Physician Assistants - General Considerations
A Physician Assistant (PA) is a health professional who practices medicine with physician supervision. As a member of the health care team, the PA provides a broad range of medical services including diagnostic, therapeutic, and health promotion/disease prevention. PAs are qualified by graduation from an accredited PA educational program and by certification by the National Commission on Certification of Physician Assistants (NCCPA) to exercise a level of autonomy in the performance of clinical responsibilities within state medical practice—authorized scope of practice and the supervisory relationship. The clinical practice of the PA includes both primary care and specialty cares roles, and spans a wide range of medical practice settings in rural and urban areas. The role of the PA is centered on patient care responsibilities, but may include educational, research, and administrative activities (HRSA, 1994).
The six clinical services performed by PAs include evaluation, monitoring, diagnostics, therapeutics, counseling, and referral.
- Evaluation is defined as the initial approach to elicit a detailed and accurate history, perform an appropriate physical examination, delineate problems, and record and present the data.
- Monitoring, or assisting the physician in developing and implementing patient management plans, recording progress notes, and assisting in providing care in office or hospital based settings is performed routinely.
- A diagnostic workup involves performance and interpretation of common laboratory, radiological, cardiographic, and other procedures used to identify pathophysiological processes.
- Therapeutics refers to performing routine procedures such as treating infections, immunizing employees, suturing or follow-up wound care, managing simple conditions produced by infection or trauma, assisting in the management of complex illness and injury, and writing prescriptions as authorized by state law.
- Counseling relates to delivering instruction to help with therapeutic compliance, emotional problems of daily living, and health maintenance.
- Referral involves facilitating patients to community health and social service agencies (HRSA, 1994, p. 16).
In the workplace, physician assistants deliver health services in all areas. Besides the above-mentioned clinical services as applied to outpatient occupational and environmental medical care delivery, PAs contribute to health promotion for workers through clinical practice, research, and teaching and often lead investigations of environmental exposures (Ramos, 1999, p. 689).
Harris, J. S. (1997) "Development, Use, and Evaluation of Clinical Practice Guidelines" Journal of Occupational and Environmental Medicine, 39, 1, January.
HRSA (1994), Health Resources and Services Administration, U.S. Department of Health and Human Services, Public Health Service, Bureau of Health Professions, Division of Medicine, Special Projects & Data Branch, pp. 16-18.
Ramos, M. (1999) "Occupational and Environmental Medicine for PAs" in Physician Assistant, A Guide to Clinical Practice, Ballweg, R., Stolberg, S., & Sullivan, E. M. (Eds.) Philadelphia: W. B. Saunders, pp. 684-711.
Maryann Ramos, PA-C, M.P.H.
May 9, 2000