Physician-PA Practice Models

Physician-PA Practice Models

Heather Marie Hylton, PA-C

Nov 30, 2010

Yes, the title of this blog is a bit dry but the subject matter itself—a most interesting area to explore!

I’ll start by saying that medical professionals in general tend to think about the near and distant future with a relatively high frequency. This probably could not be truer today as we navigate through uncertain times in the changing face of health care. When our resources become attenuated and perhaps even evaporate, how will we care for our patients?

Maximizing our current resources is certainly a key component to addressing these issues we face now and in the future as is incorporating creativity in the problem-solving process. It is in this spirit that I approach a discussion of Physician-PA Practice Models.

I will specifically focus on an inpatient model in this blog. In the mid-2000s, leadership at my institution implemented an inpatient Physician-PA practice model.  Many issues were addressed in the development of the model, including provision of continuity of care. The practice model consists of a team of 5 to 6 inpatient Physician Assistants who work closely and in cooperation with the inpatient Attending Physician to provide care to the team’s patients, and the inpatient team communicates regularly with the outpatient team regarding the hospital course and coordination of discharge care.

This model was initially rolled out in the stem cell transplant division and proved itself to be wholly successful, leading to the development and implementation of several additional teams in the same fashion. These additional inpatient teams are in the areas of hematologic malignancies, solid tumor malignancies, and pain and palliative care. The creation of these inpatient Physician-PA teams has made it possible to reduce the number of oncology patients admitted to medical overflow services and has increased the ability to provide continuity of care. For example, in the case of the hematologic malignancies Physician-PA team, patients may receive their induction or reinduction therapy and consolidation treatments (including stem cell transplant) on this team, and the PAs on the team, having had these patients on their service for prior admissions, are extensively familiar with the patients and their families/supports which can improve patient care in a spectrum of different ways.  

But this is just one idea of a Physician-PA practice model. There are many other successful models out there in both the inpatient and outpatient settings, and these Physician-PA teams are dedicated to both improving access to care and providing optimal care to their patients while remaining fiscally responsible. 

How is your practice addressing these issues?

I invite you to share your practice model experience and ideas as well as your thoughts and comments!


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