A Physician Assistant’s Role in America’s Healthcare

The need to introduce the physician assistant profession arose in the 1960s due to the shortage of doctors and the urgent need for primary healthcare services. Acting as a bridge between patients and doctors, the physician associates effectively delivered general medical services to the population, thus carving a niche for themselves in the US Healthcare System.
According to NCCPA, the physician assistant profession grew 28.6% between 2016 and 2020, reaching 148,560 certified PAs at the end of 2020. More and more physician assistants have continued to be added to the healthcare system every year without the ever-increasing demand being met, which is a testimony to the vital role physician assistants play in the US healthcare system.

What is the work of a physician assistant?

The physician assistant is a qualified medical professional who practices medicine collaboratively with a licensed physician. They exercise independent medical decision-making within their scope of practice.
They perform the following services in primary health care:

• Interview and take the medical history of a patient
• Perform physical examination
• Order laboratory tests and diagnostics to establish the nature and extent of the illness
• Diagnose the illness and prescribe medications to treat the illnesses
• Educate and counsel patients and families on the best way to manage the disease
• Assist in surgery such as setting bones and stitching wounds
• Maintain the records of patients and provide necessary documentation where insurance companies are involved
• Research on the latest treatments for best quality care
• Participate in outreach programs and talk to groups about managing disease and promoting wellness

Physician assistants also work in specialties outside primary care, assisting physicians in medical and surgical specialties and subspecialties. A physician associate could also be involved in education, research, and administrative services.

The PA-doctor relationship

While a physician assistant and a doctor perform similar roles, the doctor has full autonomy in decision making and is responsible for a clinical situation. Physician assistants sit one-on-one with the patients from diagnosis to treatment, and the supervising physician participates in a supportive role (direct or indirect) and will co-sign physician assistant orders. Physician assistants cannot practice independently in any state of the US and have to work under the supervision of a physician.
At the healthcare level, the physician associates work as a team to provide medical services to much larger volumes of the population. They work in all specialty and primary care areas, diagnosing and treating common illnesses and working with minor procedures. Physician assistants perform the routine work for doctors, leaving doctors to handle the more complex decision-making, enabling them to attend to more patients during their practice time and focus on inpatient specialty practice.

Should I visit an MD or a PA?

• Physician assistants are trained using the medical model on the same lines as physicians. Since they can perform many of the same services that doctors provide, they are ideal for the healthcare system’s first point of contact. Common medical ailments can be effectively taken care of by physician assistants. Research has shown that they provide an equivalent quality of care as most physicians and provide almost the same level of patient satisfaction.
• A patient can establish care with a physician associate much faster than with DOs and MDs.
• The patient has cost benefits as a physician assistant can provide services at a lower cost than a physician.

How can I become a PA?

To become a physician assistant, you need to have a Bachelor’s Degree (preferably science-related), acquire 3 years of work experience, and apply to an accredited physician assistant program (2-3 years). After graduating from this program, you must pass the Physician Assistant National Certifying Examination (PANCE) and obtain a license in the state you wish to practice.

What is the outlook of a PA’s job?

For the fifth year in a row, physician assistant has been named one of the top two healthcare jobs in the country by US News & World Report in its annual Best Jobs List for 2022. Physician associates report high levels of job satisfaction, have job stability and can maintain a work-life balance with ease. They spend less time and money in medical school than doctors and are able to begin practicing after 2-3 years of education with a good starting salary. They also are able to switch specializations more easily than physicians.

Dawn Morton-Rias, EdD, PA-C President and CEO of NCCPA, has stated, “This 2020 Statistical Profile of Certified PAs demonstrates that PAs are providing essential health care services in all specialties and in a variety of practice settings throughout the US. At the end of 2020, 98% of PAs maintained their NCCPA certification, and almost 10,000 newly Certified PAs embarked on their new health care career. Through new questions added in 2020, we found that even though facing a pandemic, 72.9% of PAs stated they were completely or mostly satisfied with their present job.”

According to the US Bureau of Labor Statistics, the median annual wage for physician assistants was $115,390 in May 2020.

The NCCPA states, “The average total income for Certified PAs increased by 10.9% between 2016 and 2020. Specialties with the highest average income include cardiothoracic and vascular surgery, neurosurgery, emergency medicine, and orthopedic surgery. The percentage of PAs earning more than $200,000 has almost doubled between 2016 and 2020.”

What is the importance of PA’s job in America’s healthcare?

• With the increasing demand for primary care physicians not having been met, there has been an increased reliance on physician assistants to deliver primary care services to meet the healthcare needs of the general population. It is not uncommon for physicians to assign the care of less complex medical cases to physician assistants, and physician assistants have shown that they can provide 70% or more of the care required for adults and 90% of the care in kids. They are effective in primary care, where most health problems are treated.
• Patients can avail treatment with a physician assistant in a shorter time than with an MD. Physician assistants provide physician services at a lower cost, thus lowering healthcare costs while maintaining the quality of care and increasing hospital efficiency. With greater wait times to get an appointment with an MD or DO, patients rely on physician assistants to get them medical appointments with shorter wait times.
• Physician assistants play an important role in community health in places with no adequate health infrastructure. At such times, they also play a vital role in patient, family, and community education and are involved in preventive medicine. According to NCHS Data Brief No. 77, the authors cite, “PAs or APNs are providing an increasing share of care delivered in OPDs compared with the previous decade. The findings in this report suggest that PAs or APNs continue to provide a critical health care function by providing care in settings with fewer physicians, such as rural locations, small hospitals, and nonteaching hospitals.”
• As physician assistant training is more generalist in nature, they have a flexible skillset that can be honed according to the clinical specialty. They can assist in any field within medicine, and they can switch specialties without re-certification. They could use on-the-job training to pick up any skills required for that specialty. This clinical versatility of physician associates allows them to meet the needs of the healthcare system in an ever-changing medical scenario. Results from a survey of AAPA members suggest that physician assistants who do not need additional certification to switch specialties could be used as a tool to address shortages of specialty providers.

Physical Assistants, during their training, have to deliver strong academic performances and acquire extensive clinical experience. This enables them to render quality healthcare under a physician’s supervision. By performing physicals and diagnostics and working on a treatment plan for the patient, they increase the number of patients seen in a day, giving MDs time and space to tend to more complex cases and surgeries. They also help physicians in in-office procedures and assist during surgeries. Physician assistants also play a vital role in providing healthcare in rural and underserved settings where they are the only health providers in these settings. Thus, physician associates play a crucial role in availing healthcare to a larger population at lower healthcare costs without compromising quality.

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