Introduction with certified authority to medically screen

INTRODUCTION            What is a Physician Assistant? A Physician Assistant is amedical provider with certified authority to medically screen and treatpatients.

They are also empowered to prescribe medications and perform medicalprocedures as needed. A Physician Assistant can be found in medical hospitals, specialty clinics and doctor’s offices around the nation. The caveat being thatthey work under collaboration with a Physician to ensure effective medical careis provided. They are 1 of 3 medical providers with this authority, the other 2being Nurse Practitioners and Medical Doctors. Unlike the aforementionedmedical providers, a Physician Assistant is educated and trained in GeneralMedicine. However, this does not limit them to practicing General Medicineonly.

Physician Assistant are widely known for the lateral mobility availableto them in choosing their career path. They can interchange between specialtieswithout the requirement of additional education. In fact, a Physician Assistantfrequently works in more than 1 specialty in their life time.

The path to becoming a Physician Assistant has alwaysbeen the career that I’ve wanted to pursue. Providing medical attention tothose in need is commonly on the top of everyone’s list and it is no differentfor me. However, one might ask why a Physician Assistant over a Medical Doctor? The answer is simple for me. I have never wanted to be tied down to onespecialty. I have always been intrigued by multiple systems in the body fromthe heart, to the lungs, to the skin and so on. What makes the PhysicianAssistant career shine is their ability to work in multiple specialties overtheir employment. My brother works in the ER of a hospital as a PhysicianAssistant while also working in an urgent care clinic just down the road from hishome. If he wakes up tomorrow morning wanting to work in a Cardiologist’soffice then he can! No additional education required.

The ability of aPhysician Assistant to interchange between specialties like this in invaluableand is the main reason why I have been attracted to this career path. EDUCATIONAND PROFESSIONAL ASSOCIATION            A Physician Assistant is typically required to obtain aBachelor’s Degree of the student’s choosing (typically one that is sciencerelated.) Many Physician Assistant programs require pre-requisites, such asAnatomy and Physiology, Organic Chemistry, etc.

. However, no 2 schools arealike in their elective requirements. A Physician Assistant program istypically 27 months long but some are as long as 36 months. This program includeseducation both in the classroom and within a clinic or hospital. The first yearof education is strictly in the classroom where students are required to “ hitthe books.” The curriculum is heavily based off of the program used for medicalstudents and consists of anatomy, physiology, pathology, genetics andpharmacology.

The second year consistsof 10 clinical rotations in 10 different specialties, ranging from Cardiologyto ER to Pediatrics. 7 of these specialty rotations are required of thestudent, however, the last 3 are to be chosen by the student based off of theirpersonal interests. Once the required 2, 000 hours of clinical practice has beenreached, the student is prepared to take the certification exam. The PhysicianAssistant National Certifying Exam, or PANCE, is a computer based multiplechoice exam that is separated into 5 different sections, taking 1 hour each. The exam is scored from 200 – 800.

Once the student has passed, they areallowed to put their training into action and work as a Physician Assistant.            There are numerous amounts of organizations directedtowards bettering the Physician Assistant community. The American Academy ofPhysician Assistants, or AAPA, is arguably the largest organization in theNation.

In their own words, the organization “ works to ensure the professionalgrowth, personal excellence and recognition of PAs. We also enhance theirability to improve the quality, accessibility and cost-effectiveness ofpatient-centered healthcare.” The Physician Assistant career began in 1968 andhas been watched over by the AAPA organization since. Not only are they workingto better the community now, but they are working hard to establishimprovements within the field. For example, Physician Assistants are seekingthe credibility to work independently of doctors and eventually open their ownclinics.

This would be a monumental step for the community moving forward. INFORMATIONNEEDS            Sadly, it is not infrequent to experience a situationwhere a doctor questions a Physician Assistant’s authority. The following is atypical scenario representing this case: An 18year old boy presents to the ED with sudden onset right lower quadrantabdominal pain that is sharp in nature. Upon examination, the PhysicianAssistant finds that the patient has tenderness to palpation in the right lowerquadrant with a positive McBurney’s Point Sign. The Physician Assistantsuspects acute appendicitis. CT of the abdomen confirms his suspicion. Thepatient is to be admitted for emergent surgery in the morning.

The Physician Assistantconsults a Gastroenterologist about the patient. After hearing the findings, the GI doctor believes that the patient can be sent home and the surgery can bedone as an out-patient. The 2 medical providers disagree and the GI doctorquestions the Physician Assistant’s credibility.             To evaluate the situation, we will answer a few questionsabout the medical care given. First, how did the Physician Assistant come tothe conclusion that the patient has appendicitis? Typically, the PhysicianAssistant would know that the patient’s symptoms are text book forappendicitis. However, there are resources available for any new providers whoare not accustomed to the ER setting, such as the doctor that is overseeing thecare or resources available on the internet. The National Institutes of Healthis a good resource for medical questions that need answering on the fly. Databasesare updated frequently and contain the newest information regarding patienttreatment available.

This allows up-to-date patient care to ensure the mosteffective treatment. So, using the education they’ve obtained, consultingmedical providers around them and researching health databases on the internetwill ultimately provide an answer to the medical question. Second, how shouldthe patient be treated in this scenario? Typically a Physician Assistant willconsult with the doctor who is overseeing them in the ER.

They both agree thatthe patient is to be admitted for pain treatment and emergent surgery in themorning. The Hospitalist is to be consulted to admit the patient, who agrees todo so. They require a GI consult in the morning. However, theGastroenterologist refuses as they believe that an admission is not required.

That brings us to the third question, How does a Physician Assistant handle asituation where their credibility is questioned? If this is ever the case, thedoctor overseeing the Physician Assistant should be notified of the push backfrom the GI doctor. Ultimately, it is the ER doctor’s decision whether to admitor have the patient follow up as out-patient. Hopefully, the doctors canresolve the issue and can agree on the treatment that is best for the patient. INFORMATIONRESOURCES            Important journals usedby Physician Assistants include, but are not limited to, the following: ·     TheJournal of the American Academy of Physician Assistants – Apeer reviewed journal specifically for Physician Assistants that includesarticles regarding case studies, clinical trials, developing research and professionalinterests.·     TheJournal of the American Medical Association – A peer reviewedjournal available to medical providers that contains published research, editorials, and articles focused on the sciences.·     TheBritish Medical Journal – A UK based, peer reviewed medical journalcontaining podcasts, videos, blogs and articles covering numerous subjects, such as: clinical trials, medical news, continuing education, and politicalcampaigns. Importantdatabases used by Physician Assistants include:·     PubMedHealth – A free database available to the public and health careproviders alike, containing informational resources geared towards the lifesciences and medicine.

·     MedlinePlus– Another free database available to the public, Medline provides health andmedicinal information ranging over 1, 000 different topics. Importantwebsites used by Physician Assistants include: ·     NationalCommission on Certification of Physician Assistants – Anon-profit organization established to provide certification programs forPhysician Assistants and provide continuing education post certification.·     NationalInstitute of Health – An agency collaborating with the USDepartment of Health with purposes to advance research and education inhealthcare and medicinal practices.·     AmericanMedical Association – The largest association of medical providersin the world that publishes the Journal of the American Medical Association(explained above).

·     AmericanAcademy of Physician Assistants – A society of PhysicianAssistants represented across the nation. This organization prides itself inits ability to “ ensure the professional growth, personal excellence andrecognition of Physician Assistants.”·     The PALife– A collection of resources for aspiring Physician Assistants, PhysicianAssistant students and current Physician Assistants. Some resources include: Pance exam practice, advice on applications, and continuing education. Thefollowing is a research article that may be typical for a Physician Assistantto encounter: TITLE: Diagnosisof Right Lower Quadrant Pain and Suspected Acute AppendicitisCITATION: Dahabreh IJ, Adam GP, Halladay CW, Steele DW, Daiello LA, Weiland LS, Zgodic A, Smith BT, Herliczek TW, Shah N, Trikalinos TA.

Diagnosis of Right LowerQuadrant Pain and Suspected Acute Appendicitis. Comparative EffectivenessReview No. 157. (Prepared by the Brown Evidence-based Practice Center underContract No. 290-2012-00012-I.) AHRQ Publication No.

15(16)-EHC025-EF. Rockville, MD: Agency for Healthcare Research and Quality; December 2015. PRACTICESECTION            According to the USBureau of Labor Statistics, a typical Physician Assistant is expected to make$97, 420 annually full time. It is important to note that full time is between12 – 14 shifts per month. That is approximately 3 shifts per week. Typically, aPhysician Assistant will work 15 – 20 shifts per month which accumulates tomore than $150, 000 annually.            A real life job search shows the following information: SUMMARY The Physician Assistant for MD Anderson The Woodlands will be supervise thedaily treatments in the ATC in the absence of a supervising physician. SALARY RANGE Minimum: $87, 200 – Midpoint: $109, 000 – Maximum: $130, 800 ESSENTIAL JOB FUNCTIONS Provides assessment, triage and therapeutic management of patient/family needsthroughout the disease process as an integral part of an interdisciplinaryteam.

Acts under the authority and supervision of the attending physician andin accordance with regulations, hospital policy, protocols and clinicalpathways. Obtains medical histories, performs physical examinations, reviews/orders diagnostic tests and radiographic results, formulates andmanages patient treatment plans and outcomes. Performs as first or secondassist on operative cases, using fine motor skills and manual dexterity.

Performs procedures, prescribes treatment and signs prescriptions in accordancewith institution and state requirements. Screens physician calls to educatepatient/family on care and resources. Makes rounds with interdisciplinary team. Collaborates in research projects, formulates protocols and applies research topractice. EDUCATION Required: Graduate of a Physician Assistant training program approved by theCouncil of Medical Education of the American Medical Association.

EXPERIENCE Required: None Preferred: Experienced PA preferred. Medical Oncology experiencepreferred. LICENSE/CERTIFICATION Required: PA certification by the National Commission of Certification ofPhysician Assistants. Licensed by the Texas State Board of Physician AssistantExaminers.

SUMMARY            Physician Assistants are an integral part of healthcareutilized in clinics, hospitals and offices around the world. The demand forthese providers in increasing astronomically due to their ability to work inmultiple specialties. Receiving education and certification takes as little as6 years with PA programs littered around the country. Thanks to the growing popularity, there is an abundance of resources available to aspiring or current PhysicianAssistants in the form of: health databases, peer reviewed journals and varyingwebsites. Becoming a Physician Assistant has been on my radar for as long as Ican remember and I look forward to pursue this promising career. CONCLUSION            There are many things that I have learned in this classthat can be applied to my career pursuit. Namely, the ability to utilizedatabases online to enhance my education.

A Physician Assistant is taughtmedical information as we know it. However, information is being updatedconstantly. Medical care and pharmacology is no different. With the resourcesutilized in class, such as PubMed, I am confident in knowing that I haveup-to-date information at the tips of my fingers. That being said, somedatabases can be overwhelming with the amount of information given. Over thetime of the course, we have effectively learned how to navigate and filter oursearches to find the most pertinent answers to our questions. Continuing youreducation is important for an ever changing world of information, especiallyfor a Physician Assistant.

CITATIONSearch of “ Dermatology PA jobsin Texas” – https://www. indeed. com/q-Physician-Assistant-Dermatology-l-Texas-jobs. html? vjk= 777bea8537250f0aAmerican Academy of PhysicianAssistants – https://www. aapa. org/US Bureau of Labor Statistics -https://www. bls. gov/oes/current/oes291071. html The Journal of the AmericanAcademy of Physician Assistants – https://www. aapa. org/about/business-opportunities/jaapa-advertising/ The Journal of the AmericanMedical Association – https://jamanetwork. com/journals/jama The British Medical Journal – http://journals. bmj. com/PubMed Health – https://www. ncbi. nlm. nih. gov/pubmed/ MedLine Plus – https://medlineplus. gov/ National Commission onCertification of Physician Assistants – http://www. nccpa. net/National Institute of Health – https://www. nih. gov/ American Medical Association – https://www. ama-assn. org/