Urologist-PA teams can enhance satisfaction, bottom line

I’ll let you in on a little secret: In your midst are highly trained, competent, passionate, clinical practitioners who can broaden the reach of your practice, ease your workload, and improve patient satisfaction, all while simultaneously adding to the bottom line of your practice.

These nimble health care providers are physician assistants and, according to Kenneth Mitchell, MPAS, PA-C, immediate past president of the Urological Association of Physician Assistants, in a recent article in Urology Times, an estimated 3,000 to 4,000 PAs have already made the jump to full-time urology practice.

PAs are, by profession, chameleons. As dependent practitioners, we are skilled at adapting to the practice style of our supervising physicians, providing equivalent services to our shared patients. But, we are your colleagues, too. Rigorous continuing medical education requirements mean we keep up to date on current treatment trends and procedures, helping your practice to usher in new technologies and disease-specific treatment recommendations.

Your physician assistant is also extremely flexible. Together, we decide where our services are most needed. Most states allow PAs to work under a scope of practice that is unique to their practice situation. In the case of urology, PAs may perform prostate ultrasound and biopsy, complicated catheterizations, suprapubic tube placement, and cystoscopy. Educational standards governing appropriate proctoring in these procedures have not been globally established, so it is incumbent on us to work together to develop appropriate training and supervision protocols that ensure the standard of care is being met and that patient safety is never compromised.

Building PA-physician teams is especially important now, given the anticipated shortage of urologists in the near future. According to another recent article in Urology Times, some projections suggest a 29% decrease in the number of urologists from 2009 to 2025. This decline is juxtaposed against the growing number of aging baby boomers, many of whom will undoubtedly need the services of urologists.

And, because physician assistant education programs are geared toward primary care, more needs to be done to train physician assistants to work alongside urologists. An Internet search yielded only two PA urology residency programs in the United States, with new programs anticipated for Emory University in Atlanta and the University of Southern California in Los Angeles. (The Emory program is currently in the pre-accreditation phase.) These 1-year residencies can prepare the PA graduate for immediate employment in private, general urology practices nationwide. Recent recognition of PAs and other mid-level providers by the AUA have strengthened PA-urologist partnerships by allowing shoulder-to-shoulder learning opportunities as well as by providing assistance to urologists who wish to begin incorporating PAs into their practices.

So, now that the secret is out, let’s continue to work together to build this critically important, collaborative association between physician assistants and urologists. Our patients are counting on it.

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