Chances are very high these days that when you go to see a doctor, you see a physician assistant or PA instead. These healthcare specialists have a unique role in the medical field for being on the front lines with initial consultation, diagnostics, tests, minor procedures, treatment plans and prescriptions. Each one is a nationally-certified and state-licensed medical professional.
According to thepalife.com and a U.S. News report, physician assistant is the number one healthcare job in 2019 with 40,000 PA positions open The U.S. Bureau of Labor Statistics projects PA jobs to grow 37% in the 2016-2026 decade. While doctors have 12-14 years of higher education, PA programs are like a mini-crash course in health, science and medicine over a continuous 26 to 28 months. One must have a college degree with pre-med classes like anatomy, microbiology and chemistry.
Anne Campbell, PA-C [certified] with Carilion Family Medicine in Pearisburg, graduated from UVA with a degree in neurobiology and did biotech research for years. “I met a woman who was in PA school, at a time when I had never heard of the PA profession. My interest was piqued. I wanted to find a career which could incorporate my training in science that was more people-focused. I also knew I wanted to have a family, and work-life balance was important.”
Some PA programs require two or three years experience in a healthcare environment like being a nurse, EMT, Peace Corps volunteer, ER or surgical technician. The education is intensive with comprehensive courses in pathophysiology and physiology, pharmacology, genetic and molecular mechanisms of health and disease, behavioral science and more. There are 164 accredited programs in the U.S. which cost between $71,000 and $90,000.
“I did not begin my journey knowing I wanted to become a physician assistant,” states Brandi N. Moore, PA-C. “I did always want to be in healthcare and probably thought about nursing first. I wanted a role that had more responsibilities and independence, however, I did not want to be a doctor. Therefore, I went down the path to become a PA.” Moore works with Carilion New River Gastroenterology in Christiansburg.
The idea of being able to complete a post-graduate program and be ready to work in three years appealed to Campbell. “I began taking prerequisites while working and started PA school a few years later. The program was intense but very rewarding, and at the end of a yearlong series of internships (with an emphasis on rural primary care), I felt prepared and ready to work.” She has been practicing in the New River Valley for 15 years.
While PAs can practice independently in some states, Virginia is not among them. One of the attractions of the PA career, however, is the autonomy to see and treat patients, calling in a doctor for unusually perplexing cases. “We have the ability to specialize without additional training,” Moore relates. “It’s much more on-the-job training if you choose to go into specialty practice. The supervising physician(s) will train you and can tailor that to their needs within their practice.”
Among the advantages of seeing a PA are time and extensive evaluation. Where a doctor may have 15 minutes per patient, the PA is more likely to engage in conversation over 20 to 30 minutes covering lifestyle factors that may be part of the symptoms or problems at hand. According to Dr. Doug Althouse who serves on the faculty at Virginia Tech Carilion School of Medicine, PAs have time to evaluate a patient’s symptoms and well-being from a holistic approach. “The PAs can discover home and work stress factors as well as emotional, mental and social aspects of life which may be impacting the patient’s health,” he says. Moore concurs: “We have more patient contact because we are generally much less driven by production and can spend more one on one time with patients.”
Often what propels someone to the doctor’s office is directly connected to a life stress factor or behavior which can be modified or even eliminated. The PAs are the ones to delve into lifestyle, diet, work, exercise and whole health factors. “Family Medicine is challenging, but has been so rewarding,” Campbell states. “I love treating the whole lifespan, forming relationships with families and watching my patients grow up. I have patients whom I have followed through middle and high school who have become my children’s teachers! As a physician assistant, I do feel like we have more time to spend with our patients. Like that of nurse practitioners, our training tends to have a holistic emphasis, stressing the importance of not just the patient’s problem or disease, but also addressing their mental and emotional health, beliefs, socioeconomic and other factors that will affect the success of their treatment.”
One of the biggest healthcare challenges, especially in our rural communities, is the huge shortage of primary care providers. Campbell cites a 2018 study by the Association of American Medical Colleges which estimates that by 2030 there will be a shortage of between 14,800 and 49,300 primary care physicians. PAs and NPs are doing a lot to fill this gap, particularly in rural areas.
Nurse practitioners (NP) also provide first line patient care under the indirect supervision of a medical doctor. Both NPs and PAs play a pivotal role in healthcare in large part because of the increasing shortage of physicians and more demands on the healthcare system. NPs gain their education at nursing school while PAs go to medical college or a center for medicine. Both are highly valued on the professional medical community’s front lines in the New River Valley.
Text by Joanne M. Anderson