Resources for Hiring a Physician Assistant
While physician assistants have become a household word throughout the United States (and even abroad!), they have only been practicing medicine in Mississippi since 2001. Their benefit to physicians, their practices, and their patients have been well-established and we’d like to provide resources to help both PA's and physicians come together to provide the same level of competent, caring, and compassionate care here in Mississippi. This webpage should answer some of the questions you may have about bringing a PA into your practice.
Benefits of hiring a PA
The physician-PA team enhances medicine because PA's are educated as clinical partners to provide physician-directed medical care. PA's provide a broad range of diagnostic and therapeutic services, from primary care to surgical procedures. In their work with physicians, PA's routinely perform physical exams and take patient histories, order and interpret laboratory tests, manage and treat illnesses, repair lacerations and perform office procedures, assist in surgery, write prescriptions, and provide health education and patient counseling.
Is a PA right for your practice?
One of the most valuable attributes of the PA profession is flexibility within the dynamic model of the physician-PA team. PA's can provide versatile medical care in all settings and specialties because of their broad general medical education. Hiring a PA means gaining an extra set of skilled hands, eyes, and ears. PA's offer an array of benefits to practices and physicians, including higher revenues, improvements in patient satisfaction via accessible care, and more flexibility in the schedules of their employers.
Knowing what your practice or institution needs is the first step in making the most of the physician-PA team. Where would your practice most benefit from this assistance? A thorough analysis of your current practice needs and your patient population will help you find a PA who will be the perfect fit.
Preparing to Hire
Create a job description
Begin by developing a detailed job description that reflects the needs of your practice. Be sure to involve the physicians who will be supervising the PA and consider the supervisory style and specialties of your practice or institution. Are you seeking a new graduate or a practiced veteran? Newly-graduated physician assistants usually require mentoring for the first few months of their employment. The job description should address the following issues:
Will the PA see all patients, follow-up patients, or all first-time patients? Will they establish their own patient panel? Would you like the PA to make hospital rounds? Assist in surgery? Take calls?
Mississippi laws concerning PA practice
As you create your job description, familiarize yourself with Mississippi’s PA practice act — especially its provisions concerning supervision, prescribing, and delegation. See the full Rules for the Licensure of Physician Assistants for Mississippi. In addition, the Mississippi Academy of Physician Assistants (MAPA) staff is ready to assist you with specific questions.
You can also view the laws on the Mississippi State Board of Medical Licensure. Scroll down to §73-26-1. Laws change frequently, see a more recent update of changes in Mississippi State law from the AAPA.
Application: By PA for license. Delegation of Services agreement with supervising physician required for practice. Personal interview of PA, supervising physician, or both may be required.
Scope of practice: The following rules pertain to physician assistants practicing medicine with physician supervision. Physician assistants may perform those duties and responsibilities, including diagnosing and the ordering, prescribing, dispensing of prepackaged drugs, and administration of drugs and medical devices as delegated by their supervising physician(s). Physician assistants may provide any medical service which is delegated by the supervising physician when the service is within the physician assistant’s training and skills; forms a component of the physician’s scope of practice, and is provided with supervision. Physician assistants shall be considered the agents of their supervising physicians in the performance of all practice-related activities including, but not limited to, the ordering of diagnostic, therapeutic, and other medical services.
Prescribing/dispensing: PA may apply for approval to prescribe Schedules II-V and non-controlled medications. Application to prescribe must include documentation of all pharmacology course content completed (at least 30 hours). PA's who are authorized to prescribe controlled medications must register with the DEA and Mississippi State Board of Pharmacy. Dispensing limited to times when pharmacist is not available. PA's in family planning, communicable disease or chronic disease clinics under government contract or grant may also dispense medications.
Supervision: Before any physician shall supervise a physician assistant, the physician must first (a) present to the Board’s Executive Director a duly executed protocol, (b) appear personally before the Board or its Executive Director, and (c) obtain written approval to act as a supervising physician. The facts and matters to be considered by the Board when approving or disapproving a protocol or supervision arrangement shall include but are not limited to, how the supervising physician and physician assistant plan to implement the protocol, the method, and manner of supervision, consultation, referral, and liability. Supervision means overseeing activities of and accepting responsibility for, all medical services rendered by the physician assistant. Except as described below, supervision must be continuous, but shall not be construed as necessarily requiring the physical presence of the supervising physician. New graduate physician assistants and all physician assistants newly practicing in Mississippi, except those licensed under special circumstances, require the on-site presence of a supervising physician for one hundred twenty (120) days. The supervising physician must provide adequate means for communication with the physician assistant. Communication may occur through the use of technology which may include but is not limited to, radio, telephone, fax, modem, or other telecommunication devices. The supervising physician shall, on at least a monthly basis, conduct a review of the records/charts of at least ten percent (10%) of the patients treated by the physician assistant, said records/charts selected on a random basis. During the said review, the supervising physician shall note the medical and family histories taken, results of any and all examinations and tests, all diagnoses, orders given, medications prescribed, and treatments rendered. The review shall be evidenced by the supervising physician placing his or her signature or initials at the base of the clinic note, either electronically or by hand, and shall submit proof of said review to the Board upon request. No physician shall supervise more than two (2) physician assistants at any one time. A physician supervising two (2) nurse practitioners may not supervise a physician assistant.
Develop an employment package
The MAPA and American Academy of Physician Assistants (AAPA) can assist your practice as you devise a PA employment package.
Contracts are an essential element of the employment package. Contract negotiation lays the foundation for a fair and mutually beneficial professional relationship. AAPA features guidelines for creating contracts.
Understanding hospital credentialing and privileging of PA's
Perform thorough credentials check on the candidate. During the hiring process, request the following from the PA:
- A copy of his or her current state license (with license number, DEA number if applicable, and expiration dates)
- A copy of current certification from the National Commission on Certification of Physician Assistants (NCCPA). PA's will get a certificate each time they recertify. This will have the NCCPA #, issue date, and expiration date.
- Letters of reference from previous employers and colleagues — particularly peer recommendations and physician evaluations regarding the performance of specific responsibilities (i.e., surgical skills or other special skills).
- Documentation of CME records or additional training the PA has received, e.g., current ACLS, BLS, PALS, or other certificates.
- A copy of any recent hospital privileges. If the PA has a log documenting specific procedures, request a copy.
Checking with local hospitals
Ask the local hospital(s) about their policies regarding PA practice. Have PA's worked in the hospital before? Have they been privileged? If so, what are the procedures for privileging? How long will it take? Are there any physician co-signature requirements? Are competency measures used for any procedures the physician may want to delegate to the PA? What are the admission policies of the hospital? What are the policies on initial consultation in the hospital? Knowing the institution’s policies on PA utilization in advance will save time and prevent surprises and frustration.
Create a practice agreement
Once the PA is on board, the PA and supervising physician(s) together should create a delegation agreement that flexibly defines the clinical partnership, taking into account the state laws and regulations. This is an opportunity to think through the ways in which you will work as a team. The physician and PA should discuss this document at least once a year and revise it as needed.
Get help with questions
AAPA’s Professional Affairs staff can help with a template delegation agreement. Contact Jennifer Anne Hohman for more information at 703/836-2272, ext. 3220; jhohman@aapa.org
Finding a PA
If you have made the decision to hire a Physician Assistant, there are many ways to find one suitable for your practice.
Reaching PA's in Mississippi
- Advertise the position on the Mississippi Academy of Physician Assistants’ website. Our online job list is a primary source of PA jobs available in Mississippi. Please contact MAPA at (813) 766-8807 or email your ad copy to mailto:mapa@focus-ed.net. Additionally, we are developing a job list on this website.
- Place an ad in your local or regional newspaper classifieds.
- Place an ad with the Mississippi Medical Association.
- Use word of mouth; if you know a PA, ask them if they know anyone looking for new opportunities.
Reaching PA's nationally
- Advertise your position on The American Academy of Physician Assistants PA Job Link page.
Building a Successful Physician-PA Team
Educate staff and patients
The front office staff sets the tone for patient perception of providers. It is important that they understand that the PA is your medical partner. Educate staff to present the option of seeing a PA as a positive one. For example, they could explain that PA's allow for quicker appointments and that PA care is closely coordinated with the physicians. We suggest visiting the AAPA website for some information that is perfect for educating all members of the practice or institution, from front office staff to fellow physicians, about the education, qualifications, and unique role of PA's.
Consider sending a letter to patients introducing the new PA, explaining the PA’s background, and generally describing how the physician and PA will practice together. In addition, printed information about PA's should be available in the office for patients to read and take with them. AAPA produces brochures about PA's designed for waiting rooms. To order them, visit AAPA’s online store. Here you will also find AAPA’s publication Hiring a PA, which features sample letters of introduction for use with patients and advertisement ideas for use in local newspapers.
Learn more about the PA profession
The first place to turn to is the primary national organization for physician assistants, the American Academy of Physician Assistants (AAPA). The AAPA has a wealth of information available. First up, take a look at their information on PA Practice. Here, you’ll find specific information about Team Practice and Hospital Practice. Additionally, be sure to take a look at their issue brief on The Physician-PA Team.
Also at the AAPA website, you’ll find useful information on interviewing, contracts, and the AAPA’s annual Salary Report. Included are sample documents to help you.
For PA's looking for a physician to work with and for physicians interested in hiring a PA, be sure to read the AAPA’s article on what PA's should look for in a physician partner. Finding a good match can be a wonderful thing. Take a look at this AAPA video.
Reimbursement is certainly an important issue and the AAPA provides useful information, including reimbursement basics, Medicare and Medicaid reimbursement, private payer reimbursement, workers’ compensation, current issues in reimbursement, and information on how to calculate PA productivity.
Certainly, with today’s medicine’s focus on the patient-centered medical home, PA's are perfectly positioned to be an important part of the team of providers to make this happen. The AAPA provides a lot of information about this topic.
What about the profession in general? PA school candidates, in particular, should take a look at this video of a physician interviewing a PA.
For more information
Please contact any of these resources or our Department of Admissions for questions or additional information. The physician assistant profession is rewarding and exciting and growing to meet the needs of patients throughout the US. If you’re a qualified candidate, we welcome you to apply. If you’re a physician, we hope you’ll consider adding a PA to your team!
