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Physician Assistants Bring Value to the Surgical Team

Physician Assistants are nationally certified, state-licensed medical professionals who practice on healthcare teams with physicians and other providers, including surgicalists. Although they are not licensed to perform surgery, PAs may assist surgeons in surgical procedures. They always work under the supervision of the surgeon. The core of a PA’s training is collaborative, team-based care*—which fits perfectly with the Surgical Affiliates model.

According to the National Commission on Certification of Physician Assistants (NCCPA), the profession is growing; more than 35 percent in five years. Of the nearly 109,000 certified PAs in the U.S., three percent work in general surgery and a whopping almost 19% are in surgical subspecialties (including orthopaedic, cardiothoracic vascular and neurology).**

This rapid growth of PAs in surgical fields is typified by the experience of St. Luke’s Hospital, with campuses in Newburgh and Cornwall, New York. Thomas Robb, OD, Trauma Director and Chair of Surgery at St. Luke’s and Max Auerbach, PA-C, Lead PA, are part of the surgical care team from Surgical Affiliates Management Group, which contracts with St. Luke’s to provide acute care surgery, also referred to as surgical hospitalist care.

Over the 20 years of his surgical career, Dr. Robb has worked at hospitals that had and did not have PAs. He says that it is much more difficult for the surgeon without a PA.

Max believes his job is to help busy surgeons be two places at once. He says that “because our team knows what is happening with surgical patients at any given moment, we can keep surgeons better focused on patients that need their care.”

Although PAs are not in charge of quality measures, they are always in tune to them and as part of Surgical Affiliates’ collaborative team, our PAs not only help the surgeon, they help manage the patients and do follow-up to ensure continuity of patient care. Additionally, with our entire surgical team following American College of Surgeons (ACS) and physician practice management guidelines (PPMGs), variation in care is significantly reduced. This standardizing of care has repeatedly been proven to help prevent complications and improve the quality of patient care.

With the national growth of surgical PAs, Dr. Robb and Max have several tips for hospitals and surgery programs looking to build or expand involvement of PAs.

  • Be sure PAs are integrated into the surgical team. PAs are an integral part of the surgical team and need to work closely with every team member, so they must be fully integrated into the surgical team. For example, establishing clear lines of accountability and reciprocal responsibilities of the PA and other team members.
  • Utilize PAs to improve patient satisfaction. Since they have a lot of face-time with patients, PAs have the unique opportunity to build relationships that improve satisfaction. PAs can also be tapped to help patients understand post-discharge orders and to collaborate on patient hand-offs with community physicians. Utilize the experience and skills of your PAs to focus on particular areas you team needs, such as ordering lab tests.
  • Select the right people. Take the time to find and identify the right person for your team. Each surgeon has unique preferences and needs; some want extra hands in the OR; some prefer a PA on the floor communicating with patients and collaborating with other team members.
  • Ensure the PA is credentialed and trained in surgical procedures. Make sure your PAs are credentialed and experienced in the services they provide; for example, placing central lines. Many PAs today have direct surgery experience, providing a deep talent pool for hiring. Keep in mind, though, that you need to look beyond credentials—and look for the PA that best complements your team.
  • Improve skills with on-the-job training. You should make sure to offer on-the-job training so that PAs can add to their skill set—it’s an important part of building an effective program. Creating an environment that encourages and enables PAs to learn new things enriches them personally, as well as helps the team and patient.
  • Create an empowering, collegial environment. Foster an atmosphere that encourages PAs to practice to the fullest extent of their licensure, without the need for continuous oversight. Equally important, ensure your environment encourages PAs, especially those who are new, to come to surgeons for help and input when needed.
  • Offer PAs a competitive salary and benefit package. It’s not enough to offer a challenging and rewarding career for PAs. As valuable team members, you should also make sure that an attractive compensation and benefit package is offered, as well as a schedule that promotes work-life balance.

If you’re interested in learning more, please see https://www.samgi.com/for-providers/advanced-practitioners/

* https://www.aapa.org

** http://www.nccpa.net/news/2015-statistical-profile-on-certified