There’s a wide gamut of professionals that provide healthcare to people every day besides doctors and nurses. A physician assistant, for example, typically has more time than a rushed doctor to actually spend time with patients and provide care.
At a glance it’s an easily misunderstood role—becoming a physician assistant requires more education than a nurse, and you’ve likely seen or been treated by a PA and probably just assumed they were the physician. To learn what it means to be a physician assistant, we spoke with a PA of three years, Jordan Hall.
First of all, tell us a little about your current position and how long you’ve been at it.
My name is Jordan Hall. I am a physician assistant (PA) in Atlanta, Georgia. A PA is a medical professional who is licensed both federally and locally to practice medicine. My scope of practice includes examining patients, ordering and interpreting tests, preforming procedures, and diagnosing and treating pathology under the supervision of an employing or sponsoring physician. I have been working a little over three years now. Prior to that, I was in school for about seven years preparing for this career.
What drove you to choose your career path?
Like many of my colleagues, I was drawn to medicine through an affinity for science. I was always interested in biology, chemistry, and physics, so it was natural that I gravitated towards a profession built upon those subjects. I was ignorant of this profession until I attended a career fair through the college of physiology late in my undergraduate education. Prior to the career fair, I was set on attending medical school, but what I discovered at the fair piqued my interest. I contacted a few of the doctors I was shadowing, each of whom employed physician assistants, to see if I could come observe them in clinic.
After my observations, I researched the career extensively. The broad range of options following graduation as well as the ability to take more time with each patient and not have a rushed schedule were appealing to me. Additionally, I learned I could do everything I wanted in medicine as a PA: I could see and treat patients with autonomy, prescribe medicines within my scope of practice, and participate in surgery with my attending physician. After I considered the costs and benefits, I decided it was the right choice for me and felt it suited the quality of life I wanted.
How did you go about getting your job? What kind of education and experience did you need?
Nearly all the PA programs are 2-3 year Masters programs which require a bachelor’s degree for admission. Typical acceptance is based on overall undergraduate GPA, core science GPA, and GRE/MCAT scores. There are prerequisite classes that are deemed mandatory by each institution. These classes typically include organic chemistry, microbiology, genetics, and anatomy/physiology. Most applicants have a degree in a life science, which fulfills the aforementioned requirements. Admission to a PA program is competitive, and admission boards often require candidates to have a certain number of “clinical experience hours.” Clinical experience hours are earned by observing or working alongside medical providers in a professional setting. Candidates with clinical experience have a clearer idea of what the profession entails. Clinical experience requirements can vary among programs from 200 to 5000 hours.
Did you need any licenses or certifications?
Upon completion of your professional degree from an accredited university, you must take a national licensing exam: the Physician Assistant National Certification Exam (colloquially known as the PANCE). Passing this exam is required to practice medicine as a PA. Additionally you are required to be certified in the state that you practice through the local medical board. Until recently, PAs were required to “re-certify” at the national level every six years; however, that has recently been extended to every 10 years, so it is consistent with the requirements of physicians. We also have to complete 200 hours of continuing medical education every two years.
What differentiates a physician assistant from a nurse or doctor? (I probably would have mistakenly assumed you were a nurse.)
Nurses are more limited in the decisions they can make without a physician. Nurses are not allowed to diagnosis and treat patients, order studies, or write medications. In short a nurse is not allowed to make any decisions regarding a patient without a physician permission. A more correct comparison would be to a nurse practitioner who can also do the above. We have more training than a nurse and less than a physician.
What kinds of things do you do beyond what most people
see? What do you actually spend the majority of your time doing?
Documentation is becoming a major focus in medicine right now. There has been a large push by federal review boards and private insurance to increase not only the thoroughness of documentation, but also the quality. Documentation and dictation take up about thirty percent of my time. I spend about forty-five percent of my time in person with patients in a clinical or surgical setting, and the remaining twenty-five percent is spent reviewing medical studies such as x-rays and lab test results.
PAs are able to spend more time with the patient in clinic than a physician, which is something I am always happy to do, and frankly, it is the aspect of the job that appeals to me the most. I enjoy educating my patients by discussing the finer points of pathologic findings. I feel this gives the patient a deeper understanding of their healthcare. Physicians often do not have time for such personal attention and patient education due to overbooked schedules, so PAs take pride in this aspect of the job.
What misconceptions do people often have about your job?
The profession is still relatively young and people both outside and inside medicine have misunderstandings. One misunderstanding is that a PA is still in school or training to be a doctor. If faced with this misconception, I do not take offense. I respond by explaining that I already spent a lot of time in school in order to become a PA and that I am a fully licensed medical professional who has completed all requisite training. I want my patients to feel comfortable knowing they are being cared for by a well trained, proficient professional.
The second, more troubling misconception is that one becomes a PA due to an inability to get into medical school. This misconception usually appears as an overheard derisive remark. The remark is undeserved and unsupported. PA school is incredibly competitive with a difficult academic and clinical course load. Admission rates are around three percent at most institutions (according to Yale, Duke, and GRU) due to small class sizes. Many of my classmates and I were accepted into medical school, but chose to pursue PA school instead. The misconception seems to be more prevalent in older patients. My younger patients tend to have a better grasp on my profession, which I suspect is due to an increase in the number of practicing PA’s over the last decade.
What are your average work hours?
A PA’s schedule is dependent on their individual situation and the needs of the practice and the attending physician. The schedule can be extremely flexible if necessary. My typical workweek is between forty and forty-five hours.
What personal tips and shortcuts have made your job easier?
When I was a student rotating in pediatric cardiology, I had an attending tell me to “study as if you are a first year student for the rest of your life.” What appeals to me the most about medicine and science in general is that it is a constantly evolving medium. I continue to delve into research and lectures out of professional and personal interest. I hope that this profession attracts curious and driven individuals because that is what modern medicine needs. We live in an age of increasing information availabi