Physician Assistant (PA) as a Psychiatric Specialist


I recently emailed a friend and colleague letting her know that our new Physician Assistant, specializing in psychiatric medication management at our outpatient group therapy practice in Austin, had openings and was ready to see clients! 

I sent many details her way only to be met with the question, “Can a PA see clients independently like a psychiatrist?”  Oh no! I felt foolish, mostly because my attempt to network overlooked a clearly important detail, but more so because I was unaware not everyone knows that a PA can practice as an independent specialist (clearly my privilege and lens functioning here, but that’s another article altogether)! 

Here is a person in the mental health field who owns her own private practice and works with clients every day who did not know this information, and it got me thinking about why that was and how to correct this kind of knowledge gap?

What is a Physician Assistant?

The American Academy of Physician Associates (AAPA), formerly The American Academy of Physician Assistants, notes the profession was created to “improve and expand access to healthcare” with the first graduating class coming out of Duke University in 1967.  The profession has grown in acceptance and has been welcomed increasingly over the years as a genuine solution to many issues across healthcare and government by accreditation standards, education standards, continuing medical education requirements, and more legislative (state and federal) support.

My colleague and graduate school roommate, of course had the best of intentions and meant absolutely nothing by her question. Still, it helped me to see how important it can be to address this misperception or lack of perception.  It feels important to address the gap because to address healthcare needs and access to care (global pandemic, anyone?). 

First of all, a common error that occurs when referencing a PA – it is Physician Assistant, not Physician’s Assistant.  There is no possession of these hard-working, graduate-level educated medical professionals by the physicians and the misreferenced error is oftentimes a well-intentioned mistake. Still, it can serve to be an ongoing frustration for these wonderful PA providers. 

Furthermore, the name itself changed in May 2021 from Physician “Assistant” to Physician “Associate” by the AAPA, which is much more reflective of the clinical training and expertise the profession holds rather than merely “assisting” a physician.  Each state has to accept the name change independently, and so even though the governing board has changed the name Texas still recognizes them as Physician Assistants. 

It took from 1967 to 2007 for PAs to gain prescriptive authority in all 50 states, and more recently some states have allowed PAs to start practicing without direct supervision under a physician, which is a phenomenal step in the profession and for healthcare access in general.  Unfortunately, here in Texas, this has not yet been adopted, but we’re hopeful it will in the near future…come to Texas!

Why a Physician Assistant / Associate Specialist?

A well-trained and experienced PA is and can be a specialist, and we are going to lay out reasons why PAs are specialists. We recommend seeking out a PA for your psychiatric needs rather than another provider. 

Physician Assistants Are TRUE Mental Health Specialists

A PA is NOT a medical assistant or a nurse and can specialize in Psychiatry (our favorite!), Obstetrics/Gynecology, Pediatrics, Internal Medicine, Family Medicine, Emergency Medicine, or General Surgery.  PAs who specialize are typically not dealing with any other general issues, which allows them to entirely focus on and expand their expertise in the field of psychiatry, which often also includes a wealth of knowledge about helpful supplements and holistic or therapeutic prescriptions.

Cost-Friendly Medication Management

A psychiatric PA specialist is an excellent option within the behavioral healthcare system, which often functions without insurance.  How many traditional and specialized fields within healthcare do you know that function without taking insurance?  I can’t think of any. 

Can you imagine going in to have a baby and being told, we don’t take insurance, but we’ll give you a superbill to send to your insurance?  Umm, no.  How often have you looked for a psychiatry appointment and been deterred by cost? 

A well-trained PA can see uninsured clients for a fraction of the price, making any out-of-pocket cost more manageable. PAs are also covered by almost all major insurance (including Medicaid and Medicare), which also helps manage costs. 

If your insurance goes towards a deductible, the contracted rates of PAs are oftentimes much less than that of other providers, making your deductible easier to manage.

Easier Access to Care

PAs in psychiatry are oftentimes the ones who handle the flow of a traditional psychiatrist anyway!  The very creation and mission of these professionals in this field was intended to deal with problems of access to care so why not go straight to the source of the solution? 

Our practice works very hard to consistently get clients in as soon as possible (as we are often dealing with time-sensitive mental health struggles or life/death issues) and be extra responsive.  This is important for so many reasons.  The goal is to increase access to excellent and specialized care!

Mental Health Professionals That Are Relatable and Care

We like to think of it as the perfect bend between specialized knowledge and client-focused care.  They’ve worked hard to achieve, are educated, credentialed, and qualified, but unfortunately have functioned within a hierarchical healthcare system that places physicians on top, and it seems to have instilled a sense of interpersonal realism, humility, and humanness. 

As a colleague, I have never met an entitled PA.  As a client seeking care, dealing with mental health is hard enough without feeling uncomfortable in an appointment where the professional’s ability to help you relies on your comfort level with vulnerability and asking for help.

Why can a Psychiatric Physician Associate / Assistant treat?

In the specialty field of psychiatry, PAs can work to treat the following:

  • Women’s health / PMDD / hormone variability
  • Sexual dysfunction / sexual function (in anyone)
  • PTSD / trauma
  • Insomnia
  • Anxiety / panic
  • ADHD / issues around focus
  • Depression
  • Mood disorders
  • …and can do it all through a supportive therapy and holistic lens

To summarize, you wouldn’t go to a hardware store and order a pizza (well, they may have an old one from a staff party in the back, but we wouldn’t expect it to be any good), so why see a provider who doesn’t specialize in what you’re struggling with? You shouldn’t.  

If you or anyone you know is struggling or would benefit from working with a specialized psychiatric Physician Assistant, please feel free to reach out via our contact form! We offer telemedicine and in-person appointments at our El Paso and Austin locations.

As always, take good care.

Categorized As: ,