How can physician assistants help create change? Hint: they're already wired for this

Timi Agar Barwick, the CEO of the Physician Assistant Education Association, says Physician Assistants (PAs) are hard wired to be team players. Now it's time to find some new partnerships. 

Albo: Today we're talking about change and specifically the role of physician assistants and how their role is changing, and how that will benefit the patient in team-based care. 

Announcer: Asking questions, seeking solutions. Algorithms for Innovation. Live from Baltimore at the AAMC 2015. 

Albo: Hi, I'm Amy Albo here in Baltimore at the AAMC with the Algorithms for Innovation team, and I'm speaking with Timi Agar Barwick who is the CEO of The Physician Assistant Education Association. 

So Timi, I thought we'd talk first about how you're viewing change. There's a lot of change going on in health care and medicine right now. How important do you think embracing change is to the success, even the survival of health care organizations today? 

Barwick: Critically important. And in terms of my personal reaction to what's going on both on the health care front and on the education front, I really view it as an exciting opportunity for our members and ultimately students and patients.

Albo: How do you see the role of physician assistants changing in this new environment? 

Barwick: Well, first of all, PAs are the consummate team players. It's in our DNA. By our practice laws and patterns, PAs have to practice with physicians. They have since the beginning of the profession. It's how we started. 

However, I think we need to apply that history and experience beyond physicians in this current health care arena, and that means learning about new partners. We have the mechanics down of that. We're actually, I think, expert at that piece, but we haven't brought in other partners as formally as we could, and I think with the focus on team-based care that's our opportunity to really shine and move ahead. 

Albo: Team-based care is so important in this new environment. What do you think, what sort of unique attributes do you think physician assistants bring to this environment? 

Barwick: I think our history with team-based care, understanding our role, understanding others' roles, and being comfortable with that changing environment is where we really, as I mentioned, shine and can really accelerate our knowledge and apply it to the broader base. 

Albo: And what do you think the barriers to team-based care have been in the past? 

Barwick: Well, one of the barriers, I think, relates to change, and that's how your identity forms as a profession. So if we start thinking initially about developing professional protocols and cultures around an “n” of one, it's hard to translate that to a larger group.

And so I think that as we move forward, that's going to be kind of the ace-in-the-hole for us and for other professions. If we can effectively embrace change, if we can get people to see change as an opportunity and not as a threat, potentially, to their own identity, that's a cultural shift. If we can make it, I think we're going to be there. 

Albo: Sometimes when you tell patients, "Well, the physician can't see you but his or her PA can see you," patients have maybe responded not so positively to that. Do you see that changing? 

Barwick: Actually, I think that the literature and research is that they do respond positively to that, and part of the reason is, in the case of PAs, really honed communication skills. And that's something that different medical providers have greater or lesser competence in. For us, I think, it's significant competence, and so patients respond to that because they feel like they're being consistently heard, and that's the value of the PA profession. 

Albo: Do you think the pace of change that we're seeing is too fast, too slow, just about right? 

Barwick: I think the pace of change is difficult but necessary. I think if the change had been so subtle it wouldn't be recognized as change and maybe would affect the outcome. So in essence I feel like we've ripped the bandaid off, and now people can see what's going on and what's needed. And as painful as change can be to some people, if we can frame it culturally in terms of an opportunity I think they'll embrace it. My general belief in people is that you just have to give them a little time and they'll rise, because that's what we do as a profession and as a country. 

Albo: And as we've gone around talking to people about change, one thing that's come up is that once people understand the "why" of change, the greater context of change, they're more open to accepting and moving beyond their workflows or traditional roles. Do you find that the "why" is an important factor? 

Barwick: The "why" is critically important. I think it's also not just the "why" but “how” they're going to be involved in the change. So I think having people—practitioners in particular and patients—feel like they have a voice and they're part of the process. That's what's important to them. 

Albo: What do you think most needs to change, if you could just choose one thing? 

Barwick: I think how we feel about change, because it sets the stage. If you can understand movement and that a static environment isn't helpful to anybody, not to patients, not to practitioners. If you can embrace that in a way that's positive, you can apply it in so many settings and it will be easier and faster to move through it. 

Albo: And if you had one word to describe how you're feeling at this point, what would it be?

Barwick: Excited. 

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