GIPA
offers the following guidelines for the role of Physician
Assistants (PAs) practicing in Gastroenterology and Hepatology.
These guidelines are meant to serve as a guide in practice,
but are not to take the place of state/federal legislation
or other regulatory boards. State laws and regulations
define the PA profession in each state and establish registration
and competency requirements, as well as the responsibilities
of the supervising physician.
In most states the Board of Medical Examiners is responsible
for licensing and regulating PAs. Gastrointestinal Physician
Assistants (GI PAs) may provide care for patients in various
settings including outpatient clinics/offices, HMOs, inpatient
hospital settings, and government institutions. Most GI
PAs have hospital privileges and membership on the medical
staff. GI PAs may also be involved in education, teaching,
and administrative functions pertaining to the fields
of Gastroenterology and Hepatology. Some
GI PAs are involved with research and publication.
GI PAs always practice with the supervision of a physician,
but exercise autonomy in diagnosing and treating illnesses
within their scope of practice and that of their supervising
physician. Individual PA duties are dependent on the
scope of his or her supervising physician's practice
and the desire of the physician to delegate certain
tasks or responsibilities. The range of duties and responsibilities
of a GI PA are as varied as the number of different
GI practices. Besides performing routine duties such
as histories & physical exams, daily patient rounds,
patient education, and discharge summaries, GI PA's
may perform diagnostic/therapeutic procedures. Whether
a GI PA performs these procedures is subject to state
regulation, PA training/experience, the scope of the
supervising physician, and the needs of the practice.
Such procedures may include, but are not limited to:
- Flexible
Sigmoidoscopy
- Paracentesis
- Liver
Biops
GI PAs report that the most frequent work-ups they are
presented with include, but are not limited to, the
following chief complaints:
- Work-up
of abdominal pain
- Work-up
of dyspepsia
- Work-up
of nausea/vomiting
- Work-up
of dysphagia
- Work-up
of constipation
- Work-up
of diarrhea
- Work-up
of gastrointestinal bleeding
- Work-up
of elevated liver enzymes
GI PAs obtain medical histories and perform physical
exams, order and interpret laboratory data, order and
read radiological studies, formulate a differential
diagnosis and establish a working diagnosis, formulate
a treatment plan, prescribe medication, perform procedures,
round in the hospital, and dictate H & Ps and daily
progress notes for patients with Gastrointestinal and
Liver Disease including, but not limited to the following
diagnoses:
- GERD
- Esophageal
Dysmotility
- Esophageal
Cancer
- Gastroduodenal
Ulcer Disease
- Zollinger-Ellison
Syndrome
- Gastric
Carcinomas
- Carcinoid
- Celiac
Sprue
- Whipple’s
Disease
- Ileus/Obstruction/Pseudo-obstruction
- Gastrointestinal
Lymphoma
- Hepatitis
C
- Hepatitis
B
- Autoimmune
Hepatitis
- Fatty
Liver and NASH
- Alcoholic
Hepatitis +/- Cirrhosis
- Spontaneous
Bacterial Peritonitis
- Primary
Biliary Cirrhosis
- Hemachromatosis
- Wilson’s
Disease
- Budd-Chiari
Syndrome
- Neoplasms
of the Liver
- Acute
and Chronic Cholecystitis
- Biliary
Dyskinesia
- Choledocholithiasis
and Cholangitis
- Primary
Sclerosing Cholangitis
- Carcinoma
of the Biliary Tract
- Acute
and Chronic Pancreatitis
- Pancreatic
Insufficiency
- Pancreatic
Carcinomas
- Irritable
Bowel Syndrome
- Diverticular
Disease
- Anorectal
Disease
- Crohn’s
Disease
- Ulcerative
Colitis
- Infectious
Colitis
- Microscopic
Colitis
- Ischemic
Colitis
- Colon
Cancer Screening
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