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General
Information
Q.
What is a Physician Assistant (P.A.)?
A.
Physician assistants are health care professionals
licensed to practice medicine with physician supervision.
PAs employed by the federal government are credentialed
to practice. As part of their comprehensive responsibilities,
PAs conduct physical exams, diagnose and treat illnesses,
order and interpret tests, counsel on preventive
health care, assist in surgery, and in most states
can write prescriptions.
PAs
are trained in intensive education programs
accredited by the Accreditation
Review Commission on Education for the Physician
Assistant (ARC-PA) .
Because
of the close working relationship the PAs have with
physicians, PAs are educated in the medical model
designed to complement physician training. Upon
graduation, physician assistants take a national
certification examination developed by the National
Commission on Certification of PAs in conjunction
with the National Board of Medical Examiners. To
maintain their national certification, PAs must
log 100 hours of continuing medical education every
two years and sit for a recertification every six
years. Graduation from an accredited physician assistant
program and passage of the national certifying exam
are required for state licensure.
Q.
How did the Physician Assistant profession begin?
A.
In the mid-1960s, physicians and educators recognized
there was a shortage and uneven distribution of
primary care physicians. To expand the delivery
of quality medical care, Dr. Eugene Stead of the
Duke University Medical Center in North Carolina
put together the first class of PAs in 1965. He
selected Navy corpsmen who received considerable
medical training during their military service and
during the war in Vietnam but who had no comparable
civilian employment. He based the curriculum of
the PA program in part on his knowledge of the fast-track
training of doctors during World War II.
Q.
What does "PA-C" stand for? What does the "C" mean?
A.
Physician assistant-certified. It means that the
person who holds the title has met the defined course
of study and has undergone testing by the National
Commission on Certification of Physician Assistants
(NCCPA). The NCCPA is an independent organization,
and the commissioners represent a number of different
medical professions. It is not a part of the PA
professional organization, the American Academy
of Physician Assistants (AAPA). To
maintain that "C" after "PA", a physician assistant
must log 100 hours of continuing medical education
every two years and take the recertification exam
every six years.
PA
Education
Q.
How is a Physician Assistant educated?
A.
Physician assistants are educated in intensive medical
programs accredited by the Accreditation
Review Commission on Education for the Physician
Assistant (ARC-PA). The average PA program curriculum
runs approximately 26 months. There are currently
more than 130 accredited programs.
All PA programs must meet the same ARC-PA standards.
Because
of the close working relationship PAs have with
physicians, PAs are educated in a medical model
designed to complement physician training. PA students
are taught, as are medical students, to diagnose
and treat medical problems.
Education
consists of classroom and laboratory instruction
in the basic medical and behavioral sciences (such
as anatomy, pharmacology, pathophysiology, clinical
medicine, and physical diagnosis), followed by clinical
rotations in internal medicine, family medicine,
surgery, pediatrics, obstetrics and gynecology,
emergency medicine, and geriatric medicine.
A
PA's education doesn't stop after graduation, though.
PAs are required to take ongoing continuing medical
education classes and be retested on their clinical
skills on a regular basis. A number of postgraduate
PA programs have also been established to provide
practicing PAs with advanced education in medical
specialties.
Q.
What are the prerequisites for applying to a PA
program?
A.
PA programs look for students who have a desire
to study, work hard, and to be of service to their
community. Most physician assistant programs require
applicants to have previous health care experienceand
some college education. The typical applicant already
has a bachelor's degree and approximately 4 years
of health care experience. Commonly nurses, EMTs,
and paramedics apply to PA programs. Check with
PA educational programs
of interest to you for a list of their prerequisites.
Scope
of Practice
Q.
What areas of medicine can Physician Assistants
work in?
A.
Physician assistants (PAs) are found in all areas
of medicine. They practice in the areas of primary
care medicine - that is family medicine, internal
medicine, pediatrics, and obstetrics and gynecology
-- as well in surgery and the surgical subspecialties.
Physician
assistants receive a broad education in medicine.
Their education is ongoing after graduation through
continuing medical education requirements and continual
interaction with physicians and other health care
providers.
Q.
Where do PAs "draw the line" as far as what they
can treat and what a physician can treat?
A.
What a physician assistant does varies with training,
experience, and state law. In addition, the scope
of the PA's practice corresponds to the supervising
physician's practice. In general, a physician assistant
will see many of the same types of patients as the
physician. The cases handled by physicians are generally
the more complicated medical cases or those cases
which require care that is not a routine part of
the PA's scope of work. Referral to the physician,
or close consultation between the patient-PA-physician,
is done for unusual or hard to manage cases. Physician
assistants are taught to "know our limits" and refer
to physicians appropriately. It is an important
part of PA training.
Q.
Can PAs prescribe medications?
A.
Forty-seven states, the District of Columbia, and
Guam have enacted laws
that authorize PA prescribing. PAs in
Arkansas and Illinois have statutory authority to
prescribe and will be able to write prescriptions
as soon as rules are adopted. (Arkansas and Illinois
are included in the 47 states.) In California,
PA prescriptions are referred to as written prescription
transmittal orders.
Physicians
and PAs
Q.
What do physicians think about Physician Assistants?
A.
Most physicians who have worked with physician assistants
like having PAs on staff. The American Medical Association,
the American College of Surgeons, the American Academy
of Family Physicians, the American College of Physicians,
and other national medical organizations support
the physician assistant profession by actively supporting
the PA certifying commission and the PA program
accrediting agency.
Studies
done by the Federal Government have shown that PAs,
working with the supervision of physicians, provide
care that is comparable to physician care. The Eighth
Report to the President and Congress on the Status
of Health Personnel in the United States (released
in 1992) states, "Physician assistants have demonstrated
their clinical effectiveness both in terms of quality
of care and patient acceptance."
Q.
What is the working relationship between a physician
and a physician assistant?
A.
The relationship between a PA and the supervising
physician is one of mutual trust and respect. The
physician assistant is a representative of the physician,
treating the patient in the style and manner developed
and directed by the supervising physician. The physician
and PA practice as members
of a medical team. In 1995, the American Medical
Association developed suggested guidelines for how
physicians and PAs should work as a team in the
delivery of medical care.
Suggested Guidelines for Physician-Physician
Assistant Practice
Adopted
by the AMA House of Delegates, June 1995
Reflecting
the comments from the American Academy of Physician
Assistants, separate model guidelines for Physician/Physician
Assistants practice have been developed. These are
based on the unique relationship of Physician Assistants
who recognize themselves as agents of physicians
with respect to delegated medical acts, and legal
responsibilities. They are consistent with the existing
AMA policies concerning Physician Assistants cited
in this report. In all settings, Physician Assistants
recognize physician supervision in the delivery
of patient care. The suggested guidelines reflect
those as follows:
- Health
care services delivered by physicians and Physician
Assistants must be within the scope of each practitioners
authorized practice as defined by state law.
- The
physician is ultimately responsible for coordinating
and managing the care of patients and, with the
appropriate input of the Physician Assistant,
ensuring the quality of health care provided to
patients.
- The
physician is responsible for the supervision of
the Physician Assistant in all settings.
- The
role of the Physician Assistant(s) in the delivery
of care should be defined through mutually agreed
upon guidelines that are developed by the physician
and the Physician Assistant and based on the physician's
delegatory style.
- The
physician must be available for consultation with
the Physician Assistant at all times either in
person or through telecommunication systems or
other means.
- The
extent of the involvement by the Physician Assistant
in the assessment and implementation of treatment
will depend on the complexity and acuity of the
patient's condition and the training and experience
and preparation of the Physician Assistant as
adjudged by the physician.
- Patients
should be made clearly aware at all times whether
they are being cared for by a physician or a Physician
Assistant.
- The
physician and Physician Assistant together should
review all delegated patient services on a regular
basis, as well as the mutually agreed upon guidelines
for practice.
- The
physician is responsible for clarifying and familiarizing
the Physician Assistant with his supervising methods
and style of delegating patient care.
Q.
What's the difference between a PA and a physician?
A.
Physician assistants are educated in the "medical
model"; in some schools they attend many of the
same classes as medical students.
One
of the main differences between PA education and
physician education is not the core content of the
curriculum, but the amount of time spent in formal
educationl. In addition to time in school, physicians
are required to do an internship, and the majority
also complete a residency in a specialty following
that. PAs do not have to undertake an internship
or residency.
A
physician has complete responsibility for the care
of the patient. PAs share that responsibility with
the supervising physicians.
PA
Organizatons
Q.
What is the American Academy of Physician Assistants
(AAPA)?
A.
The AAPA
is the only national professional society to represent
all physician assistants in every area of medicine.
Founded in 1968, the academy has a federated structure
of 57
chartered chapters representing PAs in all 50
states, the District of Columbia, Guam, and the
federal services.
AAPA's
mission is to provide quality, cost-effective, and
accessible health care as well as to support the
professional and personal development of PAs. The
AAPA pursues these goals through government
relations and public education programs, research
and data collection efforts, and continuing
education activities.
The
Academy's policies are set by the House of Delegates,
which meets once a year, and implemented by the
Board
of Directors. The House of Delegates is made
up of representatives from the chartered chapters,
specialty organizations, the Student Academy, and
the Association of PA Programs. Member projects
and activities are assisted by the AAPA
staff. A calendar
of upcoming AAPA events is available on this Web
site.
Q.
What is the Physician Assistant Foundation?
A.
As the philanthropic arm of the American Academy
of Physician Assistants, the Physician Assistant
Foundation's mission is to foster education and
research that enhance the delivery of quality health
care. Related to this mission are the Foundation's
goals to increase the understanding of the physician
assistant profession and to develop and promote
philanthropic activities. Learn more about the PA
Foundation on this Web site.
Q.
What is the Association
of Physician Assistant Programs (APAP) ?
A.
APAP is a national organization whose members
are thePA programs and individual PA educators.
It includes representation from accredited programs
and programs going through the accreditation process.
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