NPs and PAs: Working With You

Dipesh Navsaria, MPH, PA-C


March 12, 2002

In This Article

A Closer Look: PAs

PAs are licensed to practice medicine with physician supervision. This is important, because it means each and every PA in clinical medicine works together with a physician who maintains ultimate responsibility for the patient. PAs perform physical exams, diagnose and treat illnesses, order and interpret tests, counsel, assist in surgery, and, in most states, can write prescriptions.

The supervising physician will generally review and co-sign charts, be available to discuss and see patients with complex problems, and provide general direction. In many states (especially those with isolated rural settings), the supervising physician may be available only through radio or telephone contact. However, in most areas, the physician and PA often work in the same office or hospital. The physician will, in general, decide what a PA can or can't do, consistent with their comfort level (within the restrictions of state law, hospital bylaws, and the like, of course.)

Generally speaking, most PA schools comprise roughly 6 semesters of classroom and clinical work, similar to the preclinical/clinical setup of medical schools. While admissions criteria vary, almost every student enters PA school with at least a bachelor's degree.

There is great diversity in the degree awarded, even if the clinical training is similar; however, more and more schools are moving towards the master's degree as a standard. There is also similar variation in institutional sponsorship, from PA programs that are housed within medical schools to collaborative efforts between community colleges and hospitals. Keep in mind, though, that the clinical training is the same, irrespective of the degree or setting of the institution.

Graduates are required to take the Physician Assistant National Certifying Exam (PANCE) in order to receive national certification, and must be recertified every 6 years. On receiving this credential, they are designated Physician Assistant-Certified (PA-C).

PAs work in a variety of fields of medicine. Traditionally, most go into family practice, surgery, and emergency medicine.[2] However, PAs are found in many arenas, ranging from general pediatrics to forensic pathology.

And, incidentally, the correct term is "physician assistant" -- not "physician's assistant." A few programs used to (and may still) refer to themselves as "physician associate" programs. While many feel that this is a more accurate term (and less likely to be confused with "medical assistant"), the task of changing the nomenclature in 50-plus jurisdictions as well as other areas is more trouble than it is worth.


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