PHYSICIAN ASSISTANTS Number 508 Interest Area 13 1998
THE JOB
PHYSICIAN ASSISTANTS, as their title suggests, support physicians. They are formally trained to work under the supervision of a medical doctor, assisting in the diagnosis and treatment of diseases and injuries. These workers should not be confused with medical assistants (see California Occupational Guide No. 513).
Physician Assistants (PAs) provide primary health care in rural areas where people have little access to doctors, in inner-city clinics where people have little money for health care, and in hospitals and private doctors' offices where physicians caught up in the revolution of managed care have to see more patients in less time.
Physician Assistants perform many time-consuming tasks normally done by doctors. They interview patients, take medical histories, give physical examinations, order laboratory tests, make diagnoses, and prescribe appropriate treatment. They perform routine therapeutic procedures, such as giving injections and immunizations, cleaning and stitching minor wounds, applying splints, and removing casts. Routine laboratory procedures may include drawing and examining blood, taking cultures, and performing and reading skin tests. By doing these tasks for the doctor, PAs allow physicians more time to treat more seriously ill patients.
Alternative titles sometimes used by these workers are MEDEX, physician associate and community health medic. Some PAs help physicians in such specialty areas as pediatrics or surgery. They perform routine procedures such as physical examinations, provide postoperative care and help during complicated medical procedures such as cardiac catherizations. These specialist PAs include child health associates, urologic Physician Assistants, surgeon assistants, and emergency room Physician Assistants.
WORKING CONDITIONS
Physician Assistants work in the same places as physicians. Hospitals, clinics, and physicians' offices usually provide a comfortable, well-lighted environment, although PAs must often stand for long periods and do considerable walking. Workplaces are sometimes stressful environments filled with sick or dying people who need constant attention.
Physician Assistants belong to the California chapter of the American Academy of Physician Assistants.
EMPLOYMENT OUTLOOK
The following information is from the California Projections of Employment published by the Labor Market Information Division.
Estimated number of workers in 1993 5,110 Estimated number of workers in 2005 6,330 Projected Growth 1993-2005 24% Estimated openings due to separations by 2005 1,150
(These figures do not include self-employment or openings due to turnover.)
There were 3,132 licensed Physician Assistants in California as of March 1, 1998.
The number of Physician Assistants needed will depend on the increase in the number of prepaid health plans. The present needs are in under-served communities such as rural areas and inner cities.
Nationally, the Bureau of Labor Statistics predicts a growth rate for PAs of 50 percent above the norm for all occupational growth through 2005.
The increase in the population aged 65 and over should have a favorable impact on the employment of Physician Assistants. New nursing homes and home health care agencies that serve the elderly will require additional PAs.
The advent and growing use of communications technology, specifically the Telemedicine 3/4 device, now makes it easier for consultations between physicians and PAs and for more accurate diagnoses. This trend alone is expected to expand the use of PAs by doctors and health care providers.
WAGES, HOURS, AND FRINGE BENEFITS
The 1996 median hourly wage for Physician Assistants in California was $24.65. This number reflects all levels of experience, from new inexperienced workers to those with many years' experience; however, earnings will most likely be lower both in rural settings and inner cities.
The work week and schedule vary according to the setting. Some emergency room PAs work 24-hour shifts twice weekly and others work three 12-hour shifts each week. The work week of PAs in doctors offices may include some night office hours or early morning hospital rounds visiting patients. PAs in clinics usually work a five-day, 40-hour week.
Most employers offer the usual fringe benefits, such as paid vacation, sick leave, and medical and dental coverage.
ENTRANCE REQUIREMENTS AND TRAINING
In California, several educational programs for primary care Physician Assistants or surgeon assistants are approved by the Committee on Allied Health Education and Accreditation of the American Medical Association. They are University of California at Davis, Charles Drew Postgraduate Medical School, University of Southern California (Primary Care Physician Assistant Program and Emergency Medicine Residency Program), the Stanford University/Foothill College, and the College of Osteopathic Medicine in Pomona.
Admission requirements to these programs vary from a high school diploma to a bachelor's degree, but 60 credit hours or two years of college in a science or health professions program is common. Entry is competitive; many applicants already hold a bachelor's or master's degree. Many schools consider experience in jobs ranging from medical technician to nursing aide an important requirement for admission. Still, lack of experience need not be a barrier to applicants who are otherwise qualified.
Training programs are generally two years in length, although some are longer and a few that require prior health-related training are shorter. PA training begins with a classroom or pre-clinical phase that lasts nine to twelve months. Students then spend about a year doing clinical work in areas such as family practice, inpatient medicine, general surgery, obstetrics and gynecology, emergency medicine, internal medicine, psychiatry, and pediatrics. Often, one or more of the rotations are served under the "preceptorship" or supervision of a physician who is seeking to hire a PA.
The MEDEX training program is a shorter, slight variation of the PA program. It is designed specifically for trainees who have had extensive, direct patient care experience, and allows for a shorter period of classroom training and increased emphasis on clinical experience.
Certification of Physician Assistants is done by the California State Board of Medical Quality Assurance. The certification exam consists of an all-day written test and a practical part to assess the candidates' skills in conducting a physical examination. Applicants must have graduated from a California approved Physician Assistant Program and pass a written exam.
Individuals planning a career as a Physician Assistant should be conscientious and willing to study throughout their career in order to keep up with medical advances. They should be able to show leadership, self- confidence and emotional stability. A pleasant personality, patience and the ability to deal with all kinds of people are also helpful.
ADVANCEMENT
Formal lines of promotion have not developed within this young profession. There are no head PAs in hospitals or nursing homes as there are head nurses; by the very nature of the profession, individual PAs are supervised by physicians. Since a supervising physician shares responsibility for the quality of care rendered by the PA, this relationship must be a close one and a middle level of supervision would be an interference.
For most PAs, advancement takes the form of the added responsibilities and higher earnings that come with experience and, sometimes, with completion of continuing education courses.
FINDING THE JOB
The local county Medical Association has information on jobs available for Physician Assistants. Placement offices in schools offering training assist their graduates to find employment.
ADDITIONAL SOURCES OF INFORMATION
California Academy of Physician Assistants 9778 Katella Street, Suite 115 Anaheim, CA 92804-6446 (714) 539-1430
American Academy of Physician Assistants 950 North Washington Street Alexandria, VA 22314 (703) 836-2272
Department of Consumer Affairs Board of Medical Quality Assurance Physician Assistant Examining Committee 1424 Howe Avenue, Suite 35 Sacramento, CA 95825 (916) 263-2670 or (800) 555-8038
RELATED OCCUPATIONAL GUIDES
Registered Nurses & Nurse Practitioners No. 29 Physical Therapists No. 117 Licensed Vocational Nurses No. 313 Physicians & Surgeons No. 319 Nurse Aides/Nursing Assistants No. 442 Physical Therapy Aides & Assistants No. 451
OCCUPATIONAL CODE REFERENCES
DOT (Dictionary of Occupational Titles, 4th Ed., Rev 1) Physician Assistant (medical serv.) 079.364-018
OES (Occupational Employment Statistics) System Physician's Assistants 325110
Source: State of California, Employment Development Department,
Labor Market Information Division, Information Services Group,
(916) 262-2162.
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