Published on May 9, 2018
Anne Dang, CCPA
Vice President at Canadian Association of Physician Assistant
What benefit have you noticed since adding PA to your practice?
Dr. Dhalla: A great benefit of having our PA, Deniece, join us is increased access. We see more patients, perhaps more importantly, the quality of service for each encounter is also enhanced . Patients often present with multiple complaints, we must triage the more important ones, while maintaining a patient centered approach. With Denice, both access to care and quality have improved. In addition, she adds preventative care aspects to the patients care.
In my 15 years in practice, I realize that good communication is the foundation of great care. We follow guidelines and interpret tests, and implement recommendations. Sometimes, in the routine, we lose focus of the patient’s viewpoint. When we both see or review patients, we can better reframe our (clinician and patient) goals..
With our PA Deniece, we have better access for same day appointments. This reduces unnecessary ER visits, or walk in clinic use and allows early intervention in the course of an illness. More often, patients benefit from reassurance and counselling, along with health education.
As other physicians are retiring in our community, we have been able to take on new patients and provide care for those who would otherwise not have a family physician. In addition, having Deniece in my practice allows some patients to open up a little bit more than they would to a physician directly. Patients have a connection with Deniece and they feel they can confide their health concerns and worries, trusting that she will listen and help them.
How is it determined whether the patient gets to see a PA or MD?
Dr. Dhalla: It all depends. If a patient is in for a follow-up visit, then every attempt is made to follow-up with the same provider. For well women and children’s care, Deniece has developed a niche, to be able to care and counsel them comprehensively. Over the years, it’s wonderful to watch her connect and interact with the families.
Can you speak to the PA/MD working relationship?
Dr. Dhalla: I am proud to say that we work very well as a team for the last four years. After hiring Deniece we arranged a few days per week for her to shadow me to appreciate my clinical style of practicing medicine.
Currently, we schedule a half hour once a week, dedicated time, to review cases. This includes complex case discussion where we work together to create a plan for these challenging cases. It is my role to mentor and support her in the clinic.
As practitioners, all of us can continually learn and improve from giving and receiving feedback. One of the things which I have supported is a scope of independence and self-reliance for my physician assistant.
Deniece and I have both work on continually finding ways to improve patient flow, dividing clinical tasks and paperwork since the workload in a family practice is intensive and demanding. We are usually the patients first point of contact in traveling through the healthcare system.
Any suggestions for MDs working with PAs?
Dr. Dhalla: Based on my experience in working with a PA, the training that physician assistants receive in school is excellent.
They are trained in the medical model to assess, diagnose and treat patients.
In addition, they are also trained to work in teams and evaluate how in each area of medicine they can best help contribute within their scope of practice.
It is important to know the areas of need in your clinic before hiring a physician assistant. Then once the PA has started schedule frequent meetings and check ins to ensure you develop trust and a similar clinical style.
I encourage other physicians to learn more about this new role in our Ontario healthcare system and determine for yourself if your team may benefit from hiring a physician assistant.
•Read more about PAs in Family Medicine: http://canadianpa.ca/familypa