Physician assistant - Citizendia

In the United States, a physician assistant (PA) is an advanced practice clinician licensed to practice medicine with the supervision of a licensed physician. The United States of America —commonly referred to as the Medicine is the art and science of healing It encompasses a range of Health care practices evolved to maintain and restore Human Health by the A physician, medical practitioner or medical doctor who practices Medicine, and is concerned with maintaining or restoring human Health ^[1] PAs are not to be confused with medical assistants, who perform administrative and clinical tasks in hospitals and clinics under the direct supervision of physicians, registered nurses, nurse practitioners, or PAs. Medical Assistants can be Licensed or unlicensed health care workers who perform the administrative and clinical tasks that keep the offices of health practitioners running A hospital is an institution for Health care providing treatment by specialised staff and equipment and often but not always providing for A clinic (or an outpatient clinic) is a small private or public health facility that is devoted to the care of Outpatients, often in a community in contrast A registered nurse (" RN " is a health care professional responsible for implementing the practice of Nursing through the use of the Nursing A Nurse Practitioner (NP is a Registered nurse who has completed specific advanced Nursing education (generally a Master's degree) and training in the

1 History of the profession
2 Education and certification
3 Scope of practice
4 Employment
5 In the U.S. Armed Forces and Uniformed Services
6 International
7 See also
8 References
9 External links

History of the profession

The PA profession came into existence in the mid-1960s due to the shortage and uneven geographic distribution of primary care physicians in the United States. Primary care is a term used for the activity of a Health care provider who acts as a first point of consultation for all patients Dr. Eugene Stead of the Duke University Medical Center in North Carolina assembled the first class of PAs in 1965, composed of former U.S. Navy hospital corpsmen and U.S. Army combat medics, who had received considerable medical training during their military service and gained valuable experience during the Vietnam War. Dr Eugene Anson Stead Jr (b October 6, 1908, Atlanta Georgia - d Duke University is a private Research University located in Durham, North Carolina, United States. North Carolina ( is a state located on the Atlantic Seaboard in the southeastern United States Year 1965 ( MCMLXV) was a Common year starting on Friday (link will display full calendar of the 1965 Gregorian calendar. Hospital Corpsman (HM is a rating in the United States Navy and a member of the Navy's Hospital Corps The United States Army is a military organization whose primary mission is to "provide necessary forces and capabilities. A combat medic is a trained Soldier or sailor who is responsible for providing First aid and frontline trauma care on the battlefield The Vietnam War, also known as the Second Indochina War, or the Vietnam Conflict, occurred in Vietnam, Laos and Cambodia He based the curriculum of the PA program in part on his first-hand knowledge of the fast-track training of medical doctors during World War II. World War II, or the Second World War, (often abbreviated WWII) was a global military conflict which involved a majority of the world's nations, including

The Duke University Medical Center Archives has established the Physician Assistant History Center, dedicated to the study, preservation, and presentation of the history of the PA profession.

Education and certification

As of May 2008, there were 141 PA programs in the United States ^[2] accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA). The majority are graduate programs leading to the award of master's degrees in either Physician Assistant Studies (MPAS), Health Science (MHS), or Medical Science (MMS), and require a bachelor's degree and GRE or MCAT scores for entry. See also Postgraduate Training in Education Postgraduate education (synonymous in North America with graduate education, and sometimes described The Master of Health Science (MHS degree is a specialized master’s degree. A bachelor's degree is usually an Undergraduate Academic degree awarded for a course or major that generally lasts for three four or in some cases and Graduate Record Examination or GRE is a commercially-run Standardized test that is an admissions requirement for many Graduate schools principally in the The Medical College Admission Test, commonly known as the MCAT, is a computer-based Standardized examination for prospective Medical students Some PA programs are starting to offer a clinical doctorate degree; Doctor of Science Physician Assistant (DScPA), while a remaining few still lead to the award of an undergraduate bachelor's or associate's degree, but many of these are transitioning to graduate-level training. In some Educational systems undergraduate education is Post-secondary education up to the level of a Bachelor's degree. A bachelor's degree is usually an Undergraduate Academic degree awarded for a course or major that generally lasts for three four or in some cases and An associate degree is an Academic degree awarded by Community colleges Junior colleges four-year Universities, Business colleges

PA education is based on the medical school model ^[3], although unlike medical school which lasts four years, PA training is usually 2 to 3 years in duration. It is generalist in approach, consisting of classroom and laboratory instruction in medical and behavioral sciences, such as anatomy, microbiology, pharmacology, pathophysiology, hematology, pathology, clinical medicine, and physical diagnosis, followed by clinical rotations in internal medicine, family medicine, surgery, pediatrics, obstetrics and gynecology, oncology, emergency medicine, and geriatric medicine, as well as elective rotations. Unlike physicians, who must complete a minimum of three years of residency after completion of medical schools, PAs are not required to complete such residencies. Despite this, there are residency programs in certain specialties for PAs who choose to continue formal education in such a format. ^[4]

A PA may use the post-nominal initials "PA", "PA-C", "APA-C", "RPA" or "RPA-C", where the "-C" indicates "Certified" and the "R" indicates "Registered. Post-nominal letters, also called " post-nominal initials " or " post-nominal titles " are letters placed after the name of a person to indicate that " The "R" designation is unique to a few states, mainly in the Northeast; The "A" indicates completion of the Army Flight Surgeon Course. The Northeast is a region of the United States. As defined by the U Most PAs use "PA-C". During training, PA students are designated PA-S. The use of "PA-C" is limited only to those PAs currently certified and in compliance with the regulations of the national certifying organization, the National Commission on Certification of Physician Assistants (NCCPA).

A graduate from an accredited PA program must pass the NCCPA-administered Physician Assistant National Certifying Exam (PANCE) before becoming a PA-C; this certification is required for licensure in all states. ^[5] In addition, a PA must earn and log 100 Continuing Medical Education (CME) hours and reregister his or her certificate with the NCCPA every two years. Continuing medical education (CME refers to a specific form of Continuing education (CE that helps those in the medical field maintain competence and learn about Every six years, a PA must also recertify by successfully completing either the Physician Assistant National Recertifying Exam (PANRE) or Pathway II exam. ^[6]^[7]

Scope of practice

PAs are advanced practice clinicians, and obtain medical histories, perform examinations and procedures, order treatments, diagnose illnesses, prescribe medication, order and interpret diagnostic tests, refer patients to specialists when appropriate and first-assist in surgery. They are employed in primary care or in specialties in urban or rural regions, as well as in academic programs. PAs may practice in any medical or surgical specialty, and have the ability to move to different medical and surgical fields during their careers.

PAs are licensed to practice medicine with physician supervision, which may be either in person, by telecommunication system or by other reliable means (for example, regular chart review and consultation). The physician supervision, in most cases, need not be direct or on-site, and many PAs practice in remote or underserved areas in satellite clinics.

All states, as well as the District of Columbia, Guam, the United States Virgin Islands, and the Commonwealth of the Northern Mariana Islands, have laws or regulations authorizing physician assistants to practice medicine. PAs may also prescribe medications in all of these locations; those who prescribe controlled medications in their scope of practice must also have a DEA number. Medication, also referred to as medicine, can be loosely defined as any substance intended for use in the diagnosis cure mitigation treatment or prevention of disease The Controlled Substances Act ( CSA) was enacted into law by the Congress of the United States as Title II of the Comprehensive Drug Abuse Prevention and Control The Drug Enforcement Administration ( DEA) is a United States Department of Justice Law enforcement agency tasked with combating drug smuggling and ^[8]

Employment

According to the AAPA, there were an estimated 68,124 PAs in clinical practice as of January 2008. ^[9]

In the 2007 AAPA census, just over 56 percent of responding PAs worked in physicians' offices or clinics; 23 percent were employed by hospitals; and the remainder were employed in public health clinics, nursing homes, schools, prisons, home health care agencies, and the United States Department of Veterans Affairs. A hospital is an institution for Health care providing treatment by specialised staff and equipment and often but not always providing for Public health is "the science and art of preventing disease prolonging life and promoting health through the organised efforts and informed choices of society organisations Health care is the prevention treatment and management of illness and the preservation of mental health through the services offered by the medical, Nursing The United States Department of Veterans Affairs ( VA) is a government-run military Veteran benefit system with Cabinet -level status Approximately 9 percent of responding PAs provide health care to rural communities and those with fewer than 20,000 residents, in which physicians may be in limited supply. Rural areas can be large and isolated (also referred to as "the country" and/or "the countryside over the course of time

The U. S. Department of Labor Bureau of Labor Statistics report on PAs states, ". . . Employment of physician assistants is expected to grow 27 percent from 2006 to 2016, much faster than the average for all occupations. . . "^[10] This is due to several factors, including an expanding health care industry, an aging baby-boomer population, concerns for cost containment, and newly-implemented restrictions to shorten physician resident work hours. Baby boomer is a term used to describe a person who was born during the Post-World War II baby boom between 1946 and 1964 Residency is a stage of graduate medical training. A resident physician or resident is a person who has received a Medical degree ( MD

PAs in primary care practice can purchase $100,000-$300,000 insurance premiums for less than $600 a year. Insurance, in Law and Economics, is a form of Risk management primarily used to hedge against the Risk of a contingent loss PAs malpractice coverage are higher in greater risk specialties. In Law, malpractice is a type of negligence in which the Misfeasance, Malfeasance or Nonfeasance of a Professional, under a duty [1]

Money Magazine, in conjunction with Salary. com, listed the PA profession as the "fifth best job in America" in May of 2006, based both on salary and job prospects, and on an anticipated 10-year job growth of 49. 65%. ^[11] According to the American Academy of Physician Assistants (AAPA), in 2007 the mean total income for physician assistants working at least 32 hours per week was $86,214. ^[12] Physician assistants in dermatology or surgical subspecialties can earn $100,000-$200,000, with the mean total income for PAs working at least 32 hours per week in cardiovascular/cardiothoracic surgery listed as $104,681 for 2006. ^[13]

In the U. S. Armed Forces and Uniformed Services

U.S. Army PAs typically serve as Medical Specialist Corps officers within Army combat or combat support battalions located in the continental US, Alaska, Hawaii and overseas. The United States Army is a military organization whose primary mission is to "provide necessary forces and capabilities. The Army Medical Department of the US Army, known as the AMEDD, comprises the six medical Special Branches of the Army An officer is a member of an armed force who holds a position of authority A battalion is a Military unit of around 500-1500 men usually consisting of between two and seven companies and typically commanded by a Lieutenant Colonel The United States of America —commonly referred to as the Alaska ( Аляска Alyaska) is a state in the United States of America, in the northwest of the North American continent The State of Hawaii ( or həˈwaɪʔiː Hawaiian: Mokuāina o Hawaii) is a state in the United States located on an Archipelago in the ^[14] These include infantry, armor, cavalry, airborne, artillery and (if the PA qualifies) Special Forces units. The Infantry is the oldest and most numerous of the Combat Arms in the Armed forces, and consists Armour (or armor) is protective covering most commonly manufactured from metals to prevent damage from being inflicted to an individual or a vehicle through use of direct contact The Cavalry (from French cavalerie) is the second oldest of the Combat Arms, and as Soldiers or Warriors who fought mounted on Artillery (from French artillerie) is a military Combat Arm which employs any apparātus machine In most countries special forces (SF is a generic term for highly-trained Military teams/units that conduct specialized operations such as Reconnaissance They serve as the "front line" of Army medicine and along with combat medics are responsible for the total health care of soldiers assigned to their unit, as well as of their family members. A combat medic is a trained Soldier or sailor who is responsible for providing First aid and frontline trauma care on the battlefield

PAs also serve in the Air Force and Navy as clinical practitioners and aviation medicine specialists, as well as in the Coast Guard and Public Health Service. Aviation medicine, also called flight medicine or aerospace medicine, is a branch of preventive or Occupational medicine in which the patients/subjects Organization of the Public Health Service The Public Health Service Act placed the United States Public Health Service ( PHS) as the primary division The skills required for these PAs are similar to that of their civilian colleagues, but additional training is provided in advanced casualty care, medical management of chemical injuries, aviation medicine as well as military medicine. Aviation medicine, also called flight medicine or aerospace medicine, is a branch of preventive or Occupational medicine in which the patients/subjects The term military medicine has a number of potential connotations In addition, military PAs are also required to meet the officer commissioning requirements and maintain the professional and physical readiness standards of their respective services.

International

Canada

The PA concept is being explored in Canada, where Canadian military PAs are gaining legislative changes allowing them to work in the civilian world after retirement. Country to "Dominion of Canada" or "Canadian Federation" or anything else please read the Talk Page A military is an Organization authorized by its Nation to use force usually including use of Weapons in defending its Country (or by attacking ^[15]^[16] Education programs are now offered at the University of Manitoba in Winnipeg, McMaster University in Hamilton, Ontario, and the University of Toronto. The University of Manitoba, in Winnipeg, Canada, is the largest university located in the province of Manitoba. McMaster redirects here for others see McMaster (disambiguation. Hamilton (ˈhæməltən ( 2006 population 504559 UA population 647634 CMA population This article is about the University of Toronto's St George Campus Programs are 24 months in length.

England

In England, U. England is a Country which is part of the United Kingdom. Its inhabitants account for more than 83% of the total UK population whilst its mainland S. -trained PAs are working in a pilot project in Sandwell and West Birmingham. ^[17] Education programs are now being offered by four universities: University of Birmingham, University of Wolverhampton, University of Hertfordshire (operating as Bedfordshire and Hertfordshire Postgraduate Medical School, in conjunction with the University of Bedfordshire), and St George's, University of London. The University of Birmingham (informally Birmingham University) is a British red brick University located in the city of Birmingham The University of Wolverhampton is a British University, located on four campuses across the West Midlands and Shropshire. The University of Hertfordshire is a modern university based largely in Hatfield, in the county of Hertfordshire, England, from which the university The University of Bedfordshire is a modern university based in Luton and Bedford St George's University of London ( SGUL) previously known as George's Hospital Medical School ( SGHMS) is a specialist medical college The University of Warwick and University of Coventry have also explored offering these programs, but did not implement them due to a lack of need. The University of Warwick is a British Campus university located on the outskirts of Coventry, West Midlands, England and is Coventry University is a post-1992 University in Coventry, West Midlands, England.

Also referred to as "Medical Care Practitioners", PAs are to be employed by the National Health Service. The National Health Service is the name commonly used to refer to the four Publicly-funded healthcare systems of the United Kingdom collectively or individually (although Though currently not a registered profession, PAs can currently practice under delegation rules. Programs are 24-36 months in length.

Scotland

Pilot projects in Scotland are underway, but no official educational programs have been implemented as of 2008. Scotland ( Gaelic: Alba) is a Country in northwest Europethat occupies the northern third of the island of Great Britain. ^[18]

The Netherlands

The Netherlands has educational programs at the Academie Gezondheidszorg in Utrecht, University of Arnhem/Nijmegen, the University of Groningen and the University of Leiden. The Netherlands ( Dutch:, ˈnedərlɑnt is the European part of the Kingdom of the Netherlands, which consists of the Netherlands the Netherlands The University of Groningen (Rijksuniversiteit Groningen located in the city of Groningen, was founded in 1614. Leiden University (Universiteit Leiden located in the city of Leiden, is the oldest University in The Netherlands. Programs are 30 months in length. ^[19]

South Africa

One program is now offered in South Africa, at the University of Witwatersrand. The University of the Witwatersrand Johannesburg is a leading South African University situated in the northern areas of central Johannesburg.

Taiwan

In Taiwan, nurses can be trained to practice medicine in a 36-month program, being offered at the private Fooyin University. Taiwan ( Taiwanese: Tâi-oân/Tāi-oân (historically 大灣/台員/大員/台圓/大圓/台窩灣 is an Island in East Asia. Medicine is the art and science of healing It encompasses a range of Health care practices evolved to maintain and restore Human Health by the

Australia

Two educational programs in Australia are also planned to start in 2009, at the University of Queensland and James Cook University. For a topic outline on this subject see List of basic Australia topics. The University of Queensland (UQ is one of Australia's premier learning and research institutions James Cook University (JCU is a Public University based in Townsville Queensland, Australia and was proclaimed on 20 April

References

External links

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