11 Misconceptions About Physician Assistants

Posted By: Paul   |   PA Profession   |   76 Comments

Physician assistant misconceptions

There are plenty of misconceptions about physician assistants.

The newness of their field naturally leads to a number of misconceptions about physician assistants.  If you’ve never met a PA or been treated by one, you’re left to guess what it is that PA’s do, and sometimes these guesses (though understandable), are just plain wrong.  Hoping to dispel some of these, I’ve made up a list of the more commonly held misconceptions about physician assistants.  Hopefully it will be helpful both for those who are starting to research the field and for those who already know a few things about it.  If you have others, please let me know.

Misconceptions About Physician Assistants

  1. “Physician Assistants are assistants to doctors.”  With the poorly chosen name that our field has lived with for nearly 50 years, this one is easy to understand.  It turns out though, that PA’s are only truly assistants to doctors in the area of surgery, by being the lead assistants in surgery, even before other surgeons.  It’s important to note, however, that surgical PA’s do plenty of work on their own, including rounding on patients before and after surgery, doing bedside surgical procedures in the hospital such as inserting chest tubes and central lines, and seeing patients in the office.  As for non-surgical PA’s, the vast majority work nearly independently, and consult with their supervising doctor when they feel they need to.
  2. “Physician Assistants don’t prescribe.”  False.  State regulations vary, but for the most part, PA’s prescribe medications as any doctor does.  In some states the term is “furnish,” or “dispense” (when medications are given directly to the patient by the provider, as with samples), but these are minor distinctions.  You should know, however that when a PA writes a prescription, he/she does so as an agent of the supervising physician, and in most states the physician’s name must appear on the prescription form too.
  3. “Physician Assistants don’t prescribe narcotics.”  Taking #2 a step further, PA’s can prescribe controlled (scheduled) medications, such as opiates like Percocet, morphine, and Fentanyl.  In most states the PA must obtain a separate DEA registration to do so.  Some choose to practice without it, which means that they can’t prescribe these types of drugs, but the vast majority of PA’s, for the sake of convenience, do choose to get their own DEA registration number.
  4. Physician Assistants work under the doctor’s license.  Actually, PA’s are certified nationally (by passing a national exam, the PANCE), and licensed by the state in which they practice.  What’s the difference?  A license is a credential that allows one to practice (effectively) permanently, so long as one pays the professional fees and does regular continuing education.  PA certification is a more temporary credential that must be renewed by retestingPhysician assistant certifications must now be renewed every 10 years.  This means that every ten years, a PA must pass a recertification exam (the Physician Assistant National Recertifying Examination, or PANRE) that proves he/she is still proficient.  There are also certification exams for different PA specialties.  This is all in addition to paying annual professional fees and performing continuing medical education (CME’s).  In California, for example, PA’s must do 100 hours of CME’s every two years.  Though it’s a hassle to keep having to prove you know your work, the recertification process is a good thing.  It lends credibility to the field as a whole – PA’s must keep their knowledge up, or they can’t practice.
  5. Physician assistants don’t specialize.  Cue the buzzer – false again.  PAs specialize in pretty much every area of medicine.  About 36% of PA’s work in primary care, with the other 64% working in surgical, ER, and subspecialty areas, such as dermatology or rheumatology.
  6. “Physician assistants don’t order or interpret labs or imaging studies.”  In truth, PA’s order and interpret labs and imaging studies (x-ray/CT/MRI etc.) just as any physician does.
  7. Physician assistants provide inferior care compared to physicians.  This is very hard to measure experimentally, but the research does show that PAs aren’t sued for malpractice any more often than physicians, and the judgments from lawsuits against PAs aren’t any larger than those against physicians.  In terms of patient outcomes, the research shows us consistently that PA’s, NP’s, and MD’s are all about equal.
  8. Physician assistant isn’t a satisfying job.  Actually, the vast majority of PA’s say that they are very satisfied in most areas of their work, such as their pay, feeling that they matter, and liking what they do.  The one area where they consistently show somewhat lower satisfaction is their workload, much like physicians.  The satisfaction scores are higher for PA’s in the area of workload than for doctors, however.
  9. Physician‘s Assistant.  It’s physician assistant – no apostrophe-s!
  10. Physician Assistants don’t get sued for malpractice.  In any malpractice lawsuit, the plaintiff usually sues everyone who was involved with the patient’s allegedly improper care.  This is no less true for physician assistants.  On rare occasions, physicians can prove that they provided adequate supervision, despite the PA’s negligence, and therefore escape the malpractice judgment.  But most often, is a PA is named in a lawsuit, the PA and the MD either win or lose the lawsuit together.
  11. Physician assistants all wish they could be doctors.  Sorry, but it just aint so.  Of course, there are some who would prefer to become physicians.  But the vast majority chose to be PA’s because that’s what they preferred – because it can offer more life balance, provide more time with patients, is in keeping with debt-free living, or a hundred other reasons.  Don’t believe me?  Go talk to a few PA’s, and you will.

There are plenty more misconceptions about physician assistants.  Can you think of one we’ve missed?  Leave a comment to let us know!

 

76 Comments

  1. Aaron August 23, 2011 at 12:43 am - Reply

    Hey Paul,
    Regarding #4 above, I’m confused. Don’t individual states issue “licenses”? Because a PA does not HAVE TO do the PANRE every 6 years and stay “certified”, but then, from what I understand, they are not able to switch between states, and they are a PA, not a PA-C. Anymore insight into this?

  2. Dave Mittman, PA August 23, 2011 at 9:46 am - Reply

    One small correction. PAs do get licensed, just like all other professions. I have a license on my wall for many years. Licensing is by the state. Certification is by the NCCPA and or/ other professional boards usually connected to organizations. A state could opt to require certification to practice as all states do the initial NCCPA exam. Many states to not mandate re-certification, although employers do.
    Dave

    • Paul August 23, 2011 at 11:38 am - Reply

      Yes, Aaron and Dave, you are absolutely correct. I’ve made the change – thanks for catching that!

  3. Laurelin August 23, 2011 at 12:37 pm - Reply

    The one I hate the most is that most or many PAs would have preferred to go to medical school if they had had the chance. Even my cardiologist dad, who is extremely supportive of me, is still a little baffled by my choice.

  4. Megan August 29, 2011 at 5:02 pm - Reply

    I agree Laurelin!! PAs do not want to be physicians!! That’s why they’re PAs <3

  5. Reagin October 1, 2011 at 6:58 am - Reply

    As a respiratory therapist in a teaching hospital, I’ve met several residents who’ve said if they could do it all again, they’d go to PA school!

  6. Andi May 3, 2012 at 8:18 pm - Reply

    This was extremely helpful. I love this entire website. It’s so difficult to find credible information about the PA profession because of the many misconceptions and misunderstandings about the profession. Thanks for posting this!

  7. Levi T. McMahan September 2, 2012 at 8:16 pm - Reply

    I have two more years of pre-requisite coursework before I can apply to P.A. school, but I must say that I am sold on being a P.A. I have interviewed several P.A.’s and Physicians, and the most job satisfaction I’ve heard is from P.A.’s. I have also spoken with several medical school students, and almost all of them have warned me away from medical school, saying if they could do it again, they would’ve gone P.A.

    • Paul September 3, 2012 at 9:56 am - Reply

      It depends on your personality, I think. But the % of people who fit the personality of becoming MDs and being willing to sacrifice as much as they do to get through is much smaller than the rest. I love my work, am respected, make a difference in people’s lives, and I earn a very good living. What more could I want?

  8. Natasha February 7, 2013 at 10:53 am - Reply

    Hi all,
    Thanks for this post, I hope many people read this and understand who PAs really are. I an currently in my final year of PA school on my 7th rotation. Recently, I’ve encountered really bitter PAs who have discouraged me and advised me to even try and go to medical school. I’ve truly fallen in love with this field and very sad to see how some of these PAs are miserable. I just wanted to know does any one else out there feel they should have went to med school? I’m fairly young, only 22 years old and everyone is telling me why not med school…I’m very torn at this point. How do you deal with the people that push you to med school and discourage you from the goals you’ve set for yourself? And how do you prove to these people that it’s not because you’re lazy or afraid of the workload med students/residents go through? But simply found PA to be a far better choice. How many of you are really happy with what you do? And What should I be looking for once I’m on the search for a job? Any advice??

    • Paul February 7, 2013 at 10:51 pm - Reply

      Okay, Natasha, get ready for a soap box performance from yours truly, because this question is really important to me…

      I think in some ways you are answering your own question. Who are you becoming a PA for? I know the answer is YOU. So I think you may need to reorient your brain: don’t try to convince others of anything – you’re doing this for YOU, not for them.

      I haven’t run into many bitter PAs, but you need to realize that there are those people in any field. The bitter PAs I have run across didn’t seem to be bitter because they were PAs. In most cases they were bitter because they had continued to work for a doctor/company/hospital that was not treating them well, and/or that they were over-worked or didn’t seem to apply themselves much to their work. You can also find this in any profession. When you feel this way IN ANY CAREER, YOU NEED TO MAKE SOME CHANGES, MAN! Get a new job. Learn something new. Try some new approaches to the problems you work with. Learn in more detail the things that you already know about. Help your patients understand what is going on EVEN BETTER (believe me, as much as you explain, they will never get it all – there’s just too much). Explore a new specialty. Examine from where you derive the most personal satisfaction in your job. Are you putting as much into it as you expect out of it?

      I AM A STRONG BELIEVER THAT MOST PEOPLE WHO ARE UNHAPPY WITH THEIR CAREERS (NOT THEIR JOBS) ARE UNHAPPY BECAUSE THEY DON’T PUT ENOUGH OF INTO IT, AS IN “YOU GET OUT OF IT WHAT YOU PUT INTO IT.”

      James Allen said “As you think, so shall you be.” If you think you’re miserable and hopeless, then you’re right. If you think you’re a medical badass with a stimulating and challenging job that requires you to stretch yourself every day, then you’re right. Most unhappy people aren’t stretching themselves. Some of them cool their heels after graduation and somehow expect the job to entertain them like a little home movie watched from a recliner.

      I received an email from one of those bitter PAs you are describing early on in my blogging. He said essentially, “I’m 28, I’ve been a PA for 6 years. I’ve worked in different specialties and learned it all. And I’m unfulfilled.”

      Really? If you do it right, you could spend three lifetimes learning to be great at one specialty. As I read it, all I could think was, man, this guy is missing the point. He thinks the job should make his life happy. How much sense does that make? ZERO. The job doesn’t make you happy; you make you happy.

      To look at it another way, have you seen the other side? Have you been to a PA conference? I strongly recommend you splurge and attend an AAPA annual conference – they are a blast. You will run across more people who are motivated and LOVE their work than you have ever seen in your life. You will learn and play and dine with people who are totally enthusiastic about being PAs!

      Every now and then I have a patient who doesn’t know much about PAs (there seem to be remarkably few of those in my area) who will ask me “So when are you going to become a doctor?” I tell them flatly: “I’m not. I’m a PA, and I love it.”

      What goes through my head?
      -this person has no idea what I do, and that’s not his/her fault.
      -this person has no idea what it’s really like to be a doctor either, and it’s not his/her fault.
      -They have no idea how much time/energy/commitment it takes to be a PA (OR A DOCTOR, FOR THAT MATTER).
      -If I love what I’m doing (and I truly do), why would I care about what they think I should do? It’s just noise to me.

      It’s an interesting topic, and I’m guessing I need to write more on it. Thanks for the question.

    • Anand September 6, 2013 at 9:54 am - Reply

      You live your life for yourself. Never forget that. It’s very easy for someone to tell you their opinion. Opinions are like a-holes; everyone has one. Do what you are happy with and take what people tell you with a grain of salt. I leave my job every day realizing how happy and fortunate I am and how miserable others are around me. (They’re not miserable because of me by the way)

      • Kristin December 21, 2014 at 6:41 pm - Reply

        i have been a PA for 9 years and have never regretted the decision. I originally planned on going to med school but happened to walk by the PA school bulletin board at my undergrad and stopped to read, went in for a chat with the staff, and never turned back! I love it and can’t imagine anything else. I don’t think any of us would say we chose to be PA’s because it’s the “easy” route- the school is rigorous (I’ve had medical students state “you did 4 years of med school crammed in 2 years!”) and we are constantly learning. Many of us chose this because we want a little shorter schooling, maybe less debt, more time with family etc for similar benefits of medical school since we get to do many of the same things. But as a PA, I get to help people every day get better from whatever their issue is, help their families, counsel them, and I leave with a smile on my face!

  9. Natasha February 8, 2013 at 6:46 pm - Reply

    Paul! Your words are absolutely amazing, so inspiring. Today after reading your reply, I went to my rotation smiling because I thought a lot about it and spoke to many people…and I regained my power, recollected my thoughts and my original feeling about why I chose to be come a PA and I felt great! Stronger than ever! It really is true you get back exactly what you put in. I went in determined not to let them discourage me anymore and scrubbed in on a few cases and didn’t let anyone intimidate me!

    Thank you so much!!

    • Paul February 9, 2013 at 12:37 am - Reply

      I’m so glad! Make your career, baby.

  10. Chrissie May 24, 2013 at 11:01 am - Reply

    So glad I found this website. My youngest daughter is on her way to becoming a PA and I have been hearing from other people that she can’t write narc scripts. I was told she could do everything as a Dr could, just had to work under a supervising one. Thanks for confirming what I already knew.

    • Paul May 25, 2013 at 6:15 pm - Reply

      It does depend to a certain extent on the state where she will practice and the practice in which she works. But yes, in general, PAs can write for narcs. In CA, there is a special one-day class that is required of PAs over and above their certificate in order to prescribe scheduled (controlled or “narcotic”) medications.

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