By Marguerite Ward
Photo courtesy of Phalinn Ooi.
The health care industry is constantly changing. An increase in physicians choosing to pursue speciality instead of primary care, demographic changes in rural and urban areas, and opportunities presented by health care reform challenge the healthcare industry to meet the growing need for quality care. But with those challenges have come new opportunities for those looking to enter the field.
An increasingly important player in our nation’s health is the physician assistant, a medical professional that is uniquely positioned to respond quickly to healthcare needs.
A physician assistant (PA) is a medical professional who works under the supervision of a physician to provide a range of medical and surgical services. They examine, diagnose, and counsel patients, prescribe medicine, perform minor procedures, and assist in surgery. Unlike physicians, PAs do no have to specialize in one area of medicine, enabling them to gain experience in a wide range of areas.
Janet T. Brooks, CAP-C with over 30 years of experience says, “We are trained in many specialities, from family medicine to ER and urgent care visits, so we are able to help patients on in many different settings. We may be part of a trauma team or assisting in the delivery room. In fact, we are able to admit a woman in labor and we have done deliveries in the doctor’s absence, if the doctor didn’t make it in time.”
Typically a physician will supervise anywhere from one to four physician assistants. The PAs work semi-autonomously seeing and treating patients on their own, with the physician not required to be in the same location as the PAs.
While the definition of “supervising” depends largely on the hospital or healthcare institution, supervising physicians are nearly always required to be immediately available by telephone, email or radio if they are not in immediate proximity. The supervising physician is legally responsible for all patient care, and reviews the work of his/her PAs everyday.
Courtney Atkinson, PA-C, is a physician assistant at the Harvard Residency Program at the Brigham and Women’s Hospital. She explains how her relationship with her supervising physician/surgeon enables her to work independently.
“My extensive training in a variety of medical areas gives me the ability to work confidently. I have a very good working relationship with my physician,” says Atkinson. “There is an understanding that I if I needed to, I could call into the operating room and ask a question without any second thoughts.”
To become a physician assistant, a person must hold a bachelor’s degree, pass the demanding, national Physician Assistant National Certified Exam (PANCE), and obtain a state license. The average amount of education for a state license is approximately two years, ranging from 25-27 months.
The first half of the program, a student is immersed in “didactic” training, or classroom training. The second half of the program a student gains experience in a healthcare setting. The amount and type of “real world” experience a student gets in a healthcare setting depends on the university the student attends.
Cynthia Lord, MHS, PA-C is one of the founding members of Quinnipiac University’s nationally recognized physician assistant program. Currently the director the the PA program, she discusses the differences that exist between different education programs.
“Even though PA programs are uniquely different, they have all met the accreditation standards of The Accreditation Review Commission on Education for the Physician Assistant, Inc or ARC-PA,” says Lord.
The ARC-PA is an independent accrediting agency that protects the defines the standards of PA education and ensures compliance with those standards. There are currently one hundred and seventy three accredited PA programs nationally.
Some people worry about the difference in education between a PA and a physician, leading some to prefer to see a physician.
Brooks tells BTR, “Patients have the right to the see a physician — but rarely do they demand seeing one. Once they understand what our title entails, they realize we are equipped with the training and knowledge to take care of them.”
Nationally, there is a current shortage of primary care physicians as more and more physicians seek to specialize in a medical area. Physician assistants have played a critical role in stepping up to meet this need in primary and family care.
“Sometimes patients actually prefer us because we are able to give them the time and attention they deserve, whereas a physician may be extremely busy,” Brooks explains.
In rural parts of the United States, the shortage for primary care physicians is more pronounced. Instead of having to travel long distances or wait hours on end to see a physician, many patients are now seen and treated by physician assistants exclusively. In rural areas, physician assistants are given more independence to meet community needs.
Lord comments, “PAs are a perfect fit for a dynamically changing healthcare landscape. With a generalist education, commitment to team-based practice and a relatively short but intense training period, PAs are uniquely positioned to address both the short term and long term healthcare needs of our country.”
In 2003, a law was enacted that required medical residency programs to limit physicians to no more than 80 hour work weeks. This came from a rising concern from the effects of stress and fatigue on doctors.
However, the hourly limit nearly set off a national crisis of what could have been severely understaffed hospitals. As Lord describes, “Physician assistants seamlessly stepped in to fill the need for more physicians. We helped avoid serious panic in the industry.”
Currently there are 83,466 Physician Assistants in the United States. From 2010 to 2020, job demand for Physician Assistants is expected to have increased by an exceptional 30 percent. In real numbers, that is an increase of about just under 25,000 jobs.
Physician assistants describe their career as “rewarding” and “hands on.” The ability to explore different medical areas relevant to their community is a special opportunity that PAs have, one that attracts many into the field. For Shahana Abdullah, a second year PA student currently in the midst of her third clinical rotation, patient care was what drew her into the field.
Abdullah says, “For me, being able to become a meaningful part of my patients’ lives is a huge part of why I chose to become a PA. I love people and I find such joy in being able to help them understand who they are, the conditions they may have and how together we can work to make their lives as healthy as possible.”