Talk:Physician assistant

src: i.ytimg.com

'PA Communications Guide by American Academy of PAs (AAPA)'Bold text

July 2016

A Guide for Writing and Talking About PAs

As the PA profession evolves, so does the language used to talk about it. The explosive growth of the profession, coupled with the continued modernization of PA laws, is rapidly changing the way PAs practice and the language we use to describe what they do. This is a reference guide for how to communicate about the profession in a way that reflects the realities of modern PA practice. If you have any questions, please contact Janette Rodrigues, Editorial Director, (571.319.4382, jrodrigues@aapa.org).

The PA Abbreviation Use "PA" as the title of the profession in all copy, not "physician assistant." We do not use "physician assistant" any longer to refer to the profession as the name does not adequately depict the medical services PAs provide to patients every day. If you must spell it out to aid in external audience awareness, only use "physician assistant" once in parentheses after the first PA reference, i.e., PA (physician assistant). Use PA for all subsequent references.

The PA Honorific To promote uniformity of address in clinical and other settings, use PA as the honorific before the person's name, i.e., PA Pam Smith or PA Smith. Encourage the adoption of PA [surname] as the recommended address for PAs among staff and external audiences, unless a more suitable formal address is appropriate, such as military rank or academic role.

Who are PAs? PAs are nationally certified and state licensed to practice medicine and prescribe medication in every medical and surgical specialty and setting and in all 50 states, the District of Columbia and all U.S. territories, with the exception of Puerto Rico. PAs are educated at the graduate level, with most PAs receiving a master's degree or higher. In order to maintain national certification, PAs are required to complete 100 hours of continuing medical education every two years and to recertify as medical generalists every 10 years.

What do PAs do? o PAs practice medicine. o PAs practice in every medical and surgical specialty and setting. o PAs manage the full scope of patient care, often handling patients with multiple comorbidities. o PAs conduct physical exams, diagnose and treat illnesses, order and interpret tests, assist in surgery, coordinate care, counsel on preventive healthcare, prescribe medications and more.

How do PAs work? PAs' scope of practice is determined by their education and experience. Scope of practice is also subject to state laws and facility policy. In optimal settings, PAs practice at the top of their education, training and experience, and the scope is determined at the practice level. o PAs practice medicine in teams with physicians and other healthcare professionals.

Why are PAs unique? o PAs increase access to healthcare. o PAs provide quality care and have been shown to positively impact patient outcomes. o PAs are educated, to seamlessly work in a team-based model of care. o PAs are educated as medical generalists and recertify as medical generalists. o PAs are one of the most versatile healthcare providers; during the course of their career, most PAs will have worked in two to three specialties. o PAs manage patient care coordination and provide clinical preventive services. o Four out of five PAs report high job satisfaction.

Phrases to Avoid o Inaccurate Terminology: "PAs are mid-level providers, physician extenders, non-physician providers, advanced practice providers or advanced practice clinicians." o These terms are often misunderstood by consumers and do not accurately portray or describe how PAs practice medicine to other providers or patients. Nor do they reflect their license or legal title. If PAs need to be referenced as part of a larger group, use "healthcare provider", "healthcare practitioner," or "clinician" but the preferred reference would include simply the title name of each profession (e.g., "PAs and NPs").

o Inaccurate Terminology: "PAs work on physician-led teams." or "PAs are supervised by a physician." It is no longer the case that physicians have to be at the helm of the care team. Today's PAs collaborate with physicians. Supervision should only be referenced when required by legal and regulatory documentation. For example, patient-centered medical homes allow for various health professionals to function as leaders of care teams, including PAs. In practice, a PA's scope typically grows over time with clinical experience. It is common for a PA to serve as the lead on care coordination teams and see patients in all settings without a physician present. In fact, in many rural and underserved areas, a PA may be the only provider, with PA-physician collaboration occurring via telecommunication. -- Preceding unsigned comment added by 207.244.167.176 (talk) 23:09, 1 September 2016 (UTC)

Video Talk:Physician assistant

Third sentence.

"Physician assistants are concerned with preventing and treating human illness and injury by providing a broad range of health care services that are traditionally performed by a physician."

The third citation, of which this sentence uses, does not say what is quoted. It actually reads "Physician assistants, also known as PAs, practice medicine under the direction of physicians and surgeons. They are formally trained to examine patients, diagnose injuries and illnesses, and provide treatment."

Again, the critical part of the first sentence is "under the direction of physicians and surgeons." I am changing it. 68.50.119.13 (talk) 02:00, 17 May 2013 (UTC)

Maps Talk:Physician assistant

American Medical Association Guidelines

Why aren't the AMA Guidelines included in this article? Those guidelines clearly state (item 4 below) that the PA is responsible to the patient's physician in all settings. Since that is the requirement of the AMA, I would think it is quintessentially relevant to this wikipedia article. Anyone who comes here for info about PA's should be aware that this is the position of the AMA, especially since this document is on the website of the American Association of Physician Associates. http://www.aapa.org/uploadedFiles/content/The_PA_Profession/Federal_and_State_Affairs/Resource_Items/AMAGuidelines.pdf

Passed by the AMA House of Delegates, June 1995

1. The physician is responsible for managing the health care of patients in all practice settings. 2. Health care services delivered by physicians and Physician Assistants must be within the scope of each practitioner's authorized practice as defined by state law. 3. The physician is ultimately responsible for coordinating and managing the care of patients and, with the appropriate input of the Physician Assistant, ensuring the quality of health care provided to patients. 4. The physician is responsible for the supervision of the Physician Assistant in all settings. ...

Also, the NIH website of medical literature states: "All state laws require PAs to have a supervising doctor." See: http://www.nlm.nih.gov/medlineplus/ency/article/001935.htm It seems that this requirement is structural to the program and is hugely important to people (patients) who come to wikipedia for info about the program.

Thanks for your consideration. N0w8st8s (talk) 18:07, 29 September 2013 (UTC)n0w8st8s

src: c8.alamy.com

United Kingdom - Re-certification

Re-certification "All qualified PAs are required to re-certify every 5-6 years through a 2 hour MCQ exam, testing knowledge on all aspects of medicine, regardless of t Re-certification will move to ever 10 years in the US starting in 2015. The test is called the PANRE (PA National Recertification Exam). The content of the PANCE / PANRE Blueprint (comprehensive content) covers all organ systems with emphasis going to Cardiac, Pulmonary, and Musculo Skeletal." This section seems to combine references to the UK and US PA's Re-certification process and needs to be fixed.Joedumlao (talk) 14:52, 30 December 2014 (UTC)

src: www.healthcareworkersalary.com

"Supervision"? Time to retire it.

Per [1], AAPA no longer refers to physicians working with PAs as "supervising physicians", but rather "collaborating physicians", as more accurately reflecting the broader current scope of PA practice. Certain laws will still use the older terminology, and direct supervision is certainly one form of collaboration, but it's time to adopt appropriately modern language in the article to reflect how practice has evolved. Jclemens (talk) 22:26, 20 July 2016 (UTC)

Whether described as collaboration or supervision, this isn't just about the about scope of practise. Simplifying the description of the arrangements as collaborating is not more accurate, for example see a recent article in the Huffington Post. In the UK Physicians associates do not (yet) have a statutory register and are not legally able to prescribe or order radiological investigations. AAPA is one organisation that promotes the interests of its members. After a vote at one of their meetings, AAPA recently quietly went about replacing the terminology on its webpages from Physician Assistant to PA. I think Wikipedia shouldn't simply mimic AAPA's approach to descriptions. In terms of the responsibility for actions it seems there is legally a clear element of supervision, even though some PAs will accomplish many tasks without direct supervision. Drchriswilliams (talk) 06:11, 21 July 2016 (UTC)

There are also issues with using the generalised description that a professional group "practices medicine" when referring to a group that includes people that don't hold a primary medical qualification and aren't on a statutory register. Drchriswilliams (talk) 06:56, 21 July 2016 (UTC)

I'm wondering if this is a US vs. UK issue. In the US, physicians are increasingly abandoning low value specialties such as family medicine, and PAs (and nurse practitioners, but this article is not about then) are filling the gaps. Often times, a non-physician medical provider is going to be the only medical provider at all available in rural locations... Hence the AAPA modifying its stance to favor the more inclusive term. But that isn't going to be applicable to the UK. Do we need to segregate the article more, so as to accurately describe each nation's setting? Jclemens (talk) 07:19, 21 July 2016 (UTC)

There are some differences between how things are organised in the US an UK. But supervision is required in both. Medline Plus says that "All state laws require PAs to have a supervising doctor." This is immediately apparent in guidance issued from California to New York. Even the latest legal changes in Virginia clearly indicate that supervision is required. Drchriswilliams (talk) 21:15, 21 July 2016 (UTC)

Sorry, but those are primary sources. Wikipedia does not quote laws verbatim without reliable secondary sources interpreting them. More importantly, the legal terms are not particularly useful to understand how the profession operates. News outlets cover this evolution: Forbes, Forbes again, Politico, and Clinical Advisor, the oldest of which is 16 months old. To be sure, there's a place for discussing "supervision" in the appropriately more detailed body of the article, but the lead is not the place for archaisms. Jclemens (talk) 05:03, 22 July 2016 (UTC)

Thanks for these secondary sources, which are also better than the AAPA website material. I have spent some time trying to update the sources for this article. I appreciate there is some change in legislation and culture occurring in the US. The secondary sources do pick up on PAs being given more autonomy, but they don't report complete autonomy. As mentioned before, arrangements where there is an element of supervision can still be present, even when there is increased scope of practice. Jansen's article in Forbes in July 2016 notes that Physician assistants are escalating their lobbying efforts. It describes legislative change in the supervisory arrangements in New Jersey, but the supervision element is still there. The Politico article talks about a "collaborative culture", but the legal requirement for supervision still exists. The Clinical Supervisor article (reporting on an AAPA meeting) is clear that many state legislatures still use this terminology. Drchriswilliams (talk) 06:36, 22 July 2016 (UTC)

The issue isn't the legal language, but the lead description. Sure, from a purely legal standpoint, every physician assistant is 'supervised' by an MD or DO. Yet, in many cases, PAs own practices and employ MDs to supervise them; in many others, PAs do not routinely work at the same site as their nominal supervisors; but most common of all is that PAs simply take care of patients without needing any regular, day-to-day interaction from those nominal supervisors. Any of those arrangements would not be understood by most people as a supervisory relationship: my own states' paperwork notes that PAs and supervising physicians are "both professionally and personally equally responsible for any act performed by the PA as it relates to the practice of medicine" [2]. I'm trying to think of another instance where using the bare legal language would provide an average reader as much disinformation as it does in this case, which is why I cannot see the utility of including such language in the lead, without the necessarily verbose explanation of what it means. Jclemens (talk) 07:08, 22 July 2016 (UTC)

src: c8.alamy.com

Scope of practice: lack of citations, NPOV

Section Scope of practice has unsupported assertions and uses technical terms, i.e. "mid-level" without a link to their meaning.

Previously described as mid-level practitioners[citation--------], along with nurse practitioners, the term mid-level has been fiercely rebuked by practicing PAs[citation----------] 'who continue to provide the highest level of quality medical care, not intermediate level, in comparison to care provided by physicians'.

The bolded part of the sentence belongs in an article or section about controversies, and not in the main body of Scope. In what way is using superlatives consistent with an NPOV? MichelleInSanMarcos (talk) 12:13, 28 August 2017 (UTC)

Mid-level practitioner now points to the wikipedia article on that subject, where there are references that support and refute its use. This turns out to depend on the health system of each country. MichelleInSanMarcos (talk) 12:34, 28 August 2017 (UTC)

src: c8.alamy.com

External links modified

Hello fellow Wikipedians,

I have just modified 2 external links on Physician assistant. Please take a moment to review my edit. If you have any questions, or need the bot to ignore the links, or the page altogether, please visit this simple FaQ for additional information. I made the following changes:

• Added archive https://web.archive.org/web/20101128014328/http://dwu.ac.pg/faculties/fhs/he/bhs.html to http://www.dwu.ac.pg/faculties/fhs/he/bhs.html
• Corrected formatting/usage for http://www.bls.gov/oco/ocos081.htm

When you have finished reviewing my changes, you may follow the instructions on the template below to fix any issues with the URLs.

You may set the |checked=, on this template, to true or failed to let other editors know you reviewed the change. If you find any errors, please use the tools below to fix them or call an editor by setting |needhelp= to your help request.

• If you have discovered URLs which were erroneously considered dead by the bot, you can report them with this tool.
• If you found an error with any archives or the URLs themselves, you can fix them with this tool.

If you are unable to use these tools, you may set |needhelp=<your help request> on this template to request help from an experienced user. Please include details about your problem, to help other editors.

Cheers.--InternetArchiveBot (Report bug) 19:50, 11 December 2017 (UTC)

Source of the article : Wikipedia