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Article : What Causes Physician Assistants’ Demeaning Respect And How To Overcome It

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Birds manage their nests, bees are best known for managing the hive, and Physicians manage the wards.

Physician Assistants (PAs) are trained to manage health facilities especially in the absence of Physicians. How do these two specially trained individuals manage the same health facility?

How do two captains survive in a boat? And how do two rams drink from the same bowl?

The biggest challenge in life is defining your role. Life at the hospital is like game of chess. Each piece has its distinctive role. Each one of the pieces gives a cover for each other. That is how the health personnels are to complement each other in order to have a fully functioning hospital.

At the ward, Physicians probably see the PAs as subordinates. Foxes and dogs may bear some similarities yet, one can easily see their striking differences even under a dim moonlight. Nurses do not also count PAs as part of their circles.

So the big question is, where lies the defined role of Physician Assistants?

A story is told of an energetic PA who worked with a Physician and Nurses at the same hospital.

A Senior Nurse on duty instructed the PA to change the bed of the sick. A Physician on his daily rounds saw the PA and asked her in the act to stop because that isn’t part of her duties.

At another time, a client visits the hospital with a health issue. The client takes his hospital card and is now ready to meet the consultant.

Unfortunately, no Physician had reported at the hospital that morning. The client was asked to hold on till any of them arrives even though the said PA was present.

Meanwhile the PA is qualified enough to hold consultations on her own yet the Nurses didn’t allow her to do that.

How inferior must PA have felt at that moment?

The lingering question is, where lies the role of the Physician Assistant in the resolving health issues?

In pecking order, where would you put the PAs among the sects of Physicians and Nurses?


File Photo : PA

In 1965, Eugene A. Stead Jr., MD after discovering that there was a shortage of primary care physicians put together the first class of Physician Assistant students. He selected four Navy Hospital Corpsmen who had already received considerable medical training during their military service.

Stead based the curriculum his curriculum of the program on his knowledge of the fast track training of doctors during the Second World War. The PA concept was lauded early on and gain federal acceptance and backing as early as the 1970s as a creative solution to physician shortages.

During this era, people argue that the function of the PAs were not clearly stated and so most civilians saw them as medical doctors and hence the acknowledgment and respect fell into place naturally. The course after the war was not terminated but rather expanded to become a course studied in so many countries today.

With this expansion, the job of the physician assistant became clearer as time went by and they came in to fill the gap between doctors and patients in the sense they mostly deal with the consultation of patients. This is what people generally know and believe they do but the work is a little more complex and loaded than that.

This article is to help point out the fact that Physician assistants do try as much as doctors and hence they deserve to be treated with equal respect as the medical doctors.

A physician assistant is a medical professional who operates under a doctor’s supervision. Both, the doctor as well as the PA, share patient care responsibility. A scope of a PA’s duties include examining patients, diagnosing illnesses, taking the patient’s history, developing and carrying out treatment plans, counseling patients on healthcare plans and suturing wounds.

The main duties of a PA overlap with that of a doctor across several aspects; except for a few major procedures such as surgery. Physician assistants may assist doctors in surgical procedures but they themselves are not licensed to perform surgery. Other than that, the major difference in job functions between a doctor and a physician assistant is that a doctor works autonomously whereas a PA always works under the supervision of the doctor.

In some areas physician assistants are authorized to write prescriptions whereas in some they cannot. This constitutes the function of the PA in so many countries.

As stated above, the function of the PA overlaps with that of the medical practitioner with the major difference being that the latter is not allowed to perform surgeries but rather aid in surgeries under the supervision of the former.

When viewed like this, the major question to be posed is, “Then why is the PA still undermined?”.

Basically because the PAs are seen as nurses because of their functions and also because some hospitals classify them both as ancillary staff therefore categorizing them as “overhead” instead of revenue generators.

The lack of respect these hospitals, the institutions they work at, refuse to give them but rather “degrade “ them to that of a group below them will cause the other stakeholders being the patients to also give them that same level of respect.

Well, this could actually come to an end when the PAs themselves are able to elaborate or spell out their functions more to these health institutions. Another factor that causes the respect to lessen is the number of years the PAs spend in school.

With the structure of the course, the PAs were meant not to spend as long as medical doctors do spend in school because patient doctor ratio is very low so they then have to spend less to complete early and aid the doctor of certain “burdens” to help them concentrate on other things which seem more technical.

This is another reason people base on to undermine the PAs. Here again, they compare them to nurses because they all spend close to the same amount of time in school and so people thing that they actually train them the same way. What some refuse to understand is that, the PAs are supposed to master what the medical doctor’s master including some technical things in the shortest possible time to aid the ever rising population of patients. This in some sense means that the PAs are actually quite a smart bunch of individuals to be able to master all this in the shortest possible time.

When they are able to stop the perception that they are underqualified for certain jobs and tend to perform their functions more efficiently and effectively without making it seem more incline with that of the nurses but rather that of the medical doctors, the ospitals I am sure would stop viewing them as “overheads” but rather revenue generators and hence attach to their title the respect they see fit. As a PA, you are able to spell out your functions more if you are able to take a leadership role not only in relation to patient duty but also administrative role. This basically gives you a good image and that of your other colleagues and raises your standard.

Again, you are able to spell out your function more effectively if you are able to know your numbers. This basically means that you should work with the leadership team to gain your quarterly reports of your attributed charges and collections which you will base upon to be able to know how much you have put in and fix your various minor problems you might have on the side.

Additionally, respect for PAs can and will rise if they are able to reduce the perception that they spend almost the same number of years with nursing students doing what nursing students do exactly.

They can make various individuals understand that they learn more technical things by creating an awareness of the course and even help random individuals understand and take the course drastically reducing the problem of patient physician ratio which is ever rising as stated earlier.

Source : Dorothy Mensah (Level 200 Physician Assistant / University of Cape Coast)

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