Physician Assistants
Physician assistants, also known as P.A.s, are formally trained to diagnose and treat patients as directed by and under the supervision of a physician. P.A.s assume many of the duties physicians used to, allowing physicians to concentrate on more complex tasks with their patients. P.A.s usually practice in primary care, such as family practice, pediatrics, mental health, internal medicine, or geriatrics. They can work in surgical specialties where they perform pre- and post-op care, or may serve as first or second assistants in the OR.
Duties, Activities, and Scope of Practice
P.A.s perform physical examinations, take medical histories, and diagnose and treat illnesses and injuries. They can apply casts and splints, suture wounds, order diagnostic tests, and educate and counsel patients in treatments and preventative care as delegated by the physician. They can make house calls and check up on patients in hospitals and skilled-nursing facilities and report back to the physician.
Education and Training
The P.A. program is about two years. Applicants are required to have completed a minimum of two years of college and have some health care experience. Most applicants have a bachelor's degree, and many a master's degree. Many have backgrounds as an R.N.. Undergraduate requirements include biology, chemistry, English, math, psychology, and social sciences.
ssential
A P.A.'s duties are determined by state law and the supervising physician. In rural areas or some clinics, especially in inner cities, P.A.s may be the principal care provider in situations where the supervising physician is only physically present a few days each week but is available by phone for consultation.
The P.A. program includes biochemistry, pharmacology, microbiology, anatomy and physiology, clinical medicine, geriatrics, home health care, medical ethics, and disease prevention. Clinical training is supervised and includes rotations through geriatrics, obstetrics, emergency medicine, primary care, mental health, surgery, and pediatrics.
Additional training and residency programs are available for those who seek added responsibilities and advancement.
Licensure/Certification
Upon completion of an accredited P.A. program, all states and the District of Columbia require P.A.s to pass the Physicians' Assistants National Certifying Examination, which is administered by the National Commission on Certification of Physician Assistants (NCCPA). In order to remain certified, P.A.s must complete 100 hours of continuing education every two years. Additionally, every six years they must pass a recertification exam or an alternative program, which consists of additional training and a take-home exam.
Work Settings and Salaries
Today, about one-third of P.A.s work in rural settings and towns with populations under 50,000. Almost half work in cities with populations over 500,000. Most work in clinics and M.D. offices with physicians in primary or family practice. However, P.A.s can work in any specialty alongside physicians who supervise and delegate their work. P.A.s also work in such settings as hospitals, prisons, nursing homes, and student health care services. Many help to meet the needs of underserved areas.
The normal workweek is forty to forty five hours and often includes working evening and weekend on-call hours to meet the needs of patients.
The U.S. Department of Labor reports that the median salary for 2004 was $69,410. The Academy of Physician Assistants reports a median income of $74,264 for 2004 for P.A.s in full-time clinical practice.
Career Potential and Additional Information
The first P.A. program was started in 1965 at Duke University. Many medics returning from Vietnam seeking employment in the medical field influenced the formation of this profession. Only recently did Medicare begin to allow reimbursement for P.A. visits and care. This, along with the acceptance of P.A.s by the general public, and recognition of the cost-effectiveness of P.A.s by insurance companies and HMOs, has caused the profession to grow rapidly. An expected 50 percent increase in positions for P.A.s over the next decade is possibly a conservative estimate.
An aging population will present many new and increased demands for health care, and recognition of the cost-effectiveness of P.A.s will represent one solution to the rising costs and help to meet the demands.
For further information about physician assistant careers and programs, contact the American Academy of Physician Assistants. Their Web site is
