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 most states can write prescriptions. PAs are trained in intensive education programs accredited by the Commission on Accreditation of Allied Health Education Programs (previously the American Medical Association's Committee on Allied Health Education and Accreditation.) 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 areas of medicine can Physician Assistants work in?

A. Physician assistants (PAs) are found in all areas of medicine. Today, over 50 percent of all physician assistants practice what is known as "primary care medicine" - that is family medicine, internal medicine, pediatrics, and obstetrics and gynecology. About 19 percent are in surgery or 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-six states, the District of Columbia, and Guam have enacted laws that authorize PA prescribing. PAs in Arkansas and Illinois have statutory authority to prescribe and will be able to write prescriptions as soon as rules are adopted. (Arkansas and Illinois are included in the 46 states.) In California, PA prescriptions are referred to as written prescription transmittal orders.

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.