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PHYSICIAN ASSISTANT
In the United States, Physician Assistants or Physician Associates (PAs) are non-physician clinicians licensed to practice medicine with a physician's supervision. This supervision, in most cases, need not be direct or on site and many PAs practice in remote or underserved areas in satellite clinics. PAs can treat patients and, in most states, prescribe medicine, and in some states in the US they carry a DEA number that gives them authority to prescribe controlled medications like narcotics. PAs in surgical practices also serve as first assistants in surgery. PAs provide medical services that are reimbursed under Medicare and third party insurances.
Worldwide, the concept is being explored in Canada, where military PAs are gaining legislative changes to work in the civilian world after retirement; in England, where several US trained PAs are working in a pilot project; Scotland, where a similar pilot project project is in planning; and in Belgium, where a Physician Assistant program is underway.
Employment
Physician Assistants held about 65,000 jobs in 2005. The number of jobs is greater than the number of practicing PAs because some hold two or more jobs. For example, some PAs work with a supervising physician, but also work in another practice, clinic, or hospital. According to the American Academy of Physician Assistants, there were about 58,665 certified PAs in clinical practice as of January 2006. Even though a few legacy programs confer an Associate Degree or just a certificate of completion, most programs now confer a Master's Degree, requiring a B.S. on entry; many more are seeking accreditation at the master's level.
According to the 2005 PA census from the American Academy of Physician Assistants, just over 56 percent of PAs worked in the offices and clinics of physicians, either allopathic or osteopathic. About 36 percent were employed by hospitals. The rest were mostly in public health clinics, nursing homes, schools, prisons, home health care agencies, and the United States Department of Veterans Affairs. According to the American Academy of Physician Assistants, about 17 percent of all PAs provide health care to rural communities and those with fewer than 20,000 residents, in which physicians may be in limited supply.
Education and Certification
In 2006, there are more than -- 130 accredited PA programs in existence in the United States. They are all accredited by one body -- the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA). A majority of them are master's degree programs (requiring GRE for entry), but some are available as an undergraduate major. A number of these undergraduate programs are making a transition to graduate level training.
A Physician Assistant may use the post-nominal initials PA, RPA, PA-C or RPA-C, where the R indicates Registered and the C indicates "Certified." The "R" designation is unique to only a couple of states; most Physician Assistants use the PA-C. The certification is granted by one certifying body, the National Commission on Certification of Physician Assistants (NCCPA).
PAs and other health care providers
PAs and Nurse Practitioners
Physician Assistants and Nurse Practitioners both provide similar services in most states, the major distinction being that nurse practitioners are registered nurses by trade.
PAs and Medical Assistants
PAs should not be confused with Medical Assistants, who perform routine clinical and clerical tasks in a physician's office.
History of PAs
The Physician Assistant profession has its beginnings in the highly trained Hospital corpsmen of the Vietnam War era. Dr. Eugene Stead of the Duke University Medical Center in North Carolina put together the first class of PAs in 1965, to expand the quality of medical care resulting from a shortage of primary care physicians. For his first class, he selected former Navy corpsmen who received considerable medical training during their military service and during the war in Vietnam but who had no comparable civilian employment or equivalent. He based the curriculum of the PA program in part on his knowledge of the fast-track training of medical doctors during World War II.
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