Optimal team practice

Introduction

Optimal team practice (OTP) has been defined as “PAs, physicians, and other health care professionals working together to provide quality care without burdensome administrative constraints.” The goal of this chapter is to introduce the components that make up OTP and document its evolving history. OTP is the American Academy of Physician Assistants’ (AAPA) policy for establishing future physician assistant (PA) practice. Despite the recommendation, however, individual state law dictates how a PA functions. The information included herein is up to date at the time of this writing; nonetheless, OTP continues to be an iterative process, and as such, is ever-changing.

Meet PA Smith

PA Smith has practiced family medicine in rural, northwest Colorado for 25 years. The physician supervisor with whom she had a great working relationship abruptly retired because of a serious illness, resulting in the PA not meeting the state’s legislated physician supervisor requirement. As a result, PA Smith is no longer able to see patients. Some of the county’s patients have been left without a health care provider and have had to travel great distances to seek care. PA Smith remains in the area but has been unable to practice for the past 5 months because the rural community has had difficulty recruiting a new physician to the area who could serve as her supervisor. Colorado allows an advanced practice registered nurse (APRN) to see patients independent of a physician relationship, thereby allowing an APRN colleague with less experience to continue practicing. Although thankful some patients are getting the care they need from the APRN colleague, the lack of parity is frustrating to PA Smith.

This is a fictitious story, but the consequences are real for PAs and the patients they serve. As the PA profession has evolved and matured, it has recognized the need to explore options to address issues that may limit a PA’s ability to practice at the top of their license. This chapter describes the profession’s evolution toward OTP.

History in the making