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About the Physician Assistant Profession

Definition of a Physician Assistant

Physician assistants are health care professionals licensed, or in the case of those employed by the federal government they are credentialed, to practice medicine with physician supervision. 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 write prescriptions. Within the Physician-PA relationship, physician assistants exercise autonomy in medical decision making and provide a broad range of diagnostic and therapeutic services. A PA's practice may also include education, research, and administrative services.

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 that 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. www.aapa.org

History of the Physician Assistant Profession
1650 - 1960
Experiments in other countries and social and political events fostered the establishment of the PA profession in the United States. The use of non-physician personnel to provide services, especially in medically underserved communities has an extensive history. Many doctors in the United States have trained their own “assistants” to help with the workload in their office. Nurses are provided advanced clinical training at a major U.S. medical center in the 1950’s, but the program is not accredited by the National League for Nursing. The number of specialist physicians begins to outnumber the number of generalist physicians being educated in the United States in the 1950’s. Consequently, a growing shortage of physicians, nurses and allied health personnel to meet the demand for primary health care services is recognized.
1961 - 1970
The PA concept is introduced to organized medicine and the general public to combat a shortage of doctors and clinical support personnel. The first formal educational programs for physician assistants and nurse practitioners are established in the United States. Former military corpsmen are the primary source of students for both PA and MEDEX programs. Physician assistant graduates and students form national professional organizations to address their collective concerns. Federal funding becomes available for PA educational programs. The first organization is established to register PAs and assure employers and the public of their competence. The American Medical Association begins to explore accreditation and certification standards for PA and MEDEX graduates. This and the next decade are a time of profound change and experiment in health care in the United States.
1971 - 1980
In this decade, the PA Profession emerges as a fully integrated profession into the practice of medicine at all levels in the United States. Building on the success of the late sixties, the leaders ensure that all important aspects of the new profession are addressed and that essential structures are put in place. The Association of Physician Assistant Programs (APAP) is formed. The first National Conference on New Health Practitioners is held in Wichita Falls, Texas. The National Board of Examiners produces and administers the first national certifying examination for physician assistants. Fourteen health organizations join to establish the National Commission on Certification of Physician Assistants (NCCPA). The American Academy of Physician Assistants (AAPA) becomes the “sole spokesman” for physician assistants. A joint National Office for both the AAPA and APAP is opened in Washington, DC. There is a rapid expansion of baccalaureate PA educational programs stimulated by Federal training contracts. The first workforce studies are conducted on PAs. By mid-decade, 37 states adopt amendments to their medical practice acts which allow delegation of tasks to specially trained assistants. Multiple published studies conclude that PAs function at a level comparable to a control group of medical house officers. The AAPA establishes a House of Delegates to address policy issues.
1981 - 1990
There is an increasing trend toward specialization, and a growing recognition of PA contributions to the workforce. Reimbursement of PA services in certain settings under Medicare Part B is approved and PAs are granted commissioned officer status throughout the uniformed services. Passage and revision of legislation allows prescriptive privileges for PAs in most states.
1991 - 2000
States continue to revise legislation, rules and regulations in order to enhance the effectiveness of physician assistants. VA Medical Centers, the Military and other federally sponsored health care institutions rely heavily on PAs to bolster medical staffs. HMOs recognize the vital roles of PAs and NPs in helping to reduce cost. Steps are taken to foster and maintain close working relationships with organized medicine. There is rapid expansion of physician assistant programs, and a trend towards master's level education.
2001 - 2010
The number of accredited PA educational programs in the United States surpasses 150. The profession celebrates its 40th anniversary. International interest in the PA model of health care delivery grows with the establishment of PA educational programs in seven countries. Record numbers of new PA graduates take the PANCE. Clinical doctorate degrees are awarded to Army PAs who complete postgraduate education. A reduction in MD resident hours spurs employment and postgraduate learning opportunities for PAs in hospital inpatient settings.
2011 - Present
With the passage of the Affordable Care Act, the numbers of PAs are projected to double. PAs are seen as key components of new health care delivery structures such as medical homes and accountable care organizations. PAs move to strengthen their relationships with both organized medicine and nursing and emphasize their roles in interprofessional and team based practice, especially in primary care. Entry of military corpsmen/women into PA programs is once again emphasized by the federal government. The PA concept attracts more international attention as a cost effective model for providing health care services in both industrialized and developing countries.

This information was copied from the Physician Assistant History Center at http://www.pahx.org/.