NEWS
A Doctor's Right Hand
July 01, 2007
The 4-year-old patient was covered in an itchy rash that resembled ringworm when her mother took her to see physician assistant Melissa E. Garcia. She also was plagued with allergies.
Garcia listened as the mother described how her daughter nearly stopped breathing when bitten by fire ants or stung by bees and how her pediatrician's treatments had failed to make a difference.
The physician assistant tested the girl for allergies but also immediately prescribed a medicated cream.
Days later, the preschooler returned rash-free and eager to be a doctor.
The scenario reveals two common aspects of the job: Patients are often unclear about how physician assistants differ from doctors. But they often appreciate the treatment they get, physician assistants say.
It is partly because physician assistants approach the job in the same ways as doctors.
"You need to listen to the patient and be open," said Garcia, who spends a lot of time collecting medical history before diagnosing. "People are sometimes appalled at how much personal history I take. But I'm very thorough."
More than 30,000 people work as physician assistants, or PAs as they are called, according to the U.S. Bureau of Labor Statistics. Under doctor supervision, they take medical histories, examine patients, order and interpret lab tests, make diagnoses, update patient histories, prescribe medication, oversee therapy, and apply sutures, splints and casts. A doctor must review at least 10 percent of each physician assistant's cases.
Many physician assistants work in multiple locations. About 15 percent of PAs worked in more than one clinic in 2004, according to the American Academy of Physician Assistants.
The number of PAs is expected to increase at least 2.7 percent each year through 2014, according to the Bureau of Labor Statistics. The profession is growing much faster than most due to the push to restrain medical costs.
For instance, Allergy, Asthma and Immunology Associates of South Texas pays Garcia about 70 percent of what its doctors earn, said Dr. Joseph Diaz, who trained Garcia and supervises her work.
Doctors also want PAs to fill staffing shortages.
"There's a shortage of trained allergists," said Diaz, who is looking to hire another PA to pick up work as his office expands into the South Side. "PAs, with appropriate training, are able to be an extension of the physician."
The profession arose to give former military medics in the Vietnam War a way to use their broad medical skills in the civilian world. For instance, when Michael Champion joined the U.S. Army in the 1970s, he planned to be a nurse anesthetist until two PAs snagged him and described the job.
Today, physician assistant posts attract employees who want the prestige and responsibility afforded doctors, said Champion, a PA for 27 years and president of the Bexar County Physician Assistant Society.
"A lot of times the patients mistake you for a physician," he said.
On the other hand, sometimes patients refuse to use a PA for fear they will get inferior treatment.
In those situations, Diaz said, the supervising doctor can change the patients' minds usually by explaining the training and qualifications for PAs. Physician assistants train alongside medical students in all areas of medicine. They just spend less time in each field.
For Garcia, it was ideal. She had studied nursing until she realized during clinical rotations that she wanted a profession that allowed her to offer more input into patients' treatments. But she wanted to switch careers with limited additional study.
Garcia shadowed a PA at a hospital in Grapevine before making the change. She was sold on the new profession, she said, after learning that physician assistants are expected to be generalists -- unlike doctors.
"At that time, I was interested in so many things -- pediatrics, dermatology, allergy -- that I wanted something that would not force me to specialize," said the 36-year-old who studied at the University of Texas Southwestern Medical Center in Dallas.
Statewide, entry-level base pay averaged $61,331 a year, while experienced physician assistants earned an average base pay of $91,332 a year, according to the Texas Workforce Commission. Many physician assistants also receive productivity bonuses based on the number of patients treated at year's end.
asidime@express-news.net
PHYSICIAN ASSISTANT
Job description:
Perform most doctor's duties -- including diagnosing illnesses, ordering and interpreting tests, prescribing treatments and medications, helping in surgery -- under supervision of a doctor.
Educational requirements:
Bachelor's degree and master's from PA school; state license.
Average pay in Texas:
$81,332 a year plus bonus, according to the Texas Workforce Commission and Bexar County Physician Assistants Society.
"PAs, with appropriate training, are able to be an extension of the physician."
Dr. Joseph Diaz
physician who utilizes a physician assistant