MDs, DOs, and the physician-PA team

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The recent commentary by Erik C. Sommers, MD, (“Communication is key to the MD-PA team,” April 2017) encourages MDs and physician assistants (PAs) to be accessible and open to conversation, provide support, push limits, and be open to failure. I have been in PA practice for 36 years and I applaud his thoughts. In my opinion, his comments are spot on. However, there was a major communication problem in this otherwise excellent piece. I submit that instead of the noninclusive and inaccurate MD-PA usage, the term physician-PA team would have been appropriate. MD/DO or DO/MD-PA team also would work. Indeed, as we find ourselves engaged internationally and developing optimal team practice, using the term physician when referencing collaboration with international physician and medical consultant practice partners with a variety of credentials will be even more appropriate and important.
In that spirit of openness and conversation, I take JAAPA editors and Dr. Sommers to task. The commentary title and the narrative failed to include a vital partner in the physician-PA team—the DO. Osteopathic physicians are the other physicians who provide PA supervision. Unfortunately, they, like PAs, are not included or accurately referred to in many communications. It is wrong for PA literature to do that.
The national clinical communication safety program TeamSTEPPS (https://www.ahrq.gov/teamstepps/index.html) counsels us to use the five Cs when there is an urgent communication regarding conflict resolution, patient safety, or professional interaction (I am curious, I am concerned, I feel challenged, need to collaborate, or use my chain of command). Therefore, I am concerned: osteopathic physicians have been part of the physician–PA team since the beginning of our profession and in many medical practices across the United States, a mixed group of physicians (DOs and MDs) provide physician services alongside PAs. Osteopathic medical universities train and educate PAs across the nation.
Let us be sure we do not fail to include the DO in our commentary and discussions when we reference physicians because a DO is a physician, but is not an MD ... just as a PA is not an NP.
Accuracy is a hallmark of good practice in all communication. It is time for the PA world to lead the way. As our profession concludes its 50th year of professional existence, it is time our communication practice regarding physicians always includes the other physician, the DO, when using physician initialisms.
Gerry Keenan, MMS, PA-C
Associate Professor
AT Still University
Arizona School of Health Sciences
Department of Physician Assistant Studies
Adjunct Associate Professor
Arizona School of Dentistry and Oral Health
Mesa, Ariz.
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