MEDEX Northwest: General Information

MEDEX Northwest: General Information For More Details and Interesting Information visit our website at: http://www.medex.washington.edu Find Information About: •
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MEDEX Mission & History Faculty, Staff, & Students Frequently Asked Questions Statistics & Expenses • Degree options & training sites • Academic & clinical prerequisites • Application Materials • Admissions Timeline Explore State and National Physician Assistant Organization websites: National PA websites: WWAMI State PA websites: http://www.aapa.org http://www.nccpa.net http://www.paeaonline.org Washington: http://www.wapa.com Wyoming: http://www.wapa.net Alaska: http://www.akapa.org Montana: http://www.mtapa.com Idaho: http://www.idahopa.org Applying to MEDEX Northwest Ø Step 1: The CASPA Application CASPA Application: Open May 1st to October 1st The CASPA application opens May 1st and can be found at https://portal.caspaonline.org/. Submit the CASPA application on or before the final application deadline of October 1st. CASPA will begin the verification process only after the application has been submitted, receipt of official transcripts and reference letters. Once CASPA completes the verification process applications will be released to MEDEX for screening and review. You must submit your application to CASPA prior to the application deadline of October 1st to be considered for admissions to MEDEX Northwest. We will review all applications submitted to CASPA by the application deadline. If you have questions about the CASPA application please contact CASPA directly at [email protected]. Ø Step 2: The Supplemental Application Supplemental Application: Open May 15th to October 1st The Supplemental Application can be accessed on the Apply to MEDEX web page at http://www.medex.washington.edu Review the application instructions for general details and what may be expected during the next cycle. You can begin the MEDEX Supplemental Application as soon as you have the eleven-­‐ digit CASPA id number. MEDEX Supplemental Applications must also be submitted before our screening and review process will begin. 2 Ø Applying to the UW Please do not apply to the University of Washington at the same time as applying to MEDEX Northwest. We will provide details about how and when to apply to the University of Washington undergraduate or graduate admissions office after students are selected. Ø Applying for Financial Aid Applications for financial aid for each academic year will be available annually in December. Do not wait for acceptance into the MEDEX program to apply for financial aid. Many students apply for financial aid and the funds available are limited. An early application gives you a better chance of receiving financial aid. The Free Application for Federal Student Aid (FAFSA) can be found at http://www.fafsa.ed.gov/. The UW Financial Aid Office coordinates and awards Pell Grants, Supplemental Education Opportunity Grants, Institutional Grants, Scholarships, Perkins Loans, Stafford Loans, Graduate Plus Loans, Supplemental Loans for Students (SLS). More information about financial aid, grants, and loans can be found at http://www.medex.washington.edu Ø Interviewing with MEDEX Northwest MEDEX Northwest Selection Conference: MEDEX Northwest Interview Selection Conferences are held between October and January each application cycle. Applicants invited to interview will be notified two to three weeks in advance of the Selection Conference Date. MEDEX Northwest: Clinical Prerequisites All applicants, regardless of the degree option they are applying to, are required to meet the minimum academic prerequisites and 4,000 hours of paid, direct hands-­‐on clinical patient care experience. Our Students average 6.5 years of paid experience in the in the direct delivery of broad-­‐
based patient care, usually in a primary care setting. Common, competitive, direct patient care experience includes experience in the military (medic, corpsman, pararescueman, etc.), in emergency medicine (EMT, paramedic, emergency department technician, etc.), in nursing (registered nurse, license practical nurse, certified nursing assistant, etc.), medical assistant, and community health aide/practitioner (CHA/CHP). Other acceptable allied health fields include: mental health practitioner, international medical graduate, laboratory/medical technician, radiology technician, clinical researcher, chiropractor, massage therapist, and emergency room or clinical scribe. While these allied health fields may meet the clinical prerequisite, they are also considered fairly specialized. If your clinical experience is considered specialized, clinical volunteerism is a way of supplementing and strengthening your clinical experience background. Positions in medical billing, medical records, medical interpreter, medical transcriptionist, patient scheduler, and anything considered administrative in nature are NOT considered direct patient care and will not fulfill the MEDEX clinical prerequisite. We strongly encourage spending time as a volunteer and shadowing a PA. It is valuable experience, adds to an understanding of the PA role in healthcare, and expands the understanding of primary care. Volunteer and shadowing experience is a great way to supplement your experience but does not replace any clinical paid time. More information regarding Clinical Prerequisites can be found at: http://www.medex.washington.edu MEDEX Northwest: MCHS Prerequisites Master of Clinical Health Services: Seattle & Spokane Each prerequisite course must be completed, prior to the application deadline, with a B-­‐ (2.7-­‐CASPA) or better (per class). Each of our prerequisite courses must be taken as "stand alone" courses, separate from any prior certificate-­‐training program. Courses can be taken at any regionally accredited community college or university for a grade. This may include some college courses completed on-­‐line but check the accreditation of the on-­‐line institution before registering for courses. MEDEX MCHS Prerequisites: •
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Clinical Experience: 2 Years (4,000 hours) minimum Baccalaureate Degree (no preferred major) GRE scores within the last 5 years 10 quarter credits (equal to 6 semester credits) in Human Anatomy and Physiology 15 quarter credits (equal to 9 semester credits) in other medically related Sciences. Examples include: Biology, Microbiology, Chemistry etc. Baccalaureate Degree (no major preference) Applicants applying for the Masters program must have a prior bachelors degree or be able to verify completion of a Bachelor’s degree by December in the same application year. Please refer to the following list of prerequisites to assist in your planning for MCHS option. General Records Examination (GRE) GRE scores must be no older than 5 years and are required as part of the CASPA application. CASPA will not accept official GRE scores but applicants must self-­‐report GRE scores prior to submitting the CASPA application. GRE scores must also be sent to the University of Washington using the school code 4854. Human Anatomy and Physiology Completion of college-­‐level coursework in both human anatomy and physiology that, when combined, totals at least 10 quarter credit hours (or 6 semester credits). Courses must be in Human A&P, and must cover both anatomy and physiology. It is strongly encouraged that the A&P be taken with in the last five years. Three College-­‐Level Basic Science Courses A minimum of 15 quarter credits or 9 semester credits in a course relevant to medicine, i.e. Biology, Chemistry, Microbiology, etc. We strongly recommend that, once you have satisfied the MEDEX Science prerequisite, you continue to take Basic Science courses. Additional Graduate School Requirements: The University of Washington Graduate School requires overall minimum GPA of 3.0 or higher for the last 2 years coursework (90 quarter or 60 semester credits). The Test of English as a Foreign Language (TOEFL) is required by UW Graduate School for foreign applicants who did not complete a bachelors degree at an institution in the US, UK, Ireland, Australia, New Zealand or Canada. Master’s Program All students will participate in the core curriculum, which focuses on primary care and improving health care access for the medically underserved. Specific graduate level assignments will be woven throughout the regular PA curriculum. In addition, students entering the Masters-­‐level program will select a specific Areas of Focus offering advanced skills and knowledge in their chosen focus area. Students will declare their pathway choice during the didactic phase of training. The four Focus Areas are: •
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Rural and Underserved Healthcare Public Health and Preventive Medicine Specialty Practice and PA Education Global Health Capstone Project With faculty guidance, students will develop and complete an individual capstone project within their selected focus area. Projects will be presented to faculty and fellow students summer before graduation. Program timing With the addition of the Master’s specific coursework the MEDEX Masters program will be a total of nine (9) quarters. The additional quarter will be the summer quarter between the didactic and clinical year. Please review details about the Master’s degree option at http://www.medex.washington.edu MEDEX Northwest: BCHS Prerequisites Bachelor of Clinical Health Services: Anchorage, Tacoma & Spokane Each prerequisite course must be completed, prior to the application deadline, with a B-­‐ (2.7-­‐CASPA) or better (per class). Each of our prerequisite courses must be taken as "stand alone" courses, separate from any prior certificate-­‐training program. Courses can be taken at any regionally accredited community college or university for a grade. This may include some college courses completed on-­‐line, but check the accreditation of the on-­‐line institution before registering for courses. MEDEX BCHS Prerequisites: • Clinical Experience: 2 Years (4,000 hours) minimum • 10 quarter credits (two courses) in Human Anatomy and Physiology. • 15 quarter credits (three courses) in other medically related basic sciences. Examples include Biology, Microbiology, Chemistry, etc. • Two college-­‐level English courses at a 100 level or higher. Human Anatomy and Physiology Completion of college-­‐level coursework in both Human Anatomy and Physiology that, when combined, totals at least 10 quarter credit hours (or 6 semester credits). Courses must be in Human A&P, and must cover both anatomy and physiology. It is strongly encouraged that the A&P be taken within the last five years. College-­‐Level Science Courses A minimum of 15 quarter credits (equal to 9 semester credits) in courses relevant to medicine, i.e. Biology, Chemistry, Microbiology, etc. We strongly recommend that, once you have satisfied the MEDEX Science prerequisite, you continue to take Basic Science courses. Two College-­‐Level English Courses Both English courses must be 100 level or higher. At least one of these must be a Composition course. Speech courses are not acceptable, and CLEP scores do not substitute for an actual English course with a satisfactory grade. Advanced Placement (AP) credit will satisfy this requirement as long as it appears on an official college transcript. English courses taken in foreign countries are considered as English as a Second Language (ESL) unless taken in Australia, Canada, New Zealand, the United Kingdom, and Ireland. Please review details about the Bachelor’s degree option at http://www.medex.washington.edu 2 College Academic Distribution Requirements for admission into UW degree option. UW admission requirements must be satisfactorily completed before the first quarter (summer) of enrollment at the UW. Almost all applicants will have satisfied these requirements through high school course work, which is generally defined as that completed in grades 9-­‐12. There are, however, several ways to satisfy core requirements at the college level. In general, five-­‐quarter credits (or three semester credits) at the college level equals one year of high-­‐school study. If you completed a portion of the core requirements in high school supplement high school courses with college course work. Subject High School Years Required College Quarter credits College Semester Credits English 4 years 20 12 Mathematics 3 years 15 9 Social Science 3 years 15 9 Foreign language 2 years 10 6 Science 2 years 10 6 Fine, Visual, or Performing Arts 0.5 years 2.5 1.5 Academic Electives 0.5 years 2.5 1.5 For more information about the University of Washington College Academic Distribution Requirements (CADR) check out the details found at: UW Admissions requirements are detailed on the UW web site: Please see the following website for complete information regarding the University of Washington College Academic Distribution Requirements: http://admit.washington.edu/Admission/Transfer/CADR Information regarding CADR for homeschooled applicants is available at the following: http://admit.washington.edu/Admission/Transfer/Homeschool Questions about whether you meet UW admissions requirements should be referred to the UW admissions office (206) 543-­‐9686. [email protected] UW Admissions Transfer Credit Policies are detailed on the UW web site: http://admit.washington.edu/Requirements/Transfer/Plan/CreditPolicies BCHS Requirements for Graduation BCHS: UW Areas of Proficiency In addition to the regular MEDEX coursework, the University of Washington requires Bachelor’s Degree students to complete coursework in Areas of Proficiency (AoK) for graduation. These Areas are: • English Composition • Additional Writing (7 credits) • Quantitative and Symbolic Reasoning (Q/SR) • Areas of Knowledge (AoK) 40 credits, distributed How these are fulfilled: Requirement Course Details English Composition Satisfied by the same course as the MEDEX prerequisite in English writing Additional Writing This will be satisfied by the MEDEX preceptorship, during Senior year of the BCHS degree program. Q/SR Satisfied by one course AoK 40 credits, distributed over three areas Are additional courses outside of MEDEX coursework needed? No No YES YES Quantitative & Symbolic Reasoning (Q/SR) and Areas of Knowledge (AoK) credits must be fulfilled IN ADDITION TO regular MEDEX coursework. While in the Physician Assistant training program, there is one open summer quarter between year one and year two in which PA students are encouraged to take the Q/SR and AoK courses. Also, before being admitted to MEDEX, students may wish to work toward this requirement through comparable courses at other universities or colleges. Distribution of Areas of Knowledge credits: The 40 Areas of Knowledge (AoK) credits must be in the following three areas, with at least 10 credits, and no more than 15, in each area: Visual, Literary, & Performing Arts Individuals and Societies (I&S) This area includes a wide variety of options for the study of (VLPA) Courses in this area focus on the history, interpretation, criticism, and practice of the arts. The requirement is meant to help you develop a personal appreciation of the creative process. Examples of departments that offer such courses include art history, classics, dance, drama, English, music, and foreign languages. Most speech courses also count in this area. human beings and societies. Courses focus on the history, development, and dynamics of human behavior, as well as social and cultural institutions and practices. Departments that offer such courses include American ethnic studies, anthropology, economics, geography, international studies, political science, psychology, sociology, and women studies. I&S includes from departments such as history, philosophy, and religion courses traditionally grouped with “humanities” at other colleges. The Natural World (NW) Courses in this area focus on the disciplined, scientific study of the natural world. The area can be divided into three broad categories; the mathematical sciences, the physical sciences, and the biological sciences. Departments that offer such courses include astronomy, biology, chemistry, fisheries, forest resources, geology, mathematics, and oceanography. 2 MEDEX Northwest BACHELOR OF CLINICAL HEALTH SERVICES (BCHS) Degree Requirements Planning Worksheet Proficiency Requirement _____ English Composition _________________________ X Additional Writing 7 cr. (MEDEX preceptorship satisfies this requirement) _____ QSR (Quantitative and Symbolic Reasoning) Areas of Knowledge: 40 credits. At least 10 credits in each group, and no more than 15 in any one area. Visual, Literary & Individuals & Society (I&S) Natural World (NW) _________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________ Performing Arts (VLPA) Upper division Courses (non-­‐major) 12 credits ___________________ MEDEX summer A & P and Basic Sciences satisfies this requirement. Major: Completion of MEDEX Major Curriculum 129 ________________ PA Facts
What is a PA?
What can a PA legally do?
To practice as a
physician assistant:
Such duties include performing physical
examinations, diagnosing and treating
illnesses, ordering and interpreting lab
tests, assisting in surgery, providing
patient education and counseling,
and making rounds in nursing homes
and hospitals. All states, the District
of Columbia, and Guam authorize
physicians to delegate prescriptive
privileges to the PAs they supervise.
A physician assistant (PA) is a graduate of an accredited PA
educational program who is authorized by the state to practice
medicine with the supervision of a licensed physician. PAs are
invaluable members of the health care team, working in concert
with physicians to ensure the highest quality of care for patients.
Attend an accredited PA program
n
he typical student has
T
a bachelor’s degree and
approximately 4 years of health
care experience.
n Average
And clinical rotations
More than 2,000 hours, with an
emphasis on primary care in
ambulatory clinics, physicians’
offices, and acute/long-term care
facilities
Family medicine
General surgery
26 months of instruction
Pediatrics
With class/lab
instruction
More than 400 hours in basic
sciences (with more than 75 hours
in pharmacology) + approximately
175 hours in behavioral sciences +
nearly 580 hours of clinical medicine
Psychiatry
Emergency medicine
Obstetrics/gynecology
Internal medicine
To practice
n
Anatomy Pathology Pharmacology
Biochemistry
Clinical laboratory sciences
Microbiology
Physical diagnosis
Differential diagnosis
Pathophysiology
n
n
Behavioral sciences
PA Facts
www.aapa.org | May 2009
btain individual license from state
O
medical or PA licensing board
To maintain certification
Medical ethics
Physiology
Pass
national PA certification
exam administered by the
National Commission on
Certification of PAs (NCCPA)
(open only to graduates of
accredited PA programs)
Log
100 Continuing Medical
Education credits over
2-year cycle
n
Reregister every 2 years
n
it for recertification exam every
S
6 years
Physicians may delegate to PAs those
medical duties that are within the
physician’s scope of practice and the
PA’s training and experience and are
allowed by law.
How was the first PA
program started?
Recognizing that some residents of North
Carolina had limited access to quality
medical care, the chair of the Department
of Medicine at the Duke University Medical
Center established a program in 1965 to
educate ex-military corpsmen to practice
medicine with physician supervision.
These first students had received
extensive health care training during their
military careers. The educational model for
physician assistants was based in part on
his experience with the fast-track training
of doctors during World War II.
How does a person
become a PA?
There are more than 140 accredited
physician assistant educational
programs in the United States. They
are located at medical colleges and
universities, teaching hospitals, and in
the Armed Forces. All PA educational
programs are accredited by one body,
the Accreditation Review Commission on
Education for the Physician Assistant.
Prior to admission, the typical PA
student has a bachelor’s degree and
approximately four years of health care
experience. PA educational programs
run approximately 26 months, and PA
students may take some of their classes
with medical students.
Where do PAs practice?
The country’s 73,893 physician
assistants work in virtually every
medical and surgical setting. More
than one-third (38.2%) are found
in hospitals. More than 43 percent
of respondents to the AAPA 2008
Physician Assistant Census indicate
that their primary work setting is a
group practice or solo-physician
office. The remaining PAs can be
found in a variety of settings, such
as rural and community health
centers, freestanding surgical
facilities, nursing homes, school- or
college-based facilities, industrial
settings, and correctional facilities.
What about
reimbursement for
services provided by
PAs?
PAs offer great financial benefits to
their employers by providing high-
PA Work Settings
Other Community Health Centers
Rural Clinics
Occupational Medicine
2.3%
14.0%
Group Practices
33.4%
quality medical care for which most
public and private third-party payers
reimburse. Medicare and TRICARE
reimburse the physician assistant’s
employer for services provided by
PAs in virtually all practice settings,
as well as for assisting at surgery.
State Medicaid programs and most
private insurers also cover services
provided by PAs.
Emergency Medicine
10.5%
25.9%
25.1%
Ob/Gyn
2.3%
38.2%
10%
Family/General Medicine
4.3%
Hospitals
Solo Physician Practices
General Surgery
& Surgical
Subspecialties
General Pediatrics &
Pediatric Subspecialties
10.9%
3.5%
PAs Work in Virtually Every
Area of Medicine and Surgery
Other
4%
Other
General Internal Medicine
& IM Subspecialties
15.6%
Source: AAPA 2008 Annual PA Census
And the quality of PA
services?
Studies conducted by the Rand
Corporation have found that PAs
save as much as 20 percent of
the costs of medical care, can
perform at least 80 percent of the
functions in an ambulatory care
practice, and are widely accepted by
patients. The congressional Office
of Technology Assessment studied
health care services provided by
PAs and determined that “within
their scope of practice, physician
assistants provide health care that is
indistinguishable in quality from care
provided by physicians.”
Professional liability insurance
premiums are low because PAs
have been involved in very few
lawsuits.
Source: AAPA 2008 Annual PA Census
950 North Washington Street | Alexandria, VA 22314-1552 | www.aapa.org
PA Facts
www.aapa.org | May 2009
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Issue Brief
Physician Assistants in
Primary Care
More than 40 years ago, a group
of physicians, looking critically
at America’s health care needs,
envisioned a new type of health
professional. They hypothesized that
physicians could utilize their time and
talents more wisely, provide better
care, and reach more underserved
patients if they worked with assistants
who were trained in medicine and
practiced with physician supervision.
Their idea has evolved into the
physician assistant (PA) profession.
The PA profession emerged just when
this country was facing workforce issues
very similar to those being forecast
today — a shortage of physicians,
particularly in primary care specialties,
and maldistribution of providers.
Today there are nearly 75,000 PAs in
clinical practice; 40 percent (30,000)
practice in primary care specialties
— family practice, general internal
medicine, general pediatrics, obstetrics
and gynecology, and geriatrics.
Key to the profession’s success is the
tightly structured medical curriculum
that prepares PA students to practice
with physicians in any specialty. The
profession’s flexibility — a relatively
short educational pipeline producing
well-prepared generalist medical
clinicians — is a great resource for
policy makers who are reorganizing
priorities. Because physician assistants
Physician Assistants
and the Medical Home
Fundamentally oriented to team
practice and educationally grounded
practice medicine with supervising
physicians, state licensing laws grant
them the flexibility to move from one
medical specialty to another based on
the specialty of the physician.
in primary care medicine, physician
The Physician-PA Team
coordination of care.
PAs provide medical care to patients
and consult with supervising physicians
and colleagues as necessary.
Sometimes they refer patients to
specialists. Studies focused on PA
productivity and scope of practice
conclude that PAs in primary care
perform between 70-90 percent
of services that their supervising
physicians perform. Research
consistently finds that PAs provide care
equivalent in quality to that of physicians
and are widely accepted by patients.
Researchers debate whether PAs
“extend” physicians’ services —
performing the same types of services
as their supervising physician — or
whether they “complement” the work of
the physician — for instance, providing
patient education, care coordination,
and follow-up on behalf of the physician.
The reality seems to be some of each.
Some practices hire PAs to provide
comprehensive care to a panel
of patients with input from the
supervising physician. Others hire
PAs to provide neglected preventive
care and patient education. In some
practices, the assignment of patients
AAPA Issue Brief | Physician Assistants in Primary Care
www.aapa.org | June 2009
assistants are the perfect addition
to the management of patients in a
primary care medical home, offering
continuity, comprehensiveness and
“In emerging models of primary
care medical homes, the traditional
practice of a physician working in
isolation is shifting to collaborative
models that include physicians from
multiple specialties, nurses, nurse
practitioners, physician assistants,
and other health professionals.
This primary care paradigm will
enable professionals to adapt to the
changing demographics and needs
of patients seeking primary care.”
(Hauer KE, Durning SJ, Schawrtz
MD, JAMA. 2009;301(8):825-826.)
is random; in others, PAs see certain types of patients,
such as walk-ins, well babies, and student physicals, etc.
As with physicians, sometimes a PA becomes the generally
acknowledged “expert” for a particular condition or type of
patient. For example
a rural Nebraska community health center, a PA
n Inpractices
family medicine with a team of colleagues
He is the lead provider for the HIV care provided under the
center’s Ryan White grant.
A PA in an urban California multi-specialty group
works with 32 internists providing acute care. He cares
for many of the elderly patients. He also works with the
plastic surgery department, treating chronic and difficult to
heal wounds.
n
PA Scope of Practice
An individual PA’s scope of practice is defined by
n Education and experience
n State law
n Facility/practice policy
n Physician delegation
PA licensing laws and regulations are broadly written to
allow maximum flexibility at the practice level, leaving most
of the specific delegatory decisions to the supervising
physician. In all states plus the District of Columbia,
physicians may delegate prescriptive privileges to the PAs
they supervise. All state laws allow the flexibility of off-site
supervision by physicians as long as they are available to
the PA via telecommunication.
PA Roles in Primary Care
The primary care roles PAs fill encompass many settings
and practice models. Among the 30,000 PAs in primary
care medicine, 60 percent are employed by solo physicians
or physician group practices. The rest are employed by
community health centers, hospitals, HMOs, integrated
systems, correctional systems, home health agencies, long
term care facilities, and medical staffing groups.
Caring for the Elderly
While just one percent of PAs identify themselves as
working in geriatrics, 90 percent of all PAs report caring for
persons aged 65-84 years, and 80 percent care for patients
85 years old and older.
PA program graduates are well-grounded in the care of
elderly patients. All PA students learn to elicit medical
histories and perform physical examinations on elderly
patients. Accreditation standards require that programs
provide students with clinical experiences in the long-term
care setting and supervised clinical practice in geriatrics.
calls are not a thing of the past for the
n House
PAs who bring care to 300 low-income seniors
in Durham, North Car­olina. Patients who have health
problems compounded by mobility or transportation
difficulties are served by a multidisciplinary team in the
Physician assistants in primary care
n Perform physical examinations
n Diagnose and treat illnesses
n Order and interpret lab tests
n Prescribe medications
n Manage patients with chronic conditions
n Perform minor surgical procedures
n Provide patient education
n Make rounds (nursing home and hospital)
n Take call
AAPA Issue Brief | Physician Assistants in Primary Care
www.aapa.org | June 2009
“Just for Us” PA and patient.
Photo Credit: Duke Photography
2
“Just for Us” program created by Duke University. Team
members provide services, such as physical exams,
monitoring and treatment of chronic condi­tions, treatment
for acute conditions, lab tests, health education, and case
management. The visits are part of Duke’s “medical home”
approach to family medicine.
In a 360-bed skilled nursing facility in the Northeast,
two PAs practice full-time on site. The nursing home
practice is run by physicians from a nearby academic
medical center. The supervising geriatrician is always
available to consult when the PAs are working, and
physicians come in three times a week. Having PAs there
provides continuity of care, has reduced hospitalizations,
and is particularly effective for managing patients with
chronic conditions.
n
Caring for Children and Families
The small percentage of PAs who identify themselves as
working in general pediatrics (3%) is not indicative of the
number of PAs caring for children. Eighty percent of PAs
in family medicine report that they care for newborns; 85
percent see babies and older children, and 95 percent
see adolescent patients. The clinical breadth and team
orientation of PA education creates clinicians who are wellsuited to the challenges of family practice.
a large Midwestern system, a long-time PA
n Inpractices
family medicine, seeing patients of all ages,
sometimes three generations in a single family. He provides
comprehensive care to a large panel of patients, but holds
a special love for his newborn and pediatric patients.
Despite the trend among liability insurers to limit obstetrical
practices, this PA performs deliveries at the local hospital.
Caring for the Underserved
PAs play a key role in providing needed care for medically
underserved populations, such as frontier and border
communities, small rural towns, the urban poor, and at-risk
groups such as the elderly.
PAs are an important part of the health care workforce
that provides medical care to some of the country’s most
vulnerable children — those covered by Medicaid and the
Children’s Health Insurance Program (CHIP).
Federally qualified health centers (FQHCs) are a mainstay
for under- and uninsured patients. Nearly 20 percent of PAs
in primary care (6,000 PAs) work in urban and rural FQHCs,
community health centers, and certified rural health clinics.
the middle of the Chesapeake Bay, the residents
n Inof Tangier
Island rejoiced when a native daughter
graduated from PA school in 2006 and became their first
full-time medical professional. For years, the island’s 600
residents were served by mainland physicians and PAs
who traveled there by plane or boat once a week. The
physicians still supervise and come to the island. The PA
says that completing PA school and practicing on the island
is “a dream come true.”
and raised in a Yupik/Aleut family in Alaska,
n Born
one physician assistant provides care at a regional
hospital serving 56 villages. “They call me ‘the doctor’ or
‘our Native doctor’,” she says. “I tell them that I’m not a
family practice near Puget Sound
n Awassmall-town
created 25 years ago by two physicians with the
philosophy of serving families where they lived and worked.
Today, the practice has 15 physicians, 10 PAs, and two NPs
providing care in three locations to 27,000 patients a year.
There are three offices and two urgent care locations offering
walk-in appointments and evening and weekend hours. The
PAs provide both urgent and comprehensive care.
AAPA Issue Brief | Physician Assistants in Primary Care
www.aapa.org | June 2009
Tangier Island, Virginia.
Photo Credit: Tangier Island Health Foundation
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doctor, but they disregard that. They know that I’m not a
doctor of medicine, but I think that in their eyes,
I am their doctor.” She was inspired to become a PA by her
mother, who was a medical aide. Now her daughter is also
a physician assistant.
Caring for Our Nation’s Veterans
The first PA graduates were former medical corpsmen
who served in Vietnam and wanted to use their medical
knowledge in civilian life. The veteran/PA connection
continues today. Physician assistant programs currently
recruit medics who have served in Afghanistan and
Iraq. PA graduates provide essential medical care in
Iraq and Afghanistan as active duty members of the
Armed Services, National Guard, and Army Reserves.
The Department of Veterans Affairs is the single largest
employer of physician assistants, with about 1,800 PAs in
its clinics and medical centers.
the psychiatric nursing home unit of
n When
a Veterans Affairs Medical Center (VAMC) in
Kansas needed a clinician to provide medical care, a
physician assistant with seven years of internal medicine
experience stepped into the role. On a typical day,
after rounds with the treatment team, the PA performs
admissions, orders specialty consults, and coordinates
the patients’ medical needs. Her supervising physician
attends daily rounds, is always available by pager, and
provides night call coverage.
Caring for Rural Communities
The 1977 Rural Health Clinic Services Act improved the
delivery of health care in rural areas by assuring Medicare and
Medicaid reimbursement to certified clinics staffed by PAs and
NPs working with physician supervision. Today there are 3,700
Rural Health Clinics, many staffed by physician assistants.
Nationally, 15 percent of all PAs practice in rural areas;
often the PA is the only medical provider in the community.
arrived in a small West Virginia town 30 years
n Aago,PAwhen
the town had no resident physician. The last
full-time physician practiced there in the 1960s. Even today,
the nearest full-time doctor is 16 miles away. More than
6,200 people visited the clinic, a community health center,
in 2008. Staff recently learned that the center will receive
more than $1 million in federal stimulus money. “The
money mainly will be used to help us expand and grow our
mission, which is to support and take care of the uninsured
or underinsured,” says the executive director.
Horizon Healthcare, Inc., community health
n Ten
centers across South Dakota provide primary care from
birth to death. The staff includes six physicians, 10 PAs, four
dentists, and three nurse practitioners. All of the PAs are family
medicine providers, whose clinical interests include emergency
medicine, prevention, geriatrics, cancer awareness, and
women’s health. The PAs represent a mix of old and new
graduates — from 1975 to 2007. One PA arrived as a National
Health Service Corps provider in 1979 and is still there.
physicians, 10 PAs, and two
n ANPsteamstaffoftheseven
primary care medicine clinics of one
Pennsylvania VAMC. One PA on the team says she
loves the variety in her work and the flexibility she has
had to move within the center. During 21 years there,
she has worked in psychiatry, physical medicine and
rehab, geriatrics, and now primary care. Currently, she is
the primary care “floater,” filling in where needed when
colleagues are away. In addition, she conducts the exams
for the Agent Orange and Gulf War registries, assignments
that required specialized training.
Photo Credit: Horizon Healthcare, Inc.
Mellette County Health Clinic, White River, South Dakota.
950 North Washington Street | Alexandria, VA 22314-1552 | www.aapa.org
AAPA Issue Brief | Physician Assistants in Primary Care
www.aapa.org | June 2009
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