Performing a PA Needs Assessment

As a practice owner or employer, you constantly strive to provide the best possible care for your patients while ensuring the smooth operation of your practice. In this pursuit, you may have come across the question: "Do I need a physician assistant?"

Hiring a PA can provide numerous advantages for your practice, including increased patient access, improved workflow efficiency, enhanced physician work-life balance, and potential cost savings.

By understanding the role of a physician assistant, assessing your practice's specific needs, considering the financial implications, and learning how to recruit and hire a PA, you will be equipped with the knowledge necessary to make an informed decision about expanding your healthcare team.

I. Understanding the role of PAs and the potential to improve your practice

Understanding the role of a physician assistant is crucial in determining if your practice can benefit from their expertise. Their ability to provide comprehensive care, adaptability to different specialties, and collaborative approach make them valuable additions to any healthcare team

a) What is a PA?

A physician assistant is a healthcare professional who is licensed to practice medicine under the supervision of a physician. PAs are trained in accredited Physician Assistant programs that are affiliated with a medical school, and they complete extensive clinical rotations to gain hands-on experience in various specialties.

They are knowledgeable in diagnosing illnesses, formulating treatment plans, and prescribing medications. PAs work collaboratively with physicians, alongside other healthcare professionals, to deliver comprehensive and patient-centered care.

b) How does the flexible PA scope of practice fit into the needs of my practice?

One of the unique aspects of a physician assistant's role is their versatility. PAs are trained in a generalist model, which means they can adapt to different medical specialties and practice settings.

Their scope of practice can include conducting physical examinations, interpreting diagnostic tests, assisting in surgeries, providing preventive care, managing chronic conditions, and much more.

This flexibility allows PAs to address a wide range of patient needs and contribute to the overall efficiency of your practice.

c) How will the PA work with a supervising physician?

Collaboration is at the core of the PA-physician supervisory relationship. PAs work closely with physicians to provide high-quality care to patients. Physicians supervise PAs, providing guidance, oversight, and collaboration in decision-making.

Supervision does not necessarily require the physician to be physically present at all times. Instead, the supervision can be either direct or indirect, depending on the level of autonomy granted to the PA and the nature of the healthcare setting..

This collaborative approach allows for a team-based approach to patient care, with PAs taking on various responsibilities under the guidance and direction of physicians. By integrating a PA into your practice, you can enhance the synergy among healthcare providers and optimize patient outcomes.

II. Assess the Needs of your Practice

It is important to analyze and evaluate your practice's specific requirements. By considering patient demographics, workload, workflow challenges, and provider work-life balance, you can gain insights into whether hiring a physician assistant would be beneficial for your practice.

a) Analyze Patient Workload

Evaluate factors such as patient volume, complexity, and specific healthcare needs within your practice:

• Are you experiencing a growing patient load?

• Are there specific areas where patient wait times are longer than desired?

Identifying any trends or patterns in patient demographics and workload can provide valuable insights into whether your practice could benefit from the addition of a PA.

Increased patient access and reduced wait times are some of the potential benefits that a PA can offer.

b) Identify Workflow Challenges

Examine the day-to-day operations and workflow within your practice.

• Are there specific tasks or responsibilities that result in bottlenecks or inefficiencies?

• Are there routine clinical tasks that could be delegated that take up valuable time?

Assessing the areas where your practice experiences challenges can help identify potential roles for a physician assistant.

PAs are skilled at assessment, diagnosis, formulating treatment plans and procedures. They can perform patient education, new consults and follow-ups. Having a competent clinician seeing patients alongside the physicians can help decrease workflow challenges.

By alleviating these workflow challenges, a PA can improve the overall efficiency of your practice.

c) Evaluate Provider Work-Life Balance

Physician burnout and maintaining a healthy work-life balance are critical considerations in today's healthcare landscape.

Evaluate the workload and demands placed on your physicians.

Are they consistently overwhelmed or struggling to maintain a reasonable work-life balance?

Hiring a physician assistant can help alleviate the workload burden on physicians, allowing them more time for patient care, personal life, self-care, pursuing research/teaching endeavours and improving satisfaction.

III. Financial Considerations

When considering the addition of a physician assistant (PA) to your practice, it is important to evaluate the financial implications. While there are costs associated with hiring a PA, it is essential to understand the potential long-term return on investment (ROI) and the positive impact they can have on your practice's financial health.

a) Efficiencies Gained by Integrating a PA

Physician assistants are trained to provide efficient and effective care. By optimizing patient flow and reducing wait times, a PA can improve the overall patient experience and increase patient satisfaction.

Note: Financial considerations for hiring a PA will vary between jurisdictions (by province and territories; and even by country e.g. Canada vs. US). It is important to consider local text and reimnursement for health care services when assessing financial impact of hiring a PA.

b) Return on Investment

It is important to consider the long-term return on investment (ROI) of hiring a physician assistant. While there are upfront costs associated with recruitment, onboarding, and training, the benefits of having a PA on your team can outweigh these initial investments.

The improved practice efficiency, increased patient access, and enhanced patient satisfaction can lead to greater patient retention and loyalty, ultimately benefiting your bottom line.

c) Funding Models

There are several funding models that can make the physician assistant (PA) position financially viable in the long term. The choice of funding model may depend on various factors such as the healthcare system, practice setting, reimbursement mechanisms, and local regulations.

Sources of funding for PA salaries include:

• Out-of-physician pocket (solo or group physician practices) - more common in fee-for-service settings

• Family Health Team (FHT/FHO) Budgets

• Hospitals:

  • Hospital Budget

  • Department Budget

  • Hospital Foundation Budget

  • Hospital Research Funding

• Provincial Grants (e.g. the Ontario PA Career Start Grant that provides time-limited funding to hire a new Ontario PA graduate).

• Regional Health Authorities/Local Health Authorities (e.g. in Ontario, LHIN funding; or Funding from Winnipeg Regional Health Authority (WRHA), Alberta Health Services (AHS), etc.)

How PAs can generate revenue and contribute to funding their salaries include:

• Increased patient volume: Under the fee-for-service model, the PA's salary is funded through patient visits and services provided. Each patient encounter generates a specific fee, and the revenue generated from these visits contributes to covering the PA's salary. This model works well in practices with a high volume of patient visits or procedures, as the revenue generated can help sustain the PA position.

• Value-Based Payment Models: In value-based payment models, reimbursement is tied to the quality of care and patient outcomes rather than the volume of services provided. Under this model, practices can receive financial incentives for meeting specific quality and performance targets. By incorporating PAs into the care team and leveraging their skills and expertise, practices can enhance patient outcomes and potentially earn additional revenue through value-based payment arrangements.

It's important to note that the viability of a specific funding model depends on factors such as patient population, practice size, payer mix, and local reimbursement policies.

Practices should thoroughly assess their financial landscape, explore potential funding sources, and engage in discussions with payers, healthcare networks, and financial experts to determine the most sustainable funding model for the PA position in their specific context.

Final notes

Performing a thorough needs assessment is an essential step for any practice considering the addition of a physician assistant (PA). By understanding the role of a PA, assessing your practice's specific needs, considering the financial implications, and implementing an effective recruitment and hiring process, you can make an informed decision about whether hiring a PA is the right choice for your practice.

A physician assistant can bring numerous benefits to your practice, including increased patient access, improved workflow efficiency, enhanced provider work-life balance, and potential cost savings. By carefully evaluating these factors and considering the unique dynamics of your practice, you can make a well-informed decision that will positively impact your practice's success and patient care outcomes.