General PA Information Courtesy of the
American Academy of Physician Assistants (www.aapa.org)
Q. What is a Physician
Assistant (PA)?
A.
Physician assistants are health care professionals licensed to practice
medicine with physician supervision. PAs employed by the federal government
are credentialed to practice. As part of their comprehensive
responsibilities, PAs conduct physical exams, diagnose and treat illnesses,
order and interpret tests,
counsel
on
preventive health care, assist in surgery, and in virtually all states can
write prescriptions. Within the physician-PA relationship, physician
assistants exercise autonomy in medical decision making and provide a broad
range of diagnostic and therapeutic services. A PA's practice may also
include education, research, and administrative services.
PAs are trained in
intensive education programs
accredited by the Accreditation Review
Commission on Education for the Physician Assistant (ARC-PA) .
Because of the close
working relationship the PAs have with physicians, PAs are educated in the
medical model designed to complement physician training. Upon graduation,
physician assistants take a national certification examination developed by
the National Commission on Certification of PAs in conjunction with the
National Board of Medical Examiners. To maintain their national
certification, PAs must log 100 hours of continuing medical education every
two years and sit for a recertification every six years. Graduation from an
accredited physician assistant program and passage of the national
certifying exam are required for state licensure.
Q. How did the
Physician Assistant profession begin?
A. In
the mid-1960s, physicians and educators recognized there was a shortage and
uneven distribution of primary care physicians. To expand the delivery of
quality medical care, Dr. Eugene Stead of the Duke University Medical Center
in North Carolina put together the first class of PAs in 1965. He selected
Navy corpsmen who received considerable medical training during their
military service and during the war in Vietnam but who had no comparable
civilian employment. He based the curriculum of the PA program in part on
his knowledge of the fast-track training of doctors during World War II.
Q. What does "PA-C"
stand for? What does the "C" mean?
A.
Physician assistant-certified. It means that the person who holds the title
has met the defined course of study and has undergone testing by the
National Commission on Certification of
Physician Assistants (NCCPA). The NCCPA is an independent organization,
and the commissioners represent a number of different medical professions.
It is not a part of the PA professional organization, the American Academy
of Physician Assistants (AAPA).
To maintain that "C"
after "PA", a physician assistant must log 100 hours of continuing medical
education every two years and take the recertification exam every six years.
Q. Who is authorized
to use the title "physician assistant?"
A.
In New Jersey, the term "physician assistant" is legally protected. Only a
person licensed as a physician assistant may identify themself as a
physician assistant or use the suffixes "PA" or "PA-C" following their name.
PA Education
Q. How is a
Physician Assistant educated?
A.
Physician assistants are educated in intensive medical programs accredited
by the Accreditation Review Commission on
Education for the Physician Assistant (ARC-PA). The average PA program
curriculum runs approximately 26 months. There are currently more than 130
accredited programs. All PA
programs must meet the same ARC-PA
standards.
Because of the close
working relationship PAs have with physicians, PAs are
educated in a
medical model designed to complement physician training. PA students
are taught, as are medical students, to diagnose and treat medical problems.
Education consists of
classroom and laboratory instruction in the basic medical and behavioral
sciences (such as anatomy, 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.
A PA's education
doesn't stop after graduation, though. PAs are required to take ongoing
continuing medical education classes and be retested on their clinical
skills on a regular basis. A number of postgraduate PA programs have also
been established to provide practicing PAs with advanced education in
medical specialties.
Q. What are the
prerequisites for applying to a PA program?
A. PA
programs look for students who have a desire to study, work hard, and to be
of service to their community. Most physician assistant programs require
applicants to have previous health care experienceand some college
education. The typical applicant already has a bachelor's degree and
approximately 4 years of health care experience. Commonly nurses, EMTs, and
paramedics apply to PA programs. Check with PA educational
programs of interest to you
for a list of their prerequisites.
Scope of Practice
Q. What areas of
medicine can Physician Assistants work in?
A.
Physician assistants (PAs) are found in all areas of medicine. They practice
in the areas of primary care medicine - that is family medicine, internal
medicine, pediatrics, and obstetrics and gynecology -- as well in surgery
and the surgical subspecialties.
Physician assistants
receive a broad education in medicine. Their education is ongoing after
graduation through continuing medical education requirements and continual
interaction with physicians and other health care providers.
Q. Where do PAs "draw
the line" as far as what they can treat and what a physician can treat?
A. What
a physician assistant does varies with training, experience, and state law.
In addition, the scope of the PA's practice corresponds to the supervising
physician's practice. In general, a physician assistant will see many of the
same types of patients as the physician. The cases handled by physicians are
generally the more complicated medical cases or those cases which require
care that is not a routine part of the PA's scope of work. Referral to the
physician, or close consultation between the patient-PA-physician, is done
for unusual or hard to manage cases. Physician assistants are taught to
"know our limits" and refer to physicians appropriately. It is an important
part of PA training.
Q. Can PAs prescribe
medications?
A.
Forty-eight states, the District of Columbia, and Guam have enacted
laws that authorize PA
prescribing. In California, PA prescriptions are referred to as written
prescription transmittal orders.
Physicians and PAs
Q. What do
physicians think about Physician Assistants?
A. Most
physicians who have worked with physician assistants like having PAs on
staff. The American Medical Association, the American College of Surgeons,
the American Academy of Family Physicians, the American College of
Physicians, and other national medical organizations support the physician
assistant profession by actively supporting the PA certifying commission and
the PA program accrediting agency.
Studies done by the
Federal Government have shown that PAs, working with the supervision of
physicians, provide care that is comparable to physician care. The Eighth
Report to the President and Congress on the Status of Health Personnel in
the United States (released in 1992) states, "Physician assistants have
demonstrated their clinical effectiveness both in terms of quality of care
and patient acceptance."
Q. What is the
working relationship between a physician and a physician assistant?
A. The
relationship between a PA and the supervising physician is one of mutual
trust and respect. The physician assistant is a representative of the
physician, treating the patient in the style and manner developed and
directed by the supervising physician. The physician and PA practice as
members of a medical team.
In 1995, the American Medical Association developed suggested guidelines for
how physicians and PAs should work as a team in the delivery of medical
care.
Q. What can a
physician assistant add to a physician's practice?
A.
Physician assistants can make great contributions to increase the efficiency
of a medical practice. Having a PA can free up a physician's time, allowing
the physician more time to manage complex cases. The presence of a PA also
usually means that patients can be seen in a more timely fashion, increasing
patient satisfaction. Finally, services provided by a physician assistant
are reimbursable by insurance companies, increasing a practice's revenue.
Information
for PAs
Q. Who do I
contact with a question regarding PA practice statutes?
A.
In New Jersey, the Physician Assistant Advisory Committee (PAAC) is responsible
for the interpretation of statutes regarding practice. The PAAC may be
contacted at:
973-504-6580.
-
Physician Assistant Advisory Committee
-
PO Box 45035
-
Newark, NJ 07101
Q. How do I apply
for a NJ physician assistant license?
A.
Contact the Physician Assistant Advisory Committee at 973-504-6580. They
will be happy to send you an application packet and a copy of the
statutes. License processing time varies but usually takes around 8
weeks.
Q. How do I apply
for a prescriptive authority for controlled dangerous substances?
A.
There are several steps to the application process. You must first
contact the New Jersey Drug Control Unit, a division of consumer
affairs. Their contact information can be found here:
http://www.njconsumeraffairs.gov/drug/dchome.htm
After you have been
approved by the state, you need to make application to the DEA. The DEA
application process can be completed online at:
http://www.deadiversion.usdoj.gov/
After this process is complete, you will need to contact an authorized
prescription vendor to have the appropriate prescription blanks printed. A
list of authorized vendors may be found on the
NJ Drug Control Unit website.
Q. What do I do
about a stolen prescription?
A.
If you become aware of stolen or forged New Jersey Prescription
Blanks, you must notify the State Office of
Drug Control (973-504-6558) within 72 hours.
Q. Who may
supervise a physician assistant?
A.
Any physician possessing an
unrestricted, plenary license to practice medicine and surgery in the
State of New Jersey may serve as a supervising physician. This includes
physicians with the Doctor of Medicine (MD) and Doctor of Osteopathy
(DO) degree.
Q.
How many physician assistants may a
physician supervise?
A.
In private practice, a physician may supervise
two full-time equivalent physician assistants. In a hospital-based
setting, a physician may supervise four full-time equivalent physician
assistants.
Q.
How is a supervisory relationship with a
physician documented?
A.
Each New Jersey PA should submit a copy of a "Verification of
Supervision/Employment" form to the Physician
Assistant Advisory Committee within 10 days of establishing a new
supervisory relationship. If a PA works in multiple clinical jobs, a
form should be submitted for each supervising physician. A copy of this
form may be downloaded by
CLICKING HERE.
Q. May a resident
physician supervise a physician assistant?
A.
Provided that the resident has a
plenary license in good standing, a DO or MD resident physician may
serve as supervising physician to a physician assistant.
Q. May a dentist
or podiatrist supervise a physician assistant?
A.
Since holders of DDS, DMD and DPM
degrees are not plenary licensed physicians, they may not act as
supervising physicians for physician assistants.
Q. Must a
physician be physically present to supervise a physician
assistant?
A.
“Direct supervision” requires that a
physician assistant always be able to contact the supervising physician
through electronic means. Inpatient settings additionally require at
least intermittent presence of the supervising physician.
Q.
What are the countersignature requirements
for orders written by physician assistants?
A.
In an inpatient setting, all orders by
a physician assistant are to be signed within 24 hours. In an outpatient
setting, orders for the administration or prescription of medications
are to be signed within 48 hours. All other orders are to be signed
within a week.
Q.
May a physician assistant write orders for
therapy modalities such as physical or occupational therapy?
A.
If the prescription of therapy
modalities lies within the supervising physician’s scope of practice,
the supervising physician may delegate this prescriptive authority to a
physician assistant.
Q.
May a physician assistant manage patients
who are new to a practice?
A.
The statutes do not make a distinction between “new” and
“established” patients. A physician assistant may therefore manage new
patients provided the above mentioned requirements for direct
supervision are met. Individual insurance programs (particularly
Medicare and Medicaid) may have differing regulations.
Q.
How many times can a physician assistant see a patient without the
patient being seen by a physician?
A.
The statutes do not set a ratio of visits for patients to been
seen by a physician assistant or their supervising physician. The
requirements for direct supervision noted above must be met. The
physician assistant must remember that the supervising physician is
responsible for directing the patient’s care and must be made aware of
changes in the patient’s condition or treatment plan. Individual
insurance programs (particularly Medicare and Medicaid) may have
differing regulations.
