Say a persistent cough has been troubling you for months. Maybe you’ve been shrugging it off as an allergy, but you’ve begun to worry that it may be something more serious. You dial up your primary care physician to get an appointment and find … you’ll have to wait several months!
While such delays are common these days, particularly in a family practice, some doctors are increasingly offering patients a quick alternative: If you’re willing to see a physician assistant, you might get an appointment tomorrow.
A physician assistant, or PA, is a medical professional who’s certified by a national organization and licensed by the state to practice under the supervision of a physician. PAs can conduct physical exams, diagnose and treat illnesses, write prescriptions, order tests and much more.
They must renew their certification as medical generalists every 10 years, but many also seek specialized training in a range of different fields, which allows them to practice on medical teams in nearly every specialty. Many PAs work in emergency departments; pediatric, orthopedic and dermatology clinics; and even surgery centers.
John McGinnity, a PA in Detroit and president of the American Academy of Physician Assistants, says that the ability of PAs to move among various specialties has made them invaluable in a health care system that struggles to meet changing needs.
More people are visiting physicians than ever before, and the Affordable Care Act is giving millions more people access to care, he points out. “As we look at changes in health care, we need all hands on deck to address 32 million more patients coming into the system,” he says.
McGinty says that more than 100,000 PAs currently practice medicine around the country, and training programs graduate about 6,000 PAs each year.
The programs, often run by existing medical institutions or schools, generally are about 29 months in length and encompass two years of didactic instruction followed by clinical rotations, similar to a residency.
To qualify to enter PA training, a candidate must have a bachelor’s of science degree that includes courses in basic sciences, physiology statistics, genetics and other areas, much like a pre-med program.
Because demand for PA training is high and spaces in training programs are limited, McGinty says credentialed PAs tend to be high achievers. “We’re taking the cream of the crop,” he says.
Many of those entering PA training are nurses, paramedics, sports trainers and the like who already have a foundation in health care and realize that they could increase their value by taking the next step, McGinty says.
PA training, which began at Duke University in the 1960s, has mostly been concentrated in the largest urban centers, where the patient population is dense. But as demand has risen in the past decade, the programs are spreading at a faster clip.
Three PA training programs now operate in Louisiana, with the oldest one being in Shreveport. The second program started about eight years ago at Our Lady of the Lake College in Baton Rouge. And in 2013, a PA training program launched in New Orleans.
Debra Munsell, who heads the program at LSU’s school of allied health professions in New Orleans, says the program has had no difficulty in finding good candidates. “We had more than 300 applicants for 30 spots,” she says.
Members of the first local class of PAs are slated to graduate in May, and two more classes of 30 each will graduate in 2016 and ’17.
Munsell says doctors and clinics are already clamoring to recruit the graduates. “As soon as we were accredited to start the program, physicians started calling,” she says.
Other medical professionals are rapidly coming to appreciate the flexibility that PAs bring to hospitals and other health care settings. Those who have diverse experience or are trained in multiple specialties can easily be deployed where they are most needed within a hospital at any given time, for instance.
And in outpatient clinics or physician group practices, PAs help relieve the pressure on doctors who get too little time off.
Many of these practices and institutions are employing more and more nurse practitioners as well.
Nurse practitioners, or NPs, are individuals who blend clinical expertise in diagnosing and treating health conditions with an added emphasis on disease prevention and health management, according to the American Association of Nurse Practitioners.
They must complete a master’s or doctoral degree program and have advanced training beyond the registered nurse preparation. They also must receive national certification and be licensed by the state where they practice.
Like PAs, they bring expertise and skills that can augment and expand care in a system where access to care can be problematic.
By some measures, the U.S. health care system is nearly 60,000 doctors short of the number that will be needed to meet demand in coming years. Medical schools are not graduating physicians fast enough to keep up with need, and that bodes well for “advanced practice providers” such as PAs and NPs.
Professional training
LSU Health New Orleans offers training for both physician assistants and nurse practitioners.
For information on the Master of Physician Assistant Studies Program, see alliedhealth.lsuhsc.edu or call 556-3420 for more details.
The LSU/HSC School of Nursing offers nurse practitioner programs in primary care/public health and neonatal care. See nursing.lsuhsc.edu or call 568-4197 for further information.
