How Physician Assistants Can Benefit Your Eye Care Practice

When you think of a physician assistant, do you envision the person who examines your child when the “real” pediatrician isn’t available? That may be true, but it’s not the whole story. In reality, physician assistants work in all types of medical fields and not just when physicians are unavailable.

Physician assistants (PAs) are best viewed as ‘physician extenders’ who ease a physician’s workload, allow a practice to see more patients, improve patient engagement, and more. And if you think ophthalmology is too specialized of a field to benefit from PAs, think again.

Why You Should Consider a Physician Assistant

Ophthalmologists and eye care practice administrators would be well-advised to consider the many benefits of hiring ophthalmic PAs, according to Mary Sue Jacka, MBA, COE, FASOA, administrator at Haik Humble Eye Center in West Monroe, Louisiana. During her presentation at last year’s ASCRS·ASOA Annual Symposium & Congress, Jacka highlighted several challenges facing the ophthalmology field today.  All of these factors will require ophthalmologists to attract and retain more and more patients to sustain profitable practices:

The rise of value-based reimbursement.

As MACRA/MIPS gains traction, private payers are sure to follow in the rule’s value-based footsteps. Physicians who don’t transition into value-based payment models risk losing revenue.

Ever-growing compliance regulations.

The implementation of ICD-10, MACRA, and other quality reporting programs like ASCQR continue to place training and administrative burdens on practices.

The growing population of senior citizens.

As baby boomers age through their 60s, age-related eye diseases will take center stage. Experts expect the demand for ophthalmology services to grow even as the supply of new ophthalmologists remains flat. There’s potential for a shortage of ophthalmologists, as demand outstrips supply.

Physicians retiring in increasing numbers.

As ophthalmologists age, there are fewer younger physicians to take their places. As of 2013, 47 percent of practicing ophthalmologists were age 55 and older, according to the Association of American Medical Colleges’ 2014 Physician Specialty Data Book. And 46.8 percent of physicians said they planned to accelerate their retirement due to changes in the healthcare market, according to the The Survey of America’s Physicians from The Physicians Foundation.

Physician Assistants: Who They Are, What They Do

PAs can help eye care practices handle a large workload and give physicians time and energy to focus on complex cases. They can also help create more work-life balance, says Jacka. “Ophthalmology practices that hire PAs can help afford a normal lifestyle for the physician and consequently the PA who works with the ophthalmologist,” she explains.

Need a refresher on exactly what a PA is and does? Here’s a basic overview of how PAs differ from physicians, techs, and other clinical positions in your practice:

• PAs receive a state license to practice medicine under the supervision of a physician; they cannot practice medicine without the direction of a physician.
• Unlike techs, PAs can bill for any services that physicians can perform.
• PAs receive an exclusively medical and surgical education, unlike optometrists.

And here’s a snapshot of what ophthalmic PAs can do:

• Perform preoperative H&P surgical clearance. Arizona practice Barnet Dulaney Perkins “employs four PAs to handle the case load of their 15,000 lasers and ophthalmic surgery cases,” says Jacka.
• Interpret lab results. (For example, review OCTs and decide whether a patient needs an injection).
• Assist with surgeries. At St. Luke’s Cataract and Laser Institute in Florida, PAs open and close in surgery. “For some retina procedures, the PA can bill and be reimbursed as an assistant in surgery, in compliance with Medicare rules,” notes Jacka.
• Prescribe medication.
• Manage treatment plans.
• Manage patients with chronic conditions, like dry eye, AMD, glaucoma.
• Provide patient education