PHYSICIAN ASSISTANTS (PAs) are persons trained, certified, and licensed to take medical histories, conduct physical examinations, and diagnose and treat medical problems under the supervision of physicians. In the mid-1990s there were more than 20,000 PAs practicing in the United States in such areas as primary care, internal medicine, surgery, geriatrics, psychiatry, and pediatrics.
Eugene A. Stead, chairman of the Department of Medicine at Duke University in the mid-1960s, created this new profession. A 1959 Surgeon General's report indicated that the nation faced a shortage of medical personnel, particularly among such traditionally underserved populations as the rural and inner-city poor and elderly. Stead's idea was that medical corpsmen returning from Vietnam, with their experience treating illness and injury, could be quickly trained to work in health care. In 1965 four medical corpsman entered the first PA program under Stead's direction at Duke; thirty years later there were fifty-eight such programs throughout the United States.
The American Medical Association officially recognized the profession in 1971 and began developing requirements for PA certification. PA training has not changed a great deal since. Most programs require two years and include intensive clinical rotations under physician supervision. Physician supervision continues throughout the careers of PAs, making them "dependent practitioners" along with nurses. PAs see patients with routine and minor complaints, freeing physicians to see more serious cases, and providing continuity for regular patients in settings with medical residents and interns, whose positions turn over rapidly. All states except Mississippi license and regulate PA practice and most allow PAs to write prescriptions. The American Academy of Physician Assistants claims six jobs for every graduating PA and the Department of Labor projects a 44 percent increase between 1990 and 2005. PAs are no longer an experiment but an important part of mainstream medical care.
American Academy of Physician Assistants. Physician Assistants: Statistics and Trends. Alexandria, Va.: American Academy of Physician Assistants, 1997.
Schafft, Gretchen Engle, and James F. Cawley. The Physician Assistant in a Changing Health Care Environment. Rockville, Md.: Aspen Publishers, 1987.