Q. What is a Physician Assistant (PA)?
A. Physician Assistants are health care professionals licensed to practice medicine with physician supervision. PAs employed by the federal government are credentialed to practice. As part of their comprehensive responsibilities, PAs conduct physical exams, diagnose and treat illnesses, order and interpret tests, counsel on preventive health care, assist in surgery, and in most states can write prescriptions. PAs are trained in intensive education programs accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA). Because of the close working relationship the PAs have with physicians, PAs are educated in the medical model designed to complement physician training. Upon graduation, physician assistants take a national certification examination developed by the National Commission on Certification of PAs in conjunction with the National Board of Medical Examiners. To maintain their national certification, PAs must log 100 hours of continuing medical education every two years and sit for a recertification every six years. Graduation from an accredited physician assistant program and passage of the national certifying exam are required for state licensure.

Q. How are PAs educated?
A. PAs are educated in a medical model. The structure of PA education is similar to that for medical students. The training is roughly 2/3 the length of medical school. The average PA program is 108 weeks of instruction compared to 153 weeks for medical school. The first year, called the didactic phase, educates PAs heavily in the basic medical sciences, clinical medicine, history and physical exam, general studies, and surgical and technical skills. The second year, called the clinical phase, dedicates more than 2,000 hours to clinical rotations including Family Medicine, Internal Medicine, General Surgery, Emergency Medicine, Pediatrics, OB/GYN, Psychiatry, and electives.

Q. Where do PAs "draw the line" as far as what they can treat and what a physician can treat?
A. What a physician assistant does varies with training, experience, and state law. In addition, the scope of the PA’s practice corresponds to the supervising physician’s practice. In general, a physician assistant will see many of the same types of patients as the physician. The cases handled by physicians are generally the more complicated medical cases or those cases which require care that is not a routine part of the PA’s scope of work. Referral to the physician, or close consultation between the patient-PA-physician, is done for unusual or hard to manage cases. Physician assistants are taught to “know our limits” and refer to physicians appropriately. It is an important part of PA training.

Q. Does the supervising physician have to be present in the office while the PA is seeng patients?
A. Most states do not require that a physician be present while a PA sees patients. The physician must be available for consultation at all times, either in person or via telecommunication.

Q. Are PAs accepted by patients and referring physicians?
A. PAs are part of the physician/PA team, and together, they provide patients with quality healthcare. Public acceptance and familiarity with physician assistants has grown substantially since the profession began in the 1960's. A 1994 U.S. Department of Health and Human Services report on PAs cited a high level of patient acceptance and satisfaction with the care they received from PAs.

Q. How will adding a PA be advantageous to a practice?
A. The physician/PA team allows patient waiting times to be reduced. Patients are able to get appointments sooner and their wait in the office is lessened. There is more time for questions, counseling, and education which increases the level of patient understanding and adherence, which in turn reduces the cost of health care. Physicians are freed to attend to more pressing and complicated cases. In some cases, physicians are able to spend more time performing procedures while the PA sees to patients in the office. The physician/PA team enables patients to receive the same standard of care they would from a physician in a timely and cost-effective manner. A report by the American Medical Association regarding physicians who employ PAs looked at the effect of physician productivity and other characteristics. The findings suggested, “The incentives for employing nonphysician practitioners include increase in net income and physician productivity...”

Q. How will physicians be reimbursed for PA services?
A. Legislation was passed in 1997 that authorized Medicare reimbursement for physician services provided by PAs at 85% of physician rate charges. The majority of private insurance plans also reimburse for physician services provided by PAs.