Physician assistant
From Wikipedia, the free encyclopedia
In the United States, Physician Assistants (PAs) are non-physician clinicians licensed to practice medicine with a physician's supervision. This supervision, in most cases, need not be direct or on site and many PAs practice in remote or underserved areas in satellite clinics. PAs can treat patients and, in 49 of the 50 states, prescribe medicine. In some states they carry a DEA number that gives them authority to prescribe controlled medications like narcotics. PAs in surgical practices also serve as first assistants in surgery. PAs provide medical services that are reimbursed under Medicare and third party insurances. Their scope of practice and autonomy are only limited by their precepting physicians comfort level and that PA's clinical experience, allowing PA's to work in any area of medicine, surgery or research. Where there is a physician, there can be a PA.
Worldwide, the PA concept is being explored in Canada<ref>MPhA Newsletter - page 7 talks about Clinical Assistants prescribing rights</ref>, where military PAs are gaining legislative changes allowing them to work in the civilian world after retirement; in England, where several U.S.-trained PAs are working in a pilot project [1]; Scotland, where a similar pilot project is in planning [2]; and in South Africa and the Netherlands, where a physician assistant training program is underway [3].
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[edit] Employment
Physician assistants held about 65,000 jobs in 2005. The number of jobs is greater than the number of practicing PAs because some hold two or more jobs. For example, some PAs work with a supervising physician, but also work in another practice, clinic, or hospital. According to the American Academy of Physician Assistants, there were about 58,665 certified PAs in clinical practice as of January 2006. Even though a few legacy programs confer an associates degree or just a certificate of completion, most programs now confer a masters degree, requiring a bachelors degree on entry; many more are seeking accreditation at the master's level.
According to the 2005 PA census from the American Academy of Physician Assistants, just over 56 percent of PAs worked in the offices and clinics of physicians, either allopathic or osteopathic. About 36 percent were employed by hospitals. The rest were mostly in public health clinics, nursing homes, schools, prisons, home health care agencies, and the United States Department of Veterans Affairs. According to the American Academy of Physician Assistants, about 17 percent of all PAs provide health care to rural communities and those with fewer than 20,000 residents, in which physicians may be in limited supply.
[edit] Education and certification
In 2006, there are more than -- 130 accredited PA programs in existence in the United States. They are all accredited by one body -- the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA). A majority of them are master's degree programs (MS,MPAS,MHS) (requiring GRE or MCAT for entry), but some are available as an undergraduate major as a bachelor's or associate's degree [4]. A number of these undergraduate programs are making a transition to graduate level training.
A Physician Assistant may use the post-nominal initials PA, RPA, PA-C or RPA-C, where the R indicates Registered and the C indicates "Certified." The "R" designation is unique to only a couple of states; most Physician Assistants use the PA-C. The certification is granted by one certifying body, the National Commission on Certification of Physician Assistants (NCCPA). Every two years, PAs must earn 100 CME hours and recertify successfully by taking the Physician Assistant National Recertifying Examination ensuring competant and safe professional medical practice.[5]
[edit] PA scope of practice
Physician assistants (or physician associates) practice medicine [6], perform medical histories and examinations, order treatments, diagnose acute and chronic illnesses, prescribe medication, interpret diagnostic tests, perform invasive and noninvasive procedures, refer patients to specialists when appropriate and first assist in surgery. The education of a physician assistant is a generalist approach, modeled after the medical school curriculum. PAs may practice in general medicine or any medical or surgical specialty. Due to their broad based medical education, PA's can change specialties and have the ability to work throughout their career in different medical/surgical specialties. According to the AAPA, PAs must always work under the supervision of a physician.[7] That supervision can be in person, telecommunication systems or other means deemed reliable.[8]
[edit] History of PAs
The Physician Assistant profession has its beginnings in the highly trained Hospital corpsmen of the Vietnam War era. Dr. Eugene Stead of the Duke University Medical Center in North Carolina put together the first class of PAs in 1965, to expand the availability of medical care in the face of a shortage of primary care physicians. For his first class, he selected former Navy corpsmen, who had received considerable medical training during their military service and during the war in Vietnam but who had no comparable civilian employment or equivalent. He based the curriculum of the PA program in part on his knowledge of the fast-track training of medical doctors during World War II.
[edit] External links
- The PA Forum
- American Academy of Physician Assistants (AAPA)
- National Commission on Certification of Physician Assistants (NCCPA)
- Physician Assistant Education Association (PAEA)
- Journal of the AAPA (JAAPA)
- AAPA info about PAs
- AAPA info about PAs in Spanish (en Español)
- ADVANCE for Physician Assistants journal
- Physician Assistant History Center (Duke University Medical Center Archives)
- United Kingdom Academy of Physician Assistants (UKAPA)
