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Embracing the Physician-PA Team Model

March 9, 2011 in Current PAs, PA Educators, PA Pals, PA Students, Prospective PAs

Physician Assistant versus Nurse Practitioner

“Beth, what is the difference between a PA and an NP?”  I have had to answer this question hundreds of time – and I do it differently depending on the audience.  I have been asked by patients, physicians, friends, prospective NP and PA students, legislators, and other health care professionals.  Let me start by saying that I have nothing against NPs.  I don’t see them as… THERE’S MORE! Read the rest of this post for FREE! Register for a FREE account by clicking here. If you already have an account, log in by clicking here.

Do NPs and PAs Really Spend More Time With Patients?

March 7, 2011 in Current PAs, PA Educators, PA Pals, PA Students, Prospective PAs


This article was published in the September 2010 issue of ADVANCE for NPs & PAs and has been reproduced here with permission. Click here for more.

Role & Growth

Healthy discussion takes place among the health professions about the relative practice advantages and strengths of each. Such discussion has accelerated lately as NPs, PAs and primary care physicians jockey for position in the new world of healthcare delivery.

This is particularly the case in primary care, where several trends are leading to even more intense turf wars. Newly graduating physicians continue to avoid primary care, preferring the higher-paying specialties and subspecialties. Similar trends are occurring among PAs, but for both groups the specialty trend is being driven by high student debt and poor reimbursement for primary care. Seeing an opening, NPs are seeking to increase their profile in primary care by establishing their entry-level degree at the doctoral level and amending state practice laws to permit a wider practice scope.

In the turf wars, the professions often choose to identify specific features of their practice that appear to give them particular advantages or greater degrees of effectiveness over the others. Since physician practice has dominated healthcare delivery for the past century, other professions often seek to compare their practice effectiveness against the physician “standard” and note, for example, that the care they deliver is just as safe and effective as physician care.

The Myth of More Time

One of the most common assertions, one that seems to have existed for decades and has been perpetuated by the professions and their organizations, is the canard that NPs and PAs spend more time with their patients compared with physicians.

In my work as an educator and speaker, I regularly encounter student groups and professional audiences, all of whom tend to have the impression that spending more time with patients is one of the signature characteristics of NPs and PAs alike. When I ask applicants why they seek to become a PA, they invariably state that it is because they want to spend more time with patients. The perception seems to be ubiquitous.

Having spent much of my professional life in research and academics, I can state flatly that no study… THERE’S MORE! Read the rest of this post for FREE! Register for a FREE account by clicking here. If you already have an account, log in by clicking here.

My Next Great Challenge – PA Program Director

March 3, 2011 in PA Educators, PA Pals, Prospective PAs

I’m excited to announce that I have accepted a position as the Founding Director for a new Physician Assistant Program being established in Charleston, West Virginia. This will be a Master’s degree level program and the tentative timeline will include matriculating our first class of students in January of 2013.

For me, having a blank canvas with which to build a new program is like being a kid in a candy store! I’m quite eager to get started. In fact, even though my official start date is three months away, I’m already deeply reflecting and further developing some of my ideas. I will share just a taste of what’s going through my head:

Analytical thinking and problem-solving

My curriculum will have a heavy emphasis on the meat of medicine, problem-solving! Medicine is not about memorizing facts and figures! Don’t get me wrong, there are certain things that must be memorized. But the art and practice of medicine is not about regurgitating the proper dose of an antibiotic or memorizing the three most common presenting symptoms of pheochomocytoma. Rather, it’s about having a sound understanding of fundamentals and being able to logically work through a complex set of data. It’s about appreciating the unique dynamics involved in human interaction and understanding the role they play in making clinical decisions. Indeed, the amount of medical knowledge we have at this point in time could not be learned in several lifetimes. Furthermore, the rate at which we are learning new information is astounding. Expert guidelines change so frequently that in many cases something considered a best practice five years ago becomes obsolete today. It makes zero sense to design a curriculum around trying to teach the details of medicine and having students regurgitate this information on an examination. It doesn’t work, nor is it necessary. In fact, what I refer to as the “information dump truck philosophy” is counterproductive. With this approach, students are so worried about memorizing lists they often miss the major principles and concepts that should drive their decision making. Then, when they can’t recall all this information two months later they feel defeated and disheartened. The focus of my curriculum will be upon learning and applying the critical principles of disease and patient care so as to arm students with tools that can be used for their entire careers.

Resourcefulness

My curriculum will focus on training our future Physician Assistants to be exceptionally resourceful! To me, this means many things. Most importantly, it’s a focus on being able to access excellent information quickly, even at the point of care. But it’s also more than this, it’s training our students to understand the intricacies of a complex health care delivery system and how to appropriately interact with all members who contribute to the health care industry. For example, my students will know exactly how to approach contacting and effectively communicating with a subspecialist.  It also means motivating students to carry with them throughout their careers a passion for understanding health and disease — powerful enough to foster a continuous curiosity so as to drive them to enjoy lifelong learning!

Team-based approach

Medicine is moving more and more towards team-based care. In fact, less than a week ago, the American Academy of Physician Assistants (AAPA) and the American Academy of Family Physicians (AAFP) teamed up to release a joint policy statement entitled: Family Physicians and Physician Assistants: Team-Based Family Medicine. In a nutshell, it emphasizes patient-centered, team-based care and advocates for state and national policies to promote the delivery of such care. It also calls for educational innovations in interprofessional training. The entire concept of the Physician Assistant is based on collaboratively working with a supervising physician.  With all this in mind, someone needs to explain to me why most PA training programs are structured in such a way as to naturally encourage competition?! I can’t even begin to explain the frustration I feel when I observe students focusing their studies to obtain a certain grade, rather than learning so they can become an excellent provider and serve patients to the best of their ability.  There is a stark contrast between the two approaches.  The former encourages learning the keywords and test-taking skills you need to get an “A” whereas the latter encourages you to seek understanding so you can help a real person.   At my program, we will build a culture of learning for the sake of treating the patient, foster unification through formalized team-based learning groups, and lift each other up as opposed to claiming rank.  This philosophy will allow us to establish an environment to prepare our graduates to excel in a medical climate that will demand the interpersonal skills essential to participate as an effective team member.

There you have it!  A taste of my thoughts.  I’ll share much more over the next several months as I voyage through this exciting journey!  Now it’s time to hear what you think.  I invite all who read these words to comment! If you’re a Prospective PA Student, tell me the two or three things you feel would be most important for your PA Education. Share with me your ideas for what makes up the Perfect PA Program.

Extremely Helpful PA Journey Resources Solicitation

February 16, 2011 in Current PAs, PA Educators, PA Pals, PA Students, Prospective PAs

One of the great advantages of participating in a community site such as PhysicianAssistantED.com is gaining knowledge from others who share your passion! If you’re reading these words then you likely have a passion for the Physician Assistant profession. Perhaps you’re a Prospective PA Student working diligently through the application process. Maybe you’ve recently been accepted to a PA Program and are eagerly anticipating the first day of class. Or maybe you’re in the midst of struggling through a rigorous and challenging PA Program currently!

Wherever you’re at in your PA Journey, surely you’ve come across some resources that have been exceptionally helpful along the way! So what I’m asking you to do is to share these pearls. We’ve created the simple form below so we can compile a list of heartily recommended resources from those who share a love for the PA Profession! What has been most helpful for you?! Perhaps it was something that helped you prepare for the GREs or a Physiology Review Book. Maybe it’s a Pharmacology pocket Book. Perhaps it’s not a book at all but a specific website that you’ve found indispensable. Whatever it is, share it in the appropriate section below! In a few weeks, after we’ve received several submissions, we will create and publish a nice and tidy list of these resources for everybody to see!

After the Interview – Personalized Thank You Note

January 21, 2011 in PA Educators, Prospective PAs

On the way to my office this morning I walked by my mailbox. Therein sat a small card about 3×5 inches. What was it? A thank you note! At UW-Madison, we are in the midst of interviewing applicants for our upcoming class of students. As expected, I opened up the card to discover that it was sent by one of the candidates I recently had the privilege of interviewing. Upon finishing the final few words, having sat in my office chair during the brief read, I reclined back and reflected a bit about the candidate who’s signature lay neatly at the bottom. In my mind’s eye I could see his face. I could also remember the sound of his voice. I even began to recollect, albeit vaguely, some of the dialog that was exchanged as we sat across the table from each other ten days prior. I smiled. The thank you note had fulfilled its purpose!

Having recently launched the BETA version of PhysicianAssistantED.com, I began to think about Prospective PA Students who have been invited for an interview at a PA Program. Surely the question arises within their minds, “Should I send a Thank You note following the interview?” It was definitely something I thought about when I went through the process several years ago. This question naturally leads to other related questions: If I should send a thank you note, when? And what exactly should I say? Should I send it by email or should it be handwritten?  Will it even make a difference anyway?  They probably receive thank you notes all the time, perhaps I shouldn’t send one at all.

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Applying through CASPA… the Central Application Service for Physician Assistants

November 25, 2010 in PA Educators, PA Pals, Prospective PAs

CASPA stands for “Centralized Application Service for Physician Assistants.” CASPA is an online application service that facilitates the process of applying to participating PA Programs. At the time of this writing (11.24.10), approximately 80% of all PA programs nationally utilize CASPA as part of their admissions process.  By creating an account and completing one application, Prospective PA Students can apply to multiple programs.  Furthermore, and this is something only recently implemented, your application will remain on file even if not selected for seat in a PA program, thereby easing the process of applying during the following cycle!  The following capsulized summary was extracted from a general information page for new applicants on CASPA’s website

Once you create an account with CASPA, you can access your application frequently in order to complete the required portion of the application. Specific instructions are available within each section of the application. There is also a Frequently Asked Questions section (FAQs) if you have specific questions about entering your information into the application. After you have created and completed your application, you can e-submit it to CASPA for processing. Once the application is processed, it will be sent to your designated programs. The CASPA application will provide your designated programs with your complete biographical information and a detailed description of your academic history.


It’s important to remember that not all PA Programs participate in CASPA.  There are two ways to find out whether a program of interest participates:

-Our PA Program Profiles have a table on the left hand side entitled “Entrance Requirements.”  Towards the bottom of the table you will find information relative to whether or not that particular program participates in CASPA.  Also note that below this row you’ll find information about whether or not the program requires a supplemental application.


-The other way to find out if the program participates is through the CASPA website.  CASPA has a great page on their website that includes a table highlighting participating programs.  This also details each program’s state location, application deadline, supplemental application information, and entrance exam information!


As alluded to above, Prospective PA Students need to know that participation in CASPA does not necessarily preclude the requirement for additional application materials to be submitted. In other words, many programs that require students to apply through CASPA also require a supplemental application to be submitted directly to the program. This supplemental application may be required at the same time CASPA is submitted, or may be required only after the program has received information from CASPA validating a student’s qualifications for admission. For any school of interest, please note carefully the details regarding supplemental application requirements when applicable.

What is “Accreditation” anyway?

November 25, 2010 in PA Educators, PA Pals, Prospective PAs

The accrediting agency that has been established for PA Education is the Accreditation Review Commission on the Education of Physician Assistants (ARC-PA). Simply stated, the ARC-PA is responsible for “defining the standards for physician assistant education and evaluating physician assistant educational programs within the territorial United States to ensure compliance with those standards.”

All 50 states and D.C. require applicants to have graduated from an accredited PA program in order to be eligible for licensure. There are several different categories of accreditation which are briefly outlined and defined as follows:
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Cost of Living Index – Important to Consider

November 22, 2010 in PA Educators, PA Pals, Prospective PAs

Perhaps you’ve noticed already when researching our PA Program Profiles that we include a cost of living index for each PA Program host city.  This can be found in the table that sits next to the Google Map highlighting the location of the host city.

Physician Assistant ED Image - COLI

The cost of living index allows you to figure out how expensive it is to live in one locale versus another. Essentially, researchers employ individuals to record the prices of everyday goods and services in a multitude of cities throughout the United States. Other important variables must be considered as well, such as housing, utility, transportation, and health care costs.

This data is utilized to generate a value, the cost of living index, for each city. An index of 100… THERE’S MORE! Read the rest of this post for FREE! Register for a FREE account by clicking here. If you already have an account, log in by clicking here.

Physician Assistant Earnings

November 6, 2010 in Current PAs, PA Educators, PA Pals, PA Students, Prospective PAs

Physician Assistants are in high demand, and rightfully so.  They provide high quality health care, helping to fill one of society’s greatest needs.  The elderly population will double in the United States over the next 10-15 years.  Couple this with the fact that this same population consumes the greatest percentage of healthcare resources and you have the recipe for the perfect PA job market!  And please don’t misunderstand.  This does not equate to opportunities restricted to elderly populations.  Rather, as more energy is expended by the entire industry to serve the aging population, opportunities will abound for PAs in all areas.  In fact, there has never been a better time to consider becoming a Physician Assistant.  Our profession is amazing!  And it’s burgeoning now more than ever before.  Certainly money should not drive why one should choose to become a PA.  However, for those who desire to become a physician assistant to dedicate their careers to intimately and powerfully affecting the lives of others, it’s nice to know that PAs earn a healthy income.

Annual Earnings Information


Hourly Earnings Information

  • Even though CV/CT Surgery ranks highest in mean annual income by a margin of over 3K annually, it ranks 3rd behind Dermatology and Emergency Medicine when you consider earnings by the hour!
  • Outside the top three, when considering earnings by hour, the vast majority of specialties fall within a relatively narrow range of about $40 – $43 per hour.  For example, even though mean annual salary for Neurosurgery tops OB/GYN by a margin of nearly 20K, there is only a $2 discrepancy per hour!

Career Outlook For Physician Assistants

November 6, 2010 in Current PAs, PA Educators, PA Pals, PA Students, Prospective PAs

The PA profession began at Duke University in 1967 with the first graduating class of Physician Assistants.  Today there are more than 79,000 PAs from 154+ accredited programs.  Graduates of the first program went into primary care or surgical positions, and that focus persisted for the next twenty years. Since the early 1990s, there has been rapid expansion in the areas in which PAs practice with a shift from primary medicine to specialty areas, and even subspecialty areas within tertiary medical centers.

Likewise, a similar shift has been occurring over the past decade in the settings in which PAs practice, creating a number of jobs in areas outside the traditional clinic-based settings, including: institutional settings such as hospitals, academic medical centers, federally qualified health clinics, and in the US prison system. PAs are now being used in teaching capacities both in the expanding numbers of PA programs as well as assisting academic medical staff in medical schools and academic inpatient hospital settings.  Medical resident rules limiting the number of hours physician residents are permitted to work has produced a new need for PAs as hospitalists in direct patient care.

PAs provide high quality, cost effective healthcare and are productive members of the health care team. Physicians and hospitals/clinics are expected to employ more PAs to provide primary care and to assist with medical and surgical procedures. Telemedicine—technology used to allow consultations between PAs in rural or remote settings and physician supervisors—will expand the use of physician assistants.

Over the years the scope of practice for PAs has progressively broadened, allowing PAs to fully utilize the skills gained from their rigorous training.  Prescriptive privileges, now allowed in all states, have improved PAs abilities to contribute more effectively in patient care.  Residents who have recently graduated from medical school now gain experience working on teams that include PAs as both students and certified clinicians, so that past confusion about a PA’s scope of practice is rapidly diminishing. Job prospects, therefore, have increased in all specialty and subspecialty areas.

Job opportunities for PAs are predicted to be excellent, particularly in rural and inner-city clinics, settings in which there is difficulty attracting physicians. Job openings will result both from employment growth and from the need to replace physician assistants who retire or leave the occupation permanently. Opportunities will be best in states that allow PAs a wider scope of practice.

Job Demand Forecast

According to the U.S. Department of Labor, Bureau of Labor Statistic, employment of physician assistants is expected to grow by 39 percent from 2008 to 2018, much faster than the average for all occupations.

CNNMoney.com ranks PA as the second best job in America and projects it to be the third hottest (fastest growing) occupation over the next decade.  The most recent Money magazine article states that with the continuing shortage of physicians willing to work in primary care medicine and in remote and underserved areas of the country, the PA profession has proven to be virtually recession-proof.  This is proving true as unemployment rates in the country continue to rise while job prospects for PAs continue to improve.  A shortage of physicians projected to be as high as 13% over the next ten years, coupled with an aging population with higher than ever before life expectancy, will result in abounding opportunities for physician assistants.  Finally, with the expected increases in insured patients due to the Healthcare Reform Bill, there will be even more demand for primary care practitioners, a role in which Physician Assistants excel!

Did You Say “Free Money?”

November 2, 2010 in PA Educators, PA Pals, PA Students, Prospective PAs

“I didn’t sign up for food stamps but looking back I was a moron!”

No, I didn’t say that, but I cannot tell you the number of times I thought it. That statement was made by a close friend whose husband was in PA school while they were starting their family. When my husband began PA school we had a four-month old little girl. When he graduated 27 short months later (or extremely long depending on how you look at it) we had a 15-month old and a 2-year old. Everyone thought we were nuts for having kids while in PA school, and maybe we were, but we made it through.

One thing that helped tremendously was the opportunity to … THERE’S MORE! Read the rest of this post for FREE! Register for a FREE account by clicking here. If you already have an account, log in by clicking here.