Building Collegial Connections

By Jennifer Anne Hohman

Relationships are the cornerstone of PA practice – inherent in the team practice concept and in the unique emphasis PAs place on fostering meaningful connections with patients. Quality collegial relationships affect PA job satisfaction to a huge degree, and impact quality of care. There are many ways to promote positive connections with colleagues in the workplace across the practice team.

I’ve spoken to PAs over the years who describe feeling caught in between the various groups at work: physicians, nurses, nurse practitioners, even front office staff. Many are overworked, stressed, and even on the road to burnout. The pressure that providers experience in the world of medicine plays into the tendency to form professional cliques – a kind of survival mode. This plays out in terms of interpersonal rivalries and conflicts in which positive intent is no longer assumed, and coworkers relate to one another with wariness and distrust.

Thankfully, there is a way to use the PA talent for, and orientation toward, teamwork and collaboration to break through these barriers. PAs are innovators and can actively cultivate the values of teamwork and mutual reliance, while also recognizing that there are limiting structural factors like a profit-driven medical system and professional hierarchies.

Positive work relationships tend to include the following elements which overlap and support one another: trust, respect, and communication/clarity.


The experience of trust at work allows for effective patient care, based on the anticipation of cooperation and goodwill. It is the essential ingredient in healthcare relationships, and through it flows the crucial information about patient treatments and coordination of care.

How to build up this essential quality, especially when trust has been damaged? Harvard Business Review offers some truly useful guidance on this process, based on a review of hundreds of studies. Two of the key insights that Harvard Business Review offers are the importance of addressing the situation when a work relationship has gone off track and using the concept of a “shared narrative” to reconstruct it.

According to Harvard Business Review, our ability to recover from conflict depends on the stories we tell. They suggest “starting with a personal explanation of what you see as the cause of conflict, soliciting the other person’s explanation, and then using these as the basis for working together to reach a common understanding of what happened and why.” They also describe the concept of “relational agility,” or the capacity to find new ways of looking at one’s narrative of the conflict and willingness to reimagine new ways of relating.


The PA profession is gaining more visibility and prominence, but there are still misunderstandings in the workplace about the PA role that can affect the respect accorded PAs on the job. AAPA offers excellent resources to educate the public about PA education, medical practice and more. Consider sharing these resources with your employer and colleagues.

The issue of respect is so important for PAs in the workplace, both in terms of morale and patient care. If colleagues and staff do not respect and validate PAs to patients, there will be a direct impact on PA acceptance and effectiveness. Typically, collaborating physicians set the tone for PAs being respected and valued members of the team. If there is an issue where you practice, speak up for yourself and enlist advocates to make progress, but if the situation is irredeemably toxic, start a new job search!

Respect based on understanding the contributions of all colleagues elevates medical practice and the vivid sense of group fellowship and pride that sustains amid challenges. When PAs are respected it makes for a better environment for all, including patients. When PAs assert their value and visibility, it reinforces an ethos that impacts the entire team’s ability to serve patients.

Overcoming the habitual tendency toward hierarchy that is everywhere in medicine is difficult, but opens the door to true teamwork, creativity, and innovation. This kind of collaborative creativity is built into the DNA of the PA profession. When PAs advocate for themselves they create a more equitable workplace where their contributions are seen and valued.


PAs can play a special role in building intra-professional regard based on their own roles as communicators, coordinators of care, and mediators. Collegiality and team-focus are increasingly recognized as the hallmarks of effective medical care and I’m excited to see PAs as leaders of this new culture of care. PAs are experts at problem solving that draws on the skills and perspective of the entire team. I’ve written previously on Job Crafting, the art of asking questions designed to reassess and recast key aspects of one’s job to improve professional satisfaction. What if the entire team was brought together in a spirit of collaboration to Job Craft better ways to work together?

Harvard Business Review offers valuable insights on this process. Team job crafting becomes a tool for increasing both individual and team purpose: “As each person shares their individual and shared aspirations, colleagues ask questions to better understand and learn how to support them. As a result, this part of the process amplifies a sense of connection and belonging as everyone feels a personal stake in one another’s aspirations.” Here are some Team Job Crafting questions to consider:

  1. How does each colleague contribute to the mission of compassionate and effective care? What are some concrete, mutually beneficial goals each team member can work toward?
  2. What are the roadblocks to better collaboration and cooperation: social, organizational, other? How can the team begin to change these obstacles?
  3. How can the team embrace the blend of passions, skills, and career aspirations of members while ensuring the needs of the broader organization are fulfilled? What common values can all members of the team commit to and live by day to day?

The values and practices that make collegial relationships truly “work” include an inclusive mindset, a willingness to work on mending damaged collegial relationships, establishing boundaries, and expressing appreciation. In the challenging world of medicine, it is important to approach the very real stresses, tensions, and interpersonal issues that come with the territory in a humane and compassionate way.


Jennifer Anne Hohman is founder of PA Career Coach, a service dedicated to helping PAs create healthy and sustainable careers. Contact her with your career concerns and quandaries at [email protected].