Lehigh Valley Marketplace

By Christine A. Krahling

In last month’s “Health Watch” department, we did not accurately discuss the role of the physician assistant in our article, “Choosing the Right Physician for Your Family.” We truly regret this error.

Several physician assistants in the Lehigh Valley were quick to inform us that we had a great deal to learn about this highly respected healthcare profession and we agreed. Since October 6 -12 is National Physician Assistant Week, we thought this was the perfect time to learn more about physician assistants. I talked with three: Megan McCormack, MS, PA-C, of Urology Specialists of the Lehigh Valley, Andrea R. Seibert, PA-C, of Lehigh Internal Medicine and Justin Stauffer, PA-C, of Lehigh Valley Health Network. Join me for this interesting and educational discussion.

Why did you decide to become a physician assistant?

Megan McCormack, MS, PA-C: I was inspired to become a physician assistant while in high school from the strong medical influences in my family.

Andrea R. Seibert, PA-C: I always wanted to do something in medicine but didn’t know what. I found out about the PA profession, did my research and found it was perfect for me.

Justin Stauffer, PA-C: I became a physician assistant because I wanted to be able to care for patients while working as a member of a team.

What are some of the advantages of being a physician assistant ?

MM: Being a physician assistant allows me to have a main focal point on medicine, not on financial matters, practice management or the ongoing Medicare reimbursement cuts. At the end of the day, I practice medicine. I love recertifying in all areas of medicine so that I can be a well-rounded provider and change specialties if so desired.

ARS: Professionally, I am trained in multiple specialties and recertified every six years in all areas in medicine, allowing me to work in any specialty. Over the 18 years of practicing medicine, I have worked in cardio-thoracic surgery, orthopaedics, geriatrics, family medicine and now internal medicine.

JS: One of the professional advantages of being a PA rather than a physician is the type of responsibility. PAs carry a huge responsibility in caring for patients, but they have the advantage of working under the supervision of a physician if a patient is complex or beyond the scope of the PA’s knowledge.

Tell us how physician assistants work with physicians in terms of supervision and following the supervising doctor’s model of care.

MM: As a physician assistant, it is not our intention to ever work as a sole provider but rather work with the physicians. Hence the fact that our attendings are available 24/7 via text, phone or email and we cosign all care plans with 72 hours.

JS: The PA profession was not designed to be independent of physicians. The profession was designed to treat patients under their supervision. PAs know their limits and seek the advice of physicians in some or all patient cases, depending on the specialty or practice. In most emergency departments, there are entire sections devoted to care by physician assistants for minor emergencies such as lacerations, sprains and fracture. PAs, of course, are not limited to such minor emergencies, but also care for higher acuity patients, including strokes, abdominal pain, heart attacks, etc. We take the same approach as a physician when caring for a patient: take a complete medical history, perform a physical exam, order and interpret appropriate laboratory and radiographic tests, diagnose, and treat with appropriate interventions or medications.

What are some of the biggest misconceptions about physician assistants?

ARS: That we are “doctors in training.” People need to understand that the PA profession is a career {of} its own.

JS: A discouraging comment I hear too often when discharging a patient from the emergency department is, “Now when do I see the doctor?” In many specialties, including the emergency department, PAs are capable of effectively treating many patients without the assistance from a physician, although the physician is always available as needed.

What is a typical day like for you? Is there one?

ARS: There is never a typical day in any specialty at any time. That’s what makes medicine, ‘medicine.’ It’s never a dull moment.

JS: Accidents and emergencies are constant, and there is never a convenient time for a patient to visit the emergency department. The variable lies in each patient.

What education and training do physician assistants receive and what continuing education is expected of them?

JS: If you were to compare the curriculum of a medical school to that of a physician assistant program, you would find a large number of similarities. The majority of physician assistant programs offer master’s degrees following the prerequisite of a bachelor’s degree. The master’s degree is quite intensive, and is often condensed into a 24-32 month program. The first year involves the didactic period of learning concepts of medicine and pathophysiology, and the second year involves the clinical phase in which the student works in a variety of specialties to gain experience. A PA must log at least 100 continuing medical education hours every two years, be registered with the state, and be certified through the NCCPA (National Commission on Certification of Physician Assistants) to remain practicing. We are fully licensed and certified to practice medicine.

What are some of the greatest joys and challenges about being a physician assistant?

MM: I love my career. I wouldn’t trade it for the world. It is so rare one person is blessed with the talent of medicine and healing. My patients are family to me; there isn’t a thing I wouldn’t do for them.

ARS: There is nothing more rewarding than having a patient come in and thank you for making such a positive impact in their lives. As for challenges, it’s more about medicine in general that’s challenging, whether it’s dealing with a non-compliant patient or a difficult insurance company or getting the right medicines covered for your patient or dealing with the politics behind our healthcare system. Frustration is the greatest when you know what your patient needs but can’t seem to get it because of insurance or their own financial reasons.

JS: In the emergency department (ED), I tend to see patients at their worst, when they are in the most need of help. I find practicing in the ED provides a huge sense of satisfaction and joy when I can discharge a patient having identified and corrected the problem and making the patient feel emotionally and physically better. The challenges are always present, including complex patients in which a diagnosis is not always apparent or counseling family when a loved one is critically ill.

How has the role of the physician assistant evolved in the medical field in the past 10 years? What do you hope the future holds for this profession?

MM: PAs have allowed for easier patient access, extension of quality of care and a diversified approach to medicine. I strongly believe that there will be a continued need as people continue to age.

ARS: So much has changed since I started in 1992…from scope of practice to prescriptive privileges. The profession is growing and changing rapidly due to the tremendous changes in {the} healthcare system and hopefully as time goes on it will continue to change for the positive.

JS: I understand that the role of the PA in healthcare has taken on new responsibilities and challenges when compared to its inception in the 1960s, although the basic foundation is still there: to exercise autonomy in caring for patients under the supervision of a physician.

If there is one thing that you would want our readers to know about physician assistants, what would that be?

MM: Physician assistants combine together the knowledge of medicine with the compassion to cure and treat. I live life knowing that I’ve helped people, cured people and saved people.

ARS: That our training is intense and we are highly skilled clinicians and provide exceptional health care.

JS: The physician assistant is a qualified, trained healthcare provider that is capable of diagnosing and treating patients with a wide variety of diseases. I would encourage readers to extend their view beyond the traditional doctor-patient relationship and to build a trust in PAs in managing their healthcare needs.

Christine A. Krahling is the editor of Lehigh Valley Marketplace.