A recent Harris Poll conducted for the AAPA found 90% of patients believe physician associates are part of the solution for healthcare workforce shortages.
Physician associates (PAs) are part of the solution for workforce shortages in the healthcare sector, says Folusho Ogunfiditimi, DM, MPH, PA-C, president and chair of the Board of Directors at the American Academy of Physician Associates (AAPA).
Ogunfiditimi began his term as president of the AAPA this month. He currently works as administrator of practice management at Florida Health Care Plans. His prior experience includes serving as the associate administrator of the Detroit Medical Center Cardiovascular Institute.
HealthLeaders recently talked with Ogunfiditimi about a range of issues, including the priorities of his AAPA presidency and the ideal role for PAs on care teams. The following transcript of that conversation has been lightly edited for clarity and brevity.
HealthLeaders: What are the priorities for your AAPA presidency?
Folusho Ogunfiditimi: There are three main categories and a fourth that is not as critical. The three main categories are what I call the Three Ps.
The first P stands for patients and improving access for patient care. The ability of patients to get the care they need is critically important.
The second P stands for practice—the practice that PAs are actually working in. We need to improve outcomes, whether that is health outcomes or outcomes related to the value or productivity that PAs bring to practices. We need to be able to empower PAs as well as expand and grow their practices.
The third P stands for the profession as a whole. We need to modernize the laws around the profession. About 100 million people lack access to primary care. Only 47% of primary care needs are actually being met. So, some of the challenges that PAs have in terms of the current laws prevent us from boosting healthcare access for our patients. About 163 million people do not have access to mental health care. PAs need to be fully utilized to the extent of their training.
The fourth priority is looking at expanding the role of PAs as it relates to leadership, mentorship, and closing the equity gaps in healthcare. I want to focus on how we can mentor young PAs. So, I want to be looking at research and looking at leadership as well as looking at mechanisms to be able to effectively close health equity gaps.
HL: What is the ideal role for a PA on a care team?
Ogunfiditimi: We have talked a lot about optimal team practice—how PAs, physicians, and other healthcare providers work together to deliver care. That is the optimal role for PAs and being able to deliver services without the administrative burden that you see in terms of having constraints around them.
For example, when a PA is not legally tethered to a physician, the PA can be more flexible in the care they deliver. It would be easier to allow PAs to serve on care teams by expanding the role of PAs and making sure that PAs are able to practice to the top of their license and the top of their training. This will facilitate PAs to be able to serve in medically underserved communities, where we currently do not have enough physicians and in certain areas have no physicians. PAs are primed to provide care in those areas in states that allow them to practice autonomously.
So, the ideal role for PAs is to work on care teams with colleagues but to also have the ability to fully maximize their training and work autonomously.
HL: There are workforce shortages in healthcare nationwide, including shortages of physicians. How can PAs help to address workforce shortages?
Ogunfiditimi: PAs play a critical role in ensuring patients have access to high-quality care. A recent Harris Poll that was conducted for AAPA showed that 67% of patients who have seen a PA would trust a PA to serve as their primary care provider. The same poll showed that 92% of patients believe PAs should be allowed to provide care to the fullest extent of their education and training. The poll found 90% of patients believe PAs are part of the solution for our healthcare workforce shortages.
So, PAs play a critical role in ensuring that we can improve access to quality healthcare and improve on the disparities we see in healthcare. In most states, PAs are required to have supervision by a physician. Some states have gotten rid of that requirement, which is something we support.
Folusho Ogunfiditimi, DM, MPH, PA-C, president and chair of the Board of Directors at the American Academy of Physician Associates. Photo courtesy of the AAPA.
HL: You are administrator of practice management at Florida Health Care Plans. How did working as a PA help prepare you to serve in an administrative leadership role?
Ogunfiditimi: My training as a PA was critical to me being in a leadership role. The knowledge that I obtained at the bedside and as a clinical practitioner allowed me to be able to understand the challenges that patients have and be able to translate those challenges into potential solutions. You must be ingrained into the healthcare system to be able to make changes.
In being a PA, I had a wide variety of exposures working clinically with my patients but also sat on various committees. I realized that one of the ways I could continue to effect change is by growing in the leadership realm and impacting other providers. I am always going to be a PA at heart even though I work in administration now, and being a PA laid the foundation for where I am today.
HL: The American Medical Association has said that PAs should only practice medicine under the supervision of a physician. Are PAs capable of practicing independently of physicians?
Ogunfiditimi: The truth is that in modern healthcare there is no one including physicians who practice independently. We all practice collaboratively. PAs are fully trained in medicine, and they are fully capable of being able to practice medicine autonomously on healthcare teams. It is not a matter of whether someone wants to practice independently—there are no practitioners who practice independently. But PAs should be able to practice autonomously on healthcare teams—they should be able to practice with colleagues without restrictions so they can deliver the care they have been trained to deliver.
In states that do not require specific relationships between PAs and physicians, PAs practice in teams with physicians, and their scope of practice is determined at the practice level. Individual practices can determine how PAs work on those teams.
If a patient's condition falls outside of a PAs training, you want to be able to make sure that the PA can consult with other healthcare providers, whether they be physicians, advanced practice nurses, or other providers. Even in states where PAs are required to be supervised, physicians are rarely in the room when PAs are delivering medical services. PAs provide safe and effective care. According to our research with the Harris Poll, 95% of patients who have been treated by a PA felt valued by the PA. A study conducted in 2021 found that PAs provide the same or better care to patients as physicians at a lower cost.
So, there is evidence that shows PAs should be able to practice at the top of their license. They should be practicing autonomously—that is the only way we can be part of the solution for workforce shortages.
HL: Under what circumstances can PAs practice medicine autonomously?
Ogunfiditimi: Practicing medicine autonomously essentially means being able to eliminate some of the barriers to PAs practicing medicine. PAs can prescribe medications. PAs can diagnose conditions. PAs can treat conditions. PAs can work in all spectrums of medicine from surgery to primary care to multispecialty care. We need to allow PAs to work every day and to use their knowledge to deliver quality care without red tape or constraints such as direct supervision.
So, the opportunity to work autonomously means allowing PAs to be able to determine how they can work best at the practice level. They should be able to determine what their scope of comfort and training is as well as how they can maximize being able to offer medical services to patients, particularly in medically underserved communities, without the constraints of being tethered directly to a physician. We want to collaborate with our physician colleagues. We want to be part of healthcare teams. We want to be able to integrate with those teams and deliver care just as any other professional who has been trained to deliver that care.
Related: New President of AAPA Shares Vision for Physician Assistant Profession
Christopher Cheney is the CMO editor at HealthLeaders.
KEY TAKEAWAYS
Folusho Ogunfiditimi, the new president of the AAPA, says his priorities include promoting healthcare access and modernizing laws that regulate physician associates.
The ideal role of PAs is to serve on care teams but also to be able to practice medicine autonomously, he says.
Ogunfiditimi says working as a PA helped him develop the skills to be successful in healthcare administration roles.