The role of a physician assistant (PA) became a new, recognized medical profession in the late 1960s / early 1970s to address a shortage of primary care physicians in the US. The creator of the first PA education program at Duke University Medical Center, Eugene Stead Jr., MD, recruited several Navy Hospital Corpsmen as students and developed his curriculum based on the fast-track training of doctors during World War II.
The AAPA, the professional association now known as the American Academy of Physician Assistants, was founded in 1968. Since then, the profession has developed its own set of accreditation standards, a national certification process and continuing education requirements, and PAs have made an important difference to expand health care access to more Americans.
What is a physician assistant?
A physician assistant, or PA, is a medical clinician who provides direct patient care under the supervision of a physician.
What does a PA do?
The scope of what a PA is licensed to do may vary by state. But in general, a PA can provide nearly all the same kinds of patient care as a primary care physician—performing exams, ordering tests, diagnosing illness, developing and managing treatment plans, prescribing medications, making referrals, and providing health counseling. In fact, a PA can serve as a patient’s regular primary care physician (PCP). The main difference—PA vs. doctor—is that a PA is not licensed to practice medicine alone nor to perform surgery, although more than a quarter of them assist in some sort of surgical subspecialty.
Requirements to become a PA
Candidates with a four-year bachelor’s degree may apply to an accredited PA program. PA programs provide master’s-level education and take 27 months, or three academic years, to complete. 2,000 hours of clinical rotations and a certification exam (the Physician Assistant National Certifying Examination, or PANCE) also are required to become licensed for practice.
To remain certified, a PA must complete 100 hours of continuing medical education (CME) every two years and pass a recertification exam every ten years.
Physician assistant vs. nurse practitioner—What are the differences?
You can find PAs and nurse practitioners (NPs) working side-by-side providing primary care, but there are some meaningful differences in their training and professional backgrounds.
The most basic difference is what’s emphasized in their academic and clinical preparation. PA curricula mirror those of medical schools, but with less depth, so there’s a strong emphasis on the diagnosis and treatment of illness. NP programs also teach medical science but include the natural, behavioral and humanistic sciences, too, because of their nursing focus on the state and comfort of the patient.
In comparison with NPs, PAs are required to complete more clinical hours, pass a national certification exam, and meet more rigorous recertification requirements in order to earn and maintain a license.
Job prospects for PAs
Becoming a PA can be a secure and lucrative career choice. According to US News & World Report, physician assistant is #1 on their list of Best Health Care Jobs and #3 on their list of Best 100 Jobs overall. The Bureau of Labor Statistics ranks PA as the #5 Fastest Growing Job, and Forbes magazine ranks PA as the #7 Highest Paying Job in America.
The impact of PAs in home care
In home health care, a physician assistant works collaboratively on a team of clinicians—including PAs, NPs, and physicians—to go out into the community and provide homebound patients with primary care, complex care management, advanced care planning, and health coaching.
New models of health care delivery are using primary care house calls to improve patient access and outcomes while reducing resource utilization and cost—getting patients safely through high-risk care transitions such as hospital discharge, keeping them healthy at home, and preventing complications and readmissions.
Working in home health care, a PA gets more time and opportunity to provide meaningful, one-on-one care to each patient, educating them and their loved ones and focusing on their individual, holistic needs—all with the benefit of seeing and identifying environmental health or safety risks and medical, social, or emotional problems that wouldn’t be detected in an office visit.
With the ability to make a big difference in people’s lives and to collaborate with a team of other clinicians out in the community—not stuck in an office—many PAs find home health care to be their first choice for a fun, varied, rewarding, and stimulating career.