Physician assistants (PAs) are taking on more prominent roles as members of the health care team, and many people have questions about those roles and functions. After answering questions that are often asked about the history and background of the PA profession in a previous column, today's question-and-answer column is geared to answering questions that are often asked about the training and the work arrangements for PAs.
Q: How are PAs trained?
A: PAs are trained similarly to doctors. Most PA schools require a bachelor's degree or certain classes in college for entry. Chemistry, biology and other high-level science classes are usually required before candidates can be accepted into PA school.
Most PA schools require either medical experiences or extensive time observing a PA. When the prerequisites are met, candidates apply to one of the almost 200 PA schools throughout the United States and compete for admission.
Doctors attend medical school, which lasts about four years, while PA school lasts a little over two years.
Medical school tends to be broken down into bookwork and hands-on patient care. This is exactly how PAs are trained, too.
As a PA student at Saint Francis University, I spent the first 12 months doing didactic training—or bookwork. During that time, I was taught anatomy and physiology, how to do physical exams, make diagnoses and prescribe medicines and other treatments. I learned how to order and interpret lab tests, X-rays and other diagnostic tests. I also was taught how to do medical skills, like suturing, or stitches.
My second year of PA school was spent doing supervised medical care on different rotations in doctors' offices and hospitals. I had the opportunity to learn from emergency medicine doctors, family practitioners, pediatricians, OB/GYN doctors and others—a total of 10 different rotations were completed.
After graduating from PA school, I had to sit for a test to prove that I was ready to face real patients and make decisions regarding their treatment.
Q: Where do PAs work?
A: PAs can work in private physician offices or in institutions, such as hospitals and health clinics. They can work in specialty areas such as emergency medicine, orthopedics, general or thoracic surgery, and geriatrics. They can also work in primary care specialties, like pediatrics and family medicine.
Q: Can PAs work independently?
A: No, PAs absolutely may not work without a supervising physician, who oversees the treatment and who is actually responsible for the PA's work.
Usually, when a PA starts working for a doctor, there is a period of time when the doctor trains his or her PA about the proper protocol and procedures for patient care. The bond between PA and doctor allows the patient to get essentially the same care from the PA that they would have gotten from the doctor.
Doctors also review and sign the record of each patient. Laws and guidelines have been established to ensure adequate supervision.
Q: What is the employment outlook for PAs?
A: The current trend of PAs being more prominent members of the health care team is expected to continue. Employment of PAs is expected to grow much faster than average for all occupations over the next decade. PAs not only can relieve physicians of routine duties and procedures, they can also do so in a cost-efficient manner for physician practices and hospitals.
Scott A. Nearhoof is a physician assistant in the Mount Nittany Medical Center emergency department.