If a PA's clinical judgment conflicts with safety priorities, what is the recommended initial approach for the supervising physician?

• A. Escalate to higher authority if needed, after discussion
• B. Engage in collaborative discussion, review evidence and protocols
• C. Automatically defer to the PA's judgment
• D. Remove the PA from patient care immediately

Answer: (B)

When safety priorities conflict with a PA’s clinical judgment, the first move is for the supervising physician to sit down with the PA and discuss the case together, reviewing the evidence and the relevant protocols or guidelines. This collaborative discussion centers decisions on patient safety, using established evidence and institutional procedures to guide the plan. It respects the PA’s input while applying physician oversight to ensure the chosen path minimizes risk and aligns with safety standards.

If, after this discussion, there’s still a mismatch, then escalation to higher authority or additional consultation is appropriate. Automatically deferring to the PA’s judgment bypasses safety considerations, and removing the PA from care immediately is an extreme step reserved for clear, imminent safety or competency concerns. Documenting the discussion and rationale helps ensure accountability and learning.