Recently, a New Orleans business roundtable was asked if they had experienced medical care provided by a PA — a physician assistant. Did they know what the medical practitioner, the PA, was and could do? The resounding answer, amid nodding heads and smiles, was yes, their healthcare experience with a PA was positive and high-quality.
After 50 years and numerous studies, this is the usual response: Physicians and patients like PAs and the care they provide.
What Are Physician Assistants?
Physician assistants are medical professionals who provide a broad range of patient care in all medical specialties and medical settings throughout the country. Even the president of the United States has PAs as part of his medical team. As members of the healthcare team, PAs take medical histories, conduct comprehensive and targeted physical examinations and perform a broad range of routine and emergency medical procedures. They order and interpret diagnostic tests, formulate diagnoses and develop treatment plans, including prescribing medications and treatments.
Duke University graduated the first PAs in 1965. Military corpsmen and medics returning from Vietnam with the extensive care experience were the first students. Now, PAs typically need a master’s degree from an accredited educational program. All states require physician assistants to be licensed and all states permit prescribing, including controlled substances, except Kentucky.
There are about 25,000 PA program applicants each year, out of which about 8,000 are accepted. Prerequisites for program entrance tend to parallel or exceed those of medical schools. Educated as generalists, PAs are flexible in medical settings. Recent research shows PAs tend to work in more specialties within urban settings. Large health systems are the primary employer.
“Your PA Can Handle It,” a national media campaign for the American Academy of Physician Assistants (AAPA), was unveiled in New Orleans this past year during the PA association’s national conference to focus national awareness on the career field and remove barriers.
A Bright Future for a Growing Field
The profession is often rated first or second for overall job satisfaction, and the average physician assistant has been in practice for 12 years. The PA profession is projected to increase 37 percent from 2016 to 2026, significantly more than average for all occupations (2018 U.S. Bureau of Labor Statistics). Forbes ranked the physician assistant profession as No. 1 for three years in a row, and US News and World Report ranked PA as No. 3 on its top 100 list. The 2018 AAPA Salary Report cites that the US national average starting salary is $105,000.
Rural Demand
As more Americans move to cities, a specialist shortage persists in rural regions of the country. According to experts, while almost 20 percent of Americans live in rural areas, only 10 percent of physicians practice in those areas. As a result, those patients often face long travel distances to see a specialist, and may even wait months for an appointment.
About 12 percent of all PAs work in rural settings, according to the 2013 Annual Survey of the American Academy of Physician Assistants. PAs in rural areas are more likely to practice in primary care specialties, have a broader scope of practice, and see patients who are uninsured or covered by Medicaid or Medicare. Extensive studies demonstrate the positive effect of PAs on rural health. PAs in rural areas are often the usual care providers for patients with chronic conditions, provide care that is cost effective and safe, and increase access to care. Hiring a PA in rural medical practice can have a salutary economic effect on the business as well as the community.
Adjusting to Changing Care
An aging population has shifted increased healthcare delivery demands to community-based care rather than institutional-based care. PAs provide a sustainable, proven response to these challenges for all of Louisiana city and rural.
According to National Commission on the Certifications of PAs’ (NCCPA) most recent Statistical Report of Certified PAs by Specialty, over 3,200 PAs now work in hospital medicine, a 21 percent increase over three years. PAs are often in charge of patients throughout their hospital stay, with a physician available to see the patient on an as-needed basis.
The growing shortage of psychiatrists and increasing need for providers in mental health and addiction is leading to an increase of PAs in the psychiatric field.
PAs are increasingly providing mental health services to patients, diagnosing and managing a range of mental disorders in both inpatient and outpatient settings.
Dr. Linda Lawrence, former board president of the American College of Emergency Physicians and current NCCPA board member, says she has seen an expansion of PA’s knowledge and skills in recent years.
“This has resulted in an expanded scope of practice, making them precious partners in the emergency department,” she says. “Certified PAs will continue to be in high demand in this specialty to meet the increasing needs of both patients and health systems.”
PAs remain a proven response to the nation’s physician shortages and deliver high-quality, team-based medical care.
What This Means in Louisiana
The bottom line is that Louisiana and the Greater New Orleans are in need of physician assistants. The University of Holy Cross PA program has applied for provisional accreditation to the national accrediting body, Accreditation Review Commission on Education for the Physician Assistant (ARC-PA). The program has already received accreditation from the Southern Association of Colleges and Schools Council on Accreditation and School Improvement (SACSCASI) this past February. The state’s newest developing PA program curriculum provides high quality, procedure-rich, technologically competent education guided by experienced, qualified and skilled PA and physician clinician-educators working in interdisciplinary teams, for the 25 students admitted to the inaugural class, which starts in the fall of 2019. It will encompass 28 months and 112 credits of rigorous graduate-level clinical medical training.
UHC graduates will locally address national and regional trends in health care delivery as Louisiana healthcare sectors face rising demand, leading to long-term shortages of medical providers.
PA Gerry Keenan is the University of Holy Cross PA program director and is a professor of PA studies. He is a national board-certified PA with 38 years of clinical and educator experience, as well as a senior fellow with the Society of Emergency Medicine PAs.
