Evolution vs. extinction and the physician assistant profession

Over the years I've debated the significance of a name change for physician assistants (PAs) and what the best title is to most accurately describe the profession.

I once adamantly believed that the oft-proposed term “physician associate” was just as misleading as the qualifier “assistant.” At one point, I believed the term “physician” was the real confounder in our title. As it turns out, I was wrong in all of these instances.

The Webster-Merriam dictionary defines “physician” as “a health care provider who practices the profession of medicine,” who is “concerned with promoting, maintaining or restoring human health through the study, diagnosis and treatment of disease, injury and other physical and mental impairments.” PAs do this. “Associate” is defined as “to join as a partner, friend or companion” or “to join or connect together.”  We also do this.

Consequently, “supervision” is defined as “management by overseeing the performance or operation of a person or group.” This is not really how PAs practice.

If we went by the definitions outlined in the dictionary, PAs are associates; we are physicians, but we are not doctors (most of us, anyway). In reality, PAs provide medical and surgical services to patients, as follows:

  • In accordance with the standards of practice
  • Autonomously
  • Consulting with physicians, colleagues, nurses, administrators and even lawyers, as needs arise
  • Through maintaining certification by CME
  • Through obtaining recertification by examination

I believe that we need to change the entire perception of the PA profession to better reflect these responsibilities. A name change should not be the final goal, but rather, a necessary first step to better inform the public and our colleagues about our profession. I suggest the following redefinition of the PA profession as part of this clarification process:

              A  trained and licensed medical practitioner that abides by the standards of practice, and works
              in collaboration with physicians and other members of the health-care team to promote, maintain and
              restore human health through studying, diagnosing and treating disease, injury and other physical and
              mental impairments.

The health-care environment is changing rapidly and we need to change with it, or risk the real possibility of becoming merely an ancillary service to the physician's practice, instead of the partners that we are and historically have been. One aspect of this is keeping this discussion alive and in the thoughts of our PA constituents.

Contact the American Academy of Physician Assistants and tell them you are in favor of a clarification of our profession.  You can do this by visiting the AAPA website, logging in and answering “yes” to the survey question about a name change.

William B. Mosher, PA-C, practices at the University of Michigan Health Service in Ann Arbor. His areas of interest include in-patient medicine, private practice medical administration, emergency medicine and interventional neuroradiology. He also serves as an advisor to the university's Pre-Physician Assistant Club.

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