the physician-pa team improving access to patient care
TRANSCRIPT
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The Physician-PA Team
Improving Access to Patient Care
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Physician Assistant ProfessionBegan in 1965 at Duke University
Experienced army corpsmen and combat medics
Based on fast-track training of physicians during World War II
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Physician Assistant DefinitionHealth Professionals licensed to practice
medicine with Physician supervision
Clinical role includes primary and specialty care in medical and surgical settings, in rural and urban areas
PA’s exercise autonomy in medical decision making and provide a broad range of diagnostic and therapeutic services
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Definition continuedQualified by graduation from accredited
educational programs
Practice is centered on patient care and may include clinical, educational, research and administrative activities
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PA Responsibilities include but are not limited to:
Taking medical histories
Performing physical exams
Diagnosing common illnesses
Ordering and interpreting laboratory tests
Determining treatment regimens
Providing patient education
Promoting wellness
Assisting in surgery
Prescribing Medications
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PA Primary Work Settings PAs work in a variety of practice settings
including: Family practice, Internal medicine, Emergency
medicine, OB/Gyn, Government institutions, Surgery and as house officers.
Slightly more than 50% practice in a primary care setting
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Practice by Specialty in Pennsylvania
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Physician Assistant Education
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Physician Assistant EducationProgram Accreditation
ARC-PA
Accreditation Review Commission on Education for the Physician Assistant
• Nationally : Over 150 Accredited programs
• Pennsylvania: 20 Accredited programs
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Physician Assistant EducationProgram Accreditation
Standards approved by
American Academy of Family Physicians
American Academy of Pediatrics
American Academy of Physician Assistants
American College of Physicians
American Society of Internal Medicine
American College of Surgeons
American Medical Association
Association of Physician Assistant Programs
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Physician Assistant Education Commitment to Team practice
PA / Physician Team strongly emphasizedCurriculum follows medical model designed to
complement Physician training Students are taught to diagnose and treat medical
problems.
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Physician Assistant EducationCommitment to Team practice (continued)
Classroom and laboratory instruction provided by Physicians and PAs
Clinical rotations provide direct patient contact All PA programs must have a Medical Director as
mandated by the accreditation standards
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Physician Assistant EducationPA Program Curriculum
Didactic Phase12months basic medical science courses
Clinical Phase 12 months Clinical rotations and ongoing classroom
instruction
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Didactic Phase Behavioral Social
Sciences
Basic Medical
Sciences Human AnatomyPhysiologyPathophysiologyPharmacology
Clinical Medicine
Clinical Prep SciencesH&P: across life spanClinical proceduresClinical Decision
MakingClinical Assessment
Public Health
Issues in PA Practice
Medical Ethics/Health Policy
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Clinical Phase Family Practice
Internal Medicine
Pediatrics
Prenatal Care and gynecology
Psychiatry
Surgery
Geriatrics
Emergency Medicine
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Program Design Variations exist among different institutions but all meet same national accreditation standards
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Physician Assistant Employment
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Credentials & State Regulations
Graduate from accredited PA programs
Successfully pass national certifying exam
Acquire state license
To maintain national certification one must: complete 100 hours of continuing medical education
every 2 years take a re-certifying exam every 10 years
Obtain DEA numbers if appropriate
Credentials: hospital privileges
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Two Regulatory Boards in Pennsylvania Govern PA
Practice State Board of Medicine
(if supervisor is an M.D.)
State Board of Osteopathic Medicine(if supervisor is a D.O.)
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Written Agreements Needed Duties to be performed by PA
Location of practice
Alternate Supervisors
Medication categories that will not be prescribed
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The Physician-PA RelationshipOne of “delegated” autonomy
PA is “agent” of the physician The PAs orders are treated by regulation as if they were
given by the physician
Primary supervising physicians can only supervise four PAs
PAs can perform any and all duties and procedures customary to the practice of their supervising physician
PAs cannot perform duties and procedures not customary to the practice of their supervising physician
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Benefits to the PracticeQuicker scheduling
General increase in net income
Enlarging the practice size while saving the physician(s) time
Expansion of office hours
Triage of phone calls and test results
Office/personnel management role
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Benefits to the Physician No addition to physician work load
Increased time to spend in OR and the hospital
Increased time for “more complex” patient management
More openings for consultations
Increased time for procedures
Split night and weekend call
More efficient hospital rounds
Help with medical record completion
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Benefits to the Patient More time per patient encounter
Extended office hours
Same day walk-in care
Increased access in reaching medical provider by phone
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Expansion of Services Patient Education
Nursing home rounds
Women’s health
Home visit program
Rehab/sports medicine program
Rural health clinic certification
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Web Siteswww.aapa.org
American Academy of Physician Assistants
www.pspa.net
Pennsylvania Society of Physician Assistants