All states allow PAs to provide patient services in sites where the supervising physician is not physically present, although the physician must be available by telecommunication. Within these guidelines, flexibility marks the physician-PA relationship.

The idea of a physician-PA team and supervision is not that the supervising physician should have to accompany the PA's every step. In an effective team relationship, the physician trusts that the PA will consult him or her regularly. Likewise, the PA feels confident that the physician will be available when needed, provide learned advice, and accept the care of patients that are beyond the PA's expertise. The physician also regularly reviews records of the care provided by the PA, providing advice and guidance as needed.

PA EDUCATION
Physicians can be confident that a PA who has completed a training program and passed the national certifying exam is competent to practice. PA education was developed by physicians and is based upon the medical model. Much like a medical student, a PA receives didactic instruction in anatomy, physiology, physical diagnosis, pharmacology and pathophysiology. PA students are also required to complete clinical rotations in all of the major medical specialties, usually alongside medical students. Physicians can be comfortable working with PAs because PAs are trained to think like physicians.

EASING PHYSICIAN WORKLOADS
PAs improve patient flow by freeing up physicians to manage more complex or demanding cases. An American Medical Association survey found that PAs enhance practice efficiency, and solo physicians who employ PAs experience expanded practice, greater efficiency, and greater access to care for their patients. The survey determined that physicians who employ mid-level practitioners such as PAs were able to work one week less per year on average while supplying more hours in office visits and increasing net income.

COST EFFECTIVENESS
According to the Medical Group Management Association, PAs generate revenues greater than what their compensation costs employers. Their recent report shows that for every dollar of charges a PA generates for a practice, the employer pays on average 30 cents to employ the PA.

BOOSTING PATIENT SATISFACTION
Hiring a PA enhances patient satisfaction in several respects. Studies by the Kaiser Permanente Center for Health Research report high patient satisfaction levels for services provided by PAs. Aspects of patient satisfaction examined included interpersonal care, confidence in provider, and understanding of patient problems. With a PA on staff, patient waiting times are decreased, improving patient satisfaction through increased access to health care.