Four Workplace Devaluating Challenges all Physician Associates must Avoid

 

        As a surgical PA, I’ve experienced both supportive and challenging work environments. While some employers understand and value the PA role, others demonstrate a lack of awareness and understanding, leading to frustrating and devaluing work experiences. This article aims to shed light on these common workplace issues, offering insights for managers and administrators seeking to foster positive and productive relationships with their PA staff. While acknowledging that difficult PAs exist too, the focus here is on systemic issues that negatively impact the retention of PAs. Listed below are the devaluating circumstances leading to the resignation.

1. Workplace (Cultural) Unfairness:

        PAs thrive in fair and rewarding partnerships with physicians and healthcare administrators. Key to this is workload equity and work-life balance. Unfortunately, during times of organizational financial duress or hardships, PAs are sometimes disproportionately targeted for departmental cuts and streamlined services, often due to their “exempt” (non-unionized) status. This practice can lead to depleted PA staff carrying services excessive burdens without adequate resources, ultimately impacting patient care and satisfaction. Such unequal treatment fosters distrust and resentment, leading to high turnover and increased liability for both employees and employers. Healthcare organizations should avoid making PAs the perennial “sacrificial lamb” during times of financial austerity. Budgetary adjustments should be implemented fairly across all departments and staff members.

2. Unclear Organizational Roles:

        The PA role should be well-established and accepted in many successful organizations. However, corporate indifference or apathy can create confusion and hinder effective integration. PAs are legally and ethically obligated to consult with and refer patients to their supervising or collaborating physicians based on the patient’s condition, standard of care, and their own education and experience. This well-known team-based approach has been successful for over five decades. For organizations to fully benefit from having PAs, there must be clear role definitions, strong corporate support, and, most importantly, mutual respect and transparent communication. A synergistic, symbiotic interprofessional relationship is crucial; a parasitic “us vs. them” dynamic definitively does not bode well, hence creating power struggles and undermining collaboration. Achieving this requires a commitment from all parties to avoid pushing selfish, unilateral agendas or unreasonable managerial expectations.

3. Disrespectful Organizational/Workplace Setting:

        Like any professional group, PAs seek respect and meaningful input and feedback into matters affecting their profession and their organizational roles. They want to be acknowledged for their skills and expertise. Being treated as “technicians,” “scut monkeys,” or “gophers” is deeply offensive and creates a negative work environment. Fostering a culture of respect requires organizational familiarity and a clear understanding of the PA profession by all staff, clinical and non-clinical members. Implementing workplace interprofessional sensitivity training can create a harmonious environment where PAs can thrive both personally and professionally.

4. PA Self-Governance: A Must Component

        A key issue of poor PA utilization is the lack of self-governance by PAs within many organizations. Why should PAs be the only healthcare professionals without a voice in their own affairs? Placing PAs under the oversight of non-physician departments, such as Anesthesia (CRNAs) or Nursing, as was the author’s experience early in his career, can leave them feeling unheard, disrespected, and without adequate representation. This can be especially problematic if the department head is not a fellow PA. These circumstances create a significant disadvantage for PAs in the workplace. This outdated model should be eliminated.

Conclusion:

        These four devaluing workplace challenges can significantly demoralize and devalue PA staff, thus leading to job dissatisfaction and high turnover. Addressing these issues is crucial for creating a positive and productive work environment where PAs feel valued, respected, and empowered to provide the best possible patient care. By fostering fairness, clarity, respect, and self-governance, healthcare employers & organizations can unlock the full potential of their company PA workforce.