In the United States, a Physician Assistant (PA) is a health care professional licensed to practice medicine with the supervision of a licensed physician (either an M.D. or D.O.) [1] This article needs additional references or sources for verification. ... For the chemical substances known as medicines, see medication. ... For other uses, see Doctor. ... Doctor of Medicine (M.D. or MD, from the Latin Medicinae Doctor meaning Teacher of Medicine,) is an academic degree for medical doctors. ... Osteopathic medicine (formerly known as osteopathy) is [1] Outside the United States, osteopathic medicine is often used interchangeably with osteopathy. Doctors of Osteopathic Medicine, or D.O.s, apply the philosophy of treating the whole person (a holistic approach) to the prevention, diagnosis and treatment of illness, disease and injury...

PAs are not to be confused with medical assistants, who perform administrative and clinical tasks in hospitals and clinics under the direct supervision of physicians, registered nurses, nurse practitioners or PAs. For the Royal Navy rating, see Medical Assistant (Royal Navy). ... For the town in the Republic of Ireland, see Hospital, County Limerick. ... A clinic or outpatient clinic is a small medical facility that provides health care for ambulatory patients - as opposed to inpatients treated in a hospital. ... A registered nurse (RN), is a health care professional responsible for implementing the practice of nursing through the use of the nursing process (in concert with other health care professionals). ... A nurse practitioner is a registered nurse who has completed advanced nursing education (generally a masters degree) and training in the diagnosis and management of common medical conditions, including chronic illnesses. ...

History of the profession

The PA profession came into existence in the mid-1960s due to the shortage and uneven geographic distribution of primary care physicians in the United States. Dr. Eugene Stead of the Duke University Medical Center in North Carolina assembled the first class of PAs in 1965, composed of former U.S. Navy hospital corpsmen and U.S. Army combat medics, who had received considerable medical training during their military service and gained valuable experience during the Vietnam War. He based the curriculum of the PA program in part on his first-hand knowledge of the fast-track training of medical doctors during World War II. Primary care may be provided in community health centres. ... Dr. Eugene Anson Stead Jr. ... Duke University is a private coeducational research university located in Durham, North Carolina, USA. Founded by Methodists and Quakers in the present-day town of Trinity in 1838, the school moved to Durham in 1892. ... Official language(s) English Capital Raleigh Largest city Charlotte Largest metro area Charlotte metro area Area  Ranked 28th  - Total 53,865 sq mi (139,509 km²)  - Width 150 miles (240 km)  - Length 560[1] miles (901 km)  - % water 9. ... Year 1965 (MCMLXV) was a common year starting on Friday (link will display full calendar) of the 1965 Gregorian calendar. ... USN redirects here. ... The HM rating symbol (a caduceus). ... The United States Army is the largest and oldest branch of the armed forces of the United States. ... Medical team at work during the Battle of Normandy. ... Combatants Republic of Vietnam United States Republic of Korea Thailand Australia New Zealand The Philippines National Front for the Liberation of South Vietnam Democratic Republic of Vietnam People’s Republic of China Democratic Peoples Republic of Korea Strength US 1,000,000 South Korea 300,000 Australia 48,000... Combatants Allied powers: China France Great Britain Soviet Union United States and others Axis powers: Germany Italy Japan and others Commanders Chiang Kai-shek Charles de Gaulle Winston Churchill Joseph Stalin Franklin Roosevelt Adolf Hitler Benito Mussolini Hideki Tōjō Casualties Military dead: 17,000,000 Civilian dead: 33,000...

The Duke University Medical Center Archives has established the Physician Assistant History Center, dedicated to the study, preservation, and presentation of the history of the PA profession. On February 25, 2006 the North Carolina Academy of Physician Assistants formally opened the Stead Center in Research Triangle Park, North Carolina, in honor of Dr. Stead.

Education and certification

As of September 2007, there were more than 139 PA programs in the United States [2] accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA). The majority are graduate programs leading to the award of master's degrees in either Physician Assistant Studies (MPAS), Health Science (MHS), or Medical Science (MMS), and require a bachelor's degree and GRE or MCAT scores for entry. Several PA programs lead to the award of an undergraduate bachelor's or associate's degree [3], but many of these are transitioning to graduate-level training. Degree ceremony at Cambridge. ... This article does not cite any references or sources. ... Master of Physician Assistant Studies or MPAS is a professional degree providing training in the profession of a physician assistant based on the medical school model, to practice medicine under the preceptorship of a physician. ... This article does not cite any references or sources. ... For other degrees, see Academic degree. ... The Graduate Record Examination or GRE is a standardized test that is an admissions requirement for many graduate schools in English speaking countries. ... The Medical College Admission Test (MCAT) is a standardized examination for prospective medical students in the United States. ... In some educational systems, undergraduate education is post-secondary education up to the level of a Bachelors degree. ... For other degrees, see Academic degree. ... An associate degree is an academic degree awarded by community colleges, junior colleges, business colleges and some bachelors degree-granting colleges and universities upon completion of a course of study usually lasting two years. ...

The education of a PA is based on the medical school model [4], although unlike medical school which lasts four years, PA training is usually two to three years in duration. It is generalist in approach, consisting of classroom and laboratory instruction in medical and behavioral sciences, such as anatomy, microbiology, pharmacology, pathophysiology, clinical medicine, and physical diagnosis, followed by clinical rotations in internal medicine, family medicine, surgery, pediatrics, obstetrics and gynecology, emergency medicine, and geriatric medicine, as well as elective rotations.

A PA may use the post-nominal initials "PA", "PA-C", "RPA" or "RPA-C", where the "-C" indicates "Certified" and the "R" indicates "Registered." The "R" designation is unique to a few states, mainly in the Northeast; most PAs use "PA-C". During training, PA students are designated PA-S. The use of "PA-C" is limited only to those PAs currently certified and in compliance with the regulations of the national certifying organization, the National Commission on Certification of Physician Assistants (NCCPA). Post-nominal letters also called Post-nominal initials or Post-nominal titles are letters placed after the name of an individual to indicate that that individual holds a position, educational degree, accreditation, office, or honour. ... Regional definitions vary The Northeastern United States is a region of the United States. ...

A graduate from an accredited PA program must pass the NCCPA-administered Physician Assistant National Certifying Exam (PANCE) before becoming a PA-C; this certification is required for licensure in all states. In addition, a PA must earn and log 100 Continuing Medical Education (CME) hours and reregister his or her certificate with the NCCPA every two years. Every six years, a PA must also recertify by successfully completing either the Physician Assistant National Recertifying Examination (PANRE) or Pathway II exams [5] Continuing medical education (CME) is a form of continuing professional development (CPD) that consists of educational activities which serve to maintain, develop, or increase the knowledge, skills, and professional performance and relationships that a medical practitioner uses to provide services for patients, the public, or the profession [1]. The content...

Scope of practice

PAs obtain medical histories and perform examinations, order treatments, diagnose illnesses, prescribe medication, interpret diagnostic tests, refer patients to specialists when appropriate and first assist in surgery. PAs may practice in any medical or surgical specialty, and have the ability to move to different medical and surgical fields during their careers.

PAs are licensed to practice medicine with physician supervision, which may be either in person, by telecommunication system or other reliable means. The physician supervision, in most cases, need not be direct or on-site, and many PAs practice in remote or underserved areas in satellite clinics. Their scope of practice and autonomy are only limited by their supervising physician's scope of practice, physician's comfort level and the PA's clinical experience. Scope of Practice is a terminology used by licensing boards for various medically-related fields that defines the procedures, actions, and processes that are permitted for the licensed individual. ...

All states, as well as the District of Columbia, Guam, the United States Virgin Islands, and the Commonwealth of the Northern Mariana Islands have laws or regulations authorizing physician assistants to practice medicine. PAs can also prescribe medications in all of these locations [6], but those who prescribe controlled medications in their scope of practice must also have a DEA number. The Controlled Substances Act (CSA) was enacted into law by the Congress of the United States as Title II of the Comprehensive Drug Abuse Prevention and Control Act of 1970. ... The DEAs enforcement activities may take agents anywhere from distant countries to suburban U.S. homes. ...

Employment

According to the American Academy of Physician Assistants (AAPA), there were about 63,609 certified PAs in clinical practice as of January 2007.[7]

In the 2007 AAPA census, just over 56 percent of responding PAs worked in the offices and clinics of physicians, either allopathic or osteopathic. About 23 percent were employed by hospitals. The rest were mostly in public health clinics, nursing homes, schools, prisons, home health care agencies, and the United States Department of Veterans Affairs. Approximately 9 percent of responding PAs provide health care to rural communities and those with fewer than 20,000 residents, in which physicians may be in limited supply. Allopathic medicine is the name given by Samuel Hahnemann, the founder of homeopathy, to the methods of his medical foes. ... For the town in the Republic of Ireland, see Hospital, County Limerick. ... The United States Department of Veterans Affairs (VA) is a government-run military veteran benefit system with Cabinet-level status. ... Sign in a rural area in Dalarna, Sweden Qichun, a rural town in Hubei province, China An artists rendering of an aerial view of the Maryland countryside: Jane Frank (Jane Schenthal Frank, 1918-1986), Aerial Series: Ploughed Fields, Maryland, 1974, acrylic and mixed materials on apertured double canvas, 52...

The U.S. Department of Labor Bureau of Labor Statistics report on PAs states, "...Employment of physician assistants is expected to grow much faster than average for all occupations through the year 2014, ranking among the fastest growing occupations..." This is due to several factors, including an expanding health care industry, an aging baby-boomer population, concerns for cost containment, and newly-implemented restrictions to shorten physician resident work hours. Also according to the BLS, the PA profession is the fourth fastest-growing occupation in the U.S. For the video game, see Baby Boomer (video game). ... Residency is a stage of postgraduate medical training in North America and leads to eligibility for board certification in a primary care or referral specialty. ...

Money Magazine, in conjunction with Salary.com, listed the PA profession as the "fifth best job in America" (May 2006) based on salary and job prospects, with an anticipated 10-year job growth of 49.65% [8]. According to the American Academy of Physician Assistants (AAPA), in 2006 the mean total income for physician assistants working at least 32 hours per week was $84,396 [9]. Physician assistants in surgical subspecialties can earn above $100,000, with the mean total income for PAs working at least 32 hours per week in cardiovascular/cardiothoracic surgery listed as $104,681 for 2006 [10].

PAs in the U.S. Armed Forces and Uniformed Services

U.S. Army PAs[11] typically serve as Medical Specialist Corps officers within Army combat or combat support battalions[12] located in the continental US, Alaska, Hawaii and overseas. These include infantry, armor, cavalry, airborne, artillery and (if the PA qualifies) Special Forces units. They serve as the "front line" of Army medicine and along with combat medics are responsible for the total health care of soldiers assigned to their unit, as well as of their family members. The United States Army is the largest and oldest branch of the armed forces of the United States. ... The AMEDD Regimental Coat of Arms The Army Medical Department of the U.S. Army, known as the AMEDD, comprises the six medical Special Branches of the Army. ... An officer is a member of a military, naval, or if applicable, other uniformed services who holds a position of responsibility. ... United States may refer to: Places: United States of America SS United States, the fastest ocean liner ever built. ... Official language(s) None[1] Spoken language(s) English 85. ... Official language(s) English, Hawaiian Capital Honolulu Largest city Honolulu Area  Ranked 43rd  - Total 10,931 sq mi (29,311 km²)  - Width n/a miles (n/a km)  - Length 1,522 miles (2,450 km)  - % water 41. ... Infantry of the Royal Irish Rifles during the Battle of the Somme in World War I. Infantry are soldiers who fight primarily on foot with small arms in organized military units, though they may be transported to the battlefield by horses, ships, automobiles, skis, bicycles, or other means. ... Armor or armour (see spelling differences) is protective clothing intended to defend its wearer from intentional harm in combat and military engagements, typically associated with soldiers. ... Not to be confused with Golgotha, which was called Calvary. ... Look up airborne in Wiktionary, the free dictionary. ... For other uses, see Artillery (disambiguation). ... For other uses, see Special forces (disambiguation). ... 68W (often pronounced as 6 8 Whiskey using the phonetic alphabet) is the Military Occupational Specialty (MOS) for the United States Armys healthcare specialist, also known as the combat medic. ...

PAs also serve in the Air Force and Navy as clinical practitioners and aviation medicine specialists, as well as in the Coast Guard and Public Health Service. The skills required for these PAs are similar to that of their civilian colleagues, but additional training is provided in specific fields such as advanced casualty care, medical management of chemical injuries, aviation medicine and other specialties [13]. In addition, military PAs are also required to meet the officer commissioning requirements and maintain the professional and physical readiness standards of their respective services. “The U.S. Air Force” redirects here. ... USN redirects here. ... Aviation medicine is a branch of medicine that applies medical knowledge to the human factors in aviation. ... USCG HH-65 Dolphin USCG HH-60J JayHawk The United States Coast Guard (USCG) is at all times a branch of the United States armed forces a maritime law enforcement agency, and a federal regulatory body. ... Template:Higher standard // History of the United States Public Health Service The United States Public Health Service (PHS) was founded first by President John Adams in 1798 as a loose network of hospitals to support the health of American seamen. ...

International use of PAs

The PA concept is being explored in Canada, where Canadian military PAs are gaining legislative changes allowing them to work in the civilian world after retirement as "clinical assistants"[14], and in England, where several U.S.-trained PAs are working in a pilot project.[15] For other uses, see England (disambiguation). ...

Pilot projects in Scotland[16] and the Netherlands[17] are also underway. This article is about the country. ...

External links

• American Academy of Physician Assistants (AAPA)
• National Commission on Certification of Physician Assistants (NCCPA)
• Journal of the AAPA (JAAPA)
• Information About PAs and the PA Profession - AAPA website
• Physician Assistant Forum
• ADVANCE for Physician Assistants journal