Physician assistants (PAs) practice medicine under the supervision of licensed doctors of medicine or osteopathy, providing various health care services to patients. Much of the work they do was formerly limited to physicians. There are approximately 59,000 physician assistants employed in the United States.
Physician Assistant Career History
Physician assistants are fairly recent additions to the health care profession. The occupation originated in the 1960s when many medical corpsmen received additional education enabling them to help physicians with various medical tasks. Since then, the work of the physician assistant has grown and expanded; in addition, the number of physician assistants in the United States has greatly increased. Fewer than 100 PAs were practicing in 1970; today there are approximately 59,000.
Physician Assistant Job Description
Physician assistants help physicians provide medical care to patients. PAs may be assigned a variety of tasks; they may take medical histories of patients, do complete routine physical examinations, order laboratory tests, draw blood samples, give injections, decide on diagnoses, choose treatments, and assist in surgery. Although the duties of PAs vary by state, they always work under the supervision and direction of a licensed physician. The extent of the PA’s duties depends on the specific laws of the state and the practices of the supervising physician, as well as the experience and abilities of the PA. PAs work in a variety of health care settings, including hospitals, clinics, physician’s offices, and federal, state, and local agencies.
More than 42 percent of all PAs specialize in general medicine, such as family medicine, internal medicine, general pediatrics, and obstetrics and gynecology. Twenty-four percent of PAs are in general surgery/surgical subspecialties, 10 percent specialize in emergency medicine, and 10 percent are in internal medicine subspecialties.
Forty-nine states, the District of Columbia, and Guam allow PAs to prescribe medicine to patients; Indiana is the only state that does not authorize PAs to prescribe medication. Physician assistants may be known by other occupational titles such as child health associates, MEDEX, physician associates, anesthesiologist’s assistants, or surgeon’s assistants.
PAs are skilled professionals who assume a great deal of responsibility in their work. By handling various medical tasks for their physician employers, PAs allow physicians more time to diagnose and treat more severely ill patients.
Physician Assistant Career Requirements
Since a physician assistant needs to be good with numbers and understand how the human body works, anyone interested in this job can begin preparing in high school by taking math classes and science classes, such as biology and chemistry, as well as health classes. English and social science classes, such as psychology, will also help you improve your communication skills and give you an understanding of people.
Also, keep in mind that it’s not too early to gain some experience in the health care field. Many postsecondary institutions take into consideration an applicant’s hands-on experience when deciding whom to accept, so look for paid or volunteer positions in your community.
Most states require that PAs complete an educational program approved by the Commission on Accreditation of Allied Health Education Programs. There are approximately 136 fully or provisionally accredited PA programs. Admissions requirements vary, but two years of college courses in science or health, and some health care experience, are usually the minimum requirements. The American Academy of Physician Assistants (AAPA) reports that a majority of all students accepted, however, have their bachelor’s or master’s degrees. Most educational programs last 24 to 25 months, although some last only one year and others may last as many as three years.
The first six to 24 months of most programs involve classroom instruction in human anatomy, physiology, microbiology, clinical pharmacology, applied psychology, clinical medicine, and medical ethics. In the last nine to 15 months of most programs, students engage in supervised clinical work, usually including assignments, or rotations, in various branches of medicine, such as family practice, pediatrics, and emergency medicine.
Graduates of these programs may receive a certificate, an associate’s degree, a bachelor’s degree, or a master’s degree; most programs, however, offer graduates a bachelor’s degree. The one MEDEX program that presently exists (at the University of Washington, http://depts.washington.edu/medex/) lasts only 18 months. It is designed for medical corpsmen, registered nurses, and others who have had extensive patient-care experience. MEDEX students usually obtain most of their clinical experience by working with a physician who will hire them after graduation.
PA programs are offered in a variety of educational and health care settings, including colleges and universities, medical schools and centers, hospitals, and the armed forces. State laws and regulations dictate the scope of the PA’s duties, and, in all but a few states, PAs must be graduates of an approved training program.
Certification or Licensing
Currently, all states require that PAs be certified by the National Commission on Certification of Physician Assistants (NCCPA). To become certified, applicants must be graduates of an accredited PA program and pass the Physician Assistants National Certifying Examination (PANCE). The examination consists of three parts: The first part tests general medical knowledge, the second section tests the PA’s specialty—either primary care or surgery—and the third part tests for practical clinical knowledge. After successfully completing the examination, physician assistants can use the credential, physician assistant-certified.
Once certified, PAs are required to complete 100 hours of continuing medical education courses every two years, and in addition must pass a recertification examination every six years. Besides NCCPA certification, most states also require that PAs register with the state medical board. State rules and regulations vary greatly concerning the work of PAs, and applicants are advised to study the laws of the state in which they wish to practice.
Licensing for physician assistants varies by state. New graduates should contact their state’s licensing board to find out about specific requirements. Some states grant temporary licenses to physician assistants who have applied for the PANCE. For permanent licensure, most states require verification of certification or an official record of their exam scores.
To be a successful physician assistant, you must be able to work well with many different kinds of people, from the physician who supervises you to the many different patients you see every day. In addition to being a caring individual, you should also have a strong desire to continue learning in order to keep up with the latest medical procedures and recertification requirements. Since ill individuals depend on a physician assistant’s decisions, anyone interested in this job should have leadership skills and self-confidence as well as compassion.
Exploring Physician Assistant Career
If you are interested in exploring the profession, talk with school guidance counselors, practicing PAs, PA students, and various health care employees at local hospitals and clinics. You can also obtain information by contacting one of the organizations listed at the end of this chapter. Working as a volunteer in a hospital, clinic, or nursing home is a good way to get exposure to the health care profession. In addition, while in college, you may be able to obtain summer jobs as a hospital orderly, nurse assistant, or medical clerk. Such jobs can help you assess your interest in and suitability for work as a PA before you apply to a PA program.
PAs work in a variety of health care settings. According to the AAPA, 57 percent of all PAs are employed by single physicians or group practices; 22 percent are employed by hospitals; and 10 percent work for some type of government agency with the Department of Veterans’ Affairs being the largest government employer of PAs. They are also employed by clinics, nursing homes, long-term care facilities, and prisons. Many areas lacking quality medical care personnel, such as remote rural areas and the inner city, are hiring PAs to meet their needs. Approximately 59,000 physician assistants are employed in the United States.
PAs must complete their formal training programs before entering the job market. Once they complete their studies, PA students can utilize the placement services of their schools to locate jobs. PAs may also seek employment at hospitals, clinics, medical offices, or other health care settings. Information about j obs with the federal government can be obtained by contacting the Office of Personnel Management’s Web site https://www.usajobs.gov/.
Since the PA profession is still quite new, formal lines of advancement have not yet been established. There are still several ways to advance. Hospitals, for example, do not employ head PAs. Those with experience can assume more responsibility at higher pay, or they move on to employment at larger hospitals and clinics. Some PAs go back to school for additional education to practice in a specialty area, such as surgery, urology, or ophthalmology.
Salaries of PAs vary according to experience, specialty, and employer. The U.S. Department of Labor reports that the lowest paid 10 percent of all physician assistants earned less than $38,370 in 2005. The department also reports that physician assistants employed in offices and clinics of medical doctors had mean annual earnings of $70,770 in 2005, while those employed in hospitals earned $71,300. The median annual average salary for all PAs was $77,402 in 2005, according to the 2005 AAPA Physician Assistant Census Report. A report by the American Medical Association listed salaries in 2005 for experienced PAs at $110,000 a year. PAs are well compensated compared with other occupations that have similar training requirements. Most PAs receive health and life insurance among other benefits.
Most work settings are comfortable and clean, although, like physicians, PAs spend a good part of their day standing or walking. The workweek varies according to the employment setting. A few emergency room PAs may work 24-hour shifts, twice a week; others work 12-hour shifts, three times a week. PAs who work in physicians’ offices, hospitals, or clinics may have to work weekends, nights, and holidays. PAs employed in clinics, however, usually work five-day, 40-hour weeks.
Physician Assistant Career Outlook
Employment for physician assistants, according to the U.S. Department of Labor (USDL), is expected to increase much faster than the average for all occupations through 2014. Opportunities will be best in rural areas and inner city clinics—settings which often have trouble attracting the most qualified candidates.
The role of the PA in delivering health care has also expanded over the past decade. PAs have taken on new duties and responsibilities, and they now work in a variety of health care settings. The USDL reports that physician assistants should have good opportunities in hospitals, academic medical centers, public clinics, prisons, and inpatient teaching hospitals.