About Surgical PAs

Why Millennials are Choosing to be Physician Assistants, Not Doctors

From the Chicago Sun-Times - 3/9/18

According to the Bureau of Labor Statistics, physician assistant is one of the fastest-growing occupations in the country. In the next decade, the bureau expects the number of PAs will grow nationally by 37%, much more quickly than other professions.

This comes at a time when experts predict a huge shortage of primary care physicians in the coming years.

As of May 2016, there were 440 physician assistants employed in Delaware — larger than the number of internists, psychiatrists, OB GYNS and surgeons in the state combined, according to the bureau.

Read the article


Surgical PA Specialties

According to the NCCPA, there are more than 115,547 PAs in clinical practice alone. The AASPA represents the 38,000 PAs who work in a surgical environment.

Surgical physician assistants (PAs) are highly skilled clinicians who have received didactic and clinical training to function in all areas of the peri-operative environment, including pre-admission, testing, intra-operative first assisting, PACU care, SICU care, step-down unit, outpatient clinic, office practice and even home care.

Surgical PAs should not be confused with medical assistants, who perform routine clinical and clerical tasks. Surgical PAs handle many of the functions of a fully trained doctor, in the absence of a doctor, and exercise autonomy in medical decision-making. All PAs work under the ultimate supervision of a licensed physician, who is responsible for all decisions made regarding patient care.

The PA who specializes in surgery assistance will have extensive knowledge of surgical procedure as well as specific areas of healthcare studies. The primary role of the surgical PA is to assist licensed physicians in patient surgery. However, their involvement from initial patient assessment to post-surgery follow-up care enables surgical PAs to offer excellent continuity of patient care.

Surgical PA Roles & Responsibilities

Surgical PAs are formally trained to provide diagnostic, therapeutic, surgical and preventative care, under the supervision of a physician or surgeon. In addition, surgical PAs can function as researcher, committee member, supplier, and surgical equipment supply or pharmaceutical representative liaison and much more. The typical PA program is 25.5 months long. The curriculum parallels that of medical school and includes courses in human anatomy and physiology, biochemistry, pharmacology, physical diagnosis, pathophysiology, microbiology, clinical laboratory sciences, behavioral sciences, and medical ethics.

Physicians and physician assistant educators teach the bulk of the courses. Following approximately one year of didactic classroom work, PA students complete on average, 2,000 hours of supervised clinical practice before graduation. This includes classroom and clinical instruction during clinical rotations in both medical and surgical specialties. Required rotations include family medicine, internal medicine, general surgery, obstetrics and gynecology, pediatrics, emergency medicine, geriatrics, and behavioral medicine. PAs can bill for their services, including billing for first assist‎ in the OR.

Surgical PA Roles

While surgical PAs assist the physician in the global management of patient care in all peri-operative settings, their primary role is to assist licensed physicians in patient surgery. This end-to-end involvement enables surgical PAs to provide unparalleled continuity of patient care. Often surgical PAs handle routine problems and procedures, freeing the surgeon to concentrate on more complex patients.

In-office Patient Care

Surgical PAs can perform all manner of patient care in the office setting, as determined by the supervising surgeon.

Hospital Care

Surgical PAs can alleviate the frustration of canceled, delayed or bumped cases.

  • 1st assistant in surgery – Performs first assist duties, including ensuring all needed equipment and supplies are present. Keep your surgical skills up-to-date with CME.
  • Post-op – Writes orders in the recovery room, talks with family, visits patients, performs post-op procedures and more.
  • Discharge planning – Dictates discharge summaries, writes prescriptions, explains discharge instructions, confirms follow-up appointments and more.

Research & Administration

  • Researcher – Conducts, designs and/or participates in research studies.
  • Committee Member – Play a role on education committees, medical supply, and equipment committees and more. A hospital selects its surgical equipment based on the demands of the surgeon. More and more, surgical PAs are deciding which products to use.
  • Supplier and Pharmaceutical Rep Liaison – Serve as a mediator between the surgeon and/or practice and the drug reps/instrument sales reps.

Duties & Responsibilities

General Duties & Responsibilities

  • Performs comprehensive and problem-focused histories and physical examinations
  • Diagnoses and treats illnesses and injuries
  • Orders and interprets laboratory and radiographic studies
  • Educates and counsels patients
  • Performs minor surgical procedures
  • Performs First Assist duties in surgery
  • Assists with call
  • Renders emergency care
  • Facilitates patient referral to the appropriate physician or agency
  • Conducts research and drug studies
  • Prescribes medication in most states

Hospital Duties & Responsibilities

  • Performs first assist duties
  • Assists with surgical procedures
  • Conducts daily hospital rounds
  • Write orders and progress notes
  • Performs all admission history and physicals
  • Orders appropriate laboratory and radiographic tests
  • Performs appropriate laboratory and diagnostic studies
  • Evaluates and clarifies clinical conditions
  • Formulates and implements treatment and therapeutic plans for hospitalized patients
  • Handles discharge planning and dictates discharge summaries

Office Duties & Responsibilities

  • Sees new office patients and completes a thorough history and physical examination
  • Presents the patient to attending surgeons, if needed
  • Helps to formulate treatment plans
  • Orders appropriate radiographic studies
  • Performs office procedures
  • Evaluates post-operative patients and does routine follow-up visits
  • Is available to see patients requiring same-day office visits
  • Returns phone calls of from patients
  • Handles prescription refills
  • Reviews radiographic reports and laboratory reports for abnormalities
  • Evaluates, screens and counsels patients on health maintenance and promote utilization of community resources
  • Designs, conducts and/or participates in research studies
  • Manages databases
  • Perform quality assurance

What PAs Mean to Your Organization
Why You Should Hire a Surgical PA


Surgical PA Profession

According to the AAPA, 25% of PAs have a general surgery specialty or surgical subspecialty.

Education & Licensing

AASPA - Surgical PA Profession


Physician Assistants are licensed health care professionals trained in the same format as physicians. The training is roughly two-thirds the length of medical school with over 100 weeks of general primary care education. The average physician assistant has a bachelor’s degree and four and a half years of health care experience prior to entering a PA program.

Educational Requirements for Surgical Physician Assistants

PAs usually enter surgical practice by one of three routes:

  • Graduation from an ARC-PA accredited surgically focused PA Program
  • Completion of a surgical residency for PAs (after attending PA school)
  • On the job training (after graduating from an ARC-PA accredited Program)

Accredited Academic Program

In every state, a prospective physician assistant must complete an accredited academic program. In 2007, 137 education programs for PAs were accredited or provisionally accredited by the AAPA. More than 90 of these programs offered the option of a master’s degree; the rest offer either a bachelor’s degree or associate degree.

A PA who wants to specialize in surgery assistance will want to choose a program designed with this focus in mind. Most programs are housed in universities, colleges, or other academic institutions. However, programs can also be found in hospitals and military facilities.

Surgical Residency

While not strictly required to become a surgical PA, surgical residencies offer an excellent opportunity to expand your PA skills and gain the experience needed to globally manage patient care in the pre-, intra- and post-operative settings, as is required in specialty positions.

 

Licensing

Surgical PAs are licensed by each state to practice and must take a national certification exam given by the National Commission for the Certification of PAs (NCCPA). Each hospital board then credentials the surgical PA for specific practice privileges. So, surgical PAs are able to work anywhere the supervising surgeon has practice privileges.

Visit the NCCPA

The Growing Surgical PA Profession

Opportunities in all surgical specialties are exploding! Why is the surgical PA profession expanding so rapidly?

Cutbacks in Physician Surgical Residency Slots

The number of residency slots for physicians training in surgery has been decreasing yearly since 1980. The workload at surgical teaching institutions has not gone down, and surgical PAs are ideal for helping busy hospitals pre-op patients, keeping the OR close to schedule and performing admission and discharge work

Reduced Resident Work Hours

Regulations now require that all physician residents be limited to an 80-hour workweek. This has had a huge impact on the way that teaching hospitals function. AASPA has been working closely with physician and surgeon organizations to help combat the strain on the health care system. Surgical PAs are taking up the slack when the law requires that physicians-in-training go home.

Reimbursement for PA Surgical Services

PAs can be reimbursed for their services, making them effective in the business of medicine, both in large teaching hospitals and smaller private practices. The presence of a surgical PA on a surgeon's team allows the numbers of patients being treated to expand, thus creating sources of income.

Physician/Surgeon Relief

PAs are member of a team lead by the physician: PAs can use this relationship to become a true partner with the surgeon, which will free the surgeon to concentrate on the most complex cases. Surgical PAs often alternate “call” with their physicians.

The February 2002 edition of The Archives of Surgery report that medical students are showing a lower interest in a career in surgery. This will continue to stress the surgical workforce, and PAs are ideal to help fill the void.

Surgical PA Profession Advocacy

The final reason why our field is growing so rapidly is because of the daily work of the AASPA – much of it behind the scenes.

We network with physicians, surgeons, their organizations, hospitals, HMOs and more to guarantee that they know the effective role that surgical PAs have in healthcare. The surgical PA organizations were the first groups to ever create a marketing advertisement for our profession.

In general, surgical PAs are known as “champions of patient safety.” AASPA participates in national committees promoting safety in the peri-operative setting.

Employee Outlook

Recent statistics from CareerBuilder.com, the U.S. Department of Labor's Bureau of Labor Statistics, CNN and others show that the PA is one of the fastest growing professions in the country!

The Department of Labor expects the PA profession to grow by 27% from 2006 to 2016 – much faster than the average for all occupations. CNN.com and Forbes.com rated the PA profession as the fastest growing health profession, and the fourth fastest growing profession in 2007.

Surgical PAs – especially AASPA Members – are in Demand

Information from the AAPA shows that more than half of all PAs graduating are employed in specialty practice. Job opportunities for PAs in all surgical specialties are currently expanding dramatically, and there are more surgical PA opportunities than there are qualified individuals to fill those positions! Look at the employment section of any PA journal and you will find a majority of jobs for PAs are surgical.

Employment

More than 68,000 PAs work in clinical practices. However, the number of jobs is greater than the number of practicing PAs. According the AAPA, 15% of PAs in clinical practice hold more than one clinical job. For example, some PAs work with a supervising physician, but also work in another practice, clinic or hospital.

The 2008 AAPA Physician Assistant Census Report indicates that PAs work primarily for:

  • Single or Multi-specialty Physician Group: 44%
  • Hospitals: 24%
  • Solo Physician Office: 12%

Earnings

According to the U.S. Department of Labor, median annual earnings of wage-and-salary physician assistants were $101,480 in 2016. Employment of physician assistants is projected to grow 37 percent from 2016 to 2026, much faster than the average for all occupations. As demand for healthcare services grows, physician assistants will be needed to provide care to patients.

According to the NCCPA, the top practice settings employing the largest number of PAs in May 2016 were:

  • Office Based Private Practice: 42.3%
  • General medical and surgical hospitals: 39%
  • Federal Government Facilities/hospitals: 5.7%
  • Community Health Center: 3.4%
  • Rural Health Clinic: 2.2%