More physicians are coming to the realization that hiring a physician assistant or three could translate to a reduced workload and increased take-home pay.
Each year, a typical physician assistant treats 3,500 patients and writes more than 2,600 prescriptions, according to the 2013 AAPA Annual Survey. Those numbers can easily translate into a reduced workload and increased take-home pay for physicians.
“If you’re a physician and you have three physician assistants at a fully loaded cost of $100,000 each, that’s $300,000 of expense,” explains Matt Jacobson, CEO and founder of SignatureMD, the leading network of concierge medicine, boutique, direct care, retainer-based medicine and preventive care practices and doctors. “But those physician assistants could easily generate a million dollars worth of billing — easily.”
And more physicians are making that connection.
Growth of a profession
The number of physician assistants in the U.S. has grown by 34% since 2006 to more than 93,000. Larry Herman, MPA, PA-C, president of the American Academy of Physician Assistants, says there are two key factors contributing to that growth: an aging population, with not enough providers to go around; and the training physician assistants receive. The AAPA Annual Survey points to research indicating that the average physician assistant will practice medicine in two or three different specialties during their career.
“We are trained as generalists so we tend to be exceptionally nimble, and can very fluently move from one area to another,” Herman explains. “We’re trained side-by-side with physicians to think like physicians, in terms of taking care of patients.”
Jacobson agrees but, in addition to the 90,000-physician shortage in primary care by 2020 forecast by the American College of Physicians, he points to important numbers on the payer side of the ledger.
“Whether it’s Medicare or PPOs, a mid-level gets paid at about a 20 to 25% discount below what a physician gets paid,” Jacobson says. “The only way to pay for Obamacare is lowering your unit cost. And the only way to do that is to have a lower cost provider of care.”
Physicians embrace PAs
Jacobson says that physician assistants are a reality, and that they’re here to stay.
“Our doctors, I believe, are accepting the reality that physician assistants and nurse practitioners will be the frontline in general primary care medicine for the next 20 or 30 years,” he says. “And they’re helping to mentor that frontline.”
Herman says that in the 20-plus years he has been a practicing physician assistant, he can count on two fingers the number of times he has received pushback from physicians concerning use of a physician assistant.
“The reality is that we practice as a team,” he explains. “We don’t compete with physicians, because I don’t bill independently; my practice bills for me, my hospital bills for me, and my physician bills for me. So I don’t open up a practice, hang out a shingle across the street from the practice. PAs have always practiced in teams. And we continue to practice in teams with physicians.”
Jacobson admits that, at least at first, there is a psychological barrier that some physicians have to get past with regard to working with physician assistants. But he emphasizes that most of the physician with whom SignatureMD works have indicated that as long as they choose a qualified professional with experience and a compatible personality, the transition (to working with a physician assistant) has been relatively painless.
Hiring a physician assistant means working with a satisfied employee. According to the AAPA survey, 86% of physician assistants report high job satisfaction, compared to only 39% of physicians.
“We frequently get time to do things with patients — like sitting, explaining, and educating them — that physicians wish they could do, but because they’re pressed by reimbursements, they can’t,” Herman says. “As a result, there’s tremendously high patient satisfaction levels with physician assistants. That reinforcement to the profession is priceless.”
Jacobson says there are many other reasons why physician assistants experience such a high level of job satisfaction. He explains that physician assistants are able to get the benefit of helping people on a daily basis without the headache of running a practice.
“If you’re running a medical practice, there’s a lot of stress, there’s a lot of work, and a lot of moving pieces,” he says.
On the other hand, on a daily basis, physician assistants are helping people, they’re making people feel better, they’re interacting with patients, but they’re not responsible for billing and collection. They’re not responsible for managing the front office. They’re not responsible for integrating electronic medical records system.
“They come in, they take care of patients, they leave, they go home, they spend time with their family, then they wake up do it again,” Jacobson says.