The New Doctor Will See You Now
“Are you going to be my doctor now?”
I had been at my current job for a little over a year when I was asked to fill in for a colleague on medical leave and see some of her patients. She had been with the practice for six years and had built good relationships with the many patients in her care. These patients were willing to see me, but I could sense hesitation and even a little skepticism from some of them. I always responded with a smile and explained my role as a PA, then assured them I would provide the best care possible in my colleague’s absence.
“You’re the third person I’ve seen since I started coming to this office.”
Two physicians at my practice retired during the first year I started there, and I inherited many of their patients, who had been seeing these physicians for decades. Others had been seeing another physician who worked there before I came, but had moved on to another position in a different state. When these patients told me I was second, third, or even fourth in a line of medical providers, I had little response to give them except that I had reviewed the information in their charts and was very familiar with their treatment plan.
“Are you going to leave too?”
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This question was perhaps the most difficult to answer, but was also understandable. The medical provider who stays with one practice for their entire career is becoming an obsolete figure, and patients who are accustomed to seeing one provider for most of their lives are now facing a revolving door of physicians and APPs whenever they seek medical care. A 2022 article published in Mayo Clinic Proceedings: Innovation, Quality and Outcomes surveyed over 20,000 respondents, and they found that one in five physicians say it is likely they will leave their current practice within the next two years. It is hard to find consistent data on physician turnover in the early years of practice, but many sites estimate that at least half of physicians will leave their first position within five years of starting. The American Academy of Physician Associates (AAPA) estimates that at least 50% of PAs will change specialties during their career, and according to their 2019 Salary Report, approximately 7% of PAs switch specialties each year.
Many providers change jobs due to burnout, while others might seek career advancement, a better salary, or a specialty that is a better fit for their skill set. The unfortunate collateral damage from this changing model of healthcare is that patients must seek care from providers who may know little about them other than what can be found in their medical chart. Instead of seeing their family doctor who grew up in their community, attended their church, and was a member of their rotary club — like my grandparents’ family physician–these patients see someone like me, who is replacing a provider who has retired or moved to another position.
It is unlikely that healthcare will revert back to the old model of the career provider who stays in the same practice for forty years, so what is the solution? Aside from making improvements in healthcare to decrease burnout and increase job satisfaction so more people will stay in their positions, there are a few other things we can do. As patients will have to adjust to changing providers every few years, it is important to improve healthcare literacy and encourage patients to be their own advocates. If a patient is educated on their condition and their medications, they will be able to communicate this information with any new provider they see, and important data is less likely to fall through the cracks or be overlooked. Educating patients will also encourage them to make their own informed decisions and facilitate a more patient-centered model of care. So while I can’t guarantee my patients that I will be taking care of them for the next few decades, I can assure them I’ll do my best in the time I have, and I can give them the tools they need to take ownership of their own medical care.
References
Flexibility in the PA Profession: What Every PA School Applicant Should Know | Admissions Helpers
