Pursuing surgical subspecialties as a physician assistant

General surgery and surgical subspecialties attract a significant number of new physician assistant graduates each year due to the flexibility, variety and dynamic setting the field offers. It is also one of the highest paying PA specialties with an average annual salary of $105,000.

"Surgical PAs enjoy flexibility to move from surgery or a surgical sub-specialty to a medical specialty or vice versa,” said Michele Herrera, PA-C, of Anna Jaques Hospital in Newburyport, Mass. “Many PAs take advantage of that opportunity to make career moves. It's pretty easy to move around within the field, especially with surgical experience."

A large part of the surgical PAs job is preoperative care, or assuring that each patient is well prepared for a planned surgical procedure. Preoperative care occurs in office settings as well as hospitals.

PAs who chose to go into surgical care are responsible for educating patients regarding their clinical diagnosis and the proposed surgical treatment — i.e., the problem and the proposed solution. During this discussion the likelihood of successful outcomes and anticipated recovery time are estimated. Alternative non-operative and surgical treatment options may also be discussed.

Reviewing informed consent with patients prior to surgery is a focal point of the preoperative process and the PA's role in this crucial. Patients must understand the perceived benefits and potential complications of the proposed surgical procedure.

PAs meet with patients to take preoperative histories and conduct physical examinations, a process particularly important for patients with cardiovascular or pulmonary problems, as their surgical candidacy requires careful assessment.

PAs may refer patients with complicated medical histories to a specialist, for example, a cardiologist, to determine the surgical risk and provide medical clearance for surgery. Once a patient is cleared for surgery the PA may proceed with ordering preoperative tests and analyzing test results, ordering pre-operative medications, and generating reports for the surgeon to review prior to surgery.

Surgical PAs can also provide postoperative care and may work as first or second assistants during the procedure.

Kimberely Buckley is a physical therapist and freelance medical writer living in Gloucester, Mass.

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