician is not present, it is necessary for the physician to be available by telephone or other means of communication.

Currently, there are over 79,000 Physician Assistants in the US with the vast majority of Physician Assistants practicing in primary care. Kevin LoHenry, MPAS, PA-C, Physician Assistant Program Director at Midwestern University in Glendale, Arizona, noted that among many curriculums in medical sciences, PAs are also trained in more than 60 different surgical and specialty fields.

The American Academy of Physician Assistants (AAPA) states the mean salary for a PA is $77,000–121,000 with the median for a PA in practice less than one year at $75,000–91,000. LoHenry sees salary trends well over $100,000 for specialties such as Dermatology, Gastroenterology, and Orthopedics. He noted physicians and administrators may not be aware that employing a Physician Assistant can actually increase revenue, expand the practice, and decrease the physician's workload. In determining the cost effectiveness of adding a PA to your practice or hospital, depending on specialty, consider that a PA generates an average of anywhere from $175,000 to $300,000 in collections to a practice. Ancillary services can generate additional revenue.

With the average length of Physician Assistant programs at 2–3 years, in 2011–2012 there will be an additional 12,000 medical providers. As a physician shortage will continue to exist, Physician Assistants will certainly improve patient access to quality medical care and be an integral part of the healthcare team.

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