A Day in the Life of a Physician Assistant

By Rick Fromme

Many of us know the iconic painting by Norman Rockwell, where an elderly doctor, with his ever-present black bag, is checking the pulse of a little girl holding her doll. Chances are if a similar painting were to be put to canvas today, the elderly doctor would be replaced by a significantly younger Physician Assistant (PA).

If you read my previous blog in February, “HealthCare Job Outlook is Jammin’!” you’ll recall one of the fastest growing health care fields for the foreseeable future is Physician Assistant.  

There are several reasons for the rapid growth for this profession. As I’ve stated before — because it’s driving the function of health care in numerous fields — we live in a country with an ever-growing elder population. All those once-young Baby Boomers aren’t so any longer. Secondly, as more medical students are choosing different specialties other than primary care, increasingly, PAs are often serving as the frontline primary care providers in a variety of hospital and clinical settings (along with APRNs). According to the Bureau of Labor Statistics: “Employment of Physician Assistants is projected to grow 38 percent from 2012 to 2022, much faster than the average for all occupations. Increased demand for healthcare services from the growing and aging population and widespread chronic disease, combined with a shortage of physicians, will result in increased demand for healthcare providers, such as Physician Assistants.”

Like APRNs, PAs practice medicine under the supervision of doctors and/or surgeons. Having said that, most PAs have a fair amount of autonomy in their practice.  Depending upon what type of environment they’re in, a PA can be the main medical provider; only needing to consult with a supervising physician when absolutely necessary.

U.S. Navy Ens. Frank Percy, right, a physician’s assistant from Naval Medical Center San Diego (Photo credit: Wikipedia)

PAs' responsibilities depend on state laws, practice setting, their experience, and the scope of practice of the physicians on their health care team. In general, PAs do physical exams, consult/follow up with patients, treat various illnesses and injuries, diagnose illness/conditions, do minor surgical procedures, remove moles and other minor blemishes, drain fluids, prescribe medications (in all 50 states, the District of Columbia , and all U.S. territories with the exception of Puerto Rico), order lab and diagnostic tests, admit patients to hospitals, provide patient education and counseling, make rounds in hospitals and nursing homes, and even evaluate patients’ oral health … and more. For example, PAs working in a cosmetic surgeon’s office may do laser procedures on a patient’s skin or remove sutures after a facelift.  As you can see, PAs’ tasks and responsibilities are highly varied; hardly ever a dull day in this demanding profession. “It’s the closest thing to being a doctor without actually becoming one,” a PA friend of mine quips.  he’s not far from the truth. 

Some of the specialties employing PAs:

Family Practice/Primary Care/General Medicine

Internal Medicine

Internal Medicine Subspecialties

OB/GYN

Orthopedics

Pediatrics

Emergency Medicine

General Surgery

Surgery Subspecialties

PA Educator

Regardless of the specialty, PAs are highly trained to deliver excellent medical care. In fact, research shows patients are just as satisfied with PA-provided care as they are with physician-provided care. PAs work in urgent care, primary care, industrial medicine and even surgery. About 60% of PAs work in primary care specialties such as general and family medicine. The remainder work in sub-specialties such as surgery 

and orthopedics. Pick a medical specialty; these days, you’ll often find a PA or two serving along side or 

under the supervision of an M.D. PAs that practice in hospitals work in almost all patient-focused departments and practice with physicians in every medical and surgical specialty. PAs may be employed by the hospital (or system), medical practices or hospital medicine groups.

Heart of Cape Town Museum (Photo credit: mallix)

As discussed above, PAs often perform highly sophisticated tasks and procedures that decades ago, were only handled by doctors or surgeons. For example, take a patient who’s undergoing a multiple coronary artery bypass procedure. While the cardiac surgeon is excising and preparing the internal mammary/thoracic artery for the heart’s principal bypass graft, today it could be the surgeon’s PA who is responsible for removing and preparing the great saphenous vein from the patient’s leg to be used for additional grafts. And during post-op visits, it’s often the same PA who assesses the patient’s recovery, prescribes any medications, provides patient instruction, etc.

Most PAs see between 20 to 30 patients a day; depending upon their work environment and number of other staff members available to treat patients. For example, a PA that’s the primary care giver at a retail walk-in clinic (publically or privately owned) may see more patients than a PA who works at one of several regional care centers that belong to a major hospital. That’s because the hospital/corporate owned facility may have a few doctors, APRNs and perhaps a few other PA s on-site that help manage the work load. As well, these facilities usually have a larger support staff, which can help diminish PAs requisite paperwork (charts, prescription refills, insurance documentation, lab results, etc.). PA s working in hospitals and major medical centers may carry more shifts throughout the evenings and weekends.

Education

OUCeremony-039 (Photo credit: The Open University (OU))

Like many of the top health care jobs, to become a PA-C (Certified Physician Assistant), one must obtain a Master’s degree from an accredited program and then pass a state licensure exam. Similar to medical school, PA’s education includes instruction in core sciences: anatomy, physiology, biochemistry, pharmacology, physical diagnosis, pathophysiology, microbiology, clinical laboratory science, behavioral science and medical ethics. Also similar to a doctor’s medical school curriculum, PAs undergo a combination of classroom and clinical instruction. The average length of a PA’s Master’s degree takes about 26 months. It’s described as being “rigorous and intense.” Graduates of accredited PA programs are eligible to take the Physician Assistant National Certifying Exam (PANCE) administered by the National Commission on Certification of Physician Assistants. Some PAs further their education to the doctorate level education in a specialty of their choice (usually after several years of hands-on clinical care practice). There has been talk of advancing the requisite PA degree requirement to doctorate level, not unlike a DNP (Doctorate Nurse Practitioner) but nothing official has been established yet.

In this article I talked about Physician Assistants. I cited reasons for the profession’s increased growth rate, gave an overview of PAs numerous job functions/responsibilities, cited various specialties employing PAs and facilities where PAs practice, and discussed the educational and licensure requisites for becoming a PA-C (Certified Physician Assistant).If you found this article useful and informative, please leave a comment below. Also, feel free to share it with your colleagues and friends.

Rick Fromme combines entrepreneurial enthusiasm with an insider's knowledge of the medical industry to co-found MedMasters.com. Both his drive and perspective helps provide health care professionals with a superior mechanism with which to communicate, network and market their strengths. Prior to founding MedMasters.com, Rick operated a highly successful medical device distributorship. Other milestones in his 12-year career in the medical industry include a key position at a medical device start-up company that was later sold to the Ethicon Endo division of Johnson & Johnson. You may also reach Rick by connecting with him on Facebook, Twitter, Google+, LinkedIn and YouTube. 

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Get Smart: A Quick List of America’s Top Health Care & Medical Schools

By Rick Fromme

In one of my recent blogs, “Health Care Job Outlook is Jammin’!” I listed the Bureau of Labor Statistics’ top dozen medical/health care professions that are expected to grow between 2012 and 2022.  Correspondingly, here are U.S. News & World Report’s rankings for educational programs (undergraduate and, where appropriate, graduate) for the top twelve-listed medical/health care professions. To remain consistent with my previous blog, I’ve listed the specialties in their sequentially ranked order. Note that in some instances, several institutions tied for certain placements, whereas other placements aren’t even listed. In situations where no school/program rankings were published for a given specialty, I provided links where you can research more information.

Dentist*

The Dentist (Photo credit: Wikipedia)

Dentists diagnose and treat problems with teeth and tissues in the oral cavity, along with providing advice and administering care to help prevent future problems.

#1 University of Pennsylvania

#2 University of California at San Francisco

#3 University of Michigan

#4 University of Florida

#5 Boston University Herman M. Goldman School of Dentistry

#6 New York University

#7 University of Maryland

#8 University of North Carolina – Chapel Hill

#9 University of Southern California

#10 Everest College – Los Angeles

Adult Nurse Practitioner*

In an adult nurse practitioner program, students are trained to work with older patients in a variety of settings, including urgent care, primary care, and Specialty units.

#1 University of Pennsylvania

#2 University of California – San Francisco

#3 University of Washington

#4 Columbia University

#4 University of Michigan – Ann Arbor

#6 University of Pittsburgh

#7 Rush University

#8 University of Maryland – Baltimore

#9 Yale University

#10 Duke University

#10 University of Alabama - Birmingham

Pharmacist

Pharmacy graduate programs offer advanced education for students seeking master’s or doctoral-level pharmacy (PharmD) degrees.  

#1 University of California – San Francisco

Various pills (Photo credit: Wikipedia)

#2 University of North Carolina – Chapel Hill

#3 University of Minnesota

#4 University of Austin – Texas

#5 University of Kentucky

#5 University of Wisconsin – Madison

#7 Ohio State University

#7 Purdue University

#7 University of Michigan – Ann Arbor

#10 University of Arizona

#10 University of Southern California

# 10 University of Utah

#10 University of Washington

Registered Nurse

Graduate nursing degrees provide students seeking advanced nursing positions with the education they need to excel. 

#1 Johns Hopkins University

#2 University of Pennsylvania

#3 University of Washington

#4 University of California – San Francisco          

#5 University of North Carolina – Chapel Hill

#6 University of Michigan – Ann Arbor

#7 Duke University                                              

#7 Oregon Health and Science University

#7 University of Pittsburgh

#7 Yale University

                                                                                                                                                                 

Check Out MedMasters' Nursing Video

    

Physical Therapist (Physical Therapist Assistant)

Graduate level physical therapy programs and schools offer advanced education for students seeking physical therapy graduate degrees.

#1 University of Southern California

#2 University of Delaware

#3 University of Pittsburgh

#3 Washington University in St. Louis

#5 University of Iowa

# 5 US Army-Baylor University

#7 Emory University

#7 MGH Institute of Health Professions

#9 Northwestern University

#9 University of Miami

#9 University of North Carolina – Chapel Hill

Physician

Top medical schools provide the required advanced education to earn a Doctor of Medicine (MD) professional degree and prepare graduates to take the United States Medical Licensing Examination (USMLE). Many offer specialized training such as obstetrics or surgery.

Operating Room (Photo credit: Jeff Kubina)

#1 Harvard University

#2 Stanford University

#3 Johns Hopkins University

#4 University of California – San Francisco

#4 University of Pennsylvania

#6 Washington University in St. Louis

#7 Yale University

#8 Columbia University

#8 Duke University

#8 University of Chicago

#8 University of Michigan – Ann Arbor

Dental Hygienist

Dental hygiene programs provide a required entry level and advanced professional dental hygienist training. Certificate, Bachelors, and master’s level programs are all available. For a list of schools and programs by state, visit American Dental Hygienists Association’s Website: www.adha.org/dental-hygiene-programs.

Physician Assistant

Graduate-level physician assistant schools and programs offer advanced education for students seeking either a master’s or doctorate degree.  

Stethoscope (Photo credit: Walt Stoneburner)

#1 Duke University

#2 University of Iowa

#2 University of Utah

#4 Emory University

#4 George Washington University

#6 Baylor College of Medicine

#6 Oregon Health and Sciences University

#8 University of Medicine and Dentistry of New Jersey – Newark

#8 University of Texas Southwestern Medical Center – Dallas

#8 University of Washington

Occupational Therapist

Graduate-level occupational therapy schools and programs offer advanced education for students seeking a master's or doctorate degree in the field.

#1 University of Southern California

#2 Boston University – Sargent

#2 Washington University in St. Louis

#4 University of Illinois – Chicago

#5 University of Kansas Medical Center

#6 Colorado State University

#6 Thomas Jefferson University

#6 Tufts University – Boston School of Occupational Therapy

#6 University of Pittsburgh

#10 New York University

#10 University of Florida

#10 University of North Carolina – Chapel Hill

Phlebotomist ***

Phlebotomists are trained in procedures for safely extracting blood samples from humans. Certificate and diploma programs are offered at colleges and universities around the country.

US Navy 040921-N-4374S-002 Hospital Corpsman 3rd Class Jude Pineda draws a blood sample from a crew member during an annual physical (Photo credit: Wikipedia)

#1 University of Alaska

#2 Mountain State University

#3 Madison Area Technical College

#4 Goodwin College

#5 Ferris State University

#6 Dixie State College of Utah

#7 Davenport University

#8 Columbia Basin College

#9 Bellevue College

#10 Baker College of Auburn Hills

Veterinarian

Graduate level schools of veterinary medicine offer advanced education for students seeking to become a Doctor of Veterinary Medicine (DVM).

#1 Cornell University

#2 University of California – Davis

Jasper recuperating (Photo credit: Animals Abused & Abandoned)

#3 Colorado State University

#3 North Carolina State University

#5 Ohio State University

#5 University of Pennsylvania

#5 University of Wisconsin – Madison  

#8 Texas A&M University – College Station

#9 Michigan State University

#9 University of Georgia

#9 University of Minnesota – Twin Cities

* www.usdentalschools.com/top_school_rankings

** For Pediatric Nurse Practitioner program rankings, visit: http://grad-schools.usnews.rankingsandreviews.com/best-graduate-schools/top-health-schools/pediatric-nursing-rankings.  For Family Nurse Practitioner program rankings, visit: http://grad-schools.usnews.rankingsandreviews.com/best-graduate-schools/top-health-schools/family-nursing-rankings. For Geriatric Nurse Practitioner program rankings, visit: http://grad-schools.usnews.rankingsandreviews.com/best-graduate-schools/top-health-schools/geriatric-nursing-rankings.

*** http://education-portal.com/articles/Top_Schools_for_Phlebotomy.html

Rick Fromme combines entrepreneurial enthusiasm with an insider's knowledge of the medical industry to co-found MedMasters.com. Both his drive and perspective helps provide health care professionals with a superior mechanism with which to communicate, network and market their strengths. Prior to founding MedMasters.com, Rick operated a highly successful medical device distributorship. Other milestones in his 12-year career in the medical industry include a key position at a medical device start-up company that was later sold to the Ethicon Endo division of Johnson & Johnson. You may also reach Rick by connecting with him on Facebook, Twitter, Google+, LinkedIn and YouTube. 

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