Why Millennials are Choosing to be Physician Assistants, Not Doctors

From the Chicago Sun-Times - 3/9/18

According to the Bureau of Labor Statistics, physician assistant is one of the fastest-growing occupations in the country. In the next decade, the bureau expects the number of PAs will grow nationally by 37%, much more quickly than other professions.

This comes at a time when experts predict a huge shortage of primary care physicians in the coming years.

As of May 2016, there were 440 physician assistants employed in Delaware — larger than the number of internists, psychiatrists, OB GYNS and surgeons in the state combined, according to the bureau.

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Surgical PA Specialties

According to the NCCPA, there are more than 115,547 PAs in clinical practice alone. The AASPA represents the 38,000 PAs who work in a surgical environment.

Surgical physician assistants (PAs) are highly skilled clinicians who have received didactic and clinical training to function in all areas of the peri-operative environment, including pre-admission, testing, intra-operative first assisting, PACU care, SICU care, step-down unit, outpatient clinic, office practice and even home care.

Surgical PAs should not be confused with medical assistants, who perform routine clinical and clerical tasks. Surgical PAs handle many of the functions of a fully trained doctor, in the absence of a doctor, and exercise autonomy in medical decision-making. State laws vary regarding the role of the supervising physician, but the majority of PAs work in collaboration with or under the supervision of a licensed physician.

The PA who specializes in surgery assistance will have extensive knowledge of surgical procedure as well as specific areas of healthcare studies. The primary role of the surgical PA is to assist licensed physicians in patient surgery. However, their involvement from initial patient assessment to post-surgery follow-up care enables surgical PAs to offer excellent continuity of patient care.

Surgical PA Roles & Responsibilities

Surgical PAs are formally trained to provide diagnostic, therapeutic, surgical and preventative care, under the supervision of a physician or surgeon. In addition, surgical PAs can function as researcher, committee member, supplier, and surgical equipment supply or pharmaceutical representative liaison and much more. The typical PA program is 25.5 months long. The curriculum parallels that of medical school and includes courses in human anatomy and physiology, biochemistry, pharmacology, physical diagnosis, pathophysiology, microbiology, clinical laboratory sciences, behavioral sciences, and medical ethics.

Physicians and physician assistant educators teach the bulk of the courses. Following approximately one year of didactic classroom work, PA students complete on average, 2,000 hours of supervised clinical practice before graduation. This includes classroom and clinical instruction during clinical rotations in both medical and surgical specialties. Required rotations include family medicine, internal medicine, general surgery, obstetrics and gynecology, pediatrics, emergency medicine, geriatrics, and behavioral medicine. PAs can bill for their services, including billing for first assist‎ in the OR.

Surgical PA Roles

While surgical PAs assist the physician in the global management of patient care in all peri-operative settings, their primary role is to assist licensed physicians in patient surgery. This end-to-end involvement enables surgical PAs to provide unparalleled continuity of patient care. Often surgical PAs handle routine problems and procedures, freeing the surgeon to concentrate on more complex patients.

In-office Patient Care

Surgical PAs can perform all manner of patient care in the office setting, as determined by the supervising surgeon.

Hospital Care

Surgical PAs can alleviate the frustration of canceled, delayed or bumped cases.

• 1st assistant in surgery – Performs first assist duties, including ensuring all needed equipment and supplies are present. Keep your surgical skills up-to-date with CME.
• Post-op – Writes orders in the recovery room, talks with family, visits patients, performs post-op procedures and more.
• Discharge planning – Dictates discharge summaries, writes prescriptions, explains discharge instructions, confirms follow-up appointments and more.

Research & Administration

• Researcher – Conducts, designs and/or participates in research studies.
• Committee Member – Play a role on education committees, medical supply, and equipment committees and more. A hospital selects its surgical equipment based on the demands of the surgeon. More and more, surgical PAs are deciding which products to use.
• Supplier and Pharmaceutical Rep Liaison – Serve as a mediator between the surgeon and/or practice and the drug reps/instrument sales reps.

Duties & Responsibilities

General Duties & Responsibilities

• Performs comprehensive and problem-focused histories and physical examinations
• Diagnoses and treats illnesses and injuries
• Orders and interprets laboratory and radiographic studies
• Educates and counsels patients
• Performs minor surgical procedures
• Performs First Assist duties in surgery
• Assists with call
• Renders emergency care
• Facilitates patient referral to the appropriate physician or agency
• Conducts research and drug studies
• Prescribes medication in most states

Hospital Duties & Responsibilities

• Performs first assist duties
• Assists with surgical procedures
• Conducts daily hospital rounds
• Write orders and progress notes
• Performs all admission history and physicals
• Orders appropriate laboratory and radiographic tests
• Performs appropriate laboratory and diagnostic studies
• Evaluates and clarifies clinical conditions
• Formulates and implements treatment and therapeutic plans for hospitalized patients
• Handles discharge planning and dictates discharge summaries

Office Duties & Responsibilities

• Sees new office patients and completes a thorough history and physical examination
• Presents the patient to attending surgeons, if needed
• Helps to formulate treatment plans
• Orders appropriate radiographic studies
• Performs office procedures
• Evaluates post-operative patients and does routine follow-up visits
• Is available to see patients requiring same-day office visits
• Returns phone calls of from patients
• Handles prescription refills
• Reviews radiographic reports and laboratory reports for abnormalities
• Evaluates, screens and counsels patients on health maintenance and promote utilization of community resources
• Designs, conducts and/or participates in research studies
• Manages databases
• Perform quality assurance
  
  

What PAs Mean to Your Organization

Why You Should Hire a Surgical PA