Dr. Michael Asbach, Associate Director of Interventional Psychiatry at the DENT Neurological Institute and a nationally recognized educator, joins The JCP Podcast to discuss the critical and expanding role of Advanced Practice Practitioners (APPs) in behavioral health. With a background that spans from sports medicine to leading interventional psychiatric programs, Dr. Asbach offers a unique perspective on how the medical model training of Physician Assistants (PAs) uniquely positions them to address the growing psychiatric workforce shortage.

In a nuanced discussion, Dr. Asbach tackles the headlines and controversies surrounding the profession, including the recent British Medical Journal rapid review and the UK’s "Leng Report." He dismantles the concept of "scope creep," arguing instead for a model of "autonomous collaboration" that respects physician expertise while maximizing patient access. From the history of PAs emerging after the Vietnam War to the modern "Build, Baby, Build" approach to healthcare staffing, this episode provides a roadmap for how interdisciplinary teams can alleviate burnout and improve outcomes in the golden age of biologic psychiatry.

Episode Highlights:

00:00 – JCP Podcast Kickoff and Introduction to Dr. Asbach

01:34 – Expanding PA Engagement and Education in Psychiatry

03:22 – Career Origins and Choosing the PA Path Over Medicine

05:11 – Discovering Psychiatry and the Appeal of Interventional Innovation

08:46 – Mentorship, Research Culture, and Advancing Psychiatric Treatment

12:28 – Understanding PA Training Models and Evolving Clinical Competency

16:44 – Addressing Psychiatry Workforce Shortages Through Advanced Practitioners

20:36 – Evaluating PA Outcomes and Challenges in Measuring Quality of Care

29:24 – Rethinking Workforce Assumptions and Challenging Medical Dogma

32:37 – Regulation, Role Clarity, and Key Takeaways from the Leng Report

41:25 – Navigating Scope Creep Concerns and Physician Training Protection

47:51 – Building Effective Interdisciplinary Psychiatric Care Teams

56:44 – Supervision Ratios, Access Disruption, and Real-World Patient Impact

1:00:04 – Burnout, Non-Clinical Career Paths, and Retaining Expert Clinicians

1:08:09 – Future of Advanced Practice Providers and Closing Reflections

Key Takeaways:

"I think the future of advanced practice providers is going to be one that is collaborative, autonomous, and interdisciplinary."

"We are blessed to be able to play such an important role in people's lives... and have this front row seat to their life longitudinally."

"I’m very much a ‘build, baby, build’ approach to housing... Healthcare is very similar where the more people that we bring in as helpers, the better."

"Psychiatry is... in this golden era of kind of firmly returning back to biologic origin... and the PA medical model means that PAs have taken pathophysiology, gross anatomy, fundamentals of medicine."

"The absence of evidence is not the evidence of absence."

"It’s not about replacing physicians... but rather adjusting regulations to reflect the modern healthcare environment."

Links:

Journal of Clinical Psychiatry: psychiatrist.com/jcp/

Michael Asbach: https://www.dentinstitute.com/michael-asbach/

White Coats of the Round Table: