Physician Assistant profession (PA)

Information

HISTORY OF THE PROFESSION

The first Physician Assistant Training Program was founded in 1965 at Duke University by Dr. Eugene Stead. Currently (2003), there are 134 programs in operation.

Most programs require applicants to have at least 2 years of college experience and some experience within the health care setting (such as an emergency medical technician, ambulance attendant, health educator, licensed practical nurse or associate degree nurse). However, because of the competitive environment, the average PA student has a bachelor's degree in some field and about 4 years of health-related experience. Educational programs for PAs are typically associated with colleges of medicine and vary from 25 to 27 months in length.

The initial PA students were primarily military medics or corpsmen, who were able to expand upon the knowledge base they had received in the military to move into a role in primary care. Over the years, male domination within the profession has consistently decreased and about 59% of PAs today are women. The physician assistant role, legally associated with a supervising physician, has allowed PAs to perform tasks previously only performed by doctors: history taking, physical examination, diagnosis, and patient management.

Numerous studies have documented the ability of PAs to provide high-quality health care, comparable to that of a physician, for about 80% of the conditions seen in primary care settings.

SCOPE OF PRACTICE

The physician assistant is prepared, both academically and clinically, to provide health care services with the direction and responsible supervision of a Doctor of Medicine (MD) or Osteopathy (DO). PA functions include performing diagnostic, therapeutic, preventive, and health maintenance services.

As of 2003, PAs in 47 states, the District of Columbia, and Guam have prescriptive practice privileges. Physician assistants may not receive direct third-party (insurance) reimbursement for their services, but their services are billed for through their supervising physician or employer. (See also Types of health care providers).

PRACTICE SETTINGS

PAs practice in a variety of settings in nearly every medical and surgical specialty area. The majority (44%) of them practice within primary care areas with 31% in family practice. Other common practice areas are general surgery, surgical subspecialties, and emergency medicine. The remainder are involved in teaching, research, administration, or other nonclinical roles.

PAs may practice in any setting in which a physician provides care, allowing the doctor to focus skill and knowledge in a more effective manner. PAs practice in both rural and inner city communities. About 30% of PAs practice in areas that have less than 50,000 people. Because of the adeptness and willingness of PAs to practice in rural areas, the distribution of health care providers (in relation to the general population distribution) has been enhanced.