Shortsighted Power Struggle Dynamics

 

Tension between The AAPA and the AMA/AOA as well as many physician groups can be expected to escalate in the coming years. Over the past several years the physician community and the PA/NP Communities have been at odds over the Scope of Practice advancement sought by AAPs throughout the country. Both groups are opposed to each other’s agenda. Physicians favor restriction, and APPs favor expansion.

Many physicians' views of nonphysician providers are not very flattering ones. In fact, and currently, they seek to discredit this class of highly trained healthcare professionals by portraying them as unruly unsubordinates seeking to replace physicians with inferior care. Thus, believing this, they feel it places patients at medical risk given the short & inadequate training in their oftentimes misinformed views.

Conversely, APPs see their counterparts as entrenched myopic abusive team leaders. They rapidly claim and point out that physicians’ disdain for APPs is palpable if not visible in many circumstances. Thus, creating difficult interprofessional dynamics between both groups. Sometimes it is not uncommon to see animosity or acrimonious interactions between the two groups erupt overtly or subtly. 

Plus, APPs are not only continuing to evolve but also assume greater bedside clinical responsibilities. Traditionally part of the physician’s domain in the recent past, therefore being seen as a professional encroachment threat that has been usurped by lesser trained caregivers in their views. The fact, that PAs/NPs/CRNAs don't feel the need to be subservient practitioners to the past once-revered physician, has certainly contributed to this growing huge interprofessional strain on many fronts. 

So, given the strained relations between both groups, the question becomes this: Can physicians come to terms with nonphysician providers working alongside & collaboratively with each other?  

For physicians, the bottom line is they see themselves “as the perennial captain of the ship”. For them, is untenable to accept nonphysician providers as associates as seen & evidenced in many expressed opinions or official stances declared by their medical specialty organizations in various media or social platforms.

Likewise, nonphysician providers feel unless the physician/medical community comes to terms with acknowledging their growing presence and role (raised professional status) in the healthcare landscape, it will remain an impasse or a moot point too for them.

 If both groups fail to move beyond & come to terms, then the practice of medicine is going to be a miserable one for all stakeholders involved...including patients since neither group wants to concede to the other.