307 Physician Assistant Scope of Practice 2015
patient management tasks, the PA becomes more independent in delivering
these services within the practice.205 In time, and depending on the specialty
and setting, the PA may reach the point where he or she can autonomously
perform over ninety percent of the clinical tasks required in the practice.206
The PA’s ability to perform necessary tasks in that particular practice approaches that of the physician.207 As the PA sees patients and determines
diagnoses and management strategies with little to no physician consultation, he or she becomes an autonomous colleague in the practice.208
Negotiated performance autonomy captures the essence of the optimal
PA-physician relationship and helps to explain the success of the PA profession over the past fifty years.209 PAs are seen as essential healthcare professionals in the American healthcare workforce and are in high demand in
the medical marketplace.210 This sociologic concept may explain why PAs
appear to be satisfied in their roles.211 While the casual observer might think
that requiring a provider to have a legal relationship with a physician might
result in substantial career frustration and burn out, that is not the case.212
Career satisfaction surveys consistently show that PAs are satisfied in their
choice and find a great deal of fulfillment in their work.213 Recent assessment of PA satisfaction shows that nearly two-thirds of all PAs are satisfied
with their choice of career.214
Negotiated performance autonomy results in the capability of the PA to
gradually assume responsibility for the vast majority of medical tasks per-more likely to use judgment and become more independent in delivering patient care).
205. See id.
206. See New Health Professions, supra note114, at 475.
207. SCHNELLER, supra note 199, at 124.
208. Id. at 117.
209. James F. Cawley & E. Bush, Levels of Supervision Among Practicing Physician
Assistants, 28 J. AM. ACAD. PHYSICIAN ASSISTAN TS (forthcoming 2015).
210. Roderick S. Hooker et al., Career Flexibility of Physician Assistants and the Potential for more Primary Care, 29 HEALTH AFF. 880, 883 (2010).
211. Id. at 884. See also Carol Biscardi et al., Practice Characteristics and Lifestyle
Choices of Men and Women Physician Assistants and the Relationship to Career Satisfaction, 42 JOURNAL OF ALLIED HEALTH, 157, 157- 162 (2013) (“Sixty-five percent of men and
women completely agreed that they are satisfied with their career.
Eighty-three percent of men and women PAs believed that they can balance their personal
and professional responsibilities. While the sample was small, it does represent the demographics of PAs currently in practice and thus supports the assumption that the PA profession affords the ability to balance responsibilities and promotes career satisfaction.”).
212. See Donald K. Freeborn et al., Satisfaction and Well-being of Primary Care Providers in Managed Care, 25 EVAL. & THE HEALTH PROF. 239, 250-51 (2002) (indicating that
a 1999 survey conducted by Kaiser Permanente Northwest found that “more than 80% of
PA/NPs and physicians were satisfied with their medical careers.”).
214. Bacardi supra note 15 at 157 and 159. (2014).