Healthcare settings are packed with complicated relationships, whether they’re between providers and patients or within the care team. One such dynamic that can be uniquely challenging: the advanced practice provider and collaborating physician. Why? Because their responsibilities and work are often shared.
“In some states, MDs need to co-sign your chart, and you need to talk to them about the treatment plan,” explains Andrea Lowe, MHA, PA-C, director of employer strategy at the American Academy of Physician Assistants. “You’re both deciding on meds, what course to take — together, you’re deciding what’s best for the patient.”
If you struggle to form a fast partnership, the nature of the work certainly raises the stakes, but many APPs face this. Here are some tips, based on Lowe’s 20 years practicing medicine, that yield big results.
Communicate early and often.
This is most important, says Lowe, because “everyone has their own practice style. There’s different ways to come to a diagnosis or treat a patient that have the same outcome.” (She adds that it’s crucial to communicate with everyone on your care team, not just physicians.)
Whether you’re working with someone for the first time or you’ve butted heads in the past, it’s okay to ask how that person prefers to work together. Perhaps you can offer to see patients with the MD as a duo or to do it alone and report back your findings. You can also go a more general route and simply say, “What’s your style?”
Be willing to pivot.
Part of working on a healthcare team means dealing with lots of other people’s opinions, not just MDs’. As an APP, you might work a 12-hour shift, eight of which are with one physician, the rest with another, who may have a different workflow or approach to cases. When that switch happens, be ready to accommodate a new approach.
Ask why someone wants to do something a certain way.
At first, this might seem unnecessarily confrontational, but if you don’t understand why the physician has made a certain decision, you should say so while being mindful of how you pose the question.
For example, Lowe has asked, “Can you walk me through why you want to do it this way?” with great success. “I’ve found that I’ve been wrong and something didn’t occur to me,” she says. “Focus on the why behind the difference of opinion and course of action.”
Drop your ego.
Most of the time, when you don’t agree with the physician’s reasoning, it’s best to “agree to disagree,” Lowe says. “Arguing won’t get you anywhere.”
That said, if you do have a particularly challenging interaction, consider pulling the individual aside and saying something non-confrontational. A direct comment like, “Is there something you’d like to talk about?” can work wonders.
Remember the patient comes first.
When you have a hard time letting go of a situation, remind yourself of your responsibility to the patient. “In medicine, it’s not about being right all the time because that will lead to mistakes,” Lowe stresses. “You do what’s best for the patient.”
Focus on the positives.
“I’ve had some colleagues come to me and say, ‘Dr. so and so has a very strong personality,'” Lowe recalls. “But I’d point out to them that his patients love him. You have to see beyond that and understand that he wants what’s best for the patient.”
Reframing the dynamic can help you refocus on patient care because at the end of the day, as Lowe explains, “you’re both there to do a job.”
Stay confident in yourself — and your profession.
You’ve likely heard criticisms of APPs’ increasing practice authority, whether they’re online or at your own workplace. Lowe stresses that you shouldn’t concentrate on the negativity, but use it as an opportunity to educate others about the role of APPs.
“You graduated from PA school and passed your boards because you’re smart — don’t let anybody take that from you,” she asserts, adding that conflict in healthcare happens across the board, not just between APPs and MDs.
“Recognize that you’re a part of a team,” she advises. “Be open to doing things differently and get yourself a seat at the table … [APPs] aren’t going anywhere.”