How it Works: Physician Assistants

How it Works: Physician Assistants

By Jarrod Beachum, PA-C

This week’s blog was inspired by…me! Ok, not really. However, I do get asked pretty often what exactly a physician assistant, or PA, is. My usual go-to answer is “PA-C stands for Pretty Awesome, and I’m certified!” Thank you, thank you, I’ll be here all night.

So what is a PA? Well, there is a long history of assistants or associates who were trained and served under the direct guidance of physicians to do limited procedures and take some level of medical responsibility for a patient. The Russians developed feldshers in the 1800s, who served prominent roles in delivering healthcare to rural areas that couldn’t get doctors. They inspired many other examples of those types of providers around the world throughout the last two centuries. Our profession was also built on early American experiences where doctors would train local townsfolk to work with them, teaching them enough to function as a second hand to the physician and eventually take care of their own patients. There is a famous surgical assistant that every American should know about named Vivien Thomas, who despite formal medical training, rose to become the director of the Surgical Research Labs and Instructor of Surgery at Johns Hopkins School of Medicine. (This was especially impressive because Dr. Thomas was a black man, and his career spanned from 1930 to 1976.) In the 1960s there was a massive shortage of primary care physicians in the US. They were struggling to find ways to get enough doctors to fill those roles. Dr. Eugene Stead, MD, was working at Duke University Medical Center. He was aware that in World War II the military had a fast-track training program for doctors to serve overseas and take care of the troops. Using this as his model, he brought on four Navy Hospital Corpsmen, who at the time essentially had the same training as a paramedic but with the enhanced military medicine experience that civilians didn’t normally have. This was the very first class of PAs, and three of them graduated on October 6, 1967, which is today considered the birthday of our profession.

Today, PAs serve in both primary care and in every specialty in the medical field. We are trained in the medical model to examine, diagnose, and treat patients. We are taught to look at the whole person and deliver patient-centered care through shared decision making, and not focus just on the disease and treating symptoms. We can prescribe medicine, perform procedures, run codes, work in surgery…you name it, and PAs can most likely do it. These days, we are required to have a four-year undergraduate degree, then complete a two- to three-year master’s program. Most PA programs consist of 12 months of rigorous didactic training, usually completing over 30 credit hours a semester! We then spend another 15 months in our clinical training, working full time in various areas of medicine including primary care, emergency medicine, surgery, women’s health, behavioral medicine, pediatrics, orthopedics, internal medicine, and more. Some PAs will go on to residency/fellowship programs where they get more in-depth and focused training in a particular field, or they go straight to the workforce and work under the mentorship of more experienced providers.

Regardless of the field we work in, all PAs have to pass national boards in order to gain licensure, and we must complete continuing education classes every year to maintain our certification (the “C” in PA-C). Every 10 years we retake our national boards. These rigorous requirements ensure that PAs stay up to date in practice and clinical research so we can continue to deliver effective, cost-efficient healthcare. If you have questions or know anyone looking at this field as a career, come by 45 Urgent Care and I’ll be happy to talk with you.

Jarrod Beachum, PA-C