This job description is presented to guide Physician Assistants and Neurosurgeons. It is only a guideline in which to adapt the Physician Assistant to a Neurosurgery practice under the supervision of a Neurosurgeon, as directed by the state laws in which the Physician Assistant practices. Physician Assistants are licensed healthcare professionals trained in the same format, as are physicians. The average physician assistant has a bachelor's degree and 4 1/2 years of healthcare experience before entering a PA program. This job description for Physician Assistants in Neurosurgery includes but is not limited to:

1. General duties: Performing comprehensive and problem focused histories and physical examinations, interpret laboratory and diagnostic tests. Interpret and correlate subjective and objective data. Formulate a differential diagnosis establish and a working diagnosis. Develop a treatment plan for neurosurgical conditions within the scope of practice and in conjunction with the neurosurgeon. Implement therapeutic intervention for specific conditions were appropriate. Exercise judgment on conditions requiring consultation, referral, or evaluation by the supervising neurosurgeon or other healthcare professionals.

2. Hospital duties: first assistant in surgery, closure of a deep and superficial wounds to assist with all neurosurgical procedures to include craniotomies, spinal procedures including instrumentations, microscopic procedures. Conduct hospital rounds on a daily basis of all patients including intensive care units, write orders, progress notes, perform all admission history and physicals, order appropriate laboratory and radiographic tests such as MRI's, myleograms, bone scans, and other radiographic studies as needed or indicated. Perform appropriate laboratory and diagnostic studies, such as Lumbar punctures, ventriculostomies, myleograms, placement of tong traction, halo fixation devices. Evaluate and clarify clinical conditions, formulate an implement a treatment and therapeutic plan for hospitalized patients, discharge planning, dictate discharge summaries.

3. Office duties: to see all-new office patients and complete a thorough history and physical examination that is problem oriented for neurosurgical conditions. Present that patient to the attending neurosurgeon's and then help formulate a treatment plan, order appropriate radiographic studies and perform office procedures such as local blocks. Evaluate postoperative patients and routine follow-up visits. Be available to see those patients that require a same-day office visits. Return phone calls of from patients, handle prescription refills, review radiographic reports laboratory reports for abnormalities. Review x-rays MRIs CT scan's of hospitalized patients and office patients with the attending neurosurgeon.

4. Evaluate, screen and counsel patients on health maintenance and promote utilization of community resources. Design, conduct and or participate in research studies, manage databases, and perform quality assurance.

5. Training: For a physician assistant to have the necessary skills and expertise to perform the above procedures requires time and training. For a physician assistant who is a new grad, or without any neurosurgical experience there is a learning curve which takes approximately one year for a physician assistant to obtain the confidence in handling the day-to-day office and hospital routine. It will take time to adjust to the operating room environment. If a Neurosurgical practice hires a new grad they must understand that the Neurosurgeons must instruct and demonstrate to that individual their method of dealing with Neurosurgical problems conditions surgical techniques.

This is an education process that can be equally rewarding to the Neurosurgeon and the Physician Assistant. As the Physician Assistant grows in knowledge, education and skills this will benefit the Neurosurgeon and the Neurosurgical practice, by reducing the amount time the Neurosurgeon spends with small issues allowing the surgeon to handle the more seriously ill patients. As always, the Physician Assistant works under the supervision of the Neurosurgeon. It is the Neurosurgeon who should be the judge of the capabilities, skills and limitations of the Physician Assistant.

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