Physician assistants have historically worked until their retirement. However, both the demographics and employment expectations of the profession have changed. It is now increasingly common for PAs and other healthcare professionals to voluntarily leave clinical practice at some point during their career.
The reasons for doing so vary and include the need to address personal health issues or be a caregiver to a sick loved one, the birth of a child, working abroad or pursuing other professional opportunities. What follows is a practical checklist for PAs who plan to leave and later reenter the clinical workforce.
Although it is by no means conclusive, PAs who know and incorporate the following tips within their action plan are more likely to experience a much smoother exit and subsequent return.
Ignorance of the law is no excuse, and can be costly.
You and/or your supervising physician(s) may be required by statute or rule to notify the regulatory board of the termination of your supervising physician-PA relationship. In some states, a failure to report is not merely a trivial administrative matter but a costly one that can result in monetary fines that may be levied against one or both of you. Before you leave clinical practice, be sure to check your state laws and regulations for any and all required board notifications. If you are a prescribing practitioner who possesses either a state prescriber number or Drug Enforcement Administration registration, be sure to make all required notifications to the appropriate authorities.
In addition, Medicare imposes fee-for-service provider reporting responsibilities on individual nonphysician practitioners enrolled in the program that may be triggered at some point during the reentry process. It is important that you be familiar with them and report when required.
Timing is everything.
If at all possible, do not remain out of active clinical practice for more than 23 months and 27 days (remember to account for February in a nonleap year). Although there are no studies to support the concept that a specific time away from practice is associated with demonstrable diminution of clinical skills, additional requirements are imposed by an increasing number of states on licensees who have been out of practice for two or more years.
An ounce of prevention is worth a pound of cure.
Many of the barriers to reentry can be diminished or eliminated if you maintain some level of clinical practice. If you can, find a way to stay clinically active, even if minimally. Maintain your NCCPA certification during your absence. CME and journal reading should also be kept up to date. Keep abreast of new technologies and treatments applicable to the specialty area of practice to which you would like to return. Maintain your professional memberships to stay informed about state law and regulatory professional practice changes or advances.
Depending upon your length of time away, a state regulatory body may require you to complete a clinical practice reentry program. Although this may seem unnecessary, licensing agencies are well within their public protection mission to impose such requirements. Be prepared for the financial, mental and emotional impact this may have on your wallet, person and family—particularly since a program may not be in your local area and can vary in length. Take a look at your state’s requirements for reentering clinicians so you can plan ahead.
Stephanie Radix, JD, is a director of state government advocacy and outreach for the American Academy of Physician Assistants.