OTP Could Help Create Jobs for PAs

Optimal Team Practice or OTP is not a new type of practice; it is an idea to streamline how we do it.  The AAPA has been advocating for this but has had resistance from other groups, as they believe this is “scope creep”. I don’t think this is what the AAPA is trying to do. OTP includes three main parts; direct payments to PAs, eliminating the legal requirement for a specific relationship with a physician and creating separate PA boards or including PAs in regulating PA practice.

Optimal Team Practice occurs when PAs, physicians, and other healthcare professionals work together to provide quality care without burdensome administrative constraints.

To support Optimal Team Practice, states should: eliminate the legal requirement for a specific relationship between a PA, physician, or any other healthcare provider for a PA to practice to the full extent of their education, training, and experience; create a separate majority-PA board to regulate PAs or add PAs and physicians who work with PAs to medical or healing arts boards; and authorize PAs to be eligible for direct payment by all public and private insurers.

AAPA Website

The PA career has come a long way since its start; often compared to Nurse Practitioners as a role that can diagnose and treat patients. OTP is an idea to continue with quality care without administrative constraints. One such restriction is direct payments. Currently, PAs are not eligible for direct payments from Medicare and most commercial payers. They must be paid to their employers, which can be a barrier for certain systems, putting PAs at a disadvantage in the job market.

For a PA to practice, they have to have a practice agreement with a supervising physician. In some cases, their “supervising physician” is an attending on paper only. PAs often work as a team, and with other physicians on the team, they aren’t the closest with the supervising physician. They might be in charge of the administration, such as signing off on chart notes; however, other Physicians on the team are the mentors to the PAs. The requirement for a legal relationship with a specific physician can be a burden to the providers and the healthcare system.

Unlike NPs, governed by nursing boards, or physicians, governed by physician-led medical boards, most PAs are not governed by other PAs. Not including PAs in their governance puts them at a disadvantage, as those who are making decisions might not have their best interest at hand, and this is why it is an important part of OTP.

OTP would not change the amount a PA is reimbursed for their services. However, it could open up opportunities that did not exist beforehand. PAs are vying for similar positions as NPs, and decreasing the administrative burdens could help create new opportunities.

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