Can a Physician’s Assistant in the U.S. Army Have a Private Practice While Not Deployed?

The role of a Physician’s Assistant (PA) within the U.S. Army is highly regimented and detail-oriented. While the idea of having a private practice may seem appealing, there are significant restrictions and considerations that must be addressed. Let’s delve into the nuances of this question and explore the practicalities involved.

Understanding the Terminology

First and foremost, it's important to clarify the terminology. The correct term is “physician assistant” (PA) rather than “physician’s assistant.” The distinction may seem subtle, but it is crucial. PAs are authorized to practice medicine with the supervision of a licensed physician.

Typical Work Schedule

Every PA in the Army, and in other branches, is typically fully booked and working at their assigned clinic. In this context, the term “booked” means they are scheduled to see patients every day from their assigned duty hours. This tight schedule makes it exceedingly challenging for PAs to engage in any outside practice due to the significant time constraints.

The Importance of Supervision

Any private practice situation strictly requires a P A to have a supervising physician. This supervising physician agreement is a cornerstone of the arrangement. The supervising physician has a significant amount of responsibility, and their professional license and reputation are at risk if an issue were to arise. Even in cases where the PA had nothing to do with the potential issue, the supervising physician would still be held accountable. Therefore, the common model of a private practice, as typically understood by the general public, where an MD operates an office/clinic, is not an appropriate comparison in the military context.

Military Commitment and Education Requirements

Many military PAs are not only graduates of the same school, such as the one located at Fort Sam Houston, Texas, but also enter the service to attend that very institution. These PAs often enter into a service commitment, meaning they agreed to a set period of service in exchange for their education. Given this commitment, the U.S. Army is unlikely to permit such a PA to engage in any practice outside of their military medical duties during their service commitment period. This commitment period can last for several years, further narrowing the possibility of pursuing a private practice.

Deployment and Rotation

Military healthcare providers, including PAs, are subject to deployment. Additionally, they may experience permanent changes of station (PCS), or simply be reassigned within their current duty area. This means that even without a change of station, a PA might have to move from one military clinic to another within the same large “market.” For instance, in the San Antonio, Texas, metropolitan area, there are numerous military clinics, such as Brooke Army Medical Center (BAMC), Wilford Hall Ambulatory Surgical Center, and several smaller facilities.

This type of reassignment can involve a significant commute or move. For example, a PA working at BAMC and living on post may be reassigned to Camp Bullis, 45 minutes away from Fort Sam Houston’s base housing. This shift in work location would impact the PA’s daily schedule, leaving minimal time for any outside practice.

Loading and Time Management

Consider the daily responsibilities of a PA. They must manage appointments, patient care, documentation, and other clinical duties. These tasks are demanding and consuming, leaving little room for additional outside practice. Even if a PA desires to have a private practice, the time required to manage clinical duties and maintain a supervisory relationship can be overwhelming.

Conclusion

While the idea of a private practice is appealing, the strict regulations, full work schedules, supervisory requirements, educational commitments, and deployment realities make it challenging for a PA in the U.S. Army to pursue such an endeavor. The role of a PA is typically focused on providing high-quality medical care within the confines of their military roles and responsibilities.

For PAs considering the possibility of a private practice, it is important to understand the limitations and constraints involved. While state-specific exceptions may exist, the general framework of military service significantly restricts the opportunity to operate a private practice.