Where, how, and whom do PAs serve?

Physician assistants (PAs) are found in all areas of medicine. Today, over 50% of all PAs practice what is known as “primary care medicine” –family medicine, internal medicine, pediatrics, and obstetrics and gynecology. About 19% are in surgery or surgical subspecialties. PAs also work in all varieties of work settings–private practices, hospitals, managed care organizations. Wherever quality health care is needed, you will find a PA.

PAs are health care professionals licensed to practice medicine with physician supervision. PAs employed by the federal government are credentialed to practice. Common services provided by a PA include taking medical histories and performing physical examinations; ordering and interpreting lab tests; diagnosing and treating illnesses; assisting in surgery; prescribing and/or dispensing medication; and counseling patients.

What a PA does varies with training, experience, and state law. The scope of the PA’s practice also corresponds to the supervising physician’s practice. In general, a PA 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.

PAs can prescribe medications in 49 states. The District of Columbia and Guam have also enacted laws that authorize PA prescribing.

How did the PA profession begin?

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.

What kind of educational training do PAs receive?

PAs are educated in intensive medical programs accredited by The Accreditation Review Commission on Education for the Physician Assistant, Inc. (ARC-PA). The ARC-PA is recognized by the Council for Higher Education Accreditation (CHEA).The typical PA program is 24-27 months long and requires at least two years of college and some health care experience prior to admission. The majority of students have a BA/BS degree and just under 40 months of health care experience before admission to a PA program. While all programs recognize the professional component of PA education with a document of completion for the professional credential (PA), 98% of the programs award a master’s degree.

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.

There are currently 234 accredited programs in the U.S. All PA programs must meet the same curriculum standards.

A PA’s education doesn’t stop after graduation. 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.

For more information, read the National Governors Association article: “The Role of Physician Assistants in Health Care Delivery“