The Physicians Assistant And Healthcare Health And Social Care Essay

The Physician's Assistant and healthcare. Given the recent political drama and banter over healthcare in our nation there should be little doubt that the landscape of healthcare as we know it will most assuredly be changing. For many years, the trends in healthcare have looked unsustainable - ageing populations result in more people needing care, while a declining workforce means fewer people to pay for, and actually deliver, that care. At the same time, an inexorable rise in the costs of care linked to long term conditions reflects the impact of modern lifestyles, as well as positive advances in medicine and public health. I believe that the Physician's Assistant is going to be a large player in the healthcare world of tomorrow by lessening the workload on physicians and allowing better healthcare to remote and difficult regions, both rural and urban. The expected growth of this profession varies, depending on the source, but CNN Money ranked it the second best job over the next twenty years in healthcare, with an expected growth rate of 45 percent (CNN.com).

Many healthcare experts warn there won't be enough doctors to treat the millions of people newly insured under the Obama Care law. With the current graduation and training rates, the nation could face a shortage of as many as 150,000 doctors in the next 15 years, according to the Association of American Medical Colleges. Joseph Stubbs, president of the American College of Physicians - the second-largest doctors' group in the country, states that over 17,000 new doctors are needed right now. Where does this level of care come from? Increasing the number of Doctor's will help, but this will take at least eight years for them to be fully functional. The physician's Assistant has both the ability and training to fill this deficit in healthcare.

The field began nearly half a century ago with the return of U.S. Navy corpsmen from Vietnam; they sought to transition to life outside the armed forces. These military medics lacked the formal training that doctors underwent, but had valuable skills that could certainly be put to use in the civilian world. A specialty program based on the military's "fast-track" medical training methods was created. By the end of the 1960s, the first graduating class of physician assistants was available to help relieve the critical shortage of doctors that plagued many areas of the nation.(McCartney)

Physician assistant education programs are typically 24-32 months long, though some use a non-traditional method built around the schedules of working adults seeking career change and hold class at night and on weekends Most of the first year of physician assistant school is spent in classroom study, (didactic education); combined with learning about medical ethics, physical diagnosis, clinical pharmacology, family medicine, emergency medicine, orthopedics and psychiatry. Much time is also spent in the laboratory focusing on microbiology, chemistry and pathology. As the majority of physician assistant students have some prior healthcare background, some of the topics are seem familiar to them. In the last year of school, physician assistant students begin a few clinical rotations, each of which lasts 30-90 days (AAPA). These out-of-classroom experiences expose students to a variety of specialties, including emergency medicine, psychiatry, surgery, family medicine and obstetrics and internal medicine. Students have leeway to choose electives based on their anticipated career path. These electives may be an entirely new specialty or a repeat of one already taken. Residencies are not generally required of physician assistants, but are often available in some specialty branches of medicine, such as orthopedics, pediatrics, even surgery.

Physician assistants (PA's) must work under the supervision of a physician; however, PAs may be the principal care providers in rural or inner-city clinics where a physician is present for only 1 or 2 days each week. In these cases, the PA confers with the supervising physician and other medical professionals as needed and as required by law. PAs also have the ability to make house calls or go to hospitals and nursing care facilities to check on patients, after which they report back to the physician (Price).

The duties of physician assistants are determined by the supervising physician and by State law. PAs may work in primary care specialties, such as general internal medicine, pediatrics, and family medicine. Other specialty areas include general and thoracic surgery, emergency medicine, orthopedics, and geriatrics. PAs specializing in surgery provide preoperative and postoperative care and may work as first or second assistants during major surgeries. The 2006 Physician Assistant Census, published by the American Academy of Physician Assistants, indicates that of the more than 63,600 practicing physician assistants, about 36% are practicing in primary care. Family practice is the most common specialty for physician assistants (27%), followed by surgery and surgical subspecialties, emergency medicine, subspecialties of internal medicine, general internal medicine, and dermatology. (Price)

All States and the District of Columbia have legislation governing the practice of physician assistants. All jurisdictions require physician assistants to pass the Physician Assistant National Certifying Examination, administered by the National Commission on Certification of Physician Assistants (NCCPA) and open only to graduates of accredited PA education programs. Only those who have successfully completed the examination may use the credential "Physician Assistant-Certified", or PA-C. In order to remain certified, PAs must complete 100 hours of continuing medical education every 2 years. Every 6 years, they must pass a recertification examination or complete an alternative program combining learning experiences and a take-home examination (which is going away in 2011). The number of accredited PA programs has more than doubled from 55 to 137, since 1992. (Price) The American Academy of Physician Assistants' 2008 survey found that newly licensed physician assistants could earn anywhere from $62,000 to $90,000 while the average salary for all full-time physician assistants was just about $85,000 a year. (Price)

PAs are utilized with increasing frequency in US Emergency Departments, and general care clinics both with and without physician involvement. In 2005, they participated in 13% of all ED and clinical care visits. Although PAs were utilized more often for lower risk visits, 37% of patients seen only by mid-level providers were of urgent acuity and 3% were admitted (McCartney). This suggests that the role of mid-level providers (PA's), practicing without direct physician involvement has extended beyond simple and minor presentations. These trends in alternative staffing of ED's and patient care clinics are likely to continue, given that workforce needs in emergency medicine continue to outpace the supply (and national distribution) of board-certified emergency physicians. With the flux in healthcare, the shortage of physicians, and the steady increase in patient loads, the PA must be further utilized to help fill the deficit of provider based care in America.