Imagine the elegant efficiency of working with a medically and surgically educated assistant who can provide a wide range of surgical procedures, at your direction and discretion. Hiring a surgical PA is like gaining an extra pair of eyes and hands, not to mention hours in the week for research, difficult cases, or other interests.
Physician assistants provide medical/surgical care with physician supervision. Surgical PAs' medical education, versatility, and commitment to personalized care help surgical practices to function more smoothly. They offer surgeons increased revenues and improved patient satisfaction levels along with more flexible, forgiving work schedules.
Roles and Responsibilities
PAs work in general surgery and in virtually every surgical specialty and subspecialty. In addition to their ability to first and second assist at surgery, surgical PAs provide pre- and post-operative care and can prescribe medication. Surgical PAs frequently take evening and weekend call and provide emergency room coverage. In a typical team approach to surgical care, with a surgeon as head of the team, the PA might meet the patient in the office or the hospital, perform the preoperative history and physical examination, order and compile any necessary tests, and order any necessary preoperative medication or preparations.
Post-operatively, PAs may dictate the operative report, write the postoperative orders, and manage the surgical patient in the intensive care unit or on the ward. PAs may insert and remove lines and monitoring devices (including Swan-Ganz catheters, CVP lines, arterial lines, Foley catheters); insert and remove drains (including intrathoracic drainage catheters); regulate the pharmacological needs of the patient (including analgesics, antibiotics, anticoagulants, insulin, etc.); remove temporary pacemaker wires, casts, sutures or skin clips; and perform other tasks delegated by the surgeon.
Surgical PAs also oversee discharge planning, including the dictation of discharge summaries and confirmation of follow-up appointments. Following the patient's discharge, the surgical PA may continue to follow the patient in another facility or in the office on a scheduled or urgent basis, answer questions from patients and their families, and refill prescriptions.
Surgical PAs help smooth the operation of your practice by managing many key "nuts and bolts" tasks, including:
The findings of a Hurley Medical Center (HMC) research project, recently published in the Journal of Trauma, are potent testimony to physician assistants' quality of care. The Michigan-based medical center has employed PAs as members of the surgical staff since 1985. In 1994, HMC began a formal trauma program staffed by surgeons and PAs, who filled the role of surgical residents. In the program's first two years, despite an increase in patient acuity, the program saw an overall decrease in transfer time to the operating room of 43 percent, to the trauma ICU of 51 percent, to the floor of 20 percent. Length of stay for neurotrauma ICU patients decreased 33 percent.
All eight trauma surgeons reported that the clinical assessments conducted by PAs were consistent with their own findings. All rated the PA first assistant at surgery activities as either very good or excellent. The PA contributions saved each surgeon an average of four to five hours per day. Consistency and excellence of care, indicated by the shortened length of patient stay, was cited by the researchers as a "hallmark" of the physician-PA team model, "providing the highest quality of care" (Journal of Trauma, February 1998.)
Cost Effectiveness and Reimbursement
According to the Medical Group Management Association, PAs generate revenues covering far more than what their compensation costs employers. MGMA collects data annually comparing PA compensation with their gross charges. For surgical PAs, the employer pays 38 cents for every dollar of charges generated. (Physician Compensation and Production Survey, Colorado, 1999. Reprinted with permission from the Medical Group Management Association, 104 Inverness Terrace East, Englewood, Colorado 80112-5306; 303/799-1111. Copyright 1999.)
Medicare covers the medical services provided by PAs in all settings at 85 percent of the physician's fee schedule. Most private health plans also reimburse for services provided by PAs. All reimbursement goes to the employer of the PA. Surgical PAs can work as W-2 employees or in an independent contractor relationship. In either arrangement, payment flows to the practice.
Information Resources
For additional information on hiring a surgical PA, AAPA's newly updated guide, Hiring a Physician Assistant, features guidance on team practice, supervision, finding the right PA for your practice, writing contracts, and much more. Hiring a Physician Assistant is available through the AAPA On-line Store.
Physician assistants provide medical/surgical care with physician supervision. Surgical PAs' medical education, versatility, and commitment to personalized care help surgical practices to function more smoothly. They offer surgeons increased revenues and improved patient satisfaction levels along with more flexible, forgiving work schedules.
Roles and Responsibilities
PAs work in general surgery and in virtually every surgical specialty and subspecialty. In addition to their ability to first and second assist at surgery, surgical PAs provide pre- and post-operative care and can prescribe medication. Surgical PAs frequently take evening and weekend call and provide emergency room coverage. In a typical team approach to surgical care, with a surgeon as head of the team, the PA might meet the patient in the office or the hospital, perform the preoperative history and physical examination, order and compile any necessary tests, and order any necessary preoperative medication or preparations.
Post-operatively, PAs may dictate the operative report, write the postoperative orders, and manage the surgical patient in the intensive care unit or on the ward. PAs may insert and remove lines and monitoring devices (including Swan-Ganz catheters, CVP lines, arterial lines, Foley catheters); insert and remove drains (including intrathoracic drainage catheters); regulate the pharmacological needs of the patient (including analgesics, antibiotics, anticoagulants, insulin, etc.); remove temporary pacemaker wires, casts, sutures or skin clips; and perform other tasks delegated by the surgeon.
Surgical PAs also oversee discharge planning, including the dictation of discharge summaries and confirmation of follow-up appointments. Following the patient's discharge, the surgical PA may continue to follow the patient in another facility or in the office on a scheduled or urgent basis, answer questions from patients and their families, and refill prescriptions.
Surgical PAs help smooth the operation of your practice by managing many key "nuts and bolts" tasks, including:
- Coordinating with the hospital to prevent cancelled, delayed, or bumped cases
- Ordering necessary tests prior to surgery
- Ordering and interpreting radiological studies, EKG, angiograms, CT scans, and other procedures
- Ensuring pre-op clearance if necessary
- Providing post-operative wound checks and aftercare
The findings of a Hurley Medical Center (HMC) research project, recently published in the Journal of Trauma, are potent testimony to physician assistants' quality of care. The Michigan-based medical center has employed PAs as members of the surgical staff since 1985. In 1994, HMC began a formal trauma program staffed by surgeons and PAs, who filled the role of surgical residents. In the program's first two years, despite an increase in patient acuity, the program saw an overall decrease in transfer time to the operating room of 43 percent, to the trauma ICU of 51 percent, to the floor of 20 percent. Length of stay for neurotrauma ICU patients decreased 33 percent.
All eight trauma surgeons reported that the clinical assessments conducted by PAs were consistent with their own findings. All rated the PA first assistant at surgery activities as either very good or excellent. The PA contributions saved each surgeon an average of four to five hours per day. Consistency and excellence of care, indicated by the shortened length of patient stay, was cited by the researchers as a "hallmark" of the physician-PA team model, "providing the highest quality of care" (Journal of Trauma, February 1998.)
Cost Effectiveness and Reimbursement
According to the Medical Group Management Association, PAs generate revenues covering far more than what their compensation costs employers. MGMA collects data annually comparing PA compensation with their gross charges. For surgical PAs, the employer pays 38 cents for every dollar of charges generated. (Physician Compensation and Production Survey, Colorado, 1999. Reprinted with permission from the Medical Group Management Association, 104 Inverness Terrace East, Englewood, Colorado 80112-5306; 303/799-1111. Copyright 1999.)
Medicare covers the medical services provided by PAs in all settings at 85 percent of the physician's fee schedule. Most private health plans also reimburse for services provided by PAs. All reimbursement goes to the employer of the PA. Surgical PAs can work as W-2 employees or in an independent contractor relationship. In either arrangement, payment flows to the practice.
Information Resources
For additional information on hiring a surgical PA, AAPA's newly updated guide, Hiring a Physician Assistant, features guidance on team practice, supervision, finding the right PA for your practice, writing contracts, and much more. Hiring a Physician Assistant is available through the AAPA On-line Store.
