PA and MD—Some parallels with clinical psychology and psychiatry

This paper compares the physician's associate (PA)-primary care physician (MD) relationship with that of the clinical psychologist (Ph.D.)-psychiatrist (MD) relationship. It explores the manifest and latent, explicit and implicit, instrumental and expressive, and conscious and unconscious issues which affect the division of labor within each of these professional pairs. The greater historical depth of the psychologist-psychiatrist relationship is explored to offer a perspective on the direction in which the professional identity of the PA is moving, and likewise that of the PA-MD relationship. In both cases, it is argued that the basis for the homeostasis of role complementarity is overdetermined by unconscious issues which role partners bring to the relationship.