What Is a Physician Assistant (PA)?
A physician assistant (PA) is a medical expert that has the ability to complete just about as many tasks as a doctor. They are medical professionals and are an important part of the healthcare community in places such as hospitals and clinics. The primary role of a physician assistant is to practice medicine and medical care under the supervision and direction of a licensed doctor. Physician assistants are usually a primary healthcare provider for their patients because they are able to diagnose illnesses. They are also able to decide and implement a plan for treatment with each patient along with prescribing any medications a patient may require for treatment. Physician assistants can accumulate thousands of hours in a variety of medical specialty fields making them extremely versatile. Physician assistants must also be collaborative considering they work with many other doctors in a variety of settings.
Physician assistants are allowed to practice medicine in all 50 states and they are also able to provide healthcare in any setting or specialty field of healthcare. This kind of versatility and knowledge does not only improve access to healthcare for patients, but improves the quality of service the patients receive as well. Each physician assistant’s duties can vary depending on factors such as their personal level of experience, their field of study, and the state laws in which they are currently practicing medicine.
Physician assistants can typically perform some of the same job functions that ordinary doctors perform. Similar to a doctor an assistant is allowed to prescribe medications and develop treatment plans for patient recovery. They also have the ability to counsel patients on preventive care and conduct a full physical examination on a patient. PAs also have the ability to diagnose illnesses by ordering medical tests to be conducted. These tests can then be analyzed by the PA to aid in implementing a treatment plan for patients.
Other duties that physician assistants may be able to become involved with depending on the state laws include performing surgeries and also assisting in more extensive surgeries. Some of the less intensive duties that physician assistants are able to complete are tasks such as recording a patient’s complete medical history, and conducting clinical research within virtually any specialty medical field of their choice.
A physician assistant’s versatility also allows them to work at various hospitals at the same time and they may even choose to make rounds at places like nursing homes to aid with the elderly. PAs also work a different medical offices and community health centers. Other typical work places for physician assistants include retail clinics, workplace clinics, and correctional institutions. They are also allowed to work in educational systems such as high schools, colleges, and elementary schools.
A physician assistant may also decide to serve in our country’s uniformed services. This career path typically leads to work with various federal government agencies. The most common work place for a physician assistant is working within the Department of Veterans Affairs. Considering the sheer volume of educated and qualified physician assistants with over 120,000 in the United States alone there is still a high demand for these medical professionals. This is because of their versatility to work in various places.
Physician assistants are generally trained and educated in several fields of medical care. Generally they have education and training in medical areas such as preventive care, chronic care management, and patient education. The fact that physician assistants have a broader and more general study in several medical areas it enables them to provide a wider range of care for each patient and their symptoms. A great example of this would be if a patient went for an appointment with a physician assistant in pulmonology, the physician assistant may notice other underlying issues such as cardiac issues and either refer them to a specialist or treat them. This sort of general education and training provides convenience for patients to find treatment. The accessibility to physician assistants is also beneficial to patients because scheduling an appointment with a PA is often much easier than scheduling an appointment with a doctor.
The History of Physician Assistants
The physician assistant profession was created by a group of physicians and educators in the 1960s. These physicians and educators noticed a severe shortage of primary care physicians so they created a position called a physician assistant. These positions were created to not only improve healthcare but expand healthcare at the same time.
The very first class of physician assistants were put together and attended the Duke University Medical Center for classes in 1965. The professor for the class was a man by the name of Eugene A Stead JR. MD. Dr. Stead’s idea for a resolution to the problem of a shortage in primary healthcare providers was to design a curriculum similar to doctor’s curriculum. The major distinction between Dr. Snead’s curriculum and the typical curriculum of an ordinary doctor was that a physician assistant program of courses and study would be a type of fast track training that doctors received to be rushed into World War II.
Dr. Eugene A Snead Jr. put together the first class of physician assistant. The class was made up of four Navy Hospital Corpsmen. Each of the Corpsmen had already received extensive knowledge and field experience during their medical training for their military service. Only two short years after the Corpsmen began classes to become a physician assistant they graduated from Duke University’s physician assistant program becoming the first ever physician assistants.
It did not take long after the first class of graduates before the physician assistant program at Duke University was federally accepted. After federal acceptance of the physician assistant program, it also gained federal backing in the early 1970s. It was federally described as a creative solution to the problem of physician shortages. Shortly after federal acceptance the medical community as a whole gave their support to the new title of a physician assistant. The medical community also helped with the establishment of a standardized examination that would allow for a national certification process. The community also helped setup accreditation standards and developed continuing educational requirements in the medical field.
The First Organization for Physician Assistants
The first official organization for physician assistants was actually made up of the first four corpsmen that graduated Dr. Snead’s PA program. The American Academy of Physician Assistants was established and incorporated in 1968 and was based in North Carolina. Before it became known as the American Academy of Physician Assistants it was called American Association of Physician Assistants and the first and only members of the organization were the graduate students from the Duke University PA program.
The years after the organization was fully established in 1968 it received a steady growth rate over the next few years. After only five years the organization had already acquired over 300 members. This growth led to several changes for the American Academy of Physician Assistants. The first change was that it established a joint national headquarters for the American Academy of Physician assistants and the Association of Physician Assistant Programs, which later became known as the Physician Assistant Education Association. The new joint headquarters was first established in Washington, D.C. but was later moved to Arlington VA. In the 1970s. Shortly after it was relocated to the Old Town Alexandria, VA. in the 1980s. Recently is was moved to its current location in 2011 to the Carlyle area of Alexandria.
Education and Training
The need for physician assistants is in high demand, but becoming a physician assistant is highly demanding. Students studying for this profession most often have to have training and education in a variety of areas. They must also possess skills and training in medical technology, therapeutic implementation, and extensive knowledge in patient care. For students to obtain these types of skills and education required to become a physician assistant they must work within an actual hospital or a doctor’s office. This is due to the standards that have been put in place by the National Commission on Certification of Physician assistants that require applicants to meet certain criteria before they receive their national certification.
Physician Assistant Education
Prior to taking the certification exam to acquiring national certification, an applicant must complete several educational requirements. These educational requirements include intensive undergraduate and post-graduate studies. Before students enroll in any school in pursuit of becoming a physician assistant they must ensure that the school they are attending has an ARC-PA accreditation. An ARC-PA accreditation in the United States is granted by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA). If students enroll in a college that has not been accredited by the ARC-PA they will be ineligible to get a state licensure for medical practice or take the national certification exam.
College Education and Training
To become a physician assistant, students must complete a long and extensive educational program that typically lasts for about 27 months. During the 27 months students must complete a mixture of classroom courses along with clinical experience. Typically, physician assistants entering these intensive educational programs have already completed their undergraduate studies. Students that have already completed their undergraduate work will typically have education already in biology, scientific, and pre-medical courses. Even these students find that the curriculum at a physician assistant school can be extremely difficult.
The curriculum for most graduate level courses at a physician assistant school will typically involve courses in genetics, pathology, pharmacology, human anatomy, micro/infectious disease, medicine, and surgery. These graduate level courses are not the only things that physician assistant students must complete during the program. Students must also record at least 2,000 clinical hours in addition to their academic courses.
Clinical hours give physician assistants a chance to gain experience in various medical settings. This hands on experience can take place in setting such as an emergency room, physician’s office, or a hospital. During these clinical hours students will apply techniques and medical concepts they have previously learned about during their academic course work. These clinical hours often include a wide range of settings in specialized medical fields. Students may be sent into medical fields including psychiatry, OB/GYN, pediatrics, and internal medicine. After students have successfully completed all of their academic courses and logged at least 2,000 clinical hours they are able to graduate from their physician assistant school.
Physician Assistant Certification
After a physician assistant graduates from PA school they must register to take an exam. The exam is designed to test not only their knowledge, but it will also test their practical experience they gained during their physician assistant program and clinical work. The Physician assistant National Certifying Exam, also known as PANCE, is a multiple-choice test administered via a computer. Students must register to and apply to take the PANCE exam through the National Commission on Certification of Physician assistants.
The Physician Assistant National Certifying Exam will test a student’s knowledge and understanding in a variety of areas. The test evaluates students in areas such as maintaining health, clinical intervention, basic science concepts, taking a complete patient medical history, performing physical examinations, laboratory procedures, and conducting diagnostic studies. A typical Physician Assistant National Certifying Exam consists of five different sections. Each of these five sections have a total of 60 multiple choice questions for a total of 300 questions on the entire exam. Each of the five sections have a time limit of one hours to complete. During the course of the exam students are permitted to take a total of 45 minutes of break time.
A passing score on the exam is determined by which version of the test a student takes. Each version of the test has a different passing score because it is scaled to the difficulty of that particular version of the exam. The exam itself has a score range of 200 to 800 and most student will score an average of 500 points on the test. After students complete their exam they are told which version of the test they had and what was the required score needed to pass. They will also be told what they scored on the exam and whether or not they passed.
All students aspiring to become a physician assistant are required to pass the Physician Assistant National Certifying Exam before they can obtain their national certification. The most crucial part to remember about the Physician Assistant National Certifying Exam is that students are only allowed to take the exam within a certain time frame. After students graduate and obtain their degree they have 6 years to pass the Physician Assistant National Certifying Exam so it is important to start scheduling the exam as quickly as possible. Another important note to remember about the exam is that there is a limit to how many attempts a student can have to pass the test. Aspiring physician assistants are only allowed six attempts to pass the exam with the six-year time frame after completing graduation. There is also a three attempt limit within a single year for students wanting to take the exam.
What is the difference between a doctor and a physician assistant?
There are three separate areas that differentiate a physician assistant and a doctor. The first major difference between a doctor and a physician assistant is educational level. The educational requirements for a physician assistant in summary, as previously discussed, is roughly a four-year degree followed by a completed physician assistant program from an accredited school. Beyond that physician assistants must pass the Physician assistant National Certifying Exam and also complete ongoing continued education classes to retain their license. A doctor’s education and training requirements will take several years. Similar to a physician assistant a doctor must obtain a four-year undergraduate degree from a medical school. After doctors complete their undergraduate degree they must then complete another two years of education to obtain their medical degree. Following the completion of a medical degree a doctor must complete three to seven years of residency training. Once a doctor completes his residency and becomes board certified he can then begin to practice medicine.
The second major difference between doctors and physician assistants are their job functions. All physician assistants are required to work under a doctor’s supervision even though a physician assistant is classified as a medical professional. The physician assistant will work with doctors and share the responsibility for patient care. The overall scope of any physician assistant job duties includes taking patient’s medical history, developing and implementing treatment plans, diagnose illnesses, examining patients, stitching open wounds, and counseling for patients about healthcare plans. All of these job duties and other aspects of the job tend to overlap with the job duties of actual doctors. Exceptions include any major type of medical care such as a surgery. Any time a doctor performs a surgery a physician assistant may assist the doctor with the surgical procedure, but the physician assistant is not licensed to perform the surgery. An additional difference between doctors and physician assistants is that doctors are able to work independently without any form of supervision while all physician assistants are dependent on working under a doctor. Also another difference in job duties is the ability to write prescriptions. There are some legalities as far as physician assistants writing prescriptions and the laws surrounding these vary from state to state. There are some states that allow physician assistants to write prescriptions for their patients while other states have not made this allowance.
The third difference between doctors and physician assistants is of course salary. The salary difference between doctors and physician assistants vary from state to state and also depend on the healthcare setting, but for the most part there is a large difference in the pay scale. A doctor’s salary will vary on a variety of factors such as specialty, setting, state of employment, and other factors but on average the typical doctor salary can range from anywhere around $200,000 to $300,000 per year. Physician assistant salaries depend on those same factors as a doctor’s salary but on average they will earn a salary in a range of anywhere between $86,000 to a little over $100,000 per year.
Job Prospects and Demand
The job prospects are also a great benefit to becoming a physician assistant. Physician assistants are in extremely high demand and potentially always will be in high demand for several reasons. One large factor was the implementation of the Affordable Care Act by the Obama administration due to a widening shortage of primary care providers. The Affordable Care Act opened up new opportunities for physician assistants by reducing the number of hours required for resident training hours. This provided a remedy to the physician assistant shortage by spurring a 34% growth rate in the year 2006 alone. Over the next ten years the US Department of Labor has estimated an even larger growth rate of around 39% as physician assistants become an economical alternative to physicians for clinics. Most clinics actually prefer to hire a physician assistant as opposed to hiring a doctor, especially clinics that are not involved with any type of surgical procedures. The reason is because the cost of hiring a physician assistant is far cheaper than hiring a doctor and physician assistants can do most of the job duties a typical doctor would during an average day. Another reason that physician assistants are in such high demand is because physicians are typically extremely busy. Physicians are always looking to hire a physician assistant to provide care to their patients that do not require any form of critical care. Anyone interested in a medical career with a potential to earn a hefty salary and one that will always be in high demand, without having to spend an additional six to ten years in training and education, would benefit from pursuing a career as a physician assistant.