What is a PA?

Every year, national Physician Assistant (PA) Week kicks off on Oct. 6 with PA Day and ends on Oct. 12. While the PA profession is over 50 years old, many are still unfamiliar with what a PA does. Considering the evolution of the profession, this is not surprising. The duties of a PA from day one of the profession’s creation until now have changed over time. As you can imagine, people were cautious at the beginning of the profession, not knowing what PAs could accomplish. Over time, PAs have proven to be valued and capable health-care providers.

The PA profession was born in the 1960s at Duke University. The original idea for the profession was to further train corpsmen who already had some medical experience from their time in the military. The first graduating class produced three PAs, and a brand new group of health-care providers was born. By the 1980s, there were PAs in every state, and now there are over 100,000 PAs practicing in the US. The model has spread to several other countries and continues to gain popularity around the globe.

Why was the PA profession created? Access to quality medical care can be difficult in many parts of our country and is not a new issue; this barrier has existed since at least the 1960s. PAs are a solution for increasing patient access to care by decreasing wait times for appointments and working in underserved or rural areas that otherwise may not have any medical providers in the community. In addition to these benefits for the community, there are benefits for the PA. As you may have seen, PA is at the top of the “Best Careers” list every year. The profession offers good pay, flexibility, a low debt-toeducation ratio and high job satisfaction.

PA education also evolved over the decades. What started as a certificate program with no standardized structure or evaluation methods quickly became a highly regulated profession. The PA program at LSU Health Shreveport runs the national average at 27 months. After completing a rigorous curriculum and earning a master’s degree, students take a national, standardized board exam in general medicine. Once they pass their board exams, they become certified PAs.

Educational programs for PAs are highly regulated as well. One national accrediting body (ARC-PA) monitors and provides accreditation to all PA schools in the US. Our accrediting body is further monitored by the Council for Higher Education Accreditation. The state medical board issues PA licenses in Louisiana, and PAs who prescribe controlled substances must receive additional licenses from the Board of Pharmacy and the Drug Enforcement Agency.

All of these agencies monitor appropriate actions of PAs.

As the education and number of PAs grew, so did the responsibilities. Physician assistants have always worked with physicians. In the early days, responsibilities were limited to gathering patient information by taking a history and performing physical exams. However, it quickly became apparent that PAs were also capable of evaluating a patient, making a diagnosis and providing treatments. They were also adept assistants to surgeons. Initially, PAs could only prescribe noncontrolled substances, but over time, it became apparent that PAs could safely and appropriately prescribe all medications.

Once a physician and a PA become comfortable working together, the PA often becomes functionally independent. This means they still have a relationship with the physician but also see patients independently, consulting with their physician counterparts when necessary. This model makes the partnership efficient and further increases access to care. PAs are competent and compassionate health-care providers.

Recently, Hayley Arceneaux, who trained at LSU Health Shreveport, learned space medicine and served as the medical officer on the first all-civilian crew in space aboard the Inspiration4. There have been PAs on the medical staff at the White House, and there is even a PA in Congress. PAs have come a long way since the 1960s, and we continue to go beyond to help our patients lead happy, healthy lives.

Rebecca Clawson, MAT, PA-C, is a clinical assistant professor for the physician assistant program at LSU Health Shreveport School of Allied Health Professions.