Physician assistants (PAs) practice medicine under the supervision of physicians and surgeons. They should not be confused with medical assistants, who perform routine clinical and clerical tasks. PAs are formally trained to provide diagnostic, therapeutic, and preventive healthcare services, as delegated by a physician. Working as members of a healthcare team, they take medical histories, examine and treat patients, order and interpret laboratory tests and x rays, and make diagnoses. They also treat minor injuries by suturing, splinting, and casting. PAs record progress notes, instruct and counsel patients, and order or carry out therapy. Physician assistants also may prescribe certain medications. In some establishments, a PA is responsible for managerial duties, such as ordering medical supplies or equipment and supervising medical technicians and assistants.
Physician assistants work under the supervision of a physician. However, PAs may be the principal care providers in rural or inner-city clinics where a physician is present for only 1 or 2 days each week. In such cases, the PA confers with the supervising physician and other medical professionals as needed and as required by law. PAs also may make house calls or go to hospitals and nursing care facilities to check on patients, after which they report back to the physician.
The duties of physician assistants are determined by the supervising physician and by State law. Aspiring PAs should investigate the laws and regulations in the States in which they wish to practice.
Many PAs work in primary care specialties, such as general internal medicine, pediatrics, and family medicine. Other specialty areas include general and thoracic surgery, emergency medicine, orthopedics, and geriatrics. PAs specializing in surgery provide preoperative and postoperative care and may work as first or second assistants during major surgery.
Although PAs usually work in a comfortable, well-lighted environment, those in surgery often stand for long periods. At times, the job requires a considerable amount of walking.
PA’s work schedules may vary according to the practice setting and often depend on the hours of the supervising physician. The workweek of hospital-based PAs may include weekends, nights, or early morning hospital rounds to visit patients. These workers also may be on call. PAs in clinics usually work about a 40-hour week.
Education & Training Required
Physician assistant educational programs usually take at least 2 years to complete for full-time students. Most programs are at schools of allied health, academic health centers, medical schools, or 4-year colleges; a few are at community colleges, are part of the military, or are at hospitals. Many accredited PA programs have clinical teaching affiliations with medical schools.
In 2008, 142 education programs for physician assistants were accredited or provisionally accredited by the Accreditation Review Commission on Education for the Physician Assistant. Eighty percent, or 113, of these programs offered the option of a master's degree, 21 of them offered a bachelor's degree, 3 awarded associate degrees, and 5 awarded a certificate.
Most applicants to PA educational programs already have a college degree and some health-related work experience; however, admissions requirements vary from program to program. Many PAs have prior experience as registered nurses, emergency medical technicians, and paramedics.
PA education includes classroom and laboratory instruction in subjects like biochemistry, pathology, human anatomy, physiology, clinical pharmacology, clinical medicine, physical diagnosis, and medical ethics. PA programs also include supervised clinical training in several areas, including family medicine, internal medicine, surgery, prenatal care and gynecology, geriatrics, emergency medicine, and pediatrics. Sometimes, PA students serve in one or more of these areas under the supervision of a physician who is seeking to hire a PA. The rotation may lead to permanent employment in one of the areas where the student works.
Certifications Needed (Licensure)
All States and the District of Columbia have legislation governing the practice of physician assistants. All jurisdictions require physician assistants to pass the Physician Assistant National Certifying Examination, administered by the National Commission on Certification of Physician Assistants (NCCPA) and open only to graduates of accredited PA education programs. Only those who have successfully completed the examination may use the credential “Physician Assistant-Certified.” To remain certified, PAs must complete 100 hours of continuing medical education every 2 years. Every 6 years, they must pass a recertification examination or complete an alternative program combining learning experiences and a take-home examination.
Other Skills Required (Other qualifications)
Physician assistants must have a desire to serve patients and be self-motivated. PAs also must have a good bedside manner, emotional stability, and the ability to make decisions in emergencies. Physician assistants should have an enthusiasm for lifelong learning, because their eligibility to practice depends on continuing education.
Physician Assistants - What They Do - Page 2