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In the [[United States]], a '''physician assistant''' '''(PA)''' is an advanced practice clinician licensed to practice [[medicine]] with the supervision of a licensed [[physician]].<ref>[http://www.aapa.org/geninfo1.html "Information About PAs and the PA Profession" - American Academy of Physician Assistants (AAPA)]</ref> PAs are not to be confused with [[medical assistant]]s, who perform administrative and clinical tasks in [[hospital]]s and [[clinic]]s under the direct supervision of physicians, [[registered nurses]], [[nurse practitioners]], or PAs. |
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Physician assistants exercise autonomy in medical decision making as determined by their supervising physician. Physician assistants are educated in the medical model designed to complement physician training. Physician assistants are not to be confused with [[medical assistant]]s, who perform administrative and simple clinical tasks with limited college-level education in [[hospital]]s and [[clinic]]s under the direct supervision of [[physicians]], [[registered nurses]], [[nurse practitioners]], or physician assistants. |
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The profession is represented in the [[United States]] by the [[American Academy of Physician Assistants]]. |
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==History of the profession== |
==History of the profession== |
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==Education and certification== |
==Education and certification== |
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As of May 2008, there were |
As of May 2008, there were 141 accredited PA programs in the United States <ref>[http://www.arc-pa.org/Acc_Programs/acc_programs.html "Accredited Entry-level Programs" (6/30/2008) - Accreditation Review Commission on Education for the Physician Assistant (ARC-PA)]</ref>. The majority are [[Postgraduate education|graduate programs]] leading to the award of [[master's degree]]s in either Physician Assistant Studies ([[Master of Physician Assistant Studies|MPAS]]), Health Science ([[Master of Health Science|MHS]]), or Medical Science (MMSc), and require a [[bachelor's degree]] and [[Graduate Record Examination|GRE]] or [[Medical College Admission Test|MCAT]] scores for entry. Some PA programs are starting to offer a clinical doctorate degree; Doctor of Science Physician Assistant (DScPA), while a remaining few still lead to the award of an [[Undergraduate education|undergraduate]] [[bachelor's degree|bachelor's]] or [[associate's degree]], but many of these are transitioning to graduate-level training. Professional licensure is regulated by the state medical board. |
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PA education is based on the medical school model <ref>[http://www.aapa.org/gandp/issuebrief/education.pdf "Issue Brief - Physician Assistant Education: Preparation for Excellence" - AAPA]</ref>, although unlike medical school which lasts four years, PA training is usually 2 to 3 years in duration. It is generalist in approach, consisting of classroom and laboratory instruction in medical and behavioral sciences, such as anatomy, microbiology, pharmacology, pathophysiology, hematology, pathology, clinical medicine, and physical diagnosis, followed by clinical rotations in internal medicine, family medicine, surgery, pediatrics, obstetrics and gynecology, oncology, emergency medicine, and geriatric medicine, as well as elective rotations. Unlike physicians, who must complete a minimum of three years of residency after completion of medical schools, PAs are not required to complete such residencies. Despite this, there are residency programs in certain specialties for PAs who choose to continue formal education in such a format.<ref>[http://www.appap.org/index1.html The Association of Postgraduate PA Programs (APPAP)]</ref> |
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A |
A PA may use the [[post-nominal]] initials "PA", "PA-C", "APA-C", "RPA" or "RPA-C", where the "-C" indicates "Certified" and the "R" indicates "Registered." The "R" designation is unique to a few states, mainly in the [[Northeastern United States|Northeast]]; The "A" indicates completion of the Army Flight Surgeon Course. Most PAs use "PA-C". During training, PA students are designated PA-S. The use of "PA-C" is limited only to those PAs currently certified and in compliance with the regulations of the national certifying organization, the [http://www.nccpa.net National Commission on Certification of Physician Assistants] (NCCPA). |
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A graduate from an accredited PA program must pass the NCCPA-administered Physician Assistant National Certifying Exam (PANCE) before becoming a PA-C; this certification is required for licensure in all states.<ref>[http://www.nccpa.net/EX_pance.aspx "Physician Assistant National Certifying Exam (PANCE)" - National Commission on Certification of Physician Assistants (NCCPA)]</ref> In addition, a PA must earn and log 100 [[Continuing medical education|Continuing Medical Education]] (CME) hours and reregister his or her certificate with the NCCPA every two years. Every six years, a PA must also recertify by successfully completing either the Physician Assistant National Recertifying Exam (PANRE) or Pathway II exam.<ref>[http://www.nccpa.net/EX_panre.aspx "Physician Assistant National Recertifying Exam (PANRE)" - NCCPA]</ref><ref>[http://www.nccpa.net/EX_pathway.aspx "Pathway II" - NCCPA]</ref> |
A graduate from an accredited PA program must pass the NCCPA-administered Physician Assistant National Certifying Exam (PANCE) before becoming a PA-C; this certification is required for licensure in all states.<ref>[http://www.nccpa.net/EX_pance.aspx "Physician Assistant National Certifying Exam (PANCE)" - National Commission on Certification of Physician Assistants (NCCPA)]</ref> In addition, a PA must earn and log 100 [[Continuing medical education|Continuing Medical Education]] (CME) hours and reregister his or her certificate with the NCCPA every two years. Every six years, a PA must also recertify by successfully completing either the Physician Assistant National Recertifying Exam (PANRE) or Pathway II exam.<ref>[http://www.nccpa.net/EX_panre.aspx "Physician Assistant National Recertifying Exam (PANRE)" - NCCPA]</ref><ref>[http://www.nccpa.net/EX_pathway.aspx "Pathway II" - NCCPA]</ref> |
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==Scope of practice== |
==Scope of practice== |
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PAs are |
PAs are advanced practice clinicians, and obtain medical histories, perform examinations and procedures, order treatments, diagnose illnesses, prescribe medication, order and interpret diagnostic tests, refer patients to specialists when appropriate and first-assist in surgery. They are employed in primary care or in specialties in urban or rural regions, as well as in academic administration. PAs may practice in any medical or surgical specialty, and have the ability to move to different medical and surgical fields during their careers. |
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PAs are licensed to practice medicine with physician supervision, which may be either in person, by [[telecommunication|telecommunication systems]] or by other reliable means (for example, regular chart review and consultation). The physician supervision, in most cases, need not be direct or on-site, and many PAs practice in remote or underserved areas in satellite clinics. |
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All states, as well as the District of Columbia, Guam, the United States Virgin Islands, and the Commonwealth of the Northern Mariana Islands, have laws or regulations authorizing physician assistants to practice medicine. PAs may also prescribe [[medications]] in all of these locations; those who prescribe [[Controlled Substances Act|controlled medications]] in their scope of practice must also have a [[Drug Enforcement Administration#Narcotics registration|DEA number]].<ref>[http://www.aapa.org/gandp/rxchart.html "Where Physician Assistants Are Authorized To Prescribe" - AAPA]</ref> |
All states, as well as the District of Columbia, Guam, the United States Virgin Islands, and the Commonwealth of the Northern Mariana Islands, have laws or regulations authorizing physician assistants to practice medicine. PAs may also prescribe [[medications]] in all of these locations; those who prescribe [[Controlled Substances Act|controlled medications]] in their scope of practice must also have a [[Drug Enforcement Administration#Narcotics registration|DEA number]].<ref>[http://www.aapa.org/gandp/rxchart.html "Where Physician Assistants Are Authorized To Prescribe" - AAPA]</ref> |
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According to the AAPA, there were an estimated 68,124 PAs in clinical practice as of January 2008. |
According to the AAPA, there were an estimated 68,124 PAs in clinical practice as of January 2008. |
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In the 2008 AAPA census, 56 percent of responding PAs worked in physicians' offices or clinics and 24 percent were employed by [[hospital]]s.<ref>[http://www.aapa.org/research/Highlights08/2008AAPACensusNationalReport.pdf 2008 AAPA Physician Assistant Census Report.] page 2.</ref> The remainder were employed in [[public health]] clinics, nursing homes, schools, prisons, home [[health care]] agencies, and the [[United States Department of Veterans Affairs]].<ref> [http://www.aapa.org/research/Highlights08/2008AAPACensusNationalReport.pdf 2008 AAPA Physician Assistant Census Report.] Table 3.4: Number and Percent Distribution of Clinically Practicing Respondents by Primary Work Setting</ref> Fifteen percent of responding PAs work in counties classified as non-metropolitan by Economic Research Service of the [[United States Department of Agriculture]];<ref>[http://www.aapa.org/research/Highlights08/2008AAPACensusNationalReport.pdf 2008 AAPA Physician Assistant Census Report.] Table 3.13: Number and Percent Distribution of Clinically Practicing Respondents by Metropolitan Status and Degree of Rurality of County of Primary Work Site</ref> approximately 17% of the US population resides in these [[County (United States)|counties]].<ref> |
In the 2008 AAPA census, 56 percent of responding PAs worked in physicians' offices or clinics and 24 percent were employed by [[hospital]]s.<ref>[http://www.aapa.org/research/Highlights08/2008AAPACensusNationalReport.pdf 2008 AAPA Physician Assistant Census Report.] page 2.</ref> The remainder were employed in [[public health]] clinics, nursing homes, schools, prisons, home [[health care]] agencies, and the [[United States Department of Veterans Affairs]].<ref> [http://www.aapa.org/research/Highlights08/2008AAPACensusNationalReport.pdf 2008 AAPA Physician Assistant Census Report.] Table 3.4: Number and Percent Distribution of Clinically Practicing Respondents by Primary Work Setting</ref> Fifteen percent of responding PAs work in counties classified as non-metropolitan by Economic Research Service of the [[United States Department of Agriculture]];<ref>[http://www.aapa.org/research/Highlights08/2008AAPACensusNationalReport.pdf 2008 AAPA Physician Assistant Census Report.] Table 3.13: Number and Percent Distribution of Clinically Practicing Respondents by Metropolitan Status and Degree of Rurality of County of Primary Work Site</ref> approximately 17% of the US population resides in these [[County (United States)|counties]].<ref>http://www.ers.usda.gov/Briefing/Rurality/RuralUrbCon/</ref> |
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The U.S. Department of Labor Bureau of Labor Statistics report on PAs states, "...Employment of physician assistants is expected to grow 27 percent from 2006 to 2016, much faster than the average for all occupations..."<ref>[http://www.bls.gov/oco/ocos081.htm#outlook "Physician Assistants" - U.S. Department of Labor Bureau of Labor Statistics]</ref> This is due to several factors, including an expanding health care industry, an aging [[baby boomer|baby-boomer]] population, concerns for cost containment, and newly-implemented restrictions to shorten physician [[Residency (medicine)|resident]] work hours. |
The U.S. Department of Labor Bureau of Labor Statistics report on PAs states, "...Employment of physician assistants is expected to grow 27 percent from 2006 to 2016, much faster than the average for all occupations..."<ref>[http://www.bls.gov/oco/ocos081.htm#outlook "Physician Assistants" - U.S. Department of Labor Bureau of Labor Statistics]</ref> This is due to several factors, including an expanding health care industry, an aging [[baby boomer|baby-boomer]] population, concerns for cost containment, and newly-implemented restrictions to shorten physician [[Residency (medicine)|resident]] work hours. |
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PAs in primary care practice can purchase $100,000-$300,000 [[insurance]] premiums for less than $600 a year. PAs [[malpractice]] coverage are higher in greater risk specialties.<ref>[http://medicaleconomics.modernmedicine.com/memag/Medical+Malpractice:+Insurance/Malpractice-Consult-Liability-insurance-for-a-phys/ArticleStandard/Article/detail/118626 |
PAs in primary care practice can purchase $100,000-$300,000 [[insurance]] premiums for less than $600 a year. PAs [[malpractice]] coverage are higher in greater risk specialties.<ref>[http://medicaleconomics.modernmedicine.com/memag/Medical+Malpractice:+Insurance/Malpractice-Consult-Liability-insurance-for-a-phys/ArticleStandard/Article/detail/118626]</ref> |
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''Money'' Magazine, in conjunction with Salary.com, listed the PA profession as the "fifth best job in America" in May of 2006, based both on salary and job prospects, and on an anticipated 10-year job growth of 49.65%.<ref>[http://money.cnn.com/magazines/moneymag/moneymag_archive/2006/05/01/8375749/index.htm "50 Best Jobs in America" (May 1, 2006) - CNN/Money.com]</ref> According to the American Academy of Physician Assistants (AAPA), in 2008 the mean total income for physician assistants working at least 32 hours per week was $89,987.<ref>[http://www.aapa.org/glance.html "Facts At A Glance" (March 24, 2008) - AAPA]</ref> Physician assistants in |
''Money'' Magazine, in conjunction with Salary.com, listed the PA profession as the "fifth best job in America" in May of 2006, based both on salary and job prospects, and on an anticipated 10-year job growth of 49.65%.<ref>[http://money.cnn.com/magazines/moneymag/moneymag_archive/2006/05/01/8375749/index.htm "50 Best Jobs in America" (May 1, 2006) - CNN/Money.com]</ref> According to the American Academy of Physician Assistants (AAPA), in 2008 the mean total income for physician assistants working at least 32 hours per week was $89,987.<ref>[http://www.aapa.org/glance.html "Facts At A Glance" (March 24, 2008) - AAPA]</ref> Physician assistants in dermatology or surgical subspecialties can earn $100,000-$200,000, with the mean total income for PAs working at least 32 hours per week in cardiovascular/cardiothoracic surgery listed as $110,468 for 2008. <ref>[http://physician-assistant.advanceweb.com/editorial/content/editorial.aspx?cc=188720 2008 AAPA Physician Assistant Census Report - Specialty Reports]</ref> |
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==International== |
==International== |
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===Australia=== |
===Australia=== |
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Two |
Two educational programs in [[Australia]] are also planned to start in 2009, at the [[University of Queensland]] and [[James Cook University]]. |
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===Canada=== |
===Canada=== |
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===England=== |
===England=== |
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In [[England]], U.S.-trained PAs are working in a pilot project in Sandwell and West Birmingham.<ref>[http://www.hsmc.bham.ac.uk/publications/pdf-reports/Physician%20Assistant%20final%20report.pdf "Evaluation of US-trained Physician Assistants Working in the NHS in England" - University of Birmingham]</ref> Education programs are now being offered by four universities: [[University of Birmingham]], [[University of Wolverhampton]], [[University of Hertfordshire]] (operating as Bedfordshire and Hertfordshire Postgraduate Medical School, in conjunction with the [[University of Bedfordshire]]), and [[St George's, University of London]]. The [[University of Warwick]] and [[University of Coventry]] have also explored offering these programs, but did not implement them due to a lack of need. However, the NHS trusts in the |
In [[England]], U.S.-trained PAs are working in a pilot project in Sandwell and West Birmingham.<ref>[http://www.hsmc.bham.ac.uk/publications/pdf-reports/Physician%20Assistant%20final%20report.pdf "Evaluation of US-trained Physician Assistants Working in the NHS in England" - University of Birmingham]</ref> Education programs are now being offered by four universities: [[University of Birmingham]], [[University of Wolverhampton]], [[University of Hertfordshire]] (operating as Bedfordshire and Hertfordshire Postgraduate Medical School, in conjunction with the [[University of Bedfordshire]]), and [[St George's, University of London]]. The [[University of Warwick]] and [[University of Coventry]] have also explored offering these programs, but did not implement them due to a lack of need. However, the NHS trusts in the West Midland's are currently forcasting a large scale need. |
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Also formally referred to as "Medical Care Practitioners", PAs are to be employed by the [[National Health Service]]. Though currently not a registered profession, PAs can currently practice under delegation rules and it is expected that the required legislation will be taken before Parliament with the UK's General Medical Council expected to become the registering body. Programs are 24 months in length and are a Post-Graduate Diploma with the option of "topping up" to a Master's degree either by full or part-time study. |
Also formally referred to as "Medical Care Practitioners", PAs are to be employed by the [[National Health Service]]. Though currently not a registered profession, PAs can currently practice under delegation rules and it is expected that the required legislation will be taken before Parliament with the UK's General Medical Council expected to become the registering body. Programs are 24 months in length and are a Post-Graduate Diploma with the option of "topping up" to a Master's degree either by full or part-time study.[http://www.herts.ac.uk/courses/Physician-Assistant-Studiespg.cfm] Training is in the areas of General Medicine (including Emergency/Medical Assesment Units), Emergency Medicine (A&E) and General Practice. |
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The interests of PAs in the UK are currently being looked after by the UK Association of Physcian Assistants. |
The interests of PAs in the UK are currently being looked after by the UK Association of Physcian Assistants. [http://www.ukapa.co.uk/ |
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] |
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===Netherlands=== |
===Netherlands=== |
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===South Africa=== |
===South Africa=== |
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One program is now offered in South Africa at the [[University of Witwatersrand]]. |
One program is now offered in South Africa, at the [[University of Witwatersrand]]. |
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===United States=== |
===United States=== |
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[[United States Army|U.S. Army]] PAs typically serve as [[Medical Specialist Corps]] [[Officer (armed forces)|officer]]s within Army combat or combat support [[battalion]]s located in the continental [[US]], [[Alaska]], [[Hawaii]] and overseas.<ref>[http://www.usarec.army.mil/armypa U.S. Army PA Information]</ref> These include [[infantry]], [[armor]], [[cavalry]], [[airborne]], [[artillery]] and (if the PA qualifies) [[Special Forces]] units. They serve as the "front line" of Army medicine and along with [[combat medic]]s are responsible for the total health care of soldiers assigned to their unit, as well as of their family members. |
[[United States Army|U.S. Army]] PAs typically serve as [[Medical Specialist Corps]] [[Officer (armed forces)|officer]]s within Army combat or combat support [[battalion]]s located in the continental [[US]], [[Alaska]], [[Hawaii]] and overseas.<ref>[http://www.usarec.army.mil/armypa U.S. Army PA Information]</ref> These include [[infantry]], [[armor]], [[cavalry]], [[airborne]], [[artillery]] and (if the PA qualifies) [[Special Forces]] units. They serve as the "front line" of Army medicine and along with [[combat medic]]s are responsible for the total health care of soldiers assigned to their unit, as well as of their family members. |
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PAs also serve in the [[United States Air Force|Air Force]] and [[United States Navy|Navy]] as clinical practitioners and [[aviation medicine]] specialists, as well as in the [[United States Coast Guard|Coast Guard]] and [[United States Public Health Service|Public Health Service]]. The skills required for these PAs are similar to that of their civilian colleagues, but additional training is provided in advanced casualty care, medical management of chemical injuries, [[aviation medicine]] |
PAs also serve in the [[United States Air Force|Air Force]] and [[United States Navy|Navy]] as clinical practitioners and [[aviation medicine]] specialists, as well as in the [[United States Coast Guard|Coast Guard]] and [[United States Public Health Service|Public Health Service]]. The skills required for these PAs are similar to that of their civilian colleagues, but additional training is provided in advanced casualty care, medical management of chemical injuries, [[aviation medicine]] as well as [[military medicine]]. In addition, military PAs are also required to meet the officer commissioning requirements and maintain the professional and physical readiness standards of their respective services. |
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==See also== |
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* [[Clinical officer]], a similar class of healthcare providers in [[East Africa]]. |
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* [[Nurse practitioner]] |
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==References== |
==References== |
Revision as of 16:41, 8 June 2009
In the United States, a physician assistant (PA) is an advanced practice clinician licensed to practice medicine with the supervision of a licensed physician.[1] PAs are not to be confused with medical assistants, who perform administrative and clinical tasks in hospitals and clinics under the direct supervision of physicians, registered nurses, nurse practitioners, or PAs.
History of the profession
The PA profession came into existence in the mid-1960s due to the shortage and uneven geographic distribution of primary care physicians in the United States. Dr. Eugene A. Stead of the Duke University Medical Center in North Carolina assembled the first class of PAs in 1965, composed of former U.S. Navy hospital corpsmen and U.S. Army combat medics, who had received considerable medical training during their military service and gained valuable experience during the Vietnam War.[2] He based the curriculum of the PA program in part on his first-hand knowledge of the fast-track training of medical doctors during World War II.
The Duke University Medical Center Archives has established the Physician Assistant History Center, dedicated to the study, preservation, and presentation of the history of the PA profession.[3]
Education and certification
As of May 2008, there were 141 accredited PA programs in the United States [4]. The majority are graduate programs leading to the award of master's degrees in either Physician Assistant Studies (MPAS), Health Science (MHS), or Medical Science (MMSc), and require a bachelor's degree and GRE or MCAT scores for entry. Some PA programs are starting to offer a clinical doctorate degree; Doctor of Science Physician Assistant (DScPA), while a remaining few still lead to the award of an undergraduate bachelor's or associate's degree, but many of these are transitioning to graduate-level training. Professional licensure is regulated by the state medical board.
PA education is based on the medical school model [5], although unlike medical school which lasts four years, PA training is usually 2 to 3 years in duration. It is generalist in approach, consisting of classroom and laboratory instruction in medical and behavioral sciences, such as anatomy, microbiology, pharmacology, pathophysiology, hematology, pathology, clinical medicine, and physical diagnosis, followed by clinical rotations in internal medicine, family medicine, surgery, pediatrics, obstetrics and gynecology, oncology, emergency medicine, and geriatric medicine, as well as elective rotations. Unlike physicians, who must complete a minimum of three years of residency after completion of medical schools, PAs are not required to complete such residencies. Despite this, there are residency programs in certain specialties for PAs who choose to continue formal education in such a format.[6]
A PA may use the post-nominal initials "PA", "PA-C", "APA-C", "RPA" or "RPA-C", where the "-C" indicates "Certified" and the "R" indicates "Registered." The "R" designation is unique to a few states, mainly in the Northeast; The "A" indicates completion of the Army Flight Surgeon Course. Most PAs use "PA-C". During training, PA students are designated PA-S. The use of "PA-C" is limited only to those PAs currently certified and in compliance with the regulations of the national certifying organization, the National Commission on Certification of Physician Assistants (NCCPA).
A graduate from an accredited PA program must pass the NCCPA-administered Physician Assistant National Certifying Exam (PANCE) before becoming a PA-C; this certification is required for licensure in all states.[7] In addition, a PA must earn and log 100 Continuing Medical Education (CME) hours and reregister his or her certificate with the NCCPA every two years. Every six years, a PA must also recertify by successfully completing either the Physician Assistant National Recertifying Exam (PANRE) or Pathway II exam.[8][9]
Scope of practice
PAs are advanced practice clinicians, and obtain medical histories, perform examinations and procedures, order treatments, diagnose illnesses, prescribe medication, order and interpret diagnostic tests, refer patients to specialists when appropriate and first-assist in surgery. They are employed in primary care or in specialties in urban or rural regions, as well as in academic administration. PAs may practice in any medical or surgical specialty, and have the ability to move to different medical and surgical fields during their careers.
PAs are licensed to practice medicine with physician supervision, which may be either in person, by telecommunication systems or by other reliable means (for example, regular chart review and consultation). The physician supervision, in most cases, need not be direct or on-site, and many PAs practice in remote or underserved areas in satellite clinics.
All states, as well as the District of Columbia, Guam, the United States Virgin Islands, and the Commonwealth of the Northern Mariana Islands, have laws or regulations authorizing physician assistants to practice medicine. PAs may also prescribe medications in all of these locations; those who prescribe controlled medications in their scope of practice must also have a DEA number.[10]
Employment
According to the AAPA, there were an estimated 68,124 PAs in clinical practice as of January 2008.
In the 2008 AAPA census, 56 percent of responding PAs worked in physicians' offices or clinics and 24 percent were employed by hospitals.[11] The remainder were employed in public health clinics, nursing homes, schools, prisons, home health care agencies, and the United States Department of Veterans Affairs.[12] Fifteen percent of responding PAs work in counties classified as non-metropolitan by Economic Research Service of the United States Department of Agriculture;[13] approximately 17% of the US population resides in these counties.[14]
The U.S. Department of Labor Bureau of Labor Statistics report on PAs states, "...Employment of physician assistants is expected to grow 27 percent from 2006 to 2016, much faster than the average for all occupations..."[15] This is due to several factors, including an expanding health care industry, an aging baby-boomer population, concerns for cost containment, and newly-implemented restrictions to shorten physician resident work hours.
PAs in primary care practice can purchase $100,000-$300,000 insurance premiums for less than $600 a year. PAs malpractice coverage are higher in greater risk specialties.[16]
Money Magazine, in conjunction with Salary.com, listed the PA profession as the "fifth best job in America" in May of 2006, based both on salary and job prospects, and on an anticipated 10-year job growth of 49.65%.[17] According to the American Academy of Physician Assistants (AAPA), in 2008 the mean total income for physician assistants working at least 32 hours per week was $89,987.[18] Physician assistants in dermatology or surgical subspecialties can earn $100,000-$200,000, with the mean total income for PAs working at least 32 hours per week in cardiovascular/cardiothoracic surgery listed as $110,468 for 2008. [19]
International
Australia
Two educational programs in Australia are also planned to start in 2009, at the University of Queensland and James Cook University.
Canada
The PA concept is being explored in Canada, where Canadian military PAs are gaining legislative changes allowing them to work in the civilian world after retirement.[20][21] Education programs are now offered at the University of Manitoba in Winnipeg, McMaster University in Hamilton, Ontario, The University of Western Ontario in London, Ontario, and the University of Toronto. Programs are 24 months in length.
England
In England, U.S.-trained PAs are working in a pilot project in Sandwell and West Birmingham.[22] Education programs are now being offered by four universities: University of Birmingham, University of Wolverhampton, University of Hertfordshire (operating as Bedfordshire and Hertfordshire Postgraduate Medical School, in conjunction with the University of Bedfordshire), and St George's, University of London. The University of Warwick and University of Coventry have also explored offering these programs, but did not implement them due to a lack of need. However, the NHS trusts in the West Midland's are currently forcasting a large scale need.
Also formally referred to as "Medical Care Practitioners", PAs are to be employed by the National Health Service. Though currently not a registered profession, PAs can currently practice under delegation rules and it is expected that the required legislation will be taken before Parliament with the UK's General Medical Council expected to become the registering body. Programs are 24 months in length and are a Post-Graduate Diploma with the option of "topping up" to a Master's degree either by full or part-time study.[2] Training is in the areas of General Medicine (including Emergency/Medical Assesment Units), Emergency Medicine (A&E) and General Practice.
The interests of PAs in the UK are currently being looked after by the UK Association of Physcian Assistants. [http://www.ukapa.co.uk/ ]
Netherlands
The Netherlands has educational programs at the Academie Gezondheidszorg in Utrecht, University of Arnhem/Nijmegen, the University of Groningen and the University of Leiden. Programs are 30 months in length.[23]
Scotland
Pilot projects in Scotland are underway, but no official educational programs have been implemented as of 2008.[24]
South Africa
One program is now offered in South Africa, at the University of Witwatersrand.
United States
In the Federal Government, Uniformed Services, and U.S. Armed Forces
PAs are employed by the United States Department of State as Foreign Service Health Practitioners (FSHP). PAs working in this capacity may be deployed anywhere in the world where there is a State Department facility. They provide primary care to authorized members of the state department. In order to be considered for the position of FSHP these PAs must be licensed and have at least two years of recent experience in primary care.[25]
U.S. Army PAs typically serve as Medical Specialist Corps officers within Army combat or combat support battalions located in the continental US, Alaska, Hawaii and overseas.[26] These include infantry, armor, cavalry, airborne, artillery and (if the PA qualifies) Special Forces units. They serve as the "front line" of Army medicine and along with combat medics are responsible for the total health care of soldiers assigned to their unit, as well as of their family members.
PAs also serve in the Air Force and Navy as clinical practitioners and aviation medicine specialists, as well as in the Coast Guard and Public Health Service. The skills required for these PAs are similar to that of their civilian colleagues, but additional training is provided in advanced casualty care, medical management of chemical injuries, aviation medicine as well as military medicine. In addition, military PAs are also required to meet the officer commissioning requirements and maintain the professional and physical readiness standards of their respective services.
References
- ^ "Information About PAs and the PA Profession" - American Academy of Physician Assistants (AAPA)
- ^ Eugene A. Stead, Jr., MD Biography - PA History Center
- ^ Physician Assistant History Center
- ^ "Accredited Entry-level Programs" (6/30/2008) - Accreditation Review Commission on Education for the Physician Assistant (ARC-PA)
- ^ "Issue Brief - Physician Assistant Education: Preparation for Excellence" - AAPA
- ^ The Association of Postgraduate PA Programs (APPAP)
- ^ "Physician Assistant National Certifying Exam (PANCE)" - National Commission on Certification of Physician Assistants (NCCPA)
- ^ "Physician Assistant National Recertifying Exam (PANRE)" - NCCPA
- ^ "Pathway II" - NCCPA
- ^ "Where Physician Assistants Are Authorized To Prescribe" - AAPA
- ^ 2008 AAPA Physician Assistant Census Report. page 2.
- ^ 2008 AAPA Physician Assistant Census Report. Table 3.4: Number and Percent Distribution of Clinically Practicing Respondents by Primary Work Setting
- ^ 2008 AAPA Physician Assistant Census Report. Table 3.13: Number and Percent Distribution of Clinically Practicing Respondents by Metropolitan Status and Degree of Rurality of County of Primary Work Site
- ^ http://www.ers.usda.gov/Briefing/Rurality/RuralUrbCon/
- ^ "Physician Assistants" - U.S. Department of Labor Bureau of Labor Statistics
- ^ [1]
- ^ "50 Best Jobs in America" (May 1, 2006) - CNN/Money.com
- ^ "Facts At A Glance" (March 24, 2008) - AAPA
- ^ 2008 AAPA Physician Assistant Census Report - Specialty Reports
- ^ The Manitoba Pharmaceutical Association Newsletter
- ^ Canadian Association of Physician Assistants (CAPA)
- ^ "Evaluation of US-trained Physician Assistants Working in the NHS in England" - University of Birmingham
- ^ "The Global Applicability of Physician Assistants" - AAPA
- ^ "NHS Scotland Pilot: Physician Assistants Terms and Conditions of Service" - Scottish Executive Health Department
- ^ U.S. Department of State
- ^ U.S. Army PA Information
External links
- Accreditation Review Commission on Education for the Physician Assistant (ARC-PA)
- American Academy of Physician Assistants (AAPA)
- National Association of Physician Assistants
- National Commission on Certification of Physician Assistants (NCCPA)
- Journal of the American Academy of Physician Assistants (JAAPA)
- Physician Assistant History Center
- ADVANCE for Physician Assistants journal
- Physician Assistant Education Association
- UK Association of Physician Assistants (UKAPA)