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Here's a simple solution for family physicians who are stressed by patient overload, worried about declining revenues and unable to remember the last time they took a vacation. Hire a physician assistant, says family physician Keith White, M.D., of Independence, Ore.
"A PA is essential for any family physician who wants to improve practice revenue, improve patient quality of care and improve quality of life," says White, presenter at an Assembly core practice management and professional development course titled "Enhancing Practice Revenue, Productivity & Lifestyle Utilizing Team Practice With PAs."
White says that his PA costs the practice $78,095 a year, an amount composed of salary ($50,000) and a generous benefits package including pension, 401K and health insurance. "But the annual profit generated by my PA is $65,682, which works out to $5,474 a month that is added to my income," he says.
While some practices encourage PAs to develop their own patients, White says that he prefers a team approach in which "we each see the same patients, which means that the patients know both of us and we know all the patients." For new patients, White does the initial physical and takes time to explain that he works with a PA, who may be the provider that the patient sees on the next visit.
In White's practice, the PA participates at every level. For example, White says, "When I'm on call, she takes first calls." This top-to-bottom integration of the PA "keeps me happy, keeps my staff happy and keeps my family happy," he says. "Plus it improves my cash, and when I return from vacation, there is no flood of patients or paperwork greeting me."
Likewise, when the PA is on vacation, White is at the office.
White's co-presenters were Lynn Caton, P.A.-C., an assistant professor at Oregon Health Sciences University in Portland, and Michael Powe, director of health systems and reimbursement policy at the American Academy of Physician Assistants in Alexandria, Va. They discussed the PA-physician team from the PA's viewpoint.
Caton says PA training takes roughly 26 months, with "nine to 12 months devoted to classroom work and 55 weeks rotating through 11 specialties." He says the most popular PA specialty is family medicine, with 31 percent of PAs practicing in that area. As a group, PAs are the third-fastest-growing profession, says Caton, who added, "the number of PAs is expected to increase by 50 percent in the next five years."
Powe says that most insurers will reimburse PAs directly, although at a lower rate than payment to physicians. For Medicare billing, PAs need a separate Medicare provider number. Medicare reimburses PAs at 85 percent of the physician reimbursement, he says.
For physicians who are anxious for a quick fix to an overburdened practice, Powe says that an experienced PA can "almost hit the ground running. My wife is an internal medicine PA, and she can be up to speed in a new practice in about three weeks."
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Copyright © 2004 by American Academy of Family Physicians.