Physician Assistant Training, Collaboration, and Practice Act Legislation: Perspectives From Practicing Physician Assistants.

Introduction: This study examines training, experience, and collaborative practices of physician assistants (PAs) with employment experience and their perspectives on practice act legislation.

Methods: Mixed method study with quantitative and qualitative data.

Results: One hundred eighty participants completed the survey. During clinical employment, 81.05% of respondents reported physicians participated in training. However, supervising physicians trained only 43.46%; 56.54% reported being trained by nurse practitioners (NPs), PAs, and/or other physicians. Onsite collaboration with physicians was reported by 87.2%. Supervising physician involvement was reported by 67.3%, and of these, 59% collaborated with PAs, NPs, and/or other physicians as well. One-third collaborated only with NPs, PAs, and/or other physicians. Daily/weekly collaboration with a supervising physician was reported by 78.89% in their first position and 54.87% in their current/most recent position; 77.22% collaborated with NPs, PAs, and/or other physicians in their first position and 71.68% in their current/most recent position. Most (64.44%) felt PAs should not be legally required to have physician supervision. Most (76.12%) felt care quality would not decrease if supervision were lifted. Most (74.44%) agreed that PAs are hired less frequently than NPs in states where physician supervision is required for PA but not NPs.

Discussion: Findings suggest that team-based practice is already the current structure of PA clinical training and collaboration with PAs receiving significant support from physicians who are not supervising physicians and other nonphysician practitioners. Establishing oversight at the practice level is supported by this practice structure. Determining effects of practice act legislation on employment training, collaboration, and hiring practices warrants further research.