December 6, 2021

Physician 'assistant' or 'associate'? For PAs, the distinction is critical.

Daily Briefing

    To increase respect and understanding for their profession, the national association for physician assistants formally replaced "assistant" with "associate," transforming the group into the American Academy of Physician Associates (AAPA), Jordan Rau writes for Kaiser Health News.

    Why you should treat your APPs more like physicians

    Background

    In 1967, four former Navy medics graduated from the Duke University School of Medicine as the nation's first class of "physician assistants" (PAs). Since then, physician assistants, as they are still legally called, have steadily gained more autonomy. In fact, according to Rau, they can now perform many of the same day-to-day tasks as doctors—and in most states, they do so without immediate supervision from a physician.

    Typically, it takes 27 months and roughly 2,000 hours of clinical work to earn a PA master's degree. Conversely, family doctors are required to attend four years of medical school followed by a three-year residency where they gain around 10,000 hours of experience—and specialists often must attend even longer residencies.

    As of 2020, almost 150,000 PAs were practicing in the United States, with a median annual pay of $115,390—just slightly above the $111,680 median pay for nurse practitioners, who perform similar jobs, Rau writes. In comparison, the median annual pay for a family physician was $207,380.

    Why PAs are advocating for a title shift

    According to Rau, many PAs believe patients and the public harbor widespread misconceptions surrounding the responsibilities and privileges of a PA. They believe the term "physician assistant" often causes confusion, Rau writes, and many people believe PAs perform only minimal tasks to assist doctors.

    For instance, since she began her career as a physician assistant 23 years ago, Leslie Clayton said she has been especially bothered by one thing—the word "assistant." Even her family was confused by her profession; Clayton said it took her parents years understand that her responsibilities extended beyond taking blood pressure and performing basic tasks.

    "There is an assumption that there has to be some sort of direct, hands-on oversight for us to do our work, and that's not been accurate for decades," said Clayton, who practices at a clinic in Golden Valley, Minn. "We don't assist. We provide care as part of a team."

    In fact, many PAs argue that the term "assistant" confuses not just patients, but also state lawmakers and the people who hire medical professionals, Rau writes.

    Clayton, who recently testified before state legislators regarding a scope-of-practice bill, said that lawmakers "just couldn't get their heads around" the idea of "an assistant who doesn't have a direct supervisor." The response she said lawmakers gave her: "You guys really need to do something about your title."

    As a result, the newly renamed AAPA—in addition to eradicating the term "assistants" from its title—is advocating for the abolition of the state mandates that require formal supervision from a physician or written agreements with a physician specifying their role. According to Rau, the association estimated that the total cost of revising the profession's title would reach nearly $22 million.

    "Changing the title is really just to address that misperception that we only assist," said Jennifer Orozco, president of AAPA and an administrator at Rush University Medical Center. "It won't change what we do." (Rau, Kaiser Health News, 12/3)

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